http://jrs.sagepub.

com/
Journal of the Royal Society of Medicine
http://jrs.sagepub.com/content/96/9/470
The online version of this article can be found at:

2003 96: 470 J R Soc Med

James O'Connor
Alchemy Tried in the Fire: Starkey, Boyle and the Fate of Helmontian Chymistry

Published by:
http://www.sagepublications.com
On behalf of:

The Royal Society of Medicine

can be found at: Journal of the Royal Society of Medicine Additional services and information for

http://jrs.sagepub.com/cgi/alerts Email Alerts:

http://jrs.sagepub.com/subscriptions Subscriptions:
http://www.sagepub.com/journalsReprints.nav Reprints:

http://www.sagepub.com/journalsPermissions.nav Permissions:

What is This?

- Sep 1, 2003 Version of Record >>

by guest on July 29, 2014 jrs.sagepub.com Downloaded from by guest on July 29, 2014 jrs.sagepub.com Downloaded from
Book of the month
On the Fabric of the Human
Body, Books III and IV
The magic of Vesaliuss De Humani Corporis Fabrica lies not
so much in the marvellous dissections and illustrations, but
in the understanding that this one man virtually invented
human anatomy.
1
True, Leonardo da Vinci had undertaken
human dissections with great difculties from church and
state; but though important, they were not comprehensive.
De Fabrica was published in 1543 in seven books written in
Latin. Not only is it a singular, original piece of
scholarship,
2
but it is also a work of beauty, bearing ne
woodcuts and copperplate illustrations of his dissections
probably the creations of Jan Stephan Kalkar, a student of
Titian.
3
For many years Dr William Richardon, a classicist,
and Professor John Carman, an anatomist, have been
collaborating on the rst full translation of De Fabrica into
English. Book I was published in 1998 and Book II in 1999.
Now we have Books III and IV.
4
Vesalius was highly critical of, and at times rude about,
the publications of his contemporaries. He took issue with
Galens sacrosanct authority on several matters in a 1540
translation into Latin of his works on nerves, arteries, veins
and dissection. Vesaliuss Books III and IV indicate many
discrepancies between the received wisdom, descended
from Galen almost unchanged, and the observations of his
own detailed, laborious dissections. He denounced the
unquestioning acceptance of Galenic doctrine, because
Galens descriptions were founded mainly on observations
made not in man but in oxen and sheep. In his time,
arteries, veins and nerves were collectively regarded as
vessels: Greek angeia, Latin uasa or uasculathe threesome
of vessels. In an informative preface Richardson discloses
that this concept troubled Vesalius, because originally he
failed to nd a lumen in nerves (vide infra) whereas arteries
and veins contained hollow channels; however, he
continued to use this traditional grouping, and his notions
of physiology followed historical precepts.
A crucial example was the ancient word spirit, spiritus,
translated from the Greek pneuma, used by Galen and meaning
air in motion. The pneuma according to Erasistratus was
inhaled into the lungs and then to the hearts left ventricle
where it was changed into the vital spirit distributed by the
aorta. The Erasistratean view was that arteries contain the
vital spirit, veins blood, and nerves the animal spirit, and this
is one of the puzzling aspects of Vesaliuss account. He names
the pulmonary artery or trunk vena arterialis and the
pulmonary vein arteria venalis. But in chapter 15 of Book III
he explains that this contradiction arises in relation to the
function rather than the structure of these vessels. Another
issue was Galens account of the rete mirabile, essential to
Galens concepts of the brains circulation. Vesalius set out to
demonstrate the rete at his public dissections:
I was so keen not to gain the reputation of having been
unable to nd the plexus . . . that I imposed upon my
audience by demonstrating from a sheeps head some-
thing I had never found in a human one.
As the anatomist Carman points out, this typies the
transition of Vesalius from impressionable student to
rigorous critic.
Carman says the modern anatomist will have difculties
in assessing Vesaliuss work on nerves and vessels since
nomenclature was so limited. Vesaliuss text shows that
only the largest trunks of arteries and veins had names, and
he describes (but has no names for) smaller peripheral
branches: he uses terms such as the vein of the upper arm,
the second branch of the vein of the upper arm, and the
common vein. The text and illustrations make this plain.
We have eight cervical nerve roots, Vesalius had seven, so
that our C8 equates with Vesaliuss T1. Likewise our T12 is
Vesaliuss L1. Though De Fabrica describes the cranial
nerves, his numbering does not correspond to modern
conventions. The veins, for Vesalius, were distributing
vessels with branches, not a system of tributaries (Figure 1).
He had a limited number of human bodies in which to make
observations so that the many common anatomical
variations were underestimated. But the astonishing detail
of his work is shown in a huge illustration of all the veins
and arteries of the
body, inserted as a
superb gatefold, with
its index of 170
items, at the end of
Book III. Book IV
describes olfaction
plus the seven cranial
nerves known in
