As a chemist and experimental pharmacologist, he prepared various remedies.
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Some of these he tried out on patients himself, others he gave to practitioners who might use them. Boyle seems to have abundantly provided what we today call "curbstone consultations. In no way bound by guild rules and conventions or by rigid educational standards, Boyle was free to learn from whatever sources appealed to him. Repeatedly he emphasized the importance of learning from experience, both his own and that of others, and by "others" he included not only physicians and learned gentlemen, but even the meanest of society, provided they had experience in treating disease.
This experience need not be restricted to treatment of humans but should include animals as well. Thus, in speaking of even the "skilfullest physicians," he indicated that many of them "might, without disparagement to their profession, do it an useful piece of service, if they would be pleased to collect and digest all the approved experiments and practices of the farriers, graziers, butchers, and the like, which the ancients did not despise This casts an interesting sidelight on the snobbishness of the medical profession.
Boyle's willingness and ability to ignore the restrictions of an Establishment represent the full flowering of what I might call the Renaissance spirit—the drive to go outside accepted [Pg 34] bounds, to explore, to try , to avoid commitment, and to investigate for oneself. What internal and external factors permit a successful breakaway from tradition?
Rebels there have always been, yet successful rebels are relatively infrequent. The late seventeenth century was a period of successful rebellion, and the virtuosi were one of the factors which contributed to the success. Robert Boyle played a significant part in introducing new methods into science and new science into medicine. We must realize that Boyle was primarily a chemist and not a biologist. He thought in chemical terms, drawing his examples from physics and chemistry; he did not think in terms of the living creature or the organism, and as a mechanist he passed quite lightly over the concept or organismic behavior.
His basic anti-Aristotelianism prevented his appreciating the biologically oriented thought of Aristotle. Instead, Boyle talked about the inorganic world, of water, of metals and elements, of physical properties. He ignored that inner drive which Spinoza called the conatus ; or the seeds of Paracelsus or van Helmont; or the persistence over a time course of any "essence" or "form. As a chemist, he could seek fairly specific and precise correlations of various concrete environmental factors, and then assume that living beings behaved as did the inorganic objects which he investigated. However, he always excepted the soul of man, as outside his investigations.
But while Boyle was a skillful chemist, judged by the standards of his time, we cannot call him a skillful medical investigator. This represents, however, the fault of the era in which he lived rather than any fault peculiar to him. Boyle's medical studies fall into at least two categories. These were the purely physiological experiments, such as those on respiration or on blood, and the more clinical experiments, concerned with [Pg 35] pharmaceuticals, clinical pharmacology, and clinical medicine.
The purely physiological experiments have great merit and were profoundly influential in shaping modern physiology. The clinical experiments throw great light on the development of critical judgment in medical history, and the relations of judgment and faith. In , John Hunter wrote a letter to Jenner that has become quite famous. Hunter had just thanked Jenner for an "experiment on the hedgehog. I think your solution is just, but why think? Why not try the experiment?
A "just solution" is one that is logically correct. The "think" refers to Hunter's own uncertainty. He is not content with a verbal or logical solution to a problem, he wants empirical demonstration. Why, he is asking, should we be content with merely a logically correct solution when we can have an experiential demonstration. Try the experiment.
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Put the logical inference to the test of experience. This empirical attitude, not at all infrequent in the latter eighteenth-century medicine, was quite unusual in the seventeenth-century medicine. This was precisely the attitude that Robert Boyle exhibited in his clinical contacts.
Medicine, at least textbook medicine, was rationalistic. Textbooks started with definitions and assertions regarding the fundamentals of health. This we see particularly in a Galenic writer such as Riverius. Medicine, he said, "stands upon the basis of its own principles, axioms and demonstrations, repeated by the demonstration of nature. All were beautifully interdigitated in a logical [Pg 36] fashion, and for any recommended therapy a good reason could be found. There was, however, a serious difficulty.
If anyone were so bold as to ask, But how do you know? The exposition rested in large part on authority or else largely on reasoning from accepted premises—a "just" reasoning. And while much keen observation was duly recorded and a considerable mass of fact underlay the theoretical superstructure, the idea of empirical proof was not current.
Riverius chopped logic vigorously and drew conclusions from unsupported assertions in a way that strikes us as reckless. For a body of knowledge to be a science, it must indicate a logical connection between first principles, which were "universal," and the particular case. The well-educated physician could always give a logical reason for what he did. The empiric, however, was one who carried out his remedies or procedures without being able to tell why.
