John Hunter and Scientific Surgery

John Hunter 1728-1793

John Hunter was one of the founders of scientific surgery. He studied human anatomy with his elder brother William, developed his skills as an army surgeon during the Seven Years War, and later opened a museum of specimens and an anatomy school in his house in London. Because of the better understanding of anatomy that emerged from the increase in human dissection of the 17th century, there were many surgical advances including improved instruments and much faster procedures. But there was still no true anaesthetic and little understanding of antiseptic measures. And so surgery remained dangerous, painful and often fatal.

The rapid urbanization meant that more almshouses were established to serve the old, the sick and the dying. Some were the forerunners of hospitals that became established in the next century. But for the most part people entering the poorhouses as sick indigent patients, died there. A very small number of free clinics served the poor and many patients looked far afield for help.

Boyle and the Philosopher’s Stone

Toward the end of his life Robert Boyle withdrew from society and no longer received guests. He said that he wanted to “recruit his spirits, range his papers”, and prepare some important chemical investigations which he proposed to leave “as a kind of hermetic legacy to the studious disciples of that art”, but he never made public what these were. In 1689 he petitioned to repeal an act passed during the reign of Henry IV which prohibited the alchemical transformation of other metals into gold. The relevant part of the act states “That none from henceforth should use to multiply gold or silver, or use the craft of multiplication; and if any the same do, they should now incur the pain of felony.” A letter from Boyle to Christopher Kirkby on 29 April, 1689 underscores his arguments.

I still am, of opinion that the act of Henry IV has been, and whilst it still remains in force, will be, a great discouragement to the industry of skillful men which is very happily improved in this inquisitive age. And therefore, that the repealing of a law, so darkly and ambiguously penned, will much conduce to the public good, and be in particular advantageous to the counties of Cornwall and Devonshire where tin so much abounds.

 

Gilbert_Burnet_by_John_Riley

Gilbert Burnet (1643-1715)

Boyle with the help of his friend and spiritual advisor, Gilbert Burnet, the influential Bishop of Salisbury, succeeded in getting a new act passed in August of that year. It required that any gold and silver produced using these new processes be deposited in the royal mint in the Tower of London.

IsaacNewton-1689

Isaac Newton 1642-1727

When he died in 1692, Boyle left for John Locke a recipe for the transmutation of gold along with a reddish brown powdery substance that was necessary for the process. Sir Isaac Newton received a version of the recipe but apparently not the red earth. An exchange of correspondence between them remains, in which Newton begins by telling Locke that he too knows of Boyle’s recipe. He then writes again explaining how he learned about Locke’s possession of it and requests a sample of the red earth and further details of the alchemical process. The correspondence ends with a note in which Newton declares that he has not succeeded in his alchemical quest and is skeptical of its possibility.

Many of these bits of information have been available from soon after Boyle died in 1692 and were published in his collected works in 1714. A great deal of his alchemical work was omitted from the published works; but some was kept unpublished and some actually discarded, presumably so as not to tarnish his scientific reputation. The correspondence from Newton to Locke emerged later from other sources. Over the last fifteen years or so with the careful examination of previously unexamined existing papers, the addition of yet more information and changing perceptions of the 17th century context, the view of Boyle has transformed. In earlier accounts, his religious, alchemical and medical interests were subordinated to his strong scientific empiricism, and he was portrayed as an earnest scientist with a high degree of skepticism about alchemy. More recently, as more of his papers have been examined, Boyle’s religiosity, his deep interest in alchemy and his role in medical research have been explored in greater detail with the result that his religious scruples, his connection to the alchemical tradition and to its application to medicine, are seen by some as at least as important in understanding his work as his direct dedication to what we now consider to be experimental science. What emerges for us is Boyle’s role using his enormous resources to pursue all approaches available to him to achieve his own health. He combined the mechanical view of the body espoused by Descartes, with the chemical account developed by Paracelsus. This chemical-mechanical account of the human body became dominant scientifically in the next century and became clinically central by the 19th century.

 

 

Robert Hooke

Robert Hooke (1635-1703) 

There are no contemporary portraits of Robert Hooke. This is a recent attempt to make a portrait of him from descriptions of the time

It was during the early 1650’s that Thomas Willis began to study the nature of fevers with Robert Hooke as his technician. Willis’ ideas about fevers combine some aspects of van Helmont’s notion of fermentation with a mechanical theory of the nature of circulation. Willis disagreed with Helmont’s account of an archeus as the cause of fever. Instead he provided a mechanical explanation: the accelerated fermentation of the blood causes it to heat up excessively, creating more pressure in the blood vessels and also speeding up the pulse.

A similar mix of views and approaches is evident in Willis’ conclusions after dissecting and examining many animal and human brains and nervous systems. Like Aristotle he distinguishes the animal from the rational soul. His anatomical work revealed the strong similarities between the brains of humans and many animals and so he concluded that the animal soul is seated in the brain and allows us and the animals to have sensations, to feel pleasure and pain and to have desires and passions. He distinguishes the animal soul from the human rational soul, which is immaterial and immortal. Willis’ religious views can thus be preserved.

Health, for Willis, involved maintaining the appropriate level and type of fermentation in the different parts of the body in order to allow it to function smoothly. This could be aided by the use of iatrochemical remedies such as his “steel syrup” which he made using his own secret recipe and sold to his patients.

