Medical ideals in the Sephardic Diaspora: Rodrigo de Castro's portrait of the perfect physician in early seventeenth-century Hamburg.

Introduction

As is well known, there were no formal systems of medical ethics until the end of the eighteenth century. Yet at least from the composition of the Hippocratic Oath, western scholarly debates, particularly among doctors, on the foundations of good medical practice and behaviour produced written works. These works simultaneously reflected and contributed to setting customary rules of collective behaviour—medical etiquette—that were reinforced by pressure groups who, while they could not always judge and sentence offenders, sanctioned them with disapproval. Most early modern works on medical~ etiquette were dominated by the question of what constituted a good medical practitioner, with the emphasis sometimes on the most suitable character of a physician, sometimes on professional behaviour.1

The medical literary genre of the perfect physician appears to have been popular in the early modern Iberian world, and the frequent involvement of converso practitioners in writing about it has often been associated with the peculiarities of their profes sional posi t ion in the territories under the Spanish monarchy.2 Among the most outstanding examples of this medical genre are a couple of printed works written by two Portuguese Jewish physicians who were almost exactly contemporary with each other, namely Henrique Jorge Henríques (c.1555–1622)3 and Rodrigo de Castro (c.1546–1627).4 Despite similarities, their images of the ideal medical practitioner appear to have been modified somewhat by each author’s differing life experiences and career, as I will show later on.

De Castro’s life and works have been treated in a very limited and rather traditional way by historians, mostly according to the patterns of disciplinary history both medical and medical-ethical as well as of Jewish national history.5 Indeed, he has repeatedly been introduced as one of the founding fathers of modern gynaecology and obstetrics, as a medical ethicist well ahead of his time and, in particular, as an outstanding example of a singular, almost idiosyncratic excellence, that has supposedly characterized the professional practice of Jewish physicians throughout history.6

The present essay is an attempt to approach De Castro’s intellectual agenda in the context of the Sephardic medical diaspora, by exploring the portrait of the perfect physician that he drew in his Medicus-politicus. His views on the ideal medical practitioner need to be placed in the social context of the early modern European medical world and, specifically, in that of early seventeenth-century Hamburg.7 In order to understand better De Castro’s views, I will outline the vicissitudes of his life, beginning with his medical training at Salamanca University in about the mid-1560s. As we will see, far from any essentialist view about identities (Jewish or otherwise), De Castro’s intellectual profile was a typical example of the mutual fluid exchange of identities between the “new Christians” and the “new Jews”. This feature, which is easily detectable among early modern Sephardim, expressively illustrates the open, dynamic and complex nature of the processes of the configuration of identities, as well as the basic role that cultural diversity and mixing usually play in them.8

Still in terms of preliminary considerations, and in the light of the profound revision that the predominant historiographic paradigm of the “scientific revolution” has experienced during the last decades,9 I propose in my investigations of Rodrigo de Castro and other early modern Jewish physicians and philosophers not to be restricted by questions such as to what extent (if any) and why they participated in the scientific revolution, or whether the Jewish religion was an advantage or a disadvantage for this purpose. Rather, Iberian converso physicians’ activities should be re-situated in their specific socio-cultural context; and the intellectual “world” of these practitioners should be reconstructed in the most comprehensive way, particularly in connection with their educational background. The debt that these historiographic approaches owe to the new social and cultural history is clear, because of the greater prominence and complexity that these figures gain when they are studied through this new perspective, and because of the greater power of these strategies to reconstruct the past of Iberian medicine and science.

Rodrigo de Castro in the Context of the Sephardic Diaspora

Between the mid-fifteenth and the late-seventeenth century, the fortune of Jews in the Iberian kingdoms went through serious vicissitudes, which to a great extent determined the further history of this minority. Among them, one should emphasize first, the setting up of a new Inquisition in Spain (1478) and Portugal (in 1536, though fully in operation only after the papal bull of 1547) whose main original purpose was the prosecution of crypto-Judaism or Marranism; second, a gradual implementation—in the kingdoms under the Hispanic monarchy from the mid-fifteenth century, and in Portugal from the period of Iberian Union (1580–1640) under the aegis of Castile—of the statutes of “purity of blood” that legalized the social exclusion of new Christians, by blocking or making very difficult their access to any public position or high honour; third, the expulsion from the Iberian kingdoms of those Jews who were not prepared to comply with the decrees of forced Christian conversion dictated by the kings of both crowns—the Catholic Monarchs in 1492, and King Manoel I in 1497; and fourth, the two Sephardic diasporas: the first resulting in the late-fifteenth-century expulsions from Spain and Portugal towards the eastern Mediterranean and northern Africa, and the second, throughout the sixteenth century and on into the eighteenth, towards different places in western Europe—Italy (Venice, Verona, Livorno), the Low Countries (Antwerp, Amsterdam), southern France (Bordeaux, Bayonne), London, and Hamburg—and the Indies, both West (Caribbean area, Brazil) and East (Goa).

