The Anatomy of a Mystery: Kohanim, Dissection, and Medical Training Throughout History

The Anatomy of a Mystery: Kohanim, Dissection, and Medical Training Throughout History

Rabbi Edward Reichman, MD

In September of 2024, I accidentally opened the portal to a priestly mystery. While searching for references to the first Jewish students to attend the University of Gottingen Medical School, I came across an antisemitic work published in 1753 about the general dishonesty of Jews and Jewish oaths.[1] Therein were a few disparaging references to Jewish physicians,[2] one of whom was named Lehmann Isaac Kohen. A parenthetical footnote,³ likely precipitated by the student’s last name, caught my attention. The author references an entry in a German newspaper from 1750 regarding Jewish members of the tribes of Aaron and Levi, ritual defilement upon exposure to the dead, anatomical dissection, and the training and practice of medicine.

Further research revealed that the antecedent to this 1750 reference was a brief entry in an earlier issue of the same German newspaper, Braunschweigische Anzeigen, from 1748,[4] posing a query for the readership:

Can one prove from the Old Testament, as well as from the Talmud, or other Jewish scribes, that a Jew from the tribe of Levi or Aaron cannot or may not become a doctor? And whether God has expressly forbidden this in the Old Testament?

It would be eighteen months until a response to this query was published:[5]

In chapter 21, verses 1-11 of the second book of Moses, it is written: The LORD spoke to Moses saying: Tell the priests, Aaron’s sons, and say to them: A priest shall not defile himself by contact with the dead among his people. If, therefore, the Levites are not permitted to approach any dead person and defile themselves thereby, it follows that they are not allowed to observe dissections of corpses or participate in such procedures. And since they are thus prevented from studying anatomy, which is the very foundation of medicine, it also follows that they cannot properly learn medicine and become true medical practitioners.

Brückmann. D.

As to the precipitant for this query, I can only conjecture. Was it perhaps an encounter of the editor with a Kohen who informed him of this idiosyncratic Jewish law as he contemplated attending medical school? I suspect not, and there is no evidence of such. While the city of Braunschweig (AKA Brunswick) did not have a medical school, there were numerous medical schools in Germany where, by this period in history, hundreds of Jews were attending.[6] More likely, it was a hypothetical academic theological question, albeit with some confusion and conflation of the tribes of Kohen and Levi, untethered to any specific reality.

Introduction to a Priestly Mystery

You may wonder why I draw your attention to this passage, which hardly seems novel. Anyone remotely familiar with medical halakha, or Jewish law in general, is certainly aware of the basic laws of purity as they relate to a Kohen. Yet, what is most extraordinary about these few lines, buried in an obscure German eighteenth century local newspaper, is that as far as I was aware at the time, this was the only reference to the issue of Kohanim, anatomy, and medical training in the pre-Modern era. Prior to the discovery of this passage, I had not encountered a single discussion specifically addressing Kohanim training in medicine in either Jewish or non-Jewish sources prior to the late nineteenth or early twentieth centuries.

The issue of anatomical dissection in medical training is a staple of contemporary medical halakhic discourse.[7] The first halakhic references to general anatomical dissection are in the late eighteenth century, with the famous responsa of the Nodah biYehuda and Rabbi Yaakov Emden, yet they contain no discussion about Kohanim.[8] I have recently uncovered clear evidence that the Jewish community of Padua was dealing with the halakhic issue of cadaveric dissection already since the very time of Andreas Vesalius (16^th century), long before the days of the Noda biYehuda, but also no specific reference here to Kohanim.

The question of Kohanim, dissection and the practice of medicine has been amply discussed in modern rabbinic literature.[9] Male members of the priestly tribe (Kohen-singular, Kohanim- plural) are proscribed from exposure to ritual impurity, the human corpse being the archetypal example. The prohibited exposure entails not just direct contact, but even being under the same enclosure as a corpse (tumat ohel). As hands-on human anatomical dissection, involving direct and prolonged exposure to a corpse, is a sine qua non of current medical training, the anatomy lab serves as a potential impediment for a Kohen interested in becoming a physician.[10]

Due to these halakhic concerns, numerous rabbinic authorities prohibit outright a Kohen from entering the medical profession, though others offer halakhically acceptable options. Indeed, when the Albert Einstein College of Medicine was established by Yeshiva University, the issue of offering admission to Kohanim was raised.[11] In an article written on the occasion of the first graduating class of Einstein, Myron Kolatch addressed the complex interplay of religion and medicine at the institution:

Frequently cited as an example of how the medical school violates the Torah is its willingness to accept students of priestly descent, kohanim. Leviticus, 21: 1-4 states: “And the Lord said unto Moses: Speak unto the priests the sons of Aaron and say unto them: There shall none defile himself for the dead among his people…

Clearly, the issue has never been settled beyond dispute, and Yeshiva’s policy that each kohen who wants to take up medicine must determine his own course, certainly does not indicate a blatant disregard for the Torah.