Willis introduced Boyle to Robert Hooke who had shown remarkable mechanical skills as his assistant. Boyle hired Hooke as a “mechanick” and this clear relationship between virtuoso and assistant is in stark contrast to the ambiguous relationship he had with Starkey. Hooke, who, like Willis, had begun his student days as a servitor saw himself as “belonging to Boyle.” He lived in Boyle’s house and received an income from him until the early 1660s. In the early period Hooke was responsible for building the air pump which the two used to conduct Boyle’s most famous and successful series of experiments on the springiness of air. The air pump, like other significant technological innovations had a considerable cost, but it also opened up entirely new areas of experimentation. Boyle and Hooke used the device to perform the 43 experiments that included fresh evidence for the possible existence of a vacuum and various experiments that showed that fire would not burn and animals could not survive without air. (Killing small birds by depriving them of air was a favourite demonstration.)  This work resulted in Boyle’s first major scientific publication in 1660, New Experiments Physio-Mechanicall, Touching the Spring of the Air and its Effects.  In the later second edition he first articulated the basis for what has come to be known as Boyle’s law (under conditions of constant temperature and quantity, there is an inverse relationship between the volume and pressure for an ideal gas.)

Although the formal roles of Hooke and Boyle were clear, there has been some question about the extent of contribution of each to the process, with an increasing appreciation of Hooke’s work emerging in recent years. The period of his close collaboration with Boyle continued until Hooke moved to London in 1662 to take up his role as the unpaid curator of experiments at the Royal Society. It is very likely that Boyle continued to support him even after this move, as he did Henry Oldenberg, who had been appointed a secretary of the Royal Society in 1660. When Hooke was eventually funded by the Royal Society it was in order to pursue the History of Trades project. However he was so involved in collecting and demonstrating experimental effects, designing and constructing technological innovations in telescopes, microscopes and watches that he devoted almost no time to the History of Trades which eventually and inevitably died a slow death. But Hooke did make a preliminary list of the various artists, craftsmen, and tradesmen who were to be included:

Surveyors, miners, potters, tobacco pipe makers, glaziers, glass grinders, looking glass makers, spectacle makers, optick glass makers, makers of counterfeit pearls and precious stones, bugle makers, lamp blowers, colour makers, colour grinders, glass painters, enamellers, varnishers, colour sellers, painters, limners, picture drawers, makers of bowling stones or marbles, brick makers, tile makers, lime burners, plasterers, furnace makers, china potters, crucible makers, masons, stone cutters, sculptors, architects, crystal cutters, engravers in stones, jewelers, locksmiths, gun smiths, edge-tool makers, grinders and forgers, armourers, needle makers, tool makers, spring makers, cross-bow makers, plumbers, type founders, printers, copper smiths and founders, clock makers, methamatick instrument makers, smelters and refiners, sugar planters, tobacco planters, flax makers, lace makers, weavers, malters, millers, brewers, bakers, vintners, distillers.

It is not hard to see why it was not possible to collect all the information about the history of trades in a way that would capture every aspect of the procedures used by the wide variety of skilled craftsmen, professionals and tradesmen. Much of the “how to” knowledge is practice based rather than reducible to recipes. At the core of many “trades” was a long term apprenticeship which involved repeating the various procedures until they could be performed without error. The idea of transmitting this kind of knowledge in a written “history of trades” is not really practicable. So, for example, even today, no one learns surgery except by practicing procedures under close supervision until they are perfectly performed. There is no text book of surgery that can substitute for such practice. Nor can there be. The same is true for other “trades” from cooking to jewelry making.

When some years later, Hooke engaged in a lengthy, very public and quite nasty conflict with Isaac Newton over the origin of some of Newton’s ideas about the path of a falling body, he never for a moment raised the issue of the extent of his contribution to Boyle’s work, where he was recompensed for his subordinate role (as a mechanic). Despite Hooke’s later estrangement from Boyle, who had become more closely associated with Newton, the dying Boyle bequeathed him his best telescope and microscope.

In 1660, after Charles II became King, Boyle and eleven others founded the Royal Society. In 1662 it received a Royal Charter but no money. Boyle’s financial support in its early days was an important contribution to its survival and success. The initial membership of 143 men included not only serious scientists, but also fashionable and influential gentlemen. Over 40 of them were trained in the law; more than 30 were members of parliament. Many with only a passing interest in science came on Thursdays to witness Hooke’s demonstrations. The Royal Society played a critical role in the rise of the new science. Given the distinction that Bacon made between fact and law, members of the Royal Society came to play a vital role as especially reliable observers who could testify as to the veracity of the matters of fact displayed to them.

But not everyone was admitted to the Royal Society. Thomas Hobbes, for example, was excluded, largely because of his skepticism about the role of experiment in gaining knowledge. During this period, Hobbes’ reputation rested as much on his mathematical and scientific activity as on his political philosophy. He had contact with most of the central figures of the period including Bacon, Descartes, Harvey and Boyle. His disagreements with Boyle about the air pump experiments are well described in Leviathan and the Air Pump by Steven Shapin.  Like Descartes, Hobbes did not believe in the possibility of a vacuum, and he argued that the air pump experiments did not constitute valid evidence against his views. The air pump could not be shown to eliminate all air from the glass container. Moreover it might still leak. But his major difference with Boyle was that knowledge could not be derived from experimentation, but rather from the deduction from evidently true first principles. Hobbes came to Euclidean geometry late in life. He found that as he studied the theorems he could deduce significant facts about the world without resort to experiment at all. If one could get the correct fundamental basic principles about a subject, then one could deduce from them indubitable facts about the world. This was a very high standard for knowledge: one that Boyle’s experiments did not meet. For him, these experiments were demonstrations of particular effects done with imperfect instruments, for the edification of gentlemen. They did not result in any real increase in understanding of the world. Nor did he accept the authority of Boyle’s peers in the Royal Society as expert witnesses testifying to the supposed knowledge gained. If the world is truly a mechanism, it can be understood mathematically and causal connections can be deduced quickly, following from a comprehensive mechanical theoretical frame.

