Abstract
Don Meir Alguades’s Segulot Muvḥanyot, extant in Parma, Biblioteca Palatina MS 2474, offers a rare insight into two converging questions in the history of late-medieval medical practice: how was practical knowledge transmitted? And to what extent did this practice draw on medical theory? The present article closely examines the various features of this collection – namely, the author to whom it was attributed, the text, the codex in which it was copied, and later renditions and mentions of the text. These reveal new information on the work, its formation and its reception, as well as on fifteenth- and sixteenth-century Jewish medical practice in Iberia and among Jews of Iberian descent. Considering this text as an exemplar of recorded clinical encounters allows us to advance tentative suggestions regarding the art of tailoring medical practice in the period, and the dynamics between medical theory and the medicine provided by learned physicians. The personalized recipes further demonstrate how the formulation of trust and credibility operated in Jewish medicine of the period, and how these survived through changing social contexts.
Around 1400, in Castile, a man who was unable to sleep sought a physician’s help. He was given a recipe for a syrup which contained fennel, nuts, petals of white roses, and sugar to be taken every evening before his evening meal.1 A woman with dental problems was prescribed, by the same physician, an enema of myrtle, celery, sarcocolla, lavender, and sugar. The physician further explained that she suffered from “a great humidity in the head” and “such a great receding” that all her teeth were covered by flesh.2 Recorded at the turn of the fifteenth century, these recipes were prescribed to mostly un-named patients, whose age or hometown are in some cases mentioned. The partially individuated recipes situate this collection in between genres of medical practice literature; as such, they provide a rare account of actual medical practice. My suggestion here is that the language of the recipes – Castilian in Hebrew letters – sheds light on another relatively little-documented aspect of medical practice: that of Jews in fifteenth-century Spain and its diaspora.
Composed in Castile, the collection Parma II, extant in Parma 2474 under the title Segulot Muvḥanyot (tested medicines), contains recipes attributed to a well-known rabbi and physician, Don Meir Alguades. Despite their famed origin, they have not been much studied so far. Luis García Ballester produced a preliminary edition of a selection of the recipes and noted some of the key elements of these recipes.3 Building upon his work, this study will address further issues which Parma II unveils with respect to languages, medical education and materia medica. Then, by studying Parma II within its codex, as well as in its later rendition by Yosef HaCohen in his Meqitz Nirdamim, and another contemporary remedy compilation, I will consider the transmission of the work as a premise to further understand the medical practice of Iberian Jews and Jews of Iberian descent in the fifteenth and sixteenth centuries, their accumulation of medical knowledge, and their means of attaining authority. Placed against the broad context of the period’s records of medical practice, I suggest that Parma II should be considered part of an informal genre, a type of recording of medical encounters that provides a useful insight into the dynamics of actual medical care.
1 Don Meir Alguades
Don Meir Alguades (fl. 1390–1410) was a well-known figure in Castile at the turn of the fifteenth century. He was a leading rabbi in the Jewish community of Castile, probably serving in particular the Jews of Segovia.4 He was physician to the Trastámara kings of Castile, Juan I (1358–1390) and Enrique III (d. 1406), and perhaps also to the latter’s son Juan II (1405–1454). García Ballester suggested that he might have been associated with one of the ecclesiastical courts in Castile, as a number of his patients appear to have belonged to clerical circles.5 The high standing he enjoyed within the Jewish community is evident. The opening of his translation of Aristotle’s Nicomachean Ethics (subsequently EN) presents him as “head of the exile”. Extant documents composed by the abovementioned kings discuss his appointment as “Rab Maior” or “Juez maior,” defending the Jewish community before the king.6 His prominent position in the Jewish community is also attested in his exemption from taxes and the same exemption subsequently extended to his widow and daughter.7 Learned men of the Iberian peninsula such as Profiat Duran and Don Benbenist Lavi of the Cavalleria family are known to have been in ongoing contact with him. While throughout most of his life, it is clear that he had the king’s favour and that he was in constant dealings with Castile’s Christian society, it was claimed some fifty years after his death that he had been accused, incarcerated and sentenced to death (or, by some accounts, martyred) for participating in a plot to poison King Enrique.8 Recent scholarship has agreed that this must have been no more than a rumour feeding on anti-Jewish sentiments, which often involved accusations of poisonings.9
Unfortunately, there is little direct information on Alguades’s medical education. It is safe to assume that he obtained his professional skills through tutoring and that this education was carried out in Castilian.10 There is reason to believe that his learning was not merely practical but was also based on his readings of learned medical treatises, although it is not clear what was the language in which he had accessed these treatises. His interest in philosophy drove him to translate Aristotle’s EN from Latin into Hebrew, indicating that he knew Latin rather well, perhaps better than he knew Arabic.11 In his introduction to the EN, he explained that his impetus for translating the work from Latin was derived from his dissatisfaction with the one available Hebrew translation; translated from the Arabic by Samuel ben Judah of Marseille, Alguades deemed this Hebrew version to be incomprehensible.12 He further admitted that his knowledge of both Hebrew and Latin were insufficient for the task, though this admission may contain some measure of rhetorical humility, particularly in view of the author’s use of the common contemporary Hebrew style, which heavily relied on biblical quotes. His acknowledgement of having had the assistance of Christian teachers in the process of the translation indicates that his Hebrew and Latin might indeed not have been good enough for the task in hand.13 From his closer proximity to Latin scholarship, and his uneasiness with the existing Arabic to Hebrew translation, we might infer that Alguades was part of a Jewish community that was growing detached from the Arabic language.14 In terms of medical knowledge, this affiliation to Christian culture would imply learning dependent on Latin university education, whether through Latin or through Hebrew.15 The languages of Parma II reflect a more amalgamated medical tradition.
