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Leger, Bøker Og Medisinsk Kunnskap I Norge Rundt 17002653–6

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Leger, Bøker Og Medisinsk Kunnskap I Norge Rundt 17002653–6 PERSPEKTIV OG DEBATT Medisinsk historie Leger, bøker og medisinsk kunnskap i Norge rundt 1700 2653–6 Gina Dahl gjenintroduserte atomistiske doktriner Sammendrag [email protected] i Vesten. Fremtredende iatromekanikere Institutt for arkeologi, historie, kultur- var Friedrich Hoffmann (1660–1742) og Medisinens utvikling i den tidlig og religionsvitenskap Hermann Boerhaave (1668–1738). Dette moderne periode (1500–1800) la Universitetet i Bergen Øysteinsgate 3 systemet fikk sitt for samtiden kanskje grunnen for vår moderne medisin 5007 Bergen mest provoserende uttrykk i Julien Offray ved at blant annet (iatro)kjemiske og de La Mettries (1709–51) ideer om at men- mekanistiske kroppsoppfatninger etter nesker var en maskin – menneskemaskinen hvert fikk større betydning for lege- (l’homme machine), som handlet i tråd med vitenskapen. Tiden 1650–1800 er blitt betegnet som matematiske prinsipper. På grunnlag av Det er likevel ikke snakk om at medi- en periode preget av eklektisme innenfor den ovenfornevnte utviklingen formulerte sinen endret seg over natten. I stedet medisinen. Fremdeles var antikkens lære- Thomas Willis tre måter å klassifisere den ble flere medisinske teorier brukt og mestre, som Hippokrates og Galen (fig 1), tidlig moderne medisinen på: den aristote- testet ut side om side. Få studier er viktige. Den teoretiske overbygningen liske, den epikureiske (eller mekaniske) og hittil blitt gjort med tanke på å belyse i antikkens medisin var humoralpatologien den kjemiske (3). hvilket kunnskapsunivers leger i Norge og dens fire væsker: blod, slim, gul galle og i denne perioden befant seg i. svart galle. Disse væskene ble koblet til Legene og kildematerialet I denne artikkelen vil jeg presentere naturelementene ild, luft, jord og vann og til Med dette teoretiske mangfoldet i mente boksamlingene til legene Jacob Wol- kvalitetene kulde, varme, tørrhet og fuk- skal jeg nå ta noen dypdykk ned i boksam- denberg, Georg Blumenthal og Paul tighet. Innenfor dette systemet ble sykdom lingene til tre leger som praktiserte i Norge Dons, utdannet rundt 1700, for å se sett på som ubalanse mellom kroppsvæsker rundt 1700 for å belyse hvordan nettopp hvordan disse forholdt seg til den tidlig (dyskrasi). Balanse kunne gjenvinnes ved disse forholdt seg til samtidens motstri- moderne medisinens mangfold. bruk av årelating, svettekurer og brekk- dende medisinske teorier. Analysen av midler, og helt frem til renessansen var legenes boksamlinger baserer seg på bok- Sett under ett dekket alle de tre bok- humoralpatologien enerådende innenfor opptegnelser slik de står listet i en skifte- samlingene både antikke medisinske medisinen. protokoll (Blumenthal) (fig 3), en auksjons- teorier samt de nye debattene innenfor I den tidlig moderne perioden ble humo- protokoll (Woldenberg) og en bokkatalog legevitenskapen. Brorparten av bøkene ralpatologien kraftig utfordret av den nye (Dons). Selve samlingene finnes ikke kom likevel fra Tyskland og Nederland, anatomien. Kroppsforståelsen ble blant lenger. Utvalget av boksamlinger er foretatt hvilket vil si at disse tre legene sto i en annet radikalt endret gjennom arbeidene til på et rent pragmatisk grunnlag: Det finnes tysk, og dernest nederlandsk, lær- Thomas Willis (1621–75) (nervesystemet), svært