Hobbes was a practiced controversialist. He knew everyone and fought with many of them. His attacks on Boyle were preceded by an earlier dispute with Descartes who accused him of starting the fight only to advance his own reputation. In that case Hobbes had presented an argument for materialism and against Descartes’ claim that mind and body were distinct substances. Hobbes materialism was widely identified with atheism which was, at that time, a fear that had a stronger emotive connotation than did the threat of communism in the mid- 20th century.

John Locke and others

(c) Government Art Collection; Supplied by The Public Catalogue Foundation

(c) Government Art Collection; Supplied by The Public Catalogue Foundation

John Locke (1632-1704)

John Locke met Boyle in 1660. He came from a middle class family, went to Westminster School a bit later than Wren and Hooke and entered Christ Church, the most prominent college in Oxford in 1652. His first year was interrupted by his asthma, an illness severe enough to force him to recuperate in the country for several months that year and later at various times in his life. The university was then under the control of Puritans with mandatory attendance at two sermons a day as part of the educational process. This left him with a distrust of sectarianism and a belief in a kind of Christianity with less dogma and certainty about which approach was the right one. He graduated in 1656 and went on to get a Masters degree and take on several academic posts in Oxford. He appears to have been unsure of which path to take, but decided not to become a cleric despite his deep religious feelings. In the late 1650s he began to read medical texts, eventually becoming an academic physician. He developed a growing interest in the new science and met Boyle himself in 1660. He was never a prominent member of the Oxford study group, but his notebooks indicate that he read Boyle’s writings as they appeared and also much of Descartes with a special interest in physics.

Locke was a compulsive record keeper and much of what is known about his life is from notebooks and account books that he kept throughout his life. We know what he spent to furnish his college rooms and how much it cost him to live from term to term. Much of his collaboration with others was to help with record keeping and writing. Locke was actively involved in several of Boyle’s many efforts. One was to record the weather on a daily basis for many years in order to contribute to Boyle’s attempts to connect weather patterns and epidemics. Another was an unsuccessful attempt to measure differences in barometric pressure at the top and bottom of a mine in Somerset while recuperating from one of his many bouts of asthma. Locke also collected and categorized thousands of plants from the Oxfordshire countryside. Some of Boyle’s manuscripts were written in Locke’s hand. Though not an active participant in Boyle’s research on respiration he stayed abreast of it and wrote an unpublished paper Respirationis Usus on the topic.

Locke had training and experience in laboratory chemistry. In 1663 he attended a series of lectures in chemistry by Peter Stahl one of the chemists Boyle brought to Oxford. In 1666 he started an alchemical laboratory with David Thomas a medical colleague. Like Boyle, they attempted to make the alkahest as described by van Helmont. He jokingly wrote to Boyle that the laboratory could transmute gold from scholars’ pockets into his hands.

Anthoney Ashley Cooper

Anthony Ashley Cooper (1621-1683)

In 1666 Locke’s life changed when he met and became physician to Anthony Ashley Cooper (1621-1683) who came to Oxford hoping to find some relief from chronic pain by taking medicinal waters. Ashley, who later became the first Earl of Shaftesbury, was a well-known and wealthy politician who led the opposition to Charles II. He invited Locke to come to London to join his household. His responsibilities were various and gradually came to include everything from medical treatment to political advice. In a famous incident Locke along with Thomas Sydenham inserted a silver pipe into Ashley’s abdominal cavity to drain an abscess. This tube pipe remained in place for the rest of Ashley’s life and relieved him of the chronic pain he had suffered for a number of years. He was a grateful patient who became well known as “Tapski” because of the tube.

Thomas_Sydenham_by_Mary_Beale

Thomas Sydenham (1624-1689)

Sydenham and Locke became closer colleagues when Locke accompanied him in on his medical rounds between 1667 and 1671. Sydenham’s views were an important influence on how Locke came to understand health, and also on his philosophical views. Locke acknowledges his importance in the epistle to the reader that begins the Essay Concerning the Human Understanding. It proclaims Locke’s modest hopes in a time when others are far more able than he:

The commonwealth of learning is not at this time without master-builders, whose mighty designs, in advancing the sciences, will leave lasting monuments to the admiration of posterity: but everyone must not hope to be a Boyle or a Sydenham; and in an age that produces such masters as the great Huygenius and the incomparable Mr. Newton, with some others of that strain, it is ambition enough to be employed as an under-labourer in clearing the ground a little, and removing some of the rubbish that lies in the way to knowledge.  

 

Sydenham was trained as a Galenic physician but increasingly became focused on clinical care. His close observation of patients led him to develop strong insights into diseases. He practiced at all levels of society and it seems that much of this practice was to observe clinical cases and record them for later use. He was famously among the first to consider diseases as natural kinds, as if they were species, each with its own natural course. This allowed him to observe and record the process of numerous diseases so that they could be distinguished from each other and treated independently. Each disease had distinguishing characteristics and ran a natural course from infection through a course of illness to healing or death. As a practicing physician he appears to have taken remedies where he could find them and to have tried a wide variety of cures. His recipes for medications include material from the empirics, the galenics, and the iatrochemistry of the newer paracelsians . There is a good example of this in the regimen he provides in one of his cures for asthma.

