Philip De la Cour (1710–1785),a Jewish Physician in eighteenth-century London and Bath

Abstract

Portugal exiled its Jews in 1497. In 1536, the Portuguese Inquisition began to persecute Jews who continued to practice their religion in secret. It became difficult for the secret Jews to leave Portugal, but small communities of emigres grew up around Europe, especially in London, Amsterdam and Salonica (Thessaloniki), and beyond. As the Portuguese Inquisition became more active in the early decades of the eighteenth-century, Jews, who had been accustomed to practising their religion in secret, while outwardly conforming to Catholicism, were again sought out for persecution. Philip De la Cour's parents escaped from Portugal and arrived in London around 1707 and his eventful life in London and Bath illustrates many of the aspects of eighteenth-century Jewish medical life.

Keywords

Portuguese Inquisition Jews medicine pharmacy London Bath

Philip De la Cour was born as Abraham Gomez Ergas in London in around 1710, the son of Portuguese Jewish refugees. The first mention of his father, David Gomez Ergas, in the records of the synagogue in London dates from 14 September 1707.¹ Growing up in London, with pretensions to study medicine, he would have come under the influence of the Venice-born Haham (Chief Rabbi) of the Portuguese Jews in London, David Nieto (1654–1728). Nieto, a medical graduate of the University of Padua, had practised as a physician and as a rabbi in Livorno (Leghorn) and was regarded as equally distinguished as philosopher, physician, poet, mathematician, astronomer and theologian.² In London, he showed himself sensitive to the religious outlook of those returning to Orthodox Judaism, with much of its belief system unfamiliar to the refugees, while stressing his opposition to Spinoza's views.

In Portugal, as those who professed Judaism in secret were outwardly Catholic, they were free of the religious restrictions which prevented Jews from studying and graduating in medicine at most of Europe's universities through the Middle Ages into the early modern period. However, as his parents were former Crypto-Jews in Portugal, Ergas would have been unable to reclaim a Catholic identity to permit him to study there. As no Jew had yet studied at a British university, far less obtained a medical degree in Britain, he went to Leyden in 1730 where he graduated in 1733 with a thesis related to natural menstruation (De Naturali Catameniorum Fluxu). Leyden, like the other Dutch universities, had began to accept Jews to study and graduate in medicine from the middle of the seventeenth century and by 1730, it would have been the first choice for intending Jewish physicians from Britain. Ergas was a student during the era of Herman Boerhaave (1668–1738) whose innovative programme of clinical teaching was responsible for Leyden's prominence as a centre of medical education.

It was not until 1739 that Jacob de Castro Sarmento, another refugee from the Portuguese Inquisition, became the first Jew in Britain to graduate in medicine in Britain receiving the Degree of MD from Marischal College, Aberdeen.³ This was under a regulation which permitted the College to award the degree to someone who had completed a full course of undergraduate studies and could supply affidavits testifying to their practice of medicine. Sarmento, became a leading figure in British medicine, composing many scientific papers and introducing quinine to Britain. He had arrived in Britain as a medical graduate from the University of Coimbra, studying at a time when he was outwardly a Catholic. Ergas needed to attend a degree awarding medical school and none were open to Jews in Britain until the University of Edinburgh began admitting Jewish students in 1769.

Now known, after graduation, as Philip De la Cour, he started practising in London where he was involved in various aspects of the Jewish medical charities for the poor. There is no obvious source for this choice of name, though he may have considered that a less Portuguese name might help his professional career. The members of the Portuguese Jewish community were concentrated in the Aldgate area of London, mostly around Creechurch Lane site of the first synagogue in England, after the Jewish return in 1656.⁴ Records show a Dr Lacour in Aldgate without giving a precise address.⁵ Around this time, he married Ribca (Rebecca), the daughter of the surgeon Dr Abraham (Francisco) Machado de Sequira (1666–1747), who had been born in Rio de Janeiro. He came to Portugal to study medicine at the University of Coimbra from 1680 to 1683.⁶ He was accused by the Inquisition for Judaising in Lisbon in 1709 and sentenced to imprisonment, confiscation of property, wearing of penitential clothing, instruction in the Catholic faith and spiritual penances. He eventually arrived in London in 1731 where he was also involved in the Jewish medical and welfare charities in London.⁷

This was a period of rapid growth in the community and of its poor requiring additional provision of medical care. Most of the Jewish doctors of Portuguese origin in the eighteenth century practised in London mainly involved in the charity for the care of the Jewish poor in the capital. This gave a stipend of £20 a year, with accommodation provided and included a free supply of coal.

