Richard Lower’s De Catarrhis and Charles II’s last sneeze.

Monday, May 28th, 2012 | Peter Anstey | No Comments

Terry Doyle writes…

 

To the modern mind, one of the more surprising therapeutic manoeuvres inflicted on the Charles II as he lay dying of a cerebral disorder (more of that in another blog) in February 1685 was to make him sneeze. This was done by applying powder of white hellebore roots to his nostrils. He was also given Spirit of Sal Ammoniac tam ad invigorandum Cerebrum quam ad Sternutationem excitandum (both as a cerebral stimulant and to provoke sneezing). The ancient belief was that the animal spirits are produced and stored in the fluid of the cerebral ventricles. This was secreted through the pituitary, then dripped into the palate and also through the cribriform plate of the ethmoid bone into the nasal cavity. According to the medical theory of the time, sneezing would help to purge the brain of humours affecting it. What is interesting is whether or not one of the Royal Physicians, Richard Lower agreed to this.

Lower is best known for performing the first successful blood transfusion and for his Tractacus de Corde wherein he accurately described the structure of heart muscle. Later editions of this work contained a short additional chapter entitled Dissertatio de origine catarrhi.

Richard Lower

A reviewer noted that Lower demonstrated ‘the erroneousness of the Vulgar opinion . . . of those that apprehend great danger to the Brain from the excrementitious matter fathered therein, if it should not be purged out from thence by the Eyes, Nostrils, Ears and the Palat.’ (Philosophical Transactions 6 (1671) 2211-2). A facsimile reproduction of De Catarrhis was produced and edited by R. Hunter and I. Macalpine London, Dawsons, 1963.

Lower had extensive experience in brain research from his days in Oxford where he was the valued assistant to Thomas Willis in his production of Cerebri Anatome.

In the preface to the 1664 edition Willis wrote: ‘I made use of the Labours of the most Learned Physician and highly skilled Anatomist, Doctor Richard Lower, for my help and Companion . . . the edge of whose Knife and Wit I willingly acknowledge . . . as also his indefatigable Industry, and unwearied Labour.’ In the twelfth chapter of that work, Willis concluded that it was not possible for the cerebral fluid to be secreted into the palate. Among other things Lower investigated the ability of the arterial circle at the base of the brain, eponymously styled the Circle of Willis, to maintain the blood supply to the brain after three of the four feeding vessels had been tied off – as he described in his correspondence with Boyle (1744) The Works, London, Millar, vol. 5.

In De Catarrhis Lower demonstrated by injection of milk and ink that cerebral fluid could not pass from the brain, through the cribriform plate of the ethmoid bone into the nasal cavity and that nasal catarrh had nothing to do with the brain. He suggests that ‘almost everyone is agreed’ that the substance of catarrh consists of the serum of the blood and that it originates . . . by blocked perspiration through the pores of the body.’ Lower correctly suggests that the function of the moisture of nasal mucosa is to lubricate the inspired air. However, he mistakenly thought that the cerebral fluid passed directly from the pituitary into the bloodstream. He arrived at this conclusion by injecting milk into the internal jugular veins in the neck and noting that it bubbled out in two vessels on either side of the pituitary stalk. These are the cavernous sinuses which are next to but not in communication with the pituitary.

Yet despite Lower’s demonstration that catarrh had nothing to do with the brain, doctors continued to treat diseases of the head with errhines and sternutatories to encourage the flow of ‘pituita’ to clear the brain. Similarly, phlebotomy was a standard treatment long after humoural theory had been abandoned. Furthermore, liver disorders were treated with bleeding from the right arm and splenic disorders from the left arm. Charles II was bled from his jugular veins since his disorder was cerebral.

In all there were fifteen Royal Physicians, including Lower, attending Charles in his last illness. We know who they are as they signed the prescriptions given to the king as recorded in The Last Days of Charles II by Raymond Crawfurd, (Clarendon Press, Oxford, 1909), pp 56-68. They were all prominent London physicians and likely represented the best medical opinion of the day. Four are of particular interest.

