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Chapter Four chapter four DIABETES AND SEVENTEENTH-CENTURY MEDICAL CONTROVERSY Diabetes drew the attention of ever more English doctors, notably the Civil War-era medical titans, Thomas Willis and Thomas Syden- ham. These politically diverse physicians, the royalist Willis and the Puritan Sydenham, made major contributions to the study of dia- betes. Their antagonistic judgments about this particular disease mir- rored the theoretical and jurisdictional schism in English medicine and, while physicians like Willis and Sydenham feigned abhorrence of per- sonal quarrels, their professional disputes offer glimpses of their pri- vate values.1 Though both were illustrious doctors, Willis championed academic medicine, “conserving many of the traditional Galenic prac- tices” while adapting them “to the new medical environment;” Syden- ham, an empiricist, had “strong anti-academic sentiments, believing that medicine ought to be taught by apprenticeship, not by books.”2 As politics and religion were key components of the turbulent medical struggle, the methods and remedies of these giants of the profession will help illuminate early modern health care.3 Thomas Willis was a product of orthodox Galenists at Oxford Uni- versity, though he made a name for himself as a clinician and chemi- atrist.4 Continental critics of English universities disparaged what they 1 David Harley, “Honor and Property: The Structure of Professional Disputes in Eighteenth-Century English Medicine,” in The Medical Enlightenment of the Eighteenth Century, edited by Andrew Cunningham and Roger French (Cambridge: Cambridge University Press, 1990), 138–140. 2 Harold J. Cook, The Decline of the Old Medical Regime in Stuart London (Ithaca, N.Y.: Cornell University Press, 1986), 184–185, 224. In his influential portrait of the Royal College of Physicians, Cook spotlights Willis and Sydenham as philosophical rivals although they were not leaders of medical factions. Andrew Wear compares the two in his Knowledge and Practice in English Medicine, 1550–1680 (Cambridge: Cambridge University Press, 2000), 434–473. 3 For a lively investigation of the politics of medical ethics and etiquette, see David Harley, “Ethics and Dispute Behavior in the Career of Henry Bracken of Lancaster,” in The Codification of Medical Morality, edited by R. Baker, Dorothy Porter and Roy Porter (Dordrecht: Kluwer, 1993), 47–71. 4 Fielding Garrison called him “the leading English exponent of chemiatry:” see 82 chapter four perceived as a lack of science in the degree requirements at Oxford and Cambridge. Such reproach may have been motivated by institu- tional self-promotion as much as methodological friction and smacks of disingenuousness. Oxford certainly offered science in its arts curriculum from the 1620s, long before Willis matriculated there.5 Taking his B.A. in 1639 at Christ Church College, Willis, whose father died in the siege of Oxford in 1646, himself served in the university legion while studying medicine. Willis began to practice in Oxford immediately after obtain- ing his M.B. in 1646 and by 1650 had joined a group led by William Petty investigating chemistry and anatomy. The many scientific book- sellers in Oxford stimulated the experimental bent of this group and published their findings.6 Willis straddled the evolution of medicine and science from its roots in Galenism across Renaissance interests in natural magic to therapies involving demonstrated standards of evidence. More recent scholarship has disputed the long-held premise that the Scientific Revolution sig- naled the immediate victory of experimentalism and observation over rigid humoralism. Willis’ career supports the thesis that a more variable medical creed persisted among doctors and natural philosophers. As a transitional figure, he supported the use of fashionable folk remedies founded in Galen, such as the medical application of amulets.7 Galen had sanctioned the use of specific amulets hung around the neck to ward off particular diseases like epilepsy. Like other physicians of his day, Willis accepted the idea that an amulet could exert “occult and sympathetic action” on a diseased part of the body in a variety of ill- nesses. In his 1659 publication, De Febribus, Willis repeated a widely-held conviction that an amulet could ward off the toxin of disease. His con- temporary Robert Boyle was even more explicit, asserting that amulets Introduction to the History of Medicine, 4th ed. (Philadelphia: W.B. Saunders, 1929), 262. Kenneth Dewhurst, conversely, describes Willis’ book Pharmaceutice Rationalis as “nei- ther rational nor scientific,” containing “a mixture of Galenic, chemical and ‘vulgar’ medicines:” Dewhurst, Thomas Willis’s Oxford Lectures (Oxford: Sandford Publications, 1980), 24. 5 Robert G. Frank, Jr., “Science Medicine and the Universities of Early Modern England: Background and Sources, Part I,” History of Science 11 (1973): 204. Frank says that evidence for science teaching at Cambridge can be traced to the 1660s. 6 Robert G. Frank, Jr., “Science, Medicine and the Universities of Early Modern England: Background and Sources, Part II,” History of Science 11 (1973): 247. 7 Steven Shapin, ““The House of Experiment in Seventeenth-Century England,” Isis 79 (1988): 373–404. For the use of amulets in Stuart medicine, see Keith Thomas, Religion and the Decline of Magic (New York: Scribner’s Sons, 1971), 275–276, 189–190, 368..
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