The Bet Holim (Hospital)

In 1747, the leaders of the Portuguese community were resolved to establish a hospital for the Jewish poor and a committee of management was set up in October of that year.⁸ There was a perceived need to provide the poor with decent conditions during illness, including proper food, nursing care, bedding and other necessities. The plans for the hospital indicated a need for around a dozen beds and about 11 beds were regularly occupied.⁹ It was situated in rented premises in Leman Street near Whitechapel Road and was among the first of its kind in the Jewish world. It was a bold move for the small Portuguese community, showing their medical facilities to be far in advance of those in the larger Ashkenazi community, comprising Jews of mainly German origin. There was also a proposal to establish a dispensary for ‘families of middling circumstances’ and three doctors, namely Sarmento, De la Cour and Joseph Vaz De Silva, had all agreed to provide their services to the new institution without ‘fee or reward’.¹⁰ Sarmento and De la Cour presented some ideas on how the hospital should be run based on the experiences of recent developments with other hospitals in London.¹¹ The hospital opened in early 1748 when De la Cour joined Drs Sarmento and Vaz on the committee.

The Bet Holim's Medical Committee consisted of the two physicians and a surgeon as well as subscribers.¹² The first medical personnel were three members of the congregation: the physicians Castro Sarmento and De la Cour and the surgeon Jacob de Castre, who had already been employed as the apothecary but provided his services as surgeon free of charge. The three were closely involved in all aspects of the planning of the hospital, and, in appreciation of their generosity, they were named founders (or subscribers) of the hospital, without payment of the subscription fee, which gave them the right to attend the meetings of the hospital directors. The physicians' decision-making was therefore limited to medical matters only, such as the appointment of the two midwives.¹³

During the planning stage of the hospital, Sarmento and De la Cour requested that they be allowed to insert their own set of regulations into the Bet Holim practices, based on their medical knowledge, but the committee were unwilling to give the doctors the clinical and administrative freedoms they sought. Tensions between the doctors and other governors are evident in the records, as the hospital governors and the synagogue elders wanted to make decisions on their own, without consulting the doctors.¹⁴

Unfortunately, the hospital soon encountered difficulties. There were financial deficits, which Sarmento initially made good from his own funds, and in 1749 the apothecary was suspended over allegations of impropriety. There was also criticism of a decision made by Sarmento and De la Cour that only members of the Portuguese community, and not of the Ashkenazi community, be admitted to the hospital. The controversy attracted widespread community concern. A lampooning engraving appeared depicting a meeting of the Bet Holim Grand Committee where leading medical figures in the hospital appear as characters from classical medical history.¹⁵ Sarmento is portrayed as Hippocrates and De la Cour is Galen who is given a couplet to recite in a mixture of Spanish and Italian (Figure 1).

Figure 1.

The scurrilous engraving attacking the leadership of the Bet Holim, the hospital of the Portuguese Jewish community in London. Dr De la Cour is shown as Galen, standing on the left (number 7).

A spoof play, also highly critical of the hospital's management and doctors, entitled The Jerusalem Infirmary, or a Journey to the Valley of Jehosaphat appeared in print though it was never performed.¹⁶ There is speculation that the anonymous author is one of Sarmento's professional enemies, though opposition may have come from community members who were concerned with the long-term financial implications of running a hospital. While the accusations were damaging, such scurrilous attacks were understood to be part of life, and it did not prevent the functioning of the hospital. Indeed, the professional manner of the conduct of the hospital ensured the viability and ultimate longevity of the project.