Some sixty years hence the halakhic landscape regarding Kohanim and medical school remains largely unchanged. There have been and continue to be Kohanim who attend medical school under halakhic guidance, with varied unique modifications.

Here I do not revisit the detailed halakhic analyses but address the historical contours of the discussions. According to Rabbi Bleich, one of the first halakhic authorities to raise the issue of Kohanim physicians and the prohibition of tumah was Rabbi Isaac Shmuel Reggio in 1854.[12] The context of the case was a Kohen physician who was tasked with confirming the death of a patient who was previously pronounced dead by another physician.13] This particular query was made in the historical context of a Western society that collectively questioned the ability of physicians to accurately diagnose death. As such, it was legislated in many European countries that after the initial preliminary diagnosis of death, a physician was legally required to confirm the diagnosis with serial exams over the next few days prior to burial. [14] In the aforementioned case, the physician chosen for this job happened to be a Kohen.[15]

In addition to this unique case, halakhic discussions regarding Kohanim and medicine have largely addressed two issues: 1) The propriety of a Kohen physician attending to a critically ill patient (gosses)[16] given the high probability of the patient’s demise and subsequent conveyance of impurity. 2) The permissibility of a Kohen physician, who in the course of his practice violates the prohibitions of tumah exposure, to participate in Kohen-specific religious ceremonies, such as bestowing the priestly blessing (nesiat kapayim). Even these discussions only begin in the halakhic literature of the 19^th and 20^th centuries, with nary a trace prior, and are limited to Kohanim who were practicing physicians. Contemporary halakhic discussions on the Kohen in medical training proceed with an analysis of primary sources and do not cite any responsa or any other references from the premodern era about a Kohen medical student.

If Jews have been training as physicians for millennia, with presumably many Dr. Cohens among them, how could it be that this halakhic topic seems to have escaped serious rabbinic or any historical treatment until so recently? How do we explain the conspicuous silence in the historical record?

As this source from the Braunschweigische Anzeigen seemed purely academic, is found in a non-Jewish secular periodical, and provided no additional references, it contributed little to our mystery. The portal to the priestly mystery had opened a crack, but no wider.

While this source was discovered serendipitously (i.e., hashgachah), surely a fresh dissection of the halakhic and historical literature today, given the expansive and easy access, would reveal many previously unknown sources addressing Kohanim, dissection, and medical training in the premodern era. Or perhaps not. After an extensive search, to date, I have identified exactly one single additional relevant source before the nineteenth century, albeit of significance.

This passage also derives from a non-Jewish source, the work of Carl Wilhelm Friedrich Grattenauer (1770-1838), a German lawyer and anti-Semitic publicist, though it records a Jewish exchange.

In 1817 Grattenauer published a work devoted entirely to the tribe of Aaron,[17] where in the context of ridiculing the archaic Jewish laws related to Kohanim, and lamenting the “obscurantism” of the Rabbis, we find the following passage:

The previous Chief Regional Rabbi Joseph Jonas Frånkel in Breslau, a generally recognized learned and scientifically educated man, had heard that the medical student HI, who also came from the tribe of Aaron, was preparing anatomy here[18] and was thereby contaminating himself according to the ritual law. He therefore summoned him and asked him whether he wanted to give up this anatomical activity, which was contrary to ritual law, or renounce his privilege as a Kohen to give the blessing. The student replied: I renounce this privilege. I would rather acquire a thorough knowledge of medicine and become a sufficient member of civil society. The Rabbi dismissed him… For 20 years, Mr HI has been one of the most skilled local doctors and he is still a Jew [despite the pronouncements of a fanatical Rabbanite].

Rabbi Joseph Jonas Frankel (1721-1793) served as the Silesian district rabbi. Assuming the veracity of the story, this remarkable exchange raises a number of questions: Was this a rare encounter, or did other rabbis engage in the same practice? Does this reflect Rabbi Frankel’s unique opinion, or the halakhic consensus of the time? Was there any room for leniency with respect to Kohanim training in medicine? HI was approached by Rabbi Frankel to address his halakhically concerning practice. Were there other Kohanim who proactively sought rabbinic consultation before applying to, or attending medical school? Was the response of HI typical of other Kohanim who encountered potential halakhic obstacles to medical training, or perhaps a reflection of the cultural milieu of his time.

