The Brain Takes Shape: An Early History

The Brain Takes Shape THE BRAIN TAKES SHAPE An Early History ROBERT L. MARTENSEN OXFORD UNIVERSITY PRESS 2004 OX...

Author: Robert L. Martensen

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The Brain Takes Shape

THE BRAIN TAKES SHAPE An Early History

ROBERT L. MARTENSEN

OXFORD UNIVERSITY PRESS

2004

OXFORD

UNIVERSITY PRESS

Oxford New York Auckland Bangkok Buenos Aires Cape Town Chennai Dar es Salaam Delhi Hong Kong Istanbul Karachi Kolkata Kuala Lumpur Madrid Melbourne Mexico City Mumbai Nairobi Sao Paulo Shanghai Taipei Tokyo Toronto

Copyright © 2004 by Oxford University Press, Inc. Published by Oxford University Press, Inc. 198 Madison Avenue, New York, New York, 10016 http://www.oup.com Oxford is a registered trademark of Oxford University Press All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press. Library of Congress Cataloging-in-Publication Data Martensen, Robert L. (Robert Lawrence) The Brain Takes Shape: An Early History Robert L. Martensen. p. ; cm. Includes bibliographical references and index. ISBN 0-19-515172-0 1. Medicine—Philosophy. 2. Body, Human (Philosophy) 3. Medicine—History—17th century. I. Title. [DNLM: 1. Philosophy, Medical—history. 2. History of Medicine, 17th Cent. W 61 M377c2O04] R723.M336 2004 610M—dc22 2003060877

9 8 7 6 5 4 3 2 1 Printed in the United States of America on acid-free paper

Preface

Before taking up graduate study of the history of medicine, I practiced emergency medicine for many years in San Francisco hospitals, where we helped care for multitudes of sick immigrants. I know the following from my experiences as an emergency physician: Many people are quite comfortable holding notions of how their bodies function in health and disease that differ, often profoundly, from the formulations of scientific medicine, or biomedicine.' When reflecting then on these differences, I asked myself questions, such as, Why do we assume our frameworks of physiology and anatomy are true and other accounts false? Or, how did we in the West develop our modern ideas of mind and body? Later, I decided to explore some of these reflections historically, which is how the themes of this book began to take shape. In broad terms, the book is an exploration in Western history of two related questions. First, what makes a living human body a person? Most people in the West today—and virtually all those who believe in biomedicine—likely would respond in terms of the brain and nerves. Indeed, we take for granted that the cognitive ability of human minds is a defining quality of our species. Personhood depends on the integrity of mind, which in turn depends on sound functioning of the solid tissues of the cerebral cortex. Furthermore, if disease is understood to threaten personhood, legitimate healing depends on knowledge of relationships between structure and function that can be measured and made visible and quan-

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tifiable in health and disease. If humans have souls—a proposition that many scientists and others doubt—their explication and care are a matter for religion. These beliefs are so commonplace that we assume that it has always been so, that the biology of our bodies is about matter and outside of history. Nonetheless, alternative healers abound within our midst, and many of them subscribe to different models of body function and medical knowledge. What matters in healing, many of them counter, is not mastery of elaborate instrumental methods and measurements but rather skill in mobilizing the sick person's spirit. Rather than localizing disease in any single human organ, they maintain that spirit is an important property of the person's whole body and outlook. Many of them insist that good medical knowledge stems from accurate observation of external conditions, not technopenetrations. Likewise, they say most remedies need not be elaborate or expensive. Alternative healers, like their biomedical counterparts, claim the mantle of reason. And if we were to go to a remote non-Western place, or even into the midst of a non-Western immigrant community in the shadow of some large city university medical center, we might find many people who believe that their souls, which they might locate in a conceptual space like the "heartmind," require diligent care.2 Nonetheless, if they feel ill in their chests or their heads and have access to biomedicine, many of them seek electrocardiograms and computed tomography scans and the rest of biomedicine's technological panoply. The lack of consensus even within literate Western culture about fundamental issues of personhood, especially in its medical dimensions, led me to the second question: How and why does the human body express itself so differently to different groups within modern Western culture? Historical pursuit of answers to these questions soon yielded unexpected findings about both Western bodies and minds and alternative health care. About the first, it turns out that the equation of full personhood with functioning solid portions of the cerebral cortex is not old but rather new. It dates, in fact, from the Scientific Revolution of early modern Europe. The second finding, which I believe is related to the first, is that alternative medicine is not as new as many might think. While sectarianism in medicine dates back to Hippocratic times, the energetic efforts of alternative healers to gain institutional recognition, not to mention their proliferation, date from the Scientific Revolution, too. However, more than new approaches to nature were occurring from the mid sixteenth century onward. Very few Europeans alive in 1540 would have heard of Copernicus, for example, but almost everyone in northern Europe would have been aware that the religious crisis subsequently known as the Reformation was well under way. The heated sectarianism that began in the early sixteenth century in Western Christianity within a few decades found its counterpart in natural philosophy, including learned medicine. In no place else in Europe did what we nowadays call the Scientific Revolution and Reformation engage so closely with one an-

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other over such a brief time period as they did in England from the late sixteenth century onward to the late seventeenth century. Their confluence in that society at that time generated important historical consequences, I will argue, for it is at their English intersection from the 1640s to the 1680s or 1690s that one finds the origins of the cerebral body and its alternatives. Consequently, I spend most of this book exploring that intersection. To get a sense of the dimensions of the extended crisis that English people alive then experienced, consider just the labels of its major episodes: in the 1640s, the English Civil War, during which a rebellious Parliament eliminated the monarchy and state church to make way for the secular government of the Interregnum of the 1650s. New brooms swept out the old from their offices and assumed their predecessors' places. Many traditional clergy and loyalist gentry went into exile while others shifted their allegiances abruptly. Parliamentary restoration of the monarchy and state church in 1660, a politicoreligious settlement of differences that worked for a while only to finally fall apart during the constitutional crisis known as the Glorious Revolution of 1688. With the constitutional monarchy of William and Mary and the Whig ascendancy of the late seventeenth century, one can say that England—soon to be Britain— resolved its crisis and emerged as a recognizably modern state, arguably Europe's first. In the meantime, the crisis decades also witnessed England's emergence as a leading center of experimental investigation of nature and mathematics, not to mention its rise as a commercial powerhouse. As we shall see, along the way those who sought to shape England increasingly chose measures that favored commerce and piety in preference to their grandparents' or great-grandparents' preoccupation with the possible primacy of spirits of all kinds. Of course, history does not unfold in the abstract categories applied after the fact by historians and others. People and circumstances make history, and the following pages are replete with historical actors with enduring marquee value, such as William Harvey and John Locke, as well as anonymous authors of modest ambition and a few letters from a patient in a position to have almost seen it all. Large-scale forces, such as powerful cultural trends, may also shape historical development, and I address some of the trends that generated potent assumptions and foreclosed others. My account leaves much out. Fortunately, other historians with diverse approaches have addressed one or another aspect of the subjects discussed here. One approach, taken mainly by professionals in the neurosciences such as William Feindel, Stanley Finger, and Clifford Rose, emphasizes the anatomic and physiological work of early modern investigators in their purely medical context. In comparison, social and cultural historians, such as Andrea Carlino, Barbara Duden, Shigehisa Kuriyama, Thomas Laqueur, Jonathan Sawday, and Londa Schiebinger, among others, approach the history of the body from a broad cultural and historical perspective, and I list their works in the references. I attempt to steer a middle course, which means providing considerable detail about the theories and models

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themselves while trying to do justice to their interactive relationships with the actors, cultural trends, and subcultures that produced and celebrated them. Extensive use of theory has characterized many modern analyses of seventeenthcentury Europe, especially England, from the time of Max Weber in the late 1890s to Robert Merton in the 1930s through Christopher Hill in the 1970s to recent work by sociologist Steven Shapin and his frequent co-author, Simon Schaffer, anthropologist Bruno Latour, and others on early modern natural philosophy, and I list some of the influential approaches in the references. Because this book is intended for a diverse group of readers that includes historians, neuroscientists, anthropologists, scholars of early modern European culture, and general readers, I have tried to minimize the use of arcane words and syntax.

A Caution to Readers For a variety of reasons, many practicing historians view the past as unmasterable.3 I think two constraints have particular relevance for this book. Cultural anthropologists who study aspects of bodily experience in cultures foreign to their own, such as Robert Desjarlais's study of body and emotion in the Nepalese Himalayas or Chi Hua's recent account of sexual practices among the Na people of China, may have to deal with some disciplinary conundrums concerning representations of an "other," but at least they have the benefit of field experience of what they describe.4 Visual artists and writers of poetry and prose have the benefit of artistic license in making their bodily constructions. Religiously motivated writers concerned with the body of a divine or semidivine creature may have the benefit of their faith and theology in writing their accounts. In comparison, historians' reliance on old printed texts adds an additional level of contingency to historical interpretations, which is the mediation of print culture itself. During the sixteenth and seventeenth centuries, the print culture of natural philosophy was just taking form, a development in which representation of bodies of all kinds played an important role. I address some of this in Chapter 1. Second, historical explorations that address the past of what are now known as scientific subjects need to be mindful of their tendency to use present-day analytical concepts and word meanings that were not in existence then. Anachronisms are embedded in the very name history of science. Indeed, terms like the Scientific Revolution, which historian Herbert Butterfield coined in the late 1940s to describe the rapid change in knowledge of the natural world that occurred between, say, 1543, when Copernicus died, and 1727, when Newton died, use two venerable words in ways the historical actors Butterfield was considering would not have understood to describe a phenomenon that they did not perceive.5 That is, the predominant meanings of both science and revolution then were different than their modern ones. Scientists, by which I mean organized professionals investigating specific natural domains, only gained that descriptor in the mid nineteenth

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century. Before and during the early modern period, Europeans who seriously studied nature were known as natural philosophers, a term with a long history that can be traced back to Aristotle. The innovative ones pursued "experimental natural philosophy" or, in England in the mid seventeenth century, the "new" philosophy, not science, which then meant something not entirely different but different enough so that the routine use of them as synonyms seriously distorts the past. Although science as an academic domain and professional activity largely dates from the early and mid nineteenth century, natural philosophy (philosophia naturalis) as an academic subject took form in the thirteenth century when members of orthodox Catholic teaching orders promoted the study of nature to show the perfection and order of God's creation. As historian Andrew Cuningham has argued recently, this movement did not arise spontaneously but instead as a reaction to schism within Catholic belief concerning whether there was one perfectly good God—the traditional Christian position—or two, a good God and an evil one—the claim of the Cathars. In the broadest terms, the Cathars argued that nature, because it arose from an evil principle, inevitably tended to be corrupt. In part to provide convincing counterarguments, orthodox Catholic intellectuals, notably Albertus Magnus (c. 1200-c. 1280) and St. Thomas Aquinas (1225-1274) and their followers, resurrected Greek philosophers, especially Aristotle, and redressed them in Christian garb through their commentaries (known as "glosses") on the Greek texts they translated into Latin. Because Aristotle's texts provided an extensive and well-developed schema of nature (physis in Greek) as something separate in ways from humans and amenable to investigation yet as something with purpose, orthodox Catholic leaders found him particularly congenial. To put matters at their simplest, natural philosophy at some level was always about God's presence in nature.6 Science, at least as commonly understood from the mid nineteenth century onward, is not, at least not necessarily. One could go on at book length on the subject of "smuggled modern baggage" in histories of science from the birth of the discipline onward.7 Here I confine my comments to just two key words—anatomy and physiology—that first entered English usage in the period of 1540 to 1690. But their meanings then were often quite different than when they became recognizably modern during the eighteenth and early nineteenth centuries. Nowadays the words anatomy and physiology in their ordinary usage convey notions of well-defined professional activities existing within the life sciences and medicine. In the sixteenth and seventeenth centuries, however, physiology had a loose definition and did not exist as a professional domain. As historian John Lesch has noted, until the eighteenth century physiology was generally synonymous with "study of nature."8 In listing the contents of The Sceptical Chemist in 1661, Robert Boyle, the prominent natural philosopher, subtitled them "Physiological considerations touching the Experiments wont to be employed to evince either the Four Peripatetick Elements, or the three

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chymical Principles of mixt Bodies." In his Certain Physiological Essays, also of 1661, Boyle listed "chemistry, Anatomy, Botanick, or some other particular part of Physiology" as his subject.9 Also, early modern natural philosophers often made no clear distinction between animate and inanimate worlds. For example, when Francis Bacon (1561-1626) listed the contents of his Silva Sylvorum, or a Natural History in Ten Centuries, published posthumously in 1626, he included thirteen works as "physiological Remains." Of these, seven concerned minerals and six dealt with attractive force and transformations of inanimate bodies that Bacon characterized in biological terms.10 The word anatomy presents different issues. Shortly before Andreas Vesalius published his magnum opus on human anatomy, De Humani Corporis Fabrica (On the Structure of the Human Body, henceforth Fabrica, published in June 1543), the word anatomy entered English usage for the first time as a description of a dissected body (1540) and the process of dissection (1541). 11 From the middle of the sixteenth century until the end of the seventeenth century or a little later, many early modern writers of theological, medical, and imaginative prose also used the word anatomy in their titles. Indeed, the writing of anatomies on many different subjects during this period transformed a medico-natural philosophical activity into a literary genre. From Elizabethan John Lyly's "Euphues: The Anatomy of Wit" of 1578 through Robert Burton's sprawling Anatomy of Melancholy (1621) of the early Stuart period to Willis's Anatomy of the Brain of 1664 and beyond, anatomy often meant pursuing a subject in depth so as to find universals and the final cause of structure. According to literary scholar Devon L. Hodges, who has published the major extended exploration of the anatomy literary genre in the sixteenth century, "The wide range of such texts dramatically illustrates the Renaissance writer's concern to strip away false appearances and expose the truth."12 The motivation to eliminate false appearances was shared, ironically, by those who denigrated anatomical performances, such as the Protestant reformers considered in Chapter 1, as well as bonafide anatomists. Anatomy continued to cut a wide cultural swath well into the seventeenth century. According to the Short Title Catalogue, which lists printed books in English in 1641-1700, of the twenty-six published texts whose first title word was "Anatomy," for instance, only two or three treated the structure of animal bodies. For the poet John Lyly, who developed his classical Greek character, Euphues, with the intention of making readers suspicious of mere surfaces, especially of beauty and wit, anatomy could delve beneath the surface to show inner surfaces and depths: "For as every Paynter that shadoweth a man in all parts, giveth every peece his just proporcion, so he that disciphereth the qualities of the mynde, ought as well to shew every humor in his kinde, as the other doth every part in his colour.

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XI

The Surgion that maketh the Anatomy sheweth aswel the muscles in the heele, as the vaines of the hart."13 Sometimes early modern writers used anatomy and physiology and their cognates interchangeably. Such a practice reflects the historical reality that often even the most orthodox investigators, such as Robert Boyle, did not make clear distinctions between structure and matter and its behavior. Why was this so? More importantly, why did anatomy and physiology, which then were (and now are) primarily categories of bodily knowledge, assume a central role in early modern culture before receding in the eighteenth century? I suggest that answers to these questions are complex and address them from different perspectives. A hint may lie in the fact that commonly used cognates of corpus (body) in medieval and early modern Europe resonated with references to collective bodies such as the Catholic church, a guild, or a university faculty, not to an impersonal legal and financial entity as we understand corporation today. As these early modern public bodies experienced crises of meaning, a subject that various chapters explore, anatomy, in the sense of exploration of deep and hidden structures, held out for some the potential of true revelation at the individual and group level even as it seemed a dangerous and useless pursuit to others. Moreover, until mid-seventeenth-century philosophers, notably Descartes, advanced the notion that humans generate their own ideas, formal Christian culture generally assumed that believers participated in the divine body—Christ—as well as in the one single idea, the mind of God. This book, like most history, concerns change and continuity. Because the cerebral model and various alternatives to it did not spring up de novo in the mid seventeenth century, the first two chapters address some relevant aspects of their links to their past. In the middle chapters I discuss the work of Thomas Willis and Rene Descartes and their cohort because they provided the main cerebral models. After setting out the models and their methods of production and representation, I discuss their links, especially those of Willis, to broader interests and cultural outlooks. What constituted acceptable natural philosophy began to change toward the end of the seventeenth century, and I discuss this in Chapter 8. Finally, in Chapter 9,1 explore how and why I think the cerebral body and alternative models persist into the present. Some administrative points: Generally, the seventeenth-century English calendar, which lagged by ten days the one then commonly used on the Continent, began the new year on March 25.1 follow general historical convention by not shifting the old style dates while taking the year to begin on January 1. In quotes I have kept original spellings and use of capital letters and italics; where the referent is not obvious or letters or a word seem to be missing in the original, I add it in brackets. When quoting from manuscripts, I note with question marks those areas I cannot decipher. Many of my sources were published originally in Latin. I have not checked all the original Latin, but only those words or passages where a sig-

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nificant point hangs on the translator's English. When I make an alternative translation, I note it in the text. New Orleans, Louisiana

R.L.M.

Notes 1. By biomedicine, which I discuss in Chapter 9,1 mean the established institutional structure of the dominant Western medical approach, including its epistemological and ontological commitments. I often use the phrase learned Western medicine to refer to the literate Western medical tradition that goes back to Greco-Roman texts and their use in the early universities. 2. For a discussion of "heartmind" in contemporary Buddhism as experienced by a community in the Himalayas, see anthropologist Robert Desjarlais. Body and Emotion. (Philadelphia: University of Pennsylvania Press, 1993); also, for comparisons to Western models, see Robert Desjarlais. "On the Vagaries of Bodies," in Culture, Medicine and Psychiatry 19 (1995): 207-215. Part of Desjarlais's article addresses an earlier version of my historical account of the cerebral body, which is in the same issue. See Robert Martensen. "Alienation and the Production of Strangers: Western Medical Epistemology and the Architectonics of the Body, An Historical Perspective," in Culture, Medicine and Psychiatry 19 (1995): 141-182. Also, philosopher Amelie Oksenberg Rorty comments on Western notions of the body, including those I put forth, in the same issue. See Amelie Oksenberg Rorty. "The Science of the Humane and the Humanism of Science," Culture, Medicine and Psychiatry 19 (1995): 217-223. The three papers and another in Culture, Medicine and Psychiatry grew out of an interdisciplinary symposium on Narrative and Medicine organized by Byron J. Good and Mary-Jo Delvecchio Good and sponsored by the Cen ter for the Study of Culture and Medicine at Harvard University, February 24-25, 1994. The title of my article in Culture, Medicine and Psychiatry comes from a conference of the same name organized in 1992 at the University of CaliforniaBerkeley by James Turner, who was then a visiting professor in their Department of English. In that conference, I presented an early version of what has become Chapter 7 in this book, "The Transformation of Eve," which subsequently was published as a chapter with that name in Sexual Knowledge, Sexual Science: The History of Attitudes to Sexuality, eds. Roy Porter and Mikulas Teich (Cambridge: Cambridge University Press, 1994), pp. 107-34. 3. Charles Meier. The Unmasterable Past. (Cambridge: Harvard University Press, 1988). 4. Clifford Geertz. The Interpretation of Cultures. (New York: Basic Books, 1974). Also see Clifford Geertz. After the Fact: Two Countries, Four Decades, One Anthropologist. (Cambridge: Harvard University Press, 1995). 5. Herbert Butterfield. Origins of Modern Science. (London: Bell, 1957). See also Herbert Butterfield. "The History of Science and the Study of History," Harvard Library Bulletin (1959): 329-347. 6. See Andrew Cuningham. The Anatomical Renaissance. (Aldershot: Scolar Press, 1997), especially pp. 38-54. See also Roger French and Andrew Cuningham. Before Science: the Invention of the Friars' Natural Philosophy. (Aldershot: Scolar Press, 1996); Andrew Cuningham, "Getting the Game Right: Some Plain Words on the Identity and Invention of Science," Studies in History and Philosophy of Science 19 (1988):

PREFACE

7. 8. 9. 10. 11. 12. 13.

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365-89. Also Frederick I.E. Woodbridge. Aristotle's Vision of Nature. ed. and intro. John H. Randall Jr. (New York: Columbia University Press, 1965). I am indebted to historian David Harley for using this phrase in a letter to me of December 4, 1995, that addressed anachronism in the history of science. John E. Lesch. Science and Medicine in France. (Cambridge: Harvard University Press, 1984), pp. 15-16. Robert Boyle. Certain Physiological Essays. (London, 1661). Francis Bacon. "Table of Contents," Works. vol. 1 (London, 1889). See the current Oxford English Dictionary. Devon L. Hodges. Renaissance Fictions of Anatomy. (Amherst: University of Massachusetts Press, 1985), pp. 1-2. John Lyly. "Euphues: The Anatomy of Wyt," 1:180 in Complete Works of John Lyly. ed. R. Warwick Bond. vol. 1 (1902). Reprint (Oxford: Clarendon Press, 1967). See also Hodges. Renaissance Fictions, 22.

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Acknowledgmets

I owe enormous debts to generations of scholars concerned with ancient, medieval, and early modern subjects as well as to present-day cultural anthropologists. I have worked on this project for several years and want to express my gratitude to a number of scholars, librarians, and institutions that have supported this endeavor. At the University of California, Robert Frank, Roger Hahn, Thomas Laqueur, the late Jack Pressman, Guenter Risse, and Barbara Shapiro all taught me a great deal and provided trenchant criticism of my early efforts. Heinrich von Staden, whom I met early in my historical study, has inspired and encouraged me, for which I offer him my deep thanks. Stanley Finger, Hansreudi Isler, and Clifford Rose also have made valuable comments on my earlier treatments of Willis. The late Roy Porter, Bill Bynum, Hal Cook, and Andrew Wear at the Wellcome Institute for the History of Medicine in London, have given me valuable advice on the early modern period over the years as has Andrew Cuningham at the former Cambridge unit of the Wellcome. Arthur Kleinman at Harvard first inspired me to take up an anthropological perspective on this material, and Robert Desjarlais, Byron Good, and Mary-Jo Delvecchio Good at Harvard provided encouragement and invaluable advice on contemporary cultural anthropology. Allan Brandt, my senior history of medicine colleague at Harvard, pressed me on several key points in early versions, as did Leon Eisenberg, for which I am indebted to them. Bill Newman, then at Harvard, guided me in the alchemical literature. Along the way

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David Harley served as my cicerone to the Bodleian Library and some nuances of early seventeenth-century English religious history even as he took issue with many of my interpretations. Also, historians Jerome Bylebyl, Lisa Forman Cody, Mary Fissell, Elizabeth Furdell, Christopher Goodey, Shigehisa Kuriyama, Scott Mandelbrote, Robert Irwin, Ellen More, and Dorothy Porter have encouraged me at critical moments and provided useful comments, as has literary scholar Roger Shattuck and philosophers Daniel Garber and John Sutton. Polymath Jonathan Miller gave useful advice early on, and comments by artists Robert Irwin and Ernesto Pujol have enabled me to better appreciate the aesthetic issues at stake. For their encouragement and comments on earlier versions, I am grateful to several friends and family members, including Susan Brock, Phoebe Cutler, Vince Healy, Leslie and George Hume, Sarah Ingram-Eiser, Maggie Kent, Sally Knight, my mother, Bernice Martensen, my father, Lorenz, my brother Bill, Marcia Riwney, Anne Carver Sutro, and Barbara and Chris Wilson. I could not have written this account without the generous help of librarians and archivists at the libraries of the University of California in San Francisco, Berkeley, and Los Angeles, and the Huntington, the Bodleian, the Wellcome, the Royal College of Physicians, Lambeth Palace, Dr. Williams Library, the Public Record Office (London), the Folger, the Countway, the New York Academy of Medicine, and the Clendening, where I spent seven years and received superb assistance from Kelly Brown and Dawn McKinnis. Dawn has generously arranged for the preparation of many of the illustrations, too. In addition to cheerful encouragement, Jeffrey House of Oxford University Press has given me invaluable editorial advice. The editorial assistance of Mary Ann Travis at Tulane has improved the text considerably, and I could not have met the publishing schedule without her. Historian Lisa Forman Cody, whom Oxford University Press engaged as a reader, has offered encouragement and numerous valuable editorial suggestions. Several institutions have provided generous financial support for research trips to the libraries and archives noted above as well as for some time to write. I am especially grateful to the Guggenheim Foundation for its award of a Fellowship in 2002 and to the National Library of Medicine of the National Institutes of Health for a publication grant in 2001 (1G13LM07503-01). In 2002 the Wellcome Unit of the History of Medicine at University College, London, provided me an office and learned and congenial colleagues, especially my office mate Carol Reeves, for ten delightful weeks. My earliest work on this project received support in the form of research fellowships from the Office of the President of the University of California, the Wellcome Institute of the History of Medicine in London, and a 1994 research travel grant from the Milton Fund at Harvard University. At Tulane, where I have been since September 2002, Ian Taylor, Dean of the School of Medicine, Paul Whelton, who heads Tulane's health sciences, and

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Rick Teichgraeber III, director of the Murphy Institute for Political Affairs, have supported this project, for which I am most grateful. My children have seen me through this undertaking from its beginnings to the present, and I dedicate this book with love and gratitude to them: Bayard, Charles, and Maxwell.


Contents

Selected Events and Historical Actors, xxiii 1.

Bodies, Words, and Images, 1 Likeness and Presence, 3 Vesalius and Likeness, 4 Fuchs and Likeness, 6 Representing Likeness, 7 Words First, 9 Humoral Bodies and William Harvey, 11 Noble Parts, 13 Conclusion, 17

2.

Matter, Spirit, and the Heart, 23 Formation of the Oxford Group, 26 The Importance of Spirit: Paracelsus, Francis Bacon, and Johan Baptista van Helmont, 26 Paracelsus, 26 Francis Bacon, 28 Van Helmont, 31

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CONTENTS

Atomism: Descartes and Gassendi, 32 Blood and Body during the Protectorate, 34 Blood on the Restoration Stage, 38 Helmontians Seek and Fail to Gain Official Place, 39 Experimenting with the Blood: Injections and Transfusions, 40 Phosphorus, 42

3.

The Human Mind and "Gland H": Cartesian Models of Mind, Brain, and Nerves, 47 Chronological Issues, 52

4.

When the Brain Came out of the Skull, 75 Methods and Models of Knowledge, 79 Humans' Place in the Animal Kingdom, 81 The Virtues of Artifice, 83 Solids and Ventricles, 84 The Case against Descartes's Pineal, 85 The Importance of Hierarchy, 87 Conclusion, 90

5.

Body of Witnesses, 95 Death into Life, 95 Public versus Private, 98 Emergence of Dissections as "Pretty", 102 Patrons and the Larger Project, 109 Theological Concerns, 112 Maintaining Sovereignty, 116

6.

Toward a New Physiology of Human Conduct, 129 Descartes's Physiology of Passion, 131 Willis's Physiology of Passion and Reason, 135 Willis and Unreason, 140 Stupidity, 144

7.

The Transformation of Eve, 153 Traditional Economies of Female Moisture, 154 Medical Knowledge and Gender, 156 Blood versus Brain, 160 Alternative Visions: The Case of Anne Conway, 166 Conclusion, 169

CONTENTS

8.

Mind Without Brain: John Locke, Thomas Sydenham, and the Constitutional Body of the British Enlightenment, 175 Metaphysics and Strangeness, 175 Empiricism Becomes Respectable, 178 Continental Challenge, 179 Locke, Sydenham, and Their Revival of Hippocratic Empiricism, 180 No Body but a "Constitution", 184 Hippocrates, Galen, and the Politics of Medical Knowledge, 186 Willis, Locke, and Smuggled Mental Baggage, 191

9.

On the Persistence of the Cerebral Body and Its Alternatives, 199 The Cerebral Body and the Logic of Biomedicine, 199 Sectarianism Persists, 202 Allegiances and Medical Choices, 205 Medical Modernity as a Shotgun Marriage, 207 The Cerebral Body and Public Policy, 208 Tracing Descartes Today, 209 Conclusion, 214

Index, 219

XXI


Selected Events and Historical Actors

Background With the collapse of the western Roman empire during the fifth century CE, original versions of Greek and Roman natural philosophy, including the anatomical works of Galen (c. 130-201 CE), are dispersed eastward. For the next 1,000 years, approximately, the classical Western learned medical tradition exists in fragmentary form in Greek, Latin, Arabic, and other near-eastern languages. During this period and later, humoral theories of bodily operation reign within two schemes of human organ hierarchy: Galen's, which posits a triumvirate of heart, brain, and liver, and Aristotle's, which emphasizes the heart. Alchemical schemes, which begin to appear during the Renaissance, usually emphasize the viscera, especially the stomach and spleen.

The Sixteenth Century: Reading, Seeing, and Believing 1521: Martin Luther (1483-1546), former Chair of Biblical Studies at the University of Wittenberg, is excommunicated from the Catholic Church for, among other offenses, denying the primacy of the Pope in favor of scriptural authority. 1535: In Geneva religious reformers invade venerable churches, deface and remove religious images within them, and depose the Catholic bishop. John Calvin xxm

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SELECTED EVENTS AND HISTORICAL ACTORS

(1509-1564) joins them in 1536 and founds a theocratic regime in 1541. In 1536 Calvin, who wants all believers to read the Bible, decries the value of images and declares that only Christian scripture "allow(s) us to see God in the manner of a mirror."1 1540: The word anatomy enters English usage as a description of a dissected body and in 1541 as the process of dissection. Martin Luther consecrates the first purpose-built Protestant church. Its plaster interior is painted white and contains few images. In the meantime, many prosperous Europeans collect pictures, illustrated printed books, and natural objects. 1541: Guinta in Venice publishes Complete Works of Galen, the first full Latin translation of Galen's Greek originals. Andreas Vesalius, then at the University of Padua, and other anatomists serve as editors. Paracelsus (1493?-1541), alchemist, Christian mystic, and healer who denigrates the value of anatomy, dies in obscurity. 1542: Leonhart Fuchs (1501-1566), German surgeon and friend of Vesalius, publishes his medical botany or herbal, Notable Commentaries on the History of Plants. Fuchs asserts that his comparatively life-like botanical illustrations, a first in print culture, express "objects much more clearly than they can be delineated by any words."2 1543: The Basel printer who published Fuchs prints Vesalius's On the Structure of the Human Body. Vesalius points out that he actually dissects and illustrates human bodies whereas Galen dissected animal bodies. Nicholas Copernicus (14731543) dies as his Revolutions of the Heavenly Spheres is being published. Although his work remains obscure for decades, it characterizes the earth for the first time as another heavenly body (planet) that, contrary to appearances, makes an orbital revolution around the sun. In England the Reformation Parliament of Henry VIII (1491-1547) passes An Act for the Advancement of True Religion, which explicitly limits Bible reading to elite men. 1573: Costanzo Varolio, an Italian anatomist interested in the optic nerve, publishes a new format for representing the human brain in which the brain is depicted outside the skull as a separate solid object.3 1585: Teatro Olimpico, Europe's first permanent theater, opens in Vicenza. 1594: A large theater—literally "a place for seeing"—for anatomy is completed in Padua. 1595: First English translation of Paracelsus appears, though its sources are later considered as possibly inauthentic.


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The Seventeenth Century: Innovations, Schisms, and a New Order in England 1602: William Harvey (1578-1657)) receives an MD in Padua, where he has been studying human anatomy and animal vivisection. 1605: Francis Bacon declares that a "true model of the world" depends on a "very diligent dissection and anatomy."4 1618: Harvey publishes in Latin his anatomy lectures, which emphasize the importance of the heart. London surgeon Helkiah Crooke publishes in English a popular anatomy book in which he praises the heart for its "greatest necessity for life" and the brain for its supreme "dignity."5 The London College of Physicians publishes its first formulary of approved drugs, which includes Paracelsian metallic compounds. 1620: Puritans establish a colony in New England. 1628: Harvey publishes On the Motion of the Heart and Blood in Animals, which argues for the first time that the heart is a muscular pump that moves the blood in a circular path throughout the body. In his dedication to Charles I (16001649), Harvey analogizes the heart to the "king, in like manner, is the foundation of his kingdom, the sun of the world. .. ."6 Rene Descartes (1596-1650) moves from Paris to the Netherlands, where he takes up anatomy after abandoning a project to explain the physiology of perception in terms of geometrical and optical principles. 1633: Descartes prepares to publish his human physiology as The Treatise on Man when he hears of the Inquisition's condemnation of Galileo, which leads him to halt publication during his lifetime. William Laud (1573-1645) becomes Archbishop of Canterbury and soon seeks to restrain Puritan influence. 1639: Scotland puts up armed resistance to forces of Charles I. 1640: Irish forces clash with English Royalists. 1641: The Long Parliament impeaches and imprisons Laud, who is executed for treason in 1645. 1642: Civil War begins in England, and Charles I tells his troops that "you shall meete with noe enemyes but traytors, most of them Brownists, Anabaptists, and atheists, such who desire to destroy both church and state."7 Thomas Willis (1621-1675), who then intends a clerical career, receives an MA from Oxford and in 1644 joins Royalist forces defending the city. Charles I moves to All Souls (college), Oxford at the invitation of its Warden, Gilbert Sheldon (1598-1677).

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1645: A group of men begins regular meetings in London to discuss the "new philosophy" and perform, in their words, experiments and ocular demonstrations. 1646: Parliamentary forces take Oxford, capture Charles I, and abolish episcopacy. 1648: Under the patronage of mathematician and cleric John Wilkins (16141672), young investigators at Oxford, including Willis, form experimental clubs along London lines. Wilkins establishes a general rule of club life that prohibits "all Discourses of Divinity, of State Affairs, and of News (other than what concern'd our business of Philosophy)."8 Willis is praised by club members for his adeptness in (al)chemy. 1647-1653: Parliament abolishes the monarchy, state church, and House of Lords, and Charles I is executed in 1649. In the same year Nicholas Culpepera prolific publisher of inexpensive popular medical texts, writes that professional hierarchies should be eliminated: "priests, physicians, lawyers, all of them monopolists."9 Descartes publishes his Passions of the Soul in 1649 shortly before dying in 1650. English censorship collapses during the 1650s, and publication of alchemical texts hits a peak. In 1651 Thomas Hobbes publishes his brief for ab solute sovereignty, Leviathan Or the Matter, Forme and Power of a Commonwealth Ecclesiasticall and Civil. 1653-1658: Oliver Cromwell (1599-1658), who led the Puritan party in Parliament before organizing its army during the Civil War, dismisses Parliament, suppresses religious and political enthusiasts, and rules as Lord Protector until his death. 1659—1660: Fearing recurrence of civil war, Parliament restores the state church and invites Charles II to return from France and restore the monarchy. Anglican cleric Gilbert Sheldon, who helped finance Charles II during his exile, assumes functional leadership of the restored church. Sheldon arranges for Willis to be appointed to an endowed professorship in natural philosophy, one of two such positions in England. A few weeks later he has Oxford grant Willis his MD. With a charter from Charles II, former members of the London and Oxford experimental clubs of the 1640s and 1650s and others found the Royal Society of London along similar lines. 1662: Descartes's Treatise on Man is first published. In England Sheldon, citing the "wishes of the ruling class" and the need to "cure this disease" of sectarianism,10 succeeds in Parliamentary passage of religious statutes that require all sectarians to submit to standard church liturgy and church governance by bishops despite the desire of the king for a more moderate settlement. In 1663 Sheldon becomes Archbishop of Canterbury.


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1664: Based on his Oxford anatomy lectures and the "ocular demonstrations" they include, Willis publishes in Latin Anatomy of the Brain, Europe's first comprehensive text on the structure and function of the human brain and cranial nerves. Christopher Wren (1632-1723) provides many of the engravings. It is the first text to argue for the bodily primacy of the solid portions of the cerebral hemispheres. John Locke (1632-1704), then a medical student at Oxford, attends Willis's lectures and writes in his notebook the "the cerebrum in infants is a tabula rasa" (literally smooth tablet).11 Locke later uses the concept as a foundation for his theory of perception, which denies innate ideas. Margaret Cavendish, duchess of Newcastle, publishes Philosophical Letters: or Modest Reflections upon Some Opinions in Natural Philosophy. 1665—1666: During the years of London's great plague and fire, alchemical healers in London petition the Court for a royal charter for a Society of Chimical Physicians without success. After the fire Sheldon arranges for Wren to be the principal architect in the rebuilding of London's parish churches. 1667: Willis publishes Pathology of the Brain and Nervous Stock and, at the behest of Sheldon, moves to London, where he soon becomes England's most prosperous physician. 1672: Willis publishes a treatise on reason and passion in animals, including humans entitled On the Soul of Brutes. 1674-1677: Willis publishes volume I of Rational Therapeutics then dies in 1675 shortly before volume II appears. Sheldon dies in 1677. 1683: The word neurology enters English usage via the first English translation of Willis's Anatomy of 1664. Private madhouses begin to operate in London during the 1680s. 1685: Charles II dies and James II assumes the throne to general acclaim. Soon, however, his efforts to establish the Catholic Church on an equal footing with the Church of England induce widespread politico-religious opposition. 1688-1689: Protestant William of Orange lands an army in England and James II flees to France. Subsequently, Parliament establishes William and Mary, his Protestant wife who is also sister to James II, as joint monarchs. Subsequently, Parliament passes a Toleration Act in 1689 that permits religious pluralism. Locke publishes An Essay Concerning Human Understanding, which incorporates some of Willis's neurophysiology without acknowledging the source. 1693: The word psychology enters English usage in reference to study or doctrines of the rational soul.

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Notes 1. This chronology uses English versions of all book titles; originals are in the chapters. John Calvin, Institutes of the Christian Religion (1536-1559) quoted in Hans Belting, Likeness and Presence: A History of the Image before the Era of Art, trans. Edmund Jephcott (Chicago: University of Chicago Press, 1994), p. 550, n. 41. 2. Leonhart Fuchs, Great Herbal ofLeonhart Fuchs: De Historia Stirpium Commentarii Insignes, 1542, eds. and trans. Frederick Meyer, Emily Trueblood, and John Helle (Stanford: Stanford University Press, 1999). 1542, p. blr. For Fuchs's visual arguments, see Sachiko Kusukawa, "Leonhart Fuchs on the Importance of Pictures," Journal of the History of Ideas. 1997:58(3):403-427. 3. Constanzo Varolio De Nervis Opticis. (Padua, 1573). 4. Francis Bacon, Novum Organon (1605) in The Complete Works of Francis Bacon, 3 vols. eds. James Spedding, Robert Elllis, and Douglas D. Health (London: Longma & Co, 1889), vol. 1, p. 298. 5. Helkiah Crooke. Mikrokosmographia, A Description of the Body of Man. (London, 1618), p. 45. 6. William Harvey, Dedication, De Motu Cordis et Sanguinis in Animalibus. (London, 1628) 7. Lord's Journals v. 258; British Library, Harleian MS 163, fo. 749b. 8. John Wallis. "Dr. Wallis's Account of Some Passages of His Own Life," in Peter Langtoft's Chronicle. 2 vol., ed. Thomas Hearne (Oxford, 1725). 9. Nicholas Culpeper. A Physical Directory. (London, 1649), sig A. 10. Sheldon Letters, Bodleian Library MS Carte 45, fo. 151. See also John Spurr, The Restoration Church of England. (New Haven: Yale University Press, 1991), p. 47 11. Willis's Oxford Lectures, trans, and ed. Kenneth Dewhurst (Oxford: Sandford Publications, 1980), p. 66.