One sign that people had moved on was the publication, in 1749, by De la Cour and Jacob de Castro Sarmento of a pharmacopeia (Pharmacopeia Contracta in usum nosocomii ad pauperes e gente lusitanica curando nuper istituti) for the treatment of poorer members of the Jewish Portuguese community in London¹⁷ (Figure 2). The title page of Pharmacopeia Contracta just refers to their initials (JdeCS and PdeL) and the 99-page volume was published in Latin, the language used in British Pharmacopoeias until 1788. In some eighty of its pages, Sarmento and De la Cour outline around 140 preparations, with details on weights and measures and instructions on how to prepare the more complex medicaments. The work, intended to be an alternative to the recently revised London Pharmacopoeia of 1746 and the better regarded Edinburgh Pharmacopoeia of 1744, is prefaced by a guide to using the work. This aimed to simplify the making of the preparations while it also points out that the medicaments chosen will be found to be relatively inexpensive.¹⁸ It also represented the attempt to move away from outlandish mediaeval remedies still present in contemporary pharmacopoeias and focus on the search for active ingredients.

Figure 2.

Frontispiece of Pharmacopoeia Contracta by J De CS (Jacob de Castro Sarmento) and P De L MD (Philip De la Cour), London, 1749.

The publication of the London and Edinburgh Pharmacopoeias during the 1740s encouraged medical writers to issue their own lists of medications for hospitals in England and Scotland.¹⁹ Such lists made it easier for doctors to prescribe consistently and for medications to be prepared in advance. Like the Pharmacopoeia Contracta, many cities had a pharmacopeia for the poor. Edinburgh's was first published in 1746 and updated five times by 1770.

Sarmento left the synagogue and its associated institutions around 1756. De la Cour also distanced himself from the Bet Holim possibly during 1751 when he was admitted as a Licentiate of the Royal College of Physicians. This may reflect his impatience with the running of the hospital in which he had invested so much of his free time. It also signalled his need to move beyond practising within the confines of the small Portuguese community though he remained a member of it until the end of his life. While he could practice with the Leyden MD, obtaining a British qualification from the Royal College would, no doubt, have helped in this aim and he would seem to have continued working in London for the next 20 years.²⁰ He could have been nominated for an MD from Marischal College and indeed, he had signed an affidavit for just such a degree for a Dr HI Chandler, but holding a Leyden MD he chose not to do so.

His first wife Ribca died in 1752, aged about 40 years, and is buried in the Sephardi cemetery in the Mile End Road in London. He subsequently married Sarah da Paiba, daughter of Moses da Paiba, a former broker on the Royal Exchange, and a niece of the leading financier Gideon Samson (1699–1762).

He subsequently settled in Bath around 1772, after retiring from work in London. One contact in Bath may have been the portrait painter Thomas Gainsborough who had lived with his family in the city since 1759. One of his portraits in 1775, just one year after moving to London was that of his doctor, Dr. Isaac Henrique Sequeira, De la Cour's nephew and inheritor of his London practice. Gainsborough's oil portrait of Sequeira which now hangs in the Museo Del Prado in Madrid shows his physician in ‘a dignified pose with a thoughtful, melancholy attitude’.

Dr Isaac Henrique Sequeira

Dr Isaac Henrique Sequira (1738–1816), De la Cour's nephew, also served the Portuguese community in London. He was born in Lisbon, and had his medical education first at Bordeaux and then at Leyden where he graduated in 1758. Arriving in London, he petitioned the Bet Holim for work as an unpaid assistant, finding that very few openings were available to gain the experience to progress in the medical profession.²¹ Considering himself a religious refugee from Church persecution in Portugal with no animosity to the Portuguese crown, Sequeira served as physician extraordinary to the Portuguese Embassy at the Court of St James's in London and was honorary physician extraordinary to the Portuguese Prince Regent.²² When he died in 1816 at what was described as ‘the advanced age of 78’, he was the oldest licentiate of the Royal College of Physicians.