All told, we have a grand total of two sources before the nineteenth century referring to Kohanim, dissection and medical training, both found in non-Jewish sources, and one of which is essentially irrelevant. I have yet to find any Jewish historical or halakhic sources. The priestly mystery thus still remains- How do we explain this historical “anatomical” anomaly? In this “priestly offering,” I suggest historical and halakhic reasons for this lacuna. I hope my offering will be accepted.

A Suggested Historical Solution

An understanding of the history of medical training, and in particular, of the training in human anatomy throughout the centuries, might assist us in providing an explanation for this glaring omission.

Apprenticeship versus University Training

Universities developed as educational institutions in Europe in the Middle Ages. With respect to medical training in general, in the Middle Ages and Renaissance, Jews were generally barred, with few exceptions, from admission to European universities, which were under Catholic auspices. Jewish physicians were therefore trained almost exclusively through apprenticeship. Postmortem dissection was not a part of apprenticeship training. As such, there would have been no specific halakhic problem for the Kohen medical trainee, and we would not expect to find any such reference in the literature.

Rav Moshe Feinstein, zt”l, in his discussion of medical training for the Kohen, posits a similar, though variant, explanation of the training of the Kohen physician in the past.[19] Rav Moshe prohibited the medical training of Kohanim today, unexceptionably, is it involved required exposure to tumat met. One parenthetical line in his responsum sheds light on our discussion.

ולא יקילו ממה שמצינו מרבותינו הראשונים שהיו כהנים והיו רופאים שהם בכוחותיהם הגדולים למדו כל חכמת הרפואה במסירת כל דבר בעל פה אף בלא שום ראיה והסתכלות במתים ולא נגעו במת מעולם ולא היו באהל אחד עם מתים, אבל בזמננו שא”א זה לכן ודאי אסור

And do not think to be lenient based on the fact that we find among our rabbis of earlier generations those who were both Kohanim and physicians; their exceptional powers enabled them to learn the entirety of medical knowledge orally without the necessity of even gazing upon a human corpse (i.e., practical anatomy lab). They never touched a corpse nor were they ever under the same enclosure as one. Today, however, when it is impossible to train in medicine [without the direct exposure to a human cadaver] it is prohibited.

Rav Moshe preemptively addresses a possible refutation of his position. If it is prohibited for a Kohen to train in medicine, how is it possible that we have a record of Kohen physicians in the past? Rav Moshe suggests that these Kohanim possessed exceptional abilities which allowed them to study medicine without resorting to the dissection or observation of human cadavers (and its resultant tumah exposure). Medical history supports this general idea. Indeed, all Jewish physicians through the Middle Ages, whether Kohanim or not, studied medicine through apprenticeship, without the need to dissect or even be under the same enclosure as a human cadaver.[20]

Priestly Physicians Throughout the Centuries- The Many Dr. Cohens

Who were these Kohanim physicians that Rav Moshe references? Zimmels[21] and Jakobovits[22] identify numerous Kohanim physicians throughout history, starting from Talmudic[23] times. Some of these priestly physicians provided medical care for kings, doges and popes. In fact, we have ample historical evidence of numerous Kohanim who practiced medicine over the centuries. Nathan Koren in his expansive registry of Jewish physicians has over fifty entries with the names Cohen, Coen, Cohn, Katz, Kohen, Kohn, Kahn, or Sacerdote (priest) ranging from the 15^th to early 19^th centuries.[24]

How did these Kohanim navigate their medical training? A simple explanation is that the majority of Kohanim, along with other Jews who were barred from the universities, trained through apprenticeship, effectively bypassing any halakhic concerns for anatomical dissection. Though there are no available statistics, despite the increasing acceptance and attendance of Jewish students at universities beginning in the sixteenth century, apprenticeship likely remained the predominant mode of medical training for Jewish physicians until the mid-seventeenth to early eighteenth centuries. As apprenticeship training involved no dissection, this would account for the absence of halakhic queries in the literature for this group.

Some Jews however elected to pursue a university education. Jews occasionally attended universities from the Middle Ages onwards, usually requiring special Papal or governmental permission.[25] While anatomy was clearly always part of medical education to varying degrees, and anatomical dissection was performed sporadically across the centuries, the introduction of systematic dissection of the human body as a required part of medical training fully developed only in the sixteenth century. Until this time, even if a Kohen wished to attend medical school, there would have been little halakhic concern.