The almost forty years that elapsed between the enactment of the edict that forcibly expelled the Jews from Portugal (1497) and the setting up of the Inquisition in that country, helps to explain the strong cohesion of Portuguese Jewish communities in the following centuries, in contrast to the greater uprooting of the Spanish ones.10 On the other hand, an awareness of the changing political relationships between the two Iberian crowns throughout the sixteenth and seventeenth centuries is essential for an understanding of the migratory flows of the Jewish population back and forth between the territories of the two crowns. These occurred because of the need, on the one hand, to avoid Inquisitorial repression, and, on the other, because of the emigrants’ fluctuating expectations for their own socio-economic improvement in one or other of the two kingdoms. So, for instance, the rigours of the Portuguese Inquisition after Portugal’s annexation to the Hispanic crown by Philip II (1556–1598) meant that many descendants of Jews expelled by the Catholic monarchs who had taken refuge in Portugal and been obliged to convert to Christianity in 1497 escaped back to Spain where the converso question at that time provoked less virulence. Furthermore, Philip IV (1621–1665) offered for a while very attractive socio-economic opportunities to the Portuguese “new Christians” who migrated to Spain, despite the rapid worsening of the living conditions of these immigrants after the revolt that enabled the kingdom of Portugal to recover its independence from Spanish dominion in 1640.11

Rodrigo de Castro was born in Lisbon about 154612 into a well-off converso family, several members of which were physicians, including his father and three maternal uncles. One of them, Manoel Vaez, was royal doctor to four successive Portuguese kings, namely João III (1521–1557), Sebastião (1557–1578), Henrique I the Cardinal (1578–1580) and Philip II. Another of his uncles, Ayres Vaez, was sent by João III, his master, to Africa in the late 1530s to cure the king of Fez from a serious illness, while both kings were waging a bloody war against each other.13 Vaez’s apparent professional success in this mission did not prevent him some years later from losing the royal favour and being tried before the Inquisition as a crypto-Jew, although he was eventually given his liberty by Paul III—a pope well known for showing favour towards the Jews—who in 1541 issued a bull that protected the entire Vaez family from the Inquisition.14

Originally a Spanish and Portuguese Jewish lineage with many branches, the De Castro family soon spread widely through Europe (Bordeaux, Bayonne, the Low Countries, and Hamburg), mostly as a result of the pressure of the Inquisition. Rodrigo de Castro was the most distinguished physician of this lineage. According to his own account, he studied medicine at the University of Salamanca, whose surgical teaching by Andrés Alcázar and the commentary on the Hippocratic Prognostics by Juan Bravo de Piedrahita he praised.15 Yet, it is uncertain where he got the degrees of doctor of philosophy and medicine that on the title-page of his Medicus-politicus he claimed to hold.16

Once De Castro had finished his studies in 1570, he returned to Portugal and practised medicine first in Évora and then in Lisbon, where he settled for a while. His growing professional reputation made Philip II—the new king of Portugal after 1580—invite him to move to the East Indies in order to continue the research on medicinal herbs that had previously been carried out by two other Portuguese converso physicians: Garcia da Orta (c.1501/2–1568) from the 1530s until his death, and Cristovão da Costa/Cristóbal Acosta (c.1515–post 1592) between 1568 and 1572, when Da Costa returned to Portugal. De Castro appears to have been offered a good salary and honours in return for gathering the medicinal simples growing in all the Oriental provinces of the Portuguese crown, along with those described by Greek and Arab authorities, and for writing a commentary on them. Nevertheless, he firmly declined the royal invitation.17

At some point in the 1580s, and apparently on religious grounds due to growing inquisitorial pressure—although he may not have felt too comfortable after having declined the royal offer—Rodrigo de Castro left Portugal for Antwerp, where he probably lived for a while and gained high esteem as a medical practitioner.18 There he met Henrique Rodrígues, another Portuguese converso colleague whose kinswoman, perhaps a sister, Catharina Rodrígues, he married. After the Spaniards recovered control of Antwerp in 1585,19 he may have moved to the safer northern Netherlands (perhaps to Amsterdam, the greatest Jewish community in Europe at the time) and possibly lived there for several years.