The Chief Royal physician was Sir Charles Scarburgh, a founding member of the Royal Society, an accomplished mathematician and bibliophile. He had been a protégé of William Harvey, assisting him with De generatione animalium and attending him in his last illness.

Sir Thomas Millington 1625-1703, graduate of Westminster School (like, Lower, Wren, Hooke and Locke), friend of Hobbes and executor of Richard Lower’s will. Tractacus de Corde was dedicated to him by ‘Your most affectionate friend Richard Lower.’

Walter Charleton played a major part in introducing the ideas of Epicurus and Pierre Gassendi into England in his Physiologia Epicuro-Gassendo-Charletonia: or a fabrick of science natural, Upon the Hypothesis of Atoms (1654)

Sir Edmund King, like Lower, was a pupil of Thomas Willis in Oxford. In November 1667, he assisted Lower in performing the first human blood transfusion (on Arthur Coga who had agreed to this for a guinea). He later claimed to have dissected more than a hundred brains: Philosophical Transactions of the Royal Society 185 (Nov. – Dec., 1686), 231.

When each prescription was made out for the King, it was signed by 10 or 12 of the physicians. Most were for purgatives or bleeding. This raises the interesting research question – To what extent was humoural theory practised by physicians who decried it in their written work. Was this because they deferred to the patient’s expectations?

Translating Milton’s De Doctrina

Monday, May 21st, 2012 | MICHAEL COP | No Comments

John Hale writes…

Donald Cullington and I have almost completed our edition of John Milton’s De Doctrina Christiana, for the Oxford Complete Milton series. Because our commission was to transcribe and edit, translate and appropriately gloss its 100,000-plus Latin words, Milton’s original words, we haven’t added much to the contextualizing of its systematic theology. That was where the work’s previous editor, Maurice Kelley, put his herculean effort. Lifting my head, to look round me again, what have we been missing? This blog post is an example.

Yesterday I was indexing the following passage, which closes off its whole chapter, II.  7. Atque in hac ferme sententia doctissimos quosque theologorum, Bucerum, Calvinum, Martyrem, Musculum, Ursinum, Gomarum, aliósque video fuisse.  “I see, too, that this was more or less the view held by all the most learned theologians–Bucer, Calvin, [Peter] Martyr, Musculus, Ursinus, Gomarus, and others.”

The humdrum sentence and the little list do not set the heart aflame, nor even carry much conviction: one suspects these theologians to be “all the most learned” because, circularly, they have “more or less the same opinion as me.” Even as rhetoric, the climax is lame.

Now lame rhetoric is not like Milton, here or anywhere. What is this finale striving for?

One surprise is that he gives the final word to authorities. De Doctrina announces itself in its opening Epistle as his personal credo, deriving solely (duntaxat) from scripture, proceeding by amassed citations, and for his own use.

The next surprise is the list itself. The names come in A-Z order, except for Gomarus after Ursinus. That implies Milton read, collected, and listed alphabetically; or a source did, or his helpers did. Then at a later stage, Gomarus was added. But maybe this blog post will reach someone who knows Gomarus on the topic of Sunday worship; knows something which would indeed make him a key witness?

At present, the six names look a mixed bag. Bucerus, first up alphabetically, was well known to Milton, who had translated Bucer’s work on divorce. Milton agreed with Bucer when writing voluminously in favour of divorce for incompatibility, on scriptural grounds (Matt. 10 etc.). Bucer was not a very big name, but he was known in England, where he had lived as a Protestant exile. More important, he is also named in Rivetus’ discussion, which our excellent predecessor Maurice Kelley cites (Yale Prose Works, Vol. VI, 714 n. 19).