2 Medical Practice and the Language of Medicine in Parma II (Segulot Muvḥanyot)
The little book of tested remedies attributed to Don Meir Alguades brings together more than eighty remedies, among them a general regimen “for all men in all times” (fol. 154v) and one for seasonal pains and fevers (fol. 149v), forty impersonal recipes for an assortment of ailments, and about the same number of recipes prescribed to particular individuals with varying degrees of specificity. While the two patients mentioned in our opening paragraph remained anonymous, yet other patients are described in rough detail: amongst others, we find a five-year-old boy, an archdeacon of Calatrava, the queen’s treasurer, one Doña Leonor the wife of the Adelantado. It is impossible, however, to identify most of these patients. The recipes are not listed according to a recognized organizing scheme, such as the common ‘head-to-toe’ order; this lack of any obvious organizing principle reinforces the probability that it was initially written perhaps by Alguades’s student as a record of the teacher’s instruction, as Luis García Ballester proposed.16 All entries are short and focus on the recipe. One recipe, for example, describes how to make a paste to put on the navel; another describes a mix of equal portions of goat’s milk and kid’s skin be applied to patients’ ears every night to improve their hearing.17 The personalized entries are also brief. They do not offer a full diagnosis or patient history, but they often note the patient’s general state of health in basic Galenic terms, rather than focusing on particular ailments. For example, there is a prescription for a syrup for a man who had “great heat” and aches in his sides, and another for a woman who could not eat but had no fever.18 A little more detail appears in a recipe for “a man who had pains in his kidneys and suffered pain when urinating,” which are explained as having resulted from an overly aggressive purgation that diminished the patient’s humours.19 In most recipes, there are also instructions regarding when and how to take the proposed medicine.
Among the patients mentioned are men and women of all ages; those named appear to be mostly of Christian faith and to belong to the religious and social elites. Two of the men amongst those patients mentioned by name, Don Suleman ibn Alruya and Don Yosef, were probably Jewish.20 The list of problems varies from gout to postnatal pains, kidney stones, general weakness, and aches. As García Ballester noted, pain appears to be the common thread, the one symptom more than any other that prompted the interaction between patient and physician.21 The proposed treatments include the administering of syrups, pills, enemas and plasters, generally based on herbal concoctions with non-exotic plants such as fennel, celery, cilantro, cinnamon, extracts of garlic or various flowers, and large quantities of sugar. Their ingredients and formulation are similar to those found in contemporary recetarios, although it would be near impossible to find exact parallels to the remedies in this collection.22 There are some occurrences of Galenic terms: in particular, abundant humidity of the whole body, or of particular parts, is identified as a cause for concern. There is also distinction drawn between different kinds of fever.23 Still, it is notable that medical authorities are not mentioned, apart from one reference to Hippocrates which occurs in a general section on eating in times of pestilence.24 These defining features allow us to place the text within a broader context of the period’s medical writings.
3 Between Recipes and Case Histories
By the fifteenth century, writing case histories, or records of medical encounters, was a common practice among learned physicians working in Southern Europe. Teachers of medicine and celebrated practitioners issued detailed consilia demonstrating their professional prowess in diagnosing and prescribing appropriate regimen and remedies. The seminal study on this medical genre, by Jole Agrimi and Chiara Crisciani, further noted the function of consilia as a clinical teaching tool, but warned against seeing them as authentic accounts of the medical encounter due to the stylized nature of their approach, and due to what, in some cases, was also a heavily theorized approach.25 The subsequent work by Marilyn Nicoud on consilia and on medical letters revealed the breadth of the genre, and showed the many varied forms it took, linguistically and clinically, beyond the big tomes of collected cases.26 Iberian exemplars were also documented, both in supplementary notes added to theoretical medical texts and in standalone personal documents.27 Whether highly academic or vulgarized, these texts articulated the Galenic ideal of tailoring medicine to specific conditions; in other words, they outlined approaches to what we would now describe as personalizing care.
It is tempting to consider the remedies attributed to Don Meir Alguades as a Castilian-Hebrew lettered exemplar of this phenomenon. The fact that more than half of the entries are addressed to specific patients, whether named or unnamed, signals that the value of the recipes was in their personally tailored attention. However, in contrast to the elaborate consilia, Parma II’s personalized remedies are rather basic, both with respect to diagnosis and treatment. They do not offer a full humoral analysis of the patient’s ailment, and the recipes are mostly composed of run-of-the-mill, unassuming, recurrent ingredients. In this respect, these recipes are once more comparable to those produced in Arabic and Latin, the likes of which Alguades may have had an opportunity to read at some point. Cristina Álvarez Millán studied the case histories of Abu Bakr al-Razi, as well as anonymous compilations or recipes; in both cases, she perceived that practical collections are highly independent from theory, and can be found to disregard and even contradict the medicines prescribed in theoretical works. “Theoretical works,” she writes, “are not a reliable account of reality,” as the practice of medicine was an intuitive process that was perhaps only modified by theoretical literature and not guided by it.28 Two Latin parallels closer to Parma II are the Experimenta of Arnau de Villanova, and the manuscript transcribed by Ernest Wickersheimer in his 1939 article “Faits cliniques observés à Strasbourg et à Haslach en 1362 et suivis de formules de remèdes.”29 Both consist of short entries which include records of treatments of both named and unnamed patients, and the occasional addition of age and place. These texts further share a preference for simple remedies and a non-theoretical approach.30 They also present a functional focus with specific cures; regimen advice is scarcely included. Michael McVaugh, who edited the Experimenta, defined it as “an informal record of Montpellier’s normal therapeutic methods.”31
Seeing these three exemplars together suggests that the practice of recording medicines in such a way had spread beyond Montpellier by the late fourteenth century. It may well be that the author of Parma II knew Arnau’s treatise (it was, after all, recovered in a Salamanca manuscript); but even if he had not seen this specific text, it is evident that this method of recording practice had become widely circulated, through diverse regions and across different faith communities. Although this method was personalized in a way similar to the consilia cases, it was not oriented toward the application of theoretical knowledge in an academic manner. It also differs from the exemplary anecdotes that dotted systematic head-to-toe practica compendia.32 In their tailored but succinct, straightforward approach, these exemplars demonstrate an alternative didactic model which sought to bridge theory and practice in a different way: whilst rooted in the world of practice, further value was added with the personalization of remedies. As will be discussed below, this value drew on naming and experience as currencies of trust and authority, and less as manifestations of possible varieties. Thus, although they provided instances of observation, they did not extrapolate a conceptualized notion of observation-based knowledge, as would later be done by physicians of the sixteenth century and beyond.33
4 The Languages of Parma II
The language of the text is one of its most intriguing features. Despite Alguades’s apparent detachment from Arabic and his limited knowledge of Latin, the core of the treatise associated with him is an intermingling of Castilian and Arabic learning, with both written in the Hebrew alphabet. The method of writing Castilian words lacks consistency and follows patterns of diction rather than script, suggesting that the text is a close representation of an oral transmission.34 Hebrew words are remarkably few throughout the work. Hebrew is used in two separate instances in the recipes: one is a remedy against headaches that involves mixing equal portions of human excrement and linaloe, grinding them to a powder and applying this powder to the aching temple, while the other is a powder for extracting sweat in times of plague.35 In both recipes there are some Castilian words, but the leading language is Hebrew, not only for the bodily organs and ailments but also for the preparation instructions. As these are the last two recipes in the entire collection and as they involve a type of materia medica that does not appear in the rest of the treatise, it may well be that the two passages are a later interpolation into the core text attributed to Alguades. Throughout the text, the scribe’s marginal notes identify key words within the entries; these are mainly in Castilian but there are some in Hebrew also. The last entry translates the heading of the plague recipe into Castilian in Hebrew script: “de tamo para tienpo de magefa” (
The other place where Hebrew appears is in a paragraph that discusses blood-letting where we find a title:
Taken together, the three defining features of Parma II – the personalized recipes, materia medica, and use of language – signal that the text provides a very rare record of actual, on-the-ground, Jewish Castilian medical practice. Although it is not an autograph text, and although it was copied decades after the death of the practitioner who is said to have prescribed the remedies, the text’s structure preserves the oral and situational format. Through these elements, the actual practice of medicine can be seen, especially when the treatise is read in the context of adjacent treatises in Parma 2474, and later renditions of Alguades’s remedies.