The Brain Takes Shape


1 BODIES, WORDS, AND IMAGES For I am building in the human understanding a true model of the world, such as it is in fact, not such as man's own reason would have it to be; a thing which cannot be done without a very diligent dissection and anatomy of the world. —Francis Bacon, Novutn Organon (1605)1

Nowadays religion and science exist in separate domains for most people. Most of us assume that they speak to different aspects of the human condition. But this was not the case during the early modern period or before, at least in the Christian West. Indeed, it is impossible to understand science from an historical perspective without analyzing shifts and tensions between theology and natural philosophy, which was the antecedent in some ways of modern science, concerning relationships between matter and spirit in the macrocosm of the universe and in the microcosm of man, to use an early modern trope. Most of this book deals with these shifts and tensions as matters came to a head during the heyday of the Scientific Revolution of mid-seventeenth-century Europe. A century earlier, however, an historical moment occurred that set the stage for those debates. During the 1540s, a few European physicians and clerics, all of them men by professional necessity, asked and attempted to answer the following questions, among others, about bodies of all kinds: What is the best way to gain and transmit knowledge of humans? Of plants? Of the world itself? Of the movements of the world in relation to the sun and planets? Many early modern natural philosophers would have inserted the word "body" next to the words human, plant, and world in these questions. Just as they made broad use of the word "anatomy" as noted in the Preface, so too they commonly spoke of "bodies" in reference to many natural phenomena. Their imaginative world, in short, was embodied in a way that 1

T

THE BRAIN TAKES SHAPE

ours is not. Nonetheless, the repeated use of body strikes modern ears as tedious; hence, at the cost of some historical accuracy, I will use the word less frequently than they did. In 1947-49 as historian Herbert Butterfield considered the changes that natural philosophy underwent from the time of Copernicus in the mid sixteenth century through Galileo in the early seventeenth and on to Newton and the Enlightenment, he coined the term "Scientific Revolution," as noted in the Preface. In characterizing that revolution, Butterfield, as had his predecessor historians of science such as Pierre Duhem, emphasized developments in mathematics, astronomy, and chemistry and methods of verification that rewrote literate understanding of the physical universe. Perhaps because the history of medicine has existed as a semi-separate activity within the history of science, and the history of science mostly began with the history of physics, Butterfield and his successors did not place Vesalius or William Harvey (1578-1657) or other physicians or persons whose activities we might now place in the life sciences in the middle of their accounts. For reasons that will become clear later in this book, I think they should have. Consider the following: In 1542, as the Reformation was making its uneven way across Europe, two European physicians on friendly terms—Andreas Vesalius (Andreas van Wesele, 1514-1564) and Leonhart Fuchs (1501-1566)— published books that argued for new methods of analyzing and representing human and plant structures that quickly proved influential in medicine and natural philosophy. During the next year, Nicholas Copernicus (1473-1543), a Polish cleric with university training in medicine and a doctoral degree in canon law, died just before publication of his new, highly mathematical model of a heliocentric planetary system, a scheme that turned traditional understanding of the universe on its head. Regardless of their respective subjects, each of the three emphasized the need to understand nature without reference to metaphysical explanations and without blind acceptance of ancient authority. In the meantime, Paracelsus (1493-1542), the alchemical healer and religious nonconformist who advanced non-material explanations for many natural phenomena, died in obscurity. Ironically, both Copernican models and Paracelsian theories did not begin to exert broad influence until a generation later. During his lifetime, Paracelsus managed to alienate Catholic and Protestant authorities alike, not to mention some of his less ideological patrons. Paracelsus and his followers championed a form of anatomy to be sure—"pyrotechnical anatomy" in the words of some of his seventeenth-century English promoters—but it had nothing in common with traditional anatomy. Indeed, as we shall see in Chapter 2, for alchemists anatomy did not refer to body as such at all but rather to the ability to manipulate alchemical fires. Even as prosperous northern Europeans began to fill their houses with books and pictures containing images of natural bodies created by artists and illustra-

BODIES, WORDS, AND IMAGES

3

tors working at the behest of innovative natural philosophers like Vesalius and Fuchs, Reformist religious enthusiasts invaded Catholic churches to destroy venerable images of saintly bodies. And when the Reformers built their own churches, their walls were almost blank. When Martin Luther consecrated the first purposebuilt Protestant church in 1540, for example, its interior decoration consisted mostly of white paint. In describing the movement of bodily images out of Reformist churches and the changes in representation they underwent as they moved into pictures and books, Hans Belting, the German art historian, characterized an early modern shift from preoccupation with presence to a desire for likeness in religious visual representations of many kinds. According to Belting, beginning in the Reformation, especially in Protestant areas, The eye no longer discovers evidence for the presence of God in images of the physical world; God reveals himself only through his word. The word as bearer of the spirit is just as abstract as in the new concept of God . . . The word does not depict or show anything but is a sign of the covenant. God's distance prohibits his presence in a painted representation, sensually comprehended. The modern subject, estranged from the world, sees the world as severed into the purely factual and the hidden signification of metaphor. But the old image rejected reduction into metaphor; rather, it laid claim to being immediate evidence of God's presence revealed to the eyes and senses.2

I adapted some of Belting's analytical approaches to explore epistemological and aesthetic issues in early modern books concerned with the natural philosophy of the human body in health and disease, as well as medicinal plants, which Belting did not consider.

Likeness and Presence By likeness I mean the epistemic assumption that one may know substantial aspects of material nature and depict them accurately without relying heavily on spiritual capacities and relationships of the observer and the observed. By presence I mean the tendency to imagine knowledge of the world and the world itself as dependent on the spiritual capacity and interaction of knower and known, such as a mystical Christian's belief that God, through the Holy Spirit, suffuses all aspects of nature. The year 1542-1543 is notable not only for innovations in likeness but also for the death of a major figure in the history of presence, Paracelsus. To a much greater degree than traditional natural philosophers, Catholic intellectuals, and Reformist theologians, Paracelsus and other alchemists characterized nature, including the human body, in terms of ubiquitous spirits whose activity they conceptualized expansively. Consequently, for them, spirit and God's presence were forces in nature's forefront, and as the early modern period wore on, they often found themselves marginalized by experimentalist natural philosophers as well as Catholic and mainline Reformist leaders.

4


To the degree that the unity of outer and inner experience was culturally hegemonic, as it was in the formal culture of the Christian Middle Ages, images alone as well as the world itself tended to be seen as conveying God's presence. Images did not necessarily need to be like the exterior of what they were portraying because spirit and matter, while distinct, maintained fuzzy boundaries and intimate association with each other. Provided that the image conveyed substantial spiritual presence to the viewer, the faithful viewer could see what he or she needed. But beginning with the illustrations of the innovative natural philosophy texts of Fuchs and Versalius, the balance of presence and likeness in natural philosophy depictions of bodies began to change. As Belting has argued, "Humankind has never freed itself from the power of images, but this power has been exerted by different images in different ways at different times. . . . But the history of religion or the history of the human subject, both of which are inseparable from the history of the image, cannot be narrated without a schema of history."2

Vesalius and Likeness Church icons and bodily images based on medieval Christian versions of natural philosophy did not satisfy the new pursuit of likeness. In 1542, Vesalius finished his massive seven-book De Humani Corporis Fabrica (On the Structure of the Human Body, henceforth Fabrica, published June 1543) and its Epitome, a text of 14 folio pages (equivalent to 28 modern pages), which he described as the Fabrica's "footpath" or "appendix" in his dedicatory epistle to Prince Philip, son and heir of Emperor Charles V. Although he was only twenty-eight, Vesalius already had served five years as professor of surgery at the prestigious University of Padua. In his dedicatory letter to Prince Philip, Vesalius sounded more senior than his years as he explained why he had undertaken the publication of both texts. Expressing scorn for the "mob of Physicians that. . . perform their duty so carelessly in distinguishing the parts of the human body" because they have "never even stood by at a dissection," he declared that "no one could produce anything of value who did not perform dissections with his own hands . . . and in like manner busied himself frequently and sedulously with dissections and with simple (i.e., plant) medicines." The "pestilent doctors" who eschewed dissection merited contempt because they did not accept "Anatomy as the basis and foundation of the medical art." Indeed, anatomical knowledge of "human parts . . . in the cure of illness . .. lays rightful claim to first, second, and third place."3 Vesalius's embrace of anatomy reflected his commitment to medicine as a university-based discipline of natural philosophy. In mid-sixteenth-century universities, natural philosophy curricula in the arts typically included zoology, botany, anatomy, geology, and astrology. Aristotle, often heavily glossed and upholstered with extensive commentaries, continued to be the main authority in natural philosophy, as he had been in the early universities, although Platonic


5

influence was increasing substantially. In addition to the work of Aristotle, the study of anatomy in medical natural philosophy relied on other Greek texts, such as those of the fourth-century B.C.E. Hippocratics, Alexandrian anatomists such as Herophilus (330/320-260/250 B.C.E.),4 and, above all, Galen (c. 130-201 C.E.), the Greco-Roman physician who systematically incorporated previous medical knowledge, codified humoral theory, and actively pursued anatomic investigation. Although ancient Greek philosophers disagreed profoundly in many areas, Platonists, Pythagoreans, Aristotelians, and others shared a consensus that theories of matter and causation were at the heart of natural philosophy. Aristotle, for instance, dissected and performed vivisections on animals, but not humans, because he assumed that apprehension of a creature's structure facilitated understanding of its function. Moreover, such knowledge was essential if one wanted to understand the intricacies of the causation of natural processes.5 Vesalius was not the only prominent sixteenth-century anatomist, obviously, and one might ask how other late-Renaissance anatomists formulated their methodologies in comparison to him. Like Vesalius, virtually all of them, especially his teachers Guinther of Andernach (1487-1574) and Jacobus Sylvius (Jacques du Bois, 1478-1555) at the University of Paris, identified themselves as ardent Galenists. Guinther, for example, translated from Greek to Latin Galen's De Anatomicis Administrationibus in 1531. Indeed, Galenism gained a vigorous new life in the sixteenth century because it was not until 1514 that direct Greek-toLatin translations of Galen became available.6 Before then, knowledge of Galen's work occurred through Latin translations from heavily glossed Arabic versions of Syriac versions of Galen's Greek originals. During 1539-1541, Vesalius also participated in the sixteenth-century efflorescence of Galen publications, serving as an editor in the publication of the first complete Latin version of Galen's extant works, the Opera Galeni that Giunta of Venice published during 1541.7 Two important factors distinguished Vesalius's approach to Galen, indeed to all classical authorities, from his contemporaries, and each of them, though controversial initially, rapidly deflected the ways anatomists subsequently approached their work. First, as Vesalius indicated in the passages previously quoted from his dedication in the Epitome, anatomy was about dissecting bodies, not reading old texts. One had to use one's "own hands" to learn "anything of value." In comparison, his teacher Guinther of Andernach held appointment as a professor of anatomy but may never have dissected a human corpse.8 Second, unlike Galen, who dissected animals, Vesalius dissected humans, a distinction that historian Andrew Cuningham has explored in detail. Furthermore, Vesalius made it his mission to point out the flaws that arose from Galen's comparative method, which had been a commonplace of Aristotelian natural philosophy.9 Aside from Vesalius's publishing strategies, which I take up in the next section, his insistence on using only evidence from human bodies to represent

0


humans, as contrasted with Galen's frequent arguments by analogy from his dissections of Barbary apes and large ungulates, represents a major departure from traditional anatomical practice. Vesalius's insistence that knowledge of what human bodies were like rested on intricate dissections of humans, not animals, meant that the human body had become its own text, at least anatomically. Without any evidence that he intended to do so, Vesalius's insistence on knowing the Book of Nature in terms of authentic human bodies—not those of cows or apes as demonstrated by a prosector—paralleled Protestant reformers's exhortations to their followers to know the authentic Book of God themselves, not some traditionencrusted priestly rendition of it. Moreover, each of them as well as their adherents imagined they were returning to the true beginnings of their respective subjects. However, whereas Protestant reformers sought truth by moving away from the visual and toward the literal—from iconic bodies to texts—Vesalius and his followers insisted the path went in the other direction.

Puchs and Likeness The "Renaissance Galen Project," if you will, extended beyond new Latin translations and human anatomy into the plant world as well. Leonhart Fuchs, admirer and near contemporary of Vesalius,10 and, like him trained in humanism and medicine, also venerated Galen even as he tried to outdo him. Fuchs' major intellectual project did not involve refurbishing Galenic anatomy to reflect what the structure of the human body was really like. Instead, in his herbal De Historia Stirpium Commentarii Insignes (Notable Commentaries on the History of Plants) of 1542, he portrayed Galen as the supreme physician naturalist. Noting that Galen contemplated writing an herbal but did not complete the project, Fuchs sought to bring Galen and other ancient plant authorities up to date through the addition of the medicinal flora of Germanic areas, which the ancients had not explored.11 Of the ancient authorities, Fuchs ranked Galen supreme concerning medicinal plants because he "examined the individual characteristics of these herbs (not) once or twice or thrice, but many times over. . . ,"12 Fuchs found that almost all of the ancient authorities were diligent compared with the "sloth, apathy, indolence and negligence of some doctors" of his own day. Unlike Fuchs's contemporary "crude and unskilled drug peddlers... o r . . . the foolish and inept common crowd," Galen, Theophrastus, Dioscorides, and other ancients "explored, not just one or another region, but a large part of the earth so that not only might they see every kind of plant with their own eyes, but even feel it with their hands and taste it; so that in this way they could learn thoroughly not only each plant's likeness, but even its properties too."13 Nicholas Copernicus's De Revolutionibus Orbium Coelestium (Revolutions of the Heavenly Spheres) of 1543 was not strictly concerned with bodies, but rather with the motion of the (heavenly) spheres that contain the sun and planetary bod-


7

ies (the six planets of Mercury, Venus, Mars, Earth, Saturn, and Jupiter). Although De Revolutionibus was unintelligible to all contemporaries save a handful with advanced mathematical skills and did not significantly influence literate culture until the late sixteenth century, this section would be incomplete if it did not note, at least in passing, its publication as its author was dying. Incidentally, Copernicus, who spent his career as a member of a cathedral chapter in Poland, studied medicine for two years in Padua between his undergraduate and doctoral study of canon law in Bologna and Ferrara, respectively.14

Representing Likeness Any account of the literal "great books" of early modern Europe should acknowledge the landmark status of Vesalius's Fabrica and Fuchs's De Historia Stirpium. With the exception of some magnificent early printed Bibles, little like them in scale and detail in printed texts existed before their publication. Moreover, both Vesalius and Fuchs went to great lengths to make the act of reading their books as much as possible like the experiences of dissection and field study whose results they purported to illustrate. Through self-conscious manipulation of fonts, graphic formats, commentary, and illustrations, each sought to make his publication a virtual reality, although neither used that phrase. In the closing lines of Fuchs's dedicatory epistle to the margrave of Brandenburg, for example, he referred to the presentation copy as "our gift of this garden (hortus). .. not only because you can find in it almost every variety of plant most elegantly pictured, but also because you can pluck from it remedies for every kind of disease." In the meantime, Catholic Ignatius Loyola's (1491-1556) Spiritual Exercises (first Latin version 1541) and Calvin's Institutes of the Christian Religion (1563), disparate works to be sure, shared with Vesalius and Fuchs's texts the format of guiding the reader along an explicitly formative path. Reference to a book on herbs as a garden was common in medieval herbals, or books of medicinal plants.15 In Fuchs's herbal, it served not only as a nod to the past but also as the opening rhetorical move among a novel series of interrelated tactics that Fuchs devised to make his book as much as possible like the field study of plants that he demanded of his medical students in his courses on materia medica.16 Fuchs was not diffident about expressing his arguments in favor of his book compared to contemporary herbals. Partly, he did this to gain a competitive edge. In the "Epistle Dedicatory" after praising the work of notable predecessor German herbalists, Fuchs launched an attack on contemporaries. Noting that he would "pass over the fact that their writings are full of many serious errors," he reserved his most caustic remarks for the Frankfurt printer Christian Egenolff and his herbal, Kreuterbuch and its Latin translation, Botanicon (1540).17 Egenolff s books offended Fuchs primarily because of what his rival did and did not do with images, not his textual errors. According to Fuchs, "in many places he depicts

8


one and the same plant as two or three, differing in appearance and properties. . . . About his pictures (picturae, which may also mean painting), it is enough to say that I wonder . .. that on his pill-boxes he did not paint fawning quacks... ,"18 Fuchs attributed Egenolff's illustration practice to his greed. Using the same woodcut for different plants was much cheaper than requiring a one-to-one correspondence of a plant's woodcut illustration to its text description in an era when woodblock cutters often earned fifteen times more than the artist who originally drew the pictures.19 Nonetheless, Fuchs thought a one-to-one correspondence between text and image was essential for a book about medicinal plants to be scholarly. Fuchs was more emphatic, however, about the pedagogical superiority of pictures over descriptive text (historia). Immediately after his critique of Egenolff, Fuchs outlined his own method or plan (ratio} as follows: "In the first place, we have included whatever relates to the whole history . .. briefly. Then, to the description of each plant we have added an illustration. These are lifelike and modeled after nature and rendered more skillfully, if I may say so, than ever before. This we have done for no other reason than that a picture expresses things more surely and fixes them more deeply in the mind than the bare words of the text."20 A few pages later he expanded on the value of visual descriptions "against those who scorn pictures: What sane person, I ask, would despise a picture, which certainly expresses objects much more clearly than they can be delineated by any words, even the most eloquent? Indeed, it has been thus arranged by nature, that we are all captivated by a painting (pictura); and those things that are set forth and pictured on canvas and paper are fixed even more deeply in our minds than those described in bare words. . . . There are many plants that, although they cannot be described in words so that they are recognized, are placed before our eyes in a painting so that they are grasped at first glance.21

Although Vesalius shared several assumptions about publication with Fuchs, Vesalius's Fabrica and its Epitome demonstrate an additional layer of innovation in sixteenth-century methods of conveying "likeness" as well as the activity of reading itself.22 Vesalius explicitly designed the Epitome, the Fabrica's "footpath," so that diligent readers would be performing their own anatomic survey or lesson as they followed its textual guides through the illustrations. Briefly, the plan went as follows: The section with illustrations was divided into two parts. The first six pages began with a full-page illustration of an eviscerated male cadaver that was stripped down to the bone. In the successive five illustrations the body proceeded to gain layers of muscle and connective tissue. The second section of illustrations, which, unlike the first, were extensively annotated, depicted separate images of the circulatory and nervous systems as well as the viscera. Between the two sections, Vesalius placed single-page images of a nude man and woman, and all of the Epitome's images were made to the same scale. Vesalius intended his readers to start with the nude man and woman and work from the outside inward. As read-


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ers turned pages backward, they went more deeply into the body and imaginatively inside the opened and eviscerated skeleton that served as the first image. After returning to the nudes, the reader could then go forward to study the annotated descriptions of the circulatory and nervous systems and the body's viscera, all of which were portrayed as objects in themselves as though they had an existence independent of the body. The fact that all elements were depicted in an internally consistent scale meant that the reader could cut out systems and organs from section two and attach them to the relevant skeletal layer from section one, an activity the text encouraged in notes as well as by providing duplicate images of the viscera. In short, through assembling the manikins the reader could perform a paper dissection that mimicked the actual experience of dissecting a human body. Some copies were sold with the manikins already prepared.23 A few earlier sixteenth-century anatomy sheets contained viscera drawn on superimposed layers,24 but Vesalius's Epitome was the most detailed and extensive; also, it was the only one that directed its readers explicitly as though they were on a journey through the body's interior.

Words First Ironically, while Fuchs and Vesalius were preparing their publications as heavily scripted guides to using images, in preference to words, for knowing what nature was like, or at least the nature of human bodies and medicinal plants, leading early Reformist theologians such as Luther and Calvin (1509-1564) expressed ambivalence and, at times, scorn for visual demonstrations of God's creations in religious imagery and for the act of seeing itself. According to Calvin, after the Fall, humans lost the capacity for direct sensual knowledge of God. Human apprehension of the divine had to be mediated through the Holy Spirit, which expressed itself solely in the words of Biblical scripture: "The Holy Spirit is so bound to its truth that it only expresses its power . .. when its word is perceived. .. . The Lord had linked together the certainty of his word and his Spirit. . . . We receive the Spirit. . . when we recognize it in its image, the word."25 Therefore, religious images that sought to assist the viewer in reaching God were evidence that "The world has been seized by a crude absurdity in wishing to possess a visible form of God. .. ,"26 Indeed, for Reformers of the 1530s and 1540s, especially the Swiss, the breaking of religious images in churches proved to be an important ritual in their consolidation of local political and religious authority. Partly the Reformers destroyed and mutilated church sculptures and images as dramatic public denunciations of Catholic power. For Calvin, however, certain kinds of images were acceptable, though images of human and animal bodies remained highly problematic: "The permissible images include histories and events, as well as images and forms of bodies, without historical significance. The former serve to instruct and admonish, while the lat-

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ter can offer nothing beyond enjoyment. Yet it is precisely images of this last kind that have been always been displayed in churches. We may say that they did not serve judgment or enjoyment, but foolish . .. covetousness."27 Luther, who was tolerant of some religious imagery, existed at the other end of the spectrum of Reformist opinion on images, although he expressed no doubt that "The word of God is the most sacred of all objects, the only sacred object that we Christians know and possess. Even if we had all the bones of all the saints . . . they would not help us."28 Nonetheless, in a sermon from 1522, he acknowledged that he "must admit: images are neither one thing nor the other, neither good nor wicked. One may have them or not. . . . It is possible that there may be people who can make good use of images."29 Likeness, at least in relation to the corporeal, did not present a problem to one of Luther's confidants, Philipp Melancthon (1497-1560), a professor of Greek and theology at the University of Wittenberg, who introduced anatomy teaching into the philosophy curriculum there in the mid 1530s. Melancthon's philosophical anatomy, however, was anatomy without dissection or, perhaps, any visual representations.30 It dealt instead with classical authors who pursued anatomy among other subjects. As a leading authority on Greek philosophy, especially Aristotle, Melancthon's primary interest was the soul, not dissection methods. He argued, citing Galen, that anatomic knowledge of the body was to "take into consideration the plan and diligence of the Maker,"31 a phrase that many anatomists soon voiced in public justification of their activity. Melancthon's curricular reform was quickly imitated in other Reformist universities, where anatomy became a staple of natural philosophy in liberal arts courses from the mid sixteenth century on. (Anatomy was well established in medical natural philosophy from the late fourteenth century on.) Melancthon, incidentally, also became a close friend of Fuchs, who was his near contemporary, through the latter's close ties to Johann Reuchlin (1455-1522), his Greek, Hebrew, and Latin teacher at the University of Ingolstadt and great uncle to Melancthon. Although tensions concerning presence and likeness, word and image, became acute in northwestern Europe in the 1530s and 1540s, where the early Reformation was active, they also occurred in Catholic areas, such as the Netherlands, where the Reformation did not come until the late 1560s, as well as in Italy, and not only in reaction to Lutheran and Calvinist critiques.32 Their ubiquity in western Europe from the mid sixteenth century on suggests that more than Christian schism was at stake. Indeed, I argue in subsequent chapters that theological schism, while a potent factor in its own right for shifts in natural philosophy, was but one part of a cultural sea change33 concerning the nature and range of God's agency in the material world. At the risk of considerable oversimplification, I suggest a major component of the cultural sea change involved a gradual but inexorable move on the part of early modern learned Europeans to consider the Book of Nature and the Bible, or Book of God, to use their terms, as two separate domains, albeit


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domains with intimate links. Another, more abstract way of categorizing the change is to say that natural philosophy was gradually separating from theology and becoming its own area with its own interpretative frameworks. Humoral Bodies and William Harvey Harvey's life spans the middle of the Scientific Revolution, and after Vesalius he is the next principal actor in what I consider the emerging "crisis of the body" of mid-seventeenth-century literate Europe. After studying at Cambridge, where he received a B.A. and did some work toward an M.A., Harvey took himself to the University of Padua, which continued after Vesalius to be the leading center of medical knowledge. Vesalius was succeeded there by Realdo Colombo, who developed his experimental methods; Colombo was followed by Fabricius of Aquapente, Harvey's teacher, and Costanzo Varolio, whom I take up later. In their different ways, each of them worked along lines opened up by the new Vesalian approaches to the human body, and Harvey diligently studied them all in addition to the traditional texts.34 Whether traditional or innovative, those learned texts and the many poplar versions derived from them assumed that the bodies of warmblooded animals, including humans, operated according to a system of humors. Indeed, regardless of their religious orientation, all literate Europeans in the early modern period inherited extensive doctrines concerning the human body. Because Harvey and his Oxford followers and the Cartesians and alchemists each wrote in reaction to one or another tenet of humoralism, I will set out briefly some of its key historical features. Humoral models of bodily operation existed in several ancient versions in sixth- and fifth-century B.C.E. Greek natural philosophy. Moreover, despite some faint parallels with Ayurvedic thought, humoral physiology seems unique to the West. During the second century C.E., Galen codified the Hippocratic model into a form that remained remarkably durable. After the fall of the western Roman Empire in the fifth century C.E., eastern Mediterranean scholars preserved and transmuted Greco-Roman natural philosophy, including Galen's, which subsequently influenced Islamic medicine. Animal bodies had "humors" that circulated throughout their interior and concentrated in a few crucial organs, or "noble parts."35 Although ancient authorities disagreed on important aspects of each of these conceptions, they shared a belief that both were operative. That is, Plato, Aristotle, the Hippocratic writers, Galen, Celsius, and others each thought that the humors, which are discussed below, had primary agency in animal physiology. Also, they agreed that not only were some parts of the body more important than others but also it was worthwhile to make hierarchical distinctions about the order of parts. Galenic humoralism maintained cultural vitality for over 1,500 years. Indeed, a considerable amount of written medical opinion in nineteenth-century America

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was based on humoral physiology. At one level such venerability seems incredible. What other "scientific" thought pattern has survived as a working doctrine for 1,500 years? However, the durability of humoral thought seems less amazing, perhaps, when one recalls that Galen's original texts disappeared for almost 1,000 years, from the fall of the western Roman Empire until his original Greek became translated into Latin in the early and mid-1500s. During the interim, learned medical knowledge concerning humoral theory consisted of fragments of Hippocratic and Galenic texts that had been translated from Greek to Syriac to Arabic in heavily glossed versions before being translated into Latin beginning in the eleventh century. The successful efforts of sixteenth-century humanists to recover and publish Latin translations of Galen's Greek originals provided a new resonance to humoral theory. The philological recovery of Galen's emphasis on anatomy and structure/function relationships also stimulated anatomists like Vesalius, as noted earlier. The word humor derives from the Greek word that designates any fluid or juice whether in plants, animals, or the ethereal fluid ichor, which ancient Greeks thought circulated in the veins of their gods. Greek pre-Socratic philosophers as well as the writers of Hippocratic texts dating from 410 to 360 B.C.E. developed a fourfold model of the humors, which included blood, bile, black bile, and phlegm. "Blood" could mean either a mix or the humors involving blood and the other three humors or true blood. In both cases blood was the body's most important humor. Galen extended this quadratic scheme by aligning the four humors with the four classic elements—air, earth, fire, and water—and four seasons, ages, directions, and tastes.36 Humors also were explained in terms of the four basic qualities—hot, cold, wet, and dry. Astrologers such as Antiochus of Ascalon (c. 180 C.E.) aligned the four humors with the four cardinal points in the heavens and assigned each humor three constellations.37 The resulting schema, as historian Vivian Nutton has pointed out: . . . offered an apparently convincing explanation that linked together both man and macrocosm. The regularity of a divinely created universe, with the procession of the stars in their seasons, had its parallel in the regularity of the humors in the divinely created human body. Medieval illustrations of the body frequently draw on correspondence between the humors, the planets, seasons and the like, and the belief in an occult (or hidden) cosmic sympathy, which became increasingly common in the Renaissance, provided further proof of the validity of such links.38

In humoral schemes, an individual's health was always precarious. Internal illness, as opposed to trauma or congenital malformation, usually was a consequence of imbalance, and imbalance might result from a number of factors. Medieval medical theory amended Galen by emphasizing that individuals possessed their own complexio, or unique combination of humors and environmental factors, such as one's astrological sign and geographic location. For example, if a person with a hot and dry complexio were to travel to a cold and wet place


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under a cold and wet astrological sign, she or he might wish to consult a physician in advance for advice about adjusting diet, exercise, rest, evacuation patterns, and passions—what Galen and his successors termed the "non-naturals"— so as to minimize the tendency to imbalance, and, hence, illness. In short, a considerable amount of practical medicine concerned regimen, which often turned on dynamic manipulations of those aspects of life over which individuals might exercise some control.39 The fact that humoral models all gave primary agency to the body's fluids profoundly affected assumptions concerning relationships between the body's structure and function. It meant, first, that the human body was open and porous: atmospheric ether or pneuma—literally the "breath of life" in pre-Socratic Greek thought—and other environmental material could enter through the mouth, anus, urethra, cervix, and skin pores and cause instant change in the humors, and, hence, a person's physical or mental health. Humans were microcosms of the macrocosm, an assumption that gained wide cultural currency during the Renaissance. In subsequent chapters I will explore some consequences of these assumptions. In humoral schema, none of the solid tissues of the body were as important as the body's hollow spaces. These spaces contained the humors and humors had physiologic agency. Early anatomists and even Vesalius, who was preoccupied with skeletal and muscular themes, tended to see the interior of the body as a collection of containers and processing centers of humors. The most important containers were the heart, liver, spleen, and ventricles of the brain.

Noble Parts Physitians in their Anatomic Lectures, though the whole body lye before them, yet they read chiefely upon some more noble and Architectonical parts, the braine, the heart, the stomach, or the like. —William Spurstowe, Englands Patterne and Duty in Its Monthly Fast (1643)40

Early modern culture inherited a mix of bodily architectonics from Greco-Islamic natural philosophy. Originally, the Hippocratics, Plato, Aristotle, Galen, and their followers developed models of the body's "noble parts" that differed from each other in important respects. By the early modern period, however, distinctions between them were blurred and often had been for centuries. Galen's tendency to syncretize Greek sources accounted for some of the fuzziness, but so too did medieval and Renaissance scholarly practices that freely mixed fragments from different ancient authorities in prototextbooks, or florilegia.41 For Aristotle, the main authority on university-based natural philosophy from the early medieval universities through seventeenth-century university curricula in Europe and the New World, the heart was the most important organ of the body. According to "the Philosopher," as Thomas Aquinas referred to Aristotle,42 the

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heart was the organ primarily involved in the origin and expression of emotion: "For example we may regard anger or fear as such and such movements of the heart, and thinking as such and such another movement of that organ, or of some other. .. ,"43 Aristotle also thought that because "the definitive characteristic of an animal is the possession of sensation; and the first sensory part is that which first has blood; that is to say is the heart," the heart was the body's "central organ."44 If one of the Aristotelian heart's functions was cognitive emotion, to use an anachronistic phrase, its basic nature involved an innate heat. Indeed, the heart was the hottest part of the body. The Aristotelian brain, by contrast, was the coldest part.45 Indeed, for Aristotle, the brain seemed to serve primarily as a refrigerator for the hot vapors emanating from the heart and blood. Using his characteristic binary logic, Aristotle declared that because "all influences require to be counterbalanced. .. nature has contrived the brain as a counterpoise to the region of the heart with its contained heat." Importantly, Aristotle was emphatic that the brain "has no continuity with the organs of sense [because] when it is touched, no sensation is produced; in which respect it resembles the blood of animals and their excrement." Granted, the brain could cause "disease, madness, and death," but only secondarily through its failure to "perform its office" through inadequate control of the blood's temperature.46 The implication, which Aristotle repeated in several texts, was that the blood and humors were agents of health and disease through their influence on organs such as the brain, not the other way round. Most nonalchemical accounts of noble parts included the liver as the third primary organ, but Aristotle ceded the liver relatively little importance. He thought its position was not primary; also, it was counterbalanced by the spleen. The main reason for its secondary status, however, resulted from its failure to contain a "receptacle for blood, as does the heart." Hippocratic texts, which were written by different authors at different times, contained no codified bodily architectonic. However, the text On the Sacred Disease, which discussed convulsions, explicitly favored the brain over the heart. Denying that "we think with the heart, and that this is the part which is grieved, and experiences care," the author declared that the brain was the "messenger of the understanding." Additionally, the brain was the primary site or source of "joys, delights, laughter, and sports, and sorrows, griefs, despondency, and lamentations."47 Although these statements are unambiguous, they were not repeated elsewhere in the Hippocratic corpus. Indeed, Hippocratic authors wrote little about bodily location and governance of sensation, emotion, or intelligence. Furthermore, it is not clear whether the author of On the Sacred Disease thought the brain qua brain was important or whether its importance derived from its presumed position as the first organ to receive external air and register changes in air and other external material.48 The Hippocratic author of On the Heart, however, placed sensations, in-


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nate heat, and intelligence in the left ventricle of the heart, an opinion shared by the Hippocratic author of Diseases of Maidens.4g Plato described Hippocrates and Socrates as boon companions, which may explain why Hippocratic medical theory provided the matrix for Plato's bodily architectonic. Plato amended Hippocratic thought, however, in endowing humans with a soul with three distinct faculties located in three distinct bodily locations. Moreover, Plato followed earlier Pythagorean thought in writing that individual humans possessed a rational soul, which was immaterial and immortal and associated with the human head. Souls controlling appetite and emotion, which Plato considered to be inferior because they were inimical to the puissance of reason, were located in the lower body caudad of the diaphragm.50 Although this is not the section in which to develop the point, it is worth noting that Plato consistently drew analogies between the souls of an individual body and the soul of a collective. For example, in the conclusion of the discussion of souls cited above from The Republic, Plato referred to the "five kinds of soul" of "political constitutions."51 Galen's architectonic blended elements from Aristotle, Plato (and the Hippocratic sources that Plato used), and the Alexandrian anatomists Erasistratus (c. 270 B.C.E.) and Herophilus (c. 355-280 B.C.E.). Moreover, Galen presented his model as a seamless web, which may be why his intellectual successors rarely troubled themselves over its internal contradictions. Galen accepted Plato's tripartite division of the soul and located the rational faculty in the brain.52 Plato located emotion in the subdiaphragmatic area, but, Galen followed Aristotle in assigning emotion—the irascible faculty—a precise location in the heart. The liver contained the concupiscible faculty and was the seat of desires. In his Construction of the Embryo, Galen suggested at one point that those who privileged the heart because it came "first in construction" of the embryo, which was Aristotle's and Harvey's position, were mistaken. Instead, he wrote "The first phase of construction takes us ... to arteries, veins, chorion, and liver, not to the heart."53 The seats of the three faculties each had their own dynamic temperament, which were mixes of the four basic elements as expressed in the four humors and their reactions with air. For diagnosis and therapy, temperament was the operative term as it was the temperaments of the various faculties that physicians sought to manipulate so as to preserve health. Unlike Aristotle, the Hippocratic authors, and Plato, Galen made much of the body's nerves, arteries, and veins, all of which had been a central focus of the Alexandrian anatomists Erasistratus and Herophilus, who practiced in the Hellenistic period. Although Galen acknowledged Alexandrian contributions, his most frequent references were to their advice on practice, not to their anatomic findings. Galen's reticence concerning Alexandrian contributions to his anatomic thought may have contributed to his subsequent reputation as the supreme codifier of a unified system of ancient knowledge. Although the Alexandrians dissected humans and Galen dissected only nonhuman animals, Galen amended Alexandrian

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knowledge in that he found that arteries and veins each carried blood andpneuma. His findings differed from the Alexandrians' belief that arteries contained only pneuma and veins contained only blood. More important, Galen experimented extensively on nerves using ablation techniques (primarily ligatures and cuts) to demonstrate that motor function and perception depended on adequate function of the spinal cord and brain. This was new.54 By the early seventeenth century, medical writers were expressing puzzlement about the internal contradictions between ancient models. In 1618, the same year in which William Harvey published in Latin his first anatomy text, which emphasized the importance of the heart, prominent London surgeon Helkiah Crooke published in English a popular anatomy book that summarized contemporary understanding of anatomy and physiology, his Mikrokosmographia, or, A Description of the Body of Man. When Crooke raised the question, "Which of all the principall parts is most Noble?" he hedged his answer. First, he cited Galen as saying he preferred the "testicles before the heart" as the primary noble part before Crooke indicated that he thought the heart "hath a greater concurrent in the plea of honour. .. ." Noting the Hippocrates and Aristotle both placed the "soule" in the left ventricle of the heart, Crooke then reversed himself "to yielde the Superiority of the Braine." The reason was that "his function is more divine and more Noble than those of the heart. For example, all sense and voluntary motion proceed from it, habitation of wisdom, shrine of memory, judgment and Discernment."55 However, much later in the book, Crooke seemed to strike a compromise between heart and brain, writing, "But we say as the heart is of greatest and most instant necessity for life, so the place of dignity belongeth to the Braine."56 William Harvey, however, never expressed much written interest in the brain. Like Aristotle, whom he acknowledged as his primary authority in natural philosophy, Harvey favored the heart, although he eschewed philosophical speculation about its capacity as an organ of sense and cognition. If Harvey sought to establish that the heart was a muscular pump that circulated the blood continuously through the arteries and veins in his 1628 landmark text Exercitatio Anatomica de Motu Cordis et Circulatione Sanguinis in Animalibus, (Anatomical Exercise (or Experience) on the Motion of the Heart and Blood in Animals), henceforth, De Motu, not as a bag that reacted passively to the ebullient pneuma and fluid it contained, he left to his successors the tasks of explaining animal heat, the purpose of respiration, and the formation of the blood. Even when contemporaries and successors disagreed with his views, they acknowledged Harvey as England's most knowledgeable physician early in his career. The combination of his theory and the method that lay behind it effectively deflected European medical thought away from its traditional wholesale reliance on humoral explanations. Indeed, Harvey's model of the heart—a model that emphasized its muscular power as a pump, not its passivity as a mere vessel for active fluids—experienced considerable delay in widespread acceptance precisely because it implicitly repudiated much of humoral theory.57


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In terms of likeness and presence, Harvey's De Motu5* remains an anomaly. Harvey made his early reputation as an anatomist, as demonstrated by his popular anatomy lectures from 1616 at the College of Physicians. One might assume, therefore, that De Motu would contain many illustrations and that in addition to providing their own narrative of circulation, the pictures would also drive the textual narrative in a manner similar to their function in Vesalius's Fabrica and other contemporary Italian anatomy books. De Motu, however, contains only two illustrations. Why so few? The relative paucity of illustrations in De Motu is not because Harvey was an ardent Calvinist (he was orthodox Anglican) or because he championed nonmaterial schema of causation (he did not) or eschewed images for some other reason. I think the first word in the book's full title, exercitatio, conveys the main reason. Early modern natural philosophers often used exercitatio in an anatomic context to mean the active demonstration of a function as opposed to demonstration of static structure. De Motu's two figures attempt to illustrate a physiological experiment, a vivisection in which the experimenter is putting a tourniquet on a human subject's arm to demonstrate the existence of venous valves and their ability to prevent two-way flow of blood. The point is crucial to Harvey's argument that blood moves one way in a circular path from the heart through arteries to veins going back to the heart. In De Motu, Harvey made analogies between the heart's ventricles and pumps and their capacity to cause flow, and he framed some of his crucial arguments in quantitative terms. Because his most innovative arguments relied on dynamic evidence and quantitative reasoning, I venture Harvey thought he could show the function of the heart and circulatory system as it really was without resort to extensive illustration. In short, pursuit of likeness did not perforce oblige early modern anatomic philosophers to publish their work with profuse illustration.

