Herman Boerhaave


Herman Boerhaave was a Dutch botanist, chemist, Christian humanist, and physician of European fame. He is regarded as the founder of clinical teaching and of the modern academic hospital and is sometimes referred to as "the father of physiology," along with Venetian physician Santorio Santorio. Boerhaave introduced the quantitative approach into medicine, along with his pupil Albrecht von Haller and is best known for demonstrating the relation of symptoms to lesions. He was the first to isolate the chemical urea from urine. He was the first physician to put thermometer measurements to clinical practice. His motto was Simplex sigillum veri: 'Simplicity is the sign of the truth'. He is often hailed as the "Dutch Hippocrates".

Biography

Boerhaave was born at Voorhout near Leiden. The son of a Protestant pastor, in his youth Boerhaave studied for a divinity degree and wanted to become a preacher. After the death of his father, however, he was offered a scholarship and he entered the University of Leiden, where he took his degree in philosophy in 1689, with a dissertation De distinctione mentis a corpore. There 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.
On 14 September 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. In 1722, he began to suffer from an extreme case of gout, recovering the next year.
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 as well. 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.

Legacy

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 skilful professor not only an indefatigable teacher, but an affectionate guardian. When Peter the Great went to Holland in 1716, he also took lessons from Boerhaave. Voltaire travelled to see him, as did Carl Linnaeus, who became a close friend. 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 centre of a museum named after him; the Boerhaave Museum. Asteroid 8175 Boerhaave is named after Boerhaave. From 1955 to 1961 Boerhaave's image was printed on Dutch 20-guilder banknotes. The Leiden University Medical Centre organises medical trainings called Boerhaave-courses.
He had a prodigious influence on the development of medicine and chemistry in Scotland. British medical schools credit Boerhaave for developing the system of medical education upon which their current institutions are based. Every founding member of the Edinburgh Medical School had studied at Leyden and attended Boerhaave's lectures on chemistry including John Rutherford and Francis Home. Boerhaave's Elementa Chemiae is recognised as the first text on chemistry.
Boerhaave first described Boerhaave syndrome, which involves tearing of the oesophagus, usually a consequence of vigorous vomiting. He notoriously described in 1724 the case of Baron Jan van Wassenaer, a Dutch admiral who died of this condition following a gluttonous feast and subsequent regurgitation. This condition was uniformly fatal prior to modern surgical techniques allowing repair of the oesophagus.
Boerhaave was critical of his Dutch contemporary, Baruch Spinoza, attacking him in his dissertation in 1689. At the same time, he admired Isaac Newton and was a devout Christian who often wrote about God in his works. A collection of his religious thoughts on medicine, translated from Latin to English, has been compiled by the Sir Thomas Browne Instituut Leiden under the name Boerhaave's Orations. Among other things, he considered nature as God's Creation and he used to say that the poor were his best patients because God was their paymaster.

Medical contributions

As a credible chemist and physician of European, the human body was a very inquisitive and compelling component in agreed with other physicians of his time – like Borellis – and thus he devoted a diligent focus towards this subject matter.
Boerhaave's ideas about the human body were heavily influenced by French mathematician and philosopher René Descartes. Descartes contributed much to iatromechanical theories. Another influencer of Boerhaave's reasoning was Giovanni Borelli. He was a distinguished astronomer and mathematician in the 1600s and published writings on animal motions mirroring machinery principles. Inspired by this and Cartesianism, Boerhaave proposed that the human body's operations are based on a hydraulic model. In his work, he alluded to simple machines, such as levers and pulleys, as well as other mechanisms to explain parts of the body. Boerhaave described the body as made up of pipe-like structures such as are found in a machine. For example, pipes in a machine parallel the physiology of veins in the human body. Boerhaave took this mechanistic notion even further by noting the importance of a proper balance of fluid pressure. Fluids within the body should be able to move around freely, without obstacles. Similar to a machine, a well-being was self-regulating. The body must maintain these conditions to be a healthy equilibrium state. Boerhaave's view on medicine accepted this apparatus-like body philosophy and thus focused attention on materialistic problems rather than mystical explanations of illness.
Boerhaave stressed the atomically research conceived on sense experiences and scientific experiments. Boerhaave attracted many students to Leiden University, where he taught his perception and philosophy. Boerhaave's notion of the systematic body burgeoned throughout Europe and consequently aiding in the transformation of medical educations in European schools.
Boerhaave's intuition struck up a great deal of interest among other critical medical thinkers – one being Friedrich Hoffmann, who emphasised using physico-mechanical principles to preserve and, if needed, restore health. As a professor at Leiden, Boerhaave influenced many of his students. Some of his followers conducted experiments to bolster Boerhaave's philosophy, while other physicians rejected and proposed alternative notions about the human body. Boerhaave also contributed a great number of textbooks and writings that circulated Europe. The enrichment extracted from his lectures at Leiden. In 1708, his publication of the Institutes of Medicine was issued in over five languages with approximately ten editions. Elementa Chemia, a world-renowned chemistry textbook, was published in 1732.
Viewing the body as a mechanism deviated from the path that Galen and Aristotle previously laid down. Instead of solely relying on past finding, Boerhaave understood the importance of seeking fixed results on his own and experiencing the findings first hand. This new thinking augmented Renaissance anatomy and opened doors of novel reasoning leading up to the medical enlightenment germane to iatrochemistry.

Publications