Scientists and scholars once looked at the sixteenth and seventeenth centuries as the period in which ‘‘rationalism’’ began to replace magical and even religious thinking, or at least push occultism to the periphery. Since the 1970s, many historians have labored mightily to ﬁnd evidence that the great ﬁgures once regarded as founders of a rational, experi- mental, scientiﬁc method were actually more interested in astrology, alchemy, and other forms of mysticism and occult phenomena. To be
historically accurate, it is anachronistic to use the terms ‘‘science’’ and ‘‘scientist’’ for this time period, but historians note that astrology and natural magic could be considered proper examples of ‘‘applied science.’’ Historians once emphasized the artistic and scientiﬁc triumphs of the Renaissance, but recently scholars have focused on the many ways in which superstition and the occult sciences ﬂourished. Medicine, along with the other arts and sciences, remained entangled with astrology, alchemy, and other varieties of mysticism. Out of this mixture of art, science, and magic arose new challenges to medical theory, philosophy, and practice. One form of prognosis known as astrological medicine was based on the assumption that the motions of the heavenly bodies inﬂu- enced human affairs and health. More broadly, astrology was a form of divination. In practice, astrological medicine required knowing the exact time at which the patient became ill. With this information and a study of the heavens, the physician could prognosticate the course of illness with mathematical precision and avoid dangerous tendencies. In therapeutics, astrological considerations determined the nature and timing of treatments, the selection of drugs, and the use of charms. For example, the sun ruled the chronic diseases, Saturn was blamed for melancholy, and the moon, which governed the tides and the ﬂow of blood in the veins, inﬂuenced the outcome of surgery, bloodletting, purging, and acute illness. The putative relationships between the heavenly bodies and the human body were so complex, numerous, and contradictory that in practice it was impossible to carry out any op- eration without breaking some rule. While medical astrology occupies a prominent place in the Renaissance, it can be seen as a continuity of popular medieval doctrines that were not necessarily linked to scholarly medical theory. Physicians may have continued to study and utilize medical astrology, but many Renaissance medical treatises ignored or even explicitly condemned astrology.
Even in the twenty-ﬁrst century, a quick survey of shelves in most major bookstores indicates that astrology attracts many more readers than astronomy. Chemists, secure in their knowledge that alchemy has few devotees today, have long been amused at the continuous battle against superstition waged by astronomers. Alchemists, however, occupy an ambiguous position in the history of medicine and science, praised as pioneers of modern chemistry, damned as charlatans, or treated reverently as purveyors of an alternative way of knowing the universe.
It is generally assumed that the primary goal of alchemy was to transform base metals into gold, but alchemy is a term that encompasses a broad range of doctrines and practices. Particularly in Chinese medi- cine, alchemy encompassed the search for the elixirs of health, longevity, and immortality. In Western history, the idea that the task of alchemy was not to make gold or silver, but to prepare medicines, can be found in the writings of Philippus Aureolus Theophrastus Bombastus von Hohenheim (1493–1541), alchemist, physician, and pharmacologist. Fortunately, he is generally referred to as Paracelsus (higher than Celsus), the term adopted by the Paracelsians of the seventeenth cen- tury, who believed that therapeutics could be revolutionized by the development of chemical or spagyric drugs. (Spagyric comes from the Greek words meaning ‘‘to separate’’ and ‘‘to assemble.’’) Little is known with any certainty about his early life and education. Although he left behind a large, if disorganized, collection of writings in medicine, natural philosophy, astrology, and theology, only one authentic portrait exists. His place in the history of medicine is ambiguous, but in modern German history, Paracelsus served a major cultural icon during the Nazi era.
After a brief period as a student at the University of Basel, Paracelsus became tired of academic dogmatism and immersed himself in the study of alchemy. Instead of consulting scholars and professors, Paracelsus sought out the secret alchemical lore of astrologers, gypsies, magicians, miners, peasants, and alchemists. Although there is no evidence that he ever earned a formal academic degree, Paracelsus bestowed upon himself the title ‘‘double doctor,’’ presumably for honors conferred on him by God and nature. Nevertheless, Paracelsus secured an appointment as Professor of Medicine and city physician of Basel. Despite his new academic credentials, he seemed more inter- ested in staging scenes that would now be called media events. To show his contempt for ancient dogma, he burned the works of Avicenna and Galen while denouncing orthodox pharmacists and physicians as a
‘‘misbegotten crew of approved asses.’’ Wearing the alchemist’s leather apron rather than academic robes, he lectured in the vernacular instead of Latin. Although these public displays enraged his learned colleagues, it was a dispute over a fee for medical services that forced him to ﬂee from Basel. His enemies happily noted that he died suddenly in a mysterious, but certainly unnatural, fashion when only 48, while Hippocrates and Galen, founders of the medical system he rejected, had lived long, productive lives.
In opposition to the concept of humoral pathology, especially the doctrines of Galen and Avicenna, Paracelsus attempted to substitute the doctrine that the body was essentially a chemical laboratory, in which the vital functions were governed by a mysterious force called the archaeus, a sort of internal alchemist. Disease was, therefore, the result of derangements in the chemical functions of the body rather than a humoral disequilibrium. Physicians should, therefore, study the chemi- cal anatomy of disease rather than gross anatomy. Anatomical research itself was, therefore, irrelevant to understanding the most profound questions about the vital functions of the human body. Because life
and disease were chemical phenomena, speciﬁc chemical substances must serve as remedies. The speciﬁc healing virtue of a remedy would depend on its chemical properties, not on the qualities of moistness, dry- ness, and so forth associated with humoral theory.
