VII. PARACELSUS AND THE DOCTORS

In every generation men arise who, resenting the cautious conservatism of the medical profession, lay claim to remarkable cures by heterodox means, denounce the profession as cruelly laggard, perform wonders for a time, and then lose themselves in a mist of desperate extravagance and isolation. It is good that such gadflies should appear now and then to keep medical thought on its toes, and good that medicine should check hasty innovations in dealing with human life. Here, as in politics and philosophy, radical youth and conservative age unwillingly co-operate in that balance of variation and heredity which is nature’s technique of development.

Philippus Theophrastus Bombastus von Hohenheim called himself Aureolus as signifying the carat of his brilliance, and Paracelsus probably as a Latinization of Hohenheim.71 His father, Wilhelm Bombast von Hohenheim, was the illegitimate son of a hot-tempered Swabian noble. Left to shift for himself, Wilhelm practiced medicine among poor villagers near Einsiedeln in Switzerland, and married Elsa Ochsner, an innkeeper’s daughter and nurse’s aid, who soon afterward developed a manic-depressive condition. This ambivalent ancestry may have inclined Philip to instability, and to a resentful sense of capacities inadequately nurtured by his environment. Born in 1493, he grew up amid his father’s patients, and perhaps in undue familiarity with inns, whose unbuttoned life remained always to his taste. A dubious story alleges that the boy was emasculated by a wild boar or by drunken soldiers. No woman is known to have figured in his adult life. When he was nine his mother drowned herself. Probably for that reason father and son moved to Villach in Tirol. There, says tradition, Wilhelm taught in a school of mines and dabbled in alchemy. Certainly there were mines near by, and a smelter; and it is likely that Philip learned there some of the chemistry with which he was to revolutionize therapy.

At the age of fourteen he went off to study at Heidelberg. The restlessness of his nature showed now in his quick passage from one university to another—Freiburg, Ingolstadt, Cologne, Tübingen, Vienna, Erfurt, finally (1513-15) Ferrara—though such scholastic peregrination was frequent in the Middle Ages. In 1515, without having won a degree, Philip—now Paracelsus—took service as a barber surgeon in the army of Charles I of Spain. The campaign over, he resumed his footloose life. If we may believe him, he practiced medicine in Granada, Lisbon, England, Denmark, Prussia, Poland, Lithuania, Hungary, “and other lands.”72 He was in Salzburg during the Peasants’ War of 1525, treated their wounds, and sympathized with their aims. He had a socialist spell; he denounced money, interest, merchants, and advocated communism in land and trade, and equal remuneration for all.73 In his first book, Archidoxa (The Arch-Wisdom, 1524), he rejected theology and lauded scientific experiment.74 Arrested after the failure of the peasants’ revolt, he was saved from the gallows by evidence that he had never taken up arms; but he was banished from Salzburg, and left in haste.

In 1527 he was at Strasbourg, practicing surgery and lecturing to barber surgeons. His doctrine was a confusion of sense and nonsense, magic and medicine—though God knows how the future will describe our current certainties. He rejected astrology, then accepted it; he would not give an enema when the moon was in the wrong phase. He laughed at the divining rod, but claimed to have transmuted metals into gold.75 Animated, like the young Agrippa, by a thirst for knowledge, he sought anxiously the “philosopher’s stone”—i.e., some universal formula that would explain the universe. He wrote credulously about gnomes, asbestos salamanders, and “signatures”—the treatment of diseased organs with drugs resembling them in color or form. He was not above using magical incantations and amulets as cures76—perhaps as suggestive medicine.

But this same man, dripping with the delusions of his time, boldly advanced the application of chemistry to medicine. Sometimes he spoke like a materialist: “Man derives from matter, and matter is the whole universe.”77 Man is to the universe as microcosm to macrocosm; both are composed of the same elements—basically, salts, sulfur, and mercury; and the apparently lifeless metals and minerals are instinct with life.78 Chemotherapy is the use of the macrocosm to cure the microcosm. Man is, in body, a chemical compound; sickness is a disharmony not of Galen’s “humours” but of the chemical constituents of the body; here was the first modern theory of metabolism. By and large the therapy of the age depended for its drugs on the plant and animal world; Paracelsus, deep in alchemy, stressed the curative possibilities of inorganic materials. He made mercury, lead, sulfur, iron, arsenic, copper sulfate, and potassium sulfate parts of the pharmacopoeia; he spread the use of chemical tinctures and extracts; he was the first to make that “tincture of opium” which we call laudanum. He encouraged the use of mineral baths, and explained their diverse properties and effects.