Conclusion Decades before knowledge of the human body emerged as a focal point of culutral tension in the mid seventeenth century, knowledge and its representation were becoming problematic, at least in natural philosophy and religion. In many ways those like Vesalius and Fuchs who sought to know and portray visual likeness concerning natural bodies were on one side of an emerging epistemological fault line, and Protestant reformers who jettisoned images in favor of words were on the other. What they shared, however, was an insistence on recovering the foundations of their true respective subjects-the Book of Nature and the Book of God. Moreover, members of each group, not to mention Ignatius Loyola, designed their tomes as interactive guides that sought to convey not only particular knowledge but also the requisite attitudes and experiences involved in gaining that knowledge. Irrespective of their nominal content, these texts functioned in a sense as

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conduct guides to new vantage points on venerable subjects. The authors shared something else too: each explicitly presented his text as a path to crucial, if heretofore inaccessible, realms. But then so did the alchemists, and with considerable rhetorical flourish. By the early seventeenth century it was becoming clear to many that one did not have to proceed very far down any of these textual paths to realize that likeness—the goal of the anatomists' quest—and presence—that of the reformist theologians' and alchemists'—were diverging. God made his presence known through his word—the Book of God—and also through his spirit. When the anatomists consulted their Book of Nature—the human body—however, they experienced increasing difficulty finding spiritual substances. Instead, as we shall see in the next chapter, they began to characterize the human body in terms of visible materials that composed separate organs. As organized Christianity continued to splinter during the early seventeenth century, a trend with which the burgeoning field of alchemy was intimately associated, learned Europeans began to develop disparate ideas about the normal functions of the human body. As they did so, a venerable consensus about fundamental components of human nature began to erode. In the meantime, the body politic was becoming quite spirited, or enthusiatic to use the English early modern trope, as religious schism stimulated political discord in many parts of northwestern Europe. Notes 1. Francis Bacon. The Complete Works of Francis Bacon. 3 vols. eds. James Spedding, Robert Ellis, and Douglas D. Heath (London: Longman & Co, 1889), vol. 1, p. 298. 2. Hans Belting. Likeness and Presence: History of the Image before the Era of Art. (Chicago: University of Chicago Press, 1994), p. 16. 3. Andreas Vesalius. "To the Most Serene Prince Philip .. .," in The Epitome of Andreas Vesalius. (Basel: Johannes Oporini, 1543). trans, from Latin to English, L. R. Lind (New York: Macmillan, 1949). 4. Herophilus: The Art of Medicine in Early Alexandria, ed. and trans. Heinrich von Staden (Cambridge: Cambridge University Press, 1989). 5. For a cogent declaration of Aristotle's premises of natural knowledge, see the opening lines of Aristotle. "Physics": "When the objects of an inquiry, in any department, have principles, causes or elements, it is through acquaintance with these that knowledge and understanding is attained. For we do not think that we know a thing until we are acquainted with its primary causes or first principles, and have carried our analysis as far as its elements. Plainly, therefore, in the science of nature too our first task will be to try to determine what relates to its principles." trans. W. D. Ross (Oxford, 1950). The Complete Works of Aristotle: The Revised Oxford Translation, ed. Jonathan Barnes (Princeton: Bollingen, 1984), vol. 1, book 1, lines 184 10-15, p. 315. 6. According to Andrew Cuningham, Ferrara physician Nicolo Leoniceno (1428-1524) acquired a full Greek manuscript of Galen's Method of Healing, which was printed in 1500 in Venice. Subsequently, a Latin translation appeared in Paris in 1514. Andrew Cuningham. The Anatomical Renaissance. (Aldershot: Scolar Press, 1997), p. 79.


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7. Vesalius' s contributions were limited to light editing of existing translations of Galen's "Dissection of the Nerves, "Dissection of the Veins," and his "Anatomical Administrations" (ironically, Guinther's translation). 8. Andreas Vesalius. The Illustrations from the Works of Andreas Vesalius of Brussels. trans, and annotations by J.B. de C.M. Saunders and Charles D. O'Malley. (Cleveland: World, 1950), p. 13. 9. Cuningham. Anatomical Renaissance, 88-143. 10. Leonhart Fuchs. Great Herbal ofLeonhart Fuchs: De Historia Stirpium Commentarii Insignes, 1542. eds. and trans. Frederick Meyer, Emily E. Trueblood, and John Heller, foreword Joseph Ewan. (Stanford: Stanford University Press, 1999). 11. Fuchs. Great Herbal of Fuchs, 205. 12. Fuchs. Great Herbal of Fuchs. 13. Fuchs. Great Herbal of Fuchs, a4. 14. Edward Rosen. Three Copernican Treatises. 2nd ed. (New York, 1952), citing Leopold Prowe, Nicolaus Copernicus (Berlin, 1883^4). Reprinted (Osnabruck, Germany, 1967). 15. According to Meyer, Trueblood, and Heller, eds. Great Herbal of Fuchs, the ninthcentury author Walafrid Strabo entitled his herbal Hortulus (Little Garden). See vol. 1, no. 27, p. 841. 16. Fuchs. Great Herbal of Fuchs. See for details of his teaching methods. 17. Fuchs. Great Herbal of Fuchs, 211. See also Sachiko Kusukawa. "Leonhart Fuchs on the Importance of Pictures." Journal of the History of Ideas 58, no. 3 (1997): 403-27. 18. Fuchs. Great Herbal of Fuchs, 210. 19. Kusukawa. "Leonhart Fuchs," 406. 20. Fuchs. Great Herbal of Fuchs, 210. 21. Fuchs. Great Herbal of Fuchs, 213. 22. Adrian Johns. The Nature of the Book. (Chicago: University of Chicago Press, 1998). Johns's principal interest is the relation between print culture and knowledge, especially knowledge of nature, in early modern Europe. 23. Vesalius. Illustrations, eds. Saunders and O'Malley. See also Vesalius. Epitome, trans. Lind. 24. According to editors Saunders and O'Malley, Nicolaus de Sabio in Venice in 1539 issued two sheets of "representations of the body in which the viscera are drawn on separate, superimposed layers to suggest their sequence within the body cavities.. . ." Vesalius. Illustrations, 205. 25. John Calvin. Unterrich in der Christlichen Religion, trans. O. Weber (Neukrichen, Germany, 1955). Institutes of the Christian Religion (1536-59). 1:9:2. Cited in Belting. Likeness and Presence, 550. 26. Calvin. Institutes. 1.11. Cited in Belting. Likeness and Presence, 550-1. 27. Calvin. Institutes. 1.12. Cited in Belting, Likeness and Presence, 551. See also P. Earth and W. Niesel. Opera Selecta. (Munich, 1928) vol. 1, pp. 100-1. 28. Belting. Likeness and Presence, 548. See also Martin Luther. German Catechism. Weimar ed. (1529)30.1:145. 29. Belting. Likeness and Presence, 548. See also Martin Luther. "Invocabit" Sermons. Weimar ed. (1522) 10.3:26. 30. Cuningham. Anatomical Renaissance, 231. 31. Cuningham. Anatomical Renaissance, 231. n. 33. See Cuningham's translation, Melancthon, Comentarius de Anima. (1540) f. 44v-45 r. 32. Belting. Likeness and Presence, 16. 33. For a recent discussion of the forty-year debate concerning the proposition that through-

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34. 35.

36. 37. 38. 39. 40. 41.

42.

43. 44. 45. 46. 47.

48.

49. 50. 51. 52.


out Europe the seventeenth century experienced a general crisis, see The General Crisis of the Seventeenth Century. 2nd ed., eds. Geoffrey Parker and Lesley M. Smith (London: Routledge, 1997); also, Theodore K. Rabbi. The Struggle for Stability in Early Modern Europe. (New York: Oxford University Press, 1975). For the most extensive discussion of Harvey's natural philosophy, see Roger French. William Harvey's Natural,Philosophy. (Cambridge: Cambridge University Press, 1994). Greek authors, including the Hippocratics, Plato, Aristotle, Galen, and other authorities used the term "parts." By the early seventeenth century, if not slightly earlier, texts began to use the English or English equivalent of the phrase "noble parts" commonly to refer to the heart, brain, and liver. Relevant Galenic treatises include his "The Elements According to Hippocrates" and "Mixtures." For an excellent concise history of humoralism, see Vivian Nutton. "Humoralism," in Companion Encyclopedia of the History of Medicine, eds. William Bynum and Roy Porter (London: Routledge, 1993), vol. 1, pp. 281-91. Ibid., 288. Nancy G. Siraisi. Medieval and Early Renaissance Medicine. (Chicago: University of Chicago Press, 1990). William Spurstowe. Englands Patterne and Duty in Its Monthly Fasts. (London, 1643), p. 21. See Knowledge and the Scholarly Medical Traditions, ed. Don Bates (Cambridge: Cambridge University Press, 1995). See especially Faith Wallis, "The Experience of the Book: Manuscripts, Texts, and the Role of Epistemology in Early Medieval Medicine," pp. 101-27. Thomas Aquinas (1225-74), a member of the Dominican Order who spent most of his life in Paris, wrote commentaries on Aristotle, Boethius, and Pseudo-Dionysius. Aquinas's Summa Theologica, which put Aristotle into a Christian context, has been a fundamental text of Roman Catholic theology. Aristotle. "On the Soul," in Complete Works, book 1, lines 408b7-9, p. 651. Aristotle. "Parts of Animals," in Complete Works, 666a33-37. Ibid., 652a28-30. Ibid., 652a24-653b7. Hippocrates. "The Sacred Disease." trans. W.H.S. Jones (Cambridge: Harvard/Loeb Library, 1992), XVII: 1-10. 50. For Hippocratic brain physiology, see VI-X, XX. In XIV: 10-20 the author mentions opening the skull of a cow with convulsions: "If you cut open the head you will find the brain moist, very full of dropsy and an evil odour, whereby you may learn that it is not a god but the disease which injures the body. So is it also with a man." Henry E. Sigerist. A History of Medicine, vol. 2 (New York: Oxford University Press, 1961), p. 274. See also Diane Puklin. "Medical Psychology in the Seventeenth Century: The Idea of a Neurological Emotion in the Thought of Thomas Willis." Unpublished doctoral dissertation in history. (University of Chicago, 1980), p. 6. Plato. "Protagoras," in Plato, the Collected Dialogues, eds. Edith Hamilton and Huntington Cairns (Princeton: Princeton University Press/Bollingen, 1961), section 311b-c. Plato. "The Republic, IV," in Plato, the Collected Dialogues, section 439c-441, p. 681-3. See also Plato. "Timaeus," section 69, p. 1192. Plato. "The Republic, IV," in Plato, the Collected Dialogues, section 445c-d. Phillip De Lacy. "Galen's Platonism." American Journal of Philology 93 (1972): 36-7.


21

53. Galen. The Construction of the Embryo in Selected Works, trans. P.N. Singer (Oxford: Oxford University Press, 1997), pp. 698-9. 54. Galen. Construction of the Embryo, 678-80. 55. Helkiah Crooke. Mikrokosmographia, A Description of the Body of Man. (London, 1618), p. 45. 56. Ibid., 453. 57. Jerome J. Bylebyl, ed. William Harvey and His Age. (Baltimore: Johns Hopkins University Press, 1979). 58. The full Latin title is Exercitationes de Motu Cordis Et Sanguinis in Animalibus (London, 1628).


2 MATTER, SPIRIT, AND THE HEART

When William Harvey published Exercitatio Anatomica De Motu Cordis et Sanguinis in Animalibus (De Motu) in 1628, he compared the heart's role in animal bodies with that of Charles I in England: "The heart of animals is the foundation of their life, the sovereign of everything within them, the sun of their microcosm, that upon which all growth depends, from which all power proceeds. The king, in like manner, is the foundation of his kingdom, the sun of the world around him, the heart of the republic, the fountain whence all power, all grace doth flow."1 As Harvey grew older, however, he assigned more physiologic agency to the blood than to the heart. In De Motu he wrote that the heart possessed an innate heat, but by the 1640s, if not earlier, he had decided that the "innate heat belong(s) to the blood alone."2 As he worked on embryos in the late 1640s he became convinced that, "It is therefore evident... the blood is ... the builder and preserver of the body and principal part wherein the Soul hath her Session. . . . "3 During the 1960s, historians Christopher Hill and Gywneth Whitteridge engaged in extended debate concerning Harvey's political outlook as he moved from "heart" in the early 1600s to "blood" during the Interregnum.4 I think Harvey, who served Charles I as his primary physician during the English Civil War, remained a monarchist to the end. Harvey, like Aristotle, whom he acknowledged as his primary authority in natural philosophy, never expressed much interest in the brain. Neither did many other 23

24


prominent English intellectuals before the Restoration. Arguing in 1651 that the soul could not be an incorporeal substance, Harvey's friend Thomas Hobbes, the philosopher and tutor to Charles II when he was a young prince, chose the blood, citing as his authority the Hebrew taboo on eating blood in Deuteronomy 12:23: "Eat not the blood, for the blood is the soul, that is the life."5 During the early years of the Restoration, alchemical physicians such as George Thomson, described the blood as a "most pure Sweet. . . Vital Juice . . . made by the Archeus . . . the principal matter for Sense."6 Although alchemical healers often credited Harvey, Thomas Willis, and other Oxford physiologists for their work on the blood, they denigrated the experimental methods on which that work depended. At the same time, traditionally oriented physicians, such as Edmund O'Meara, criticized Willis and his colleagues for their emphasis on the heart and blood at the expense of the bodily humors of classical Galenic theory. When Harvey's kinswoman, Lady Anne Conway (1631-1679), who consulted Harvey and Willis about her chronic headaches, declared her belief in the primacy of the blood in the late 1670s, she had spent at least two decades studying alchemical texts and had made a recent conversion to Quakerism.7 Harvey's model of the heart and circulation of the blood achieved international prominence beginning in the 1640s. Thanks to his stimulating influence on younger Oxford investigators and the proliferation of Oxford colleges that took place from the 1620s through the 1640s, among other factors, England for the first time became a leader in European natural philosophy. One might think, therefore, that by the Restoration, if not before, Harvey's models might have achieved the status of "normal science," to use the late Thomas Kuhn's term for theories of nature that manage to achieve widespread acceptance among orthodox investigators.8 However, they did not, at least not in the form Harvey and his disciples would have wished. I should emphasize at the outset that the partisans of one or another physiologic model often changed their allegiances suddenly. Also, the balance of political and professional power, problematic throughout most of the century, often shifted subtly but suddenly too, even after the Restoration. In this chapter, I argue that the failure of Harveian models to gain hegemonic status in medical natural philosophy reflects a broader crisis in England during the Interregnum and early Restoration concerning the respective roles of matter and spirit in the macrocosm of the universe and the microcosm of man, to phrase the issue in early modern terms. Just as in religion the orthodox often denigrated dissenting Christians as "enthusiasts" for their dramatic expressions of religious fervor,9 so too natural philosophers felt compelled to take positions concerning the identity and extent of spiritual agency in nature, including human physiology and behavior. As late as the 1630s, learned English people continued to express, if anything, only mild disagreement concerning the physical causes of human behavior. Educated people, if not able to achieve consensus, were, as historian Michael MacDonald notes, "still able to reconcile all of the main types of causal

MATTER, SPIRIT, AND THE HEART

25

explanations for unusual behavior, passions, and thoughts."10 From the English Civil War of the 1640s onward, however, English preachers, physicians, natural philosophers, and public authorities achieved little consensus about the causes and meanings of normal and abnormal behavior. Tensions were present in other European countries, but the decades of political, social, and religious rupture that England experienced at mid century rendered its intellectual soil especially fertile for new natural philosophy hybrids of human physiology. Indeed, I will argue that "enthusiasm" and its containment lay at the center of a general crisis in the middle of the seventeenth century not only in natural philosophy but also in learned culture concerning nature and the human condition in its theological, social, and political dimensions. Many historians have written about the religious, political, and social dimensions of this crisis, although few other than Michael Heyd have explored its role in medical natural philosophy.11 I do not ignore developments in other European communities, but I choose to refract them through an English lens. Such an approach inevitably generates distortions; in comparison to a review from a Europeanwide perspective, however, a qualified Anglocentric approach potentially provides greater clarity in understanding how English natural philosophers and others experienced their intellectual world and sought to change it. After describing some contours of the community of mid-seventeenth-century English experimental natural philosophers, I briefly explicate the physiological theories that most engaged them: vitalist and alchemical doctrines that were then current as well as the refurbishment of Greek atomism by Pierre Gassendi and Rene Descartes in France and Holland. Next, I discuss how humoralism, alchemy, and atomism, none of which was completely distinct from the others, became visible in the new conceptions of the blood and heart—together with the lungs the main components of the vital soul of classic humoralism—put forward by those who self-consciously followed in William Harvey's footsteps. Finally, I describe problems that proponents of the competing models of the vital soul encountered during the early years of the Restoration. Assessment of the influence of learned natural philosophy and medicine on popular culture remains problematic.12 Readers who look to popular culture for explanations of historical change may assume that tracts written mostly in Latin by elite investigators mainly for each other influenced little more than learned natural philosophy, especially for the emerging natural philosophy that presented itself as "new." Even so, skepticism leaves open the question of how general cultural issues may have suffused innovative natural philosophy. Also, popular culture probably contained much more medical knowledge, especially knowledge of the traditional kind, than one might assume. The plethora of popular versions of learned medical knowledge and treatment that emerged from the mid sixteenth century onward suggests that ordinary people shared a great deal of medical knowledge with their physicians.13

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Formation of the Oxford Group Inspired partly by Harvey's presence in Oxford during the mid 1640s, groups consisting mostly of young university students of natural philosophy began forming experimental clubs that met there regularly to discuss and perform experiments. While the Civil War continued to rage outside—occasionally even engulfing that university town as the Royalist and Parliamentary armies traded its occupation— inside the clubs that met in one or another Oxford college, an atmosphere of "Philosophical Liberty" self-consciously reigned that continued through the Interregnum. Mostly this reflected the commitment of the clubs' principal sponsor, John Wilkins (1614-1672), a conformist Anglican minister who assumed the wardenship of Oxford's Wadham College in 1648, to intellectual spaces that excluded politics and religion from natural philosophy. As was the case in parallel groups in London with which Wilkins and John Wallis (1616-1703) had been involved, one of the general rules of the experimental clubs was the exclusion of "all Discourses of Divinity, of State-Affairs, and of News, (other than what concern'd our business of Philosophy),"14 a policy that was later adopted by the Royal Society as well. Perhaps partly because of Wilkins's personal interest in subjects such as astronomy, mathematics, and universal language, which were also central interests of "hermetic" philosophers, he remained wary of the mystical aspects of theology and natural philosophy. Indeed, one cannot tell from the title of some of Wilkins's texts, such as Mathematical Magick or Mercury: or the Secret Messenger or Discourse Concerning the Possibility of a Passage to the World in the Moon, on which side of the fence he sat. Any of them could have served as the title of an alchemical or overtly mystical tome; yet it was clear to him and his colleagues as well as to contemporary critics that there was a fence and that they stood on opposite sides. Skepticism about spirits and mysticism did not translate into censorship, however. The young men who pursued the "new" philosophy in their extracurricular experimental clubs avidly studied the latest versions of alchemy and atomism as they slowly began amending Harvey's circulation theory and its powerful explication of the vital soul. Because alchemical theory entered England before the atomism of Gassendi and Descartes, I begin with it.

The Importance of Spirit: Paracelsus, Francis Bacon, and Johan Baptista van Helmont Paracelsus By the middle of the seventeenth century, Theophrastus Bombastus of Hohenheim (14977-1541), the man known as Paracelsus, had been dead so long and his work was so amended by followers that determining the English response to an authen-


27

tic Paracelsian corpus seems impossible. From a bibliographic point of view, discussion of Paracelsian influence is severely compromised. The theory of matter in Paracelsus's Philosophia ad Athenienses, for example, had been strongly attacked for its impiety in the sixteenth century by the Dutch philosopher Erastus.15 When that text was translated into English during the Interregnum, it was again taken up and attacked for its theory of matter. According to historian Walter Pagel, however, Paracelsus probably did not write the text. Similarly, in 1595 Robert Bostocke, who served as Paracelsus's earliest English commentator, based his Paracelsian theory, The difference betwene the auncient Phisicke . . . and the latter Phisicke, on sources that may be nonauthentic.16 The tendency of Willis and Robert Boyle, to mention only the most prominent of mid-century Oxford chemists, to make reference to Paracelsus without citing specific texts compounds this bibliographic confusion. Regarding the place of Paracelsian thought in English physiology of the blood, one might ask if the Oxford physiologists knew what they were talking about when they made reference to Paracelsus. Regardless, they seemed to value him highly. For example, the then new reading room of the Bodleian Library contained Paracelsus among the names of eminences engraved on its frieze. The Oxford physiologists also were familiar with transitional figures, notably Robert Fludd (1574-1637) and Daniel Sennert (1572-1637), who attempted to integrate Paracelsian chemical ideas into extant medical theories.17 Paracelsus always included God as an active presence in every aspect of nature. When he wrote about the prime matter of the world, as he did in the Opus Paramirium, an authentic text of 1531, he equated it with "fiat." In another authentic text, his Book on Minerals, the first principle "was with God, the beginning, that is ultima matera; this ultma materia He made into prime matter." When Paracelsus talked about the prime matter of individual bodies and the necessity of a physician to understand their chemistry, he wrote: "God created all things, something from nothing. This something is a seed . . . all things are created as prime matter and after that the vulcan follows and turns them into ultimate matter through the art of alchemy." The "seed" referred to here was "the element of water." The transformation of "fiat" into "materia" happened through the spiritual agency of Paracelsus's three principles: salt, sulfur, and mercury. These principles were the origin of the elements and the material principle of all animal bodies. Matter then individuated into specific objects through the agency of their specific "blacksmiths"—the vulcan and Archei—on the object's original prime matter, or seed.18 Paracelsus's frequent, if unacknowledged, references to Greek philosophy and Christian texts endeared him to some English natural philosophers. According to Paracelsus's first English commentator, Robert Bostocke, Paracelsus's use in the passages above of flat and materia alluded to St. Augustine.19 However, historian Walter Pagel attributes the allusion to the prologue of the Gospel according to John: "In the beginning was the Word."20 Paracelsian use of the seed concept, which was a venerable alchemical trope, echoed Plato's use of seed in his late

28


work, Timaeus.21 Not surprisingly, perhaps, English Neoplatonists in the 1660s, such as the philosopher Henry More in Cambridge, regularly studied alchemical theory not only with Robert Boyle but also through conversations with visiting alchemists.22 Although More, the most prominent of those in Cambridge who sought to meld Platonism with Christian doctrine, never went so far as to declare that spirit and matter were interconvertible, as the alchemists maintained, he did write that spirit, despite its immateriality, was real.23 Paracelsus and his followers had long been potent influences on English medical therapeutics just as they had been on the Continent from the third quarter of the sixteenth century onward. Writing in 1602, for instance, the English physician William Clowes indicated he would be "thankful to God" for "anything that may be to the good of the Patients . . . be it eyther Galen or Paracelsus." Despite the success of Paracelsian medicines, however, Clowes found Paracelsian "Doctrine hath a more pregnant sence than my wit or reach is able to construe."24 Nonetheless, the London College of Physicians included several Paracelsian compounds of mercury and antimony, including calomel, in 1618 in its first formulary of approved drugs.25 These were carried over into the second edition, which Nicholas Culpeper translated into English in an inexpensive edition in 1650.26

Francis Bacon For those who are wont to conceptualize the history of science as a progressive accumulation of knowledge of the material world at the expense of notions of the agency of unseen spirits and powers, it is tempting to place alchemists such as Paracelsus on the margins, as at best protoscientists or prescientists. It is less easy to place Francis Bacon on the margins, however; indeed, most traditional histories of science characterize Bacon as a foundational figure of the modern scientific enterprise. Yet Bacon's theory of matter and his characterization of spirit reflect his profound commitment to some alchemical notions. Moreover, if readers are willing to let the orthodox Bacon stand, in part, for orthodox English cosmology in the early 1600s, a brief review of his matter-spirit theory may help illuminate how deeply some vitalist aspects of alchemical ideas penetrated English thought before the Oxford physiologists became active. This is not to suggest that all learned conformist English people thought as Bacon did. Most probably did not think in detail about matter theory at all. Why should they have? I mean merely to suggest that Bacon's matter-spirit theory supports an interpretation that vitalism occupied a central place in proper English natural philosophy in the early seventeenth century. Bacon's most extensive discussion of the relations between spirit and matter occurred in a manuscript fragment entitled "De Viis Mortis," which exists as a heavily annotated mix of prose and aphorisms and dates from 1620. It deals with


29

the prolongation of human life, and according to its translators, Graham Rees and Christopher Upton, Bacon may have intended it as the basis for a never-completed section of his magnum opus, the Great Instauration. Many of the ideas in "De Viis Mortis" do appear, however, in Bacon's published Historia Vitae Et Mortis (1623) and his Novum Organum.21 Assessment of explicit influence of Bacon's vitalist cosmology on Oxford physiology remains problematic. In 1661, Boyle and Wilkins28 attempted to reproduce a Baconian thought-experiment on planetary creation, which indicates some knowledge on their part of Bacon's more speculative thought. However, although the Oxford physiologists as a group paid verbal obeisance to Bacon, they did not make a practice of citing his specific texts. At one point in a lecture in 1664, Locke recorded Willis as describing blood as oil and the heart as a lamp in a manner that echoed Bacon's characterization, but the reference was not explicit.29 For Bacon, "all spirit of things is a breath compounded of an airy and flamy substance." Moreover, "every tangible being possesses and holds a spirit within itself. . . . However, this spirit is certainly not some force, or energy, or trifling thing but is clearly a thin body distributed and invested in the grosser parts of the object. (Nor again is this spirit outer air which has covertly stolen in or insinuated itself but simply a thin and innate body different from air.)" Spirits differed from one another and were "compound" substances. Concerning matter, Bacon was explicit that it had a quantifiable mass: "For we do not understand matter in the fashion of the schools as something abstract or potential but in fact as a real thing whose bulk can be determined in the case of any object, be it greater or smaller, as far indeed as calculations are concerned."30 Bacon thought all bodies had a dual nature: "Every tangible being here within the surface and outer parts of the earth has a spirit hidden in the grosser body; nor is there any tangible body known to us which is not made up of a dual nature, namely of spirit and gross matter." Spirit was a "corporeal substance (albeit invisible and intangible) which occupies the spaces." It was "simply . . . another body enveloped and invested in the grosser body." Furthermore, it was "native" and "individual": "For the juice of the grape is not water but wine, a liquid very different from water. In the same way that spirit is not air but a tenuous substance . . . very different. . . from ordinary air." All of these conditions pertain "within the surface of the earth and its outer crust (which certainly does not extend very far into the depths)."31 According to Bacon, the remainder of the earth was lifeless and inert. In his elemental thought, Bacon retained the Paracelsian principles of sulfur and mercury, but he regarded them as only natural substances. Salt was not a principle to him but only a compound of sulfur and mercury. Concerning matter and spirit, Bacon made no sharp distinction between inanimate and animate forms. Living spirit, as opposed to inanimate spirit, however, had the ability to be "branching" as well as being possessed (more or less)

30


of a "kindled flame." The "kindled spirit" was "like a gentle flame," that needed "alimentation" to avoid "consumption and dissolution."32 Both animal and vegetable forms of "every living spirit" possessed this flame "differing greatly in degree" from one to another.33 The principal distinction between animal and vegetable forms was that the branching forms of animal spirits had the additional feature of a spirit repository Bacon called the ventriculis cerebri, or ventricles of the brain.34 Bacon's ideas shared many similarities with Paracelsus's vitalism. First, both assumed that the universe, or at any rate that portion of the thin crust of the earth where they thought life took place, was a chemically mediated experience. Second, both thought spirit and matter were necessary for the existence of all things. Third, neither made a sharp dividing line between animate and inanimate forms. Fourth, both accorded the study of medicine an important place in natural philosophy because mastery of it held the potential for prolonging life. However, Bacon's thought differed profoundly from Paracelsian theory in other important ways. Unlike almost any excerpt from Paracelsus, the tone of "De Viis Mortis" and Bacon's other natural philosophy is remarkably secular. Stripped from Bacon's account of matter and spirit are allusions to Christianity as well as to the supernatural. In contrast to Paracelsian thought, Bacon made spirit corporeal, if still intangible. Importantly, for Bacon, things existed dualistically but not pantheistically. Although Paracelsus had become known (and notorious for) his analogies between the microcosm of living things and the macrocosm of the stars, Bacon fixed his attention on that portion of the earth—its "outer crust"—that interacted with the air. The rest may have been "matter" to Bacon, but its existence did not figure substantially in his thought. In terms of animal bodies, blood was important, as it was to Paracelsus, because Bacon thought it to be an appropriate locus of therapeutic intervention. However, Bacon added a layer of distinction between animal and vegetable forms that was lacking in the theories of Paracelsus: the ventricles of the brain. Although Bacon did not develop the theme in "De Viis Mortis," elsewhere he described quite a different relation between man and scientific knowledge than that common among alchemists.35 In Bacon's Utopia, Solomon's House, knowledge accumulated through cooperative work over time by industrious members of a team, a description that members of the College of Physicians in the 1650s and the Royal Society in the 1660s applied to themselves. In comparison, Paracelsus and his followers operated in a framework that Walter Pagel has termed "the individual Savant and his World."36 According to the Paracelsians, healers were akin to charismatic priests in that their knowledge was from individual divine illumination regarding the secrets of nature. Until alchemical physicians sought royal recognition as a professional body during the early Restoration, they paid little attention to institutional frameworks. Additionally, they seldom acknowledged predecessors or shared specifics of therapy.


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Van Helmont Like Paracelsus, Jan Baptista van Helmont (1579-1644) championed presence; indeed, he imagined each body, both living and nonliving, as having its own immaterial spirit, the Archeus. However, he framed bodily processes such as digestion and respiration on quite different principles than those of either Paracelsus or the Oxford physiologists. For van Helmont, the primary chemical process in bodies was the reaction of materials to acid, a process he termed "ferment." Helmontian ferment, however, was not about animal heat, as it had been for Aristotle and Harvey. Because van Helmont's primary reaction was that of acid-alkali, he had little use for the notion of fermentation that was central to Oxford conceptions of the blood, as I will describe shortly. Likewise, van Helmont expressed little need for the Paracelsian three principles of mercury, salt, and sulfur. Also, of the classic four elements—air, earth, fire, and water—van Helmont considered only two— air and water—as basic elements. In addition to the acid-alkali ferment, van Helmont's other major transforming agency was fire. Matter was conserved, and the universe was full. Within the human body, van Helmont thought that the foremost organs were the stomach and spleen, for that was where he placed the principle Archei. The spleen was important because it supplied acid to the stomach, where the resident Archeus directed the first of six transformations that turned food into blood. The blood received its final form in the left chamber of the heart, where an acid-alkali reaction occurred that imbued it with its vital spirit.37 Despite his rejection of the Harveian model of circulation, van Helmont thus had a conception of the blood that endowed it with an ontological status not seen in Galenic humoral theory or Paracelsian chemistry. However, despite his replacement of the Galenic coctions, or cookings, of food into humors in the visceral organs, van Helmont placed an even greater number of agents—the Archei—all over the body and universe. Although none of the Oxford investigators took up the spiritual cosmology of van Helmont's matter theory, his work appealed to them on methodological grounds. Van Helmont performed experiments, a practice that major investigators, such as Robert Boyle, as well as minor figures, such as Robert Sharrock, found attractive. Both Boyle and Sharrock, for instance, appreciated van Helmont's experimental efforts to show that water was the basic element of nature. Sharrock, who later became a conservative Anglican divine, performed a number of plant experiments during the 1650s and published his findings in Oxford in 1660 as The History of the Propagation and Improvement of Vegetables by the Concurrence of Art and Nature. Citing Bacon's recommendation of horticulture as his inspiration, Sharrock, in collaboration with Boyle, attempted to extend van Helmont's well-known willow tree experiment.38 Having sought to prove that water was one of the two primary elements, van Helmont had weighed a willow tree shoot and planted it in a tub of soil that had been weighed when dry. Five years

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later, van Helmont weighed the willow (weight gain, 164 pounds) and the dry soil (weight loss, 2 ounces) and ascribed the young tree's increase in mass wholly to the transformational power of water.39 Desiring to speed up the process, Sharrock planted a number of different root stocks in separate vials of water and weighed the surviving plants after a month. Boyle performed a similar experiment. Although both appreciated van Helmont's experimental findings, neither one accepted van Helmont's larger claims that water was the basis of life and that all living and nonliving objects were capable of transformation.40 Van Helmont also developed a concept of diseases as specific entities, which departed considerably from humoral theory as well as received Paracelsian doctrine. Van Helmont and Paracelsus both characterized diseases as specific objects that had their own specific seeds,40 and both characterized each disease as an alien force or a poison with its own Archeus that caused a corresponding Archeus (Archei) of the body to react. Disease, then, was the body's experience of a dialogue or battle between the resident and invading Archei for control of the body. Alternatively, morbid events could happen as a consequence of the resident Archeus becoming decadent. However, whereas Paracelsus emphasized macrocosmic influences—the stars—in disease creation, van Helmont focused on local interactions between the alien disease seed, its Archeus, and the host's Archeus. Because van Helmont was preoccupied with Archei, the principal ones of which he seated in the stomach and spleen, his therapeutics had a distinct approach. Since he thought that much of the interaction that caused disease took place in the visceral organs, he did not place primary emphasis on the blood or heart or brain. Instead, he aimed his therapeutic interventions toward causing evacuation of the harmful products of the Archeinal interaction. Helmontian healers administered powerful purgatives, laxatives, and emetics. Fever, humors, and the blood, which had been the leitmotif of Galenic and Oxford conceptions of disease, were but side issues in van Helmont's conceptual framework. One consequence was that selfidentified Helmontian physicians, believing in the primacy of spirit and water as they did, had little use for bloodletting, an ancient practice that was compatible with both humoral theory and the new Oxford models.