Take away ten ounces of blood from the right arm, and next day give the common purging potion, which must be repeated twice more, once every third day. On the intermediate days of purging let the following medicines be used: Take of the seeds of anise, finely powdered two drams; Locatellus’s balsam enough to bring it into a mass for pills and make six pills of a dram, three of which are to be taken every morning and at five in the afternoon, drinking four ounces of the bitter decoction without purgatives, warm after them. If the disorder does not go off, let the whole process be repeated. (Works of Sydenham, on acute and chronic diseases page 463 )

 

Sydenham is widely seen to be in the tradition of Hippocrates because of his close observations and record keeping of clinical cases. He brought to his observations a skepticism about the unquestioning acceptance of received methods and an openness to new clinical interventions from any source to see if they worked. He became a strong advocate of opium as a painkiller and was an early proponent for the use of Peruvian bark (from which quinine was made) to fight the ague (usually malaria). This cure has its roots in prehistoric America, and like many herbal cures was passed down through hundreds of generations in an oral tradition. It is interesting that, though Sydenham was just one of several early adopters of this material, Locke sees this as one of Sydenham’s greatest accomplishments. No doubt he himself benefited from quinine. Sydenham’s star began to rise only in the 18th century, when the quality of his clinical work became well recognized.

Arthur Coga

Arthur Coga (First patient to have a blood transfusion from a sheep)

As we have seen, much of the experimentation in 17th Century England was done with animals, but in 1667 the first transfusion into a human was performed. The patient was Arthur Coga, who had studied at Cambridge, and was said to be a bachelor of divinity. He was indigent, and “looked upon as a very freakish and extravagant man.” His pay was 20 Shillings. In a letter to Robert Boyle, he is described: “Mr. Coga was about thirty-two years of age; that he spoke Latin well, when he was in company, which he liked, but that his brain was sometimes a little too warm.” The experiment was performed on November 23rd, 1667 for the Royal Society, in the presence of many “spectators of quality, and four or five physicians.” Coga wrote a description of his own case in Latin, and when asked why he had not the blood of some other creature, instead of that of a sheep, transfused into him, answered, “Sanguis ovis symbolicam quandam facultatem habet cum sanguine Christi, quia Christus est agnus Dei” “The blood of a sheep symbolizes the blood of Christ, since Christ is the lamb of God” (Birch’s “History of the Royal Society,” vol. ii., pp. 214-16).

 

John Wilkins

John_Wilkins

John Wilkins (1614-1672)

In 1655, after he returned to England, Robert Boyle moved to Oxford and joined the scientific group begun by John Wilkins at Wadham College. Although Wilkins was Oliver Cromwell’s brother-in-law, he gathered around him a circle of new scientists with a wide range of political and religious backgrounds. Once in Oxford Boyle dramatically increased his level of activity. He found rooms outside the college, established laboratory space, hired assistants and amanuenses and began several streams of experimental work including a continuation of his alchemical work on metals and his studies of blood and digestion. He also started the series of experiments on “the springiness of air” that would make his reputation as a leading scientific figure. He appears to have connected all his work to health so that even his experiments on air were relevant to his interest in respiration and to provide some understanding of why blood changed colour once it passed through the lungs.

Boyle had already begun to correspond with Thomas Willis, the Helmontian physician with whom Petty had also worked on dissection. It was natural that when Boyle arrived in Oxford Willis became one of Boyle’s many collaborators. Willis had begun his studies at Oxford as a servitor – a student who paid his way by being a servant, most often to other students. He joined the Oxford group in 1648 and spent four years working with Petty. Together they performed autopsies and continued to dissect large numbers of living animals. Petty was a confirmed mechanist who believed that the body was a machine and the best way to understand it was to take it apart. Willis used his alchemical training to reduce blood and other bodily fluids to their more basic Paracelsian components. Under Cromwell his medical practice languished because of his Royalist Anglican sympathies and he was forced to apply his chemical skills as a “pisse-prophet”, a diagnostician of urine samples including tasting them for sweetness. (His practice expanded substantially after the restoration of Charles II to the throne and eventually he became one of the wealthiest practitioners in Oxfordshire. Much of this was due to his secret recipes for drugs that were expensive and apparently effective as well. His influence followed him when he moved to London in 1667 at the request of Archbishop Sheldon. )

 

Robert Boyle as Patient and Scientist

Boyle

For us Robert Boyle is of particular interest in examining ideas of health during the Scientific Revolution because he was, “arguably the most influential figure in the emerging culture of late 17th century Britain.” (Hunter, Scrupulosity page 1.) He was also sick for most of his life and was under the care of many physicians. His illnesses were chronic and debilitating from a relatively early age. There is little doubt that he believed that scientific and alchemical research could find a cure and that faith would save his soul forever.

Boyle scholarship became reinvigorated in the late 20th century as his papers began once more to be carefully reviewed, and the pace of study accelerated. We now have a growing account of the many influences on his scientific thought and a good basis for considering how he, as a scientist, a religious person, and a patient thought about health. This can expand our growing understanding of health during his time (and our own).

Boyle was the youngest of seven sons among the 14 children of Richard Boyle, the first Earl of Cork (1566-1643), “one of the richest and most influential men in Britain.”( pXXI Works v 1)  His father accumulated great wealth by leveraging his position as the Lord High Treasurer of Ireland into one of the largest landholdings in the country. He established towns on his accumulated property, built castles, hired a large private army to defend his holdings, and mined his estates for minerals to increase his income. The elder Boyle was 61, wealthy and titled when Robert was born. He was raised as an aristocrat and was sent to a wet nurse in the country for the first years of his life to give him a better chance to survive infancy and to keep him away to avoid premature emotional attachment. Because his mother died when he was three, he had very little contact with her. He also hardly knew his father who sent him to Eton from the age of 8. When he was twelve in 1639, he and his brother Francis were sent on a grand tour of Europe with Isaac Marcombes as their governor and tutor. Even after visiting much of Europe, Boyle stayed with Marcombes until 1643 when he was sixteen, partly because of unsettled conditions in Ireland and partly because funds for his return travel were stolen by their messenger. His father died in 1643 while Robert was in Europe, having fallen out of favour and lost control over some of his fortune but leaving a substantial inheritance nonetheless.