That is, he could not trace out the logical connection between first principles and the particular case. Galenism suffered especially from logical systematization, and the system of van Helmont, while far less orderly, also had its own basic principles on which all else depended. Boyle, however, practiced medicine on a thoroughly different basis. He did not depend on system or logic. In the words that Hunter used to Jenner over a hundred years later, other physicians would think the answers to their problems.
Boyle, however, preferred to try the experiment. He wanted facts. But this attitude, which sounds so modern, so praiseworthy and enlightened, had one serious flaw. What was a fact? And how did you know?
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This important problem, so significant for the growth of scientific medicine, we can study quite readily in the works of Robert Boyle. The problem, in a sense, resolves around the notion of credulity. What shall we believe? Boyle makes some distinctions between what he has seen with his own eyes and what other people [Pg 37] report to have seen.
Thus, he mentions "a very experienced and sober gentleman, who is much talked of" who cured cancer of the female breast "by the outward application of an indolent powder, some of which he also gave me. Or again, he talks about "sober travelers" who made certain claims regarding the treatment of poisons. But, he says, "having not yet made any trial of this my self, I dare not build upon it. There are numerous such instances, scattered throughout his works, where he reports an alleged cure but specifically indicates his own mental reservations.
Clearly, he is quite cautious in accepting the statements of others, even though they were "sober" or "experienced" or even "judicious. His skepticism he indicates in references, for example, to Paracelsus and van Helmont. Their specific remedy against "the stone," he says, and their claims that they can reduce stones to "insipid water, is so strange not to say incredible that their followers must pardon me, if I be not forward to believe such unlikely things, til sufficient experience hath convinced me of their truth.
A claim is made, but if this claim runs counter to Boyle's own accepted body of knowledge, or to logical doctrines derived from other directions, mere assertion cannot carry conviction. In judging the effectiveness of a remedy or the credibility of a statement, one of the most important weapons was analogy. Direct observation of a phenomenon was good. Next best was direct observation of some analogous phenomenon whereby one [Pg 38] body acted upon another to alter its properties or induce significant changes.
Boyle drew his analogies largely from chemistry, but he had no hesitation in applying them to medicine. Claims that medicines swallowed by mouth could dissolve stones in the bladder seemed a priori unlikely. Yet there was considerable authority that this took place; many persons had reported that this was a fact. Boyle kept an open mind. He might be highly skeptical in regard to the claims for any particular medication, but he did not deny the principle involved. The possibility that some fluid, when swallowed, could have a particular specific action on stones in the bladder, without affecting the rest of the body, he considered quite plausible through the analogy that quicksilver has an affinity with gold but has no effect upon iron.
Furthermore, a substance than can corrode a solid body may nevertheless be unable to "fret" a different body which is considerably softer and thinner, if the "texture" does not admit the small particles. In other words, he was very open-minded. He refused to dismiss all such claims, and provided analogy as a reason for keeping his mind open; yet he refused to accept particular claims of medicine that dissolved stones, because the evidence was not convincing.
We could scarcely ask for more. An important seventeenth-century medical document was the report of Sir Kenelm Digby, regarding the so-called "weapon salve. One great advantage of chemistry, thought Boyle, lay in the [Pg 39] help it provided in investigating the materia medica.
Chemistry, he thought, could help to purify many of the inorganic medicines and make them safer, without impairing their medicinal properties. Furthermore, chemistry could help investigate various medications customarily employed in medicine, where "there hath not yet been sufficient proof given of their having any medical virtues at all. While a major interest, perhaps, was a desire to provide inexpensive medicines, he was well aware that much of what went into prescriptions probably had no value. Furthermore, he felt that his chemical analysis could indicate whether value and merit were present or not.
The same skepticism applies to remedies that, far from being expensive, were common and yet rather disgusting. The use of feces and urine as medication was widespread. The medical virtues of human urine represent, he believed, a topic far too great to be considered in a brief compass. But he declared that he knew an "ancient gentlewoman" suffering from various "chronical distempers" who every morning drank her own urine, "by the use of which she strangely recovered.
But in therapeutic trials that he himself had witnessed, he seemed utterly convinced that the medication in question was responsible for the cure and was quite content to accept the evidence of a single case. He discussed the "efficacy" of millepedes, which he found to be "very diuretical and aperitive. Many remedies of this type, the so-called old wives' remedies, were those of empirics. As mentioned previously, Boyle felt deeply concerned because physicians tended to ignore the al [Pg 40] leged remedies of those who had not had formal training in medicine.
He believed that great specific virtue probably lurked in many of these remedies, and he maintained that the chemists should investigate them without the prejudice that the medical professions exhibited. As part of this view, he felt that "simples" should be more carefully studied, because medicinal virtues inhered in single substances and that complicated combinations were unnecessary.
