Chemistry and Medicine in the Eighteenth Century

The first of two Anglo-Dutch Meetings was held at the Museum Boerhaave, Leiden from 22 to 24 April 2004. It was organised jointly between the Royal Society of Chemistry Historical Group, the Museum Boerhaave, the Society for the History of Alchemy and Chemistry, the Chemiehistorische Groep van de Koninklijke Nederlandse Chemische Vereniging and the Genootschap GeWiNa. The proceedings began with a reception on Thursday evening at the Museum and the conference the following day attracted an international audience of about 80.

The morning session was chaired by Prof. Dr Ernst Homburg from the University of Maastricht and commenced with Dr Noel Coley of the Open University speaking on Eighteenth century chemical physicians and the empirical art of medicine. Dr Coley began with a description of eighteenth-century medical diagnosis and treatment as an empirical skill. Therapy was based on the ancient humoral pathology and blood-letting was a common treatment. The use of leeches and the role of medical botany were discussed as the basis for the extraction of drugs and medicines. The extension of material medica was touched on, as was the prevalence of quackery and the ridicule in which much of medicine was widely held.

How then could chemistry help to improve the quality of medicine? The problems of eighteenth century chemistry were mentioned – animal analysis by destructive distillation, the predominance of the phlogiston theory and belief in vitalism all served to hinder the utility of chemistry in medical practice. Urine analysis and the study of urinary calculi as well as the analysis of mineral waters made important contributions to eighteenth century medical chemistry, but the results were not impressive. The majority of physicians ignored the possibility that chemistry might have anything to offer medical practice. However, new entrants to the profession, trained at Leiden or Edinburgh, brought a more positive view and in Britain several young physicians, pupils of Cullen or Black, began to offer lectures on chemistry both privately and in the medical schools. Then, after the revolutionary developments derived from eighteenth-century studies in pneumatic chemistry and introduced by Lavoisier, Dalton and others, the way was cleared for the rapid expansion of clinical and medical chemistry in the nineteenth century.

The second paper entitled Some Changes in Eighteenth Century Materia Medica was delivered by Professor Harm Beukers of the University of Leiden and focussed on the development of medicinal substances in the eighteenth century. In the early seventeenth century there had been upwards of 6000 items of materia medica. Out of these fewer than 200 were derived from animal and mineral sources, with the majority originating from plants and based on the ideas of Dioscorides. Many of these galenical medicines were mixtures containing large numbers of drugs, with each hospital having its own selection. However during the eighteenth century various changes occurred. The naming of drugs began to be rationalised; the range of drugs in use was gradually reduced; pharmacopoeias, which would become statutory, began to appear; and chemistry increasingly produced drugs to replace some of the old galenicals. Additionally attempts to explain the processes of disease and how medicines acted in the body began. Taking the case of the Netherlands as an example, the speaker showed how the drugs made available for various sections of the public were carefully selected according to quality, effectiveness and cost, with cheaper ones reserved for the treatment of the poor. This selection was particularly important in the case of military medicine and Professor Beukers explained how the relevant authorities, acting upon the advice of military and naval surgeons, also carefully chose the drugs included in the medicine chests of the army and navy.

Dr Anna Simmons of the Open University delivered the next paper entitled Medicine, Monopolies and Mortars: The Pharmaceutical Trade at the Society of Apothecaries in the Eighteenth Century. Dr Simmons explained how the Society of Apothecaries is generally studied in terms of its current functions as a medical licensing corporation and livery company. However, there was a significant third strand to its activities from 1672 to 1922: the pharmaceutical trade at Apothecaries’ Hall. Following the foundation of a laboratory in 1672, this was one of the earliest establishments in England for producing drugs on a large scale. Whilst the primary function of the laboratory was to produce chemical medicines, it also played a central role in the Society’s activities, developing its role as a guarantor of drug quality, asserting its pharmaceutical authority, encouraging the chemical education of the apothecary and reasserting the Society’s precedence in drug production.

Following the foundation of the Navy Stock in 1703 and the Laboratory Stock in 1713, the Hall pharmaceutical trade developed further, with the monopolies held with the Navy and the East India Company forming the backbone of its trade. However throughout the eighteenth century the Society’s activities were influenced by the changing role of the apothecary and the evolving practices of chemistry, pharmacy and medicine. Despite these changes, the laboratory and the pharmaceutical trade remained central to the Society’s activities. The laboratory was an essential component of the Society’s reputation as a high-quality manufacturer and its production capacity was unchallenged.

The final paper in the morning session was delivered by Professor Lissa Roberts of the University of Twente and entitled Solution to Revolution. Dutch Chemistry between Science and Industry. Professor Roberts sketched a new approach to the “chemical revolution” transcending divisions between the history of science and history of technology and placed calls for chemical reform in the Netherlands in that explanatory context. She argued that whether or not individual Dutch chemists accepted the theories of the “new chemistry” as developed by Lavoisier and his colleagues, they were not in a position to follow the French drive towards standardization and dependence on quantitative measurement because of local conditions. That is, the Netherlands’ lack of centralisation precluded this form of socio-chemical reorganisation. Furthermore the Dutch generally did not follow the entrepreneurial direction of their British counterparts because of their cultural commitment to maintaining a marriage between economic and moral reform – what they called “oeconomic patriotism”. In examining the Dutch situation in this way her paper provided an interesting and novel approach to late eighteenth and nineteenth-century developments in chemistry and its relations with industry and contemporary Dutch society.