Vesaliuss time. Then
follow illustrated
chapters on the spinal
cord, cervical, thor-
acic and lumbosacral
nerves and their
branches in the limbs.
The text contains
marginal references,
which the authors
lucidly tabulate and
explain in modern
nomenclature
B
O
O
K
S
467
J O U R N A L O F T H E R O Y A L S O C I E T Y O F M E D I C I N E V o l u m e 9 6 S e p t e m b e r 2 0 0 3
Figure 1 The hollow vein laid bare and
freed from all other parts
by guest on July 29, 2014 jrs.sagepub.com Downloaded from
throughout the books. They refer to annotated illustrations
with lengthy explanatory indices (captions). The high
quality of the translation is evident. The correlation with
modern terminology must have posed great difculties for
reasons explained. Many excellent translators notes clarify
Vesaliuss descriptions and nomenclature. For example,
Vesalius states that the origin of the coronary arteries stands
behind the small membranes; the translators explain: these
small membranes were not called valves until after
Vesaliuss time. A paragraph on p. 184, headed Do the
Optic Nerves have a Channel?, illustrates the clarity of the
translation, and an example of optic atrophy gives the
avour of Vesaliuss methods:
Among the other nerves of the body these alone are said to
be perforated by a perceptible channel; and this is why the
Greeks (especially Herophilus and Eudemus) called them
poroi optikoi (optic channels). I can state that I have never
found such a channel, though I have operated with this sole
end in view on the optic nerves of living dogs and other
large animals and even on the still warm head of a man who
had been beheaded: I made a very careful examination of his
nerves barely fteen minutes after his execution, carefully
keeping them warm in hot water. I found no such channel
anywhere throughout the entire length of the nerve, nor
anywhere in the mutual congress of the nerves; and yet I
should have found a very large one there, seeing that the
reason for the congress, according to Galen, is so that single
things should not look double to us . . .
I shall here make mention of two things that I have
noticed. . . . a woman . . . her right eye had withered at the
onset of maturity leaving the left unaffected. In the woman
the right optic nerve was much thinner than the left over its
entire length not only at the point of insertion into the eye
but also at the origin and on the right side of the congress of
the nerves. The right nerve was not only thin but harder
and redder. . . .
To those fascinated by medical history or those who may
wonder how current anatomy was founded and how
Vesalius interpreted his observations, this sumptuously
produced translation is an unparalleled contribution that
does great credit both to its authors and to its publisher.
J M S Pearce
304 Beverley Road, Anlaby, Hull HU10 7BG, UK
REFERENCES
1 Pearce JMS. Andreas Vesalius: the origins of anatomy. In: Fragments of
Neurological History. London: Imperial College Press, 2003:313
2 Menzoian JO. Lest we forget: the contributions of Andreas Vesalius and
Ambroise Pare to my surgical practice. Am J Surg 1999;178:8591
3 Rudakewich M. The recognition of the anatomical artists in the works of
Vesalius, Albinus, and Hunter. J Biocommun 1998;25:27
4 Vesalius A (transl. W F Richardson in collaboration with J B Carman) On
the Fabric of the Human Body: a Translation of De Humani Corporis Fabrica Libri
Septem. Vol. III, Book III: The Veins and Arteries; Book IV: The Nerves.
Novato: Norman Publishing (PO Box 867, Novato, CA 94948-0867,
USA; e-mail: dianah@jnorman.com), 2003 [286pp; ISBN 0-930405-83-8
(h/b); US$250]
Watson and DNA: Making a Scientic
Revolution
Victor K McElheny
365pp Price 18.99 ISBN 0-470-85429-4 (h/b)
Chichester: John Wiley, 2003
On 25 April 1953 the proposed double helical structure of
DNA was rst published in Nature and thereafter referred to
as the WatsonCrick model, so-named after the two
authors. At the time many thought protein was the genetic
material and not DNA and there was reluctance among
some scientists to accept the model, in part because Watson
and Crick had done no experimental work themselves but
used the data of others, most notably those of Rosalind
Franklin. When the model received its rst convincing
experimental conrmation in 1958, the way was open for
Watson and Crick and their collaborator Maurice Wilkins
to receive the Nobel Prize in 1962. Watson was still only
34. One is therefore reminded of a line from a W B Yeats
poem What then? sang Platos ghost What then? .
After receiving the Nobel Prize Watson published his
personal account of the DNA story in The Double Helix to a
storm of comments and criticisms. One reviewer at the
time described it as fresh, arrogant, catty, bratty and
funny. Although it had been rejected by the esteemed
Harvard University Press, The Double Helix became, and
remains, a best seller. This was 1968, the year he married
and also became director of the Cold Spring Harbor
Laboratory, a post he held until 1993. Here he fostered
much excellent research, particularly on human disease,
recruited many young and active scientists and attracted
much funding for the laboratory. It was largely through his
effort and perseverance that recombinant DNA technology,
