On Leibniz: Expanded Edition

11. Leibniz and Socialized Medicine

201 In the autumn of 1688 Leibniz at last realized his long-standing aspiration for an audience with the ruling prince of the Holy Roman Empire, Leopold I. He nursed the hope of persuading the emperor to appoint him as an advisor for projects of public interest, and in the course of this audience he made many proposals along these lines. Leibniz went to extraordinary lengths to plan for this meeting, drafting not just one but four preparatory memoranda for his presentation. The two longest of them, written in Latinate German, occupy more than fifty closely printed pages,1 and they give a very detailed sketch of Leibniz’s past activities and envisioned projects. The memoranda are among the most revealing documents Leibniz ever wrote. They cover in considerable detail the whole of his productive career to date and deal with a vast array of topics, covering not only his contributions from adolescence onward but outlining a vast array of inventions and projects, realized and envisioned, that are mechanical, cultural, and political. On the surface of it, the litany of innovations covers a range of unlikelihoods reminiscent of Baron Münchhausen. As usual with Leibniz, there were proposals for the organized systematization of knowledge: a historical society (Collegium Imperiale Historicum), a mining academy (Bergkollegium ; Collegium Metallicum), a universal reference library (Thesaurus Humani Generis), an archival institute charged with preparing a manual of imperial assets and facilitates (Breviarium Imperi), and an imperial academy charged with creating a panoramic Encyclopedia Realis akin to that of the  11 Leibniz and Socialized Medicine 202 Leibniz and socialized medicine French Encyclopédie, which would be originally published in 1751 through 1772. There also were various proposals for increasing state revenues (coinage reform, new modes of taxation) and industrial innovations (new methods for manufacturing and dying fabrics, new processes for making wine and beer). Then too there were innovations to enrich the public good: a new universal language with its own Scriptura universalis that could be learned in fourteen days, a new way to illuminate Vienna’s streets with oil lamps, and new measures for improving public health. Various machines and mechanical devices also figured on Leibniz’s agenda, including: • novel carts and springs able to move vehicles in mud and otherwise difficult conditions • a boat that sailed upstream faster the stronger the opposing current • a machine for storing power and releasing it at various speeds (presumably based on the principle of the spring, as with wind-up toys) • a cipher machine for easy and secure coding and decoding2 • a windmill transmitting power more efficiently than any existing models3 Also prominent in Leibniz’s program was a long, heartfelt project for the improvement of medical practice, which Leibniz described as follows: I have often wished that there would be an Order [Society] whose devotees would offer not just public worship [gottes dienst] for the cure of souls but also undertake the cure of bodies and treat everyone without charge. For all physicians are mercenaries, concerned only for an extensive practice with many patients. And once their repute achieves this, there is no more real dedication, but scarcely have they set eyes on their patients than they write their prescriptions, knowing they will be paid one way or the other, whether they cure well or ill. However, since no such Order exists, there should be encouragement for Christian and well-intentioned physicians who manifest a more than ordinary zeal for the public good. One should also induce learned physicians to submit their ideas for the betterment of medicine and the requisite arrangement for its realization, so that the best of them could be adopted. It would be especially constructive in all states and cities to identify those particularly noteworthy [medical] observations which are Leibniz and socialized medicine 203 to be found with almost all patients and ailment. Then some physicians especially engaged for this purpose could evaluate and study these procedures , and these then could be mandated for introduction in hospitals through legislation. I am certain that in this way we shall in a few years arrive at a greater Thesaurus of Observations than ever achieved in a prior century.4 It emerges from Leibniz’s representations to the emperor that he hoped to realize official support for: 1. Establishing a policy of having physicians make regular reports of significant findings regarding illnesses and their response to modes of treatment. 2. Creating a medical assessment...