The status quo would change in the sixteenth century under the guidance of Andreas Vesalius, a young Professor of Human Anatomy at the University of Padua. As divine providence would have it, the very university at which Vesalius established the field of anatomy was the first institution to officially allow, beginning even before the times of Vesalius, Jewish students to train in medicine. By the sixteenth century hundreds of Jews flocked there for this historically unprecedented opportunity.

Given the introduction of systematic anatomical dissection into the medical school curriculum in the 16^th century, how could a Kohen now navigate a university medical education? From this point in history, we would expect to see halakhic discussions about Kohanim attending medical school.

One might suggest that Kohanim, being knowledgeable in the potential halakhic pitfalls, simply refrained from becoming physicians once dissection became an unavoidable aspect of medical training. Indeed, Rabbi Jakobovits maintains that less Kohanim entered the field of medicine in the eighteenth century, a statement he buttresses with reference to articles about the matriculation records of some German universities (Frankfurt and Duisburg), and the low number of those with a priestly name as compared to the percentage of Kohanim in the general population: “Even today, the usual proportion of Jews bearing the name “Cohen” alone (others, too, may be of priestly descent) is at least 2-3%.” He adds that this lower percentage of Kohanim in medical school “can only be explained as reflecting the growing misgivings with which the choice of medical career by students of priestly descent was generally viewed.”[26]

While this may have been true in Germany in later centuries, the archives of the University of Padua reveal a different statistical reality. The archival record of Jewish graduates of the University of Padua from the early 16^th to the early 19^th centuries includes nineteen graduates with the last name of Coen or Sacerdote.[27]

Even if we concede that not all those named Coen, or derivatives thereof, were necessarily Kohanim, many certainly were. Below is the family crest of Samuele Coen as it appears in his Padua medical diploma from 1702.[28] Notice the image of the hand configuration used by the Kohen during the Priestly blessing.

In addition, there are eleven members of the Cantarini family, a family of Kohanim, who graduated as physicians from the University of Padua during this period. Below is the front page of the medical diploma of Grassin Cantarini (1703),[29] here again we find the Kohen’s symbol.

The percentage of Kohanim who attended Padua’s medical school, roughly thirty out of a total of some 350 for this period, is significantly higher than the average percentage of Kohanim in the general Jewish population.[30] How then do we explain the absence of discussion in the literature? It is certainly possible that these relatively few Kohanim, despite their high percentage of the total, simply did not inquire of rabbinic authorities. Alternatively, the few inquiries that did occur where not committed to writing, or did not survive the ravages of time.

More problematic is that some of the Kohen Padua graduates were outstanding Torah scholars and prolific authors, such as Isaac Hayyim Cantarini,[31] Tuviya HaRofe (AKA Tuviya haKohen),[32] and Abraham Sacerdote (AKA Avraham HaKohen).[33] Oe mnight have expected at least one of these scholars to address this issue somewhere in their writings. Yet, there is no mention in any of their extensive writings of any concern with their participation in the anatomy course. Indeed, while Tuviya fondly recalls his medical training in Padua in the introduction to his Ma’aseh Tuviya, there is no mention of any challenge with performing dissection as a Kohen. Cantarini, in his Pahad Yitzhak, devotes a section to a tragic case where a Jewish body was kidnapped by non-Jewish students for the dissection table. Again, no mention of any concern about Kohanim and dissection. In addition, we have an account of Cantarini bringing Abraham Levi, a visiting scholar to Padua, to see the anatomy theater to showcase the highlights of Padua.[34]

 

While we may not find the names of these three Kohen student scholars etched into the wooden planks of the structure, they all likely took their seats,[35] along with their other non-Kohen Jewish classmates, in the famous anatomical theater at the University of Padua, which was inaugurated in 1595 as the first permanent structure devoted to anatomical dissection, and is still standing to this day.

I suspect that the answer to the conspicuous omission lies elsewhere, based on the history of anatomical training in general, and at the University of Padua in particular.

The Nature of Anatomical Teaching in the Pre-Modern Era

A mention of anatomy lab today evokes an image of a small group of students huddled over a body with dissecting instruments in hand. We also often find reference to the anatomy students designating a name for their cadaver, as they dissect one body for the entire course. Unlike the anatomy labs of today, in pre-Modern times body preservation technologies were not available, and a corpse was only usable for a few days to weeks. The dissections or yesteryear were held in an “anatomical theater.”[36] The format of anatomy teaching involved the professor alone performing the dissection and teaching over the body while others merely observed. Students did not perform any hands-on dissection, partially because there was little time until the decomposition of the body, and thus had no direct contact with the corpse. This can be seen in the frontispiece of Vesalius’ classic work:

This is also reflected in the design of the anatomical theater in Padua, which was built shortly after the tenure of Vesalius, and can be visited today.

