Paracelsian Medicine Leads to a New Understanding of Therapy

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Paracelsian Medicine Leads to a New Understanding of Therapy

Overview

Few issues stirred up debate in the sixteenth and seventeenth centuries as much as the ideas and writings of the medical reformer Theophrastus von Hohenheim, widely known as Paracelsus (c. 1493-1541). Paracelsus attacked the academic medical establishment of his time and offered an alternative way of thinking about pathology, the understanding of the processes through which diseases occur. For Paracelsus, diseases were specific entities or powers that attacked particular parts of the body. Medicine should therefore aim to attack diseases through the use of chemically prepared substances that have a correspondence with the disease. This approach led to a new understanding of therapy and encouraged many people to use chemically based remedies for diseases. Many Paracelsian ideas seem bizarre today, but they are significant because they provided an alternative to a medical system that many had come to see as stale, useless, and unable to meet people's medical needs.

Background

The medical system taught in Renaissance universities relied heavily on book learning and philosophical theory. Generally, health and disease was understood as a matter of balance and imbalance within the individual body. It was believed that the body contained substances called humors, which could become corrupted. Disease occurred when this corruption affected the functions of the body. Therapy worked by the principle of "cure by contraries," which aimed to restore the body to its normal balance. For example, the physician would attempt to cure a disease that was an imbalance of heat and moisture through the use of remedies with the contrary qualities of cold and dryness. The physician could also restore the body to balance by drawing the corrupt humor out of the body, through methods such as bleeding and purging. Every patient was a unique case, because the balance of humors and qualities that made up each person was unique. Therefore, therapy was supposed to be individually tailored to each separate case of illness, rather than based upon previous experience of the disease. Those nonacademic practitioners who treated people on the basis of experience alone were disparagingly referred to by physicians as "empirics" or "quacks."

During the sixteenth century, there were many signs of dissatisfaction with this system. The inability of orthodox medicine to adequately explain or treat some major diseases was a source of frustration for many people, both patients and practitioners. Plague continued to ravage most parts of Europe throughout the sixteenth and seventeenth centuries, and orthodox physicians appeared helpless in the face of the pestilence. In the late fifteenth century, Europe also experienced the first outbreaks of what came to be known as syphilis. Believed to be brought to Europe from the Americas by crew aboard Christopher Columbus's voyage of discovery, the pox caused a great deal of suffering and excited a moral panic similar to the twentieth-century response to AIDS. For many, the pox highlighted the inadequacies of orthodox medicine. Academic physicians seemed to expend more energy on arguing whether or not the disease was new than actually treating it. The medical approach that insisted that each illness be treated on the basis of the patient's individual characteristics did not fit in well with the treatment of widespread epidemics. It is in the discussion of these two diseases, plague and syphilis, that one is most likely to find innovation in the explanation and treatment of disease in the sixteenth century. Paracelsus focused upon the treatment of plague and syphilis in many of his writings.

As well as this medical background, there were many intellectual developments during the Renaissance that partially explain the development of Paracelsian medicine. Orthodox medicine was part of the intellectual system of university natural philosophy, which was based upon the thought of the classical philosopher Aristotle. However, during the Renaissance, other systems of intellectual thought, such as Neoplatonism, challenged the dominance of Aristotlelianism. Those scholars who were interested in Neoplatonism looked at the universe in quite different ways. They explored the connections and harmonies between different aspects of the cosmos, and emphasized the way in which the wise man could manipulate these cosmic harmonies for his own benefit, including in the sphere of medicine. Many of these influences can be seen in Paracelsus's writings, particularly in the emphasis of his medicine upon man as a microcosm, containing within himself all the phenomena of the universe. Neoplatonism also influenced Paracelsus in his understanding of astrological influences upon health and disease. In Paracelsian thought, it was these connections between man and the universe that must be explored if the physician was to understand health and disease within the human body.

Paracelsus's career also coincides with the period of religious and social upheaval known as the Reformation. The history of Paracelsian medicine throughout Europe is closely involved with the spread of Protestantism. Paracelsus's condemnation of the authority and monopoly of the orthodox physician in administering medical care parallels Martin Luther's rejection of the Church's monopoly over access to God. Paracelsus's reform of medicine was a part of the reform of religion and society that was occurring throughout the German territories in which Paracelsus lived and worked. Though Paracelsus never identified himself within any of the various sects of the Reformation, nor officially renounced his Catholicism, the religious and philosophical content of his writings shows similarities with many of the mystical thinkers of the German Reformation.