Finally, De Castro moved to Hamburg where he may have taken up residence in 1594—right at the time when this city was becoming a significant settlement for Portuguese Jewish refugee families, and for a growing colony of the Amsterdam Jewish community. His professional services on the occasion of a devastating plague epidemic in Hamburg in 1596, on which he published a little medical work that very year,20 allowed him to win a good standing among the local population as well as recognition from the Hamburg political authorities. In this regard, De Castro followed the path of other Jewish medical practitioners who took advantage of most doctors’ flight when the plague crisis broke out, in order to gain the favour of the municipal authorities.21 His plague treatise should be considered not only the result of his medical concerns, but also as a source of income and a way of self-promotion in a highly demanding context for this sort of medical literature.22 De Castro never held the position of city physician at Hamburg that he doubtless aspired to, but his medical reputation continued to grow both there and in the regions and states around this city republic. His medical clientele would include several princes and other distinguished persons, including the King of Denmark, the Archbishop of Bremen, the Duke of Holstein, the Duke of Mecklenburg, and the Landgrave of Hessen.

In Hamburg, his two elder sons were born and his first wife died in about 1602 as a result of her third childbirth. This premature loss may have influenced De Castro’s publication of De universa mulierum medicina (Hamburg and Cologne, 1603–1604), a lengthy medical treatise in two volumes on women’s “nature” and diseases.23 Ten years later, when he was almost in his seventies and about the time his elder son Benedict was beginning his university medical education, De Castro published his Medicus-politicus (Hamburg, 1614),24 a treatise that his biographer Moritz Kayserling characterized as a genuine medical testament.25

While in Hamburg, De Castro showed at first a nominal attachment to the Church and, indeed, his first wife was buried in the Catholic cemetery of this city republic. Yet, in 1612 his name was included in the list of Hamburg’s Jewish community26 along with those of his second wife, his two elder sons from his first wife—both of whom would become physicians27—and three other small children from the new wife. In fact, De Castro would eventually recover the faith of his ancestors to the point that in 1614—the very year of his Medicus-politicus—he appears to have written in Portuguese a treatise on herem (Jewish excommunication or anathema).28 He died on 20 January 1627, and was buried in the cemetery of the Jewish Portuguese congregation at Altona.29

Given that the right to residence was officially granted to Jews in Hamburg only in February 1612 (albeit with some restrictions), it seems clear that De Castro joined his Jewish brethren early. Rather interestingly, well-off Jewish fugitives from the Portuguese Inquisition began to settle in 1590s Hamburg as Portuguese “traders”. For a while, they professed Judaism in an increasingly open way, but continued to have their children baptized. In the face of the Lutheran citizenry’s growing hostility to the Portuguese Jews, in 1617 the Hamburg senate chose to enlarge the minority’s trade privileges at the expense of their civic rights, as they were forbidden to possess houses and lands, and obliged to part with the properties they owned before that law was passed. In recognition of the services rendered to the city of Hamburg, its senate partly exempted De Castro from complying with this law.30

Rodrigo de Castro’s Portrait of the Perfect Physician

As advertised on its title-page, the subject matter of the Medicus-politicus was those aspects or functions of medical practice which were related to the republic’s governmental tasks. This work of De Castro’s maturity was addressed to “practitioners, patients, those attending them, and every cultivator of letters, particularly those involved in the discipline of government”, and from its presentation it clearly aimed to draw attention to the virtues of good physicians and to denounce the frauds and impostures of bad physicians, all this with the purpose of restoring the pristine magnificence of medicine.31 De Castro announced his hope of contributing to the public utility as much as to his sons’ expected medical training, as well as of letting coming generations of physicians know his contribution to the task of codifying medical practice. He claimed that his Medicus-politicus was based not only on the authorities quoted but also, and above all, on the findings and experiences of his own long career as a medical practitioner. And he even claimed to be the first to have written such a medical work in which theory, practice, precepts and the conditions of the perfect physician were combined.32 De Castro’s Medicus-politicus was dedicated to two senators of the Hamburg republic,33 who he promised would be remembered by future doctors for having been patrons of his planned code.34