Lunch was held around the reconstructed Anatomy Theatre at the Museum Boerhaave. Whilst the GeWiNa members attended their general meeting, the other conference participants enjoyed guided tours of the Museum. Amongst the impressive exhibits seen were J.H. Van’t Hoff’s molecular models, Antoni van Leeuwenhoek’s microscope and numerous anatomical specimens.

The afternoon session was chaired by Professor Jack Betteridge, Chairman of the RSC Historical Group and commenced with a paper by Dr Rina Knoeff of the University of Maastricht entitled “…in medicine all possible good can be expected from it”. On the role of chemistry in Boerhaave’s medicine. Dr Knoeff discussed the importance of chemistry as the basis of Boerhaave’s medicine from 1710. Although far more emphasis has been placed on the mechanistic nature of Boerhaave’s medicine, than on the importance he gave to chemistry, he did not slavishly follow Newton’s attempts to reduce all the properties of matter to forces of attraction. Rather he recognised various other natural forces and in chemistry he saw the best way to discover the individual properties of natural bodies. This was crucial for understanding the workings of the human body, which led to the development and preparation of remedies. He studied body fluids and their chemical reactions, which he regarded as the basis of the movement essential to life. He ascribed many illnesses to putrefaction of the blood due to stasis, whilst diet and regimen were considered most important in maintaining health and digestion was seen as a chemical process. He also rejected the acid-alkali theory of the iatrochemists because he found so many healthy animal fluids to be neutral.

Dr Knoeff paid particular attention to how Boerhaave adopted a “Hippocratical manner” in his medicine as well as in his chemistry and showed how he focussed on detailed observations of symptoms and devotion to the patient’s well-being. In particular Boerhaave’s repetition of the Hippocratic call for the physician to follow nature as his sole guide led to chemistry (which Boerhaave considered the key to nature) becoming a central part of his medicine. Furthermore on the subject of chemistry, he emphasised that it was more important to know what it is and what it does, rather than merely to use chemical remedies.

Dr Robert Anderson of Cambridge University then delivered the recently instituted Wheeler Lecture which this year was entitled Boerhaave to Black: the evolution of chemistry teaching. Dr Anderson began by emphasising how Hermann Boerhaave (1668-1738) and Joseph Black (1728-1799) were the most widely sought-after teachers of chemistry in the eighteenth century, attracting students from Continental Europe, Russia, North America and the West Indies. Boerhaave taught medicine, botany and chemistry at Leiden University, and he in turn strongly influenced medical teaching at Edinburgh.

The Edinburgh medical school was founded in 1726 by four hand-picked young Scottish physicians who were sent to study with Boerhaave and who were later appointed professors of medicine. They advertised their course as being specifically Boerhaavian in content. Gradually during the century the systematic descriptions of drug preparation, which occupied a large part of the course, were replaced by an approach that emphasised the independence of chemistry as a subject in its own right. A new generation of teachers led by William Cullen (1710-1790) had links with an aristocracy which wanted to benefit from resources on their land, while industrial initiatives were taken by those who had attended the chemistry lectures of Cullen and Black. Although chemistry teaching had originally been intended for the benefit of medical students, the proportion of those attending who would later graduate in medicine was quite small. It is not easy to know exactly what was taught by Boerhaave and Black. The dense texts (initially pirated in Boerhaave’s case and posthumously published from inadequate jottings in Black’s) may not relate closely to what was actually being presented at the lectures. Most manuscript “student notes” were created by professional scribes. It is clear, however, that skilled demonstrations were performed and that Black revelled in his skills of showmanship.

In an era when pneumatic chemistry was so fashionable, it is fitting that the development of the eudiometer formed the subject of the closing paper, entitled The goodness of air: eudiometry as a tool in eighteenth century chemistry and medicine, which was delivered by Dr Trienke van der Spek of the Museum Boerhaave. Joseph Priestley discovered that atmospheric air is composed of different components, of which one is essential for the respiration of animals and humans. He invented a way to measure this component using “nitrous air” (nitric oxide) and suggested a relation between the “goodness” of the air thus recorded, and its healthiness. This resulted in a strong focus on the medical utility of pneumatic chemistry in the last quarter of the eighteenth century. A new type of instrument – the eudiometer – appeared in 1775, largely based on Priestley’s method to measure the “goodness” of the air. With this instrument Priestley’s contemporaries started on environmental research throughout Europe, monitoring the goodness of graveyards, sewage, factories and woods. The results of these investigations were almost immediately disputed in terms of their reliability and usefulness by certain critics. Nevertheless they also led to recommendations to improve public health and to the emergence of “pneumatic medicines”. Dr van der Spek then provided a technical description of the different kinds of eudiometers and their uses, focussing on the role that scientists such as Martinus van Marum and Jan Ingenhousz played in the application of medical eudiometry in the Netherlands.

On the Friday evening a highly successful conference dinner was held in the Restaurant Koetshuis de Burcht in the centre of Leiden and on the Saturday excursions were made to the Museum Cruquuis, the Teylers Museum and the Botanical Museum. This provided an enjoyable conclusion to the conference and we are all looking forward to the second meeting which will be held in London in autumn 2005.

Noel Coley and Anna Simmons