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.
Thomas Sydenham, the experimental physician
Peter Anstey writes…
The London physician Thomas Sydenham (1624–1689) is regarded today as one of the greatest physicians of the seventeenth century. He is even claimed to have had an influence on the philosophy of John Locke. But what exactly is the basis of Sydenham’s reputation?
A careful study of the appearance of Sydenham’s name in the medical writings of the latter decades of the seventeenth century and the correspondence of his friends and associates reveals that during his professional years he faced constant opposition and criticism. Henry Oldenburg, Secretary of the Royal Society, said of him in a letter to Robert Boyle (24 December 1667): ‘with so mean and un-moral a Spirit I can not well associate’. Sydenham was never to become a Fellow of the Royal Society or of the College of Physicians.
However, his posthumous reputation is markedly different. After his death, Sydenham was praised for three things: his commitment to natural histories of disease; his decrying of hypotheses and speculation; and his Hippocratic emphasis on observation. Interestingly, these are the hallmarks of the experimental philosophy. Witness, for example, what Locke says of him in a letter to Thomas Molyneux of 1 November 1692:
- I hope the age has many who will follow his example, and by the way of accurate practical observation, as he has so happily begun, enlarge the history of diseases, and improve the art of physick, and not by speculative hypotheses fill the world with useless, tho’ pleasing visions.
By the early eighteenth century Sydenham’s name could hardly be mentioned without effusive praise, such as that found in George Sewell’s ode to Sir Richard Blackmore:
- Too long have we deplor’d the Physick State, …
Then vain Hypothesis, the Charm of Youth,
Oppose’d her Idol Altars to the Truth: …
Sydenham, at length, a mighty Genius, came,
Who founded Medicine on a nobler Frame,
Who studied Nature thro’, and Nature’s Laws,
Nor blindly puzzled for the peccant Cause.
Father of Physick He—Immortal Name!
Who leaves the Grecian [Hippocrates] but a second Fame:
Sing forth, ye Muses, in sublimer Strains
A new Hippocrates in Britain reigns.
These comments are of the most general nature. There is nothing about the actual content of Sydenham’s medical theories or therapeutics, which were so harshly criticized while he was alive. It is all about his methodology and it is cashed out in terms of the experimental philosophy.
Thomas Sydenham, by a remarkable change in fortunes, came to be regarded as the archetypal experimental physician largely thanks to his posthumous promoters such as John Locke. Sydenham, for better or for worse, was the experimental physician that the promoters of the experimental philosophy had to have.
Locke’s Master-Builders were Experimental Philosophers
Peter Anstey says…
In one of the great statements of philosophical humility the English philosopher John Locke characterised his aims for the Essay concerning Human Understanding (1690) in the following terms:
- 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 every one 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 other of that Strain; ’tis Ambition enough to be employed as an Under-Labourer in clearing Ground a little, and removing some of the Rubbish, that lies in the way to Knowledge (Essay, ‘Epistle to the Reader’).
Locke regarded his project as the work of an under-labourer, sweeping away rubbish so that the ‘big guns’ could continue their work. But what is it that unites Boyle, Sydenham, Huygens and Newton as Master-Builders? It can’t be the fact that they are all British, because Huygens was Dutch. It can’t be the fact that they were all friends of Locke, for when Locke penned these words he almost certainly had not even met Isaac Newton. Nor can it be the fact that they were all eminent natural philosophers, after all, Thomas Sydenham was a physician.
In my book John Locke and Natural Philosophy, I contend that what they had in common was that they all were proponents or practitioners of the new experimental philosophy and that it was this that led Locke to group them together. In the case of Boyle, the situation is straightforward: he was the experimental philosopher par excellence. In the case of Newton, Locke had recently reviewed his Principia and mentions this ‘incomparable book’, endorsing its method in later editions of the Essay itself. Interestingly, in his review Locke focuses on Newton’s arguments against Descartes’ vortex theory of planetary motions, which had come to be regarded as an archetypal form of speculative philosophy.
In the case of Huygens, little is known of his relations with Locke, but he was a promoter of the method of natural history and he remained the leading experimental natural philosopher in the Parisian Académie. In the case of Sydenham, it was his methodology that Locke admired and, especially those features of his method that were characteristic of the experimental philosophy. Here is what Locke says of Sydenham’s method to Thomas Molyneux:
- I hope the age has many who will follow [Sydenham’s] example, and by the way of accurate practical observation, as he has so happily begun, enlarge the history of diseases, and improve the art of physick, and not by speculative hypotheses fill the world with useless, tho’ pleasing visions (1 Nov. 1692, Correspondence, 4, p. 563).
Note the references to ‘accurate practical observation’, the decrying of ‘speculative hypotheses’ and the endorsement of the natural ‘history of diseases’ – all leading doctrines of the experimental philosophy in the late seventeenth century. So, even though Sydenham was a physician, he could still practise medicine according to the new method of the experimental philosophy. In fact, many in Locke’s day regarded natural philosophy and medicine as forming a seamless whole in so far as they shared a common method. It should be hardly surprising to find that Locke held this view, for he too was a physician.
If it is this common methodology that unites Locke’s four heroes then we are entitled to say ‘Locke’s Master-Builders were experimental philosophers’. I challenge readers to come up with a better explanation of Locke’s choice of these four Master-Builders.