The treatise is divided into four books or parts of uneven length, where, with some thematic inconsistencies, a great number of questions concerning what nowadays we would define as medical ethics and etiquette are formulated and discussed. In book I,35 De Castro defined medicine, compared it with other disciplines like jurisprudence, agriculture, and the military art, and debated its pre-eminence over jurisprudence, in addition to refuting the “medical sects” and other opponents of allegedly genuine medicine. In book II,36 he established medicine’s origins, its relationships with other health practices (mostly surgery and pharmacy), the disciplines requisite for physicians, and the indispensable items of an ideal medical library; and he also opened a wide discussion on a number of epistemic questions (relevance of experience, reason, and authority—Galen’s “three doctrines”). In book III,37 De Castro enumerated and characterized the “virtues” required in the perfect physician as well as the “vices” medical practitioners should avoid; he also defined the ways false physicians can be identified; and dealt with general questions about clinical relationships (clothes, look, way of approaching the patient and his/her assistants, ways of establishing prognoses, particularly from urine, use of clinical information from the face of the patient, medical consultations, sanctions for malpractice, honoraria, gifts and favours), and on to the appropriate behaviour of practitioners in the face of peculiar clinical circumstances, such as those concerning insane, hopeless, ungrateful, and hostile patients, as well as those who have not asked for medical attention. Finally, in book IV,38 he discussed questions concerning irregular practices (fascination, love philtres, and incantations), medico-legal expertise (people who pretend to be ill, poisoning, head injuries, drowning, lost virginity, sterility, and the purchase of slaves), and a heterogeneous set of issues such as macro- and micro-cosmic correlations, the analogy between the human body and a “well-ordered republic”, the occult properties of things, and the therapeutic powers of music.

Much of the contents of De Castro’s Medicus-politicus are commonplace in pre-modern western medical ethics and etiquette, so to speak. Its narrative is firmly rooted in the Galenic–Avicennan medical tradition, and is established on the Hippocratic ideals of the medical practitioner and practice, with a remarkable degree of Judaic religious and moral influence. Among the sixty-seven chapters making up this work, a peculiar structure is repeated, the roots of which lie in scholastic logic, and are witness to De Castro’s university training at Salamanca during the 1560s. Its chapters, whose titles themselves often consist of a scholastic quaestio, usually begin by exposing a number of different views about the topic under discussion. Then, arguments in favour and against these views are presented, and these alternative opinions are usually refuted. Finally, De Castro formulates and justifies his conclusions on each issue discussed. The narrative is often peppered with examples taken from the authorities of learning, who reflect not only his university arts and medical training, but also his wide knowledge of Old Testament sources. Yet he was not very generous with explicit references to specific anecdotes or episodes from his own professional experience, despite having claimed at the very beginning of his work that this was the main source feeding his narrative. This feature, which contrasts with the contents of Henríques’ and other contemporary writings on similar subjects, may have followed from De Castro’s claim—expressed in the prologue letter addressed to the two Hamburg senators—to confer on his Medicus-politicus the prescriptive value of a code for medical professional behaviour.

Male, Virtuous, and Expert in Medicine

Rodrigo de Castro’s shaping of the perfect physician began by defining him as “male, virtuous, and expert in medicine”.39 What did he understand by each of the ingredients in his definition? The first and most obvious is the perfect physician’s male condition. As one might expect, the single regular function he assigned to women as health practitioners was that of midwives (obstetrices), who played an auxiliary role to a physician’s professional activities, and whom, by the way, he did not always differentiate clearly from the reviled sluts (mulierculae),40 to whom he repeatedly referred.41 In the remaining passages of Medicus-politicus where women were also mentioned, they appeared as patients, as attendants to patients—who were usually their husbands—or mediators in clinical relationships, and as the most usual agents or victims of fascination.42

