Review of Jewish Contribution to Medicine in the UK: 350th Anniversary
The following article was contributed by Prof. David Katz to the 350th Anniversary of the Resettlement of Jews booklet.
It should come as no surprise that Jews have played a prominent role in medicine in Britain over the past 350 years. The tradition of Jews in medicine dates back to antiquity, is reflected in the numerous Talmudic debates on medical topics, and has been a feature in almost every Diaspora. The names of physicians such as Assaf Harofe, based in Babylon (modern Iraq), and Maimonides (with roots in Spain, working in Egypt, and with contacts in both Babylon and Yemen) are legendary, and pre-1656 a Marrano physician, Lopes, had already made his mark in London, albeit chiefly in political intrigue.
For the first 100 years after 1656, however, Jewish doctors in Britain were unusual. Difficulties in attending universities, in placing in apprenticeships, and in gaining admission to the developing Royal Colleges, all contributed. Also, most of the early Sephardi Jews were merchants. Few entered the professions. It was only in the mid-18th century, and in Scotland in particular, that Jewish doctors began to graduate. Several of these were controversial figures, both within medicine and within Judaism. The names of Jacob de Castro Sarmento and of the Schomberg family (Meyer Loew, and Ralph), are recorded, and there was also a well-known “quack”, Samuel Solomon, with very dubious credentials. An interesting insight into Jews and medicine from this period is that it was from London that the question was asked by a medical student: is it permissible to attend a dissection (i.e. a post mortem) on the Sabbath?
The early 19th century saw the opening of an institution where Jews, among other non-Anglicans, could graduate. University College London (UCL) was founded with this principle, and there was gradual acceptance of the idea amongst all the medical schools, in parallel with the campaign to permit Jews to become members of Parliament. UCL was also the focus of another Rabbinic enquiry: since the body of it’s founder Jeremy Bentham, is kept in perpetuity on display in the building, is it permissible for Jews who are ‘Cohanim’ (priests), and forbidden contact with a corpse, to study there?
Undoubtedly the major Jewish figure in British medicine in the 19th century, and the man who made the most important Jewish contribution during the first 250 years, was Ernest Hart. Remarkably he remains relatively unknown, despite his role as public health doctor and advocate – a field where British ideas and practices led the world – and as a central figure in the development of the British Medical Association. In a combination of public health and clinical practice, Asher Asher, originally from Glasgow, was also an important personality, who left medicine eventually to become secretary of the United Synagogue. In the latter party of the century Felix Semon was the first prominent Jewish surgeon, and was knighted.
Most of the Jewish doctors of this period were of ‘Western European’ origin. Whether Sephardi or Ashkenazi, although they still faced some prejudice, they were ‘part of the Establishment’. Towards the end of the century, associated with considerable Eastern European migration to Britain, medicine began to be seen as a very desirable objective for the young talented Jew. The immigrants saw education as their priority, and a professional education as highly desirable. Perhaps less favourably, the professions were also seen as mobile skilled occupations with less dependence on outsiders! Consequently many of the 20th century Jewish leaders of the medical profession were the children of such immigrants. During this period in addition to London and Scotland, the medical schools in Liverpool and Manchester, and eventually other large cities, began to admit Jews as students, although there remained problems for talented young Jews: neither Israel Doniach, later a distinguished pathologist, nor Jerry Morris, later an eminent epidemiologist, were able to get training posts in London. Outside the mainstream, in fields such as psychiatry, Jews were not as disadvantaged: for example, Sir Aubrey Lewis was responsible for the major academic initiatives in the subject. However, Jewish consultant staff appointments in larger numbers only came after the Second World War with the advent of the National Health Service.
During the mid 20th century Lord (Henry) Cohen, a neurologist from Liverpool, was President of the General Medical Council and played a central role in the profession. In the same period Lord Rosenheim became the first Jewish President of the Royal College of Physicians, and promoted academic medicine. Samson Wright was the outstanding physiology teacher of his time, and was the leader in rescue efforts during the 1930s. In medical administration Dame Albertine Winner was prominent. Jews also became surgeons, and Sir Stanford Cade, Harold Ellis, and Sir Roy Calne, and more recently Michael Baum, Lewis Spitz, Irving Taylor and Gerald Westbury have held professorial posts. Three Presidents of the Royal College of Physicians have been Jews – Sir Raymond Hoffenberg, Lord (Leslie) Turnberg and Sir George Alberti. Sir Stanley Simmons was President of the Royal College of Obstetrics and Gynaecology; Sir Martin Roth was prominent in the foundation of the Royal College of Psychiatrists; Lotte Newman in the Royal College of General Practitioners; and David Baum in the Royal College of Paediatrics. John Marks was chairman of the British Medical Association for many years, Sir Anthony Epstein (who discovered the virus that causes infectious mononucleosis) was a Vice – President of the Royal Society, and Sir Peter Lachmann was founding President of the Academy of Medical Sciences. In parallel with these achievements, the Jewish iconoclastic tradition was also continued: Maurice Pappworth spent almost his entire career as an outsider, but had very lasting impact not only because of his teaching skills but also because of his importance in highlighting that medical research on human subjects needs to be honest and ethical.
