Wednesday, November 11, 2015

1664: Sylvius improves medical image

Sylvius started a medical clinic at Leyden in 1658.
A future successor of his was Herman Boerhaave,
who re-established respect for the profession by
having his students learn at the bedside, and focusing
on studying the patient before regarding theories.
Methods used at the clinic were so popular that
they quickly spread to other clinics in Britain, and
then throughout the whole of Europe. 
Francois de la Boe, also known as Sylvius, was among the first physicians who helped transform alchemy into chemistry, and improve the image of the medical profession.  

He was born in Hanau in the Netherlands in 1614, was educated at Paris, Sedan, Leyden and Basle, and earned his medical degree from Basle at the age of 23. He opened a practice at Hanua, and later moved it to Leyden and then Amsterdam.  He quickly became a very successful physician.  (1, page 115)

In 1660 he was hired as professor at Leyden, and in 1664 he opened the first medical clinic at Leyden. He also started what is believed to be the first university chemical laboratory.  (1, page 115)(2, page 68)

Bradford said: 
Here he had many pupils on account of the clinical method of instruction and his convenient system with its therapeutics. 
He was, therefore, among the first to take the student to the bedside of the patient in order to get the best medical education. This was an idea adapted and perfected by a future student and professor at Leyden by the name of Herman Boerhaave. This model of educating medical students would be later adapted by medical schools throughout Britain, all of Europe, and eventually the United States. (2, page 68)(3)

Bradford said Sylvius was a firm user of chemistry, and in this way transitioned the profession from alchemy to chemistry. His main ideas about medicine mainly follow the Hippocratic model, that diseases are caused by an imbalance of the humours. Although, like most physicians, he ads his own elements to the theory. Of this, Bradford said: (1, page 116)
There were three cardinal fluids—the saliva, the pancreatic fluid and the bile. The majority of diseases are caused by excess of acidity in the system or alkalinity. Health consisted in the undisturbed performance in the body of the process of fermentation; the saliva was thought to give rise to hectic fevers because there was some fever after eating. (1, page 116)
Bradford said the diagnostics of Sylvius can be summed up by the following passage by Sylvius:
As often as the whole blood appears black, it indicates that the acidity predominates; if the blood is redder, it shows that the bile in it is overabundant. In the first case the acid in the body and in the blood must be diminished; in the second, the bile must be lessened and its power broken. If the blood which is normally free from odor and of a sweetish taste, tastes salty, the alkali in the body is too pure, and when brought into contact with the acid spiritus engenders a humor of a saline taste which is prejudicial to the body. Fever is diagnosed by the pulse and not by the heat of the body. (1, page 116) 
In blending chemistry and medicine, says that he "held that all phenomena of life and disease are based on chemical action."  Britannica also says that he blended William Harvey's proof that blood circulated through the body with the Hippocratic and Galen humoral theory. (3)

Regarding the view of Sylvius on the respiratory system, late 18th and early 19th century asthma expert Robert Bree said the following about Sylvius:
According to Sylvius, the parenchyma of the lungs is sometimes dense and corrugated, occasioning dyspnoea. He attributes this state to the restringent quality of the blood, but it may be assigned perhaps, with more reason, to preceding inflammation. (4, page 32)
Bradford said "his therapeutics were simple. We must get rid of the acids or the alkalies. When the acid is in excess give an alkali, when the alkali is in excess give an acid.  (1, page 116)

Bradford continued "(the) general object of therapeutics was to keep up the strength of the patient, remove diseases, mitigate symptoms, and remove their causes."  He listed the following as the remedies of Sylvius:
  • Heating methods
  • Absorbants
  • Emetics
  • Etc. 
Unlike most physicians of his era, he did not recommend bleeding.

Bradford said his ideas regarding medicine earned him many followers, although of his remedies, on the other hand, "it has been said that his therapeutics cost as many lives as the thirty years' war." (1, page 116)

Overall, like various other physicians from the 18th century (such as Boerhaave), and even while he was an ardent supporter of older theories, his contributions helped transform medicine away from "mythical speculation to a rational application of universal laws of physics and chemistry." (3)

  1. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey
  2. Foucault, Michael, "The Birth of the Clinic," 2003, Great Britain, Routledge Classics 
  3. Franciscus Sylvius,,, accessed 11/12/13
  4. Bree, Robert, "A practical Inquiry into Disordered Respiration," 1810, London,  
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