He noted the occupational and geographical factors in disease, studied fibroid phthisis in miners, and first linked cretinism with endemic goiter. He advanced the understanding of epilepsy, and related paralysis and speech disturbances to injuries of the head. Whereas gout and arthritis had been generally accepted as natural and incurable accompaniments of increasing age, Paracelsus claimed that they were curable if diagnosed as due to acids formed by food residues too long retained in the colon. “All diseases can be traced to a coagulation of undigested matter in the bowels.”79 These acids of intestinal putrefaction he called “tartar” because their deposits in joints, muscles, kidneys, and bladder “burn like hell, and Tartarus is hell.”80 “Doctors boast of their [knowledge of] anatomy,” he said, “but they fail to see the tartar sticking to their teeth”;81 and the word stuck. He proposed to check the formation of such deposits in the body by a healthy diet, tonics, and improved elimination; he tried to “mollify” the deposits by using laurel oil and resin compounds; and in extreme cases he advocated surgery to allow the accretions to escape or be removed. He claimed to have cured many cases of gout by these methods, and some physicians in our time believe they have made cures by following Paracelsus’ diagnosis.

News of cures accomplished by Paracelsus in Strasbourg reached Basel. There the famous printer Froben was suffering acute pain in his right foot. The doctors advised amputation. Froben invited Paracelsus to come to Basel and diagnose the case. Paracelsus came, and effected a cure without use of the knife. Erasmus, then living with Froben and many ailments, consulted Paracelsus, who prescribed for him—we do not know with what success. In any case these famous patients gave the young doctor new fame, and a strange medley of circumstances brought him close to that university professorship which he coveted.

At this time the Protestants were a majority in the city council of Basel. Over the objections of Erasmus and the Catholic minority, they dismissed Dr. Wonecker, the city physician, on the ground that he had “uttered fresh words against the Reformation,”82 and they appointed Paracelsus in his place. The council and Paracelsus assumed that the appointment carried with it the right to teach in the university; but the faculty condemned the appointment, and—knowing the weakness of Paracelsus in anatomy—proposed a public examination of his fitness. He evaded the test, began practice as city physician, and gave public lectures in a private hall without university sanction (1527). He gathered students by a characteristic invitation:

Theophrastus Bombast of Hohenheim, doctor of both medicines and professor, greetings to the students of medicine. Of all disciplines medicine alone... is recognized as a sacred art. Yet few doctors today practice it with success, and therefore the time has come to bring it back to its former dignity, to cleanse it from the leaven of the barbarians, and to purge their errors. We shall do so not by strictly adhering to the rules of the ancients, but exclusively by studying nature and using the experience which we have gained in long years of practice. Who does not know that most contemporary doctors fail because they slavishly abide by the precepts of Avicenna, Galen, and Hippocrates? .... This may lead to splendid titles, but does not make a true doctor. What a doctor needs is not eloquence or knowledge of language and of books... but profound knowledge of Nature and her works....

Thanks to the liberal allowance the gentlemen of Basel have granted for that purpose, I shall explain the textbooks which I have written on surgery and pathology, every day for two hours, as an introduction to my healing methods. I do not compile these from excerpts of Hippocrates or Galen. In ceaseless toil I created them anew upon the foundations of experience, the supreme teacher of all things. If I want to prove anything I shall not do so by quoting authorities, but by experiment and by reasoning thereupon. If, therefore, dear reader, you should feel the impulse to enter into those divine mysteries, if within a brief lapse of time you should want to fathom the depths of medicine, then come to me at Basel.... . Basel, June 5, 1527.83

Thirty students registered for the course. At its opening Paracelsus appeared in the customary professorial robe, but at once he cast it aside, and stood forth in the rough garb and sooty leather apron of the alchemist. His lectures on medicine were given in a Latin form prepared by his secretary Oporinus (who later printed Vesalius’s Fabrica); on surgery he spoke in German. This was a further shock to the orthodox physicians, but hardly so disturbing as when Paracelsus proposed that “no pharmacist should act in collusion with any doctor.”84 As if to signalize his scorn of traditional medicine, he merrily threw into a bonfire—lit by students to celebrate St. John’s Day (June 24, 1527)—a recent medical text, probably the Summa Jacobii. “I threw into St. John’s Fire,” he said, “theSumma of the books, so that all the misfortunes might go up in the air with the smoke. Thus the realm of medicine has been purged.”85 Men compared the gesture with Luther’s burning of a papal bull.

