The Physicians of the Rome Plague of 1656, Yaakov Zahalon and Hananiah Modigliano
Reclaiming a Long-Lost Role and the
Only Known Example of Father and Son Diplomas

By Edward Reichman

Ellen Wells of the Smithsonian Libraries wrote,[1] “The plague of Rome of 1656 was one of the best recorded medical events of the 17^th century. It was referred to in most major political and ecclesiastical histories, in diplomatic correspondence and in personal memoirs. Books and pamphlets were issued in profusion. Commemorative prints were published …” The Jewish physician Yaakov Zahalon[2] contributed to this documentary phenomenon from the Jewish perspective.[3] Zahalon is one of the most famous physicians in Jewish history, and his book Otzar HaHayyim, published in Venice 1683, is one of only few original Hebrew medical treatises written in the premodern era. Therein, Zahalon added to the personal memoir genre of the plague.[4]

In the context of his discussion of pestilential fevers and plague, Zahalon records his recollections, both medical and non-medical, of the Bubonic Plague in Rome of 1656.[5] This passage is well-known and has been partially translated by Friedenwald.[6] It is in this passage that we read of Zahalon preaching from the balconies of the Rome Ghetto due to the closure of synagogues during the plague, an account recalled frequently over this past year.[7]

Zahalon was clearly present and practicing medicine in Rome during the epidemic, as he mentions a first-hand encounter with a patient, Shabtai Kohen, who died with fever and groin swelling, typical of bubonic plague. Zahalon diagnosed an intestinal hernia, despite the insistence of the non-Jewish physician that the patient had succumbed to plague. A diagnosis of plague would have necessitated quarantine of Kohen’s entire household. A postmortem exam confirmed Zahalon’s diagnosis. Yet, Zahalon’s exact role during the plague has remained elusive.

Regarding the administration of medical care in the Ghetto during the plague, Zahalon identifies a number of medical roles. An isolation house, called a Lazaretto, was set up in the Ghetto to accommodate those afflicted with plague.[8] The medical care in the Lazaretto was provided by Samuel Gabai, and his father, Ciroccio (Mordechai), who succumbed to the plague.[9]

Zahalon discusses the division of the ghetto into three sections, each with its appointed physician.[10]

The three physicians who equally divided the medical care of the city were Hananiah Modigliano, Gavriel Lariccia, and Yitzhak Zahalon. Who were these three physicians?

On Lariccia, I have found no additional information, and it is possible that this mention by Zahalon may be the only historical record of his existence. As recorded by Zahalon, Lariccia died during the plague.

On Modigliano, we are fortunate to have archival material. Hananiah Modigliano was a graduate of the University of Siena in 1628 and was one of a mere eleven Jewish graduates from this university from the years 1543 to 1695.[11] His medical diploma is extant and housed in the Jewish Theological Seminary Library.[12]

The invocation reads “In Dei Nomine Amen” (in the Name of God, Amen). While I have not seen any other diplomas of this period from the University of Siena,[13] there are a number of extant medical diplomas from this period issued by the University of Padua. The typical Padua diploma invocation reads “In Christi Nomine, Amen” (in the Name of Christ, Amen). The only diplomas that deviated from this norm were those of non-Christian students, in particular diplomas of Jewish graduates. Virtually every Jewish graduate’s diploma begins with the invocation, “In Dei Aeterni Nomine.” It is possible that the University of Siena made the same accommodations for its Jewish graduates as did Padua, few as they may have been.[14] Modigliano was also identified as a Jew in his diploma, with the word “Hebreo” appearing after his name:

This was also commonly found in the diplomas of the Jewish graduates of Padua, where the word “Hebreus” or “Iudeus” would typically, though not always, follow the name of the Jewish graduates.

We next hear of Modigliano on August 14, 1650, when upon the departure of Rafael Corcos,[15] the Roman Jewish community appointed three new worthy teachers, one of whom was the doctor Hananiah b. Rafael Modigliano.[16] As reported by Zahalon, Hananiah tragically died while serving as a physician for the Jewish community in Rome during the Bubonic Plague of 1656.

Modigliano’s son Raphael was also a physician, as well as a rabbi.[17] Extant medical diplomas of Jewish students are exceedingly rare, yet in this case, we are fortunate not only to possess a copy of Hananiah’s diploma, but we also possess the diploma of his son Raphael as well.[18] This is the only known case of extant father and son diplomas. A copy of his medical diploma from the University of Ferrara in 1662 is below:[19]

The invocation, similar to his father’s diploma, reads, “In Dei Nomine, Amen,” and he is likewise identified as “Hebreus.”