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We find innumerable examples scattered through Boyle's writings regarding the relations between chemistry and medication, numerous descriptions of cures, and skepticism regarding other alleged cures. As an important example, I would indicate Boyle's discussion of one of van Helmont's alleged cures.
Van Helmont described the remarkable cures brought about by a man identified only by the name of Butler. Apart from van Helmont's discussion, we can find no trace of him in medical annals, and van Helmont's own account is extremely skimpy. There are no dates given, and the only temporal clue is that Butler apparently knew King James—King James I, naturally.
Butler was an Irishman who suddenly came into world view while in jail. A fellow prisoner was a Franciscan monk who had a severe erysipelas of the arm. Butler took pity on him, and to cure him took a very special stone which he had and dipped it briefly in a spoonful of "almond milk. Almost immediately thereafter, the monk, not aware of the medicine, noted an extremely rapid improvement. Van Helmont related other cures. For example, a laundress who had a "megrim" [migraine] for sixteen years was cured by partaking of some olive oil, into a spoonful of which Butler dipped the stone.
Other cures for which van Helmont vouched included a man who was exceedingly fat; he touched the stone every morning with the tip of his tongue and very speedily lost weight. Van Helmont's own wife was cured of a marked edema [Pg 41] of the leg. Similarly, a servant maid who had had severe attacks of erysipelas which were "badly cured," and the leg leaden colored and swollen, was cured almost immediately. An abbess, whose arm had been swollen for eighteen years, partly paralyzed, was also cured. Van Helmont, however, indicates that he himself, when he thought he was being poisoned by an enemy, did not secure any benefit from the use of the stone.
Later, however, it turned out that, because of the nature of the illness, he should have touched the stone with his tongue, to take its virtue internally, rather than merely anointing the skin with oil into which the stone had been dipped. Van Helmont makes it very clear that this is not magic or sorcery; there is no diabolic influence, no necromancy.
He drew attention to the overwhelming effects which might result from a cause which was so minute that it could not be perceived by the senses. We cannot here go into the theoretical background which underlay van Helmont's conceptions, but we must mention at least briefly his idea of a basic mechanism.
Van Helmont considered the action to be that of a ferment, where an extremely minute quantity can produce a tremendous effect. He gives the analogy of the tooth of a mad dog, which, although any saliva has been carefully wiped off, can nevertheless sometimes induce madness. The effect of the stone seems to be comparable. Its power becomes manifest even in enormous dilution and can multiply, for it can import its remedial virtue to a vast quantity of oil. Moreover, the stone had a sort of universal power against all diseases.
Such a virtue could not be vegetable in its nature, but was, he thought, connected with metals. He pointed to the well-accepted medicinal virtues which inhered in gems. Metals also had great medicinal potency. Antimony, lead, iron, mercury, were well known, and of special importance was copper, the Venus of the early chemists. The medicinal virtue which inhered in Butler's stone and in other powerful fermental remedies, van Helmont designated [Pg 42] as "drif," which he said means, in the vernacular, virgin sand or earth. This virtue requires a metallic body in which to inhere.
The general concept is not unfamiliar, of a virtue or power or ferment which was attached to a material object, and it is this type of explanation which was so preponderant in, for example, Porta's Natural Magick. Van Helmont speaks of the "first being," which translates the Latin Ens , of Venus or copper. Vitriol is the basic substance, and for purification of the virtue we require a "sequestration of its Venus from the dregs of the vitriol. This was the background from which Boyle set about to secure a potent remedy. Van Helmont had discussed his experiments whereby he tried to create a medicine which would have the virtues of Butler's stone.
Boyle attempted to improve on van Helmont's technique. Copper—Venus—was the basic metal, and Boyle started with vitriol or copper sulfate. He gave fairly explicit directions for the preparation, including calcination, boiling, drying, adding sal armoniack, subliming twice. The resulting chemical represented a purified medicine which he prescribed in variable dosage, from two or three grains, up to twenty or thirty at the maximum. He declared it to be a "potent specifick for the rickets," since he, and others to whom he had given it for use, had "cured" a hundred or more children of that disease.
The medicine he also prescribed in fevers and headache, and he thought it "hath done wonders" in obstinate suppressions of the menses. It also improved the appetite. It worked, he declared, through the sweat and, to some extent, the urine. As another example, he gave directions for preparing essence of hartshorn—prepared, literally, from the horn itself. The preparation, strongly alkaline, he prescribed in small doses of eight to ten drops. If first, Only the view the invention of improvement information and material progress in seventeenth in its pre-requisite something.
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