One cannot underestimate the impact of Jewish refugees and immigrants from the 1930s to medicine in Britain. Sir Ludwig Guttman’s contribution to rehabilitation medicine is legendary. Eva Alberman was responsible for important epidemiological programmes, Hans Krebs and Albert Neuberger were distinguished biochemists, and Leslie Brent, who came on the kindertransport, was part of the group that discovered immunological tolerance. However, a key foundation of modern medicine – worldwide – was laid by a non-medical refugee to Britain, Sir Ernst Chain, when working in the School of Pathology at Oxford. The story of the discovery and synthesis of penicillin is well-known; perhaps less well-known is that J.B.S. Haldane, the dominant figure in British biomedicine of the period, was quoted that saving Chain was one of his major achievements; and that Chain also played a role in promoting the Weizmann Institute, and hence in the remarkable development of Israeli biomedical science.
In addition to this German and European migration, there has continued to be a flow of Jewish doctors into Britain. Some came with their parents, some came for training, following a tradition well-established in Scotland, and some came as graduates. Many have been attracted to the research environment. These have included several South Africans, of whom the most prominent are Sidney Brenner and Sir Aaron Klug, Nobel prize winning directors of the Laboratory for Molecular Biology at Cambridge. Lewis Wolpert based his elegant developmental biology studies on his background as an engineer, and Victor Dubowitz is the acknowledged authority on genetic muscle diseases. Three of the recent Jewish members of the Royal Society – Marc Feldmann (from Australia), Mark Pepys and Anthony Segal – are also immigrants.
The strength of this Medical Research Council (MRC) environment was itself built up by Sir Arnold Burgen. At the MRC, also in the field of antibiotic research, Philip D’Arcy Hart – a scion of the Anglo-Jewish establishment – was responsible for the controlled trial of the use of streptomycin in the treatment of tuberculosis. This was not only a landmark in the history of the disease, but also in the methods used to study different treatment modalities in general. A refugee from Nazism, Sir Walter Bodmer, achieved fame as a geneticist before heading Cancer Research. Ivan Roitt and Deborah Doniach described auto-immune diseases, and Robin Weiss has had two careers, first in cancer studies and later as a leader in research on retroviruses, which cause AIDS. The epidemiological British Jewish tradition has been carried forward by Sir Michael Marmot with his long term studies of health patterns in civil servants.
Probably the most prominent Jewish doctor in Britain to-day is Robert Winston, who is known both as a fertility expert and as a promoter of public understanding of science. Although Lord Turnberg (see above) and Lord Winston are not the first Jewish physicians to achieve peerages, they are representative of changed times, and of a coming of age of the Jewish contribution to British medicine. Both have strong affiliations within Judaism, and within the Jewish community. Their role as Jewish doctors is very evident, and serves as an example to the wider public, as well as to the young men – and increasingly women – who are following in the British Jewish medical tradition.
With this wealth of talent, and of fascinating and diverse life stories, it is not surprising that the history of British – Jewish medicine has attracted increasing interest, and several authors have begun to tap on the fascinating primary sources and archives available. For example, the Scottish experience has been described by Kenneth Collins (Go and Learn, Aberdeen University Press, 1988). From the patient point of view Lara Marks examined Jewish mothers and maternity care in the East End of London (Model Mothers, Oxford University Press, 1994). The professionalisation of the Jewish community into law and medicine during the past century has been chronicled by John Cooper (Pride versus Prejudice, Littman, 2003). In addition memoirs offer interesting perspectives. Oliver Sacks writes of both his parents: Sammy Sacks was a general practitioner, and his mother, Elsie Landau, was a gynaecologist at a time when few Jewish women were doctors. Another woman doctor, Annie Hillman, features prominently in the biographies of the Herzog family; and Mary Gordon, a Durham graduate, who became a major in the British Army Medical Corps, and was also mentioned in a recent Rabbinic biography, helped Jewish immigrants reach Israel from Cyprus in the late 1940s.
Finally, any serious discussion of the role of Jews in British medicine must also include another important non-medical, and refugee immigrant, leader. To-day the role of ethics in medical schools and medical practice is taken for granted, but when the late Chief Rabbi, Lord Jakobovits, wrote his classic work ‘Jewish Medical Ethics’ this was not the case. His pioneering interest in this field has had a wide and lasting influence, and is undoubtedly one of the main Jewish contributions of the past 350 years.