Rivetus cites the same five, but in a different order: Calvin, Bucer, Martyr, Musculus, Ursinus. This order is not A-Z. It moves from big to little, and/or it’s chronological. So Milton or his atelier has re-ordered alphabetically, and perhaps added Gomarus later. Gomarus (pub. 1628) is not chronologically later than Ursinus, so did Milton read him later, for himself? This too would awaken a thirst to know more about Gomarus. Did the version which was being recopied by Picard here show two stages of work in Milton’s study or scriptorium?

And yet the manner of the reference needs closer attention first. Video fuisse, “I see that this was the view.” On other occasions too Milton cites at second hand. This hearsay is both true to his paramount allegiance, to scripture, and a little disappointing. Who wants to make excuses for the blind Milton?

Calvinus is a very big name indeed, bigger even than Miltonius. What’s curious is that Milton does not mention him in De Doctrina except here, on the underwhelming topic of Sunday church. He is a felt presence at other times, because Milton labours to formulate the right connection of works with grace. His Arminian position was hard-won. Yet in tilting against the opposition he doesn’t name Calvin. At the moment, in blogging mood, I explain this to myself as a home-grown or autodidact quality of the whole theology (compatible with his derivative way of citing the big fish) or a side-effect of uneven reading of theologies (mostly Ramist ergo post-Calvinic compilations, those being composed in the same schematic way as he compiled).

Martyr is the Italian exile, Peter Martyr Vermigli. Milton would relish reading P.M. as both favoured polygamy because of Old Testament patriarchal practice. Some of his reasoning turns up in Milton’s own recommendations, in De Doctrina I. 10.

Of Musculus and Ursinus , like Manuel in Fawlty Towers, “I know nothing.” It would be good if this blog were to catch the attention of a reader who knows Musculus or Ursinus independently (for even Kelley was not interested in them for their own sake)?

And so with Gomarus, Johnny-come-lately to Milton’s six. How true is it that the six are in hac ferme sententia doctissimi quique theologorum, “all the most learned theologians”? How does Milton know they are all the most learned if he hasn’t read them deeply for himself? What do those who know the work of all six, on their own terms, think of the grouping? and of the accolade? and in general of this mode of corroboration?

Such questions pour forth from a humdrum chapter: there will be others from more crucial places. We hope that our work will encourage such questioning.

Massey University Symposium “Editing Early Texts: Practice and Protocol”

Friday, May 18th, 2012 | MICHAEL COP | No Comments

Massey University is holding its “Editing Early Texts: Practice and Protocol” symposium on Friday, June 15, 2012.  Its keynote speaker is Professor Paul Salzman of La Trobe University, editor of two Oxford World’s Classics editions, Early Modern Women’s Writing, and An Anthology of Elizabethan Prose Fiction.

This symposium is for scholars and postgraduate students involved in the editing of early literary and non-literary texts. ‘Early’ is being interpreted quite broadly, c. 1500-1800, and speakers have editing interests in Shakespeare and early modern drama, early modern poetry and prose, eighteenth-century fiction, early modern women’s writing and early modern historical texts. Papers will also focus on the digital humanities and online editing.

Dr Vicki Spenser’s new monograph Herder’s Political Thought: A Study of Language, Culture, and Community

Thursday, May 17th, 2012 | MICHAEL COP | No Comments

 

We are pleased to announce that Dr. Vicki Spenser’s new book Herder’s Political Thought: A Study of Language, Culture, and Community has just appeared with University of Toronto Press:

 

Johann Gottfried Herder was a philosopher and important intellectual presence in eighteenth-century Germany. Herder’s Political Thought examines the work of this significant figure in the context of both historical and contemporary developments in political philosophy.

Vicki A. Spencer reveals Herder as one of the first Western philosophers to grapple seriously with cultural diversity without abandoning a commitment to universal values and the first to make language and culture an issue of justice. As Spencer argues, both have made Herder a source of inspiration for the pluralist turn of contemporary political philosophy. Contending that in an era of globalization, it is no longer possible to ignore Herder’s crucial insights on the relationship between cultural membership and individual identity, Spencer demonstrates how these ideas can help us understand, and perhaps resolve, the linguistic and cultural-political struggles of our times.