Paracelsus’ life in Basel was as heterodox as his lectures. “The two years I passed in his company,” said Oporinus, “he spent in drinking and gluttony, day and night.... He was a spendthrift, so that sometimes he had not a penny left.... Every month he had a new coat made for him, and gave away his old one to the first comer; but usually it was so dirty that I never wanted one.” 86 Heinrich Bullinger gave a similar picture of Paracelsus as a hard drinker, and “an extremely dirty, unclean man.” 87 But Oporinus testified to remarkable cures performed by his master; “in curing ulcers he almost did miracles in cases which had been given up by others.” 88

The profession disowned him as a degreeless quack, a reckless empiric, incapable of dissection and ignorant of anatomy. He opposed dissection on the ground that the organs could be understood only in their united and normal functioning in the living organism. He returned the scorn of the doctors in the liveliest billingsgate. He laughed at their barbarous prescriptions, their silk shirts, finger rings, sleek gloves, and haughty gait; he challenged them to come out of the classrooms into the chemical laboratory, to put on aprons, soil their hands with the elements, and, bending over furnaces, learn the secrets of nature by experiment and the sweat of their brows. He made up for his lack of a degree by taking such titles as “Prince of Philosophy and Medicine,” “Doctor of Both Medicines” (i.e., physician and surgeon), and “Propagator of Philosophy”; and he salved the wounds of his vanity with the confidence of his claims. “All shall follow me,” he wrote, “and the monarchy of medicine shall be mine.... All the universities and all the old writers put together are less talented than my a—“89 Rejected by others, he took as his motto, Alterius non sit qui suus esse potest—“Let him not belong to another who can be his own.” 90 History rebuked his boasts by making his family name Bombast a common noun.

Whether through collusion with the university faculty, or in a spontaneous revolt of students against a dogmatic teacher, an anonymous Basel wit composed—and prominently exposed—a lampoon in dog-Latin, purporting to be written by Galen himself from Hades against his detractor, whom he called Cacophrastus—Dung-speaker. It made great fun of Paracelsus’ mystical terminology, called him a madman, and suggested that he hang himself. Unable to find the culprit, Paracelsus asked the town council to question the students one by one, and to punish the guilty. The council ignored the request. About this time a canon of the Basel Cathedral offered a hundred guilders to anyone who would cure him of his disease; Paracelsus cured him in three days; the canon paid him six guilders, but refused the rest on the ground that the cure had taken so little time. Paracelsus sued him in court, and lost. He lost his temper too, denounced his critics as Bescheisser and Arschkrätzer (cheaters and rear-scratchers), and published, anonymously, a pamphlet branding the clergy and magistrates as corrupt. The council ordered his arrest, but deferred execution of the order till the next morning. During the night Paracelsus fled (1528). He had been ten months in Basel.

In Nuremberg he recapitulated his experience at Basel. The city fathers gave him charge of a prison hospital; he worked impressive cures; but he inveighed against the jealous medicos of the town for their dishonesty, their opulence, and the size of their wives. Noting that the majority of the council was Protestant, he defended Catholicism. The Fuggers, who sold guaiac, were alarmed by his contention that this “holy wood” was useless in the treatment of syphilis. In 1530 he persuaded an obscure printer to publishThree Chapters on the French Disease, which so berated the doctors that a storm of opposition forced him to resume his wandering. He wished to publish a larger work on the same subject, but the city council forbade its printing; Paracelsus, in a letter to the council, pleaded with ineffective eloquence for the freedom of the press; the book was never printed in his lifetime. It contained the best clinical description of syphilis yet written, and advised internal doses, rather than external applications, of mercury. Syphilis became a battleground of vegetable vs. chemical therapy.

Moving to Saint-Gall, Paracelsus lived for half a year in the house of a patient. There and later he wrote his Opus paramirum—“the very wonderful work”—his Paragranum—“against the grain”?—and Die grosse Wundartzney (The Great Surgery), all in rough German. They are heaps of crude ore, with here and there a gem. In 1534 he relapsed into magic, and composed Philosophia sagax, a compendium of the occult.

When his patient in Saint-Gall died he took to the road again, passing from place to place in Germany, sometimes begging his bread. In his youth he had uttered some religious heresies—that baptism has only symbolic significance, that the sacraments are good for children and fools, but useless for men of intelligence, and that prayers to the saints are a waste of time.91 Now (1532), poor and defeated, he experienced religious “conversion.” He fasted, gave his remaining goods to the poor, wrote essays of devotion, and consoled himself with hopes of paradise. In 1540 the Bishop of Salzburg offered him asylum, and the man who had encouraged revolution there fifteen years before accepted gratefully. He made his will, bequeathing his few coins to relatives, his instruments to the barber surgeons of the city; and on September 24, 1541, he yielded his body to the earth.

He was a man overcome by his own genius, rich in varied experience and brilliant perceptions, but too little schooled to separate science from magic, too undisciplined to control his fire, too angrily hostile to infuse his influence into his time. Perhaps his career, along with Agrippa’s, helped to swell the legend of Faust. Until a century ago people suffering an epidemic in Austria made a pilgrimage to his grave in Salzburg, hoping to be healed by the magic of his spirit or his bones.92

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