During a thunderstorm in Switzerland, Boyle had a profound religious experience which molded his religious feeling and had a lasting impact on his intellectual outlook. Throughout his life he continually tried to integrate his deep religious beliefs with his scientific work. His concern for scrupulous honesty in observation, his fear of oaths which could not be fulfilled, his concern about the atheistic consequence of some scientific positions all contributed to his rather complex scientific and religious thinking.

Boyle returned to England in 1644 at the age of 17. After his return he resumed a close connection to his older sister Katherine, spent a considerable amount of his time settling his share of his father’s legacy and establishing himself at Stalbridge, the Boyle family estate. His sister introduced Boyle to Samuel Hartlib (c.1600-1662), the German born “intelligencer” who gathered and disseminated information about scientific practices and innovations in such diverse fields as chemistry, animal husbandry and medicine. Hartlib was an advocate of the formal collection and documentation of all useful knowledge (panosophy) into what came later to be the History of Trades project of the Royal Society to gather practical information in all the areas advocated by Bacon in The New Atlantis. He also perpetuated Bacon’s vision of a science that was led by natural philosophers rather than clerics. The circle surrounding Hartlib met to exchange information and seek help in their projects. Early on Boyle, for example, attempted to apply some of Hartlib’s modern methods of animal husbandry at his estate.

For Hartlib, physicians and others involved in health care had skills and knowledge and were considered to be artisans or tradesmen with practical knowledge of their particular pursuit. They knew how to prepare remedies and what must be done to help people improve their health, or prevent illness. Collecting and recording their knowledge and skills fit comfortably into Hartlib’s overall ambition. One element of Boyle’s understanding of health learned from Hartlib was that there were practical procedures and remedies that could prevent illness, improve health, and, if necessary, cure disease. And this strand of Boyle’s interest continued throughout his life. He purchased formulae for remedies of all kinds, consulted a wide array of health care providers, and tried out a multitude of potential cures on himself and his family.

Quite a lot of the practical knowledge of the time was made up of trade secrets. Many practitioners including physicians kept their recipes for remedies, elixirs and tonics to themselves because their exclusivity contributed to their livelihood. But there were also thought to be even deeper secrets that would allow one to make universal elixirs that could cure all disease and preserve youth. By this time Boyle also believed the there was a Philosopher’s Stone.

Boyle corresponded frequently with Hartlib and considered his circle to be an “invisible college.” Members of this group were in frequent contact with each other. It included collectors of health remedies such as a Benjamin Worsley (1617-77) and the Boate brothers, Gerard (1604-1650) and Arnold (1606-1653) who furnished Boyle with numerous recipes. It also included people interested in the new science like William Petty (1626-1687), who with Boyle and others was a founder member of the Royal Society. Boyle’s communication with this group almost certainly sparked his interest in chemistry, and his desire to build a laboratory at Stalbridge.

By the late 1640’s Boyle had a growing interested in the new experimental science and was beginning to gather information that could contribute to it. He also contemplated a search for the Philosopher’s Stone. These facets of his beliefs and activities continued to evolve throughout his life. Up until 1649 his writings were literary and religious rather than scientific, though his failed efforts to establish an alchemical laboratory and seek the Philosopher’s Stone are mentioned in letters to his sister Katherine (Viscountess Ranelagh) in 1647 where the fragmentation of his oven is compared to the religious fragmentation of the day.

That great furnace whose conveying hither has taken up so much of my care….has been brought to my hands crumbled into as many pieces as we into sects, and all the fine experiments and castles in the air I had built upon its safe arrival have felt the fate of their foundation. Well I see I am not designed to the finding out the Philosopher’s Stone, I have been so unlucky in my first attempts in chemistry. (Hunter Correspondence vol. 1 page 50)

 

In 1649 he contracted a case of the ague (a severe fever, most likely malaria) from which he almost died, and from that point on he suffered from ill health. He developed tremors in his hands so that he could not write and his voice became much weakened so that one had to strain to hear him. In another letter to his sister in 1649, written while he was recovering in Bath, he declared his acceptance of God’s will about life and death.

What [God] has decreed of me, He best knows, for my part, I shall pray for a perfect resignation to his [blessed] Will, and a resembling acquiescence in it. And I hope Spirit will so conform me to his dispensations that I may cheerfully by his assignment, either continue my work, or ascend to receive my wages. (page 80 Correspondence vol 1 Letter to his sister Lady Ranelagh from Bath August 2 1649)

 

His illness marked an important turning point. After it his interest in science and medicine became intense – his first nonliterary manuscript is a series of “Memorialls Philosophicall,” a collection of recipes and formulae begun in January 1650. It contained mostly medical remedies, many of them for fever. Some examples include the use of nutmeg and alum, or cobwebs and snails for the ague, and a poultice for the feet guaranteed to cure the fever “prepared by pounding leaven, onions and garlic, and pigeon dung into a paste with turpentine.” (Newman and Principe p.216) These remedies are fairly typical of the traditional herbal and organic remedies widely employed by empirics as well as physicians at the time.