 

Thomas Sydenham’s Tractacus de Podagra

Sunday, May 13th, 2012 | Peter Anstey | No Comments

Terry Doyle writes …

If Thomas Sydenham (1624–1689) were transported to a modern lecture hall to hear a chemical pathologist explaining how gout is caused by the bodies of some individuals being unable to metabolise and excrete uric acid, which is then deposited in the peripheral joints, he would probably mutter to himself, ‘that is just as I thought’. Reading his Tractacus de Podagra of 1683 in Latin is interesting on at least two counts. The first is for the excellent clinical description of gout and the second is the frequent use of Greek text. As Peter Anstey most helpfully pointed out to me, Sydenham wrote only in English and had all his work translated into Latin, and his Tractatus was probably translated by Gilbert Havers or John Mapletoft.

Coming to De podagra as a neophyte in this area, a working doctor is immediately impressed that here one is reading the product of practical experience – obviously Sydenham is very familiar with the various presentations of gout, of which he was, famously, a sufferer himself. He describes the systemic and prodromal symptoms leading up to a full-blown attack of the disease, noting that although it most commonly affects middle aged men, it rarely affects women and then after menopause. He notes that some cases seem to have a hereditary basis and these individuals may be more slender and younger than the stereotypical obese over-imbiber of port wine. Some observations, seemingly inconsequential to the casual reader, are typical of the notes of a working doctor – such as his reference to the desquamation of the skin over a gouty tophus and the fact that although the initial attack affects one joint, later attacks are polyarticular and febrile. The work is sprinkled with such insightful observations.

Sydenham has been frequently referred to as the ‘English Hippocrates’ (see Peter Anstey, ‘The Creation of the English Hippocrates’, Medical History, 2011, 55: 457-78). One justification for this might be that he discusses the disease in terms of the Hippocratic doctrine of humours. If one were to substitute the words ‘uric acid’ for ‘excess of humour’ in De podagra (Sydenham freely admits he has no idea of the nature of this humour) one would have a fair description of the pathophysiology of gout. He says that the body of the sufferer is unable to ‘cook’, ‘separate’ and ‘evacuate’ whatever humour it is, and the products are deposited in the peripheral joints – which is essentially what happens. Secondly, Sydenham follows Hippocrates’ belief in the value of careful observation of symptoms. One of Hippocrates’ aphorisms is that if one listens to patients long enough, they will tell you the diagnosis. Thirdly, both believe that if the doctor can do no good, at least no harm should be done. Thus Sydenham suggests avoiding bleeding and purging, since in his experience they are not only useless but harmful. On the contrary, he found that drinking liberally of non-spirituous fluids (to flush out the renal stones) and partaking of mild sudorifics such as Sarsaparilla are at least helpful to the sufferers.

The other feature of interest in the Latin text of 1683 is the frequent use of Greek words in original script – at total of 37 words or phrases in 130 pages. On the first page he describes gout as ‘naturam δυσνοητον’ meaning ‘difficult to understand’. Most of the words are fairly straightforward like απεψια, αταξια, μιασματα, ανωμαλια. At one point he coyly says that flatus may be evacuated ‘sive ανω sive κατω’ (either upwards or downwards). Some words seem like new coinages, such as γαλατοποσια (a milk drinker) and ποδαγιωντων (of gout sufferers) but they appear in Liddell and Scott. The word ‘podagra’ is derived from the Greek for ‘foot trap’, and is of ancient usage in English. The OED notes that John of Trevisa used it in his De proprietaribus rerum of 1398.