There is a central oval table surrounded by coliseum-like concentric rows of progressively elevated platforms. This basic architectural design was copied for other anatomical theaters across the world, such as those below:

University of Bologna: Anatomical Theater (est. 1636)

University of Leiden: Anatomical Theater (est. 1594)

This illustration is from 1610. Parenthetically, the Keeper of the Anatomical Theater of Leiden from 1617-1650 was Professor Otto Heurnius.[37] Heurnius was the promoter for the medical graduation of David de Haro,[38] the first Jewish medical graduate of the University of Leiden.

By the mid 1600’s Jews started attending the University of Leiden in higher numbers. We have numerous matriculation records of Jews with the name Cohen.[39]For example:

Samuel Cohen from Hamburg matriculated to the medical faculty (M) in September 1646.

A Pure Solution

As a medical student in the anatomical theater served only as an observer, and performed no actual dissection, there would have been no concern for impurity conveyed through direct contact with a corpse. The only potential concern for a Kohen in the anatomical theater would have been tumat ohel, whereby impurity is conveyed by being under the same enclosure as a cadaver. While there is general halakhic consensus that impurity conveyed by direct contact applies to the bodies of both Jews and non-Jews, there is a halakhic debate regarding whether a non-Jewish corpse conveys tumat ohel.[40] It is certainly possible that the Kohanim who attended the lectures in the anatomical theater of Padua (and in anatomical theaters at other universities at this time) relied on the permissive position that a non-Jewish corpse does not convey tumat ohel. This would have allowed them to attend dissections without violating any halakhic precepts.

However, there still remained at least a theoretical possibility that the cadaver would be Jewish, in which case the permissive option would no longer apply. For a unique historical reason, this concern was non-existent for the anatomical dissection course at the University of Padua. In fact, the university struggled to provide cadavers for the course and turned to each community represented on campus, including the Jewish community, to provide bodies for the dissection table. However, the Jewish community adamantly refused, citing religious concerns with postmortem dissection. While there was continuous tension about this issue, the Jewish community arranged an agreement to provide large sums of money annually to the university for the privilege of releasing the Jewish community of this obligation. This general agreement, with periodic reassessments and renegotiations, essentially remained in force for some two hundred years.[41] Thus, all the Coens and Cantarinis who attended the University of Padua did not have to worry about the possibility that the cadaver under the scalpel of Vesalius or Fallopius was Jewish.

The Architectural Design of the Padua Anatomical Theater

Moreover, a unique structural feature of the Padua anatomical theater may have further mitigated any potential halakhic concern for a Kohen wishing to study medicine at Padua. The original anatomical theater had a retractable roof[42]  which was opened during dissections to release or eliminate the foul odors of a progressively decaying cadaver. Thus, even tumat ohel may have been a non-issue as in the absence of a roof there would have been no halakhic enclosure to convey impurity. This would have virtually eliminated the halakhic obstacle for a Kohen medical student.

An Alternate Solution for Kohanim

What of a Kohen desirous of a university medical education who would not rely on a permissive ruling regarding tumat ohel and the non-Jewish cadaver? By the 17th century, medical schools struggled to acquire enough cadavers to meet the growing demand of anatomy students. The need to provide a nonperishable substitute led to the production of highly accurate anatomical wax models that were sculpted through direct observation of dissected cadavers. Such models had distinct advantages, as they neither decomposed nor emitted foul odors and were continuously available. They proved essential to the education of generations of medical students who would otherwise, due to the short supply of cadavers, not have access to the anatomical education gleaned from human dissection.[43]

Spectacular wax models were produced throughout Europe, especially in Italy and England, from the seventeenth to nineteenth centuries, some of which can be seen to this day in Museums in Florence (La Specola), Bologna and London.[44]

This seems to me to be an ideal solution for a Kohen who wished to train in medicine in the Early Modern period. The use of wax models, with no human cadavers involved at all, would pose no halakhic problem whatsoever. While I am unaware of any Kohen medical student who ever took advantage of this option, the modern iteration of this concept, as we discuss below, may entirely replace cadaver dissection.