Atomism: Descartes and Gassendi In their relentless attempts to fashion a theory of matter that would adequately anchor their empirical work, the Oxford physiologists, like many other early modern natural philosophers, looked backward to the ancient Greeks, and specifically to the particle or atom theory of Democritus. They and the London groups active during the 1640s and 1650s did not absorb his work directly, however, but through the heavily amended versions of it put forward by Descartes and Gassendi. Harvey and the alchemists would not have been much help, for neither were atomists. Although the matter theories of Gassendi and Descartes bore striking


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differences, the English often referred to them together without differentiating between them. Generally, however, the English preferred Gassendi's theories over Descartes's, which seems paradoxical when one considers that Descartes accepted Harvey's theory of blood circulation before it gained widespread acceptance in England while Gassendi had little use for Harveian models.42 In contrast to Descartes, however, Gassendi made an explicit place for God in his matter theory. According to Gassendi, a French priest, there was more than just matter in its various forms and random motion in the universe. God was responsible for all motion and could intervene at any time.43 It may be, as historians James and Margaret Jacobs have argued, that Oxford physiologists qualified their acceptance of a completely mechanical universe in the 1650s because they found that purely mechanical thinking, such as the philosopher Thomas Hobbes expressed in his notorious Leviathan of 1656, "sucked too much spirit out."44 If so, Oxford acceptance of Gassendi, with his problematic circulation physiology, represented an instance of the Oxford group trimming its natural philosophy sails to suit an ideological wind. In any case, atomic philosophy was only one-half of the spirit/matter formulation that formed the basis of Oxford physiological chemistry. Other factors help to explain the limited impact of Cartesian physiology on English theories of the blood.45 Perhaps the most important theoretical objection Willis, Lower, and their colleagues mounted to Cartesian physiology arose from their differing explanations of the heart's contractility. Although Harvey had argued that blood circulated because muscular ventricles pumped it through the pulmonary artery and aorta and their arterial branches, the Cartesians argued that the heart moved because its walls transferred their innate heat to the particles of the blood and so caused the blood to expand so that it went into the arteries.46 In the Cartesian scheme, the motion of the heart depended completely on the blood. Although it occupied a central place in Cartesian physiology, the Cartesian heart was little more than a passive vessel with an innate faculty of heat. Ironically, Descartes, who wanted to eliminate Aristotelian models of innate qualities and faculties from the universe, granted a crucial faculty to the heart. Descartes nonetheless exerted a strong intellectual pressure on English natural philosophy from the time they first expressed awareness of him in the 1640s until the late 1660s. Descartes's lack of experimentalism compromised his influence, however. As suggested previously, English natural philosophers prided themselves on their experimentalism, and, increasingly, they upbraided the Cartesians for their lack of it. As Vesalius and Fuchs took pains to establish in the previous century, likeness concerned methods, arguments, and images, a sequence that Harvey had demonstrated brilliantly in De Motu. But experiment was not Descartes's strong suit. In the 1650s, for example, Robert Boyle dissected a flounder, removed its heart, and cut it in two. Withdrawing excess blood from the dead flounder's now divided heart, he noted that it continued beating. How could this be, he asked, if

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Descartes had been correct? The flounder was a cold-blooded animal; its heart beat even when it was without blood.47 Even in the late 1660s Oxford investigators still wrestled with Cartesian physiology. Richard Lower's Tractatus de Corde, published in 1669, began with a detailed discussion of the heart's muscular structure. After repeated boiling of hearts to reveal their muscular detail, Lower argued that the helical patterns of fibers indicated that the heart's ventricular contractions in systole must expel the blood completely and with considerable force.48 Furthermore, when Lower substituted another liquid for blood into the veins of a living dog, he observed that the heart continued beating regularly until the dog's blood had been almost completely replaced. This could not be true, he argued, if the heart's motion depended on an in situ exothermic chemical transformation of the blood. This was so even though Descartes imagined the body's heat as an innate ferment of the heart, which, incidentally, was the position Willis took during the 1650s. Instead, Lower concluded that it was clear from several experiments that the heart was only a muscle and that the principal chemical reactions and their heat occured in the blood.49

Blood and Body during the Protectorate Never a great believer in chemical analysis, Harvey had little idea how the blood sustained life. In 1653, he said of chemical analysis: "It is, however, an argument of no great cogency to say that natural bodies are primarily produced or composed of those things into which they are ultimately resolved."50 In comparison, beginning at least with his Lumleian lectures of 1616, Harvey recognized the importance of the lungs, which he found superior to the liver: "Without the liver you cannot survive for a prolonged period, but without the lungs not even for a moment. .. . The lungs generate spirit, or rather, in my opinion, they imbue the ailment [with spirit]."51 Other than saying that spirit was not air, however, Harvey never precisely defined the term. Other historians have written books on the influence of vitalist and mechanistic thought, particularly that of the alchemists Paracelsus and van Helmont and their followers and the Cartesians and Gassendi on English natural philosophy. This section is not synoptic; instead, I focus on aspects of Continental thought on bodily spirit and matter that were problematic for English Harveians at mid century. The vitalism of Paracelsus and van Helmont as well as the mechanism of the Cartesians loomed large in that respect. Within the Oxford and London experimental clubs, reception of their ideas was partial and contingent. In comparison, English investigators quickly and more or less completely incorporated work by Continental anatomists that confirmed and expanded Harveian models. For example, Jean Pecquet's discovery of the thoracic duct, disclosed in 1651, stimulated considerable work at Oxford on chyle and the role of the liver in blood production within three years of its publication. Although Pecquet's work presented


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conceptual problems to traditional Galenists, it did not for the Oxford physiologists. This was in part because Pecquet and other Continental anatomists, such as Marcello Malpighi (1628-1694) and Regnier de Graaf, accepted the circulation of the blood as outlined by Harvey and amended by his mid-century followers and in part because they avoided explicit philosophical speculation. In comparison, Paracelsus, Descartes, Gassendi, and van Helmont all wrote at great length not only about bodily organization but also about cosmological themes that included the nature of spirit and matter and their interactions. Indeed, for each of them, natural philosophy was only one piece, albeit a crucial one, in their larger philosophical programs. As the Oxford physiologists developed their ontologies of the blood during the 1640s and 1650s, they chose selectively from the more cosmologically inclined of the foreigners. In this, they echoed the reluctance of Robert Boyle and John Wilkins, both of whom explicitly cautioned against making cosmological claims about natural investigations. The Oxford physiologists were familiar with the full spectrum of Continental work on matter theory and the body. In the texts concerned with blood that they published during the 1650s and 1660s, Willis, Francis Glisson, George Ent, Lower, Nathaniel Highmore, and Boyle frequently cited the alchemist Franciscus de la Boe, or Sylvius (1614-1672), Descartes and his disciples Cornelis van Hooghelande and Henry Regius, Daniel Sennert (1572-1637), Pierre Gassendi, and Niels Stensen (16481686), as well as those of an earlier generation, including Jean Fernel (1497-1558) and Paracelsus. Early texts from the Oxford group tended to make indirect reference to contemporary Continental writers, especially the Cartesians. For example, in his 1641 Apologia Pro Circulatione Sanguinis, which vigorously defended Harvey's circulation theory, George Ent did not mention Descartes by name. Nonetheless, in the introduction Ent praised the work of Henry Regius, perhaps the most well-known of Descartes's medical followers. As did Descartes in his Discourse on Method of 1637, Ent also denigrated the existence of the various bodily "faculties" of university Aristotelianism. Even Oxford undergraduates in the early 1650s, such as John Locke, were reading recently published Continental works such as van Helmont's Ortus Medicinae of 1648. Widespread translation into English during the 1650s and 1660s of many works of alchemical Continental authors, as noted earlier, reflected a broader public interest in these topics as well. Beginning with the collapse of censorship during the 1650s and extending through the 1660s, England experienced a veritable flood of alchemical publications. Walter Charleton's selected translations of van Helmont, the Deliramenti Catarrhi (London, 1650), a Ternary of Paradoxes (London, 1650), and Spiritus Gorgonicus (Leyden, 1650) preceded by twelve years John Chandler's English version of van Helmont's Ortus Medicineae (1648), which Chandler entitled Oriatrike or Physick Refined and published in 1662. Several English translations of Paracelsus appeared during the 1650s, including his Archidoxies and the (pseudo Paracelsus) Philosophy to the Athenians. English

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versions of important Helmontian and other alchemical texts also appeared in the 1650s, including Jacob Boehme's De Signatura Rerum (translated by John Sparrow) of 1650 and George Starkey's Natures Explication and Helmonts Vindication (London, 1657) and Pyrotechny Asserted and Illustrated (London, 1658). In 1652, Elias Ashmole published his Theatrum Chemicum Britannicum, a general collection of alchemical texts of diverse kinds. When Walter Charleton turned away from van Helmont in the early 1650s to take up atomism, he completed an extensive explication of Gassendi's matter theory, which was published in 1654 as the Physiologia Epicuro-Gassendo-Charlotoniana. However, Gassendi's own work remained largely untranslated; only a highly edited version, entitled the Mirrour of True Nobility and Gentility (W. Rand, translator), appeared in London in 1657. In 1656, Thomas Willis first published a collection of treatises that represented a synthesis of much of the Oxford group's thought on spirits, matter, and the blood, his De Fermentatione (On Fermentation), De Febribus (On Fevers), and De Urines (On Urines), which was published in London in 1659 as Diatribae duae MedicoPhilosophicae (henceforth Diatribae). Aside from Harvey's anatomic publications, Diatribae was perhaps the first English medical text to gain an international reputation. Cited approvingly by subsequent authors as late as 1737,52 the Diatribae and Willis also received strong criticism from diverse critics in the 1660s. In terms of its theory of matter, the Diatribae borrowed heavily from both Paracelsian ideas and the Epicurean atomism of Gassendi. Willis liked Epicurean atomism because it "avoids occult qualities, sympathy, and other refuges of ignorance." Nonetheless, he qualified his praise. The problem was that Gassendi did not perform experiments; his theory "rather supposes than demonstrates . .. and induces notions extremely subtil and remote from the sense."53 Even so, Willis praised Gassendi for the comprehensiveness of his theory. His "Epicurean Philosophy mostly aptly deduces the phenomena, almost of all meteors, and the reasons of them, from the exhaltations of sulfur, and salts, either nitrous, vitriolick, aluminous, or armonical."54 Although Willis and the Oxford physiologists in general defined "spirit" increasingly in material terms as the century wore on, in On Fermentation, Willis characterized spirits, which he then considered responsible for all natural phenomena, as ethereal and descended from the fiery heavens. Using language redolent of Paracelsus, Willis had these "spirits" join "primigeneous seeds" that contained chemically active principles of spirit, salt, and sulfur. Spirit and seed together explained growth, change, and individuation. By their action on each other ("intestine motion"), these agents caused fermentation. Fermentation produced heat through the interactions of "subtil particles" with heavier and thicker earthly particles. Fermentation thus was the key natural process that linked animate and inanimate bodies and governed life and death.55 In animal bodies, life sustained itself through a "fermentation or accension" that took place in the heart. As a conse-


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quence of the agitation of the particles of spirit, salt, and sulfur in the heart, the blood "boiled up" and carried the heat to all tissues of the body.56 Based on his analysis of blood according to his chemical grammar of five elements—spirit, salt, sulfur, water, and earth—blood contained "very much Water and Spirit, a mean of Salt and Sulfur, and a little of Earth."57 By distilling the blood in healthy and sick bodies (an experiment Willis performed as early as 1650-1651), he argued that one could then learn something of the nature of its "affections" in health and disease.58 In this early scheme Willis, like Francis Glisson in his treatise on the liver, De Hepatis, of 1654, did not entirely dismiss the humors of classic Galenic thought. However, he described them in the same chemical framework as that of the blood. Furthermore, unlike van Helmont, who did not accept the circulation of the blood and assigned specific ferments to specific organs, Willis had all his humors circulating in the blood: "the Blood is an only humor; not one thing about the Viscera, and another in the habit of the Body, nor is it moved at one time by Phlegm, and another time with Choler, or Melancholy, (as is commonly asserted) but the Liquor growing hot in the Vessels, is only Blood, and wheresoever it is carried through all the parts of the Body, it is still the same, and like it self."59 In On Fevers, Willis linked the general subject of fevers to chemical problems in the blood. Fever usually was a consequence of fermentation gone bad, a "Fermentation or immoderate Heat, brought into the blood. . . that caused it to be stirred up with a rage through the Vessels."60 Given that fever was an unwanted form of fermentation that circulated throughout the body, the goal of therapy was to regulate ferment. Alien matter was to be expelled through bloodletting, ernesis, purgation, or sweating. Fever was to be regulated through measures to promote cooling. Blood was to be strengthened through administration of medicines including those containing mineral salts, such as steel. As Don Bates has pointed out in his review of seventeenth-century fever literature, none of this by itself was original. By combining a chemical explanation of the blood and fever with circulation theory, however, "Willis's treatise exchanged Aristotelian qualities, ancient humours, and Galenic physiology for Cartesian corpuscles, chemical constituents, and Harveian circulation."61 Willis also managed to smuggle in considerable alchemical material, as noted above. In this sense, the early work of Willis, who was valued at the time by his Oxford contemporaries not for his skill as an anatomist but as "our Chymist,"62 represented a synthesis of the "new philosophy," to borrow contemporary John Wallis's term,63 regarding the blood during the period 1645 to 1660. By the late 1650s, both the "new" philosophers and the alchemists had welldeveloped concepts of blood as a thing-in-itself. Furthermore, both groups discussed the blood in chemical terms, as did the Cartesians. Yet the chemical process they all referred to—"ferment"—carried quite different meanings in their schemes. Although the Cartesians and the Oxford physiologists paid a lot

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of attention to heat, the Helmontians more or less ignored it. Instead, they emphasized digestion, which the Oxford group rarely considered. Cartesians and the Oxford physiologists both accorded central importance to the heart. Given Descartes's early acceptance of Harvey's circulation theory, it might seem at first pass as though the two groups shared similar outlooks. Despite their shared "cardiocentric" bias, however, the two groups seemed to imagine different hearts. As time went on, they also seemed to imagine different bloods as well. Compounding their conceptual differences were their differences in method. A strong experimental basis of theory, such as evidenced by van Helmont, went a long way in gaining the respect of the English Harveians. The perception by the English of the Cartesians' weakness in this area diminished their influence in England. Similarly, in the case of disease and fever—a central subject in seventeenth-century medical theory—the Helmontians, Paracelsians, and "new" philosophers had welldeveloped ideas that seemed to overlap. Nonetheless their models of disease causation implied different therapeutic tactics. Even though alchemists and the Oxford physiologists favored chemical explanations and chemically based medicines, for example, they ended up with distinctive approaches to managing illness. In short, when the Oxford physiologists looked at the body as developed in foreign thought, they saw models that, despite their nominal similarities, rested on assumptions about spirit and matter that differed profoundly from their own. Perhaps this is one reason why some critics characterized both the Cartesians and the alchemists as "enthusiasts" even though their positions on spirit could not have been more opposed.64

Blood on the Restoration Stage The overall effect of slippages between the Oxford physiologists, alchemists, atomists, and traditional Galenists became apparent publicly during the early years of the Restoration. The formation of the Royal Society, which counted most of the major Oxford figures among its founders, and attendant publication by its secretary, Henry Oldenburg, of a journal, the Philosophical Transactions, early in the 1660s, both reflected and promoted a growing interest in natural philosophy among the educated and powerful.65 Furthermore, publication of large numbers of works on natural philosophical subjects, particularly those concerning medicine and alchemy, in English and Latin continued at a high pace. Royal patronage of the Society, although not financial, seemed to be a genuine expression of the new monarch's interest in natural philosophical subjects, especially chemistry. It was widely known among the genteel that Charles II had set up a chemical laboratory in his palace at Whitehall and imported a court (al)chemist, Nigaise Le Fevre, from France in October 1661.66 Furthermore, the establishment of the Royal Society as an important new semipublic body meant that natural philoso-


39

pliers and their patrons had more at stake in terms of reputation than they had when their experimentation and study occurred in cloistered spaces. The salient questions for an historian to ask, therefore, may not have much to do with determining who was a vitalist or who was a mechanist. As I have attempted to establish in earlier sections of this chapter, strong currents of vitalism and atomism flowed throughout orthodox English natural philosophy from approximately 1600 onward. Not only was alchemy popular among otherwise disparate groups during the Restoration, but also alchemical theory informed all the major physiologies of the period. Indeed, one might argue that concerning relations between spirit and matter, Restoration educated society, the audience for natural philosophy as well as the source of most of its major practitioners, was more interested in discernment and control than it was in making categorical judgments. The interesting historical question may not be whether the Oxford physiologists and other prime movers in the early Royal Society had a substantial interest in transmutation, but rather how they determined the existence of what was to them the crucial matter, the nature of a real transmutation. Who or what was the real alchemist (alchemy)? What was the real blood, and what did it do in the body? In terms of the place of matter, spirit, and the blood in medicine and human physiology, these tensions were expressed in at least three ways during the 1660s. Usually considered separately by historians, they include the controversy of the mid 1660s between self-identified "Helmontian" healers and members of the College of Physicians; the blood transfusion experiments performed by the Oxford group there and at the Royal Society, which I consider next; and the movement away from the blood and toward the brain by Willis and his colleagues, which follows in the next chapter. Linkages between these areas include overlapping chronologies and personnel. Consideration of the element phosphorus by the Royal Society in the 1670s and 1680s, although it falls outside the chronological limits of this chapter, suggests continuing interest in blood chemistry by a cross-section of eminent natural philosophers while also illustrating their concern about the public handling of potentially transforming substances. Helmontians Seek and Fail to Gain Official Place Seeking to gain status for "chimical medicine" as a separate institution, a number of Restoration notables as well as Court hangers-on petitioned the Court for a royal charter for a Society of Chimical Physicians in 1665. Initially promoted in a pamphlet by Thomas O'Dowde, a groom of the royal bed chamber and sometime empiric healer, the petition gained the signatures of Gilbert Sheldon, then Archbishop of Canterbury, his then ally Henry Hyde (the Earl of Clarendon and Lord High Chancellor), and the Presbyterian ally, amateur chemist and confidant of Charles II, George Villiers (the Duke of Buckingham), among other notables. George Thomson (1620-1679), a Leiden-trained physician who published a

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number of medical texts, was the most prominent of the physician sponsors. As Harold Cook has noted, "Aside from an interest in chemistry, members of the group appear to have lacked much in common."67 Although their petition attracted impressive initial support, the Society of Chimical Physicians never received official approval from either the Court or Parliament. Why did the petition fail? Writing from the viewpoint of medical institutions, particularly the College of Physicians, Harold Cook has assigned the failure to a falling-away of influential backers from O'Dowde, who was portrayed as a "quack" by his opponents. In examining the same controversy, Piyo Rattansi has emphasized the role of the chemical physicians as a stalking horse for the apothecaries' long-standing efforts to gain power relative to the College. Both Cook and Rattansi also note the disruptive effect of a plague epidemic, which took some 100,000 lives in London in 1665-1666, including those of several leading promoters of the chemical cause.68 Rattansi maintains that the chemical physicians failed to gain institutional status not only because their promoters could not sustain patronage by the powerful but also because the apothecaries had gained sufficient public status through their service during the plague that they no longer needed the alliance. "The larger battle, in which the Helmontians had acted for a time as third party, was now joined again."69 By 1700, it is true that the apothecaries had gained considerable latitude from their former overseers, the College of Physicians. Other factors may have mattered as much or more than O'Dowde's decline in esteem and the London plague. It is one thing to note, as Rattansi does, that chemical therapies were already in the College formulary. They had been as well in the College formulary of 1619. However, a reading of Helmontian texts from the 1650s and 1660s reveals deeper levels of therapeutic and theoretical difference between the Helmontians and their more traditionally educated brethren. Although it is not clear that these differences were crucial in the failure of the Society to gain official stature, they do suggest why Helmontianism stopped being an intellectual force in learned English medicine within a few years of the Society's setback.

Experimenting with the Blood: Injections and Transfusions English work on embryology and chemistry in the experimental clubs of the 1640s and 1650s had been highly descriptive and theoretical. Although it provided new interpretative frameworks for understanding bodily processes in health and disease, it did not promise rapid change in practice. One other development that had its beginnings in Protectorate Oxford did, however. Originally conceived to investigate the action of poison, specifically snake venom in the body, the animal injection experiments undertaken during the mid 1650s by Wilkins, Wren, Boyle, Willis, Bathurst, and others provided another level of support for the concept of blood as an organ, a thing-in-itself. As early as the summer of 1656 Wren wrote


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to William Petty, then in Dublin, that, "I injected wine and ale into the mass of blood in a living dog by a vein in good quantity till I made him drunk but soon after he pissed it out. . . ."70 In the same epistle Wren also related that he had injected a powerful emetic into a dog's vein. Wren and his colleagues expressed optimism that their drug injection experiments would have therapeutic implications early on. In the same letter to Petty he continued, "It will be too long to tell you the Effects of Opium, Scammony & other thing that I have tried this way: I am now in further pursuit of the Experiment, which I take to be of great concernment, and what will give great light both to the Theory and Practice of Physick."71 As an investigational technique to supplement anatomical explorations, injections of colored dyes soon became central in the kinds of vascular mapping experiments that Willis and Lower made use of in Willis's Cerebri Anatome (1664) and Lower's Tractatus de Corde (1669). With the eager support of Wilkins, Boyle, and Lower in 1665, injection soon became transfusion.72 In contrast to the injection experiments, which had been mainly private, however, transfusion demonstrations and experiments had a markedly public character. This was true not only in England, but on the Continent as well. During transfusion's brief heyday in France, Italy, Germany, and England during 1666 to 1668, numerous public and fewer private transfusions of blood took place between large animals and animals to humans.73 In England, Lower and the surgeon Edmund King, who later collaborated with Willis on brain dissections, performed the first English transfusion between an animal—a sheep— and a human—Oxford undergraduate student Arthur Coga—before the Royal Society in Boyle's Arundel House in London on November 23, 1667.74 All transfusion work in Europe came to a halt, however, with the deaths of two human transfusees in France in 1668. Because so few transfusion experiments were performed, it is difficult to hazard more than speculation concerning their social meaning to contemporaries. Nonetheless, some contemporary comments suggest that bystanders may have paid particular attention to a transformational potential in transfusion. At least to some observers, a successful transfusion seemed to offer the prospect of an improved personality. As diarist Samuel Pepys recorded after hearing from physician William Croone of a dog-to-dog transfusion performed at Gresham College, London, on November 14, 1666: "This did give occasion to many pretty wishes, as of the blood of a Quaker to be let into an Archbishop, and such like."75 Bystanders to the transfusion of sheep's blood into the aforementioned Coga, whom Wilkins described to Pepys prior to the transfusion as "a Little frantic" and "a kind of minister" and "a poor and debauched man," observed that the addition of twelve ounces of sheep's blood to Coga had a good effect. Coga himself said he felt "much better since," and Pepys noted that Coga, who gave his account in Latin, "speaks very reasonably, and very well," even though Pepys thought Coga "cracked a little in his head." Willis did not participate in the transfusion work.

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Phosphorus With its cool light, elemental phosphorus, which was brought to the Royal Society in the late 1670s, was immediately valued as a substance with physiological significance. If the more cautious natural philosophers, such as Boyle, shied away from "conjectures" about its philosophical meaning, others, such as Frederick Slare, thought they had found in phosphorus Willis's veritable vital flame. Describing Boyle's recovery of elemental phosphorus from human urine, Slare wrote in 1681, "The learned Willis (were he alive) would rejoyce to see such a Product out of our Bodies . . . that did kindle and impregnate our blood."76 Even John Evelyn, (1620-1706) founding member of the Royal Society who was known for being chary of enthusiastic discourse, got a bit carried away, at least in his diary entry of December 13, 1685: "It [phosphorus] seemed to exhibit a theory of the education of light out of the chaos, and the fixing or gathering of the universal light into luminous bodies. This matter, or phosphorus, was made out of human blood and urine, elucidating the vital flame, or heat, in animal bodies. A very noble experiment."77 Although the spectacle of cool light from elemental phosphorus caused Evelyn and others to express rapture, it also made them anxious about popular interpretations of a process that seemed miraculous. They thought display and discussion of phosphorus must be carefully controlled for two reasons. First, public display of such an arresting visual phenomenon without adequate philosophical discussion might mislead the audience into conflating natural philosophers with showmen or magicians or, what would be worse, into mistaking magicians for philosophers. How could the audience tell the difference? Second, casual display of such a bedazzling substance carried a moral danger: Audiences might respond only at the level of the senses and fail to develop their reasoning. In view of the Helmontians' reputation for the handling of their arcana, it is significant to note that Boyle left his receipt (formula) for the preparation of phosphorus in a sealed note to the Royal Society, whose secretary published it in the Philosophical Transactions after Boyle's death.78 For the Oxford physiologists and their supporters, it was clear by the early 1660s that their model of matter and spirit in the vital soul of the blood and heart, while influential internationally, was not sufficient to secure their theoretical and professional hegemony at home. One might think that the return of the monarchy and re-establishment of a state church settled the issue of "enthusiasm" in all its manifestations, but as the above anecdotes suggest, mere restoration of old institutions did not in itself guarantee that unbridled enthusiasm was not capable of a phoenixlike rebirth. As we shall see in subsequent chapters, Restoration establishment leaders in the 1660s felt they needed to take additional measures in many areas of English national life; veterans with long memories of the English Civil War, they were all too aware of the consequences if they took too few.


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Notes 1. William Harvey. "Epistle Dedicatory," in Anatomical Studies on the Motion of the Heart and Blood, trans. Chaunccy Leake (Baltimore: Charles Thomas, 1941), p. 3. 2. William Harvey. Anatomical Exercises Concerning the Generation of Living Creatures. (London: James Young, 1653), p. 458. Jerome Bylebyl argues that Harvey believed the blood, not the heart, was primary in the body as early as his anatomy lectures of 1618. See Jerome Bylebyl. "The Medical Side of Harvey's Discovery" in William Harvey and His Age. (Baltimore: Johns Hopkins University Press, 1979). 3. Harvey. Anatomical Exercises Concerning the Generation of Living Creatures, 281. Wellcome 26836/B/l. 4. The Hill-Whitteridge debate appeared originally in the journal Past and Present. Charles Webster later published it in his edited collection, The Intellectual Revolution of the Seventeenth Century. (London: Routledge, 1974), pp. 160-96. 5. Thomas Hobbes. Leviathan. (New York: Everyman's Library Alfred A. Knopf, Random House, 1991, p. 337. 6. George Thomson. The True Way of Preserving the Bloud. (London: N. Crouch, 1670), pp. 31-2. 7. Anne Conway. The Principles of the Most Ancient and Modern Philosophy (1692), ed. Peter Loptson (the Hague: Martinus Nijhoff, 1982), p. 218. See also Anne Conway The Conway Letters, ed. Marjorie Hope Nicholson, rev. Sarah Hutton (Oxford: Clarendon Press, 1992), pp. 378-87. 8. Thomas S. Kuhn. The Structure of Scientific Revolutions. 2nd ed. (Chicago: University of Chicago Press, 1970), chapter 2. 9. For the most recent general discussion of "enthusiasm," see Michael Heyd. "Be Sober and Reasonable:" The Critique of Enthusiasm in the Seventeenth and Early Eighteenth Centuries. (Leiden: EJ Brill, 1995). 10. Michael MacDonald. Mystical Bedlam. (Cambridge: Cambridge University Press, 1981). 11. Heyd. "Be Sober and Reasonable." Since the 1960s historians have argued about the existence and extent of a "general crisis" of the seventeenth century. For an introduction to recent scholarship on the subject, see The General Crisis of the Seventeenth Century, 2nd ed., eds. Geoffrey Parker and Lesley Smith (London: Routledge, 1997) 12. For a discussion of the historiography of popular culture, see "Preface," in Carlo Ginsburg. The Cheese and the Worms, trans. John and Anne Tedeschi (Harmondsworth: Penguin, 1982). 13. Andrew Wear. Knowledge and Practice in English Medicine, 1550-1680. (Cambridge: Cambridge University Press, 2000). 14. John Wallis. "Dr. Walk's's Account of Some Passages of His Own Life," in Peter Langtoft's Chronicle. 2 vol., ed. Thomas Hearne (Oxford, 1725). See also Robert G. Frank, Jr. Harvey and the Oxford Physiologists. (Berkeley: University of California Press, 1980). See also Barbara Shapiro. John Wilkins (1614-1672). (Berkeley: Uni versity of California Press, 1969). 15. Walter Pagel. "The Prime Matter of Paracelsus." Ambix 9, no. 3 (1961): 118-35, especially 127. 16. Ibid., 126. See also Allen Debus. "The Paracelsian Compromise in Elizabethan England." Ambix 8, no. 2 (I960): 71-94. 17. Nicholas Culpeper translated a version of Sennert's medical chemistry in the 1650s. On Sennert, see Donald G. Bates. "Thomas Willis and the Fevers Literature of the

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18. 19. 20.

21.

22. 23. 24.

25. 26.

27.

28.

29. 30. 31. 32. 33. 34.

THE BRAIN TAKES SHAPE Seventeenth Century." Medical History, supplement no. 1 (1981): 45-70. See also Allen Debus. The Chemical Philosophy. (New York: Science History Publications, 1977), vol. 1, pp. 191-293. Pagel. "Prime Matter of Paracelsus." Ambix 9 No. 3 (1961): 118-35. Ibid., 124-5. Ibid., 119. For a recent analysis of John, death, and the transformation of spirit and matter, see Henry Staten. "How the Spirit (Almost) Became Flesh: Gospel of John." representations 41 (1993): 34-57. In comparison to some Platonic texts, the Timaeus was well-known in Europe from the fourteenth century onward. The text mentions seed in two places. In the first, section 86 b-d, Plato ascribes bodily disease to disorders of the soul, "which depend on the body." If a man is in "great joy or in great pain . . . he is mad and is at the time utterly incapable of any participation in reason. He who has the seed about the spinal marrow too plentiful an overflowing . . . is for the most part of his life deranged...." In section 91 b, Plato identifies seed as a fluid generated in the "marrow" that causes "lust" and whose regular discharge in men and women prevent "all variety of diseases." Plato. Collected Dialogues, eds. Edith Hamilton and Huntington Cairns (Princeton: Bollingen, 1961). Conway. The Conway Letters, 317-20. Conway. The Conway Letters. William Clowes. A Right Frutefull and Approved Treatise for the Artificiall Cure of That Malady Called in Latin Struma. (London, 1602), "Epistle to the Reader." Cited by Debus, The Chemical Philosophy, 178. Ibid., 190. Nicholas Culpeper. A New Method of Physick, or a Short View of Paracelsus and Galen's Practice in Three Treatises by Simeon Partilicius (Simon Partliz). (London, 1650). Francis Bacon. Historia Vitae et Mortis and Novum Organanon in Works, 7 vols., eds. J. Spedding, R. L. Ellis, and D. D. Heath (London, 1857-1861), chapter 4, section c; and chapter 5, section b. Cited by Graham Rees and Christopher Upton, trans., in "Francis Bacon's Natural Philosophy: A New Source." British Society for the History of Science, 1984. Graham Rees. "The Fate of Bacon's Cosmology in the Seventeenth Century." Ambix 24 (1977): 27-38, especially p. 29. For more on Bacon's influence on seventeenthcentury thought, see Charles Webster. The Great Instauration. (London: Duckworth, 1975). See also Michael Hunter. Science and Society in Restoration England. (Cambridge: Cambridge University Press, 1981), chapters 1, 2 and 4. For more on Bacon's cosmology, see Graham Rees. "Francis Bacon's Semi-Paracelsian Cosmology and the 'Great Instauration.'" Ambix 22 (1975): 161-73. See also Graham Rees. "Matter Theory: A Unifying Factor in Bacon's Natural Philosophy?" Ambix 24 (1977): 11025. See also Graham Rees. "Francis Bacon's Semi-Paracelsian Cosmology." Ambix 22 (1975): 81-101. Thomas Willis. Oxford Lectures, ed. Kenneth Dewhurst (Oxford: Sandford, 1980), p. 53. See also Rees and Upton. "Francis Bacon's Natural Philosophy," p. 28. Rees and Upton. "Francis Bacon's Natural Philosophy," pp. 131-9. Ibid., 151. Ibid., 171. Ibid., 169. Ibid., 36.


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35. For Bacon's general conception of learning, see Francis Bacon. The Advancement of Learning, ed. G.W. Kitchin (London: Everyman's Library, 1973). For Bacon's philosophical Utopia, see Francis Bacon. The New Atlantis, ed. G. C. Moore (Cambridge: Cambridge University Press, 1900). 36. Walter Pagel. Paracelsus. (Basel: Karger, 1982), p. 2. 37. J.B. van Helmont. Oriatrike. trans. John Chandler (London, 1662), p. 183. 38. For a discussion of the background of Sharrock and Boyle's work and their attitude toward van Helmont, see Charles Webster. "Water as the Ultimate Principle of Nature: The Background to Boyle's Sceptical Chymist." Ambix 13 no. 2 (1966): 96-107. 39. van Helmont. Oriatrike, 690-3. See also Charles Webster. "Water as the Ultimate Principle of Nature." Ambix 13 no. 2 (1966): 98-9. 40. Charles Webster. "Water as the Ultimate Principle of Nature." Ambix 13 no. 2 (1966): 100. On van Helmont's philosophical and religious claims, see Walter Pagel. "The Religious and Philosophical Aspects of van Helmont's Science and Medicine." Supplement, Bulletin of the History of Medicine no. 2 (1944). 41. Walter Pagel. "Van Helmont's Concept of Disease—To Be or Not to Be? The Influence of Paracelsus." Bulletin of the History of Medicine 46 no. 5 (1972): 419-54. 42. Descartes indicated his acceptance of Harvey's work on circulation as early as 1631. Descartes to Mersenne, November or December 1932. Cited by Everett Medelsohn. "The Changing Nature of Physiological Explanation in the Seventeenth Century," in Melanges Alexander Koyre. vol. 1 (Paris: Herman, 1964), p. 375. 43. J. R. Jacob and M. C. Jacob. "The Anglican Origins of Modern Science: The Metaphysical Foundations of the Whig Constitution." his 71 (1980): 251-67. 44. Ibid., 257. 45. Theodore Brown has argued, in contrast, that Descartes was a major influence on English physiology in the seventeenth century. However, he does indicate that acceptance of Cartesian physiology as more pronounced in Interregnum London than in Oxford. See Theodore Brown. "Physiology and the Mechanical Philosophy in Mid-SeventeenthCentury England." Bulletin of the History of Medicine 51 (1977): 25-54. 46. Rene Descartes. "Discourse on Method" in The Philosophical Works of Descartes. trans. E. Haldane and G. Ross. vol. 1 (Cambridge: Cambridge University Press, 1931), pp. 110-2. 47. Robert Boyle. "Some Considerations Touching the Usefulness of Experimental Naturall Philosophy." pt. 2 (Oxford, 1663), pp. 14-8. Robert Frank indicates this section was written in 1656-57. See Frank. Harvey and the Oxford Physiologists, 140, n. 2. 48. Richard Lower. Tractatus de Corde. (London, 1669), pp. 20-36. See also Frank. Harvey and the Oxford Physiologists, 210-3. 49. Lower. Tractatus de Corde, 65-8. 50. Harvey. Anatomical Exercises Concerning the Generation of Living Creatures, 468-9. 51. William Harvey. The Anatomical Lectures of William Harvey, ed. and trans. Gweneth Whitteridge (London: Livingstone, 1964), p. 87r. Cited by Bylebyl. William Harvey and His Age, 66, n. 186. 52. According to Audrey Davis, Phillip Hecquet in La Medicine naturell of 1737 praised the fermentation/fever theory as being the first medical theory to take into account the circulation of the blood. See Audrey B. Davis. Circulation Physiology and Medical Chemistry in England, 1650-1680. (Lawrence, Kans.: Coronado Press, 1973), pp. 250-1. Willis's Diatribe was published in Latin in three later editions in London (1660, 1662, 1677), two in Amsterdam (1663, 1669), two in Geneva (1676, 1694), and in Dutch in 1676.

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53. Thomas Willis. Diatribe. "On Fermentation," in Dr. Willis's Practice ofPhysick, Being the Whole Works of that Renowned and Famous Physician, trans. Samuel Pordage. (London: T. Dring, C. Harper, and J. Leigh, 1683), p. 2. 54. Ibid., 11-2. 55. Ibid., 9. 56. Ibid., 12. 57. Ibid., 48. 58. Ibid. Also, on Willis's use of distillation in assessment of a patient's condition in 1650/ 51, see Thomas Willis. Casebook 1650-1651. ed. Kenneth Dewhurst (Oxford: Sandford, 1980), p. 52. 59. Willis. Diatribe. "Of Fevers," p. 48. See also Davis. Circulation Physiology, 84-7. 60. Willis. Diatribe. "Of Fevers," p. 48. See also Davis. Circulation Physiology, 154-8. 61. Bates. "Thomas Willis and the Fevers Literature of the Seventeenth Century." Medical History, supplement no. 1 (1981): 50-1. 62. Anthony A. Wood. Athene Oxonienses. (London, 1817). Facsimile reprint (Johnson Reprint Corp.: New York, 1967), p. 1051. 63. John Wallis. "Account of Some Passages of His Own Life," written in 1696 and printed in Thomas Hearne. Works. (Oxford, 1725), 1, clxii-clxiii. Cited in Shapiro. Wilkins, 25. 64. Heyd. "Be Sober and Reasonable." 65. The Philosophical Transactions, or an Account of the Ingenious and Accompt, with Henry Oldenburg as its editor and reviewer, commenced publication in 1665; the Royal Society received its first charter in 1663. 66. J. Andrew Mendelsohn. "Alchemy Politics in England 1649-1655." Past and Present 135 (May 1992): 31-78, especially p. 31, n. 9 and p. 72. 67. Harold Cook. "The Society of Chemical Physicians, the New Philosophy, and the Restoration Court." Bulletin of the History of Medicine 61 (1987): 61-77, especially p. 71. 68. Stephen Porter. The Great Plague. (Gloucestershire: Thrupp Stroud, 1999). 69. P. M. Rattansi. "The Helmontian-Galenist Controversy in Restoration England." Ambix 12 no. 1 (1964): 1-23, especially p. 23. 70. Christopher Wren. Parentalia. (London, 1750), p. 228. See also Frank. Harvey and the Oxford Physiologists, 171-8. 71. Ibid. 72. Robert Boyle. Works, VI, p. 480, in Frank. Harvey and the Oxford Physiologists, 176, n. 82. See also Davis. Circulation Physiology, 173-205. See also N.S.R. Maluf. "History of Blood Transfusion." Journal of the History of Medicine 19 (1954): 59-107. 73. Richard Lower. "De Transfusione Sanguinis ex Animali Alio in Aliud: Quo Tempore et qua Occasione ab Authore Inventa sit," in Tractatus de corde. (London, 1669). See also Wren. Parentalia, 228, 233-7. 74. Regarding the sheep/Coga experiment, see Philosophical Transactions 30 (1667): 557. 75. Samuel Pepys. Diary (1633-1703). (London, 1825), Nov. 14, 1666. 76. J. V. Golinski, "A Noble Spectacle: Phosphorus and the Public Cultures of Science in the Early Royal Society." Ms 80 (1989): 11-39, especially p. 23. 77. The Diary of John Evelyn, ed. E. S. de Beer (London: Oxford University Press, 1959), pp. 835-6. Cited by Golinski. "A Noble Spectacle." Isis 80 (1989): 23, n. 42. 78. "A Paper of the Honourable Robert Boyle's . .. Being an Account of His Making the Phosphorus." Philosophical Transactions 17 (196) (1693): 583-4. Cited by Golinski. "A Noble Spectacle." Ms 80 (1989): 19, n. 27.

3 THE HUMAN MIND AND "GLAND H": CARTESIAN MODELS OF MIND, BRAIN, AND NERVES

Descartes and other educated people in the 1500s and early 1600s who wanted to learn about the brain would have encountered two different types of images depending on whether an early modern author approached the body primarily from a philosophical or a medical point of view. Brain illustrations from books emphasizing natural philosophy usually showed a line drawing of a man's head in profile with three more or less circular areas in its upper half. The illustration from Gregor Reisch's (1467-1525) popular Margarita Philosophica (Pearl of Philosophy} of 1503 is typical (Fig. 3.1). At first glance such images may look silly to modern eyes, but they seem less strange when one recalls that humoral physiology was about fluids, some of them ethereal, and their interactions with their containers, not about the agency of the body's solid tissues. Such accounts were widely available in natural philosophy as taught in the schools and universities. Following a venerable tradition established by early Church fathers such as Nemesius (fl 390 C.E.)1 and continued by Muslim physicians such as Avicenna (980-1037 C.E.), natural philosophers usually assigned external sensory functions to the anterior chamber, imagination and rationality to the middle, and memory to the posterior.2 The phrase "common sense," the literal translation of the typical sensis communis of the anterior ventricle, was not understood in the modern sense of a down-to-earth cognitive style, but instead as the place where inputs from the five external senses mingled and affected the animal spirits. Galen articulated the 47

FIGURE 3.1 This illustration from Gregor Reisch's (1467-1525) Margarita Philosophica (Pearl of Philosophy) of 1503 represents typical medieval and Renaissance conceptions of human brain structure and mental operation. Ventricular spaces, not cortical tissues, are emphasized, with common sense occurring in the anterior ventricle, rational thought in the middle, and memory in the posterior. Image courtesy of Clendening Library of the History of Medicine, University of Kansas.

THE HUMAN MIND AND "GLAND H"

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three-cell model originally, but he did not localize functions as precisely as his Christian and Persian successors. Illustrations like Riesch's, which other publishers copied in many iterations up to the late 1700s, usually placed little visual emphasis on cortical tissues, which were shown as small undifferentiated masses on a skull's inner margin, and instead favored the cavities. Vesalius's anatomy of the brain in his Fabrica exemplified the predominant medical approach. A decapitated head partially opened at the top would be illustrated with the outer layer of the brain visible (Fig. 3.2). Although in many respects Vesalius, like other anatomists, followed Galen's anatomic method of vertical mid-line brain cuts as outlined in the latter's Anatomical Procedures, he amended the master in two ways. First, as noted earlier, Vesalius made a point of

FIGURE 3.2 This illustration from Book VII of Vesalius's Fabrica (1543) demonstrates the predominant method of dissecting brains prior to Varolio and Willis's innovations that demonstrated the brain as a separate object completely out of the skull. Image courtesy of the Clendening Library of the History of Medicine, University of Kansas.

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dissecting human brains, not those of oxen, which Galen had relied on. Indeed, Vesalius scoffed at the value of comparative anatomy, which had been a mainstay of Aristotlelian natural philosophy of the body.3 Second, Vesalius began making horizontal slices through the skull with its brain in situ. (Galen removed the upper part of the skull, too, but he advised vertical cuts through the superior or inferior sagittal sinus ("that large vein extended there lengthwise").4 Vesalius's horizontal cuts exposed the ventricles at the appropriate levels, but in comparison to three-cell brain models, Vesalian imagery gave more space to solid tissues at all brain levels. Also, Vesalius took care to describe and illustrate various solid structures, such as the cerebellum. Leonardo da Vinci (1452-1518/19) dissected human corpses in secret. Although drawings in his unpublished notebooks, such as illustrations from 1504, depicted brains removed from their skulls, they were ox brains, not human brains, da Vinci was the first to experiment with injecting wax into the cerebral ventricles, but his influence on subsequent anatomic technique remains unclear.5 It is not known, for example, whether he had any influence on Vesalius, who showed pieces of the brain, such as the cerebellum, in separate illustrations in the Fabrica (Fig. 3.3). Costanzo Varolio (1543-1575), a successor to Vesalius's anatomy chair on the medical faculty in Padua, is credited with originating a different method of brain dissection that continues as the main technique today, at least in medical school curricula. Instead of starting his dissection from the top of the head down, Varolio advanced straightforward reasons for beginning from the brain's base: You are aware of the usual manner of dissecting the head—that used by the ancients as well as the moderns—which begins with the upper part. First, the upper part of the calvarium is cut off and removed. . . . I, considering most organs of the brain to be near the base of the head, and the brain by its weight, especially in the dead, to compress them between itself and the calvarium, judged this usual method of dissection to cause many difficulties; therefore I usually begin .. . from the base of the brain. If one proceeds in this way, each of its organs may be observed as completely as desirable, but as this method of dissection is unusual so also it is very difficult.6

Varolio published his innovation in his book of 1573 on the optic nerve, which, with the other cranial nerves, were his central interest. He wanted readers to know that his new technique made the brain and the upper portion of the "spinal marrow" (brain stem nowadays) not appear "continuous," as it did with traditional techniques, but instead as "contiguous" elements. In doing so, he declared that the origin of the optic nerve could be "properly seen."7 Varolio's representational tactics, especially his arrangement of brain parts to highlight the origin of the optic nerve, provide an early example of how anatomists manipulated their bodies so as to portray likeness in their own terms. As we shall see, Descartes and his followers made selected use of each of these traditional approaches to the brain and nerves as they advanced their own physiology of mind and normal human behavior. And, just as Cartesians and Oxford

FIGURE 3.3 Vesalius was the first in print culture to show pieces of the brain, such as the cerebellum, as separate tissues. Book VII, Fabrica (1543). Image courtesy of Clendening Library of the History of Medicine, University of Kansas.

