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 Though not an active participant in Boyle’s research on respiration he stayed abreast of it and wrote an unpublished paper Respirationis Usus on the topic.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.
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 (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 (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).