Herman Boerhaave

(click to enlarge)
Hermann Boerhaave, detail of a portrait by Cornelis Troost; in the Rijksmuseum, Amsterdam. (credit: Courtesy of the Rijksmuseum, Amsterdam)

(born Dec. 31, 1668, Voorhout, Neth. — died Sept. 23, 1738, Leiden) Dutch physician. As a professor at the University of Leiden, he was renowned as a teacher, and he is often credited with founding the modern system of teaching medical students at the patient's bedside. His reputation as one of the greatest physicians of the 18th century lay partly in his attempts to organize the mass of medical information known at the time, in a series of major texts and encyclopedic works.

For more information on Hermann Boerhaave, visit Britannica.com.

The Dutch physician and chemist Hermann Boerhaave (1668-1738) was the leading medical teacher of the early 18th century. His works on medicine and chemistry had widespread use as basic textbooks.

Hermann Boerhaave was born on Dec. 31, 1668, at Voorhout, Holland, the son of a minister in the Dutch Reformed Church. A painful leg ulcer which affected him for 5 years during his youth excited his interest in medicine. He aimed first to combine a career as a pastor and physician. After entering the University of Leiden in 1684, he took courses in mathematics, natural philosophy, botany, and languages, as well as in theology.

In 1690 Boerhaave obtained the degree of doctor of philosophy and began medical studies. As a physician, he was almost entirely self-taught, medical instruction at Leiden being at a low ebb. He obtained his medical degree in 1693 from the University of Harderwijk.

Having come under suspicion of being sympathetic to the doctrines of Spinoza, Boerhaave abandoned the idea of an ecclesiastical career and began to devote himself exclusively to medicine and science. His private practice in Leiden was not lucrative but left him time to continue his studies and begin extensive experiments in chemistry.

His highly successful teaching career began in 1701. He taught medicine at the University of Leiden and gave private courses in chemistry. During the next 8 years he published in Latin his two major medical works, The Institutes of Medicine and The Aphorisms concerning the Knowledge and Cure of Diseases. Numerous editions were produced and the works were widely translated, even into Japanese. They continued to be used as textbooks for at least 50 years after his death.

Boerhaave was appointed professor of medicine and botany in 1709. In this post he greatly improved the collection of the celebrated botanical garden of the University of Leiden and carried out an extensive correspondence with the world's leading botanists. In 1714 he became professor of medicine and a physician to St. Cecilia Hospital in Leiden. There in his small clinic he established the value of bedside teaching for medical training.

He obtained the chair of chemistry in 1718 and for 11 years held three chairs simultaneously. His definitive Elements of Chemistry (1732) became very famous and was the source of his influence on 18th-century chemistry.

A tall and robust man of immense erudition, Boerhaave was a superb teacher. He was patient, unaffected, and readily approachable by his students. They flocked from all parts of Europe to hear his lectures, thereby increasing the renown of the University of Leiden. Boerhaave died, universally esteemed, in 1738 of heart disease.

Further Reading

The definitive study of Boerhaave is G. A. Lindeboom, Herman Boerhaave: The Man and His Work (1968). A good background book is Douglas Guthrie, A History of Medicine (1945; rev. ed. 1958).

Boerhaave, Herman (1668–1738), Dutch professor of medicine, botany, and chemistry. Boerhaave began life as the son of a village minister and ended it as professor at Leiden University and communis Europae praeceptor ('teacher to all of Europe'). He lost his mother at five and his father at fifteen, which left his stepmother with nine children to care for. Widow and children moved to Leiden, where student lodgers helped pay the bills and Boerhaave pursued his studies of and love for chemistry.

Though Boerhaave hoped to follow his father's career path, local patronage steered him in a different direction. He graduated from Leiden in 1690 with a philosophy degree and had begun giving private mathematics lessons when he was offered a job cataloging an important book collection for the university library. The university milieu—especially Leiden's library and anatomy theater—fostered a growing interest in medicine, leading Boerhaave to take a medical degree at the University of Hardewijk in 1693. (Hardewijk was famous for the low cost of its degrees.) Patronage brought him back to Leiden University and he began teaching an introductory course for medical students in 1701.