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physiologists debated the physiology of the blood and heart, so too they argued over the brain, nerves, and mind. In terms of their influence on modern neurophysiology, the details of Cartesian physiology, like those of its Oxford counterparts, are long gone. Some of Descartes's themes about the relationship of mind and body, however, continue to resonate in contemporary cognitive science.8 Indeed, perhaps because Descartes is one of the few major Western philosophers after Plato and Aristotle to take the body, health, and medicine seriously as philosophical subjects, his ideas on mind and body have exerted considerable influence on Western philosophy, especially epistemology, since the mid seventeenth century.9 Present-day philosophers of mind, for example, still wrestle with Cartesian accounts of human memory in terms of their validity for contemporary cognitive science.10

Chronological Issues The chronology of Descartes's natural philosophy of mind and body is important but a bit tricky. Descartes was alive when he and his followers criticized Harvey about his physiology of the blood and heart, and Harvey was able to respond.11 However, Descartes, who died in 1650, was not alive when Willis published Cerebri Anatome in 1664, although many of his followers were active. Also, although Descartes wrote his major treatise on the human body, De Nomine, known subsequently in English as The Treatise on Man, during 1632-1633, he chose not to publish it in his lifetime. Instead, his followers arranged publication in Latin in 1662 and in French (as L'homme) in 1664. During his life, however, Descartes published two abbreviated versions of his natural philosophy of the human body. The earlier, written during 1638-1640, first appeared in Latin in fragments in several of six Meditationes de Prima Philosophiae (Meditations on First Philosophy) in 1641 and was soon followed by another Latin edition in 1642, in which Descartes made minor changes from the first edition, and an authorized French edition of 1647. Before publication of any edition of the Meditations, Descartes circulated drafts of his meditations among a few supporters and critics, notably Thomas Hobbes and Pierre Gassendi, and the book's first edition took the form of Descartes's six meditations followed by six sets of objections together with Descartes's replies to the objections, a format that mimicked scholastic Aristotelian debate. Descartes also repeated many of his De Homine arguments in an unfinished and unpublished manuscript of 1647-1648, Description of the Human Body. Stimulated by his correspondence during the 1640s with Princess Elizabeth of Bohemia (1618-1680), a niece of Charles I of England, Descartes's final published work, Les Passions de I'Ame (Passions of the Soul, henceforth Passions), which first appeared in 1649, contained summary versions of the brain, nerves, and animal spirits as outlined in the manuscripts on the body of the early 1630s. However, it went much further than Descartes's earlier works in its expo-


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sition of his philosophy of relations between soul, body, animal spirits, passions, and reason. The tortuous path of Descartes's publications on the body meant that his later work appeared in print decades after he wrote early manuscripts whose publication he suppressed during his lifetime. Willis and his colleagues seldom specified which version of Descartes they were disputing, however. Indeed, as I noted earlier, in formulating their theory of matter, which was a major research topic for them during the 1650s, Willis and his followers often lumped Descartes with his French contemporary, Pierre Gassendi, whose natural philosophy differed profoundly from Descartes in important respects. The publishing chronology sketched above supports the speculation that the Oxford group first learned Descartes's views on mind, nerve, brain, and body primarily from his Meditations and Passions, not De Homine or L'homme. Regardless of how and precisely what Willis and his Oxford group knew of Cartesian natural philosophy of the body, they expended great efforts in their attempt to demolish it, both of the blood and heart and the brain and nerves from the 1650s on through the 1670s. Perhaps as a consequence, their own views were partly shaped in opposition to Cartesian models. Moreover, the issues at stake between them—primarily the agency of spirit, the relationship of mind and body, and the cogency of solid flesh and its exploration—resonated well beyond the anatomic into many aspects of their respective natural philosophies. And the Oxford critique was hardly the first the French philosopher experienced; during his lifetime, Descartes, who deliberately provoked debate,12 received extensive criticism on theological and philosophical grounds. Although from a Cartesian perspective notions of a dialectic with Oxford are not tenable chronologically, Descartes's successors in the late seventeenth century revised their arguments in light of Oxford neurology. As Descartes came first chronologically, I devote this chapter to selected aspects of his thought on brain and mind and the next chapter to that of Willis and his English collaborators. Today Descartes belongs mostly to the history of philosophy, not the history of science and/or medicine. This categorization probably would have puzzled if not surprised him. Early and late in his career and at a few points in between, Descartes characterized his intellectual goals, not to mention the philosophical enterprise itself, as profoundly concerned with medicine and health. In his mid-career Discourse on Method of 1634-1636 (first published in French in 1637), Descartes averred "to devote the rest of my life to nothing other than trying to acquire some knowledge of nature from which we may derive rules in medicine which are more reliable than those we have had up till now."13 In Principles of Philosophy, which he undertook as a comprehensive textbook of his philosophy during the early 1640s and published in an unfinished form in 1643, Descartes characterized philosophy as follows: "Philosophy as a whole is like a tree; of which the roots are metaphysics, the trunk is Physics, and the branches emerging from the trunk are all the other

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branches of knowledge. These branches can be reduced to three principal ones, namely, Medicine, Mechanics, and Ethics (by which I mean the highest and most perfect Ethics, which presupposes a complete knowledge of the other branches of knowledge and is the final stage of Wisdom)."14 Writing to the Marquis (later Duke) of Newcastle in 1645, Descartes affirmed, perhaps for heightened rhetorical effect, that "the conservation of health has been at all times the principal end of my studies."15 According to Adrien Baillet, his late-seventeenth-century biographer,16 Descartes became interested in medicine shortly after moving to the Netherlands in late 1628. Earlier, while in Paris, his main interests had been in geometry, optics, and a general theory of method, which he then characterized in terms of mathematics. Visiting butchers' shops in Amsterdam to gain animal parts for dissections he performed in his rooms, Descartes in the late 1620s and early 1630s might be assumed to be just another amateur anatomist. In terms of his self-presentation, he was, at least some of the time. In a letter to his close friend Mersenne from 1639, for example, he described his previous decade of dissecting as having "taken into consideration not only what Vesalius and the others write about anatomy, but also many details unmentioned by them, which I have observed myself while dissecting various animals."17 As in other areas of his natural philosophy, Descartes positioned himself in anatomy as a "modern" by aligning himself with Vesalius, who was still the predominant contemporary anatomic authority in the early 1600s. It would be an error, however, to read too much into Descartes's private comments concerning the importance of knowledge of anatomic detail. In contrast, comments he intended originally for publication expressed offhand regard for anatomic work. At the beginning of his Treatise on Man (written in 1632, first published in 1662 as De Nomine), his main text on the human body, Descartes let readers know he was not writing a comprehensive treatise and certainly not an anatomy text: "I shall not pause to describe to you the bones, nerves, muscles, veins, arteries, stomach, liver, spleen, heart, brain, not all the other different parts . . . for I am assuming . . . that you can get some learned anatomist to show them to you . . . ,"18 Later, in the preface to his Description of the Human Body, written during 16471648, he downgraded the epistemological importance of anatomic knowledge emphatically: "And everyone has, at one time or another, seen various animals opened up, and gazed on the shape and arrangement of their interior parts, which are very much like our own. One need have studied no more anatomy than this to understand this book, for I shall explain any further details as the need arises."19 As the Oxford physiologists discerned during the 1650s as they contemplated Descartes's view of the heart and circulation, Cartesian anatomy and physiology were not primarily about ocular demonstrations, which was a common early modern trope for experimental activity, including anatomy. Instead of using a rhetorical style that proceeded from anatomic "facts" to theory, which was the


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textual tradition from Herophilus onward through Galen, Vesalius, and the Oxford physiologists, Descartes in De Homine seemed more intent on inscribing the themes of natural philosophy onto the bodies he described. It was, as I will argue shortly, as though abstract philosophical principles were shaping the body, not the other way around. Each step of Descartes's intellectual journey from his early interest in hydrostatics and the mathematics of falling bodies in the 1610s to formulation of general rules during the early 1620s to light and optics in the late 1620s and early 1630s found expression in his model of the brain and nerves as detailed in his Treatise on Man. As he anatomized in Amsterdam during 16291632, Descartes also ground hyperbolic lenses and wrote treatises on optics (first published as Dioptrique in 1637) and the physics of light (the unfinished Treatise on Light of 1632, first published as part of Le Monde in 1664). However, in the 1630s, Descartes was pushing against a strong epistemological current, which was the search for likeness noted in Chapter 1. Part of his genius lay, I think, in his ability to recognize that trend and adapt to it. Indeed, as I will argue shortly, he deliberately manipulated his words and images of human brains and nerves so as to co-opt the emerging trend for likeness for his own purposes. That his purposes had little to do with presence as described in Chapter 1 only complicates my account. Descartes, after all, made a concerted attempt to read spirit out of nature. But the paradox is that he did so with such rhetorical flourish that some of his contemporary critics disparaged him with the same word they used to disparage fundamentalist religious sectarians, as an enthusiast.2® In the meantime, Descartes took care to construct his public persona along the lines of a "new" natural philosopher. He may never have functioned more as a polymath than during his time in Amsterdam in the late 1620s and early 1630s; nonetheless, intellectually, all his varied activities shared a few common assumptions. Indeed, Descartes's anatomic projects occurred in the broader context of his lifelong commitment to an epistemology that placed the formulations of pure intellect over any sensory knowledge. By "pure intellect" I mean the persistent tendency of Descartes to place the imagining human mind in a transperceptual theoretical space, above the body and largely independent of its sensory inputs. In this he could not be more unlike Aristotelian natural philosophy, which placed high epistemic value on sensory perception. Although recent Cartesian scholars dispute the degree to which Descartes made the physical and material coincide with the natural, no one quibbles that his theory of matter facilitated, even favored, mathematical treatments of nature.21 Descartes changed his mind several times during his career, but even in the late 1620s, when he gave up on mathematics as a "universal method" for understanding nature,22 he tended to argue, sometimes implicitly, that natural bodies, both animate and inanimate, were amenable to exhaustive description in terms of geometry. He was able to do so, some recent philosophers have argued, because he persistently conflated nature with matter. In his unfinished Treatise on Light, written in 1632,

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he commented "by 'Nature' here I do not mean some deity or other sort of imaginary power. Rather, I use the word to signify matter itself. . .. "23 Furthermore, by framing all natural forms and qualities of animate and inanimate bodies solely in terms of the "motion, size, shape, and arrangement of [their] parts,"24 he succeeded in removing substantial forms, such as the soul of classical Greek cosmologies, and qualities from nature.25 By framing nature solely in terms of a few types of homogeneous parts, he also succeeded in deflecting the natural philosophical accounts of all kinds away from the biological, which had been the hallmark of Aristotle's approach, toward the mechanical. Descartes's theology aided his turn to the mechanical. According to Descartes, God injected original motion into the universe, and God's perfection meant that motion was conserved. Then, declining to intervene on an ongoing basis, God stepped back, probably for good. In Descartes's view, God was unchanging and perfect. God "established these laws [of Nature] in such a marvelous way that... the laws of nature are sufficient to cause parts of this chaos to disentangle themselves and arrange themselves in such a good order that they will have the form of a most perfect world. . . . "26 Descartes then argued that God's regularity and perfection meant that processes of the material world could be understood largely by the application of mathematically informed rules. When taken together, Descartes's assumptions that nature consisted solely of bits and arrangements of undifferentiated matter whose motions were sufficiently regular to be amenable to mathematical analyses served well his rhetorical practice of writing about human bodies as "machines" that "resembled humans in almost every way." Although Descartes's animal-machines were fleshy and adaptive, he characterized the most basic process that fueled them—fermentation—solely in terms of a mechanical process, the "ebullition" of extended tiny bits of matter in motion.27 Descartes's tendency to use venerable biological terms, such as fermentation, while eviscerating their traditional content expressed itself throughout his accounts of living bodies. For example, although he used the term spiritus animales (animal spirits, the traditional name for the stuff of brain activity and nerve transmission) in his presentation of brain and nerves in the Treatise on Man at places where his predecessors might have used it in theirs, his natural philosophy left no function for immaterial "spirit." It was an important elision, for it stripped "animal spirits" of vitalist notions explicit in Paracelsus and van Helmont, implicit in Oxford physiology, and even present in Gassendi's refurbishment of Greek atomism. Descartes's manipulations of meaning were subtle; unless one read carefully, I venture that Descartes's preservation of syntactical conventions concerning the phrases "animal spirits" and "vital spirits" made it difficult for early moderns to readily apprehend his ablation of the phrases' traditional meanings. Descartes intended the Treatise on Man as one of three topics of what he conceived as a comprehensive account of the world, the other two consisting of inanimate nature, known as the (unfinished) Treatise on Light, and the "Rational Soul," which


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he did not write.28 The only aspect of the human Descartes exempted from his physics, broadly defined, was the human intellect. Everything else—which, for Descartes included the human brain as well as light itself—could be defined in terms of matter acted on by or acting on particles arranged in various ways and moving in a fluid plenum. Before I proceed further with Descartes's Treatise on Man in its various versions, a cautionary is in order. The fact that Descartes's manuscript was published posthumously by different disciples in different versions in Latin and French means bibliographic precision, in the sense of knowing which parts of the published texts were by Descartes and which by his followers, is occasionally compromised. A minor example is the decision compilers made to divide the work into titled parts and articles. The 1662 Latin De Homine, edited by Florentio Schuyl, contained 36 untitled parts and 58 numbered figures. In comparison, the first French edition, arranged by Claude Clerselier and published as L'homme in 1664, was divided into four major titled parts containing a total of 106 numbered articles and 70 numbered figures. Illustrations in one edition, such as the often-reproduced Figure 64 of a woman in profile of L'homme (Fig. 3.4), are not necessarily in the other. (She is not.) Consequently, one needs to tread cautiously when attempting attributions to Descartes.291 hope to finesse this constraint by using "Descartes" to mean the contributions of the philosopher Descartes as well as those of his posthumous editors, Schuyl and Clerselier, and any unnamed contributors to De Homine and L'homme. Because the illustrations from the French and Latin editions occasionally differ, I will be noting which edition provides each Cartesian illustration used in this chapter. Although lumping Descartes with his followers rides roughshod over Descartes in biographical and bibliographic terms, it reflects the reality that readers from the early 1660s on, including Willis and his Oxford colleagues, knew of Descartes's thought on the human brain and nerves not only from texts Descartes published during his life, but also from those his disciples edited and published after he died. Because my analysis has as much to do with the reception of Cartesian natural philosophy of the body in the mid seventeenth century as it does with the master's own (unfinished) version, I am not as concerned as I would be otherwise about lumping, not splitting. Modern readers cannot know, after all, what version Descartes might have published of De Homine, especially in the turbulent publishing atmosphere 1633, when news of Galileo's condemnation led Descartes to abandon Le Monde in despair.30 De Homine probably would have been mainly about the brain. Only the first ten percent of either the 1662 or 1664 versions was devoted to the rest of the body, and Descartes left no private indication that he intended to change that balance. Reflecting Descartes's commitment to the idea of human intellectual function independent of bodily sensation, he began Le Monde by establishing the independence of images from the objects they were assumed to depict: "For although everyone is commonly convinced that the ideas that we have in our mind are wholly

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FIGURE 3.4 This widely reproduced image from Descartes's Treatise on Man (published as L'homme [1664]), illustrates his belief in the centrality of the pineal gland (the inverted pear shape in the left center of the woman's skull) in human perception and intentional action. The image is not in the first edition, published 1662 as De Homine. Image courtesy of Clendening Library of the History of Medicine, University of Kansas.

similar to the objects from which they proceed, nevertheless I cannot see any reason that assures us that this is so."31 Descartes may have intended his argument mainly as a counter to a tenet of scholastic Aristotelianism that valued sensory knowledge in assuming that the soul received images transmitted from objects that resembled the objects themselves.32 Nonetheless, Descartes's belief in the independence of images from objects informed not only his physiology of brain and nerve function, but also his aesthetics of representation. For example, in part IV of the Dioptrique of 1637, he applied this belief to visual representations, perspective, and reality: "Thus it often


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happens that in order to be more perfect as an image and to represent an object better, an engraving ought not to resemble it."33 Although Fuchs, Vesalius, Willis, and others went to great lengths to persuade readers that the illustrations in their books recorded the reality of the bodies being depicted, Descartes equivocated. At times, as we shall see, he chose images that pushed likeness; at other times, however, he favored schematic drawings and made little pretence that they resembled natural objects. Indeed, he could not pursue physical resemblance as a primary goal and also maintain allegiance to his overriding concern, which was the establishment of the immaterial human intellect as the defining nature of the human condition. As he characterized mental function later in the Meditations, first published in 1640: "It is certain that I am really distinct from my body, and can exist without it."34 Hydrostatics, which had been his main interest in 1619 and thus one of his earliest micromechanical explorations, provided Descartes the metaphorical framework for brain and nerve physiology. Referring probably to the extensive fountains and grottos of the royal gardens at Saint-Germain-en-Lay, where he may have lived for a year in his late teens,35 he compared solid portions of the nerves to "the pipes in the mechanical parts of these fountains." Descartes, like others from Galen on,36 characterized the stuff of actual nerve transmission as "animal spirits," whose agency he compared to the pressured "water" whose flow caused the fountains to operate. The heart provided the source of the water pressure, the "brain's cavities with the apertures," and the pineal gland served as the flow valve. The rest of the body ran "like the movements of a [water] clock or mill, which the normal flow of water can make continuous."37 Although Harvey, not to mention Galen and many other investigative physicians from the early common era onward, used analogical reasoning in explicating bodily operations, they did not go as far as Descartes, who used it almost exclusively. As for the agency and constitution of the animal spirits themselves, Descartes provided a highly abstract account that relied on hydrostatic principles. Based on the then common knowledge that flowing water followed the most direct path, he provided an illustration in L'homme and De Homine that depicted the heart, ascending aorta, and cerebral vessels as being in an almost straight line. Because the "brain's cavities" (cerebral ventricles) were in "the most direct line from the heart" (Fig. 3.5), he argued they received "all the most energetic, strongest, and finest parts of this blood."38 Using the present tense, he then wrote: "the parts of the blood that penetrate as far as the brain, they serve not only to nourish and sustain its substance, but above all to produce there a very fine wind, or rather a very lively and very pure flame, which is called the 'animal spirits.'"39 Animal spirits were generated in the pineal gland, which he described as a "very full-flowing spring" that received the "smallest and most agitated parts" of the blood that suffused the surface of the brain. When describing how these small and agitated parts of blood became animal spirits, Descartes became uncharacteristically

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FIGURE 3.5 Descartes's physiology relied on hydrostatic principles. This illustration from his Treatise on Man (1662, 1664) is meant to demonstrate that the "brain's cavities" are in the "most direct line from the heart" and therefore receive "all the most energetic, strongest, and finest parts of this blood," which the pineal gland turns into animal spirits, the stuff of nerve transmission. Image courtesy of Clendening Library of the History of Medicine, University of Kansas.

vague: "And so, without any preparation or alteration, except being separated from the larger parts and retaining the extreme speed that the heat of the heart has given them, they cease to have the form of blood and are called animal spirits."40 Perhaps Descartes was not familiar with human brains. In the section just cited, he referred to "tapestries" of small vessels at the base of the brain. So too had Galen, who, referring to a now untraceable text by Herophilus, called them an "amazing net" (rete mirabile). This vascular network occupied an important place in Galenic neurophysiology because it was where Galen thought vital spirit began


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changing into animal spirit, a process he thought concluded in the ventricles.41 However, the rete mirabile, although present in large ungulates (Galen used oxen), is not present in human brains. The anatomist Berengario da Carpi (1460-1530) was the first to question the existence of the rete mirabile, writing in 1521 that "I doubt that Galen did otherwise than imagine that a rete mirabile is located there [at the base of the brain]."42 Vesalius, who was emphatic about the importance of using human anatomy specimens to describe the human condition, wrote in the Fabrica that he was "completely astonished" at his former "stupidity and too great trust in the writings of Galen" concerning the existence of rete mirabile. Once Vesalius started doing public dissections of human heads, he decided "the carotid arteries wholly fail to produce such a reticular plexus [rete mirabile] as that described by Galen."43 It would have been handy for Descartes, as it was for Galen, for humans to have rete mirabile as the site of transformation of vital spirits into animal spirits. But Vesalius had taken pains to demonstrate that was not the case. Furthermore, perhaps because he had no viable candidate as a replacement, Vesalius wrote little concerning the production site and process of animal spirits and gave only passing notice to the pineal. Consequently, although Descartes was not burdened with a troublesome precedent that called for rebuttal, he did not have a credible modern medical or philosophical authority, either, for his preoccupation with the pineal. Although Descartes almost always assigned generation of vital spirit to the pineal gland, in one instance he seemed to hedge his bets. At least, he was not ready to give up completely the venerable idea that animal spirits were generated in the ventricles: "I have decided for the present to say nothing about the ventricles other than that they are hollows or cavities in which air, drawn in during inspiration, and vital spirit, transmitted to them by the heart, are altered by the power of the peculiar substance of the brain into animal spirit."44 Descartes's elevation of the pineal gland to a central role in brain and nerve activity was new. Not that previous anatomists had ignored the pineal; perhaps because it is one of the few single midline structures in the brain—but not the only one—and lies (hangs) free on all sides but its stem, the pineal gland was noticed by ancient anatomists, including Herophilus and Erasistratus, but they did not ascribe it a major role. Galen discussed the pineal in several places, and his account in Book IX in Anatomical Procedures, a text well known to Vesalius, who edited a Latin translation of it in 1539,45 and, presumably Descartes, Willis, and others, typified traditional treatment of the pineal in at least two respects. First, Galen usually discussed the pineal as an element of the ventricular system, not as a subject-in-itself. Second, he did not express much interest in its possible function(s): "You will see the third ventricle between the two first and the fourth in the posterior. For you will observe the passages on which the pineal gland rests, extending to the middle ventricle in such a way that two [ducts] of some size appear

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in the opening . . . when the pineal gland has been separated from the surrounding parts and rests intact over the passage, it usually slips down rather than remaining upright as when it was covered with membranes and vessels; usually, too, it slips backwards as it falls."46 What interested Galen in the neighborhood of the pineal was the passage from the third to fourth ventricle and the wormlike structures along its floor. Along with serving as the source of animal spirit, the pineal did other important conceptual work for Descartes. Indeed, in many ways it served as the bodily nexus for his interest in optics and general methods (regulae). As he commented early in Passions in the section entitled, "How we know that this gland [the pineal] is the principal seat of the soul: Apart from this gland, there cannot be any other place in the whole body where the soul directly exercises its functions."47 A survey of the illustrations in De Homine suggests the lengths to which Descartes went to reinforce his verbal commitment to the pineal. The book contains fifty-eight illustrations, some of which are repeats. Suppose one assigns each illustration to one of six themes based on its predominant visual feature. The themes and number of illustrations in each are heart and circulation (two), nerve (six), brain and nerve (eight), eye (sixteen), pineal (fourteen, nine of which also give prominence to the eye), and nerve and behavior (twelve). The themes and assignments are arbitrary to be sure, but the fact that fifty-six of fifty-eight illustrations of a text purporting to be about the human body are devoted to some aspect of brain and nerve suggests the extent to which Descartes reduced the human body to its brain. That more than half the illustrations emphasize the eye and/or pineal (invariably labeled "gland H" in Cartesian illustrations) suggests how greatly Descartes further reduced the brain to its eyes and pineal gland. In the "Sixth Meditation" of his Meditations on First Philosophy, first published in 1641, he acknowledged the pineal's crucial role in pithy terms: "My next observation is that the mind is not immediately affected by all parts of the body, but only by the brain, or perhaps just by one small part of the brain, namely the part which is said to contain the 'common' sense.'"48 According to Descartes in a letter of the same year to Mersenne, "Only the conarion [pineal gland] fits these conditions."49 Often Descartes presented the pineal-eye-light relationship in terms of an external object with straight dotted lines extending from its edges to an eye with its lens, where the lines refracted and entered a curving tube of lines described in the text as the optic nerve. From the curving tube, the lines would converge on the pineal, which was shown suspended in a cavity (Fig. 3.6). (I have described this as a temporal progression because that is how Descartes usually presented it in the text.) In some illustrations the pineal gland was attached to the brain by fine lines, the "nerves." By its motion, the pineal would cause nerves to move. In other illustrations the visual suggestion was of a pendulum, the pineal shown as a small oval at the base of a calla lily-like body connected superiorly to a cerebral "substance" that resembled a horizontal sausage (Fig. 3.6). In pendular schemes, the


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FIGURE 3.6 The pineal gland (H) as a pendulum transmitting stimuli from the optic nerve to the cerebral cortex in Descartes, Treatise on Man (1664). Image courtesy of Clendening Library of the History of Medicine, University of Kansas.

pineal's animal spirits would disproportionately enter clusters of nerves with which it came in close proximity. Descartes's descriptions of brain and nerve structures incorporated his hydrostatic physiology, which is not surprising. Accordingly, the nerves, which he often referred to in De Homine as tubules, were tubes or pipes containing smaller tubes (Fig. 3.7) whose coverings were continuous with the outer two covering layers of the brain (Fig. 3.8). Galen, whom Descartes never cited, also thought the coating of the nerves proceeded from the outer layers of the brain, the meninges, as did Herophilus and Erasistratus, but he did not assume that nerves were hollow. As had his Alexandrian predecessors, Galen thought nerves transmitted pneuma, to be sure; unlike them, however, he thought nerves were composed of a semisolid inner part, which he compared with "pith" or "heartwood" of a tree, and two outer envelopes that were continuations of the brain's outer layers.50 Although Descartes made frequent reference to cerebrum in contexts that suggested cerebral cortical tissue, he did not elaborate on the brain's solid aspects other than to write that they were composed of "very fine fibers."51 The idea that natural bodies, including human, were composed of fibers is ancient.52 However, the ancients, such as Plato, assumed in living bodies that the blood's fibrin formed the body's sinews while the defibrinated blood provided the material of the flesh. In comparison, Descartes extended fiber's range to include flesh as well as the musculoskeletal system. Instead of a solid or fibrous brain, however, he typically described

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FIGURE 3.7 Descartes's model of nerves as tubes. Treatise on Man (1662). Courtesy of Clendening Library of the History of Medicine, University of Kansas.

the cerebrum in terms of its spaces and fluids: "I shall explain in detail all that happens in the cavities and pores of the brain, what route the animal spirits follow there, and which of our functions this machine can imitate by these means."53 Although Descartes wrote initially about the brain and nerve's solid tissues and "very fine fiber," his rapid switch to a bodily grammar of "pores" and "cavities" conveyed a notion of the brain and nervous system more hydrostatic than anything since Herophilus and Erasistratus first characterized nerves as hollow. So too at the beginning of De Homine, Descartes had begun his account of the heart in terms of its solid "flesh" before undermining that word's conventional meaning by describing heart tissue almost exclusively in terms of its "pores" and "cavities."54 Descartes's repeated substitutions of meaning for his key words spirits, vital, and animal, not to mention tissue and solid, reduced them to becoming little

THE HUMAN MIND AND 'GLAND H'

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FIGURE 3.8 Illustration from Descartes's Treatise of Man (1664) depicting the continuity of the coverings of nerves with the brain's meninges (outer coverings). Courtesy of Clendening Library of the History of Medicine, University of Kansas.

more than linguistic placeholders in a natural philosophy of animal bodies that sounded both humoral and solid without being either, at least as those concepts had been understood previously. He could have faced the issue directly through coining neologisms—his concepts were that new and neologisms were common in natural philosophy at the time—but he chose not to. Descartes seems to have been quite aware that he was playing games with his readers concerning the meanings of key words. When Gassendi criticized him for his "ambiguity" concerning the word "soul" in the Meditations on First Philosophy of 1641, Descartes replied blithely: "Our job, however, is not to change the names after they have been adopted into ordinary usage; we may merely emend their meanings when we notice that they are misunderstood by others."55 Descartes' s rhetorical deftness concerning bodily solids and liquids left his natural philosophy with an implicit model of the human body as a fluid plenum without any classical essences or qualities. Moreover, his disciples extended the tactic to the illustrations of De Homine/ L'homme by frequently depicting body parts as solids while the explanatory texts

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characterized their activity in terms of interactions between their pores and/or cavities and vital and animal spirits. Additionally, both De Homine and L'homme interlarded "realistic" illustrations of heart and brain with highly diagrammatic outline drawings of brain, nerve, and external objects. In doing so, they were trading on readers' expectations of the emerging likeness print culture that illustrations purporting to display the newly visible inner world of natural bodies, including human, would observe post-Vesalian visual manners of representing the real. By this means, Descartes further blurred the lines between the human body as a complicated arrangement of solid and liquid, which was the emerging orthodoxy, and the body as a subset of a cosmology of a universe of containers of ebullient corpuscular fluids moving in various force fields. Cartesians manipulated not only imagery of the brain and nerves, but also of the heart and reproductive organs. (Descartes never paid much written attention to the digestive or excretory systems.) In De Homine, for example, the first illustration was of an en bloc dissection of the heart, proximal aorta, and lungs with the heart's left ventricle in the foreground. (Fig. 3.9) Probes were shown sticking out of great vessels, but cavities were not displayed. One might be looking at a heart as described by Harvey and his follower Richard Lower, both of whom characterized the heart as a muscular pump. Indeed, the illustration portrayed the heart and respiratory system as solid-seeming tissue. But the explanatory text went the other way: "And note that the flesh of the heart contains in its pores one of those fires without l i g h t . . . to the extent that the blood enters either of its two chambers or cavities, it is promptly inflated and expanded."56 Granted, according to Schuyl, who edited De Homine, Descartes did not devise Figure 1. In terms of how Descartes's followers understood him and presented him to the reading public, however, the issue of the master's authorization of a particular illustration seems almost beside the point. Schuyl noted that Descartes devised Figure 41, which showed a male figure with a solid-seeming body; however, the figure's only internal brain structure was the pineal in the form of an oval cavity attached to some curving lines.57 The Cartesians' adroit use of elision and synecdoche in text and figure supported their larger goal of aligning their model of the human body with their cosmos without reference to classical and Renaissance cosmologies of microcosm (man) and macrocosm (the universe), which they loathed. What, after all, was Cartesian cosmology about if not a fluid plenum in which all bodies operated dynamically according to optical and geometric principles without reference to something else? Similarities between illustrations of the heavens from the Treatise on Light with some on the brain-pineal-eye from the Treatise on Man suggest the unity and integration of Descartes's cosmology. For example, compare Figure 4 in Treatise on Light (Fig. 3.10), which was intended to show how heavenly bodies revolve around their own axes and sun, and Figure 5 (Fig. 3.11), which Descartes wrote

FIGURE 3.9 Although Descartes's Treatise on Man illustrated the heart, depicted here with the lungs en bloc, as a solid that readers might plausibly interpret in line with Harvey's portrayal of the heart as a muscular pump, Descartes's accompanying text characterized the heart as two cavities whose walls expanded and contracted passively in response to the chemical expansion and contraction of blood within. Treatise on Man (1664). Courtesy of Clendening Library of the History of Medicine, University of Kansas.

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FIGURE 3.10 Planetary orbits from Descartes's Treatise on Light (1664). Descartes intended the Treatise on Light and Treatise on Man to be a single work, The World, which also included material on the formation of colors, geometrical optics, and possibly music and other material. Courtesy of Clendening Library of the History of Medicine, University of Kansas.

depicted the revolution of the earth and its atmosphere, including the moon, around its center, with the situation of the pineal (gland H) in the brain as shown in Figure 54 of L'homme. Visually, the pineal, center of the earth, and sun all occupy central positions in more or less oval shapes. Descartes intended Figure 6 (Fig. 3.12) in the Treatise on Light to depict forces of circular motion around the sun and Figure 41 (Fig. 3.13) in L'homme to show refraction in the crystalline humor of the eye. Although quite different in subject, they resemble each other in scale, type, and arrangement of important parts. The isomorphism of the illustrations in their texts was but another way for Cartesians to reinforce the unity and economy of their natural philosophy. However, it led to a curious result. Their isomorphism, and the reach for a unifying theory of nature that it represents, mimicked venerable notions of the microcosm of man and the macrocosm of the universe and its corollary of the doctrine of signatures, such as the resemblance between a walnut and the cerebral cortex, which had been staples of two natural philosophy traditions Descartes loathed, the hegemony of scholastic Aristotelianism in the schools and the hegemony of spiritual agency in Renaissance alchemy. In the meantime, Descartes's reliance on a heretofore insignificant structure, the pineal, left him open to criticism that his

FIGURE 3.11 Illustration from Descartes's Treatise onMan (1664) demonstrating similarities between the position of the sun in the universe in Figure 3.10 and the pineal (gland H) in the brain. Courtesy of the Clendening Library of the History of Medicine, University of Kansas.

FIGURE 3.12 Illustration from Descartes's Treatise on Light (1664) depicting forces of circular motion around the sun. Courtesy of the Clendening Library of the History of Medicine, University of Kansas.

FIGURE 3.13 Illustration from Descartes's Treatise on Man (1664), which portrays the refraction of crystalline humor of the eye, bears resemblance to Figure 3.12 with its demonstration of some forces of planetary motion. Courtesy of the Clendening Library of the History of Medicine, University of Kansas.


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model was not like the human brain and nerves at all. Descartes was dead when the charges were leveled, but his followers never recovered. Instead, as we shall see, Cartesian physiology of both heart and brain ended up being considered primarily as footnotes to his epistemology and as dead-ends in medical theory. In the meantime, another model of the human brain and mind with its own version of likeness and presence came to the fore within two decades of Descartes's death.

Notes 1. Nemesius of Emesa. "On human nature," in Cyril of Jerusalem and Nemesius ofEmesa. trans, and ed. William Telfer (Philadelphia: Westminster Press, 1955). Also in Edwin Clarke and C.D. O'Malley. The Human Brain and Spinal Cord. (Berkeley: University of California Press, 1968), pp. 463-5; Edwin Clarke and Kenneth Dewhurst. An Illustrated History of Brain Function: Imaging the Brain from Antiquity to the Present. 2nd ed. (San Francisco: Norman, 1996). 2. Avicenna. Canon of Medicine, trans. O.C. Gruner. A Treatise on the Canon of Medicine ofAvicenna, incorporating a translation of the first book. (London: Luzac, 1930). Cited in Clarke and O'Malley, Human Brain and Spinal Cord, 20-1, 465-7. On the medieval models of cerebral localization, see Ynez Viole O'Neill. "Diagrams of the Medieval Brain: A Study in Cerebral Localization," in Iconography at the Crossroads, ed. Brendan Cassidy (Princeton: Princeton University Index of Christian Art, 1990). 3. Andreas Vesalius. Fabrica. 1543. For a comparison to medical conceptions of the brain, see Ynez Viole O'Neill, "Meningeal Localization: A New Key to some Medical Texts, Diagrams, and Practices of the Middle Ages." Mediaevistik 6: 1993: 211-238. 4. Clarke and O'Malley, Human Brain and Spinal Cord, 762. 5. Martin Clayton. Leonardo da Vinci: The Anatomy of Man: Drawings from the Collection of Her Majesty Queen Elizabeth H. (Boston: Little Brown, 1992). 6. Constanzo Varolio. De Nervis Opticis. (Padua, 1573). Translated by Clarke and O'Malley, Human Brain and Spinal Cord, 820-3. 7. Ibid. 8. John Sutton. Philosophy and Memory Traces: Descartes to Connectionism. (Cambridge: Cambridge University Press, 1998). 9. See, for example, Daniel Garber. Descartes Embodied. (Cambridge: Cambridge University Press, 2001). In the Introduction, p. 2, Garber notes: "But there is a particular way in which Descartes approached the task of replacing the Aristotelian philosophy with a mechanical philosophy. Although Descartes was interested in what we would call mathematical and scientific questions, it was important for him to ground his view of the make-up of bodies and the laws that they observe in what he called a metaphysics." 10. Ibid. See also eds. Stephen Gaukroger, John Schuster and John Sutton. Descartes' Natural Philosophy. (London: Routledge, 2000). 11. William Harvey. "Letter to Jean Riolan," 1649. trans. Robert Willis (1848) in Esmond R. Long, Selected Readings in Pathology. (Baltimore: Thomas, 1929), pp. 71-4. 12. Descartes to Mersenne, 28 January 1641, concerning his circulation of drafts of the six meditations: "I shall be glad if people make me as many objections as possible— and the strongest ones they can find. For I hope that in consequence the truth will

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13.

14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29.

30.


stand out all the better." "Translator's Preface," in Philosophical Writings of Descartes. trans. John Cottingham, Robert Stoothoff, and Dugald Murdoch (Cambridge: Cambridge University Press, 1999), vol. II: 63. AT vi. 78. The standard French edition of Descartes's work is Oeuvres de Descartes. (AT). 2nd ed., 11 vols. eds. Charles Adam and Paul Tannery (Paris 1974-86). Following the convention of current Cartesians, such as Stephen Gaukroger, I refer to volume number and page number by Roman and Arabic numerals, respectively. See Stephen Gaukroger. "References on Descartes' Works," in Descartes' Natural Philosophy, eds. Stephen Gaukroger, John Schuster, and John Sutton (London: Routledge, 2000): "In the case of the Principia and the Passions, however, references are to Part and Article number, since this is a more convenient way of locating passages." Rene Descartes. "Letter from the Author," in Principles of Philosophy, trans. Valentine Rodger Miller and Reese P. Miller. (Dordrecht: Kluwer Academic, 1992), p. xxiv. Descartes. Principles of Philosophy. Adrien Baillet. La vie de Monsieur Descartes, 2 vols. (Paris: 1691). Facsimile edition, Geneva, 1970. ATii. 525. See also Annie Bithol-Hesperies. "Cartesian Physiology," in ed. Gaukroger, Schuster, and Sutton. Descartes' Natural Philosophy, 349-82. Rene Descartes. The World and Other Writings, ed. Stephen Gaukroger. (Cambridge: Cambridge University Press, 1998), p. 100. (based on AT) Rene Descartes. Preface to "Description of the Human Body," in ed. Gaukroger. The World and Other Writings, 171-2. Also AT 226. Michael Heyd. "Be Sober and Reasonable": The critique of Enthusiasm in the Seventeenth and Early Eighteenth Centuries. (Leiden: EJ Brill, 1995), p. 4. Gary Hatfield. "Descartes' Naturalism About the Mental," in ed. Gaukroger. Descartes' Natural Philosophy, 630-58. See Stephen Gaukroger. Descartes' System of Natural Philosophy. (Cambridge: Cambridge University Press: 2002), pp. 6-10. Rene Descartes. "Treatise on Light," in ed. Gaukroger. The World and Other Writings, 25. Also, AT 37. Descartes. "Treatise on Light," in ed. Gaukroger. The World and Other Writings, 18. The classic version of this argument may be found in Edwin A. Burtt. The Metaphysical Foundations of Modern Physical Science. (London: Routledge, 1924). Descartes. "Treatise on Light," in ed. Gaukroger. The World and Other Writings, 23. AT 34-5. For a brief discussion of early modern meanings of "machine," see "Introduction," of ed. Gaukroger, Schuster, and Sutton. Descartes' Natural Philosophy, 15-6. Descartes. Discourse on Method, AT, pt. v. Most twentieth-century commentators on Descartes's natural philosophy of the body, including Cottingham, Gaukroger, and Garber, rely on the AT edition, which is based on L'Homme. Consequently, perhaps, discrepancies between De Homine andL'homme have received little comment. Additionally, to my knowledge my discussion in this chapter of Cartesian print culture in reference to the animal body is the first. In November 1633 Descartes wrote to his confidant Mersenne: "I had intended to send you my Le Monde as a New Year gift. .. but in the meantime I tried to find out. .. whether Galileo's Sisteme du Monde was available. . . . I was told that . .. Galileo had been convicted and fined. I was so surprised by this that I nearly decided to burn


31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45.