He succeeded in outfitting his first laboratory in Stalbridge in the summer of 1649. The critical piece of apparatus was the oven capable of keeping a high temperature for long periods of time and doing alchemical metallurgical work. In a letter to his sister the oven’s marvels are ecstatically described. (Letter of 31 Aug 1649)

It was soon after his illness that Boyle had his first contact with George Starkey (1628-1665), through Robert Child (1613-54) another member of the Hartlib circle. Starkey was an American graduate of Harvard University who had trained as a Helmontian physician and alchemist. It seems that Boyle first consulted Starkey about his health, but their relationship soon evolved and Starkey began to introduce Boyle to the fundamentals of laboratory work, alchemy and Helmontian medicine. It was from Starkey that Boyle collected a large number of iatrochemical remedies and alchemical preparations in the Paracelsian and Helmontian tradition. Starkey brings together many of the strands of Boyle’s thinking. Starkey is a deep believer in the need for God’s help in the quest for unearthing the secrets of nature. He is also a gifted experimental chemist and so he can test the results of these revelations to see if he has got them right. And his objective coincides with one of Boyle’s – to discover and make use of the Philosopher’s Stone. Starkey believes, with Boyle that the fruits of this labour should be widely disseminated and used to improve the human condition. Starkey also believes that the secrets of how to create the Philosopher’s Stone, should be carefully guarded, so that it is not abused and converted from its “luciferous” or light giving role into a “lucriferous” or merely commercial application for the benefit of a few.

In his letters of 1651 and 1652, having taken Boyle into his confidence, Starkey repeatedly describes many chemical cures as the products of his alchemical work. He refers to the “Philosopher’s Elixir”, universal cures for disease and claims in several letters to have created the universal solvent, the alkahest, which reduces material to its basic (lowest) constituents. It is a major step in the process of creating the Philosopher’s Stone and the transmutation of such base materials into (the highest) and most pure materials, such as gold. In the surviving letters it is evident that Starkey’s alchemical pursuit has as its objective the discovery of a universal cure as much as it is for the creation of gold. Starkey boasts of using the alkahest to create a special kind of sulfur (one of Paracelsus’ philosophical elements) which will contribute to these objectives and tells Boyle that with it

you will clothe paupers and I heal the desperate among them. I prophesy that you will be nobler than van Helmont and Paracelsus himself, for whatever things I have found are yours, not because I solicit your munificence, which is very great in this, but from that sincere love and honour (in which I attend you). January 1652

 

Here Starkey appears to refer to the creation of gold with which Boyle will be able to enrich the poor. Starkey takes for himself the use of the panacea with which he will heal the hopelessly ill. This passage also strongly suggests that Boyle has funded this work through his “munificence” (You will remember that this is a philanthropic virtue only available to the wealthy).

Boyle was an ideal “virtuoso.” He was a gentleman-scientist of the first order. His wealth, aristocratic background and connections to political power contributed mightily to his position in the scientific world. His wealth allowed him to support his many activities, and his aristocratic connections gave him wide political and social access. Throughout his life Boyle supported the research efforts of many individuals, the establishment of laboratories, as well as religious and charitable works such as translating the bible and spreading the gospel to other parts of the world. He purchased recipes from healers, hired amanuenses (secretaries), “laborants” and “operators” (technicians) to support his research and writing. There is some lack of clarity as to whether Starkey’s relationship with Boyle was as a collaborator or as an operator. Starkey viewed himself as a collaborator, but Boyle never publicly acknowledged his debt to him and may very well have thought of him as a hired technician. Boyle also did not adhere to Starkey’s demand for secrecy and transmitted much of the material entrusted to him to other members of the Hartlib circle. There has been some speculation about why he did not keep Starkey’s secrets. Some concluded that he must have paid for Starkey’s work and so considered him to be his operator, others that he was trying to steal the glory for himself, still others that he felt a greater loyalty to his colleagues in the invisible college, and even that the college was itself a secret organization that would keep the secrets and then decide what to disseminate and what to keep hidden on the Baconian model. What is clear is that Boyle valued the results he received from Starkey and referred to them for much of his career. Starkey was instrumental in strengthening Boyle’s lifelong efforts to find the Philosopher’s Stone, although his contact with Boyle diminished when Boyle went to Ireland in 1652 in order to help settle the Irish part of his father’s estate. Starkey’s experimental efforts continued during this time and without Boyle’s support he amassed debts that he could not repay and was finally jailed as a debtor. Letters to Boyle from members of Hartlib’s circle advised him of Starkey’s fate and may have succeeded in discrediting him, for there is so far no evidence of their further collaboration. Starkey later returned to medical practice and died of the plague while caring for patients in London during the plague year of 1665.

Boyle’s intensive experimental activity continued even while he was in Ireland for almost the entire period of 1652-1654.  In Ireland the lack of a furnace forced him away from his chemical work. William Petty who had left England to be the physician-general of the army in Ireland and was an expert at dissection, joined Boyle to dissect hundreds of live dogs to confirm Harvey’s description of the circulation of blood and to learn more about the digestive process. The trip to Ireland secured Boyle’s fortune, probably with Petty’s help and Cromwell’s approval. Petty himself went on to become the surveyor general of Ireland and amassed his own enormous fortune.

Boyle suffered a second severe fever in 1654 when he fell off a horse in bad weather, which resulted in the permanent deterioration of his vision. His condition was such that few manuscripts after 1654 are written in his own hand.[Hunter, 2000 #414] Almost all were prepared by secretaries (amanuenses) who would accompany him as he engaged in his experimental work and record his dictation. While recovering in 1654, he wrote to Frederick Clodius (1625-1661), Samuel Hartlib’s son-in-law, who was a physician and an alchemist. He declared his unfitness to travel, asked for advice about his illness and discussed several possible remedies, including ones for kidney stones which apparently was yet another ailment adding to his chronic discomfort. (ref) Boyle understandably had an ongoing concern for his own health (which later deteriorated even more after a severe stroke in 1670), and a strong interest in health related research.