From the first pages of Medicus-politicus, it is clear through De Castro’s emphasis on the relevant feature that physicians were endowed with wisdom by nature, as much as with art by training. Only through these qualities could the required fusion be achieved between knowledge and virtue in consonance with the demands of the Hippocratic medical ideal. This justified, therefore, his reminder that “in the old days the science of healing was considered as a part of wisdom, so that the cure of diseases and the contemplation of natural and moral things rose from the same authors”.43 De Castro was concerned to refute Pietro d’Abano’s view that physicians, because of their nature and of the celestial bodies dominating medicine, were usually neither good nor wise persons, but of bad habits.44 And he did it by means of arguments that discredited judiciary astrology, showed the probity of customs of most eminent medical authorities (“Hippocrates, Galen, Avicenna, Celsus and others”), and emphasized the theological and medical incongruence implied by associating such a beneficial art with its allegedly depraved practitioners.45

The Nobility and Origins of Medical Art

De Castro’s own definition of medicine as “an art based on reason and experience to obtain and preserve health”46 led him to make profession of a Hippocratic-Galenic faith, and to attack the empiricist and methodist sects, whose theoretical bases and patterns of practice he refuted with a number of arguments.47 To the rejection of these two old medical sects, he added a third contemporary one, that of the chemists, whose origin he ascribed to Paracelsus, and whose rapid spread through Europe he noted with great alarm. Like many other European university practitioners of his time,48 he was concerned about marking the scholastic difference between the followers of Paracelsus on the one hand, and, on the other, the pharmacists in charge of preparing drugs according to physicians’ prescriptions, whom he respected and defined as “true chemists” (verus chymista). He blamed the “new and superstitious medicine” of the chemists for preferring novelty to truth, and of infesting the “well-ordered republic” with new principles and causes of diseases that implied the rejection of those owed to the ancients, and the consignment to oblivion of Hippocrates’ and Galen’s philosophy and medicine.49 In his diatribe against chemical medicine, De Castro responded to Paracelsus’ claim to have found the principles of things in the Holy Scriptures, by echoing the accusation, widespread among the contemporary medical establishment,50 that Paracelsus had prepared the remedies prescribed for epilepsy by means of a magic art taken from evil spirits—necromancy.51

After having rejected several arguments from a variety of sources—explicit in the cases of Cato and Pliny the Elder—questioning the need for medicine and its practitioners, De Castro vindicated the antiquity of this art and its constant presence, in one form or another, among all the ancient peoples.52 He referred the origins of medicine to the God of the Old Testament, through the words of the well-known passage in Ecclesiasticus (38: 1–15), where medicine and physicians are praised, and he said that the divine origins of this art are to be combined with the obligation that men apply themselves to cultivate medicine and to search for natural remedies in order to preserve or restore health.53 Against those who categorized medicine as a vile profession because medical practitioners were required to manipulate such coarse and filthy things as bodily discharges, both natural and unhealthy, De Castro held that medicine was a science of a noble, superior order, for its theoretical part refers to physics—just as politics does to jurisprudence, and metaphysics to theology—while its practical part pursues something so useful and fruitful as the recovery and preservation of human health.54

De Castro vindicated the origins of medicine for the Jewish people on the basis of the above mentioned passage of Ecclesiasticus, and on the huge work by the wise king Solomon on natural questions, including medicine—which was allegedly destroyed at the burning of the temple of Jerusalem by Nebuchadrezzar II (605–562 bce)—without omitting the idea that the earliest information on medical matters dated from Adam himself. However, echoing the words of Georgius Cedrenus, an eleventh-century Byzantine chronicler, he argued that king Ezechias of Judah (726–697 bce), was offended because the Jews, although provided by these works with the remedies for diseases, forgot to praise God for curing them, and instead offered medicine to the Greeks.55

