Boerhaave and the Flight from Reason in Medicine

Boerhaave's is a name to reckon with. It is invoked often in the history of medicine and science as if there were a widespread understanding of his views, his accomplishments, and his causal influence. Our "knowledge" about Boerhaave's importance, however, is often familiarity with the icon rather than the person. The mythology makes him into perhaps the greatest rational systematist of modern medicine, providing the foundation for eighteenth-century academic medicine. Even less-exalted claims tend to emphasize his singular importance. If we treat him instead as a very thoughtful and articulate participant in the intellectual culture of his day, we can not only show his debt to others, we can, more importantly, draw some conclusions that show his partisanship for a particular outlook.

Rather than trying to reconcile reasoned theory with sensory experience, Boerhaave placed all his confidence in the latter; rather than attempting to unify knowledge of mind and body, he declared that the physician needed only to understand the latter. In his religion as in his medicine he trusted experience rather than reason, shedding discussion of doctrine and its consequences. Whatever he may have believed when he prayed, Boerhaave's medical teachings explicitly avoided any reference to immaterial powers, whether they be faculties or a soul, in favor of that which could be known through the senses. Accordingly, in contrast to medical professors like Georg Ernst Stahl, he separated his religious views from his medical ones. Moreover, given his refusal to comment at length on the relationship between the rational soul (or mind) and the body, materialists such as Julien Offray de La Mettrie could claim him as one of their own. Examined from this point of view, his work points to one of the main sources of tension in academic medicine at the beginning of the eighteenth century: would it lead people away from a full account of humans into the merely useful knowledge of the corporeal body?

Until recently, most accounts of Boerhaave have taken their direction from the Oratio academica: In memoriam Hermanni Boerhaavii, delivered by his colleague Albert Schultens in November 1737 and published soon thereafter. In addition to his personal acquaintance with Boerhaave, Schultens had access to Latin notes about his life written by Boerhaave himself shortly before his death, apparently with the forthcoming occasion in mind. Schultens printed Boerhaave's words in large italics, and they were subsequently gathered together as the so-called Commentariolus. ¹ Schultens's oration was a paean to the good character and powerful intellect of his former friend. His Latin account served as the basis for the English biographical essays by Samuel Johnson and by Boerhaave's student and admirer William Burton. ² They, too, saw him in heroic terms. Until recently, most English-language accounts derived from them. Dutch historians of medicine tended to reinforce the view of Boerhaave as the highest pinnacle of Enlightenment medicine. For instance, in 1968 the professor of anatomy at the University of Leiden, J. Dankmeijer, gave an address on Boerhaave asking "Is Boerhaave's Fame Deserved?"--to which he emphatically answered "yes." ³ More significantly, Gerrit Lindeboom's major English-language study of Boerhaave, also from 1968, is a revival of Schultens's enthusiasm in modern dress. For Lindeboom, Boerhaave brought order to chaos: "before Boerhaave's appearance practical medicine was in a state of confusion and often not more than a precarious empiricism," or worse; "hence," he concludes, "there was a lifetime's work for a man with keen insight into the momentous needs of theoretical and practical medicine and of medical education. Such a man made his appearance in Boerhaave." ⁴ Until the end of the 1960s, then, the major accounts in English and Dutch stressed Boerhaave's superb character and his rational intellect. ⁵

French historians, on the other hand, treated Boerhaave as of far more ordinary mental capacity. Charles Daremberg, for example...