©The Royal Society/Richard Valencia.

Experimental medicine in mid-17th-century England

Peter Anstey writes …

In my last post I claimed that the London physician Thomas Sydenham (1624–1689) faced much opposition during his professional career, and yet his posthumous reputation was that of the experimental physician par excellence. But was Sydenham the first experimental physician, the first English Hippocrates?

This question raises, in turn, the further issue of the extent to which the experimental philosophy, which emerged in England in the late 1650s and early 1660s, influenced English medicine. The hallmarks of Sydenham’s method – at least as championed by John Locke, the Dutch physician Herman Boerhaave and the Italian Giorgio Baglivi – were his commitment to natural histories of disease, his strident opposition to hypotheses and speculation, and his strong emphasis on observation. Interestingly, each of these methodological tenets can be found in the writings of physicians, and especially the chymical physicians (who opposed the Galenists of the College of Physicians), in England from the late 1650s.

Opposition to dogmatism and speculation was focused on the Galenists who, as the polemicist Marchamont Nedham claimed:

    in a manner after their own Phantasie, framed the Art of Physick into a general Method, after the fashion of some Speculative Science; and so by this means, a copious form of Doctrin, specious enough, but fallacious and instable, was built’ (Medela medicinae, London, 1665, p. 238)

By contrast, there was a strong emphasis on observation and experiment amongst the chymical physicians. George Starkey, the American émigré, whose chymical medicine had a profound influence on Boyle, but who died of the plague in 1665, opens his Nature’s Explication (London, 1657, p. 1), which is dedicated to Boyle, with the following claim:

    What profit is there of curious speculations, which doe not lead to real experiments? to what end serves Theorie, if not appplicable unto practice.

In 1665 in his Galeno-Pale, the chymical physician George Thomson entitled his tenth chapter ‘An Expostulation why the Dogmatists will not come to the touchstone of true Experience’. Thomson explicitly identifies himself as an experimental physician in his Misochymias elenchos … with an assertion of experimental philosophy, London, 1671.

Moreover, very early in the life of the Royal Society there were calls for natural histories of disease. Christopher Wren and Robert Boyle both set this as a desideratum for medicine and saw it as part of the broader program of Baconian natural history that the Society was pursuing. And in the 1660s Bacon’s method of natural history was affirmed and practised by physicians of the likes of Timothy Clarke and Daniel Coxe. Clarke had been involved in the exciting blood transfusion experiments of the mid-1660s and Coxe was a chymical physician, who even tried, though without much success, to get Sydenham interested in chymistry.

It is pretty clear then that Sydenham was not the first English physician to adopt and employ the new method of the experimental philosophers. Indeed, from the time that it first emerged, the experimental philosophy was applied in medicine. Why is it then, that Sydenham and not Clarke, Coxe or Thomson is hailed as the English Hippocrates? Part of the answer must lie in the fact that the chymical physicians were decimated by the plague in 1665, for they stayed in London in the belief that they could cure it. Part of the answer also lies in the politics of Restoration medicine and the mixed fortunes of the College of Physicians and its vexed relations with the Royal Society. And yet there must have been other factors involved. I have documented the emergence of Sydenham’s posthumous reputation in ‘The creation of the English Hippocrates’ which appears in Medical History this month. But I am not satisfied that I have a full understanding of the Sydenham phenomenon and I look forward to hearing insights that others might have.

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