The Ideal Medical Library

To De Castro, this early ceding of medicine to the Greeks did not cancel the Jews’ original primacy in this art, but marked a turning point in the history of medicine. Indeed, his indispensable library for the “perfect physician” had as its mainstays three groups of “most proven writers”: the Greeks, the Latins, and the Arabs. All were presided over by a trio made up of Hippocrates, “supreme father of medicine”, Galen, “from whose works you can perfectly grasp medicine”,56 and Avicenna, whom he described as the architect of the structure of medicine.57 Among the Greeks, De Castro included ancient classical authorities (Hippocrates, Plato, Aristotle, Theophrastus, Dioscorides, and Galen) as much as post-classical and Byzantine medical writers (Aretaeus of Cappadocia, Oribasius, Alexander of Tralles, Paul of Aegina, Aetius of Amida and Joannes Actuarius). Among the Latin medical writers, he first mentioned Cornelius Celsus—whom he called the “Latin Hippocrates”—and then Scribonius Largus, Pliny the Elder, Quintus Serenus, Caelius Aurelianus and Theodorus Priscianus. Last but not least, among the Arabs, he referred, in the first place (inprimis [sic]), to Avicenna,58 and then to Averroes, Rhazes, Avenzoar, Mesue and Serapion.59

De Castro defined as insane the view of those who had reviled the Arab medical tradition, and he vindicated its legacy outright, among other reasons because Arab physicians flourished at a difficult time when “the best disciplines remained deeply deserted and buried”, and they did not teach religion but medicine. Against the drastic anti-Arabism of most Hellenist physicians, he put forward the case of Jean Fernel who, without denying Averroes’ and Avicenna’s supposedly obscure phrasing, is introduced as having defended the view that it was worthwhile taking their opinions on curing diseases into account before going into other new ones.60

At the fourth level, De Castro placed the modern medical writers (neoterici), “men of our age and of the age of our elders, who were distinguished for their great wisdom, and had admirably improved, enlarged and illustrated the medical art with their commentaries” in different literary genres, such that their works should instruct and adorn the physician’s library.61 The long list he provided is full of late medieval and Renaissance Latin medical authors—as well as, rather inconsistently, some late-ancient and other Arab writers—and his thread followed the different subject matters: anatomy, medicinal herbs, surgery, encyclopaedic compendia of medical knowledge, natural history, commentaries on Hippocrates, Galen and Avicenna, medical controversies, consilia and epistles, practical medicine, particular diseases, pharmacopoeias and antidotaries, and dietetics.62

Finally, on the fifth level De Castro placed authors of non-medical texts (poetry, agriculture, history and politics), again ancient as much as “modern” ones. Rather remarkably, at this point he praised the abundance of political writers in his age, and urged his readers to take as much advantage as possible from their works “to enlarge and improve the appearance of physicians’ moral habits as well as medical science and art”.63 While in this regard the influence of sixteenth-century Spanish neo-scholastic theologians, philosophers, and jurists like Benito Arias Montano, Juan Ginés de Sepúlveda, and even Francisco de Vitoria, is apparent in several passages of Medicus-politicus, their names were not always explicitly mentioned.64

The Model University Training for a Medical Practitioner

Given all this, it is not surprising that Rodrigo de Castro showed himself to be a firm defender of university education and that he considered it the best training for future medical practitioners. Strikingly enough, however, he introduced the Salamanca medical faculty as the model place for medical education on the basis of the supposed meticulous procedures that were followed there with respect to studies and exams, in contrast to the corrupted arrangements and frauds in other universities, whose identity he did not reveal.65 In addition to some positive, affectionate evocations of his early years in Salamanca,66 De Castro also turned to the example of that Castilian university in order to solve a dubium about how to proceed in a difficult medical practical case,67 as well as to reinforce the idea that the risk of malpractice by future practitioners was minimized when the quality of their training scrupulously matched the rules laid down in the relevant university statutes.68

Among the components of the training of the perfect physician, De Castro enumerated six of the seven disciplines making up the trivium and quadrivium (rhetoric, dialectics, arithmetic, geometry, music, and astrology); linguistic expertise in Latin, Greek, Arabic, and vulgar languages—the more the better, he stressed, so as to allow practitioners to communicate with patients from different nations in their own tongue;69 natural philosophy and moral philosophy; cosmography, anatomy and materia medica.70 De Castro’s remarks on the utility of astrology and of moral philosophy deserve a little comment.