Of note, the document explicitly restricts his medical practice to Jewish patients.

We also have record of Raphael delivering weekly Shabbat sermons in the synagogue in Siena. Moses ben Samuel ben Bassa of Blanes records in his manual for preachers, Tena’ei ha-Darshan,[20] that both he and Raphael Modigliano would deliver weekly sermons, after which they would each provide constructive criticism of the other’s sermon.

What of our third and final physician, Yitzhak Zahalon? Regarding the third of the Jewish plague physicians for Rome in 1656, the author does not reveal additional details about him, despite their sharing the same last name. A few sentences later, however, Yaakov Zahalon enumerates the fatalities of the plague at around eight hundred deaths and mentions his cousin, the young skilled surgeon, Yitzhak Zahalon, amongst the casualties.

This has led at least one scholar to identify the physician in charge of one third of the city as the same Yitzhak Zahalon, the surgeon and cousin of Yaakov, the author. Sosland writes, “Three Jewish doctors are mentioned by Zahalon as having charge over the patients. One of them was a first cousin of our author, a certain Isaac Zahalon, a “skilled surgeon” who died toward the end of the epidemic.”[21]

With the physicians in charge of the medical care of the Lazaretto, as well as the different sections of the Ghetto, accounted for by name, we are left to wonder about the role, if any, the author, Yaakov Zahalon, played during the plague. As Sosland notes, “as to the exact role Jacob filled, we have no direct knowledge.”[22]

Zahalon’s medical work was published in Venice in 1683, and unlike the work of his rough contemporary, Tuviya Cohen, whose Ma’aseh Tuviya has been reprinted numerous times, has not yet merited even a second printing.[23] There is however one extant manuscript of Zahalon’s Otzar HaHayyim housed in the Vatican,[24] dated from no later than 1675, and it is in this manuscript that we find the solution to the riddle of Zahalon’s role in the administration of medical care to the Jews in the Rome Ghetto during the plague.

The manuscript appears to reflect that Otzar HaHayyim was initially part of a larger multi-section work entitled Ohalei Yaakov Otzar HaHokhmot. Zahalon’s medical work is labelled as section two, Hokhmat HaRefuah, the only section in the Vatican manuscript.

Below is the section describing the division of the city into three sections, each with its respective physician.

There is one key difference in this passage between the printed edition and the manuscript version. The physician in charge of the third section of the city is not Yitzhak Zahalon, whose identity is ambiguous, but rather, Yaakov ben Yitzhak Zahalon, none other than the author himself! A part of the name was accidentally omitted in the printed work. Zahalon refers to himself here in third person. This correction now facilitates a better understanding of the next sentence in the text, in which Zahalon continues to refer to himself, expressing gratitude to God for having rescued him from the ravages of the plague.

In this vein, I conclude with a comment on Zahalon’s conclusion to his plague passage. Despite the unspeakable tragedies experienced by the Jewish community, Zahalon ends his plague discussion by sharing a positive, though bittersweet, thought reflecting the continuity of the Jewish community:

As a good sign for the people of Israel, a pregnant woman named Zivia, the wife Yitzhak Mondolfo, contracted the plague, and though confined to the Lazaretto, was able to deliver a healthy child, whom she was able to nurse for a period before her demise. In the final line of this section in the printed work, we read that the child was still alive “until today,” and that his name was Efraim Levi. Though Zahalon’s book was published in 1683, this line appears in the manuscript, thus “until today” would be some twenty years after the plague.

While this indeed is some form of consolation, the manuscript adds an additional sentence which yields a far more powerful conclusion.

“And the circumcision was performed there (in the Lazaretto), and I say to you by your blood you shall live, and I say to you by your blood you shall live.” Zahalon concludes with the phrase from Yechezkel 16:6 which is traditionally recited as part of the circumcision ceremony. The allusion here to the plague is obvious.

Omitting this last sentence denies us not only the additional factual information about the performance of the circumcision in the Lazaretto, itself a remarkable event, but also Zahalon’s homiletic flourish which marked the community’s (re)birth after the tragedies of the plague. As I write these words, we are still in this midst of the Covid 19 pandemic, though the dissemination of the vaccines portends, God willing, for its cessation in the near future. These final intended words of Zahalon resonate deeply with us today, perhaps even more so than they would have when Otzar HaHayyim was published, some three decades after the plague.