Boerhaave introduced his students, via Hippocrates and Thomas Sydenham (an English physician known as the "Shakespeare of medicine" [1624–1689]), to medicine as a clinical profession. By 1703 he had announced his preference for iatromechanism (the mechanical theory of medicine) and in subsequent publications, such as Institutiones Medicae (Institutions of Medicine, 1708), he put his mechanical principles and faith in observation to work. Observation became even more important when Boerhaave became botany professor and director of Leiden's botanical garden in 1709. At his inaugural lecture, he codified his philosophy with the motto simplex veri sigillum ('simplicity is the sign of truth'). The more he pursued his work, however, the more of a challenge his creed became. The botanical garden, for example, was planted according to three different systems, and his efforts to bring order to Leiden's botanical collection (see the second volume of his Index Plantarum [Index of Plants], 1720), were only partially successful. It was his student, Carl Linnaeus, who first published a consistent botanical system in 1735.

Moving between simplicity of theory and specificity of medical treatment presented a further challenge. In 1714 the increasingly popular Boerhaave began teaching clinical medicine by taking students to visit patients at Leiden's Caecilia Hospital. Here, he and his students directly faced the tensions between theory and practice. On one hand, students learned diagnosis and care. On the other, they learned a systematic way to account for the human body's economy of health and disease. True to his mechanical views and his desire to consider human physiology in a simple manner—that is, apart from metaphysical questions about the relation between physical being and the cause of life—Boerhaave taught students to focus on the circulation of blood and other bodily fluids, along with involuntary functions such as breathing, sweating, heartbeat, and peristaltic motion.

This systematic mediation between theory and practice made Boerhaave's work enormously influential. As his students graduated, they took with them the tools necessary to make medical study and practice both dynamic and authoritative. Once his followers gained official positions, in Austria, for example, alternative forms of medical practice—such as that of Franz Anton Mesmer (1734–1815)—were driven from court and country. In Edinburgh, Boerhaave's graduates staffed a medical school that eclipsed Leiden's popularity in the second half of the eighteenth century by offering the same kind of inspiring training for a fraction of the price. At the University of Göttingen, Albrecht von Haller (1708–1777) transformed his teacher's mechanical approach into a physiological research program by examining the differences between involuntary and apparently voluntary motion. Refusing to give in to vitalism (the doctrine that life cannot be explained scientifically), Haller argued for the distinction between muscular irritability and nervous sensibility. While Boerhaave and others like him separated theology from medicine out of intellectual modesty regarding divine purpose, and for the sake of clinical and experimental rigor, one former student made a philosophy of this separation. Taking the idea of mechanism to its extreme, Julien Offroy de La Mettrie (1709–1751) argued that humans are nothing but machines.

Boerhaave became Leiden's chemistry professor as well in 1718. His influential lectures presented chemistry's traditional elements (earth, water, air, and fire) as instruments of physical and chemical change. This gave chemistry a level of theoretical simplicity in which theory served to organize increasingly complex laboratory practices (see his Elementa Chemiae [Elements of chemistry], 1732). In both medicine and chemistry, Boerhaave's strength lay in connecting theoretical considerations to the demands and challenges of practice. This, rather than any startlingly original discoveries, is what made him a popular and influential educator. He died in 1738.

Bibliography

Knoeff, Rina. Herman Boerhaave (1668–1738): Calvinist, Chemist, and Physician. Amsterdam, 2002.

Lindeboom, G. A. Herman Boerhaave: The Man and His Work. London, 1968.

Luyendijk-Elshout, ed. Walking with Boerhaave in Leiden: The Trail of the Past. Leiden, 1994.

—LISSA ROBERTS

Herman Boerhaave
Herman Boerhaave (1668–1738)
Born	December 31, 1668(1668-12-31) Voorhout
Died	September 23, 1738 (aged 69) Leiden
Residence	Netherlands
Nationality	Dutch
Fields	Physician
Institutions	University of Leyden
Alma mater	University of Leyden
Doctoral advisor	Burchard de Volder
Doctoral students	Gerard Van Swieten
Known for	Founder of clinical teaching

Herman Boerhaave (Voorhout, December 31, 1668 – Leiden, September 23, 1738) was a Dutch botanist, humanist and physician of European fame. He is regarded as the founder of clinical teaching and of the modern academic hospital. His main achievement was to demonstrate the relation of symptoms to lesions.