46. 47. 48. 49. 50. 51. 52.

53. 54. 55.

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all my papers, or at least let no one see them. . . , so I prefer to suppress it rather than publish a mutilated copy." In AT 1. 270-1. See also Gaukroger. Descartes' System of Natural Philosophy, 19-21. Descartes, AT. xi. 3. See also Betsy Newell Decyk. "Cartesian Imagination and Perspectival Art," in eds. Gaukroger, Schuster, and Sutton. Descartes' Natural Philosophy, 447-86. Decyk. "Cartesian Imagination and Perspectival Art," in Gaukroger, Schuster, and Sutton. Descartes' Natural Philosophy, 457. Descartes, AT vi. 113^1. Descartes. Meditation VI, AT vii. 78. See ed. Gaukroger. The World and Other Writings, 107 n. 16. Galen cited Herophilus' use of "psychic pneuma" in coining the term "animal spirits." See Clarke and O'Malley. The Human Brain and Spinal Cord. Descartes, ed. Gaukroger. The World and Other Writings, 107. (Cambridge: Cambridge University Press, 1998). Ibid., 103. De Homine (1662), p. 14. Ibid., 104-105. De Homine (1662), pp. 15-6. Ibid., 106. De Homine (1662), p. 16. Galen. "Use of parts," I, 575-578; IX, 4; XVI, 11. trans, and ed. Charles Daremburg. Galen, Oeuvres Anatomiques, Physiologiques et Medicales. 2 vols (Paris: Balliere, 1854-56). Giacomo Berengario da Carpi. Commentaria cum Amplissimis Additionibus Superanatomia Mundini. (Bologna, 1521). Vesalius. Fabrica. Book VII, Chapter XII. 2 vols., v. 2. English translation in Clarke and O'Malley. Human Brain and Spinal Cord, 768. Vesalius. Fabrica. Book VII, Chapter VI. I have used the English translation by Clarke and O'Malley. Human Brain and Spinal Cord, 718. For the Venetian Giunta edition of Opera Galeni of 1541-42, Vesalius edited three Latin translations: "Dissection of the Nerves," "Dissection of the Veins and Arteries," and his former teacher Guinther of Andernach's version of Galen's "Anatomical administrations." Galen. "Anatomical Procedures," in Opera Omnia. Editionem Curavit. ed. C. G. Kiihn. (Leipzig: Cnobloch, 1821-33), II, 728-31. 20 vols. in 22. English translation in Clarke and O'Malley. Human Brain and Spinal Cord, 712. Descartes. "Passions." trans. Cottingham, Stoothof, and Murdoch. Philosophical Writings of Descartes, I: 340. Descartes. "Mediations on First Philosophy." trans. Cottingham, Stoothof, and Murdoch. Philosophical Writings of Descartes, II: 59. Ibid. James Longrigg. Greek Rational Medicine. (London: Routledge, 1993), pp. 210-4. Descartes. "Treatise on Man," in ed. Gaukroger. The World and Other Writings, 108. Plato's Timaeus 82b-e contains a typical account of fiber in ancient thought about the composition of human bodies: "In the natural course of events, flesh and sinews arise from blood—sinew from the fibrin . . . flesh from the coagulation of what is left when the fibrin is removed." Ibid. Descartes. "Treatise on Man," in ed. Gaukroger. The World and Other Writings, 101. AT 123. Descartes. "Fifth Set of Replies to Pierre Gassendi," "Fifth Set of Objections," in

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Meditations on First Philosophy, trans. John Cottingham, Robert Stoothoff, and Dugald Murdoch (Cambridge: Cambridge University Press, 1999), vol. 2, p. 356. 56. Illustration De Homine. (1662), p. 6; text p. 5: "Scire quoque operae pretium est, in poris parenchymatis cordis contineri ignem quendem sine lumine (de quo alibii) quo istud tarn calidem, fervidumq redditur, ut simul ac sanguis alterutrum ejus ventriculum intrat, illico intumescat, & dilatetur." 57. Descartes. De Homine. (1662), p. 94.

4 WHEN THE BRAIN CAME OUT OF THE SKULL

During the 1660s and early 1670s, publishers with close personal ties to Thomas Willis published under his name the first comprehensive European texts on the structure and function of the human brain and nerves and their diseases and treatments. They included, in order of their appearance, the book commonly known then and now by its short title, Cerebri Anatome (The Anatomy of the Brain or Cerebral Anatomy, abbreviated hence forth as Anatomy). Among the learned, Anatomy was popular from the outset, the expensive quarto first edition being knocked-off in three less expensive octavo versions in 1664 alone. Subsequently, it appeared in five more Latin versions between 1666 and 1683. As Willis noted in the text, Anatomy was just the first book of a planned sequence of texts on nervous diseases, the place of man in the animal kingdom, and rational treatments for nervous and other diseases. Subsequently, in 1667 his Pathologiae Cerebri, etNervosi Generis Specimen (Diseases of the Brain and Nerves, abbreviated hence as Pathology) appeared, and in 1670 Affectionum quae Dicuntur Hystericae et Hypochondriachae, a treatise on hysteria and hypochondria, which were common diagnoses then. In 1672 Willis published a text he alluded to in Anatomy, DeAnima Brutorum (On the Soul of Brutes), and finally in 1674 and 1675, his two volumes on "rational" therapies for many illnesses, the Pharmaceutice Rationalis, appeared, the second volume shortly after his death.

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As I noted in the Preface, many professionals in the neurosciences have written about Willis's techniques and accomplishments in terms of their relation to previous and subsequent developments in neurology and neuroscience. Because these references exist and I am writing this book mostly to explore other questions, this chapter aims to explicate Willis's Anatomy in terms of his overall goal of establishing his doctrine of brain and nerve as truer to human nature than any previous or contemporary alternative. Four themes merit special attention: (1) his methods of knowledge, (2) solidity and hollowness, (3) his critique of the pineal, and (4) the importance of hierarchy. In this chapter I emphasize structural concerns at the expense of function, which I discuss in the next chapter. As noted in the Preface, Willis, like other early modern anatomists, made no sharp distinctions between structure and function. That came later, as physiology came into its own intellectually, if not institutionally, during the early eighteenth century. I hope my attempt to disentangle what was entangled may promote clearer understanding for present-day readers of what Willis and his team were up to, but I acknowledge it probably distorts Willis's work in terms of how his contemporaries apprehended his models. Gender, which I take up in Chapter 7, also figured in Anatomy, though not as prominently as in Pathology or his text on hysteria/hypochondria. Although contemporaries often referred to Anatomy and Pathology as Willis' books on the brain and "diseases of the Head,"1 respectively, the full title of the former reveals two important aspects of the project that may otherwise escape notice. Early modern books often carried long and redundant titles. Anatomy's long title, with slash marks to indicate separate lines, was CerebrilAnatomd: Cut AccessitlNervorum Descriptiolet Ususi'Studio I Thomas Willis. As suggested by the word "Studio," Anatomy of the Brain was a group project, a fact that Willis acknowledged in the Preface2 and elsewhere. According to him, Richard Lower, MD (1631-1690), who later succeeded to Willis's London medical practice, performed many of the book's "anatomical administrations," and Thomas Millington, MD (1628-1704) and Christopher Wren (1632-1723), doctor of law and then Savilian Professor of Astronomy, often assisted. Willis also credited Wren for drawing "many [of the book's] Figures of the Brain and Skull." (Fig. 4.1)3 Ralph Bathurst (1620-1704), a physician and Anglican cleric, helped edit Anatomy. In this discussion I will use Willis to stand for himself as well as for the group of which he was a part. (In Chapter 5,1 discuss his larger network in detail.) When noting a specific anatomic detail or interpretation, Willis also acknowledged occasionally the work of Continental counterparts who worked on the brain, such as his mention of physician Johann Wepfer's morbid anatomy on apoplexy4 and philosopher Pierre Gassendi on the rational soul. He also cited ancient authorities, including Aristotle, Galen, and, rarely, Hippocrates. Willis made it clear, though, that he intended to be innovative and not bound by previous authorities. Echoing the early Descartes and other Oxford natural philosophers, he declared in the Preface: "I determined . . . not to pin my faith on

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FIGURE 4.1 Christopher Wren's engraving of the human brain from below, which was the first illustration in Willis's Cerebral Anatomy (1664). The illustration portrays the collateral circulation at the base of the brain, which is discussed extensively in the text. Courtesy of the Clendening Library of the History of Medicine, University of Kansas.

the received Opinions of others, not on the suspicions and guesses of my own mind, but for the future to believe Nature and ocular demonstrations: Therefore thenceforward I betook my self wholly to the study of Anatomy. . . ." In Chapter 19, which put forward novel arguments on the nervous system in general, he repeated: "I have not trod the paths of others. . . ."5 The long title also reveals that the book was as much about the nervous system as it was about the brain per se, or at least that was how some contemporaries

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considered it. Indeed, the title page of Samuel Pordage's 1681 English version, first published in his Remaining Medical Works of Dr. Thomas Willis, described the book as two "treatises": (1) "of the anatomy of the brain" and (2) "of the description and uses of the nerves."6 Because Pordage provided the only published Latin-to-English translation of Willis's works and because his version of Anatomy of the Brain is commonl available today, I will be using its pagination and quoting from it with the exception of changing Pordage's translation of a few key words. Pordage translated Willis's cerebri as "brain," his medulla oblongata as "oblong marrow," and his cerebellum as "cerebel." Other than using "Cerebri anatome" in the book's title to refer to the whole brain, however, Willis restricted the use of cerebri. When he wrote cerebri, he usually meant just the cerebral hemispheres or cerebral cortex, not the modern notion of the brain as composed of three major structures: hemispheres, cerebellum, and medulla or brain stem. Moreover, for reasons I will discuss shortly, he viewed the distinction as crucial. Therefore, I think readers will have a clearer understanding of Willis's intentions if "cerebral hemispheres" is substituted for Pordage's use of "brain." My other changes are minor. Even in Pordage's day, the cerebellum was commonly referred to by that word, not "cerebel"; so too most early modern anatomists called the medulla by that term, not "oblong marrow." Willis's "cerebellum" and "medulla" conform to presentday usage, although in recent decades many physicians and neuroscientists commonly use "brain stem" as a synonym for medulla. Although Descartes wanted to displace Aristotle as the principal authority on the natural world, Willis's goal was seemingly more modest, merely to "unlock the secret places of Mans Mind," as he wrote in Anatomy's dedication to Gilbert Sheldon, then newly promoted by Charles II from Bishop of London to Archbishop of Canterbury. Nonetheless, as we have seen already with Descartes and will shortly with Willis, each used various rhetorical and visual tactics to enhance the naturalness or likeness of their respective models of brain and nerves. However, although Descartes worked from the outside in, if you will, from a general theory of matter and motion to the brain and nerves, Willis presented himself as working from the inside of the body outward to a comprehensive natural philosophy of behavior in the animal kingdom. In his model of brain and nerves Willis expressed little about presence, or spiritual agency, at least explicitly, perhaps because his 1650s model of blood and its byproducts assumed spirit had some material agency. Both men were capable of considerable slyness in their publications, although heretofore only Descartes has been called on it, as suggested by Gassendi's comments on Descartes's rhetoric noted in the previous chapter. In comparison, so far Willis has been regarded by modern interpreters as he was by many of his contemporaries—as "an orthodox, pious, and charitable physician. . . . [who] was a plain man . . . yet for his deep insight [and] happy researches in natural and


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experimental philosophy, anatomy and chymistry [and] for his wonderful success and repute in his practice. .. ."7 I think his reality was much more complex. Indeed, he, like Vesalius, Fuchs, and Descartes, was interested in the persuasive possibilities of manipulating word and image in the emerging print culture of likeness. An early clue may be in the structure of Anatomy, which reads like two different books, at least to me. Willis organized the section on the nerves, which forms the last nine of the book's twenty-nine chapters, in a straightforward head-to-toe fashion, the first four cranial nerves coming first and the nervous innervation of the pelvis and lower extremities coming last, which had been Galen and Vesalius' presentation format, but he laid out the treatise on the brain, which constitutes the book's first twenty-one chapters, in a less than systematic format, at least from a strictly anatomic perspective. Although the chapters on the brain proceeded in general from the brain's outer to inner structures and from the top of the brain to the spinal cord, Willis made significant detours. For example, although Chapter 1 explicated his method of "anatomical administration," which is what one might expect given his intention of establishing a "new" method of understanding the body, Chapter 2 did not discuss in detail the brain's outer coverings, or meninges, but rather its lower portion, the medulla, and "hinder parts of the head." Willis did not take up the meninges in earnest until Chapter 6. Even the book's early discussion of the medulla was not an orderly explication of its structure and uses—that came in Chapter 13; instead, Chapter 2 used the nominal subject of the medulla and underside of the cerebral hemispheres to introduce general themes that later chapters reinforced.

Methods and Models of Knowledge Like Aristotle, Galen, Avicenna, Vesalius, Harvey, and his fellow Oxford physiologists (and unlike Descartes), Willis set great store by sensory knowledge, a commitment he made clear early in the preface: "Where matters appear to the Senses, we do not so easily run upon errors." In terms of the brain and nerves, however, sensory knowledge was constrained by the reality that one "cannot see the pathways of animal spirits."8 Nonetheless, Willis was confident that repeated "anatomical administrations" performed over time would yield sufficient knowledge to be able to form theories with a rigor that fell just short of mathematical rules, if only because "ocular demonstrations"9 simply were "not absolute in all [their] numbers."10 Willis's rhetorical nod to mathematics seems just that; unlike Harvey, he did not make quantitative arguments, and his texts and extant lecture notes provide no evidence that he shared Descartes's tendency to argue that all of nature actually could be mathematized. However, mathematics, especially geometry, had suggested certain knowledge in natural philosophy from the Greeks on, and Willis

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wanted to make medicine a rational enterprise, as his scheme of publications on brain and nerve physiology and pathology and the title of his last work suggest. By mentioning mathematics, Willis was letting his readers know that he allied himself with Galen, Vesalius, and the rationalist tradition in learned medicine and natural philosophy, not with the empiricists. He also took pains in the Preface to let readers know he was stepping away from the old anatomic tradition that relied on textual authority more than the visible evidence of some particular corpse under the knife. In this he was not as strident as Vesalius, who argued that all worthy physicians needed to perform dissections; nonetheless, he was determined to move beyond being "like a Painter . . . at the will of a bold Fancy and Pencil" whose products were little more than "Poetical Philosophy and Physick" full of "deceits and incantations. . . ."n As the book's full title made clear, Willis was committed to anatomy as the primary means of understanding the structure and function of the brain and nerves. It provided "some rational Arguments," as Willis put it in the Preface, for understanding the senses and "affections."12 Anatomy provided a "firm and stable Basis," he continued, for a "more certain Physiologic than I had gained in the School" as well as support for a "Pathologie of the Brain and nervous stock... ,"13 Willis, in common with many early modern investigators, used anatomy in the expanded sense I comment on in my Preface. Anatomy was capable of showing structure and function or, as he commonly phrased it, the "offices" and "uses" of various body parts. Where he differed from most of his contemporaries was in his effort to use postmortem findings on his own patients to advance his arguments for disease causation. He was not the first investigator to do this. Indeed, he may have been inspired by Harvey, who late in life bemoaned the plundering of his papers during the Civil War. According to a contemporary, Harvey considered the loss "the greatest crucifying to him that ever he had in all his life"14 because it prevented him from completing his final major project, a book of anatomic findings on his "sick" patients to better chart the natural history of their diseases.15 However, Willis was among the first in Europe to use what Harvey termed "Medical Anatomy" (known as "morbid" anatomy in the eighteenth century and "pathological" anatomy in the late nineteenth) in an extended way on particular organ systems.16 (Since the early twentieth century, a similar practice has been known as "clinical correlation" and has been a standard feature of medical training, especially in what is now known as the specialty of internal medicine.17) Willis did "medical" anatomy in addition to the usual search for "standard" structures in his anatomies of persons with unknown medical histories. Often he combined the two approaches, the better to reinforce an important theme. Another early practitioner of pathological anatomy, to use an anachronism, was Johann Jakob Wepfer (1620-1695), a Swiss physician who investigated cerebral apoplexy and the cerebral circulation in Shaffhausen, where he served as municipal physician.18 Willis emphasized that many of the brain's important structures, including its vessels, came in two's: two cerebral hemispheres, for example, and anterior and


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posterior arterial systems. On both theoretical and practical grounds, he was impressed: . . . the Cerebral Hemispheres [are] as it were twofold, that there might be a provision made against the defect of one side by the supplement of the other. . . . Further, in man, who hath cerebral hemispheres more large and capacious than other Creatures, either Hemisphere is again subdivided into two lobes. . . . Certainly this second partition of the humane Cerebral Hemispheres seems to be designed for its greater safety. . . . so the Cerebral Hemispheres, like a Castle, divided into many Towers of places of Defence, is thereby made the stronger and harder to be taken.19

Indeed, Willis is remembered most by present-day neurologists for his elaboration of the collateral circulation between the carotid and vertebral arteries at the base of the brain, known as the "circle of Willis."20 To make his point, after he described their structures as a circular system, he cited the example from a "dissection" of a deceased patient's brain. The man had a blocked carotid artery, but Willis wrote he never experienced an "apoplexy" (fit or convulsion); instead, he enjoyed "free exercise of mind and animal function to the last moment." (His death was caused by a tumor.21) Sometimes, Wills made clinical hypotheses based on dissections of nonhuman animals. To reinforce his point in Chapter 13 that the presence of streaks on the medulla's "chamfered bodies" signified healthy human function, he used the example of puppies: "furthermore, in whelps newly littered that want their sight.. . these streacks (normal on these bodies) being scarce wholly found, appear only rude."22

Humans' Place in the Animal Kingdom Like Aristotle, Galen and Descartes, as well as his fellow Oxford physiologists (and unlike Vesalius), Willis also championed comparative anatomy. Believing that humans and "four-footed" animals shared similar brains and nervous structures, he often prefaced his comments on an exception by beginning with "the Brains of men and four-footed Beasts alike. . . ,"23 He also thought that birds and fishes shared similar brains and nervous systems. The comparisons were a way of placing man within a continuum of God's creation; also, the differences permitted Willis to argue for a distinctive place for some human brain structures he did not find in other organisms. As I discuss later in detail, Willis found humans in a middle zone between angels and lower animals, such as birds and fishes, an assumption that favored his analogies between humans and "four-footed Beasts" or what, post-Linnaeus, are called mammals: the "Brains of Man and four-footed beasts were alike in most things... as it were Twins from the Creation of the World, do testifie their affinity in nothing more than the fabrick of the Brain."24 Anatomy reinforced similarity between humans and mammals not only in texts but also in its arrangement of illustrations. A full-page illustration placed between pages 86 and 87 showed arterial structures from brains of a human, horse, and

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calf to illustrate subtle similarities/differences in vascular structures. To demonstrate the similarity between human and other mammalian brain structures, including the pineal, in Figure 7 he used a sheep's brain, not a human's (Fig. 4.2). In addition to direct depictions of brains and nerves of nonhuman mammals, Willis reinforced his commitment to the similarity of humans and mammals through regular alternation in the illustrations between a human example and one taken from a mammal, usually a large ungulate.

FIGURE 4.2 Because Willis believed humans and large "warm blooded animals" shared virtually identical patterns of nerve structure in their spinal cords and lower bodies, he used an engraving of a sheep's brain to illustrate the "wandering and intercostals nerves" in Cerebral Anatomy (1664). Courtesy of the Clendening Library of the History of Medicine, University of Kansas.


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As Anatomy progressed down the body and into the lower spinal cord, he wrote that humans and mammals were virtually identical in their innervation. Therefore, he advised readers, he chose a composite animal illustration for his eleventh table, because the branches of the "wandring and intercostal nerves" to the lower abdomen in "both Man and four-footed beasts" is "almost alike" though there was some differences between them and "fishes."25 Finally, at the end of the book in Chapter 29, he asserted there was no more need for "neurologie" in the book because in "man and brute beasts" the "configuration of every pair of Nerves is still the same or alike in all."26

The Virtues of Artifice Nowadays, the word artificial, at least among highly educated groups in advanced consumer economies, often carries a negative connotation, a "natural" object is usually the preferred alternative. This was not the situation in early modern Europe. At a time when God was commonly referred to as the "Great Artificer," natural philosophers and others interested in nature, including Willis, commonly phrased their investigational zeal in terms of a desire to understand God's artifice. In discussing the brain's circulation of blood, Willis put the issue this way: "Certainly there can be nothing more artificial thought upon, and that can better argue the Providence of the great Creator, than this fit or convenient disposition of the disposition of the blood in the brain, and without i t . . . accommodated to the necessity of every one."27 In the expanding materialist cultures of early modern Europe, artificial was also a term of approbation for what humans could do. Bacon hoped human artifice would lead to greater exploitation of nature's abundance. In common with Continental humanists from Marsilio Ficino on, Elizabethan poets and musicians valued artifice in poetry and melody. Adroit human artifice could enable humans to gain better apprehension of God's artifice, which was nature. In other words, early modern persons did not usually contrast artifice to nature as we today might. Instead, they celebrated the former as a tactic for understanding and representing the latter. As Fuchs demonstrated with his plant illustrations that frequently combined a plant's different life phases in one illustration, artifice in depicting the natural was thought capable of conveying a heightened sense of the real or like. (Such visual games were, of course, a staple of Renaissance high art.) Willis used several artifices to convey the real to his readers. Provided an illustrator was prepared to use artifice to heighten or create the illusion of the real, illustrations in a text could avoid most of the indeterminacy inherent in real-life witnessing, and Willis and his colleagues, like Vesalius and Fuchs, made the most of it. Describing how he got the brain out of the skull, Willis noted that his technique made the brain "as much as may be, be all plain or open to the Spectators."28 In Chapter 5, I discuss Willis's specific representational tactics.

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Solids and Ventricles To understand Willis's contribution, which is another way of saying the discontinuity between his work and previous knowledge, a little background on older ideas of brain structure may be helpful. Even those writer(s) of ancient texts that most emphasized the role of the brain, such as the Hippocratic text on epilepsy, The Sacred Disease (430-450 B.C.E.), described it primarily in terms of its status as a container and transit point for breath (pneuma) from outside the body to the muscles and viscera. Nonetheless, the brain was key: "Men ought to know that from the brain, and from the brain only, arise our pleasure, joys, laughter, and jests, as well as our sorrows, pains, griefs, and tears."29 Intelligence, by which the author(s) seemed to indicate cognitive and emotive function, however, came from the air: "I hold that the brain is the most powerful organ of the human body, for when it is healthy it is an interpreter to us of the phenomena caused by the air, as it is the air that gives it intelligence."30 The Hippocratic text did not discuss the substance of the brain. Instead, it described the brain's cavities as a reservoir that communicated breath and humors to and from the rest of the body either in some unspecified direct manner ("breath") or through "veins," which "lead up to it from all the body": "For when a man takes in breath by the mouth or nostrils, it first goes to the brain, then most of it goes to the belly, though some goes to the lungs and some to the veins . . . the air that goes into the lungs and the veins is of use when it enters the cavities and the brain, thus causing intelligence and movement of the limbs."31 Plato's (429-347 B.C.E.) description of the brain in his Timaeus also emphasized the brain's ventricles and the head as a vessel of the "Seed" that activated intellectual function.32 When he discussed the brain, Galen (129-199 C.E.) concentrated in his comparatively brief explication on undermining the Aristotelian proposition that the heart was the center not only of the body's nourishment but also of its intelligence. He seemed preoccupied with the brain's heating and cooling properties as compared to those of the heart as well as its proximity to the senses and cranial nerves, which were the subject of his extended discussion.33 Unlike ancient commentators and Descartes, Willis paid more than lip service to the notion the brain's solid tissues were the center of its action. Granted, he was convinced their agency depended on adequate circulation of healthy blood, which was one reason he emphasized the importance of the meningeal vessels and collateral arterial circulation at the base of the brain. Before discussing the solid tissues themselves, he wanted to establish just which circulation it was that mattered. The point was crucial. If one followed older ventricular models or Descartes's refurbishment of them, one would have a brain with plenty of ventricular circulation and almost no role for its solid structures, especially the tissues of the cerebral hemispheres. Willis wanted to avoid such an interpretation of the brain at all costs. By establishing the blood vessels, not the ventricles and


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"pores" of brain tissue, as the proper circulatory system, he set up his argument for the solid portions of brain and nerve. However, the text of Anatomy suggests he was not content with mere positive assertion concerning the importance of vascular circulation. Beginning in Chapter 1 and continuing throughout most of Anatomy, Willis took pains to minimize the role of the ventricles. It was as though Willis was playing a take-no-prisoners game: If the ventricular circulation model stood, his could not. He began his demolition in Chapter 1. The ventricles were simply not important. How could they be, he asked rhetorically, as they had almost no primary existence; instead, they were mere consequences of the stretching of other tissues (the fornix)34; they were merely "secondary" and "narrow."35 Furthermore, the ancients were mistaken about the use of the ventricles: The ventricles were really for excretion, an argument he buttressed with postmortem findings on his patients. They were just unimportant vacuities, he added in Chapter 11, and because astronomers did not bother to investigate vacuities, why should anatomists36? Furthermore, the nerves were not hollow, but a particular kind of solid: "no cavity can be seen in them, no not by the help of Spectacles or a Microscope."37 Instead, the nerve "substance . . . appears plainly firm and compacted," like a "honeycomeb" or "Indian cane"38 (presumably sugar cane, an analogy not much different than Galen's description, noted earlier, of nerve interiors as "heartwood.") The reason Willis went on about nerve solidity was that hollow nerves would have undercut his larger model, perhaps fatally. All the important nerves either began in the brain or depended on it, by which he meant the solid tissues of the cerebral hemispheres. And "animal spirits," the stuff of nerve transmission, was special and limited in quantity. According to Willis, the "animal spirits are so subtil they do not require a cavity for their expansion, not in Substance of Brain or nerves but that the Ventricles, commonly so called, ought to be deputed to some other office than this. . . ,"39 Nerves also were made of "fibres," which were similar to fibers in ordinary tissues. It was these fibres that received "first of all and mediately the impressions of sensible things."40 Nerve fibers in the flesh of the lower body were not continuation of nerves though "dependent" on them; instead, they were either "spermatick," by which Willis meant embryonic or formed secondarily from blood. His view of fiber was consistent with Platonic natural philosophy and less expansive than that of Descartes, as I noted earlier.

The Case against Descartes's Pineal In making his case for a cerebral model of solid tissues serviced by a rich collateral network of blood vessels, Willis expended great effort writing against the hydrostatic ventricular/pineal model of Descartes. Much of this was implicit; he only mentioned Descartes by name a few times in Anatomy's, first section on the brain and not at all in the second section on the uses of the nerves. When his col-

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league Richard Lower published his Treatise on the Heart (Tractatus de Corde) in 1667, he too attacked Descartes both implicitly and explicitly. I would like to know their specific reasons; unfortunately, one can only speculate, as Willis left no extant manuscript versions of Anatomy or any notes, and Lower's extant correspondence does not settle the matter. It would be useful to know, if only to have a fuller understanding of the oppositional nature of relations between Oxford and Cartesian natural philosophy; perhaps Willis's model of brain and nerves would have been less solid and Lower's of the heart less emphatically muscular if the Oxford partners felt less challenged by their philosophical rival. In any event, Willis did not waste time in Anatomy before taking on Descartes's pet brain structure, the pineal. After describing the flow of animal spirits between the medulla and the cerebral hemispheres in Chapter 2, he called the "chink" in the "valley" where they flowed the "Anus or Arse-hole [where] the Pineal Glandula or Kernel is placed" (emphasis original).41 Later in the text he characterized the site as a "drainage hole," the pineal presumably serving as a stop valve.42 In Chapter 2, he also argued that the pineal did not have a major blood supply, it just appeared that way on casual examination.43 Besides, it was not really free to move much as it was only an "infolding" of choirodal tissue. Willis's analogy between the whole body and the brain (with Descartes presumably occupying the anus) provided rhetorical support for his construction of the cerebral hemispheres as a synecdoche for full human beings. Willis's early demotion of the pineal, undertaken while ostensibly talking about something else, set him up for his major assault on the pineal, which he elaborated in Chapter 14, entitled "Of the uses of the Pineal glandula and the Choroidal Infolding. ..." In it he argued that since the pineal did not have a significant blood supply, it could hardly be the source of animal spirits, for their manufacture required abundant blood. Moreover, the pineal was common in man, beasts, fishes, and fowls—and larger in them than us—so how could Descartes argue it was the seat of the Rational Soul in man? Besides, the medulla and underside of the cerebrum had many "kernels," and the pineal was not substantively different from them.44 Given that Willis considered the pineal, if not its champion Descartes, so insignificant, I find it telling that he devoted most of a separate chapter to it. In parallel with his extended attack on Descartes's version of the pineal, ventricles, and animal spirits, Willis mounted his own version of brain structure and function. Like that of Descartes's, it too had many internal consistencies. As had Descartes, Willis provided a midline structure to manage internal communication in the brain, the "callous body" (nowadays known as the corpus callosum). The callous body, a solid structure, was where the " animal spirits mingle as in a publick Emporium or Mart... for the uses of every faculty."45 It also provided a communication path between the hemispheres so that function could be preserved if one hemisphere suffered injury. And, importantly, it was common to all animals with brains. Descartes was wrong: "The seat of humanity does not lie in a midline struc-


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ture" was the implied message; moreover, adequate brain function does not depend on just one structure, but rather the dynamic cooperation of several elements, most of which have a double in case one fails. Within the same time period, Willis's friends among the High-Church Anglican clergy, whom I discuss in Chapter 5, were advancing analogous arguments about the social body of England. Significantly, they stressed the need for English people to cooperate under the leadership of the church and its Episcopal head. In doing so, they drew upon a venerable tradition of organic analogies between society and the human body in Christianity that stretches back to the New Testament and in English thought at least to John of Salisbury (1115-1180) in the twelfth century.46

The Importance of Hierarchy Anatomy's, second section, the "Description and Use of the Nerves," is where Willis took leave of Descartes, at least explicitly. As one might expect, hierarchy continued as an important theme. Indeed, the best way of "division" of the nerves (the context suggests Willis meant "classification") was not whether they were primarily sensory or motor or hard or soft—two venerable classificatory criteria— but instead determining which nerves were "Clients and Servants of the Cerebral Hemispheres, [and] perform only spontaneous Acts, and [which)] others, Ministers and Servants of the Cerebellum, are employed only about the exercises of the involuntary function."47 Despite Willis's opening lines about his new classification scheme, the format of "Description and Use of the Nerves" followed traditional presentations in the manner of Galen, whose Uses of the Parts remained the standard authority, albeit one called increasingly into question as I noted previously. When considering the auditory nerve, for example, Willis discussed at length human capacity for making and remembering melodies, as had Galen. And like Galen and Vesalius, Willis's description of the cranial nerves proceeded from one (smell) onward, and from top to bottom of what nowadays is called the brain stem. He frequently noted the views of ancient and modern anatomic authorities, such as Galen and Fallopius, usually just to acknowledge their original descriptions. He also remained relentlessly comparative with frequent references to nonhuman animals, usually large ungulates or dogs. Where one of their nerve structures differed notably from humans, he explained the difference through assessment of their functional needs versus ours. Generally, his tone was cordial and rather intimate, as though he were recasting lectures for print: The reason the "mutual kisses of Lovers, impressed on the Lips, so easily irritate love and lust by affecting both the Praecordia (area of the heart) and Genitals . .. and also admitted by the eyes" was because branches of what he called the fifth nerve innervated not only their lips and eyes but also the "lower belly."48 Unlike Descartes, who in crucial respects located mind outside of brain, Willis made mind adhere to brain as it never had before.49 Furthermore, as I will explore

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in subsequent chapters, Willis and his extended social circle had a particular version of mind to advance. Suffice it to say here that preservation of hierarchy was a crucial theme of their version, which is another reason, perhaps, why Willis paid so much attention to relationships between the cerebral hemispheres, cerebellum, medulla, spinal cord, and nerves. The gist of his argument was that at all times the cerebellum, medulla, cranial nerves, spinal cord, and peripheral nerves were in rank under the direction of the cerebral hemispheres. Resorting to political metaphors, he averred in the first lines of the preface that just as "The Romans sometimes promised to themselves an Empire . . . neither could they persuade themselves, that the Capitol should be the Head of the World, unless it had been built upon the Skull of a Man."50 Later chapters spelled out what he meant. In Chapter 17, the "nerves of the Cerebellum are compelled to obey the beck and government of the Cerebral Hemispheres. . . . The Cerebellum is not a free and municipal city.... So much for the [non-cranial] Nerves, which being subjected to the Government and Laws of the Cerebellum, seem to obey and serve under it...." The relationships were harmonious and cooperative: The cerebral hemispheres and cerebellum "perform mental offices as it were in a circle,"51 and the flesh/body received animal spirits "secondarily derived from the Head through the bodies of the Nerves."52 Such a tight hierarchy could only work, Willis thought, if each structure did not presume a role reserved for its superior. Repeatedly, he argued that there was "no immediate commerce between Cerebral Hemispheres and the Cerebellum."53 One anatomical reason he maintained the distinction between cerebral hemispheres and cerebellum was that comparative anatomy had shown him that "the Cerebellum itself. . .is found almost in all Animals of the same figure and proportion. . . ." Even those animals "diverse from Man," such as "fowls, fish, and mice" had a "similar cerebellum."54 This was not surprising, he argued, for the smooth functioning of the bodies of both man and beast required active management of their many similar "involuntary" functions, which was something the "regular" infoldings of cerebellar tissue were designed to do.55 Such similarity between man and beast was not the case for important portions of the cerebral hemispheres, nor for some of their functions, as I will discuss in the next chapter. Willis also thought a well-organized human brain and nervous system could only work if the animal spirits, the "subtil" (al)chemical element crucial for the cerebral hemispheres to control most important aspects of thought and bodily function, were elaborated in solid tissues of cortical (gray matter nowadays) and medullary (white matter) portions of the cerebral hemispheres themselves. (In comparison, Galen thought animal spirits were elaborated in the cerebral ventricles, and, as I noted previously, Descartes wrote they constituted themselves in pores and passages of the undifferentiated brain, with the pineal serving as their "fountain.") According to Willis, the medullary or inner portions of the cerebellum also manufactured animal spirits "designed for some works," such as the involuntary


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"beating of the heart, easie respiration. . . ." These automatic activities were "wholly distinct from the cerebral hemispheres," whose "irregular" convolutions signified their control of voluntary activities, which by definition were variable.56 In accordance with his commitment to cerebral initiation of voluntary thoughts and actions, Willis limited the amount and role of animal spirits. Although their "nutrition" activated many bodily functions, he did not want their elevated role degraded by routine functions that linked them intimately to the lower body. In Chapter 20 he hypothesized: "although nutrition depends in some measure upon the influence of the nervous Juyce, yet it is highly improbable, that all the several parts of the whole Body should be nourished only by this provision. For besides that this were to impose upon the Government of the Soul itself, and its primary Organs, the cooking office of nutrition wholly unworthy the excellency and dignity of those parts... ,"57 The demands of the lower body were simply too great; providing their nutrition was base work, and therefore inappropriate for an organ as exquisite as the cerebral hemispheres. Willis reinforced his view by invoking a metaphor involving division of human labor: "it seems also that the nervous Liquor should be altogether unfit for the administering to this Province: because when often times immense expenses are made of the aliment to be assimilated in the substance of the solid parts, especially by immoderate sweat, also by continual labour and exercise, which country-men and Labourers daily use, it is not possible that such losses should be repaired only by the nourishment supplied. . . ,"58 Willis's work during the 1650s on the chemistry of the blood, especially his model of fermentation, supplied the model for his elaboration and action of the animal spirits in Anatomy. As one might expect from his previous rhetoric of the blood, which borrowed heavily from the grammar of alchemical distillation, Willis continued his alchemical imagery in discussing the production of animal spirits. As the ever finer blood vessels coursed from the inner meningeal layer, the pia mater, through the cerebral hemispheres and cerebellum, Willis described the "distillation" of animal spirits from increasingly "subtil" components of blood, a reaction that occurred in the "substance of the cerebral hemispheres."59 Moreover, this exothermic reaction did not cause the spirits to "fly away," which they were "apt to," because the "Meninges, like an Alembick," kept them contained. (Alembicks, glass flasks with narrow necks curving to wide bottoms, were one of the basic containers for alchemical manipulations such as distillation.) Lest one think that the same process of distillation might go on in the medulla, which Willis did not want readers to confuse in rank with the cerebral hemispheres, he pointed out in the same section that "other shoots of the same [blood] vessels, covering the medulla, do only impart to it heat. . . ."60 After explicating the chemistry of the animal spirits, Willis added some examples of anatomic findings from deceased patients who had been sick, which, he argued, demonstrated that blockage of animal spirit flow caused disease: "I have sometimes opened the heads of the defunct,

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which when living, were obnoxious to most miserable headaches . . . where the seat of the pains was, the Pia Mater or interior, grew to the Dura Mater or exterior for some space . . . and by their growing together had excited a sharp and unequal tumor. . . ."61 Willis freely used military and governmental metaphors and wrote that "there be instituted a particular Cence (census) or Muster.. . following the order of Nature . . . in the animal Body."62 In comparison to Anatomy's exposition of the brain, however, "Description and Use of the Nerves" contained few freighted metaphors, and Willis's use of other editorial comments remained sparse. Conclusion As Willis and others brought the brain out of the skull in order to present it and its solid tissues as things-in-themselves, other early modern investigators sought to establish new ontologies for other organs as well. Much of this activity was stimulated by the early and mid-sixteenth-century revival of Galen's publications, as I noted previously. As one might expect, Padua, the intellectual home of Vesalius and Varolio, not to mention William Harvey, was an early center of exploring organ systems as things-in-themselves, but the practice soon became a trend that spread throughout Europe. In the opening pages of his text on female reproduction, De Mulierum Organis Generationi Inservientibus of 1672, which contained many illustrations of human uteri out of their enveloping bodies, Dutch physician Regnier de Graaf crowed: "and Galen never saw a human uterus, not even in his dreams. . . ."63 Sometimes the activity was stimulated by discovery of a previously unknown aspect of animal structures, such as Pecquet's 1651 discovery of the thoracic duct, which generated considerable Oxford interest in chyle and the role of the liver in blood production during the 1650s, as I noted in Chapter 2.M Professional medical organizations also commissioned historia, or a description of an organ system. During the late 1650s, the London College of Physicians (later Royal College of Physicians) commissioned Cambridge physician and natural philosopher Francis Glisson to write on the liver. The choice of organ was not casual, as the liver was one of the Galenic triumverate of noble parts. Nor was the timing of the commission, which occurred as part of the College of Physicians' larger effort during the 1650s to fashion itself as an active center of medical research. As with Willis and Anatomy, Glisson's name was on the text, theAnatomia de Hepatis of 1654, but it was a group effort, a reality he acknowledged in several places in the text. In 1656 the president of the College of Physicians commissioned a young Fellow, Thomas Wharton, to investigate glands; Adenographia, which was his individual work, appeared in 1656.65 Treatises devoted to single-organ systems extended beyond Latin texts for physicians and readers with university educations to include vernacular texts intended for surgeons and others without extensive university training. And the fact that a text might be in a vernacular


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language did not mean necessarily that it was cheaply produced. Eminent surgeons, such as Georg Bartisch, on retainer as court oculist to the Duke of Saxony, occasionally produced elaborate texts on the anatomy and techniques of their specialties. Bartisch's Das Augendienst (On the Care of the Eye) of 1583, for which he took credit for the illustrations, contained many flap diagrams of the eye that directed the reader to lift up paper layers as successive illustrations depicted deeper structures in the eye's interior. As I discussed in Chapter 1 regarding Vesalius and Fuchs, Bartisch sought to make the experience of reading about the structure of the eye as much as possible like an experience of dissecting one. Although their approaches and intentions differed profoundly in many respects, what set Descartes and Willis's efforts apart from these other explorations was their shared ambition of being read as authoritative natural philosophers of the human condition, not merely as innovative anatomic investigators of an important organ system. They also shared a commitment to the importance of what they viewed as a priori conditions of mind that did not depend on its relation to brain— in Descartes's case the nonmaterial nature of mind, and in Willis's the immortality of a divinely created rational soul. Although Descartes left spirit out of the body, including the brain, Willis put spirit in by virtue of his incorporation of his spirit-driven fermentation theory of the blood. Although he made a place for spirit, he also used his theory of generation of nervous juice to secure spirit's boundaries. It would not be able to run amuck as it might in a fully alchemical account. In addition to chemical control of spirit, the dominance of the cerebral cortex over the rest of the brain and lower body kept the spirits of passion in bounds as well, at least among the healthy. In framing their accounts of the human condition in relation to their respective models of the brain and nerves, Descartes and Willis each formed a natural philosophy inextricably intertwined with his respective portrayal of the physical body itself. But by placing the metaphysical in tangential relationship to the brain, they each created a paradox: How can one have a metaphysical body? In one sense the paradox came with the age. As I suggested in the Preface, natural philosophy was not science as that term has been understood from the nineteenth century on. God, and therefore by definition immaterial spirit, was always in the picture. Or, to put the matter in disciplinary terms, theology and natural philosophy had not yet parted.