5 Parma, Biblioteca Palatina MS 2474
The only extant copy of Parma II is found in a manuscript composed in 1493, some eighty years after it was initially conveyed by the author. It was copied in Spino Monferrato, a commune not far from Genoa, Italy; both the year and location suggest that it was composed by an exiled Jew who resettled in Italy. The palaeographer Malachi Beit-Arié identified him Judah b. Solomon ibn Avi Shabbetai ha-Levi who was the scribe of at least one other medical text copied in 1495.39 Sifting through the manuscript’s pages provides further information on the context of Hebrew medical learning of the time; its educational-practical function is underscored by the choices of the copyist, as well as the additional excerpts later inserted by several hands, presumably those of successive owners of the manuscript. That the one identified owner, Shmuel Shaar Arye (Rabbi Samuel Portaleone), was active towards the end of the sixteenth and early seventeenth century, and belonged to a family of renowned physicians, suggests that the manuscript was kept, perhaps also used, for over a century, within professional circles.40
While intended to serve a physician or a physician-in-training, Parma 2474 cannot be categorized as a physician’s notebook, despite the odd insertions of lists and recipes.41 It contains a selection of texts which are copied in their entirety. These include four complete medical works and five shorter tracts, all dedicated to medical practice. The first and longest of these works is a translation to Hebrew of Constantine the African’s adaptation of Ibn al-Jazzār’s Zād al-Musāfir, the Viaticum by its Latin name.42 This is one of the fullest copies of this particular anonymous translation, known by the Hebrew title Yair Nativ (“Enlighten the way”) and misattributed to Isaac Israeli (fols. 6r–128v).43 This text is followed by two diagnostic guides – on pulse and on urine (fols. 129r–134r) –, a phlebotomy guide (fols. 135r–v), and a short dictionary of names of diseases (fols. 156r–157v). Two other treatises are collections of recipes, both under the title Tested medicines, but with a slight variance in the Hebrew spelling, between the Segulot Muvhanot for the first collection (Parma I, fols. 136r–144r) and Segulot Muvḥanyot for the second, that attributed to Don Meir Alguades (Parma II, fols. 145r–155r). Excerpts of lists of purgatives and recipes are added on the covers and in between the major texts. Looking at the manuscript as a whole, we find that – with the exception of the two recipe collections – the texts’ main language is Hebrew, even if they are heavily reliant on vernacular leʿazim for medical terminology. Together they provide a rounded foundation for a Jewish practising physician whose main language of medical education was Hebrew but for whom, at least in the first years of the manuscript’s existence, the medical practice was most probably conducted in the vernacular.
The two compilations appear remarkably similar in content and form. They both include short recipes against various aches and ailments, neither of which is arranged in a ‘head-to-toe’ order. They are also linguistically exceptional within the manuscript. Both use predominantly Castilian in Hebrew script, and evince extensive code-switching. But despite this seemingly shared Castilian context, a closer look reveals that they originate from distinct socio-medical environments. The first recipe collection, Parma I, relies on Hebrew in a more substantial way and has no Arabic words at all. Most of its entry titles are in Hebrew: e.g.,
Two other distinct differences can be observed: 1. In contrast to Parma II, Parma I is doubly anonymous, having neither attribution nor named patients or claims for personalized recipes. 2. The materia medica of Parma I includes many animal ingredients, among them burnt chicken feathers, boiled rabbit hairs, dog’s faeces, a bat’s brain, the milk of a mare, pig’s fat, menstrual blood, as well as corals and fabrics. Notably, these are all detailed in Hebrew, not in the main language of the text which was Castilian. Parma II has a more conservative use of animal ingredients, recommending the use only of those that would have been found within the customary household kitchen, such as goat’s milk or chicken broth. There is one remedy that requires the use of human faeces and another that uses burnt fabric, but as suggested above, the two may have been interpolated into the text by mistake; brought together at some point, either by current or previous scribes who erroneously thought that they were part of the corpus of Alguades’s recipes. Their distinctive use of Hebrew and their location at the end of the treatise support this hypothesis.