He categorically rejected divinatory judiciary astrology, which he defined as harmful, vain, superstitious, and condemned by the Holy Scriptures; and he did not appear to be very enthusiastic about the influences of the movements of the celestial bodies upon the healthiness of the air, the seasons of the year, the diseases of the living, and dearth. He appears to have been prepared to accept with no reservation only the medical value of astrological knowledge concerning critical days, bloodletting, and the administration of drugs. Yet, even here, he warned against those “superstitious and harmful” physicians and surgeons who paid more attention to the stars than to urine and the pulsations of the arteries.71

On the other hand, De Castro emphasized the relevance of moral philosophy for medicine because it calmed the soul’s disturbances, which he claimed to be not only the cause but also the symptom of many diseases. By referring to Galen (specifically, to Quod animi mores corporis temperamenta sequantur and De cognoscendis curandisque animi affectibus) as the authoritative source, De Castro held that diseases of the soul and diseases of the body communicated with each other, such that the care of the soul should not be neglected when bodily diseases are being treated.72

De Castro’s and Henríques’ Portraits of the Perfect Physician: Resemblances and Contrasts

Despite the resemblances of Rodrigo de Castro’s portrait of the perfect physician to that depicted by his contemporary Henrique Jorge Henríques,73 there are not a few differences in their images that appear to be the result of their authors’ disparate life experiences and careers. Certainly, both authors shared the condition of being Portuguese practitioners of Jewish lineage, as well as having been near contemporaries at Salamanca, although Henríques had begun his studies at Coimbra. Their further careers were, however, somewhat divergent. Indeed, Henríques developed his medical career in Castilian court settings under the protection of the powerful ducal house of Alba, and mostly lived in the area close to the Portuguese border. He appears to have remained outwardly Catholic until the end of his days in 1622. Yet, his relatives and servants were then denounced to the Inquisition, prosecuted and imprisoned for two years, under the charge that they had buried his body according to Jewish rituals.74 Unlike Henríques, we have already seen that De Castro practised medicine in Portugal for only a short while before he migrated in the 1580s to the Low Countries, and in the 1590s to the Hanseatic republic of Hamburg, where he fully recovered the faith of his Jewish ancestors and became a prominent member of the Sephardic medical diaspora, not least as a result of his Medicus-politicus (Hamburg, 1614).

Henríques’ Retrato (1595) reflects an ideal of a medical practitioner who was anchored in the prevailing values of Counter-Reformation Spain, although the author’s dissatisfaction when confronted by many medical issues in late-sixteenth-century Castile, and his political and moral proposals to improve medical practice, at some point made his portrait of the perfect physician to be rather its reverse. Indeed, Henríques’ attention was focused on criticizing such issues as the weakness of arts training; the low educational standards in Castilian medical faculties; practitioners’ lack of travel experience; lack of control of health practices and practitioners by the political authority (Protomedicato); and the social promotion of inefficient practitioners at the expense of competent ones, who were excluded. Needless to say, this last issue meant an implicit denunciation of the serious discrimination stemming from the application of the “purity of blood” statutes to the selection of medical practitioners in charge of municipal and public jobs.75

By contrast, De Castro’s Medicus-politicus represents a self-confident vindication of the public usefulness of university medicine, as well as of the political role for university medical practitioners in the city of Hamburg. It was written by a “new Jewish” physician who enjoyed a prominent socio-professional position, one that he did not then appear to have perceived as threatened. Although he claimed the original primacy of medicine for the Jews, he by no means appropriated this art for his nation; on the contrary, he was concerned to stress that medicine comes from God the Creator, that it was necessary and, in one way or another, it had been present among all the peoples in the world from the earliest times. Not surprisingly, it was his son Benedict de Castro who, about twenty years later, under growing anti-Jewish pressure, would advocate transforming the converso practitioner’s stigma into a sign of honour, by claiming in his Flagellum calumniantium (1631)—a Jewish apology written as a reply to a libel against Portuguese Jewish practitioners—that the physician’s “holy task” was a specifically Jewish venture.76

In his seventies, after a brilliant professional career, and with a new religious identity, De Castro appears to have wished fully to experience during the rest of his life the physical and temporal distance which may have given him relief from his memories of the difficulties he had gone through during his early professional days in Portugal until inquisitorial pressure finally pushed him to join the Sephardic diaspora in northern Europe. His unquestionable awareness through many channels (family contacts, testimonies by recent immigrants, and so on) of the personal and professional difficulties of his converso colleagues in the territories under the Hispanic monarchy did not prevent him from taking the medical faculty of Salamanca as the example of a university institution on a European scale that could guarantee the training of the best physicians. This university was implicitly a central target of Henríques’ criticisms about the low educational standards in the Castilian medical faculties, not least because its “purity of blood” statutes were far from mild.