Notes 1. Letter of Richard Lower to Robert Boyle, 24 June 1664, in Thomas Birch. The Works of the Honourable Robert Boyle, vol. 6 (London: Rivington, Davis, Johnston, 1772). 2. Thomas Willis. "Preface to the Reader," in Anatomy of the Brain, trans. Samuel Pordage (1681), verso. Facsimile: ed. William Feindel (Montreal: McGill University Press, 1965). 3. Willis. Anatomy of the Brain, 57.

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4. 5. 6. 7.


Ibid., 125. Ibid. Ibid. Anthony Wood. "Eulogy," in Willis' Oxford Lectures, trans, and ed. Kenneth Dewhurst (Oxford: Sandford Publications, 1980). 8. Willis. "Preface," Anatomy of the Brain. 9. Willis's translator Pordage uses this term first in Chapter 13 ofAnatomy of the Brain, 102. In Pathology the phrase occurred frequently in reference to anatomical findings. 10. Willis. "Preface," Anatomy of the Brain. 11. Ibid. 12. Ibid. 13. Ibid. 14. William Harvey to Jean Riolan, the younger, 1649. Translated from Latin by Robert Willis (1848) in Esmond R. Long, Selected Readings in Pathology (Baltimore: Thomas, 1929), pp. 11-4. The relevant portion in Harvey's letter: "I also intend putting to press my Medical Anatomy, or Anatomy in its Application to Medicine. Not with the purpose, like Riolanus, of indicating the seats of diseases from the bodies of healthy subject, and discussing the several diseases that make their appearance there, according to the views which others have entertained of them, but that I may relate from the many dissections I have made of the bodies of persons diseased, worn out by serious and strange affections, how and in what way the internal organs were changed in their situation, size, structure, figure, consistency; and other sensible qualities, from their natural forms and appearances.... From pathology the use and art of healing, as well as occasions for the discovery of many new remedies, are perceived." 15. John Aubry. Brief Lives, Chiefly of Contemporaries, Set down by John Aubrey, between the Years 1669 and 1696. ed. Andrew Clark, 2 vols. (Oxford: Clarendon Press, 1898), v. 1, p. 303. 16. For eighteenth-century clinical correlation, see Giambattista Morgagni. De causis et sedibus morborum. (1761). The Seats and Causes of Diseases, trans. Benjamin Alexander (London: Millar and Cadell, 1769). 17. Christopher Crenner, MD, PhD, is currently preparing a monograph on Richard Cabot, MD, the late nineteenth-early twentieth century Boston physician who inaugurated the modern clinical pathological conference at Massachusetts General Hospital. These conferences are reported regularly in the New England Journal of Medicine. 18. Johann J. Wepfer. Observationes Anatomicae ex Cadaveribus Eorum quos Sustulit Apolexia. (Shaffhuasen: Sutur, 1658) 19. Willis. Anatomy of the Brain, 91. 20. Wepfer also described the anastomosis between the carotid and vertebral systems at the base of the brain, as did Galen, but he did not elaborate on its form or function. For a translation of Wepfer's findings, see Edwin Clarke and C.D. O'Malley. The Human Brain and Spinal Cord. (Berkeley: University of California Press, 1968), pp. 772-5. 21. Willis. Anatomy of the Brain, 83. 22. Ibid. 23. Ibid., Chapter 1. 24. Ibid., 75. 25. Ibid., 187. For reference to fishes, 179. 26. Ibid., 180. 27. Ibid., 73.


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28. Ibid., 56. 29. "The Sacred Disease," in Hippocrates. 4 vols., trans. W. H. S. Jones (Cambridge: Harvard University Press, 1923), vol. 2, p. 175. 30. Ibid., 179. 31. Ibid., 159-61. 32. Plato. Timaeus. trans. Benjamin Jowett. Plato: the Collected Dialogues, eds. Edith Hamilton and Huntington Cairns (Princeton: Princeton University Press, 1961), pp. 1195-6, 73 b-d. 33. Galen. "The Use of Parts," in Oeuvres Anatomiques, Physiologiqu.es et Medicales. 1 vols., trans, from Latin to French, C. Daremeberg (Paris, 1854-6), vol. 1, pp. 532-5. 34. Willis. Anatomy of the Brain, 61. 35. Ibid., 65. 36. Ibid., Chapter 11, especially p. 91. 37. Ibid., 127. 38. Ibid. 39. Ibid. 40. Ibid., 128. 41. Ibid., 65. 42. Ibid., 107. 43. Ibid., 66. 44. Ibid., 106-7. 45. Ibid., 91. 46. John, of Salisbury. Le Policraticus de Jean de Salisbury, trans, from Latin to old French, Denis Foulechat (1372). Ms. No. 24287 de la B.N. livre IV/ presented in modern French and annotated by Charles Brucker. (Nancy, France: Presses Universitaire de Nancy, 1985). See also M.A. Brown. "John of Salisbury." Franciscan Studies xix (1959). 47. Willis. Anatomy of the Brain, 137. 48. Ibid., 143. For fragments of Willis's Sedleian lectures at Oxford on the brain and nerves from the 1650s, see Kenneth Dewhurst's translation of Richard Lower and John Locke's notes in Willis's Oxford Lectures. Locke then intended a career in medicine. 49. Robert Frank. "Willis and His Circle: Brain and Mind in Seventeenth-Century Medicine," in The Languages of Psyche, ed. George S. Rousseau (Berkeley: University of California Press, 1990). 50. Willis. "Preface," Anatomy of the Brain. On metaphors see George Lakoff. More than Cool Reason, (Chicago: University of Chicago Press, 1989). 51. Willis. Anatomy of the Brain, 120-1. 52. Ibid., 126. 53. Ibid., 111. 54. Ibid., 67. 55. Ibid. 56. Ibid., 111. 57. Ibid., 134. 58. Ibid. 59. Ibid., 88-9. 60. Ibid., 88. 61. Ibid., 90. 62. Ibid.

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63. Reinier de Graaf. De Mulierum Organis Generationi Inservientibus (1672). Facsimile edition, (Nieuwkoop: Dutch Classics in History of Science, 1965). 64. Robert G. Frank Jr. Harvey and the Oxford Physiologists. (Berkeley: University of California Press, 1980), pp. 104-5. Pecquet's discovery, however, was not reviewed until No. 7, 1667, of the Philosophical Transactions, pp. 461-4. 65. Thomas Wharton. Adenographia. (London: JG Impensis, 1656). English trans. Stephen Freer, intro. Andrew Cuningham (Oxford: Clarendon Press, 1996).

5 BODY OF WITNESSES

To see ourselves as others see us can be eye-opening. To see others as sharing a nature with ourselves is the merest decency. But it is from the far more difficult achievement of seeing ourselves amongst others, as a local example of the forms human life has locally taken, a case among cases, a world among worlds, that the largeness of mind, without which objectivity is self-congratulation and tolerance a sham, comes. —Clifford Geertz, Local Knowledge: Further Essays in Interpretive Anthropology (1983)1

Death into Life At a high level of abstraction, the many and diverse ways human groups have coped with illness and healing may seem almost alike. As anthropologist Arthur Kleinman has noted, in one form or another every grouping of humans possesses "a coherent structure of health beliefs and the institutionalization of decisive therapeutic practices."2 Moreover, the world's three venerable literate healing systems— Western biomedicine (including its Arab-Islamic variants), Indian Ayurvedic, and traditional Chinese medicine—as well as most vernacular or preliterate ones share several other characteristics. According to Kleinman these include, among other features, "master metaphors, idioms and other core symbolic forms that . . . legitimate practical therapeutic actions . . . and rhetorical strategies that healers deploy to move patients and families to engage in therapeutic activities. . . ."3 As one moves from these abstract universals toward particular knowledge traditions and healing practices, however, profound differences between the learned Western tradition, which I call biomedicine, and the rest emerge. If we limit the meaning of "biomedicine" for discussion purposes to the practices of its principal knowledge creators and their patrons, these differences become especially apparent. Arguably, Western learned medicine's most distinctive knowledge-making feature has been its historic reliance on anatomy. By this I mean anatomy in its 95

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narrow sense of the activity of anatomists deconstructing the insides of individual bodies as well as in the word's broader meaning as exploration of the body's internal structures and their relationships to function, as I discussed briefly in the Preface. Ayurvedic and traditional Chinese medicine have historical elements with some superficial parallels to Western anatomy, but neither system has taken up dissection consistently. When non-Western systems use cognates for anatomy in its functional sense, their methods of deconstructing humans and exploring their insides, not to mention the questions they ask, differ considerably from Western practices.4 For these Asian knowledge traditions, I think I do not exaggerate when I say that anatomy remains on their conceptual sidelines. In comparison, by demanding that medical knowledge relate structure to function in healthy and sick individuals, Western medicine's intellectual leaders from the Alexandrine anatomists, Galen, Vesalius, Harvey, Willis, and their intellectual kin on down to present-day masters of genomics have placed extreme emphasis on materialism as the only valid basis for knowledge. Aside from quantitative arguments, which began influencing Western therapeutics in the early nineteenth century, one must demonstrate the body's structure and function, however minute, to be believed. In other words, likeness has been framed in anatomical terms, a formulation that methodologically has trumped other approaches to medical knowledge making in the Western tradition. Accounts that rely on superficial description, a group that includes virtually all Hippocratic medicine and its intellectual descendants, are valuable mainly when structural accounts are not available, at which point they assume secondary status. To give a modern example: Consider the neurological disease multiple sclerosis (MS). Before the routine use beginning in the 1980s of magnetic resonance imaging (MRI) machines, which can produce finely detailed images of soft internal structures, neurologists diagnosed MS based on a suggestive patient history and physical examination. As no single laboratorty test or imaging study could rule in or out the disease, physicians observed patients over time to see if their function degenerated according to the typical course of the disease. With MRI machines, however, usually one can establish the diagnosis early as MR images are both highly specific and sensitive for MS. "Ocular demonstrations," to use the early modern phrase, lie at the metaphorical heart of Western medicine and, more generally, Western science. Demonstrations do not occur in a social vacuum, obviously. Witnessing, either in person or virtually by way of representations in texts and visual aids, is one of the two key social processes—the other being reproducibility—that provides a warrant for any prospective Western natural philosophy or scientific knowledge claim. In short, bodies and anatomic demonstrations performed on them in front of witnesses have provided a crucial guarantee of epistemic authority in biomedicine. But that is not all. Equally important, leading natural philosophers from the early modern period on as well as today's scientists assume that nature operates accord-

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ing to a "single, underlying, universalizable truth, a unitary paradigm."5 In comparison to other systems, Western learned medicine (and Western science in general) have insisted on single causal chains to explain specific phenomena, at least since the Scientific Revolution. Indeed, as I stated earlier, cultural tensions occurred at the historical moment when Western natural philosophy, including medicine, tacitly began to proceed as though nature in its everyday operations excluded the Ideological. The idea of a single causal explanation is also specific to biomedicine; in comparison, Ayurvedic and traditional Chinese medicine provide flexible and pluralistic explanations for almost any bodily phenomenon. As in medicine, so too in religion: Judaism, Christianity, and Islam, the three principal Western religions that trace their lineage from Adam and Eve, each assume God is one entity. Moreover, one has to look no further than Genesis, the foundational story for all three, to see that preoccupation with human bodies, witnesses and witnessing, and unitary explanations form important parts of the conceptual core of learned Western religious traditions as well. In comparison, Hinduism and Buddhism are pluralistic in terms of divinity and find the human dimensions of their essential realities elsewhere and by different methods. When one comes to Christianity, the religious tradition in which anatomy took on its recognizably modern form, resonance between medicine and religion becomes especially powerful. Indeed, tensions about human flesh, witnessing, and unitary causation lie at the core of Christianity to a degree that makes it culturally unique. God becomes a single human body who is born, lives, and dies. Then God resurrects this particular dead body, Jesus, who regains eternal life as God. Believers celebrate this miraculous transformation with a ritualized cannibalism: the sacrament of communion in which the faithful eat a wafer and drink wine to connect with the body and blood, respectively, of the risen Christ. Moreover, Jesus may have spent his early adult life as a carpenter, but he fulfills his godly mission as a healer. Even when he is not performing one of the thirty-two healing miracles recorded in The New Testament, Jesus' disciples and followers repeatedly refer to him as a healer. Nowadays, religion is mostly a private matter, especially among scientists. I doubt that any present-day anatomists or molecular biologists have glossed their presentations in religious terms. However, in the early modern period, when theology and natural studies were still intellectually and socially codependent, if uneasily so, investigators routinely exclaimed in their texts about the wonders of God's world and the Book of Nature as a complement to the great book, the Bible. As a group, few in Europe did this with more rhetorical flourish than the Oxford physiologists, especially during their early years. According to a young Robert Boyle, who wrote the following when he was twenty-one or twenty-two: "when, in a word, by the help of anatomical Knives, and the light of Chymical furnaces, I study the Book of Nature, and consult the glosses of Aristotle, Paracelsus, Harvey, Helmont, and other learned Expositors of that instructive Volume, I find myself

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oftentimes reduc'd to exclaim with the Psalmists (Ps. 104.24) "How Manifold are thy works, O Lord in Wisdom has thou made them a//!"6 According to Willis, the human cerebrum was both the "chapel of the Deity" and the "chief mover" in the "engine" of the human body.7 Indeed, if anyone was concerned that brain anatomy might be disrespectful of God's handiwork, Willis reassured them in his 1664 Anatomy that "Whoever professes Philosophy . . . I do judge him not only to have shaken hands with religion, but also with Reason."8 Not only did Willis present his work as an examination of God's handiwork, he also presented the investigative physician as Christ-like: "There should be an Entrance into the Church thorow the Spittle; for that it appears, our Saviour to have used almost this method . . . that the health of the Soul, should take its beginning from the restored health of the Body."9 Thomas Sprat, who actively promoted the Royal Society during the early Restoration, was even more emphatic in associating the paradox of Christ's humble methods and miraculous healing power with the "new" philosophy and medicine when he wrote in 1667: "The medicines for Religious distempers must be changeable according to the Diseases: and in this we imitate Christ himself in his method of healing mens bodies: some cures he performed by voice, some by Prayer, touch of hands, and even by his Spittle mingled with Earth."10 In this chapter I explore Willis's anatomy in comparison to its contemporary Continental counterparts. I will argue that it formed its own subculture with intentions, expectations, circumstances, settings, and purposes that expressed and generated specific meanings concerning spirit, control, and hierarchy, among others. Far from providing a "thick description," in the sense of a detailed account of philosopher Gilbert Ryle's "established codes"11 of a particular individual or social practice, I nonetheless intend to provide a sketch of what a "thick description" of what Willis's Cerebral Anatomy, and Pathology of the Brain, and Rational Therapeutics might include if one considered the perspective of Willis's patrons, participating patients and subjects, and their families. In other words, I aim to offer readers an historical account of the anatomists' actions from an anthropological perspective that seeks to provide, in Geertz's words, "the[ir] structures of signification . . . and determin[es] their social ground and import."12

Public versus Private When a "very noble lady" who had been a patient of Willis's died after she had seen "many other Physitians," he returned to her home at the behest of her "Friends that her dead Carcase, kept long opened for the funeral, should be diligently inspected, and so the genuine causes of the Disease and her Death, might be investigated."13 Echoing this sentiment, the Duchess of Newcastle wrote she did not want to see learned physicians criticized because they could not "restore every Patient to his former health . .. [when] they have only outward signs of inward

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distempers." Indeed, she thought the advance of medical knowledge suffered because "all [people] are not dissected after they are dead, to inform Physitians of the true cause of their death."14 In 1667 Willis reported postmortem findings on a child of "a nobleman," a "noblewoman," members of the gentry, among others, in addition to the "very noble woman." He performed most of these investigations in Oxford, as the text in which they appeared, the Pathology of the Brain and Nervous Stock, was substantially completed by the fall of 1663, when Willis still lived there. He performed some of them in patients' houses and the rest at The Angel, an Oxford coaching inn he leased with two partners as a combination of consulting rooms, patient lodgings, and anatomy and chemistry chambers.15 These human anatomies, together with those of the "whole Hecatombs of Animals" he had "slaughtered" in preparation for his Anatomy of the Brain published in 1664, provided the "ocular demonstrations" that he claimed as support for his "more certain Physiologic" as well as his "Pathologic of the Brain."16 As noted earlier, Willis, like many other early modern natural philosophers, also couched his enterprise in classic terms: "For either by this way, viz. by Wounds and Death, by Anatomy, and a Caesarean Birth, Truth will be brought to Light, or for ever lye hid."17 At the time Willis penned the above lines, physicians and surgeons had been giving private anatomy lessons and public anatomy demonstrations in one or another city in western Europe for more than 150 years. Indeed, in several cities anatomy lectures provided important public entertainments during the winter. Imagine for a moment that you are in Bologna on a winter day in 1640 and looking for something to do. You might want to go to the theatre. Although the show on offer at the largest theatre in town would be inherently dramatic and replete with persons acting out carefully scripted roles, it would differ profoundly from anything you might see in a typical theater then or afterward. For one thing, the principal actor would be dead, the corpse of a criminal who had been executed recently. For another, the author would not be a playwright, but instead a doctor, albeit a doctor performing according to a detailed script. Depending on which day you went in a ten- or fifteen-day cycle, you would see and hear a professor point to and occasionally cut different parts of the corpse as he explicated their structure and use. Opening performances were special, as the town's civic, religious, and academic leaders would likely attend and possibly remark on the proceedings.18 In all cases the "public" bodies of newly executed criminals provided the center of interest. Should you happen to miss the show in Bologna, you would be able to catch a similar show in a number of other European cities. Indeed, in 1640 the public anatomy show in Leiden had already been running for forty-three years, and that in Amsterdam for twenty-one. But this not at all the case in London, at least not then. During the eighteenth century fashionable Londoners began flocking to privately financed anatomy theaters, such as William Hunter's on Great Windmill Street, for lecture demonstra-

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tions. However, England never developed a civic culture of anatomy on anything like the scale it achieved in Italy, France, and especially during the seventeenth century in Holland.19 Although by the late sixteenth and early seventeenth centuries Bologna (1638), Padua, Leiden (1597), Delft (1614), Amsterdam (1619), and several other cities in Holland alone had communally financed anatomy theaters, in seventeenth-century England only the professional corporations and guilds in London—the College of Physicians and the Barber-Surgeons Company—had dedicated spaces for the seasonal performance of anatomies. These English performances were public in the legal sense—the body was of a recently executed felon—they were not public in the double sense they were in Italy, the Netherlands, and Paris. Not only was the audience largely limited to physicians and surgeons, but even among them attendance was scanty. The annals of the BarberSurgeons and the College of Physicians for the first half of the seventeenth century both note low attendance and occasional cancellation of the "public" lectures, which occurred at their greatest frequency a maximum of six times a year. In 1645, for example, the Barber-Surgeons secured an endowment of 250 pounds to generate income for the provision of one body and six lectures (initially by a physician) a year. The annals also indicate that despite regulations obliging attendance by "free" surgeons, absenteeism was rampant and considered a problem. Early in the century some London surgeons doubtless performed dissections for apprentices and students, who paid an admission fee, but the evidence is indirect and scanty.20 During the 1620s, the annals of the Barber-Surgeons record complaints about private anatomies being performed in the "upper kitchen" of their guild hall, and by 1631 their Masters authorized provision of a separate room for "private dissections."21 During the Restoration, semipublic anatomies occurred occasionally, but unless one was male and on familiar terms with one's physician or barber-surgeon or a member of the Royal Society, admission was unlikely. Moreover, before the entrepreneurial anatomy performances of mid-Georgian London, the space would not be a purpose-built theater with good sight lines but rather a plain room with a comparatively small audience. The public culture of anatomy on the Continent differed markedly from the English approach. In northern Italy and Holland, anatomy was highly regulated from the fifteenth century on. Both the kinds of bodies used and the settings of their deconstruction were specified. For example, in both Holland and Bologna, civic regulations required that the corpses for student dissections and the later public dissections had to be those of persons who had been "foreign" to the community in question. In Bologna, for example, this took the form of a requirement dating from 1442 that specified that bodies for student dissections had to come from at least thirty miles away.22 From an examination of the context of similar regulations for Amsterdam, Jan Rupp has concluded that the "foreign" restriction was to "prevent a sense of outrage on the part of the relative and neighbours of

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the executed criminal" or deceased indigent hospital patient.23 Furthermore, physicians and surgeons in Leiden, Amsterdam, and Delft were not allowed to perform "private" dissections in their homes or other places until the 1660s.24 In contrast, English royal regulations from 1540, which granted the BarberSurgeons the right to four executed criminals per year, did not restrict private activity.25 When Willis and surgeon William Day removed the (presumably) dead body of a felon from an Oxford scaffold in 1651 to take her to Day's rooms for dissection, a number of bystanders joined them.26 In 1638 the Barber-Surgeons disciplined a member for performing a "private" anatomy, but his infraction resulted from his doing the deed in his home as opposed to the guild hall, not because the body was locally known.27 Indeed, England did not develop a regulatory code for reconciling the interests of anatomists and the public until Parliament passed the Anatomy Act of 1832. Both medical and nonmedical interests in manipulating dead bodies seem to have developed significantly later in England than on the Continent. Among medieval nobility, the postmortem custom of dividing a noble corpse into parts, each of which received burial subsequently in the noble's various estates, did not occur as commonly in England as in the rest of Europe, especially in France.28 However, Tudor monarchs, especially Elizabeth I, refurbished a medieval Continental custom, the heraldic funeral. Both Tudor and Stuart monarchs attempted to regulate the funerals of persons with the rank of baronet or bishop and above. Although the practice dwindled by the middle of the seventeenth century, Elizabeth I and, to a lesser extent, James I actively promoted funeral licensing by the Crown and close management of funeral processions and burial rites by the College of Arms. For example, when one of England's twelve dukes died, his funeral was postponed until Crown agents and the remaining eleven dukes arrived.29 Consequently, significant delays occurred between a noble's death and his or her burial, a factor that favored the increasingly common practice of embalming. At the embalming of Sir Nicholas Bacon in 1578, three doctors were attended, but two surgeons did the actual work.30 Despite the Crown's regulatory initiative to control burial rites of the nobility, many resisted embalming and heraldic funerals. James Montague, Bishop of Winchester in the late sixteenth century, for example, directed in his will that his body should undergo "no cutting or mangling," but it was to no avail. He was, in fact, embalmed twice, the first effort failing to delay putrefaction sufficiently.31 By the 1630s, church burial records suggest that families nominally required to obtain a funeral license frequently chose an unlicensed nocturnal funeral.32 Because night funerals took comparatively little time to organize, postmortem manipulation of the corpse was not necessary. The choice of a quick nocturnal funeral was an obvious one for those who did not want to be embalmed or undergo autopsy. Records suggest they were most popular with aristocratic women and their children. Frances, Duchess of Richmond, directed in her will, proved in 1639,

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that "I may be speedily buried and not opened for so my sweet Lord out of his tender love commanded me that I should not be opened."33 During the reign of James I, both the College of Arms and Anglican leaders objected to nocturnal burials, but the practice seems to have grown nonetheless.

Emergence of Dissections as "Pretty" During the early decades of the seventeenth century, two unexpected royal deaths occasioned postmortem examinations. The death at a young age and subsequent postmortem of James I's son, Henry, Prince of Wales, received considerable public attention in 1612. In response to rumors of poisoning, the Privy Council ordered an autopsy, which was performed by surgeons and witnessed by the royal physicians and numerous courtiers. The report, which indicated death from natural causes, circulated rapidly in manuscript form in England and abroad.34 Similarly, the autopsy report on James I, whose death in 1626 was also rumored to be secondary to poisoning, received wide notice.35 Until William Harvey, however, English medicine, including anatomy, remained backward compared to its Continental counterparts. When its commentary is placed next to Vesalius's Fabrica of 1543, English surgeon Thomas Vicary's Anatomic of the Bodie of Man of 1648 seems retrograde. For example, although Vicary stated that the "Brain is the governor or Treasury of the 5 Wits," he described its physiology mostly in terms of lunar influences on the brain's motion within the skull.36 Surgeon Helkiah Crooke's Mikrokosmo Graphia, a popular vernacular anatomy first published in 1618, however, incorporated post-Vesalian innovations in anatomy although Crooke spent his entire career in England. Not only did England not have the civic and university anatomy forums present in Italy, Holland, and France; neither did it have the large hospitals, royal patronage, and effective central professional bodies that characterized French medicine and surgery under Louis XIV.37 Unlike Vesalius and his followers, English medical educators before Harvey did not integrate a surgical approach into medicine as effectively as their Continental peers. Some physicians, such as Richard Andres, performed anatomy with the London Barber-Surgeons in the 1630s, but he represented an exception. Harvey, however, trained at the University of Padua (MD 1602), which in 1600 was the center of advanced European medical thought, and he brought that approach to England in a public way from 1616 onward in his published Lumleian Lectures in Anatomy at the College of Physicians. For Harvey, as for the Italians who trained him, structure almost invariably implied function, which Harvey characterized in physiological, not astrological, terms. Like the Continental anatomists he imitated, he occasionally discussed dead patients and their ailments in his lectures and texts.38 In terms of understanding the continuum between health and disease, Harvey considered the bodies of sick patients almost more useful than

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those who had been healthy. As he wrote to his colleague, the Parisian anatomist Jean Riolan (the younger) in 1649: I also intend putting to press my Medical Anatomy, or Anatomy in its application to Medicine. Not with purpose, like Riolanus, of indicating the seats of diseases from the bodies of healthy subjects, and discussing the several diseases that make their appearance there, according to the views which others have entertained of them, but that I may relate from the many dissections I have made of the bodies of persons diseased, worn out by serious and strange affections, how and in what way the internal organs were changed in their situation, size, structure, figure, consistency; and other sensible qualities, from their natural forms and appearances. .. . From pathology the use and art of healing, as well as occasions for the discover of many new remedies, are perceived.39

During the Civil War, however, Harvey was "plundered" of his "anatomical histories of his patient sick bodies."40 As a result, Harvey's extant works make but modest use of pathological findings and clinical correlations. But his followers in Oxford, aware of his larger project, made such findings and correlations central to their arguments. Harvey was not the only English physician educated in Padua. In June 1654, for example, three English physicians who had studied in Padua directed a surgeon in the dissection of deceased Anglican divine Jeremy Whitaker. Also, scattered records indicate that surgeons and physicians performed some postmortems on soldiers who died in military hospitals during the Civil War. However, before the 1640s—the decade in which Harvey's theories and approach became accepted on both sides of the Channel—the anatomic method had little impact in England. This changed markedly in the 1650s, 1660s, and 1670s, primarily because of the success of Harveian models in stimulating additional investigation. Indeed, in 1685 surgeon Edmund King, a London collaborator of Willis discussed earlier in connection with hysteria, recorded that he had dissected "over a hundred brains."41 Most of King's hundred brains would have once occupied the skulls of gentry, clerics, and academics who came from families who had been Royalist during the Civil War and High-Church Anglican in their religious outlook. Although on the Continent the bodies of charity and military hospital patients and executed criminals formed the majority of early modern anatomic subject, in England the bodies of patients who had enjoyed relatively high social status provided the substrate of anatomic research. Why did they assent, and what were the implications of their participation? It was not because English people in general looked favorably on manipulation of the corpse. All extant evidence indicates that ordinary people did not want their bodies manipulated when dead, primarily because many believed that a fresh corpse retained sentience.42 Coroners' courts, for example, often took place in the presence of the body in question because of the widely held belief that a corpse would bleed if touched by the killer. Occasionally, courts specified that the body of a suicide should be buried outside of a village under the highway with its heart staked so as to prevent wandering of the decedent's spirit.43 As noted

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earlier, the rising proportion of unlicensed funerals among the gentry suggests that reluctance to undergo dissection and/or embalming was not confined to the relatively powerless. Several factors may account for the success of Willis's anatomic project among his particular subculture of elite Royalist and High-Church Anglican persons. Evidence does not permit definite conclusions about the importance of any one factor, however. The fact that powerful people often had a family heritage of postmortem manipulation may be the most important nonmedical influence. The older practices of division of the corpse and embalming both rested on a notion of the bodies of the aristocracy and upper clergy as possessing a semipublic nature. Ironically, their bodies, like the truly "public" bodies of executed criminals, in one sense existed on the same plane: Both were regarded as cultural resources by the living. In a practical way the old death practices meant that members of the elite subculture were accustomed to their friends and relatives being opened and cut after death decades before Harvey, Willis, and their collaborators became active. A more immediate and probably more influential factor was the increasing prestige of natural philosophy among cultural leaders. Charles II, whose medical interests inclined to iatrochemistry much more than anatomy and who proved to be no special friend to the College of Physicians, nonetheless attended one of George Ent's anatomy lectures at the College of Physicians in 1665 and knighted Ent at its conclusion.44 Thomas Sprat expressed delight at the new fashion for natural philosophy. According to Sprat, the "new" philosophy itself was partly about wealth and power, and it was not a moment too soon: "For now Philosophy, being admitted into our Exchanges, our church, our Palaces, and our Court, has begun to keep the best company . . . and to become the Employment of the Rich and the Great . . . whereas it was of old for the most part the study of the Sullen and the poor."45 Echoing Willis's distinction between blood and "nervous Juyce" and the latter's lack of capacity to nourish the "immoderate sweat of countrymen and Labourers,"46 the Duchess of Newcastle argued in 1664 that the prosperous needed learned medicine precisely because of their prosperity. Noting that "Country-people and Labourers take little or no Physick (medicine)," yet lived longer than "Great and rich Persons," Cavendish attributed their longevity to their "laborious exercises and spare diet." In contrast, the elite were "most commonly lazie and Luxurious," conditions and habits that bred "superfluities of humours, and these again breed many distempers." Consequently, the nobility needed learned medicine. Its "lenitive" medicines and greater understanding would "mediate" the disease burden of their "luxurious" lives. After all, she concluded, "physicians with good and proper medicines, have, and do as yet rescue more people from death, than the Laws do from ruine."47 Cavendish was not original in linking refinement to frailty. A staple of Renaissance literate culture was the characterization of scholars as vulnerable to bouts of

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strange behavior because of excessive reading. Indeed, Galenic humoralism assigned certain tendencies to anyone whose habit or occupation might cause their fluids to become unbalanced. Willis's reminder to his readers of the classic Roman maxim— mens sane in corpore sano—allied him with a venerable tradition even as he exploited it as a link to his anatomic project. What distinguished the new attitude from older humanist ideas was its emphasis on material connections between blood, the solid tissues of the brain, and the mind at the level of the individual patient and his or her family. Parents might let Willis or Lower anatomize their child who died convulsing in the hope that the knowledge gained would help save another child, perhaps one of the couple's future ones. Potentially, the new anatomy of "sick patients' bodies," to use Harvey's term, offered more than a sound mind in a sound body; for families it might mean that one could avoid the effects of inheritable harmful familial tendencies. Familiarity if not facility with microscopes and telescopes as well as the rhetoric of the "new" philosophy of the Royal Society was becoming part of the cultural furniture of both investigative medicine—Willis was the first European to regularly use the microscope in human anatomy48—and mainstream genteel life. If interest very quickly merged into fashion as the figure of the gentleman microscopist became a staple of late Restoration satire, I would argue that permission for private postmortem of one's relative or friend expressed a profound acceptance of the emergent prestige of natural philosophy. Diarist Samuel Pepys did not leave word of attendance at a human dissection, but he jotted that he spent an enjoyable half-day dissecting "pretty" things like cows' eyes with Lower and two other medical people.49 In his dissection of the orthodox Anglican minister Robert Bacon, Edmund King concluded his recitation of "matter(s) of fact" with the note that they had been "attested by [the decedent's] own relations who were ye Eye Witnesses of it."50 Writing in 1662 on the death of his friend, the influential High-Anglican scholar Henry Hammond, his biographer, John Fell, whom I take up shortly, included two pages of autopsy details on the grounds that "the Reader cannot want the curiosity to desire to know everything that concerned this great person."51 Willis performed the postmortem. Because of the Civil War and the numerous exiles it entailed, the subculture that endorsed Willis and his colleagues was more cosmopolitan than it would have been otherwise. Charles II as well as his courtiers, including the Newcastles, and High-Anglican advisers, had spent all or part of the Interregnum in Paris. When they returned to power in England, they brought with them Continental customs, among which was the long-established practice of elite postmortem. As historian David Harley has pointed out, the first European royal autopsy whose findings were widely disseminated was performed on Henri IV in Paris in 1610.52 Both the Oxford physiologists, via the approach and example of Harvey, and an important strata of their (eventual) patients via exile gained a different perspective than the prevailing English one on death and its lessons through their diverse exposures to foreign influences.