The absence of animal parts in the recipes attributed to Alguades (Parma II) should not be attributed only to a religious observation of dietary laws, despite the ongoing debate on this topic during the period.44 It is more likely that the use of faeces or other secretions as materia medica was not part of his practice due to his professional formation and expertise, which, as García Ballester noted, relied heavily on the regimen notion of the six non-naturals.45 Iolanda Ventura and Cristina Álvarez Millán have shown that, generally speaking, Galenic cures refrained from using dreckapotheke and that texts which included such remedies generally relied less on medical theory and belonged to a more popular register of healing that oftentimes verged on magic.46 To be sure, the borders between such practices were porous. It is probable that fifteenth-century patients used both kinds of remedies without distinction, and there are indications that at least some healers did so too.47 Nevertheless, the above evidence suggests that Alguades and his student, belonged to the more conservative Galenic, herbal, tradition of medicine, and that the dreckapotheke recipes were later interpolations.48
Despite the notable differences between the two compilations in Parma 2474, the copyist and its eventual readers brought the two kinds of medicine together. Their juxtaposition and the visual similarity of the two collections allowed the two therapeutic approaches to merge, eroding any historic differences between sophisticated Galenic learning and popular remedies, likewise between Arabic and Hebrew origins. If I am correct in identifying the two final recipes in Parma II as interpolations, this merging began to occur before 1493. In Italy, it would go on to merge even further: some forty years later, Yosef HaCohen (1496–1575) announced that he had reissued Meir Alguades’s remedies in a book he titled Meqitz Nirdamim. This rendition (which I will further discuss below) attributed to Alguades a cure for heavy menstrual flow which relies, in fact, on a remedy that appears in Parma I; there is no remedy for heavy menstrual flow in Parma II. The materia medica required for the cure in question moreover is animal – requiring the powder of a burnt buck’s horn.49 It is certainly possible that this remedy could have reached Yosef HaCohen through other texts, as it was not an uncommon treatment; it appeared, for example, in the Trotula text De curis mulierum.50 It is also possible that the fact that the remedy treated menstruation problems, involving both blood and the female body, allowed it to enter more easily the usually herbal Galenic recipe collections.51 But this was not the full extent of Yosef HaCohen’s attributions; he additionally attributed to Alguades recipes that were patently dreckapotheke recipes: for sciatica, he recommended an ointment made with a mix of rabbit hair, mouse faeces, salt, ashes and honey; for spleen ailments, an ointment made of goat’s faeces soaked for a night in vinegar.52 Although there are gaps in this history of transmission, the fact that this sixteenth-century author considered it plausible that Don Meir Alguades could have been the originator of such remedies indicates that he saw no difference between the two traditions, and clearly did not identify Don Meir Alguades’s expertise as one associated with pure herbal medicine. In sixteenth-century Italy, the two traditions appeared to have merged. Or perhaps, as a source of medical authority, the name Alguades had already taken on a life of its own.
6 Records of Medical Practice: Authority and Reception
Don Meir Alguades was certainly recognized among Spanish Jews, and those exiled from Spain, as a paragon of medical wisdom. In addition to the 1493 Parma manuscript, Don Meir Alguades is mentioned several times as the source of recipes in another fifteenth-century Hebrew compilation of cures. He is credited as the “author” of a purgative to cleanse phlegm and red bile from a pained and cold stomach; the purgative includes saffron and pepper. Another remedy with which he is credited is one that involves placing warmed cabbage leaves on a male patient’s bloated thigh; and another is for a pessary comprised of garlic and fennel.53 There is no direct connection to Parma II: the first and second recipes are not mentioned there, and the third, which includes details about the specific condition written in Hebrew-scripted Castilian, may be a version of a syrup prepared for a man who, according to Parma II, could not urinate for five days and suffered great pains.54 The absence of connection to Parma II suggests that various Segulot might have been added to – or subtracted from – this corpus in fifteenth-century Castile, across different manuscripts. This was a common phenomenon in the circulation and transmission of medical recipes. Recipe collections were often open-ended and malleable, even if they already had an established association with an authoritative name.55 This possible flexibility in transmission could also mean that Alguades’s famous name could have been attached to apocryphal recipes to vouch for their credibility.
6.1 Authority
As several scholars have argued in recent years, credibility was an important element in recipe collections of medieval medicine. Despite not having a set system of drug-trial in place, physicians were concerned with demonstrating the efficacy of cures. Among the questions medieval physicians raised were how to discern efficacious remedies from false ones, how to ensure that precise measures were kept, how to ascertain whether ingredients were of quality, and whether a physician should use remedies that had no rational or consistently proven effect.56 Attributing remedies to a recognized authority, as did the author of JTS 2776, and indeed, the author of Segulot Muvḥanyot (Parma II), was one of the simpler ways of persuading readers of the efficacy of any given treatment.
More elaborate methods of assessing drugs included various experiments, such as testing on animals, applying forms of control, etc.57 In the Hebrew- script and Hebrew-language texts, these are not detailed, but the notion of experience – or claims of experience – recurred throughout, if only as reassuring rhetoric vouching for the veracity of their content. The titles of the two remedy collections in Parma 2474 confirm that the remedies had been tested and could therefore be regarded as useful and trustworthy. Parma I, moreover, concludes most of its recipes with the promise that the medicine will work (
Statements of personal knowledge and experience offer another form of guarantee of the value of a proposed cure. The abovementioned JTS MS 2776, which includes recipes by Alguades, uses this method repeatedly throughout the codex. The compiler was a contemporary physician, Hayyim ben Musa (ca. 1380–1460), another prominent Jewish figure in Castile.59 Hayyim, an author of a polemical treatise and translator of an abridged work of Ibn al-Jazzār from Latin, may have known Meir Alguades personally, as both were physicians in the courts of prominent men of the region.60 It is possible that he received these recipes in person, either from Alguades himself or from one of his students (his references indicate that Alguades was already deceased at the time of writing). In addition to the common attribution of various recipes to well-known medical authorities, whether Greek (Hippocrates and Galen), Arabic (among others, al-Razi and Maimonides, whom he might have read in Hebrew) or Latin (Arnau de Vilanova), and to fellow physicians, probably well-known to contemporary readers but now forgotten – such as Yosef ben Yhia of Catalonia and Alfonso Martinez –, the compiler repeatedly emphasized his own authority as a collector of remedies and as a practitioner.61 In several places, Hayyim ben Musa also states that he tried the remedies and saw their success; in one instance, he admits that while a plaster for loss of voice worked on one occasion, at other times it did not.62 In addition to the first-person experiences, the recurrent references to time or duration (how long did it take for the cure to work, how long did it last, etc.) were all meant to secure the readers’ trust in the efficacy of the cure.
These accounts of trial and error detailed in the first person recall the personalized recipes of Parma II. Both attempted to record practice. Yet, the comparison highlights the particular way in which Parma 2474 uses Meir Alguades’s name, and the distinctive way in which practice is described in Parma II. By contrast with the active first-person voice used by Hayyim ben Musa, Meir Alguades’s name is mentioned in only one entry of Parma II, and the only other occurrences of his name besides are in the title and in the concluding lines of the text. The isolated single mention of his name within the entries appears in a follow-up recipe to Don Suleman ibn Alruya who, having receiving a purgative syrup, began emitting much blood in his urine: “To this said Don Meir, God bless him …” (…
Rather than being intended as a demonstration of his success, the physician’s name is mentioned only as part of a methodical analysis of the medical situation. The focus remains on the medical record rather than on personal experience. This is further seen in the manner of presenting the records. The cases included by Hayyim ben Musa comprise a small portion of the text and are told in the manner of exemplary tales (
פרה לה מוגיר קי אישטאבה די פארטו קי טיניאה לה קריאטורה מואירטה טומי ג׳ אונס׳ די סומו …
(for a woman who was in labour with a dead creature, take 3 ounces of juice …);
און אומה אביאה מידיאו אביו קי טיניאה פיידרה אינלס בידיגה מאנדו קי טומאשין …
([for] a man who feared he had stone in the bladder, he ordered to take …).64
Such stylistic choices, which may seem incidental, demonstrate the spectrum of purposes for which the making of records of medical practice was used in the late-medieval period: between asserting authority and the gaining of trust, to the references to experience as part of producing and pursuing medical knowledge; between documenting the author/physician’s own successful practice, to assembling records of effective medical care. While in the copying of his recipes, Alguades’s name was introduced as an authority, the rendition of these recipes, and their inclusions by other physicians within the Parma II authority, is founded on Alguades’s personal professional engagement with specific ailments.