By Way of Conclusion

Jews were given recognized residence rights in Hamburg in 1612, two years before Rodrigo de Castro published his Medicus-politicus. By then, he must have felt confident enough about his own social status in that Hanseatic city republic not to hide his Jewish religious beliefs. And during his later years De Castro chose fully to recover and live the religion of his ancestors—like his colleague and friend Abraham Zacuto (1575–1642) in Amsterdam, and probably inspired by him. In addition to his apparently lost work on Jewish excommunication, De Castro’s deep Jewish religiosity at that period can be inferred from at least three major features of his Medicus-politicus, first, his knowledgeable use of the Holy Scriptures that he repeatedly resorted to as an authoritative source for this work; second, his insistence on the holy aspects of medicine regarding the divine origins of this art and the way he understood medical practice; and third, his familiarity with, concern about, and approval of the magical powers of the cabala as a therapeutic resource.77

Anti-Semitism was widespread in Hamburg in 1614. Yet those medical practitioners belonging to the well-off and then still tiny Sephardic minority would not begin to suffer directly from the xenophobic passions of the Lutheran majority until later decades. In this context, De Castro’s strong alignment with the Hippocratic-Galenic-Avicennian medical tradition may have been not only a consequence of his university education in mid-sixteenth-century Salamanca, but also a strategy by him to reinforce before the Hamburg political authorities the probity of the Sephardic medical elite’s understanding and practice of medicine. In this way he avoided the risk that his medical practice was identified with that of German Jewish practitioners who, according to the extremely negative cliché then prevailing in Germany, were considered to be professionally incompetent, avaricious, murderous quacks and wizards whose apparent talent for medical practice was attributed to a pact with the devil.78

De Castro, however, did not stop here, and he also chose to keep his distance from the kind of medicine that a great number of other contemporary health practitioners were carrying out in Hamburg and, presumably, in the whole of Germany. Indeed, in addition to having portrayed a great many irregular practitioners and practices that his perfect physician was opposed to, he launched a harsh attack on Paracelsus and the “sect of chemists”, among whose followers may have been most of those Christian practitioners who competed with the Jewish ones for the same medical market. His invectives against Paracelsus, who had objected to the idea that Jews possessed more talent for medicine than Gentiles, and had himself been committed to an exclusively Christian ministry for this art,79 led De Castro to counter-attack by insisting that Paracelsus had resorted to necromancy in order to prepare some medicinal remedies.

De Castro defined his perfect physician as “male, virtuous, and expert in medicine”. To him Hippocratic-Galenic-Avicennian medicine was the basis for the best medical practice; and the medical faculty of Salamanca a kind of model university school for training the best practitioners. As usual among most sixteenth- and seventeenth-century Iberian converso practitioners, De Castro’s medical profile was characterized by a remarkable eclecticism that was respectful towards ancient, medieval and Renaissance medical authorities, and included a positive re-evaluation of the Arab legacy, but which openly rejected medical sects, particularly Paracelsianism.80 His esteem for the Arab medical authorities was typical of the medical neo-scholasticism prevailing in late-sixteenth- and early-seventeenth-century Spanish and Italian universities. Yet, I wonder to what extent this appreciation of Arab medicine was also intended by De Castro and other Jewish practitioners as a tacit vindication of their own medical cultural tradition and converso identity, so closely related to the Arab during the Middle Ages.81

Last but not least, the fact that the literary genre of the “perfect physician” dealt with what practitioners “should be”, their intellectual and moral ideals, and the terms of their professional education and practice, meant that for the converso minority it was not only a public window where they could project their professional aspirations, but also a suitable way to express nonconformist driving forces in the medical arena of early modern European societies, which had been completely dominated by Christian elites (both Catholic and Protestant), who had excluded religious minorities to a greater or lesser extent. Given the assiduousness of converso practitioners in cultivating this genre, one might, for instance, wonder whether behind De Castro’s decision to write and publish a work like Medicus-politicus there was a desire to differentiate themselves from their “old Christian” colleagues. But Jewish practitioners’ images of the ideal medical practitioner nevertheless differed from each other—perhaps no less than those of their Catholic and Protestant counterparts.