De la Cour in Bath

De la Cour spent some of the last years of his life at the Princes Buildings in Bath. There he quickly achieved some prominence where he was considered to be a ‘celebrity doctor’ venerated by his patients and well regarded for his advice on diet.²³ There are some indications of his medical practice in Bath, not surprising given the numbers of visitors to the city for health reasons. For example, Jacob Franks paid De la Cour a guinea a week for attendance on his wife and himself during the first four weeks of their stay in Bath.²⁴ At the time of his departure for Amsterdam in 1780, De la Cour was maintaining a lavish life-style, paying tax on four male servants at his home in the Princes Buildings.²⁵

Bath was growing rapidly as a spa town attracting many of the country's wealthier citizens.²⁶ At this time, Bath had a lively local trade in various medicines which were distributed by a variety of commercial outlets.²⁷ Physicians in Britain were naturally concerned about the widespread use of proprietary medicines without proper medical scrutiny and unauthorised practitioners could be susceptible to satirical attack.²⁸ However, Sarmento and De la Cour's pharmacopeia of 1749 shows a classic approach to medication. Thus, they could sympathise with the anonymous physician, writing the same year, acknowledging that proprietary medicines might be successful but pointing out that ‘diseases are not cured by medicines and receipts, but by a learned and methodical use of them, whereunto Empiricks cannot attain’.²⁹

There was just a fledgling Jewish community in Bath in the last half of the eighteenth century but there were many Jewish medical visitors to ‘take the waters’ or to consult with patients holidaying in the city. A letter written by the prominent physician of German-Jewish origin, Dr Isaac Schomberg, a graduate of Leyden, and son of the successful but controversial and litigious Dr Meyer Low Schomberg, indicated in 1761 that a number of Jews were present in the city.³⁰ Isaac's twin brother Ralph, a medical graduate from Marischal College, was also a regular visitor to Bath, describing the place as ‘very full and brilliant’.³¹ Italian born Ephraim Luzzatto (1729–1792) was a medical graduate from Padua and an accomplished poet who may also have lived in the city for a short time.³² The ‘quack’ Samuel Solomon, purveyor of the immensely popular Cordial Balm of Gilead, who had obtained a Marischal College MD in 1798 by dubious means was also a visitor. There is evidence of an indirect connection with another ‘empiric’, William Brodum (c.1767–1824), born Issachar Cohen in Copenhagen, a stallholder at Covent Garden who had also obtained the Aberdeen Degree in 1791 by dubious means. In an advertisement for his Nervous Cordial³³ in the Glasgow Advertiser in 1798, Brodum indicated that his Cordial was based on a recipe of De la Cour. Brodum had not even arrived in London at the time of De la Cour's death in 1785, and when Brodum was advertising in the press, De la Cour had been dead for over a decade. Brodum must either have derived his Cordial from De la Cour's pharmacopeia or just considered that the name De la Cour would enhance his sales.³⁴

In his Essays on Jewish History, Lucien Wolf records that De la Cour's final years were ‘clouded by misfortunes’ without indicating what these misfortunes were. He and his wife relocated in 1780 to Amsterdam and it may be that some family tragedy prompted the move. Settling in New Heersgraft, he was living in the greatest community of Iberian Jews in Western Europe.³⁵ De la Cour was buried in the Jewish cemetery in Amsterdam on 30 December 1785 and was survived by his second wife Sarah but with no record of surviving children.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Kenneth Collins

Author biography

Kenneth Collins, is a retired Glasgow GP. He is Senior Research Fellow at the Centre for the History of Medicine at the University of Glasgow and is currently Visiting Professor in the History of Medicine at the Hebrew University of Jerusalem. He has been Editor of Vesalius: Journal of the International Society for the History of Medicine and is a prolific medical history author and editor.

References

Registers of the Mahamad – the governing body of the Portuguese Jewish community, London Metropolitan Archives, LMA/4521/A/01/02/001, fl. 61.

Jacobs J, Lipkind G and Nieto D. Jewish Encyclopedia. New York: Funk and Wagnalls, 1906.

See my Go and Learn: The International Story of the Jews and Medicine in Scotland (Aberdeen UP, 1987). Sir Hans Sloane, the foremost British physician of his day, President of the Royal Society and founder of the British Museum was one of those providing an affidavit for Sarmento's MD Degree in Aberdeen.

Jews were expelled from England in 1290 and were allowed to return during Oliver Cromwell's Commonwealth.

Ancestry.com. London, England, Land Tax Records, 1692–1932 (database on-line). Provo, UT, USA: Ancestry.com Operations, Inc., 2011 shows that Dr Machado De Sequeira lived in Creechurch Lane and Dr Lacour (sic) was also resident in Aldgate.