Greek words and text interspersed with Latin in medical books was not new. The first textbook on anatomy published in England, David Edwards’ Introduction to Anatomy of 1532 (facsimile edition edited and translated by C.D. O’Malley and K.F. Russell, Stanford UP, 1961), uses them freely. Edwards was Reader in Greek at Corpus Christi College Oxford in 1521 in addition to studying medicine. Sydenham would have studied Greek as part of his undergraduate course in medicine and his friend John Locke taught Greek for a time. What was the reason for the insertion of Greek words in to Sydenham’s Latin text? None appear to clarify the argument. They seem rather in the nature of literary flourishes, particularly when he refers to Lucian’s play Τραγοποδαγρα (The Gout Tragedy). He may be merely using the professional argot of his medical contemporaries, who mostly had a similar educational background. Modern doctors seem to use baffling acronyms for a similar end.

Three questions remain to be answered. (1) To what extent did Sydenham work in the reference frame of the Hippocratic doctrine of humours? (2) To what extent did 17th century doctors’ knowledge of Greek contribute to medical nomenclature? (3) What was Sydenham’s relationship with Thomas Short to whom Tractacus de Podagra was dedicated? Short took over Richard Lower’s lucrative practice when the Lower fell from Court favour because of his Whig politics. I look forward to hearing from readers who might be able to help with these questions.

The Case of Thomas Emes

Sunday, May 6th, 2012 | Peter Anstey | No Comments

Plenty of obscure books were published in the early modern period and for anyone who is prepared to spend a few hours scouring a database as powerful as Eighteenth Century Collections Online (or its 17th-century equivalent EEBO) it is not uncommon to turn up a work about which little is known.

Now, as a student of the philosophy of John Locke (1632–1704), I am interested in the impact of Locke’s thought on subsequent generations. One of Locke’s most notorious and widely discussed remarks in the Essay concerning Human Understanding (1690, 1st edn) concerns the possibility that God might supperadd to ‘Matter fitly disposed’ the power of thought (Essay IV. iii. 6). Earlier in the year, I stumbled upon a book (unhelpfully) listed in ECCO as Vindici? Mentis attributed to Thomas Emes and published in 1702. I found it by searching for occurrences of the term ‘fitly disposed’. The correct title is Vindiciae Mentis

Here is how Emes introduces his extended discussion and what he says clearly alludes to Locke:

It is supposed by some that God may give a Power of Thinking, to matter some way or other fitly dispos’d; at least that none has ever demonstrated the Contrary, and whether it be demonstrable, it to them a Question. (p. 26)

Of course scholars have been writing about the impact of this claim for decades. John Yolton, for example, wrote not one, but two books about it: Thinking Matter (1981) and Locke and French Materialism (1991). Until very recently, however, Emes’ book had slipped under the radar of modern scholarship. Yolton doesn’t mention it in either of his books on the thinking matter controversy, which is understandable because they were written years before the availability of the new databases. But searches of Google Scholar and JSTOR turned up nothing either, except of course the book itself.

Moreover, John Attig’s superb Locke Bibliography lists 104 works under the subject ‘Thinking matter’ dating from 1695, but it doesn’t include Emes’ book. Even worse, the article on Thomas Emes in the Oxford Dictionary of National Biography fails to mention this work even though there are very strong grounds for attributing it to him. Poor old Emes! His work really did fall dead-born from the press (to echo Hume).

This neglect of Emes’ book has recently been rectified by Udo Thiel in his excellent The Early Modern Subject: Self-Consciousness and Personal Identity from Descartes to Hume. Thiel’s discussion of Vincidiæ Mentis (pp. 227–9) is concerned, not with the thinking matter controversy, but with the question of personal identity. However, Thiel does provide good evidence for the attribution of authorship to Emes and mentions that the book was discussed in a pamphlet in 1702 by Henry Layton.

So what then is the value of this highly obscure book? As far as philosophical sophistication goes, it is a work of little merit. But with regard to what it tells us about the reception of Locke’s ideas and the wider debate about the nature of the soul, the mind–body distinction and personal identity, this work has a minor, though important, place in the broader context in which these issues were discussed.

I will contact John Attig straight away and ask him to add the name ‘Emes’ to his Locke bibliography. I will also ask ECCO to correct the title of Emes’ book. Meanwhile, start searching ECCO. Who knows what you’ll turn up?