or genetic engineering, and later the Human Genome
Project became accepted. In regard to the latter he ercely
challenged those, such as Craig Venter and the head of NIH,
Bernadine Healy, who wanted the project privately
nanced. The data would thus have been excluded from
the public domain. Fortunately Watsons view prevailed
and the project was successfully completed with public
funding from both the US and the UK. Since 1993 Watson
468
J O U R N A L O F T H E R O Y A L S O C I E T Y O F M E D I C I N E V o l u m e 9 6 S e p t e m b e r 2 0 0 3
by guest on July 29, 2014 jrs.sagepub.com Downloaded from
has continued to travel widely, lecturing on genetics. In
2002 he received an honorary British knighthood.
McElhenys book not only traces the history of the DNA
story up to the Human Genome Project but also details the
personalities of those involved, particularly of Watson
himself and those of his colleagues and critics. Watsons
forthright views on prenatal diagnosis, genetic screening,
gene cloning and germ-line gene therapy have generated the
kind of controversy on which he seems to thrive. The
popular fears expressed in these areas, and recently on
genetically modied foods, he rejects: You should never
put off doing something useful for fear of evil that may
never arrive. I have met Watson twice (though he would
never remember me) and have heard him lecture on several
occasions, and found him eccentric, provocative and
entertaining but above all intellectually stimulating. The
book captures all these facets of his complex personality.
The story of DNA, excluding the more recent Human
Genome Project, has been told several times previously,
most notably by Crick (What Mad Pursuit), Olby (Path to the
Double Helix) and Judson (The Eighth Day of Creation). In the
past two years Watson has also published a collection of
essays on the subject (A Passion for DNA) and his personal
memoirs (Genes, Girls, and Gamov: After the Double Helix). Is
there thus any need for this book? I think there is, since it
brings the story up to date and also gives a very detailed
analysis of the personalities, foibles and squabbles of those
whom the author includes in the story (mainly Americans).
There have been fewer attempts to present a perspective
of these events from outside the US. Crick himself admitted
he did not need to seek publicity for himself because
Watson could do it for both of them. Recently, however,
John Sulston, another Nobel Laureate, has offered a British
perspective in his The Common Thread: a Story of Science,
Politics, Ethics and the Human Genome.
The story is one of the most fascinating in the history of
science, in no small measure because of the personalities
involved. No doubt the subject will continue to attract
attention for years to come.
Alan Emery
Green College, Oxford OX2 6HG, UK
Presumed Curable
Colin Gale, Robert Howard
128 pp Price 14.50 ISBN 1-871816-48-3 (p/b)
Peterseld: Wrightson Biomedical, 2003
A distracted young woman in strong clothes looks out
from the front of this collection of 61 case histories of the
later nineteenth century from Bethlem Hospital. Each is a
window onto a unique human story, selected by the
hospitals Senior Archivist and Professor of Old Age
Psychiatry.
For those seeking historical understanding, continuity is
a wonderful thing, and Bethlem has had an unbroken
existence (though on several sites) for over 755 years. One
important adjunct to its records in the mid-Victorian period
was photography. Though this was never subject to any
formal policy, many portraits still exist from that time and,
since all are over 100 years old, names can be attached to
them without breaching the rules of condentiality.
Surprisingly, some were taken by Sir Francis Galton, who
thought that such photographs would open the possibility of
replacing natural selection with benign human intervention
as the explanation of species change. In this, he was to be
disappointed. An album of patients photographs, though,
grouped by diagnosis, was assembled for the instruction of
students, some of whom spent a year or so in the hospital
as part of their clinical training.
The books title refers to the admission criteria for
Bethlem, which included a hope of recoveryan
optimistic view that the authors say was by no means
always disappointed. Admitted patients were to be
preferably of the educated classes (including medical
men), but unable to pay for a private asylum. If all went
well, they would probably spend a month in the
convalescent branch at Witley just before discharge. On
the other hand, if there was no sign of recovery after twelve
months, relatives would be asked to make alternative
arrangements. Discharged uncured, these unfortunate
individuals would be transferred either to a private
institutionmany of which were licensed to admit
paupersor else to a county asylum (a fate which
admission to Bethlem had been intended to avoid). From
1881, paying patients could also be admitted and from
1886, voluntary boarders, anticipating the legal reforms of
1930 for other mental hospitals.
Within Bethlem, the authors say it was a therapeutic
environment that was mainly relied on to produce mental
improvement. This was the moral treatment pioneered at
the York Retreat in the 1790s, and Bethlem embraced it in