Archives of the University of Coimbra: PT/AUC/ELU/UC-AUC/B/001-001/M/000759. The records indicate three years of study but no confirmation of graduation.

Appointment of Abraham De Sequeira Machado as physician of Sedaca. London, 16 February 1735, Arquivo Nacional da Torre do Tombo (Lisbon). Document (in Portuguese) at London Metropolitan Archives, Spanish and Portuguese Jews' Congregation, Contract Book 1732–1762, fl. 20. Consulted at https://nationbetweenempires.files.wordpress.com/2018/01/abraham-De-sequeira-machado-nomeac3a7c3a3o-mc3a9dico-sedaca.pdf The text of the agreement reads: Em 24 De Sebat 5495 ajustaram os Senhores do Maamad com o Sr. Doutor Abraham de Sequeira Machado de ser médico da Sedaca com as condições seguintes: Que será obrigado assistir a todos enfermos que estiverem a Sedaca e a todos os mais que os Senhores do Maamad lhe ordenarem e derem em rol sem por isso pretender mais que o ordenado que abaixo se Declara. Que se obriga assistir-lhe com todo o cuidado e diligência, assistindo com toda a caridade e amor, sendo obrigado a ir a suas casas a todo tempo que for chamado a primeira vez e as mais, conforme a necessidade o pedir. Que receitará aos doentes tanto de boticário, como da Hebra, o que lhe for necessário somente para a doença e não a outro f im. Que pelo seu orDenado será todos os anos libras vinte e quatro esterlinas a pagar aos quarteis, de que recebeu logo um adiantado, e libras Dez esterlinas cada ano para a casa, e vinte e quatro sacos de carvão, e o massoth que lhe for necessário para a sua família para a Páscoa de Pessah, e o tempo começou a correr desde Roshodes Tebet, e por assim ajustarem os Senhores do Maamad com o dito Senhor Doutor Abraham de Sequeira Machado assinou este contrato que se obriga a cumprir e guardar como nele se contém. Feito em Londres a 24 De Sebat 5495.

First Minute Book of the Governors of the Bet Holim (Heb: hospital). Meeting held (in English) on 18 October 1747. The hospital was to have 20 beds as the number of sick at any one time was around 10 to 12. Staff included a matron, a nurse, an apothecary, two Englishwomen midwives and a cook from the Ashkenazi community.

Lieberman

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10.

Full Details of the roles of Sarmento and De la Cour in the establishment of the Bet Holim can be found it Richard Barnett, Dr Jacob De Castro Sarmento and Sephardim in Medical Practice in eighteenth-century London. Transactions of the Jewish Historical Society of England 1978; 27: 91–93.

11.

Lieberman JR. The founding of the London Bet Holim hospital in 1748 and the secularization of sedaca in the Spanish and Portuguese Jewish community in the eighteenth century. Jewish Historical Studies 2017; 49: 118.

12.

Lieberman JR. The founding of the London Bet Holim. p.121.

13.

Lieberman JR. The founding of the London Bet Holim, pp.131–132.

14.

Lieberman JR. The founding of the London Bet Holim. p.122.

15.

Lieberman JR. The founding of the London Bet Holim. pp.133–134.

16.

The full text of the play is given in Richard Barnett, Dr Jacob De Castro Sarmento. Transactions of the Jewish Historical Society of England 1978; 27: 104–109.

17.

The London Pharmacopoeia dates back to the early seventeenth century, but a substantial revision was made by Sir Hans Sloane in 1721. Some ancient remedies were still retained but in 1746 a new edition was produced which emphasised the most effective preparations omitting ‘superfluous ingredients’ and products now Deemed to be disgusting. The Pharmacopoeia of Sarmento and De la Cour was published just three years after this edition. The first Edinburgh Pharmacopoeia was published in 1699 and its fourth revision was published in 1744. The London, Dublin and Edinburgh pharmacopeias merged to establish the British Pharmacopeia in 1844.

18.

Haigh

. The British dispensatory. South Africa Medical Journal 1974; 48: 2041–2044. .

19.

Matthews LG. History of pharmacy in Britain. Edinburgh and London 1962, pp.79–89.

20.