6.2 Reception
Alguades’s enduring fame was cemented in Yosef HaCohen’s aforementioned Meqitz Nirdamim. Meqitz is a curious episode in the transmission of Alguades’s medicine. The title refers to a compilation of over 200 remedies, now extant in two manuscripts, of which only 36 are recipes attributed to Alguades; other recipes are credited to Alguades’s pupil Yosef, and Yosef HaCohen commented on both and added further recipes of his own.65 In some cases, such as in the cure for sleeplessness, Yosef’s recipe replicates the one found in Parma II, indicating a particular prescription associated with Alguades throughout the century.66 Even a cursory look, however, reveals that not all 36 remedies follow in an easily traceable manner the pattern of the entire compilation: not in the personalized format, nor in number and order of entries and, most importantly, not in content; more work must be done in order to fully map this amalgam.67 Yet, even without offering a complete analysis of this work in its own context, we may discern the duality of the preservation of Alguades’s medicine, in which the name and authority seems to have outlasted the specific kind of medicine he practised.
Yosef, who lived near Genoa in the sixteenth century (not far from where Parma 2474 was copied) was born to a family of the Sephardic diaspora. His father was born near Cuenca, and fled to Avignon, where Yosef was born, and from there they moved to Italy. Like his father, he became a physician, and in his later years he also turned to writing histories (he was the author of The Valley of Tears, a history of the Jewish people which details the events of the expulsion from Iberia).68 In Meqitz, he took upon himself the task of translating the Spanish recipes of Alguades and his pupil into Hebrew and Latin (“I saw [good] to copy [translate] it into the Holy language, and to write each and every recipe in Latin”), and to add his own recipes and commentary. While he acknowledged that there was no real novelty in the work, he explained that he composed Meqitz for its usefulness to students in the art of medicine.69
This explanation reveals the subtle shift that Jewish medical knowledge underwent at the turn of the sixteenth century with the expulsion from Iberia. In addition to the previously noted incorporation of dreckapotheke, which appears to have been an inadvertent alteration of Alguades’s Galenic medicine, Yosef’s readership could no longer read Castilian, let alone Arabic. Beyond language proficiency, this change signals an adoption of a new medical context. The Schoenberg manuscript neatly divides the bilingual text, with each entry comprised of a Hebrew text (Hebrew in Hebrew letters) that includes the name of the medicine or a brief description of the recipe and the recipe itself, with some leʿazim – transliterated words – for the materia medica. This is followed by a translation of the recipe into Latin in Latin letters. The use of Latin letters in a Hebrew manuscript, particularly for the recipe’s ingredient list, is indicative of the changing social context of Yosef’s presumed readers, those who were now more reliant on university education and Latinate medicine.70 Yet despite the changing medical-social-linguistic context of Jewish medical practice in Italy, Don Meir Alguades’s name still retained much of its allure as a medical authority of old. By adding his own remedies and suggestions to those of the master and his pupil, Yosef could depict himself as the third generation of that lineage, a testimony to his own medical wisdom and the trustworthiness of his recipes. I would suggest that this claim to authority goes beyond the purely medical: for Yosef, the historian, the valour of Alguades, whose tale of martyrdom he recounted in The Valley of Tears, had a special appeal; Meqitz, as such, was more than a medical work – it was a monument to Iberian Jewry. In this sense, Yosef was drawing his authority from the sense of a lineage, and from the particular notion of Jewish medical expertise, more than from claims for the efficacy of his remedies. The nature of this Jewish medical expertise was so changed, however, that it no longer represented Alguades’s actual practice, but was more an amalgam of Hebrew recipes of diverse origins.
7 Conclusion
The unfolding of the different layers of Segulot Muvḥanyot (Parma II) provides us with new and more nuanced information about fifteenth-century medical practice among Sephardic Jews; it also raises some new questions about this medical practice and about the eventual legacies of this knowledge in sixteenth-century Italy. The recipes ascribed to Don Meir Alguades reveal a herbal medical practice of simple drugs based on common, local ingredients that continued to be immersed in Arabic tradition (both through terminology and materia medica), even when Arabic learning and language were becoming less accessible to the Northern Castilian Jewish physician. His practice subscribed to Galenic principles but did not engage with them directly. Actual experience – and the ability to tailor medicines to a specific patient – were certainly valued, but as is evident in equivalent Latin collections, this did not necessarily involve an in-depth study of the patient’s complexion, but rather a directed focus on a particular complaint. The non-diversified list of prescribed materia medica serves as another indication of the recourse to a more restricted and simple medical practice. For at least some working practitioners, this kind of medical care was treated as something distinct from dreckapotheke. We are left then with the question of how widespread was this distinction between a practice of Galenic impetus and a practice that owed more to dreckapotheke: was it shared by all Castilian Jewish physicians? Other Jewish healers? Patients? Undoubtedly, it was not. In fact, the compilation of Parma 2474, and Yosef HaCohen’s rendition in Meqitz Nirdamim, indicate that Alguades’s lesser use of dreckapotheke was a very local and time-bound distinction. A fuller study of Hebrew and Hebrew-scripted remedies would be required to allow us to draw, in time, firmer conclusions regarding the existence of historical boundaries, places of origin, and languages.
Finally, the records of medical practice written in Hebrew and in Hebrew script demonstrate that – as well as being part of a contemporary medical tradition – their authors were part of an inner Jewish tradition of medical authority, driven not only by knowledge and experience, but also by a sense of communal belonging.
Acknowledgements
The author would like to thank Leigh Chipman, Ilil Baum, Renana Bartal, Ayelet Even-Ezra, Thomas Rütten, and the journal’s anonymous reviewers. This study was supported by the Israel Science Foundation under grant 1040/15.