Medicine in the 17th Century, Cont’d

Jan_Baptist_van_Helmont_portrait

Johann Baptista van Helmont (1579-1644)

Paracelsus was the primary influence on this Belgian physician-alchemist. Van Helmont was a Paracelsian who used chemical medicines and had a strong interest in alchemy, but revised and elaborated many of Paracelsus’ positions including the nature and number of elements and his explanation of disease. His experimental work included attempts to show that water was an even more basic constituent of matter than Paracelsus’ three philosophical principles of sulfur, mercury and salt. In one famous experiment he planted a willow seed in 100 kilograms of earth, added only water for several years and found that the tree now weighed 75 kilograms while the weight of the earth did not significantly change. Van Helmont denied the explanatory value of Aristotelian final causes but believed something quite similar. The seed contained an archeus, a kind of spirit that could transmute water into willow. He held that there were many different kinds of archei each functioning in this seed-like way. In the body they transmuted food into blood through a process of digestion or fermentation. As external agents archei could enter the body to cause disease by a process of putrefaction. Much of van Helmont’s experimental laboratory work reduced various substances to discover the gases that contained their archei and to produce medicines to counteract their effects.

Van Helmont’s search for the Philosopher’s Stone was an attempt to find the ultimate seed, one that would transmute base metals into gold, but more importantly would function as a panacea by finding a spirit that could cure all ills. His methods, like those of Paracelsus were dependent on mystical visions as well as laboratory experiments. A step toward finding the Philosopher’s Stone was the chemical formation of the alkahest, a kind of counter Philosopher’s stone which was a universal solvent that could ferment or digest material into its basic (lowest) constituents.

Paracelsus, through van Helmont had a growing number of followers in England who were especially interested in iatrochemistry and alchemy, including George Thomson (1617-1677) and the young American George Starkey (1628-1665).

Baldwin_Hamey_van_Dyck

(c) Royal College of Physicians, London; Supplied by The Public Catalogue Foundation

Baldwin Haney (1600-1676)

By the middle of the 17th century, the views of Galen, Paracelsus and Descartes had all become part of the then current understanding of medicine and the human body. However academic physicians continued to be trained as Galenists and they dominated the medical schools, the Royal College of Physicians and were the practitioners to the wealthy. Baldwin Haney (1600-1676) whose wonderful portrait is by Anthony van Dyck is an excellent example of the wealthy physicians who were members of the College.

William_PettyThomas_WillisAnne Greene

William Petty (1623-1687)Thomas Willis (1621-1675) Anne Greene (1628-1665).

In the famous case of Anne Greene, Thomas Willis, William Petty and some medical students who were studying anatomy with them,  revived her after she had been hung for the murder of her illegitimate child (a crime she did not commit). Her body was given to them for dissection, but as they prepared her, they found that she was still breathing. They used humoral techniques to revive her: they poured hot cordial down her (cold) throat, bled her, rubbed her limbs and applied hot plasters.

As we have seen, the three academic medical influences at the time came from Galen, Paracelsus and Descartes. Each was accompanied by a metaphorical picture of health which retains some currency today. The first saw health as a good balance among the humours, the second as appropriate chemical composition, and the third as a smooth running machine. Regardless of their primary orientation many physicians had absorbed and included aspects of each of these three positions, and most employed remedies that were a mixture of all three. The complexity surrounding their ideas about health derived from the intermingling of these different ways of thinking. The theoretical differences among the academic physicians meant little to the vast majority who could not afford expensive doctors.

 

William Harvey and St. Bartholomew’s Hospital

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William Harvey (1578-1657) and St. Bartholomew’s Hospital

William Harvey was a careful experimentalist who observed the heart’s activity, proved that blood circulates in the body and that the heart functions as a pump to pulsate blood through the arteries and that the blood returns to the heart through the veins. Harvey had studied and done his early research in Italy and benefited from the more liberal dissection practices and more advanced understanding of anatomy. His discovery was a major revision to the Galenic account that there were two systems of blood: the natural system which was fed by the liver and absorbed by the body and the vital system in which blood flowed from the heart, was cooled by the lungs and distributed heat and life to all parts of the body through the arteries. Harvey was a member of the Royal College of Physicians of London that had been founded in 1518, functioned as a guild in its early days and was an important step in the professionalization of doctors. From a patient’s point of view Harvey’s post as Physician in Charge of St. Bartholomew’s Hospital from 1609 until his death is a critical part of his accomplishment. While at St. Barts he provided free care to the poor, was Royal Physician to the King, maintained a lucrative practice to the rich, and did much of his research. This was early in a long medical tradition of practicing and doing research while caring for the poor while also earning a good living from the well off.

St. Bartholomew’s Hospital

Early hospitals functioned as poorhouses. St. Bartholomew’s which was founded in 1123 was among the oldest hospitals in Europe. During the Reformation it was defunded and then reopened by Henry VIII as the “House of the Poore in West Smithfield in the suburbs of the City of London of Henry VIII’s Foundation” in 1547. And in the tradition of medicine, academic doctors used the hospital as a research and teaching site, although there was no medical school there until the 19th century.

René Descartes and Rational Mechanism

Descartes’ ideas about the nature of matter and of the world are not like Bacon’s. He introduces the notion of the body as a machine: “..so also the human body may be considered as a machine so built and composed of bones, nerves, muscles, veins, blood and skin that even if there were no mind in it, it would not cease to move in all the ways it does at present when it is not moved under the direction of the will.” (Descartes René, Philosophical Essays Meditations Bobbs Merrill 1964 page 138)  However Descartes, like Bacon is deeply interested in health. “The preservation of health has always been the principle end of my studies” (CSMK III 275) Part of the attraction of the idea of the body as mechanism was that it would allow for a rational medicine. If a healthy body is a smoothly running machine, then medical interventions would be much like mechanical ones. He therefore hoped to devise “a system of medicine which is founded on infallible demonstrations.” (CSMK III 17).  Descartes proposes a program of division of effort in research and publication that has become a dominant influence on medicine ever since. In the Discourse on Method he makes an early proposal for a program of work to derive the medical benefits of his approach.