få opptegnelser av legers biblioteker domstradisjon. William Harvey (1578–1657) (blodsirkula- i perioden, noe som gjør disse boksamlin- sjonen) og Richard Lower (1631–91) gene unike, da de er indikatorer på hva (respirasjonen). Også i Danmark endret leger i Norge leste og hva man kunne få tak anatomer som Niels Steensen (1638–86) i av medisinsk litteratur tidlig på 1700- og Thomas Bartholin (1616–80) sentrale tallet. En mindre studie er gjort av boksam- dogmer innenfor den galenske anatomi. lingen til legen og læreren i fysikk ved I tillegg oppsto det fra 1600-tallet av to Christiania Gymnasium, Ambrosius Rho- medisinske systembygninger som fra hvert dius’ (1605–96) boksamling (4). sitt hold tilbød alternative forklaringer til Siden det her kun dreier seg om tre bok- den galenske modell. Den ene, iatrokjemien samlinger, gjør ikke boksamlingene krav på (iatro = lege), forfektet at kroppen kunne noen form for representativitet. Men, som forstås ut fra kjemiske prinsipper. Ret- ningen hadde sine røtter i alkymien slik den ble utformet av Paracelsus (1493–1541), og viktige representanter var Joan Baptista Hovedbudskap van Helmont (1579–1644) og Franciscus ■ Medisinske boksamlinger gir oss verdi- Sylvius (1614–1672) (fig 2). I Danmark- full informasjon om legers teoretiske Norge ga man på 1600-tallet ut flere farma- og praktiske orientering kopeer som inkluderte kjemisk fremstilte ■ Studiet av tre norske legers boksamlin- medikamenter (2), og den danske legen ger speiler at medisinen rundt år 1700 Peder Sørensen (1540–1602) var en av i stor grad var preget av teoretisk og Paracelsus’ mest berømte tilhengere. praktisk eklektisme Det andre systemet, iatromekanikken, ■ På bakgrunn av boksamlingene kan Artikkelen er basert på forfatterens var grunnlagt på matematiske og mekaniske legene sies å ha stått primært i en tysk, doktoravhandling om legers og presters prinsipper. Et viktig teoretisk grunnlag dernest nederlandsk, lærdomstradisjon boksamlinger i perioden 1650–1750 (1). her var gjenoppdagelsen av Lucretius’ (ca. 95–ca. 55 f.Kr.) De rerum natura som Tidsskr Nor Legeforen nr. 24, 2009; 129: 2653–6 2653 PERSPEKTIV OG DEBATT Medisinsk historie jeg vil vise i det som følger, er visse grunn- lertid akademiske pretensjoner: I 1725 nevnes ikke i listingen av Woldenbergs leggende trekk felles for boksamlingene, ble han immatrikulert ved universitetet bøker, men de fleste av bøkene i Blumen- noe som gjør det mulig å formode at en del i København, og han ble kreert doktor thals og Dons’ samlinger kom fra Tyskland, av det som avdekkes her også vil gjelde for i medisin i 1733. Fra 1736 og frem til han deriblant Leipzig og Frankfurt (am Main andre legers kunnskapstilfang i samme døde i 1742, virket han som lege i Kongs- eller an der Oder). Flere av Dons’ medi- periode. berg (5, bind 1 s. 472). sinske bøker kom også fra Nederland, De tre legene hvis boksamlinger Paul Dons (1689–1748), ble født i Trond- i særlig grad Amsterdam og Leiden. Disse behandles i denne artikkelen, ble utdannet heim og praktiserte som lege i hjembyen. områdene var da også blant de viktigste i perioden 1670–1733. Jacob Woldenberg Dons studerte i København ved Ehlers Col- intellektuelle og kommersielle sentrene (1649–1735) ble født i København. Han legium (1710–11) og Borchs Collegium i perioden. «Bestselgerne» i mitt materiale mottok doktorgraden ved universitetet (1711–15) og tjente deretter som assistent- var derfor i utgangspunktet primært skrevet i København i 