12 May

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.

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