Kohanim in Medical School from the Eighteenth Century Onwards

From the eighteenth and into the nineteenth century, apprenticeship became less accepted and university training was often required for licensure. As a result, Jewish admission to medical schools increased exponentially throughout Europe and the United States. In addition, the anatomy labs began to transition to hands-on dissection for all students. This was simultaneously accompanied by a major cultural movement in Germany, the main location of Jewish medical training at this time, known as the Haskala. This movement was associated with the decreasing religiosity of at least a percentage of the Jewish university students, not to mention the conversion of some to Christianity. A family name of Cohen on a matriculation record in this period, even if identified, is certainly no guarantee of a student knowledgeable or concerned with the issues of tumah.

How would a Kohen navigate medical training in this milieu? The student encountered by Rabbi Frankel in Breslau was training precisely in this context, at the end of eighteenth century. Was the student known by his initials “HI” training in a medical school where he was required to perform hands-on dissection, and this is perhaps why Rabbi Frankel ruled as he did; or perhaps the medical school still had an anatomical theater, as many still did, and Rabbi Frankel did not accept the permissive ruling that tumat ohel does not apply to a non-Jewish cadaver. Was “HI” influenced by the newly forming Haskala movement in Germany at that time, which led him to be less deferential to rabbinic authority?

Two additional examples of Kohanim and medical training from the nineteenth century are illustrative. We have at least one record of a “Cohen” in the early nineteenth century refusing to go to medical school because of the required anatomical dissection. A young Albert Cohen, originally from Paris, describes his initial encounter with anatomical dissection in Vienna in the early nineteenth century:[45]

I went to Vienna, where I pursued my studies at the grammar school and university from 1826-1834. Being now nineteen years old, it became necessary to decide what profession I would adopt. Hitherto all young people of my native place who devoted themselves to literature studied medicine; this was then the only profession open to me. To please my parents, I would have followed the same career, had I ever been able to prevail upon myself to dissect a corpse. Several times I entered the anatomical theatre, but each time I was seized with unconquerable disgust. I therefore requested my parents to allow me to follow my own taste. Henceforth I devoted myself to the study of Oriental languages.

I suspect the parental conversation about his career change may have been a bit more dramatic than reflected in this passage. Nonetheless, we learn that it was anatomy that turned this young Jewish Kohen student away from a career in medicine, though it does not appear to have been halakhically motivated.

Around the same time, Sigismund Cohen, a native of Lower Silesia, the area of modern-day Poland and the rabbinic domain of Rabbi Joseph Jonas Frankel a few decades earlier, attended the University of Viadrina (Frankfurt), graduating in 1846. The topic of his dissertation- Talmudic Medicine:

For a Jewish medical student to write a medical dissertation on a Jewish topic was quite uncommon, to say the least.[46] It is somewhat ironic that a thorough analysis of Biblical and Talmudic law might have led Cohen to the realization that there was a potential halakhic issue with his training and may have preempted the necessity for Cohen to write this dissertation in the first place. Nevertheless, as this dissertation is remarkable on many levels, I offer a few comments.

From a medical and medical historical perspective, Cohen acknowledges his professors by name, one of whom was Jan Evangelista Purkinje, who taught him human physiology. Purkinje, a Czech anatomist and physiologist, was one of the most famous scientists in Europe and his discoveries included the so-called Purkinje Cell in the cerebellum and the so-called Purkinje fibres in the electrical system of the heart, structures familiar to any medical student today.

This dissertation also has great significance in the field of Jewish medical history. While we do not know with certainty the nature of Cohen’s Jewish knowledge and religious observance, the dissertation includes a brief biography as an appendix. An excerpt about his early education is below:

While we find reference to the study of “Pentateuchi origine” and “grammatice Hebraica,” Talmudic study is not specifically mentioned, and there is clearly a strong educational focus on secular studies. The 28-page dissertation itself however contains a wealth of Talmudic references.

I also draw attention to three specific sources cited by Cohen, one from a century earlier, the others contemporary.

1) Benjamin Wolff Gintzburger, Medicina ex Talmudicis, inaugural Dissertation 1743

Benjamin Wolff Gintzburger was one of the first Jewish graduates of the University of Gottingen. It was my search for references to Gintzburger that precipitated this contribution.[47] His medical dissertation, referenced by Cohen, is one of the first works written on Biblical and Talmudic medicine.[48]

Apropos our discussion about dissection, Gintzburger is better known in the halakhic world as the questioner of a (now famous) teshuva to Rabbi Yaakov Emden about performing anatomical dissection on Shabbos.[49]

2) Abraham Hartog Israels, Tentamen hist.-med. Exhibens Collectanea Gynaecologica ex Talmude Babylonica (Grongen, 1845)

Israels graduated from the University of Groningen in 1845, just a year before Cohen, and the topic of his dissertation was obstetrics and gynecology in the Babylonian Talmud.