1679 og ble deretter lege lege ved Kvæsthuset. Vel hjemme i Trond- av tyske og nederlandske forfattere (tab 1). i hæren. I 1686 ble han utnevnt til botanicus heim avanserte Dons fort også innenfor Enkelte engelske og danske leger ser i Norge, og i perioden 1686–87 tjente han byadministrasjonen. Blant annet ble han likevel ut til å ha vært populære, og av som lege i Kongsberg. I 1688 ble han stads- valgt til borgermester i 1733, og han jobbet danske leger gjelder dette ikke minst med- fysikus i Bergen, en stilling han ble i frem også som dommer. Dons fortsatte likevel lemmer av den prominente Bartholin-fami- til sin død (5, bind 9 s. 165–6). På tross av i sin stilling som stadsmedicus (7). Vi vet lien, spesielt Thomas og Caspar d.e. sin lange tjenestetid har Woldenberg kun lite om hvordan Dons praktiserte som lege. (1585–1629). etterlatt seg noen få brev. I disse klager han Selv om bøkene kom fra spesifikke nett- over at barberere, jordmødre og prestekoner Boksamlingene og deres innhold verksområder, speiler ikke boksamlingene ikke respekterte legens monopol på å kurere Av de tre bokeierne eide Dons den desidert noe radikalt brudd mellom «gammelt» og indre sykdommer (6). største samlingen. Den talte i alt ca. 580 «nytt»: Et viktig trekk ved boksamlingene Georg Henrich Blumenthal (1687–1742) bøker (8), men mange av disse var ikke av er bøkenes relativt høye alder. Både i Blu- studerte ved universitetet i København medisinsk karakter. Woldenbergs boksam- menthals og Dons’ boksamlinger, der tryk- 40 år etter Woldenberg. Han vokste opp ling var på ca. 300 bøker (9), Blumenthals keår nevnes, er de fleste av bøkene 50–100 i Tyskland og startet sine medisinske stu- på ca. 160 bind (10). Antallet verker som år gamle. Flere av bøkene var dessuten dier i Luneburg. Senere ble han kirurg listes i denne typen materiale kan ikke alltid skrevet av forfattere fra antikken. Også et på en hvalfangstskute som seilte langs eksakt gjengis pga. unøyaktig registrering. svært høyt antall medisinske forfattere Grønlandskysten. I 1710 bosatte han seg Sett under ett ser det ut som om visse listes i de forskjellige protokollene: I Blu- i Danmark hvor han virket som kirurg for områder var spesielt viktig for distribu- menthals boksamling, for eksempel, er hele den danske flåten. Blumenthal hadde imid- sjonen av medisinsk litteratur. Trykksted 90 forskjellige forfattere representert. Figur 1 Galen og Hippokrates fremstilt som apoteker og lege i krypten i Domkirken i Anagni i Italia, freske fra 1200-tallet. Foto akg-images/SCANPIX 2654 Tidsskr Nor Legeforen nr. 24, 2009; 129 Medisinsk historie PERSPEKTIV OG DEBATT Figur 2 Franciscus Sylvius (1614–72). Foto Figur 3 Skifteprotokoll. Statsarkivet i Kongsberg Science Photo Library/GV-Press/NordicPhotos Samlingene dekker også mange forskjel- samlingene. Verket består av tre deler: Del 1 Daniel Sennert (1572–1637), som er en av lige emner. Alle tre eide bøker om botanikk, omhandler hermetisk filosofi, del 2 signatur- de forfatterne som er representert med flest farmasi og anatomi. Den tyske legen Paul læren og i del 3 gis det oppskrifter på lege- bøker i boksamlingene. Sennerts samlede Amman (1643–91), professor i medisin, midler fra den paracelsiske tradisjonen (13, verker, som Woldenberg eide, var på over botanikk og fysiologi i Leipzig, ser ut til s. 347–8). Verk av Franciscus Sylvius 3 000 sider, og her diskuteres alt fra giftig å hva vært spesielt populær.
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