Oud Poelgeest Castle, Herman Boerhaave's home in Oegstgeest, near Leiden. This was the site of his outdoor botanical garden that was renowned during his lifetime and rivaled Hortus Cliffortianus, the garden of his friend and sponsor to Linnaeus. He traveled back and forth to his friend's garden and to the Leiden University by trekschuit.

Contents 1 Life 2 Personal life 3 Publications 4 See also 5 External links 6 References

Life

He was born at Voorhout near Leiden. Entering the University of Leiden he took his degree in philosophy in 1689, with a dissertation De distinctione mentis a corpore (on the difference of the mind from the body), in which he attacked the doctrines of Epicurus, Thomas Hobbes and Spinoza. He then turned to the study of medicine, in which he graduated in 1693 at Harderwijk in present-day Gelderland. In 1701 he was appointed lecturer on the institutes of medicine at Leiden; in his inaugural discourse, De commendando Hippocratis studio, he recommended to his pupils that great physician as their model.

In 1709 he became professor of botany and medicine, and in that capacity he did good service, not only to his own university, but also to botanical science, by his improvements and additions to the botanic garden of Leiden, and by the publication of numerous works descriptive of new species of plants. In 1714, when he was appointed rector of the university, he succeeded Govert Bidloo in the chair of practical medicine, and in this capacity he introduced the modern system of clinical instruction. Four years later he was appointed to the chair of chemistry also. In 1728 he was elected into the French Academy of Sciences, and two years later into the Royal Society of London. In 1729 declining health obliged him to resign the chairs of chemistry and botany; and he died, after a lingering and painful illness, at Leiden.

His reputation so increased the fame of the University of Leiden, especially as a school of medicine, that it became popular with visitors from every part of Europe. All the princes of Europe sent him pupils, who found in this skillful professor not only an indefatigable teacher, but an affectionate guardian. When Peter the Great went to Holland in 1715, to instruct himself in maritime affairs, he also took lessons from Boerhaave. Linnaeus traveled to see him, as did Voltaire. His reputation was not confined to Europe; a Chinese mandarin sent him a letter addressed to "the illustrious Boerhaave, physician in Europe," and it reached him in due course. The operating theatre of the University of Leiden in which he once worked as an anatomist is now at the center of a museum named after him; the Boerhaave Museum.

Boerhaave first described Boerhaave's Syndrome, which involves tearing of the esophagus, usually a consequence of vigorous vomiting. He notoriously described in 1724 the case of Baron Jan von Wassenaer, a Dutch admiral who died of this condition following a gluttonous feast and subsequent regurgitation^[1]. This condition was uniformly fatal prior to modern surgical techniques allowing repair of the esophagus.

Boerhaave was critical of his Netherlands contemporary, Baruch Spinoza, attacking him in his dissertation in 1689.

Personal life

On September 14, 1710, Boerhaave married Maria Drolenvaux, the daughter of the rich merchant, Alderman Abraham Drolenvaux. They had four children, of whom one daughter, Maria Joanna, lived to adulthood [1]. In 1722, he began to suffer from an extreme case of gout, recovering the next year.

Publications

• Het Nut der Mechanistische Methode in de Geneeskunde[2] (Leiden, 1703)
• Institutiones medicae (Leiden, 1708)
• Aphorismi de cognoscendis et curandis morbis (Leiden, 1709), on which his pupil and assistant, Gerard van Swieten (1700–1772) published a commentary in 5 vols.
• Elementa chemiae (Paris, 1724).

See also

• Boerhaave syndrome

External links

Wikimedia Commons has media related to: Herman Boerhaave

• Samuel Johnson's 1739 biography of him online: Life of Herman Boerhaave
• Museum Boerhaave in Leiden, National Museum of the History of Science and Medicine
• A recent discussion of Boerhaave's Syndrome in the New England Journal of Medicine (subscription required)
• Works by Herman Boerhaave at Project Gutenberg
• "Aphorismi de Cognoscendis et Curandis Morbis" (1709; “Aphorisms on the Recognition and Treatment of Diseases”)
• "Elementa Chemiae" (1733) (Elements of Chemistry)
• "A New Method of Chemistry" (1741 & 1753) (English Translation of "Elementa Chemiae" by Peter Shaw)

References

1. ^ Boerhaave H. Atrocis, nec descripti prius, morbii historia: secundum medicae artis leges conscripta. Leiden, the Netherlands: Lugduni Batavorum Boutesteniana, 1724

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