In terms of the impact that it had upon medicine, the most significant insight of Paracelsus's thought was the way he took alchemical concepts and applied them to the understanding of the processes of nature. Alchemy was an ancient mystical tradition, which involved the quest for the secret of transforming metals into gold. It had practical medical significance because many alchemists were also involved in the search for substances that could purify the body and therefore prolong life. However, alchemy was a tradition that existed outside the bounds of the kinds of knowledge considered acceptable by establishment medicine. It was part of a manual, craft-based tradition, rather than the learned knowledge of the universities. Paracelsus insisted that alchemy was a crucial part of medicine. To develop remedies, the physician needed to gain access to the hidden powers involved in disease and its cure. Alchemical processes released these powers that existed within material objects, so that they could act upon the disease and drive it out of the body. In place of the elements and humors of orthodox medicine, Paracelsus offered a more chemically based analysis of matter, which rested upon what he termed the three principles: mercury, salt, and sulphur.

The effect of this approach was to change the nature of medical therapy. In the place of the changes in diet and the herbal concoctions that the orthodox physicians favored, Paracelsus advocated strong remedies, often metallic based, which attacked the diseases at their roots. These remedies did not work according to the orthodox principle of cure by contraries. Instead, Paracelsus believed that like cured like, and the physician had to identify a similarity between the disease in the body and the substance in the outside world that could be used to cure it. Seeing disease as an entity that attacked a part of the body, rather than a general imbalance of humors, encouraged the search for specific chemical remedies for these specific diseases. Paracelsian writings provided an important theoretical justification for those who believed in the worth of chemical medicines and encouraged many to develop chemical remedies for diseases.

Their use of metallic-based remedies meant that chemical physicians often had to answer the accusations that they were poisoners whose remedies killed more than they cured. But Paracelsus was well aware that many of the substances he used could be dangerous, and he criticized the rash use of mercury in the treatment of syphilis, while still maintaining that careful use of alchemically prepared mercury could cure syphilis. Exponents of Paracelsian medicine believed that by exposing some of these dangerous substances to alchemical processes, they could be rendered fit for human consumption and have dramatic results in the treatment of many diseases. An example of this is the ether substance Paracelsus called spiritus vitrioli, which he developed as a sedative for use in the treatment of epilepsy. This was first time the medicinal potential of ether was recognized.

Impact

In the years after Paracelsus's death, those who advocated chemical medicines became a serious challenge to the medical establishment. In the late sixteenth and early seventeenth centuries, the question of the worth of chemical medicines was one of the most fiercely debated issues among the intellectual elites of Europe. Not all who supported chemical medicine regarded themselves as Paracelsians, but most felt that Paracelsus had achieved some great insights in the development of chemical medicine. By the mid-seventeenth century, most physicians accepted that chemical remedies were part of the physician's arsenal against disease.

An important part of Paracelsus's attack upon orthodox medicine was his insistence that medical knowledge should rest upon experience, rather than book learning. This means that Paracelsus has often been seen as an early advocate of experimental science. This has been over-stated, and it must be remembered that many of Paracelsus's claims are based upon a kind of mystical intuition rather than experiment or observation. However, Paracelsus's approach to the study of the cosmos certainly made a contribution to the major shift that occurred in this period in the way people viewed the world around them. His insistence that knowledge of health and disease in people required knowledge of the correspondences between the human body and the outside world was an encouragement to closer observation of the natural world. His belief that true knowledge was found not in the dead wisdom of books but in the study of the living physical world led him to make some bizarre claims, but it also stimulated new and profound insights.

Paracelsus's refusal to accept the limits that orthodox medicine placed upon medical knowledge was a crucial part of his appeal for later generations of scholars. His willingness to explore traditions of knowledge that were shunned by orthodox medicine, such as alchemy and therapies based in popular medicine, challenged the boundaries of what was accepted as proper knowledge. He believed that if a reform of knowledge could be instituted, then people would discover the cures that God had created for the treatment of all diseases. This optimistic belief in the human capacity for the discovery and improvement of wisdom was an encouragement to all those who were dissatisfied with the existing systems of knowledge. This is why, throughout the sixteenth and seventeenth centuries, Paracelsus's ideas were used by those who sought reform in a variety of spheres.

KATRINA FORD