This dissertation gained notoriety for its fourth chapter, on Cesarean section, which suggests that the rabbis of the Mishnah were able to perform cesarean section with maternal survival, something not recorded in secular medical history until around 1500. This was based on an interpretation of a Mishna in Bechorot.[50]  Cohen discusses this chapter in his dissertation.

3) Eliakim Carmoly, Histoire des Médecins Juifs, Anciens et Modernes (1844)

Carmoly served as the major work of reference in Jewish medical history for this period. Selections were translated into English just one year after publication.[51] While the reliability of Carmoly’s work was called into question by critics,[52] it nonetheless contains a wealth of valuable information.

Returning to our student, regarding Cohen’s presumptive status as a Kohen training in medicine, he devotes a chapter of his treatise to anatomy and cites a passage in the Talmud where dissection was performed.[53] More relevant, in his bio, he includes mention and thanks to those who assisted him during his studies in the anatomical theater:

Anatomical dissection did not appear to be an impediment for this Cohen. However, there is one observation, admittedly a possible over-read or mistranslation, which may indicate specific accommodations for Sigismund in his dissection course.[54] In his lengthy list of professors, Cohen simply mentions the subject and the professor. In his mention of the anatomical theater, he adds, “in the anatomical theater there were guides for me….” Could this possibly be an allusion to specific accommodation provided to Sigismund? Perhaps his professors performed the dissection while he observed but did not touch the corpse directly.

Conclusion: The Opening and Reclosing of the Priestly Portal

Halakhic references to a Kohen attending medical school are noticeably absent from rabbinic literature before the nineteenth century. We have suggested plausible explanations for this anomaly. For much of history, Jewish physicians trained through apprenticeship where formal anatomical instruction was not required. As such, there would have been no halakhic issues for a Kohen, as noted by Rabbi Moshe Feinstein. When Vesalius introduced the comprehensive anatomy course into the medical school curriculum, dissections were performed in anatomical theaters, where students never touched the cadavers. At least some Kohanim may have relied on the permissive ruling that non-Jewish cadavers do not convey tumat ohel. When hands-on dissection became the norm, as Rabbi Lord Jakobovits suggested, it is certainly possible that many religiously observant Kohanim elected to bypass medicine as a career choice, or were perhaps discouraged to do so by local rabbis like Rabbi Frankel. Of the Kohanim who opted for a medical career, some may have sought rabbinic approval, though no records exist. Others, whose priestly-sounding names appear in university matriculation records of the period, may have been less Jewishly educated or less religiously observant. Hence no halakhic questions would have been generated from this latter group.

The portal to rabbinic discussion on this topic only fully opened in the twentieth century. In the modern era we have a diverse halakhic landscape regarding the training of Kohanim in medicine, including discussion about the permissive ruling of tumat ohel, as well as creative solutions to potentially allow direct dissection. I leave these discussions to each Kohen student and his posek but leave you with a final thought.

Given current advances and changing perspectives in anatomical training, we may again soon see the portal close to the corpus of responsa related to the Kohen medical student. Some five hundred years after Vesalius introduced anatomical dissection into medical training, which was accompanied by the exhumation of bodies from their graves, we are now on the cusp of the (re)burial of human anatomy lab and its associated cadavers. With advances in imaging technology and simulation, coupled with the ethical re-evaluation of body procurement methods and preservation, the expansive year-long anatomy course with full body dissection is rapidly becoming a relic of medical history.[55] The classic dissection table is gradually being replaced with the likes of the digital Anatomage table:

If this is not sufficient, it is now possible to produce life-like anatomical models with the use of 3D printing.[56] Even dissection of the model may be possible.

These conceptual descendants and updated versions of the Florentine wax models may soon replace cadaveric dissection altogether.[57] The list of medical schools eliminating or significantly curtailing human anatomy lab courses is continually expanding.

While the impact of the diminution of human dissection on medical education remains to be determined, if phased out, it will certainly have a significant halakhic impact and it may return us to the days of the earlier generations mentioned by Rav Moshe Feinstein when students “learn the entirety of medical knowledge without the necessity of gazing upon a human corpse.” This would potentially open the door for Kohanim to attend medical school (at least for the pre-clinical years) with halakhic impunity.[58] We may notice a commensurate rise in the number of Dr. Cohens in hospital registries. The medical halakhic textbooks may no longer include a chapter on “The Kohen in Medical School,” and the halakhic discussions on this topic may again fall silent. If future scholars at some later stage of history ponder the priestly mystery of the intermittent silence of the historical record on Kohanim, dissection and medical training, I suspect their search engines will direct them to this article.