the second half of the nineteenth century in its wish to
escape the Hogarthian image of Bedlam. Patients actual
experience, though, depended greatly on the ward to which
they were assigned. The more disturbed found themselves
in basement units which were notorious within the
institution, though even in wards for the incurable there
was monitoring for any signs of improvement.
Each case vignette contains the text of the medical
certicates for admission, together with a short history and
patients own comments, where these exist. Today, the
outcome of many of these cases would be enormously
better, but the authors remind us that mental health 469
J O U R N A L O F T H E R O Y A L S O C I E T Y O F M E D I C I N E V o l u m e 9 6 S e p t e m b e r 2 0 0 3
by guest on July 29, 2014 jrs.sagepub.com Downloaded from
professionals still face diseases of uncertain aetiology that
devastate the lives of sufferers and their families and for
which there are no cures . The need for care of long-
term illness and disability is no less today than it was in
Victorian decades. Publication of this historically important
material was made possible by a pharmaceutical company,
which deserves our gratitude.
Hugh Freeman
Green College, Oxford OX2 6HG, UK
Alchemy Tried in the Fire: Starkey, Boyle and
the Fate of Helmontian Chymistry
William R Newman, Lawrence M Principe
344 pp Price US$40 ISBN 0-226-57711-2 (hb)
Chicago: University of Chicago Press, 2002
The very word alchemy has since the seventeenth century
conjured images of prescientic occultism and the vain
pursuit of metallurgic transmutation. In contrast, chemistry
is regarded as a modern science, based on measurement,
laboratory experiment and rationality, which emerged
during the age of reason. In Alchemy Tried in the Fire
Newman and Principe challenge the notion that the
distinction between the two was so sharp by considering
the interplay between the careers of the celebrated
American alchemist George Starkey and the physicist,
chemist and natural philosopher Robert Boyle. Both authors
have written extensively on the chemistry of Boyle and
more recently on his less well-known contemporary,
Starkey. This book represents a culmination of much of
their research by focusing on Starkey, his relationship with
Boyle and their laboratory work during the 1650s. A second
volume of Starkeys laboratory notebooks and correspon-
dence with Boyle is to follow.
The relationship between Starkey and Boyle and their
respective disciplines is central to the book. Of particular
interest is the way in which Boyle represented Starkey as
old-fashioned and held chemistry as a philosophical tool
quite separate from its alchemical roots. In addition in his
later work, Boyle claimed as his own much of the scientic
development from collaborative projects with Starkey.
Starkey came from America to England in 1650. Like
other notable men of the time such as Richard Lower and
Thomas Willis, he worked in the Commonwealth as both
physician and chemist. Starkey had regular contact with
Boyle between 1650 and 1654, and continued to inuence
him thereafter. From 1651 to 1658 he kept three detailed
notebooks and ve partial transcripts detailing a broad range
of laboratory projects which, along with his personal
correspondence, form the basis of the authors argument.
The book demonstrates clearly how Boyles chemistry
changed from occasional references in otherwise theological
treatises to a much more experimental practice, following
his contact with Starkey. Indeed, Newman and Principe
argue that Starkey appears to have tutored Boyle, and
demonstrate how some of Boyles early work mirrors
previous projects and conclusions found in Starkeys
notebooks.
The book cites the contribution of medieval alchemists
such as Paracelsus and Jan van Helmont in the development
of chemistry, providing evidence that the alchemy of
Starkey followed a long tradition of measurement,
description and experiment. This point, often forgotten in
subsequent popular accounts, is of interest but forms an
unnecessarily long section in the rst part. In contrast, there
is a lack of biographical detail on Starkey before his work in
England, and the unfamiliar reader is left unsure of why
Starkey emigrated and to what extent he represented
scientic practice in America.
The analysis of Starkeys notebooks reveals a synthesis of
the scholastic methodology learnt at Harvard and the
experimental philosophy of the laboratory. Newman and
Principe provide an elegant account of how Starkey
complemented theory and practice, building on the
tradition of van Helmont while working on projects of his
own. This section of the book particularly reveals the detail
and logic employed by Starkey as a unique example of
laboratory practice in the alchemy of this period. Although
the amount of detail can at times be heavy for the non-
specialist, the authors provide compelling evidence for their
case and succeed in presenting a balanced and informative
evaluation of alchemy and its basis in the science of the mid-
seventeenth century.
James OConnor
7 Millcroft Rise, Lofthouse Gate, Wakeeld WF3 3TL, UK
470
J O U R N A L O F T H E R O Y A L S O C I E T Y O F M E D I C I N E V o l u m e 9 6 S e p t e m b e r 2 0 0 3
by guest on July 29, 2014 jrs.sagepub.com Downloaded from