List of Manuscripts Consulted
New York, Jewish Theological Library MS 2776, fifteenth century, anon. Hebrew compilation of cures by Hayyim ben Musa (d. 1460).
Parma, Biblioteca Palatina MS 2474, 1493 AD, copied by Judah b. Solomon ibn Avi Shabbetai ha-Levi 136r–144r: 105 medical recipes [heretofore: “Parma I”] 145r–155r; medical recipes attributed to Meir Alguades [heretofore: “Parma II”].
Philadelphia, Lawrence J. Schoenberg MS 468, sixteenth century, Yosef HaCohen’s Meqitz Nirdamim (1496–1575).
St. Petersburg, The National Library of Russia MS EVR I 338, fols. 1r.–39r. fifteenth century, anon. Hebrew compilation of cures.
Turin, Biblioteca Nazionale Universitaria MS A V. 10, sixteenth–seventeenth century, Yosef HaCohen’s Meqitz Nirdamim (1496–1575).
Parma, Biblioteca Palatina MS 2474, fol. 148r. A list of the manuscripts consulted will be found at the end of this article.
Ibid., fol. 147v.
Luis García Ballester, La búsqueda de la salud: sanadores y enfermos en la España medieval (Barcelona, 2001), 214–215, 473–484.
There has been some suggestion that Alguades studied under Rabbi Yehuda Asher (HaRosh), who was a prominent Castilian rabbi, but this has not been convincingly corroborated; see Susan L. Einbinder, “Meir Alguades: History, Empathy, and Martyrdom,” Religion & Literature, 42 (2010), 185–209.
García Ballester, La búsqueda de la salud, 480.
Macarena Crespo Alvares, “El cargo de Rab Mayor de la Corte según un documento de Juan II fechado en 1450,” Edad Media: revista de historia, 4 (2001), 157–198.
Yolanda Moreno Koch, Las taqqanot de Valladolid de 1432: un estatuto comunal renovador (Salamanca, 1987), 74–77.
Heinrich Graetz, History of the Jews, ed. and transl. Bella Löwy, vol. 6 (Philadelphia, PA, 1898), 195 [in Hebrew]; Rosa Vidal Doval, Misera Hispania: Jews and Conversos in Alonso de Espina’s Fortalitium fidei (Oxford, 2013), 105–106.
The accusation is first mentioned in Alonso de Espina’s Fortalitium fidei, against a curious backdrop. Alguades is mentioned in a chapter on a host miracle that occurred in Segovia in 1415, when a certain Jewish physician stole the host and brought it to a synagogue, where he and a number of other Jews tried to desecrate the host by putting it in boiling water. To their surprise, Jesus himself appeared to them. Fearing punishment, they brought the host to a
monastery, telling the abbot of the miracle, but a few days later a young monk consumed the desecrated host and died. A royal investigation, which saw the rounding up of a number of culprits, occasioned the torturing of Don Meir Alguades, causing him to confess his involvement not only in the host desecration but in the killing of Enrique III as well. The association between host desecration and regicide by poisoning is another indication for the accumulation of anti-Jewish tropes; see Alonso de Espina, Fortalitium fidei contra iudeos saracenos aliosque Christiane fidei inimicos (Nuremberg, 1494), 172v–173r. On poison accusations, see Joseph Shatzmiller, Jews, Medicine, and Medieval Society (Berkeley, CA, 1995), 85–89.
On Jewish medical education, see Shatzmiller, Jews, Medicine, and Medieval Society, 14–35; Carmen Caballero-Navas, “Medicine among Medieval Jews: The Science, the Art, and the Practice,” in Science in Medieval Jewish Cultures, ed. Gad Freudenthal (Cambridge, 2012), 320–342.
Don Meir Alguades’s translation was based on Robert Grosseteste’s translation of the EN, although he believed he was translating Boethius’s translation; see Chaim Meir Neria, “‘It Cannot be Valued with the Gold of Ophir’ (Job 28:16): Rabbi Joseph B. Shem-Tob’s Commentary on Aristotle’s Nicomachean Ethics. Sources and Analysis” (PhD diss., University of Chicago, 2015), 60.
Neria, “It Cannot be Valued,” 398; Lawrence V. Berman, “The Latin to Hebrew Translation of Aristotle’s Nicomachean Ethics [in Hebrew],” Jerusalem Studies in Jewish Philosophy, 7 (1988), 147–168.
“
Alguades’s better acquaintance with Latin learning is also attested in his estimation that there were far more renditions of Aristotle’s work in Latin; see Neria, “It Cannot be Valued,” 398.
On the acquaintance of Iberian Jewish physicians with Latin medicine, see Luis García Ballester, Lola Ferre and Eduard Feliu, “Jewish Appreciation of Fourteenth-Century Scholastic Medicine,” Osiris, 6 (1990), 85–117; Maud Kozodoy, “Late Medieval Jewish Physicians and their Manuscripts,” Social History of Medicine, 32 (2019), 734–750.
The manuscript mentions Don Meir Alguades as deceased (z
Parma, Biblioteca Palatina MS 2474, fol. 149v: “para el oir piel de cabron leche de cabra partes iguales echen delyo enel oido de noce.”
Ibid., fol. 145r.
Ibid., fol. 153v.
Ibid., fols. 149r, 154r.
García Ballester, La búsqueda de la salud, 480–481.
Similar ingredients and instructions can be found, for example, in El libro de recetas, a compilation of recipes attributed to Gilberto (perhaps Gilbert the Englishman), ed. Isabel Zurrón in Text and Concordance of MS 3063 de la Biblioteca del Palacio Real: El libro de recetas de Gilberto (Madison, WI, 1988). For a contemporary English equivalent, see Margaret Connolly, “Evidence for the Continued Use of Medieval Medical Prescriptions in the Sixteenth Century: A Fifteenth-century Remedy Book and its Later Owner,” Medical History, 60 (2016), 133–154.
Parma, Biblioteca Palatina MS 2474, fol. 149v.
Ibid., fol. 151r.
Jole Agrimi and Chiara Crisciani, Les consilia médicaux, transl. Caroline Viola (Turnhout, 1994).