Of all the Jewish doctors in London during the eighteenth century only eight were admitted as Licentiates while there were no less than 10 MDs awarded to Jews from Aberdeen, Glasgow and Edinburgh universities during the same period. Lucien Wolf, Essays in Jewish History, (Jewish Historical Society of England, 1934), p.169.

21.

Richard Barnett, Dr Jacob De Castro Sarmento. Transactions of the Jewish Historical Society of England 1978; 27: 104–109.

22.

Links had been maintained by members of the Portuguese Jewish community in London with the Portuguese monarchy and many of the civil and educational bodies from early in the eighteenth century. Joseph Jacobs, Goodman Lipkind, Sequira, Isaac Henrique, Jewish Encyclopaedia, (New York, 1906) Vol. XI, p.200. Consulted at http://www.jewishencyclopedia.com/articles/13434-sequira-isaac-henrique. See also entry for Dr. Sequeira in William Munk, Roll of Licentiates of the Royal College of Physicians of London, Vol. 2, p.291.

23.

Noy D. Dr Johnson's friend and Robert Adam's client Topham Beauclerk. Newcastle-upon-Tyne: Cambridge Scholars, 2016, p.205.

24.

Greater London Record Office. Acc. 775/71. Quoted in Malcolm Brown and Judith Samuel, The Jews of Bath. Transactions of the Jewish Historical Society of England 1982; 29: 156.

25.

Greater London Record Office. MDR 1777/4/195 and Bath municipal rate books 1772-9. Quoted in Malcolm Brown and Judith Samuel, The Jews of Bath. Transactions of the Jewish Historical Society of England 1982; 29: 156.

26.

Borsay A. Medicine and charity in Georgian Bath: a social history of the general infirmary, c.1739–1830. Aldershot: Ashgate, 1999, pp.7–9.

27.

Brown PS. Medicines advertised in eighteenth-century Bath newspapers. Medical History 1976; 20: pp.152–168.

28.

Borsay A. Medicine and Charity in Georgian Bath: a Social History of the General Infirmary, c.1739–1830. Aldershot: Ashgate, 1999.

29.

Quoted in Brown PS. Medicines advertised in eighteenth-century Bath newspapers. Medical History 1976; 20: p.163.

30.

Cecil Roth: The Rise of Provincial Jewry (London, 1950), p.27. Isaac Schomberg's note in 1761 that ‘we have a good many of Bnei Israel in Bath’ can be found in British Museum MS Add 28542, f.163. Roth records Jewish residents in Bath from the 1730s. Isaac Schomberg (1714–1780) was a son of Dr Meyer Low Schomberg, an early Jewish medical graduate in Germany and an active member of London's Ashkenazi community of Jews of German origin. Isaac Schomberg obtained the Degree of MD in Leyden in 1745 but wishing a British qualification, and in dispute with the Royal College of Physicians in London, he entered Trinity College, Cambridge, in the early part of 1747 as a student of ‘physic’. He was baptised on 7 August 1747 and as a Christian was able to take the necessary religious tests on being awarded the MD in 1749. See Oxford DNB, WP Courtney, revised by Edgar Samuel, Isaac Schomberg, http://www.oxforddnb.com/view/10.1093/ref:odnb/9780198614128.001.0001/odnb-9780198614 128-e-24823 .

31.

Samuel E. To the ends of the earth: essays on the history of the Jews in England and Portugal. London: Jewish Historical Society of England, 2004, p.267.

32.

Richard Barnett, Dr Jacob De Castro Sarmento and Sephardim. 1978; 27: 112.

33.

A medication containing mostly a decoction of sassafras and guiacum with added sugar.

34.

Kenneth Collins, Go and Learn, pp.37, 38, 40. Marischal College took legal advice concerning Brodum's Degree but Robert Blair, the Solicitor General, advised that a Degree once awarded could not be taken away. Brodum produced A Medical Essay on the Nature, Cause, and Cure of Coughs, (Sherwood, Neely, and Jones, London, 1814) and a presentation copy was given to the Prince Regent. King George III had received Brodum's earlier work favourably (Guide to Old Age, or A Cure for the Indiscretions of Youth, 1795).

35.

Munk's Roll of the Licentiates of the Royal College of Physicians of London (Volume 2, page 178) gives the year of De la Cour's removal to Amsterdam as his date of death.