It is true that medicine at present contains little of such great value; but without intending to belittle it, I am sure that everyone, even among those who follow the profession, will admit that everything we know is almost nothing compared with what remains to be discovered, and that we might rid ourselves of an infinity of maladies of body as well as of mind, and perhaps also of the enfeeblement of old age, if we had sufficient understanding of the causes from which these ills arise and of all the remedies which nature has provided. (575) [63] Discourse page 46

 

For Descartes knowledge must carry certainty: he will achieve knowledge by deriving it from first principles which are themselves certain. This method can apply to any area liable to the impact of reason, including medicine.

This approach sets the project of medicine for the next 300 years. It considers the body to be a mechanical device that can be learned about and understood entirely apart from the person who, as it were, inhabits it. Gilbert Ryle describes that person as a ghost in a machine. Such a project can study the body without considering the person at all. They are completely separate, and, according to Descartes, connected only at the pineal gland. This gives medicine a free rein to study the body and its health as distinct from the person who lives in it. This utter separation of body and mind has a powerful effect on the relationship between physicians and patients. If the Cartesian project succeeds then a healthy body is relatively independent of the patient who inhabits it and the physician who is the expert about the body must have the authority to deal with it. It is Descartes who gives our bodies over to scientific medicine, and turns us into patients. We will remain passive subjects well into the 20th century.

Viewing the body as a machine was a very fruitful way of thinking about it. The approach has led to many successes in the history of medicine, from the view of the heart as a pump, to the idea of the digestive tract as part of a food processing plant with plumbing spigots and drains.

Research on the bio-mechanical framework flourished. Later in the 17th century Robert Hooke and Anton van Leeuwenhoek will use the newly developed microscope to learn about the nature of cells. Robert Boyle will use Hooke’s pump to explore respiration and circulation. He will confirm Harvey’s results about the circulation of the blood.  Descartes is a great influence on future investigations of the body. Boyle and his medical colleagues dissected hundreds, if not thousands of live dogs and other animals to try to learn more about the mechanics of the body. The hunt for human cadavers became more intense and medical education included far more anatomical studies. Schools of anatomy under people like John Hunter flourished. Galen, who had dissected only animals, was shown to be mistaken about the many organs which differ in humans and animals. Cadavers were bought, stolen and sold.  Researchers and medical students were always at the scene of public executions to gain access to bodies immediately after death. In the famous case of Anne Greene, medical students revived her after she had been hung for the murder of her illegitimate child.

Health in England During the Scientific Revolution

The level of mortality of 17th century England was far higher than it is today. English life expectancy at birth the first half of the century was 36.4 years. If one succeeded in living until 30 one could expect to live another 30 years. In London the situation was worse. The high rate of mortality was comprised of infant deaths: (Between 149 and 160 of every thousand infants died in the first year of life), a high level of maternal mortality, and death as a result of epidemics of plague and the ague (various fevers like malaria). Apart from immigration, the population of London was actually declining during this period.

Added to the mortality figures, the state of health of the living was also poor. Those who survived the various epidemics and fevers suffered from uncomfortable chronic conditions for much of their lives. Morbidity affected all classes especially in cities. A person from the working class was old by the age of 40. The biographies of most of the luminaries of the period point out their individual ill health, but few recognize how widespread ill health was among the general population. The diaries and memoirs of the time give many indications of the fact that the vast majority of those who lived beyond 40 suffered from debilitating chronic conditions. We will review only a few of the major figures, most of whom lived with chronic diseases into old age.

  • Francis Bacon, like many of his contemporaries, was in somewhat delicate health because he had survived serious fevers and other more minor complaints at frequent intervals, and famously died at age 65 of a chill trying to find out how long a chicken could be preserved by stuffing it with snow.
  • René Descartes escaped early morning classes as a child because of his poor health and later expressed a strong interest in the health consequences of his work. He died on February 11, 1660 at the age of 54 from a serious respiratory infection he contracted in the draughty castle of Queen Christina of Denmark.
  • Thomas Hobbes’ poor health until he was forty was followed by an increasing palsy that made his hands tremble so that he was forced, like Bacon before him, to dictate his writings. He lived to the ripe old age of 81.
  • John Locke (died age 71), himself a physician, was asthmatic and was given detailed regimens by Thomas Sydenham, who sent him to the country for long periods of recuperation.
  • Robert Hooke’s biographers describe his poor health as an infant and child and his stooped walk as a result of a malformed spine. His diaries record his constant struggle with a number of chronic and uncomfortable conditions including “giddiness, indigestion, flatulence, blockages in his nose and ears, occasional loss of the sense of taste and smell, headaches, heart palpitations, sore and watery eyes, noises in the head, fevers, chills and insomnia.”(Bio page 145) When well, he always attributed his recovery to God’s intervention. (Jardine page 89-90). Hooke died at 68.
  • Among Thomas Sydenham’s works was his clinical account of gout, based largely on his own experience.( Died at 65)

It is hardly surprising that many active participants in the scientific revolution had a strong interest in health issues and participated actively in research associated with it. The widespread incidence of ill health and chronic disease was tied to the hope that the new science would unlock some of nature’s secrets about the maintenance and recovery of health. There were some very powerful patients in the seventeenth century.