Marilyn Nicoud, “Expérience de la maladie et échange épistolaire: Les derniers moments de Bianca Maria Visconti (mai–octobre 1468),” Mélanges de l’École française de Rome: Moyen Âge, 112 (2000), 311–458; eadem, “Alla ricerca degli autori cosiddetti ‘minori’: un percorso nella tradizione manoscritta del ‘consilium’,” in Summa doctrina et certa experientia. Studi su medicina e filosofia per Chiara Crisciani, ed. Gabriella Zuccolin (Florence, 2017), 195–222; eadem, “Les conseils médicaux en langues vulgaires: recherches sur des formes de communication entre patients et praticiens,” Romance Philology, 71 (2017), 523–562; eadem, “Troubles dans le genre: Les voies multiples de la tradition manuscrite des consilia médicaux,” in Ecritures médicales: Discours et genres, de la tradition antique à l’époque moderne, ed. Laurence Moulinier-Brogi and Marilyn Nicoud (Lyon, 2019), 101–132.
Fernando Serrano Larráyoz, “Consejos médicos en lenguas vernáculas para las élites hispanas durante la Baja Edad Media y el Renacimiento,” Llull: Revista de la Sociedad Española de Historia de las Ciencias y de las Técnicas, 42: 86 (2019), 43–68.
Cristina Álvarez Millán, “The Case History in Medieval Islamic Medical Literature: Tajārib and Mujarrabāt as Source,” Medical History, 54 (2010), 195–214.
Michael R. McVaugh, “The Experimenta of Arnald of Villanova,” Journal of Medieval and Renaissance Studies, 1 (1971), 107–118; Ernest Wickersheimer, “Faits cliniques observés à Strasbourg et à Haslach en 1362 et suivis de formules de remèdes,” Bulletin de la Société française d’histoire de la médecine, 33 (1939), 69–92.
McVaugh, “Experimenta of Arnald of Villanova,” 108–110.
Ibid., 109.
See, for example, the accounts included in the works of Valesco de Tarenta or Giovanni Matteo Ferrari da Grado; in William Henry York, “Experience and Theory in Medical Practice During the Later Middle Ages: Valesco de Tarenta (fl. 1382–1426) at the Court of Foix” (PhD thesis, Johns Hopkins University, 2003); Henri-Maxime Ferrari, Une chaire de médecine au XVe siècle. Un professeur à l’Université de Pavie de 1432 à 1472 (Paris, 1899).
Katharine Park, “Observation in the Margins, 500–1500,” in Histories of Scientific Observation, ed. Lorraine Daston and Elizabeth Lunbeck (Chicago, IL, 2010), 15–44; Gianna Pomata, “Observation Rising: Birth of an Epistemic Genre, 1500–1650,” ibid., 45–80; and Lorraine Daston, “The Empire of Observation, 1600–1800,” ibid., 81–114.
For a systematic account of trends in writing Castilian in Hebrew letters, and particularly aspects relating to orality and to strings of words, see Esperanza Alfonso and Javier del Barco, Translating the Hebrew Bible in Medieval Iberia: Oxford, Bodleian Library, MS Hunt. 268 (Leiden, 2021), 261–336.
Parma, Biblioteca Palatina MS 2474, fol. 155r.
María Teresa Herrera, Diccionario español de textos médicos antiguos (Madrid, 1996). For the use of Arabic in Castilian, with a list of words that entered medical language, see the series of articles by María Teresa Herrera and María Concepción Vázquez De Benito, “Arabismos en el castellano de la medicina y farmacopea medievales [A puntes para un nuevo diccionario (I–IV)],” Cahiers d’Études Hispaniques Médiévales, 6 (1981), 123–168; 7 (1982), 173–216; 8 (1983), 165–196; 10 (1985), 71–100.
Luis García Ballester, “A Marginal Learned Medical World: Jewish, Muslim and Christian Medical Practitioners, and the Use of Arabic Medical Sources in Late Medieval Spain,” in Practical Medicine from Salerno to the Black Death, ed. Luis García Ballester et al. (Cambridge, 1994), 353–394; Pieter Sjoerd van Koningsveld, “Andalusian-Arabic Manuscripts from Christian Spain: A Comparative Intercultural Approach,” Israel Oriental Studies, 12 (1992), 75–112.
Ilil Baum, “A Hebrew-Letter Fragment in Mixed Castilian-Catalan from around the Time of the Expulsion and its Implications for the Emergence of Judeo-Spanish,” in Caminos de leche y miel: Jubilee Volume in Honor of Michael Studemund-Halévy, ed. David M. Bunis, Ivana Vučina Simović and Corinna Deppner, vol. 2 (Barcelona, 2018), 46–63.
Hebrew Manuscripts in the Biblioteca Palatina in Parma, no. 1534, 451.
Parma, Biblioteca Palatina MS 2474, fol. 7r. For more on Rabbi Shmuel and his medical library, see Meir Benaya, “Rabbi Shmuel of Sha’ar Aryeh on Physicians and Medicines,” Korot, 9 (1990), 265–271. [in Hebrew]
On the genre of physicians’ notebooks, see Efraim Lev, “Mediators between Theoretical and Practical Medieval Knowledge: Medical Notebooks from the Cairo Genizah and Their Significance,” Medical History, 57 (2013), 487–515.
Brian Long, “Body and Soul: The Production and Reception of Medical Translations from Arabic in the Long Twelfth Century” (PhD diss., University of Notre Dame, 2015).
Moritz Steinschneider, Die hebräischen Übersetzungen des Mittelalters und die Juden als Dolmetscher: Ein Beitrag zur Literaturgeschichte des Mittelalters, meist nach handschriftlichen Quellen (Berlin, 1893), 703–704.
See, for example, Joseph Ziegler, “Religion and Medicine: On the Adaptation of Latin and Vernacular Medical Texts to Hebrew Readership,” Würzburger medizinhistorische Mitteilungen, 18 (1999), 149–158; Carmen Caballero-Navas, “Medicine and Pharmacy for Women. The Encounter of Jewish Thinking and Practices with the Arabic and Christian Medical Traditions,” European Review, 16 (2008), 249–259.
García Ballester, La búsqueda de la salud, 484.
Iolanda Ventura, “Medicina, magia e Dreckapotheke sull’uso delle sostanze animali nella letteratura famraceutica tra XII e XV secolo,” in Terapie e guarigioni: convegno internazionale, ed. Agostino Paravicini Bagliani (Florence, 2010), 303–362; Cristina Álvarez Millán, “Drug Testing, Tested Remedies and Medical-Literary Genres in Medieval Islam,” Suhayl. International Journal for the History of the Exact and Natural Sciences in Islamic Civilisation, 18 (2020), 205–273.
See below, findings from JTS MS 2776.