In a burst of optimism, Paracelsus declared that all diseases could be cured when, through alchemy, one came to understand the essence of life and death. The challenge of ﬁnding a speciﬁc remedy for each disease seemed overwhelming, not because of a scarcity of medicines, but because nature was one great apothecary shop. Confronting nature’s embarrass- ment of riches, the alchemist could be guided by the method of separation, the Doctrine of Signature, and the astrological correspondences among the seven planets, seven metals, and the parts of the body.
Rejecting the Galenic principle of curing by the use of contraries, Paracelsus favored the concept that like cures like. But, discovering
The Microcosm—a seventeenth-century alchemical chart showing the human body as world soul.
the true nature of the remedy, which was traditionally a complex mix- ture, could only be accomplished by alchemically separating the pure from the impure, the useful from the useless. Within the vast materia medica already known to sixteenth-century healers, poisons had always been of particular interest, because they were obviously very powerful agents. Paracelsus argued that alchemy made it possible to separate out the curative virtues hidden within these perilous substances. Galenists denounced Paracelsians as dangerous radicals who used poisons as remedies. In response to these accusations, Paracelsus ridiculed his critics for their use of unsafe purgatives, exorbitantly priced theriacs, and nox- ious mixtures made with mummy powder, dung, and urine. All things could act as poisons, he declared, but the art of alchemy could ‘‘correct’’ poisons.
In place of traditional complex herbal preparations, Paracelsus and his followers favored the use of puriﬁed drugs, especially minerals such as mercury, antimony, iron, arsenic, lead, copper, and their salts, and sulfur. Determining whether new chemical remedies actually had speciﬁc therapeutic virtues could, obviously, be very risky. Fortunately, many toxic materials cause such rapid purgation that not enough would be absorbed to provide a lethal dose. Moreover, in some cases, the alchemical puriﬁcation processes probably removed everything but the solvent. On the other hand, some attempts at puriﬁcation produced interesting new substances. For example, attempts to distill off the essence of wine created ‘‘strong liquors’’ that were made into medicinal cordials. On occasion, entirely new and interesting drugs emerged from the chaos of the alchemical laboratory. Of special interest is the possibility that Paracelsus was one of the ﬁrst to discover the narcotic effects of ethyl ether, which was known as ‘‘sweet vitriol.’’ Not all Paracelsian drugs were derivatives of toxic metals; his ‘‘lauda- num,’’ a preparation used to induce restful sleep and ease pain, was essentially opium in wine.
Although Paracelsus ridiculed traditional uroscopy, he accepted the underlying idea that since urine contains wastes collected from the whole body it must harbor valuable diagnostic clues. Instead of uros- copy by ocular inspection, he proposed diagnosis by chemical analysis, distillation, and coagulation tests. Given the state of qualitative and quantitative analysis, however, his chemical dissection was likely to be about as informative as ocular inspection. In urine analysis, as in studies of potential remedies, many Paracelsians ignored the important residues and concentrated all their attention on the distillate. A work attributed to Paracelsus, but generally regarded as spurious, provided instructions for the chemical examination of urine by the measurement of volume and speciﬁc gravity, using a measuring cylinder ingeniously designed as a replica of the human body.
To replace humoral categories of disease, Paracelsus attempted to develop a system based on analogies to chemical processes. While gen- erally obscure and inconsistent, his chemical concepts were peculiarly appro- priate to metabolic diseases, dietary disorders, and certain occupational diseases. For example, in classifying gout as a ‘‘tartaric disease,’’ he had indeed chosen an example of a metabolic disease in which body chemistry has gone wrong: in gouty individuals, a metabolic product forms local deposits, primarily in the joints, in a manner very roughly analogous to the way in which tartrates sediment out of wine. He also pointed to a relationship between cretinism in children and goiter in adults (disorders caused by a lack of iodine in the diet). According to Paracelsus, miners, smelter workers, and metallurgists exhibited a variety of symptoms because their lungs and skin absorbed dangerous combinations of unwholesome airs and clouds of poisonous dust. This noxious chemical mixture generated internal coagulations, precipitations, and sediments. Such examples can create the impression that Paracelsus had valid reasons for his attack on Galenism and actually held the keys to a new system of therapeutics, but it is easy to read too much into the Paracelsian literature and confuse obscurity with profundity. Nevertheless, later advocates of chemical or Paracelsian medicine were involved in the transformation of pharmacology and physiology, diagnostics, and therapeutics. The Society of Chemical Physicians was founded in 1665. Successful examples of chemical medicines forced even the most conservative physician to think about the limits of Galenism and tempted many orthodox physicians to experiment with the new remedies. Despite the opposition of the College of Physicians and its attempts to suppress the use of the new chemical remedies, the English Paracelsians achieved considerable recognition. By the mid-1670s, even those who rejected Paracelsian philosophy were beginning to accept the new chemical remedies. Moreover, debates about the chemical philosophy of life served as an alternative to the mechanistic systems that invaded the medical sciences in the wake of the Newtonian revolution. Debates between ‘‘mechanist physicians’’ and ‘‘chemical physicians’’ continued into the eighteenth century.
Despite evidence of intellectual continuity, Renaissance scholars seemed to believe that they were making a major break with the medieval and Arabic past, primarily by recapturing and assimilating classic Greek texts. Similarly, many physicians were convinced that medicine was undergoing rapid and signiﬁcant changes. Physicians and surgeons were acquiring anatomical and pharmacological knowledge and ideas that promoted increasingly sophisticated debates about the nature of the human body and the cause of disease. This did not automatically change the nature or efﬁcacy of their prescriptions and procedures, but it made the search for further knowledge possible and highly desirable.