Appendix:

The Importance of the Study of Broadsides in Jewish (Medical) History – The Kohen Physician Today and the Diagnosis of Death

In June of 2024, I participated as a speaker in a conference entitled, “The Role of Broadsides in Jewish Ritualistic and Cultural Space,” organized by Professor Avriel Bar-Levav of the open University of Israel and held at the new National Library of Israel. It was the first conference of its kind, dedicated solely to the integration of Broadsides into the study of Jewish history. Taking a single printed page (the definition of a Broadside) out of Avriel’s playbook, I briefly share an example of the value of Broadsides for the study of Jewish medical history, as it relates to our topic.

As mentioned in the article above, one of the earliest halakhic sources relating to a Kohen and the practice of medicine addresses the case of a Kohen physician who was asked to confirm the death of a patient in order to facilitate burial. The question was asked in the nineteenth century, in the medical historical context of a generation concerned about the misdiagnosis of death and the resultant institution of a three-day delay in burial to medically confirm a patient’s demise.

While the prolonged delay in burial may be a relic of the past, the necessity to confirm death remains a part of modern medical practice. As such, similar halakhic cases of a Kohen physician involved in the confirmation of death occur to this very day. I share one example here which reflects yet another fascinating and complex chapter in Jewish medical history, evidenced by a broadside found in a miscellaneous collection of broadsides in the Library of Congress.

In 1976 Rabbi Moshe Lemberger was asked about the case of an observant Kohen physician who witnessed a cardiac arrest of a man on the street.[59] The person did not survive. While it is generally prohibited for a Kohen to come in contact with a corpse, if this physician were to officially declare death of the person on the scene, and attest to the absence of foul play, the deceased would be transferred directly to the funeral home for immediate burial.

As per the questioner, if the Kohen physician refused to intervene, the patient would be transferred to the hospital. Burial would certainly be delayed, and in addition, there would be a high likelihood of autopsy, with organs often removed from the deceased without consent. Rabbi Lemberger concluded that this would constitute a case of met mitzvah (a deceased person with no one to attend to their burial), and due to these extenuating circumstances, the Kohen could expose himself to impurity to prevent the delay of burial and likely desecration of the body.

This comment “and often organs are removed from the deceased without consent” reflects a reality in Israel at this time.[60] When Israel established its own hospitals and medical system in the early twentieth century, it struggled to navigate a halakhically acceptable path for the allowance of autopsies, an integral part of standard medical practice. While detailed guidelines for the performance of autopsies were established with rabbinic guidance, many members of the medical community rejected any restrictions on their practice. Despite the legislation, the medical establishment flagrantly disregarded the laws and were known in many cases to perform autopsies, including organ removal, without patient or family consent. This evolved into a notorious autopsy scandal in the young State of Israel, which shattered faith in the medical establishment, with reverberations felt to this day. This ultimately resulted in the reformation and greater enforcement of the law.

I recently discovered a lone broadside buried in a miscellaneous collection housed in the Library of Congress,[61] which though undated, was likely printed around the time of the above responsum.

This Broadside was clearly intended to be posted in a cemetery and is divided into two sections.

On the left side is an accusation that the deceased more likely than not underwent an autopsy upon their death, and that the remaining relative, the likely reader of the broadside, did nothing to prevent it.

Dear Brother,
You are now standing beside the grave of your relative who was dear to your heart and whose flame of life was suddenly extinguished.
We wish to ask you if you have considered the possibility that your loved one has undergone extensive dissection [autopsy] and while the body is here, who knows the location of the internal organs of the body. Perhaps they never merited to a proper burial (more than 50% of bodies are dissected in Jerusalem).
What did you do to prevent this from happening?
As you stand beside the grave, the deceased beseeches you to repent for this. How will you answer?
The answer:
Accept upon yourself to protect your loved ones in the future. With all your power and capability seek to prevent the forced dissection by pathologists done merely for personal advancement.
Do this for the honor of both the living and the dead.
Committee for the protection of the honor of man

On the right side of the broadside is a text to be recited by the remaining relative asking forgiveness from their deceased loved one for allowing them to undergo an autopsy.

This unique broadside contributes to the study of the history of autopsies in Israel, provides valuable information possibly not attainable elsewhere, and adds to the relatively few items of material culture in Jewish medical history.