Compare with Álvarez Millán, “Drug Testing, Tested Remedies,” 257.
Parma, Biblioteca Palatina MS 2474, fol. 138v. Philadelphia, Lawrence J. Schoenberg MS 468, fol. 12v.
Monica Green, The Trotula: A Medieval Compendium of Women’s Medicine (Philadelphia, PA, 2001), 118.
The use of buck horn appears in NY, JTS MS 2776, fol. 39r. alongside a range of remedies that involve unusual animal parts and animal faeces, such as rabbit dung (ibid.), or dog’s dung (fol. 15v). For another contemporary Iberian compilation demonstrating the mix of herbal, animal, and magical remedies, see St. Petersburg, The National Library of Russia MS EVR I 338, esp. fols. 15r.–16r; see also Meritxell Blasco Orellana, Manuscrito hebraicocatalán de farmacopea medieval: edición paleográfica, Ms. Firkovitch I Heb-338 de la Biblioteca Nacional de Rusia (Barcelona, 2006), 55–59.
Philadelphia, Lawrence J. Schoenberg MS 468, fol. 15v, 18r.
NY, JTS MS 2776, fols. 34r, 83r, 93r. The manuscript is described in Alexander Tobias, Catalog of Hebrew Manuscripts from the Jewish Theological Seminary of America Library (New York, 1990), s.v. MS 2776.
Parma, Biblioteca Palatina MS 2474, fol. 146r.
For a meticulous analysis of the transmission of the much wider circulating recipes of pseudo-Mesue which demonstrates these tendencies, see Iolanda Ventura, “Ps.-Mesue’s Antidotarium sive Grabadin and Renaissance Recipes Collections: A Preliminary Overview of the Fortleben on an Authoritative Pharmaceutical Text,” in The Recipe from the XIIth to the XVIIth Centuries: Europe, Islam, Far East, ed. Bruno Laurioux and Agostino Paravicini Bagliani (Florence, 2023), 493–536.
York, “Experience and Theory in Medical Practice”; Michael R. McVaugh, “The ‘Experience- Based Medicine’ of the Thirteenth Century,” Early Science and Medicine, 14 (2009), 105–130; Charles Burnett, “Experimentum and Ratio in the Salernitan Summa de Saporibus et Odoribus,” in Expertus sum: l’expérience par les sens dans la philosophie naturelle médiévale, ed. Thomas Bénatouïl and Isabelle Draelants (Florence, 2011), 337–358; Danielle Jacquart, “De la faillibilité de l’art médical aux erreurs du praticien au début du XIVe siècle: une imperceptible marge,” in Errors and Mistakes: A Cultural History of Fallibility, ed. Mariacarla Gadebusch Bondio and Agostino Paravicini Bagliani (Florence, 2012), 129–146; Aurélien Robert, “Le pouvoir des incantations selon les médecins du Moyen Âge (XIIIe–XVe Siècle),” in Le pouvoir des mots au Moyen Âge, ed. Nicole Bériou, Jean-Patrice Boudet and Irène Rosier-Catach (Turnhout, 2014), 459–489.
Michael R. McVaugh, “Determining a Drug’s Properties: Medieval Experimental Protocols,” Bulletin of the History of Medicine, 91 (2017), 183–209; Álvarez Millán, “Drug Testing, Tested Remedies.”
Parma, Biblioteca Palatina MS 2474, fol. 141r.
Steinschneider, Die hebräischen Übersetzungen, 706.
Graetz, History of the Jews, 419–420; Ram Ben Shalom, Facing Christian Culture: Historical Consciousness and Images of the Past among the Jews of Spain and Southern France during the Middle Ages (Jerusalem, 2006), 273–274. [in Hebrew].
NY, JTS MS 2776, fol. 35v.
Ibid., fols. 30r, 31r, 32v, 37r.
Parma, Biblioteca Palatina MS 2474, fol. 149r; see the translation of this entry into Spanish in García Ballester, La búsqueda de la salud, 478–479.
Parma, Biblioteca Palatina MS 2474, fols. 150r, 148r.
Steinschneider, Die hebräischen Übersetzungen, 775 has a brief discussion of this work which is found in Turin, Biblioteca Nazionale Universitaria MS A V. 10 and in Philadelphia, Lawrence J. Schoenberg MS 468. The Turin manuscript is described in Codices Hebraici manu exarati Regiae Bibliothecae quae in Tauriensi Athenaeo asservatur, ed. Bernardinus Peyron (Rome, 1880), 125–127. On the Schoenberg manuscript (once London, Montefiore MS 444), see Moritz Steinschneider, “Medicinische Handschriften im Besitz des Herrn Halberstam,” Magazin für die Wissenschaft des Judentums, 10 (1883), 166–169. A transcription of the cures attributed to Alguades from the Schoenberg manuscript – namely, fols. 8r–22r – is available in David Margalit, “R. Yosef ben Yehoshua HaCohen and the Manuscript of ‘Sefer Meqitz Nirdamim’ 1496–1577 [in Hebrew].” Korot, 6 (1975), 533–560.
Philadelphia, Lawrence J. Schoenberg MS 468, fol. 10v.
A brief analysis of Meqitz suggests that its association with Parma II (or its extant version in Parma 2474) is less visible than has been previously suggested, both in terms of content and context. It seems possible that the manuscript which Yosef HaCohen had in front of him contained remedies by Alguades’s pupil alongside others, perhaps those found Parma I. To reach a more conclusive understanding of the relationship between these collections would require a separate full analysis of this transmission, beyond the scope of the present study.
On his life and work, see Robert Bonfil and Josef Ha-Cohen, Chronicle of the French and Ottoman Kings, vol. 1 (Jerusalem, 2020), 25–29. [in Hebrew]
Philadelphia, Lawrence J. Schoenberg MS 468, fol. 8r.
Towards the end of Philadelphia, Lawrence J. Schoenberg MS 468, the translation to Latin becomes more fragmentary. In the later extant manuscript of Meqitz, which dates to the sixteenth or seventeenth century. The text is only in Hebrew without the Latin translation: see Turin, Biblioteca Nazionale Universitaria MS A V. 10. On sixteenth-century medical education among Italian Jews, see David B. Ruderman, “The Impact of Science on Jewish Culture and Society in Venice (With Special Reference to Graduates of Padua’s Medical School,” in Gli ebrei e Venezia: secoli XIV–XVIII, ed. Gaetano Cozzi (Milan, 1987), 417–448, 540–542.