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I am not sure, however, whether the factors cited above provided both the necessary and sufficient conditions to account for the orthodox elite's participation in the in the private anatomic enterprise of Willis and his colleagues. For one thing, all of the conditions cited above had been present on the Continent for some time, not to mention the early modern Continental fashion for public anatomy theaters. Leading sixteenth-century anatomists practicing in Italy—Vesalius, Gabriel Fallopius (1523-1562), Realdo Colombo (1516-1559), and Eustachius (15241574)—described pathological organs occasionally.53 However, they made few systematic efforts to link pathological abnormalities with disease processes or patient histories. Colombo's De re Anatomica (1559), for example, devoted a section to pathological findings, but its emphasis was on "rare and abnormal things," including "monsters of nature," which were a category of fashionable interest at the time. Antonio Benivieni's the Hidden Cause of Disease (1507) represents an exception. Obtaining permission from patients' relatives in twenty-two instances, Benivieni sought to correlate their clinical histories with postmortem findings. However, he made only weak correlations, perhaps because his anatomies were not detailed.54 What made Restoration England unique was the intersection of an investigative team with a well-developed program and focus—establishment of the cerebral body as the true architectonic—with a determination on the part of their clientele to re-establish their paramount position in politics, society, and religion. The Duchess of Newcastle, well-known in Restoration court circles for her disparagement of microscopy ("deluding glasses"), nonetheless supported the "new" philosophy of medicine in its competition with traditional Galenic humoralists as well as popular healers. To do otherwise, she believed, would be to support "hereticks."55 Her attitude, which had echoes in the rhetoric of the controversy between the Helmontians and collegiate physicians noted in Chapter 2, reflected the Restoration establishment's increasing tendency to promote the knowledge claims of loyal and orthodox thinkers and maintain wariness toward any knowledge claims, including those of popular medicine, that had been given radical interpretations by religious sectarians and medical popularizers. After all, Nicholas Culpeper, the mid-century medical popularizer, wanted to see all professional English monopolies done away with: "The liberty of our commonwealth is most impaired by three sorts of men: priests, physicians, and lawyers, all of them monopolists."56 When the world had turned upside down in the 1640s and the monarch and head of the established church executed, many High-Church Anglicans and Royalists found themselves on the bottom. They were not eager to embrace any approach that eschewed hierarchy in favor of popular enthusiasm. Suppose that instead of the noble, Willis had attempted to frame his arguments in terms of the anatomical structures of criminal bodies and the occasional charity case. How would one know whether his declarations regarding a body's clinical course and structural pathology reflected a normally operating rational soul,

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an antemortem disease, the bodily disruption of an execution in the case of the criminal, or the taint of the decedent's base social position? The prestige of elite endorsement doubtless figured into the equation. At least, if one's arguments were based on the bodies of the undesirable, why would elite patients and physicians be inclined to accept them or consult their promoter? Given the intense interest in witnessing expressed by diverse early modern persons, as well as its role in the history of science,57 it may be useful to consider a few aspects of the anatomic ritual as practiced by Willis and his colleagues. Clearly, it was much different than the official demonstrations of Continental anatomy theaters or the lecture rooms of the medical organizations. The speaker was not behind a podium reading or by a well-lit table as the prosector demonstrated a semiprepared anonymous cadaver. Instead, the lighting was dim, and the corpse personally known, quite likely emitting horrible smells, and displaying in its open form convoluted masses of indistinct and putrefying organs. Not only would an infectious process—the usual cause of death—contribute to this, but so too would the common delay of a day or more between death and postmortem. In this setting, it is difficult to imagine that the ten or thirty professional or lay witnesses saw much more that what the lead physician or surgeon told them was present as he poked and cut about. Certainly, this was the case with the "ocular demonstrations" of brain structures that Willis described and illustrated. Not only does the brain not exist independently of the skull and its membranous attachments, but also, fresh brains that are removed from the skull do not retain their shape, as noted earlier. Instead, unless fixed with fluids that preserve and stiffen, they tend to sag over minutes into an amorphous mass with a half-spherical shape. Helkiah Crooke noted as much in 1618 when he advised would-be anatomists to "take the head of a man newly cut off" to avoid the "waterish" quality that otherwise set in.58 By way of contrast, muscular structures, such as the heart, tend to retain their shape for some time. As we shall see in the next chapter, this indeterminacy of neuroanatomic "facts" was not lost on contemporary critics. However, it does not seem to have troubled Willis's medical and lay supporters. In the text The Natural History of the Passions, published in 1674, the author indicated in the preface that he was writing "not as Orator or Moral Philosopher, but only as a Natural one conversant in Pathology."59 He then proceeded to describe human affective states in terms that recapitulated Hammond, Gassendi, and Willis. Indeed, he praised them and Bacon lavishly while attacking Cartesian physiology at length. The author made it clear that the new cerebral model was not for everyone. Specifically, he did not "recommend" his treatise to the "unlearned" and the "vulgar," citing as his reasons their inability to distinguish truth from error and his doubt that the new knowledge "can neither please nor reform them."60 I do not know who wrote the book. A penned note on the title page of the Wellcome Library copy indicates Henry Carey (1596-1661), the second Earl of Monmouth. However, as the printed text

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contains references to Willis's DeAnima Brutorum of 1672, that attribution seems impossible. In the Uncertain Art ofPhysick of 1684, which purported to be a translation of a work by the Italian anatomist Leonardo di Capria, the translator/author, who identified himself as "J.L. Gent," developed the thesis that learned medicine was progressing from a discipline of "art," which he equated with uncertainty and the practice of empirics, to one of "rational physick." Anatomists had led the transformation, and Harvey was the greatest of them in "former ages." In 1684, though, honors should go to Willis, whose "new system of Rational Physick" was "advancing apace along the path of immortality and Glory." No doubt further progress by "modern anatomists" and the "new Natural Philosophy" would bring about additional improvements.61 The book was dedicated to Robert Boyle, a common dedicatee of many authors. In late 1686, Edmund King, whom Charles II knighted shortly before his death, heard about the final illness of one Robert Bacon, an orthodox Anglican minister at Windsor who had a reputation as a minor theological scholar and was known for his even and cheerful personality and abstemious habit. For the previous twelve years, however, Bacon had been subject to a variety of disablements, including falling to the right, transient abdominal pains, night sweats, and, near the end, "put[ting] 2 or 3 Hatts at a time upon his Head like an Antick" and speaking with "Vociferation" with little provocation. Wanting to learn what "might occasion so great a change was in him some Years before his Death," King, who was not the patient's physician, approached the minister's family regarding permission for a postmortem. They not only granted permission; according to King, they watched as the surgeon dissected Mr. Bacon's head, chest, and abdomen shortly after his death. In reporting his findings to the Royal Society, which published them promptly in the Philosophical Transactions, King noted that he had "dissected more than an hundred brains and never saw such a one."62 One wants to ask at this juncture, just what kind of ritual was being performed? Scientific and propositional, religious and unshakeable, or something of both? The fact that the witnesses often watched their recently dead relatives being cut up argues to some extent for the latter. According to the twentieth-century philosopher Wittgenstein, religious belief: "will show, not by reasoning or by appeal to ordinary grounds for belief, but rather by regulating . . . [the believer's] whole life. This is a much stronger fact—foregoing pleasure, always appealing to this picture. This in one sense must be called the firmest of all beliefs, because man takes risks on account of it, which he would not do on things that are far better established for him; although he distinguishes between things well-established and not well-established.. . ,"63 Even when later writers questioned Willis's neurological theories, particularly those on animal spirits and nerve transmission, they tended to accept and reproduce his team's images of the brain as "real." The well-known religious dissenter

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and naturalist John Ray, who published an influential late-seventeenth-century compendium of the Book of Nature entitled The Wisdom of God Manifested in the Works of Creation, had little use for Willis's neurological theory, but his text borrowed directly from Willis's neuroanatomy, particularly his comparative work.64 Thomas Gibson, a Fellow of the College of Physicians and the author of the synthetic Anatomy of Human Bodies Epitomized, first published 1682, noted that "learned" men did not agree about the nature of the animal sprits Willis discussed. Also, Gibson was not confident of Willis's characterization of the seventh cranial nerve: "but for Dr. Willis says, (I cannot tell how truly.)"65 He used Wren's illustrations of the brain, however, and acknowledged their origin in Willis's Anatomy, and the latter received by far the most citations.66

Patrons and the Larger Project In common with many early modem natural philosophers, not to mention today's scientists, Willis and his colleagues benefited from considerable patronage. Although patrons did not subsidize his anatomic enterprise directly in a manner analogous to modern-day research grants, they arranged for publication of his findings and promoted him and his colleagues actively and successfully. Moreover, his patrons, some of whom were his patients, formed a tight network. For many years they possessed considerable power in the English government and state church and they were not shy about using it. Most of them were long-term friends and/or allies who shared a long-term agenda with broad cultural and social ambitions. By virtue of his training, practice, marriage, and religious orientation, not to mention his natural philosophy, Willis existed at the heart of the network. So too did Wren, who also had the benefit of inherited High-Church Anglican privilege. In comparison to the social demography of the London experimental clubs of the 1640s, the young men who became most involved in Harveian physiology at Oxford came from predominantly orthodox Anglican backgrounds. Moreover, several of them, including Willis and Bathurst, entered Oxford with the intention of becoming Anglican divines and changed their vocational emphasis only when Royalist defeat made an Anglican religious career seemingly not possible.67 As did Bathurst, others, such as the major figure, Seth Ward (1617-1689) and the (unrelated) virtuoso John Ward (1629-1681), earned part or all of their livelihoods practicing natural philosophy (Seth Ward became Savilian Professor of Astronomy at Oxford in 1649) or medicine (John Ward) until the Restoration made Anglican religious vocation again feasible.68 In terms of family background, five of the thirteen major Oxford physiologists, to use historian Robert Frank's term, had fathers who had Anglican religious vocations.69 They also tended to come from established families, some of whom possessed considerable property and social station.70 Three came from families headed by gentlemen or above. Two

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were from yeoman stock, and the fathers of the remaining three were a goldsmith, a clothier, and an attorney.71 Willis did not have an MD when Gilbert Sheldon, then Bishop of London, Warden of All Souls (College), Oxford, and de facto the nation's most powerful prelate, arranged his appointment as Sedleian Professor of Natural Philosophy at Oxford in 1660. (The MD came a few months later, also courtesy of Sheldon's intervention.) Sheldon, who Pepys described as a man of "great business, among the most powerful in England,"72 was less interested in theology than he was in recovering church wealth and controlling ministers, the universities, and congregations. According to another biographer, Bishop Burnet, Sheldon had the character of a "learned man" before the Civil War, but after "was now so engaged in politicks, that scarce any prints of what he had been remained. . . . He seemed not to have a deep sense of religion, if any at all."73 Sheldon may have cultivated an independent interest in natural philosophy, as his papers at Lambeth Palace contain an undated and unpublished manuscript Latin Principia on natural philosophy that I think is in his hand. Alas, I have not been able to decipher his handwriting. Assuming effective control of the university as the monarchy and church returned to power, Sheldon made professorial room for Willis simply by kicking out the chair's then current occupant, the Presbyterian Joshua Crosse. Such moves were common on both sides. When the Royalists lost the Civil War, the Parliamentary victors forced out approximately 2,000 orthodox Anglican prelates and academics while their leaders, Charles I and Archbishop Laud, lost their heads. When the Royalists returned to power with Sheldon as their de facto religious leader—his ally Archbishop Juxon being chronically ill and very old—Sheldon's group "ejected," which was the early modern term for forced resignations, approximately 2,000 moderate and nonconformist clergy from their parishes in their first three years.74 In 1667, Willis relocated to London at the urging of Sheldon, who was then his patient as well as Archbishop of Canterbury. Sheldon held the latter post from 1663 until his death in 1677. Sheldon also arranged a Lambeth doctorate in medicine for Edmund King, the London surgeon who collaborated with Willis on his later anatomic work; the prelate also arranged King's appointment as a physician to Charles II.75 Richard Lower's political and religious sympathies were always suspect in the eyes of Royalists and High-Anglican churchmen, but Willis trusted and relied on him, which was probably why Sheldon encouraged Lower's practice in London as long as he remained relatively reticent in political and religious matters. Sheldon's interventions may have benefited Christopher Wren most of all. With his friend and ally John Fell, whom I shall take up shortly, Sheldon managed Wren's appointment at age twenty-nine to the Savilian Professorship of Astronomy at Oxford in 1661. After the great London fire in 1665, Sheldon and his allies gave Wren the bulk of the architectural commissions to rebuild London

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churches. Later in the 1660s, he commissioned Wren to design his personal gift to the university, the Sheldonian Theatre for public university functions. He also made a gift of 2,000 pounds to support a "Learned Presse," the forerunner of Oxford University Press, in the theater's basement.76 William Petty, another early associate of Willis and sometime Oxford polymath, also received several church architectural commissions although he was not a Royalist or High-Church Anglican favorite. Sheldon's name appeared on the top of the petition of the nascent Society of Chemical Physicians for a royal charter in the plague year 1665-1666, but my supposition is that his early backing, which he did not sustain, resulted from his cultivation for favor with Charles II, an amateur chemist who maintained cordial relations with some Helmontian healers. Even before Charles II assumed the monarchy, Sheldon, who had served his father, secured the promise of full restoration of church lands and money that had been seized by sectarians after the Civil War. In 1660 a number of loyal Anglicans wanted, like their newly restored king, to reach a relatively inclusive religious settlement for Protestants, including moderate Presbyterians. Indeed, Sheldon, who managed to secure appointment from the king to the Privy Council in 1660, hosted a conference of Anglican bishops and Presbyterian leaders at his Savoy residence in 1661 to discuss liturgy and other church matters. No agreement was reached, which led both sides to lobby Parliament for legislation in favor of their respective interests. During its first few years the Cavalier Parliaments passed various religious acts concerning liturgy and church governance, the Act of Settlement of 1660 and Act of Uniformity of 1662 arguably being the most important. Areas of disagreement abounded between the various sects and between them as a group and the orthodox Anglicans concerning liturgy and church governance. The crucial issue with most of them, including even those who would otherwise nominally conform, such as moderate Presbyterians, involved the issue of church hierarchy. Presbyterians by definition opposed episcopacy; Sheldon and his allies insisted they conform and persuaded Charles II to insist as well. They won, at least in the short term. Instead of sanctioning modest levels of diversity of liturgy and governance, a tightly drawn Act of Uniformity of 1662, passed with Prayer Book attached, gave the "Episcopal Party," as Sheldon's faction was popularly known, the legal backing to pursue their vision of orthodoxy. The law specified that all sectarians, sober and pious as well as fervent enthusiasts, were required to submit to a standard liturgy and governance by bishops under the suzerainty of Sheldon as archbishop. Shortly after passage of the Act of Uniformity, Charles II appealed to some Anglican bishops to loosen its strictures through asserting a royal prerogative to dispense some dissenting individuals from the Act's requirements. On behalf of the bishops, Sheldon refused, identifying episcopacy with "the wishes of the ruling class, against opponents either royal or plebeian."77 According to Sheldon: "Tis only a resolute execution of the law that must cure this disease [sectarianism], all

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other remedies serve and will increase it; and it's necessary that they who will not be governed as men by reason and persuasions should be governed as beasts by power and force, all other courses will be ineffectual, ever have been so, ever will be. . . ."78 As part of his effort to extend the restored church's control into everyday English life, Sheldon revived episcopal licensing of the professions and influential trades. Writing to all bishops in 1665, he directed the bishops by letter: "every one of them particularly certify me, the names sirnames, Degrees & qualities of all Practicers of Physick within their respective Dioceses: In what towns villages or Places they live; whether Licensed & by whom; & how they appear affected to His Ma(jesty) gouerm(en)t & ye Doctrine & Discipline of ye church of Engl[an]d." In the letter's next section, Sheldon asked the bishops to report "cases of all nonconforming ministers."79 Three months later, Sheldon expressed concern regarding the "secretly printing activities of London printers." These activities might lead to "disorder. .. dire mischief... and great prejudice of the publick." To assert control, he instructed the Stationers' Company of London to "bind no any apprentice contrary to the (ancient) Rules." Also, he asked the Stationers' Company to "certify to" him "the number of printers in London and the addresses of all apprentices."80 As part of his tenacious pursuit of what he viewed as the re-establishment of true orthodox English Christianity, Sheldon, like many politically adept officials in other times and places, made and broke alliances during his long and varied career. He did form several (adult) life-long associations, however, with likeminded men at Oxford and elsewhere and provided them loyal support. At Oxford, Sheldon was especially close to at least three High-Church Anglicans who proved influential in disseminating the new natural philosophy of brain and nerves: theologian Henry Hammond (1605-1660), with whom he served Charles I and with whom he was briefly imprisoned in Oxford when it came under Parliamentary control in 1647 during the Civil War; John Fell (1625-1686), who was Hammond's biographer, Sheldon's chief ally at Oxford, Willis's brother-in-law, Warden of All Souls (College), and from 1675 on, Bishop of Oxford; and Richard Allestree (1619-1667), provost of Eton, the minister who presided over Willis's marriage to Mary Fell, and author of influential conduct books that I discuss subsequently. During the Civil War, some or all of them met regularly in Willis's Oxford lodgings to hold clandestine Anglican services.

Theological Concerns As he explicated the soul in neurological terms, Willis cited two main authorities: Pierre Gassendi, whom I discussed earlier, and Henry Hammond. Later, when Hammond died, Willis anatomized him as Fell recorded the details in his biography of Hammond.81 Hammond in turn had been close to Archbishop Laud and

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provided intellectual support for his administration's efforts to reduce the influence of ardent Calvinism in the English church. In the early 1600s to be an ardent Calvinist was to be a Puritan, a term whose subsequent meaning has expanded considerably. But in the early 1600s ardent Calvinists were often called Puritans by their detractors. Later, those so labeled adopted the name as their own even as the term Puritan expanded its boundaries. Ardent Calvinists were also known by contemporaries as religious enthusiasts, a term that contemporaries used pejoratively to refer to someone who, pace Calvin, put few if any bounds on spirit. I use the term ardent Calvinist and not just Calvinist because to some degree every member of the Church of England in those days was a Calvinist, so pervasive was his influence on English religion from the late sixteenth century onward. Even though Calvinists maintained that God was remote, unknowable, and arbitrary concerning mercy, they also held that rigorous cultivation of one's spiritual life was both necessary and sufficient behavior. Thus, while God might never be present for a believer—God was not obliged—the believer's task was to cultivate himself or herself for God's possible presence. As ardent Calvinists argued for presence in the form of the primacy of the Biblical word and the spirit, they eschewed the value of established church liturgy, which placed tight bounds on spontaneous expressions of religious rapture, and Episcopal authority. Instead, they favored unmediated experience, a posture that led many of them to question the value of other forms of institutional mediation as well, including the absolutist claims of monarchy. By the late 1630s Archbishop Laud, for one, could not contain the ardent Calvinists administratively, which is mostly why he lost his head in 1645. Hammond, instead, waged his campaign through writing theological texts. Hammond's social connections and his texts provide a lens through which one may get a sense of the theological topography, if you will, that Willis and his religious supporters sought to negotiate and, in time, reshape. Willis made direct use of Hammond's characterization of the human soul in Hammond's Practical Catechisme, a text that went through twelve editions from 1644 to 1683, as possessing a dual nature. Hammond wrote the soul was both immortal and immaterial as a Rational Soul and "subtle" and "finely material" as a corporeal soul. Hammond's characterization resembled Gassendi's, though I cannot determine if he was familiar with the Frenchman's thought.82 In contrast to the Calvinists, who stressed the arbitrary nature of God's predestination of souls for salvation, Hammond emphasized the conditionality of God's offer of salvation: Salvation depended on living well. Living well, in turn, depended on habitual repentance, obedience, duty, and performance. Assuming that one lived well by these precepts, God's offer was open to all. Not only did this make the world and God more reasonable, in the sense of less arbitrary, it also undercut the sectarian impulse to resort to displays of religious enthusiasm, such as speaking in tongues, to demonstrate the presence of the unknowable God's spirit.

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Since the late sixteenth century, when Calvinist influence began exerting power in the English church, some Anglican theologians had resisted Calvinist characterizations of God as unknowable and arbitrary and its corollary, that one's soul was predestined. Instead, late-sixteenth-century theologians such as Richard Hooker reached back into Catholic humanist tradition and argued, following Thomas Aquinas and others, that God's laws were natural and that natural law was the law of reason: "The natural law," wrote Hooker in the early 1590s, "meaning thereby the law which human nature knoweth itself in reason universally bound unto . . . comprehendeth all those things which men by the light of the natural understanding evidently know."83 Calvinism, or Puritanism as it became popularly known in England during the early seventeenth century, influenced every European Christian in the sense one had to take a position concerning reformist arguments. The increasingly selfidentified Anglican intellectuals did not repudiate Calvinism wholesale; nor did they deny that scriptural authority and church tradition were not crucial. Nonetheless, Hooker, Laud, Hammond, and their collaborators all argued for a theology that valued reason, by which they meant reason as represented in traditional moral and natural philosophy, as an independent authority in matters theological along with church tradition. With the rise of the "new" natural philosophy in the mid-century experimental clubs and its subsequent public success in the Restoration, "evidence of reason" became even more popular as an Anglican trope among the strictly orthodox, such as Sheldon, as well as among "latitude men" such as Edward Stillingfleet (16341699), who served as Dean of St. Paul's before becoming Bishop of Worcester in 1689. Stillingfleet voiced a common belief among this diverse group when in 1682 he preached in favor of a prose style akin to that in the Philosophical Transactions of the Royal Society. According to him, "the style and way of writing" should be "to join clearness of expression with evidence of reason."84 In comparison, Calvinist theology severely constrained curiosity, which the "new" philosophers praised as reasoned inquiry. According to Calvin, one should "not indulge curiosity." It was a sin "when miserable man endeavors to force his way into the secret recess of Divine wisdom . . . that he may discover what is determined concerning him at the tribunal of God."85 Scripture alone, not some amalgam of scripture, tradition, and reason, had full authority. Calvin maintained the Fall was the essential fact of the human condition. Because of their original sin, men and women were permanently alienated from God, who was unknowable. Therefore, humans existed with no assurance of redemption. A person might be saved, but only if God had so predestined his soul. General providence, a trait of God's behavior that appealed strongly to the self-consciously Anglican like Hammond, had little place in Calvinistic thought. One could only hope for special providence, or salvation. So much for the individual sinner. Socially, Calvinists interpreted the universality of the Fall and the general wretchedness of man's

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condition as factors favoring congregational election of ministers and equality among those ministers. Moreover, they promoted literacy and widespread distribution of vernacular Bibles, as I noted in Chapter 1. Needless to say, they were adamant in their opposition to episcopacy.86 Ironically, the other main component of mid-seventeenth-century nonconform ism, Christian mystics, also tended to assign reason a subsidiary role, or at least reason as defined by orthodox Anglicans. Sharing several crucial cosmological assumptions that lay behind the theory of matter of Paracelsus, van Helmont, and other alchemists, the Rosicrucians, Familists, Quakers and other enthusiasts, tended to value reason only so far as it amplified an "inner light." Far from being remote, God was directly accessible through cultivation of this "inner light" in individual and social life. Although the various mystical sects were diverse in many respects, they also shared a deep belief in free will. Echoing Anne Conway, whom I discuss in the next chapter, they tended to characterize human souls as possessed of liberty of choice and free of predetermined constraints.87 Socially, they tended to share the idea that the brotherhood (and sisterhood) of the spirit argued for egalitarian administration of church and community. Another great irony of Reformation Protestantism was that both Calvinists with their distant and unknowable God and Christian mystics, who tended to celebrate God's nearness and accessibility, sought a similar crucial moment in their individual religious lives: the epiphany of a conversion experience, a numinous religious ecstasy that virtually demanded public demonstration of enthusiasm. When John Winthrop, the early New England Puritan leader, recalled in later life his "illumination," he noted he had been "filled with joy unspeakable, and glorious with a spirit of Adoption."88 Before the eighteenth century, when religious enthusiasm declined for a time among most Christian sects, Calvinists and mystics alike were convinced that speaking in tongues and other seemingly odd behaviors were signs, they prayed, of God's extension of divine grace or special providence. Standing apart from the fervent Protestants but exerting cultural pressure nonetheless were those natural philosophers who sought to read spirit out of the universe. If emphasis by the hotter sort of Protestants threatened High-Church claims for the need for episcopacy and a liturgy that minimized spontaneous expressions of enthusiasm, constructions of nature and the church as essentially material and civil raised the specter of atheism. In this sense the formulations of the Cartesians and Hobbes, despite their denials of atheism, were never far from orthodox theological concern. Calvinists and Protestant sects that emphasized inner spirit and "inner light" and ardent materialists existed in Continental Europe too, as did those like Gassendi who characterized reason in terms more or less compatible with traditional definitions of natural law. Indeed, most Protestant sects in England could have traced their theological roots, had they so wished, to the Continent. Tensions within Protestantism and the specter of atheism existed to some degree everywhere during the Reformation and Counter Reformation of early modern Europe. But only in

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seventeenth-century England did they converge with other political, social, and cultural developments to form an unstable mixture that led to an extended national crisis of identity and management from the 1630s through the 1680s. As the Restoration progressed in the 1670s, and conservative Anglican leaders and the Court voiced their absolutist positions more frequently, members of mystical sects, especially the Quakers, experienced increasingly harsh suppression. Those who questioned hierarchy, even if they attempted to do so in remote private gatherings, were not to be tolerated. Willis's emphasis on hierarchy in his physiology found its counterpart in his patrons' emphasis on hierarchy in social and political arenas. During the Interregnum, the public status of Roman Catholicism was not the divisive issue it had been under the Tudors, but the reinstallation of the monarchy in 1660 in the person of Charles II and his marriage soon after to a Catholic princess, Catherine of Braganza, daughter of John IV of Portugal, signaled that the "popish religion," as contemporaries termed it pejoratively, returned as another potent factor in English political and religious life. Charles II's ongoing negotiations with France and receipt of initially secret payments from the French government reinforced a widespread English sense of political and religious threat from Continental Catholic powers, not to mention doubt of their own leader's devotion to England as a Protestant nation. Tensions about the role of Catholicism in English life increased throughout Charles II's reign, and their history is intricate. Charles II died a professed Catholic in 1685 and was succeeded by his Catholic brother, James II. Three years later England secured its future as a Protestant nation through a complicated series of events known as the Glorious Revolution, when Parliament exchanged the Catholic James II for his Protestant daughter and her husband, Mary and William of Orange.

Maintaining Sovereignty Political historians John Pocock and Gordon Schochet have argued, I think persuasively, that the theme of sovereignty lies at the heart of England's extended political crisis of the seventeenth century. By sovereignty, they mean "power and authority as a coherent and legal singularity." In the early seventeenth century, Jean Bodin, the French author who first developed the concept, characterized sovereignty as "the most high, absolute, and perpetual power ouer the citizens and subjects in a commonweal... that is to say, The greatest power to commaund."89 According to Pocock and Schochet, "The political thought of the Interregnum, from as early as 1647 through 1660, was concerned with the replacement of a sovereignty that had collapsed; and the political thought . . . (to 1800) . . . was concerned with ensuring that this problem should never again recur."90 Although Pocock and Schochet limit their discussion of sovereignty to its political context, I maintain that concerns about hierarchy and power—about the

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very notions of what it means to be "head" and "body"—suffused English political, religious, and intellectual life, especially from the mid 1650s on. One cannot write adequate history of English natural philosophy in the early modern period without acknowledging some codependence, to use an anachronistic term, between it and important religious and political themes of the period. Many other historians of early modern natural philosophy have reached the same general conclusion. Beginning in the 1930s with Robert Merton and continuing into the 1980s with Charles Webster and their followers, some have characterized the emergence in mid century of the "new" natural philosophy as an expression of "Puritan" values and social structures.91 Earlier, German sociologist Max Weber linked Protestant values, which he defined in more or less Calvinist terms, with the formation of capitalism.92 In contrast, in looking at the later seventeenth century, James and Margaret Jacobs and others have argued that Boyle, Newton, and "Latitudinarian" Anglicans in general favored mechanistic theories in part to "escape the taint of heresy associated with the occultism and animism of the radical sectaries."93 Willis's characterization of the learned physician's role as Christ-like, noted earlier, resonated with both medical and religious meaning. Although the Christianized medical tradition derived from Galen emphasized the belief that it was "physick," not the physician, who was the beneficiary of divine grace, Willis fashioned himself in accord with hermetic and Paracelsian conceptions of the "priestphysician."94 Given the history of Paracelsianism as an intellectual resource for radical critics of the medical and religious establishments before the Civil War, Willis's choice of persona in the 1660s seems odd.95 Seemingly anomalous, Willis's behavior illustrates an important dimension of the cultural politics of the period. Influential Anglicans of moderate temperament, forerunners of the "Latitudinarians" who became influential in politics and religion from the late 1670s on through the Glorious Revolution of 1688, made regular use of the metaphor of the physician as priest. For them, not only medical theory but also the College of Physicians itself served as a model for healing a nation ravaged by disputes. Preaching before Parliament shortly after the Restoration, Edward Reynolds, Dean of Christ Church, Oxford, spoke on the "means and methods of God's healing a sick nation." The text was Malachi 4:2-3, interpreted by Reynolds to mean, "We see here healing promised to those that fear God's name." The nation was "sick" with divisiveness. To heal it, Parliament needed to be a great "council and College of Physitians" and "imitate the example of Christ, who is the Lord that healeth us." Moreover, the "right honourable patriots" needed to be united, for "the patients will not fall out if the physitians be agreed."96 Preaching a week later before the House of Peers, Reynolds continued in the same vein: "We have seen Princes on scaffolds . . . parliaments broken.... Blood on the land . . . and there is not any degree of order. . . . The way therefore unto Healing is ... to keep our differing opinions to ourselves . . . [so that] the peace of the Church is not endangered thereby."97

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Court attitudes regarding political and scientific matters sometimes changed quickly. In part, this reflected the character of Charles II. For an ailment, the fickle king might as readily consult a learned physician as he would an apothecary; on religious matters, he might consult a Presbyterian, such as Richard Baxter, before his Archbishop Sheldon. Politically active aristocrats, such as Anthony Cooper, first Lord Shaftesbury, moved from positions of favor to exile in short order. In broad areas of official life, beliefs and loyalties were contingent. As I noted in Chapter 2, chemistry, even iatrochemistry, was never wholly a radical activity, even in the periods when it was most under attack by Fellows of the College of Physicians and High-Church apologists.98 No one group or idea enjoyed hegemonic status for long. For a few years in the middle 1660s, it seemed as though both experimental philosophy and High-Church orthodoxy were secure: Both radical sectarians and Presbyterians had been excluded from official religious life, and in 1665 the king himself visited an anatomy demonstration at the College of Physicians, as noted earlier. Within a few years, however, some began attacking the "new philosophy" as, well, too new and enthusiastic. At the dedication for the Sheldonian Theatre in Oxford in 1669, the conservative Anglican Robert South drew connections between Cromwell, religious fanatics, and experimental philosophy." The "spirituous particles" of Oxford physiology and Willis's theory of the "evil conformation" that they caused the brain to take on in illness were never neutral terms. Rather, they represented aspects of a rhetorical dynamic derived from earlier traditions of alchemical theory of matter still influential in the later seventeenth century.100 Regarding the animist and occultist aspects of alchemy, the question remains: How present were these strains in the new cerebral body? Although the radicals of the 1640s and 1650s had emphasized the vitalistic and pantheistic aspects of alchemy and Paracelsianism so as to undercut social arguments for religious and professional hierarchy, the circles in which Willis moved emphasized nature's duality: God was providential and could intervene, but matter moved mechanically. It may be, as the Jacobs have argued, that in terms of physical laws of universal motion, the "new philosophy" constructed a theory of matter that severely limited the vitalist aspects of alchemy and occultism in Neoplatonism.101 Such an argument, however, does not adequately take into account just how "alchemical" Willis or Isaac Newton could be when it came to the soul and its resurrection. Not only was the Resurrection a metaphor for the production of truth about the body through examination of the body in death but, as Newton noted, "the body soul & spirit by means of the strongly attractive power of ye soul (wch as a medium attracts & unites the other two) become reconjoyned in order to a resurrection."102 I suggest that Willis's model of the cerebral body, constructed as it was to emphasize the supremacy of order and reason over passionate enthusiasm, satisfied a broader High-Church need for a "natural" explanation of the supernatural

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phenomenon of the Christian Resurrection. For example, in 1673 Robert Sharrock (1630-1684), an Anglican minister on good terms with Sheldon and an early member of the Royal Society, published a sermon on the Resurrection that referred to Willis's theories of nerve function of the corpus striatum and the corpus callosum.103 By constructing a physiology of reason that borrowed heavily at times from vitalist doctrines of attractive force, Willis's view of the body and its constituent parts represented a comprehensive system of the physical and moral action of God that included the imminence of the Resurrection. In practical terms, physicians' preservation of the "habit of reason" in their patients aided Anglican divines in one of their central tasks: the conversion of sinners before their bodily death. After the Fall, sin and death were not only inevitable, they were inextricably entwined. Richard Allestree spoke for many when he preached that "sin and Death are of so near, so complicated a relation, as though they were twins, the birth and Issue of one Womb and moment, yet they are also one anothers off-spring and beget each other."104 For sinners, death would be double. Not only would the sinner experience the first death of the body, but his soul and body would be in perpetual torment as of Judgment Day.105 Unlike the millenarian Puritan reformers of the 1640s and 1650s, High-Church millenarians in the Restoration did not intend the prospect of a final Judgment to hasten the reform of social injustices.106 Their millenarianism was a quieter, largely private affair. According to Allestree, physick for the mortally ill was helpful not to prolong bodily life, which was suffering the torment of terminal disease anyway, but to give the sinner time to convert while still rational. After all, he preached, Christ's promise of eternal life was a dispensation offered to humans, who, alone among God's creatures, were both rational and redeemable. Conversion might be achieved by the operations of God's providence alone, of course, and by the reading of the proper spiritual guides; it was aided, however, by active consideration of issues of conscience by the afflicted and his or her minister.107 High-Church emphasis on techniques of "proper dying" mirrored their emphasis on "proper living."108 Eschewing the sectarians' quest for spiritual growth at all costs, High-Church theologians instead produced numerous conduct guides for the laity that emphasized piety, reason, and obedience, which they assumed belonged together. If this balance led to what historian Richard Westfall terms a "spiritual mediocrity," nonetheless it satisfied High-Church desires for an episcopally controlled piety that excluded religious and political dissent while simultaneously promoting specific behaviors for proper Englishmen and Englishwomen. Perhaps Richard Allestree wrote the most influential conduct guides. His The Whole Duty of Man, for example, went through at least forty-nine editions from 1658 to 1832. According to Allestree in his popular The Ladies Calling, first published in 1673, educated men were like an "inclosed piece of a common, which by industry and husbandry become a different thing from the rest." This made men "artificial," which Allestree framed as a "male" activity of high value. With

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"obedient" wives tending their homes, reasonably pious Englishmen, like the "Spartans—not withstanding their ready address to military virtue," ought to use their artifice and sense of duty to "address to Empire."109 Allestree's conduct guides were an important part of a prolonged effort by the Hooker-Hammond-Sheldon faction within the English Church to use the press proactively to shape genteel culture. When Archbishop William Laud became chancellor of Oxford University in 1629, one of his early initiatives was establishment of a "Greek press" in Oxford and London for the purpose of printing Bibles, the manuscripts of early church fathers, and texts supporting his view of Protestantism, such as Pope Clement Fs Ad Corinthios Epistola before 1633 and William Chillingworth's The Religion of Protestants a Safe Way of Salvation (Oxford, 1638). When he became chancellor in 1667, Sheldon sought to build on Laud's foundations, which had fallen into disrepair. Working closely with John Fell, who in 1669 was one of the most powerful men in the university, Sheldon's gift of 2,000 pounds for a "learned presse" in the basement of his new Sheldonian Theatre permitted the High-Church group to mount a sustained publication of texts supporting their views. Fell planned an ambitious program, proposing sixteen works that ranged from the Greek Bible, Latin and Greek classical authors, up to contemporary works by learned men in Latin and English, as well as a dictionary. In 1672, Fell and three partners leased the rights to the press from the university. Shortly thereafter friendly authors, such as Richard Allestree, who had been publishing his popular Whole Duty of Man with London printers, moved their titles to Fell and his Oxford press.110 Willis published his early quarto editions ofDiatribae duae Medico-Philosphicae of 1658 and Cerebri Anatome of 1664 with Richard's brother, the London printer James Allestry (Allestree) and his partner John Martyn (or Martin). Allestry's name as printer appears alone on the title page of Willis's Pathologiae Cerebri of 1667 and 1668, and also his Affectionum que Dicuntru Hystericae of 1670. The two printers also served as joint publishers to the Royal Society and printed Secretary Henry Oldenburg's first volume of the Philosophical Transactions. James Allestry died in 1670, which is probably why Willis then moved his publishing to Fell's press at the Sheldonian Theatre, which put out first editions of his De Anima Brutorum and the two parts of Pharmaceutice Rationalis. When one stands back and looks at Henry Hammond, Samuel and John Fell, Gilbert Sheldon, Christopher Wren, Richard Allestree, Mary Fell Willis and her husband, Thomas, and their friendly witnesses and readers, not to mention other figures I have not discussed, the contours of a multigenerational subculture may be discerned. During the Restoration, especially during its first fifteen years, they used their diverse talents and positions in the restored government and church as well as in academic institutions and publishing houses to promote their views of who and what English people and their nation ought to be. I suggest that the physiological task for Willis and his natural philosophy colleagues was similar to the theological task of the High-Church divines with whom he prayed and published:

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the proper composition of the orthodox English body. Just as the Oxford physiologists had incorporated notions of spirit and enthusiasm in their model of the blood and circulation during the Interregnum, they found a place for them in their Restoration doctrine of brain and nerve. For Willis, after all, bodily chemical operations were "ferments," and the skull an "Alembic."111 However, he made sure spirits and their passions were subservient to the authority and ordering agency of the sovereign, solid, cerebral cortex in a way that they were not in either humoral or alchemical systems. So too I would argue that High-Church Anglicans and their legislative allies in the Cavalier Parliament devoted their energies to containing religious and political expressions of enthusiasm so as to secure their own sovereignty and yet remain spiritual. (After 1660 virtually no one with any influence in the government wanted to return to the secularity of the Interregnum.) Despite the hopes of Presbyterians, independents, moderate Anglicans, and at first Charles II himself for a Restoration settlement that would provide some legal toleration for people who sought religious community outside of (or in addition to) that provided by the Church of England, the High-Church party was able, at least legislatively, to repress religious and political dissent until James IPs reign began to crumble in the mid 1680s. Notes 1. Clifford Geertz. Local Knowledge: Further Essays in Interpretive Anthropology. (New York: Basic Books, 1983), p. 16. Quoted in Renato I. Rosaldo Jr. "A Note on Geertz as a Cultural Essayist," representations 59 (1997): 30-4, especially p. 31. 2. Arthur Kleinman. "What Is Specific to Western Medicine?" in Companion Encyclopedia of the History of Medicine, eds. W. F. Bynum and Roy Porter (London: Routledge, 1993), p. 15. 3. Ibid. 4. For English language sources: On Arab-Islamic medicine, see Edward G. Browne. Arabian Medicine. (Cambridge: Cambridge University Press, 1921); Manfred Ullmann. Islamic Medicine. (Edinburgh: Edinburgh University Press, 1978); Lawrence I. Conrad. "Arab-Islamic Medicine," in Companion Encyclopedia of the History of Medicine, eds. W. F. Bynum and Roy Porter (London: Routledge, 1993), pp. 676-725; Lawrence I. Conrad. "The Social Structure of Medicine in Medieval Islam." Bulletin of the Society for the Social History of Medicine (1985): 37; Richard Walzer. Greek into Arabic: Essays on Islamic Philosophy. (Oxford: Bruno Cassirer, 1962). On Ayurvedic medicine, see Julius Jolly. Indian Medicine, 2nd ed. (New Delhi: Munshiram, 1977); Hermann Kulke and Dietmar Rothermund. A History of India, rev. ed. (London: Routledge, 1990); Debiprasad Chattopadhyaya, Science and Society in Ancient India. (Calcutta: Research India Publications, 1977). On traditional Chinese medicine, see Paul U. Unschuld. Medicine in China: A History of Ideas. (Berkeley: University of California Press, 1985); Charles Leslie, ed. Asian Medical Systems: A Comparative Study. (Berkeley: University of California Press, 1976); Shigehisa Kuriyama. The Expressiveness of the Body. (New York: Zone, 1999); Arthur Kleinman and Peter Kleinstadter, eds. Medicine in Chinese Cultures: Comparative Studies of Health Care in Chinese and Other Societies. (Washington, D.C.: John Fogarty Center of Advanced

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Study in the Health Sciences, 1975); and Manfred Porkert. The Theoretical Foundations of Chinese Medicine: Systems of Correspondence. (Cambridge: MIT Press, 1974). 5. Kleinman, "What Is Specific to Western Medicine?" 16. 6. Written in 1648 but published in 1661, these sentiments are from a letter written by Boyle to his sister, the Countess of Warwick, and published as Some Motives and Incentives to the Love of God. 2nd ed. (London, 1661), p. 56. 7. Thomas Willis. "Epistle Dedicatory" and "Preface to the Reader," in Anatomy of the Brain. (1664). 8. Willis. "Epistle Dedicatory," in Anatomy of the Brain. 9. Thomas Willis. "Epistle Dedicatory," in Pathology. (1667). 10. Thomas Sprat. History of the Royal Society. (1667). eds. Jackson I. Cope and Harold W. Jones (London: Routledge, 1958), p. 376. 11. See Gilbert Ryle. "Thinking and Reflecting," and "The Thinking of Thoughts: What Is 'Le Penseur' Doing?" in Collected Essays, 1929-1968. vol. 2, Collected Papers. (London: Hutchinson, 1971), pp. 465-6. 12. Clifford Geertz. "Thick Description: Toward an Interpretive Theory of Culture," in The Interpretation of Cultures. (New York: Basic Books, 1973), p. 9. See also "The Fate of 'Culture'": Geertz and Beyond," in representations 59. ed. Sherry B. Ortner (Berkeley: University of California Press, 1997), especially Stephen Greenblatt. "The Touch of the Real," pp. 14-30. 13. Willis found the meninges (the covering layers) of her brain "distended with Blood," a finding he interpreted as confirmatory of the neurological origin of her convulsions. Willis. Pathology, 75-8. 14. Margaret Cavendish, Duchess of Newcastle. Philosophical Letters; or, Modest Reflections upon Some Opinions in Natural Philosophy. (London, 1664), p. 352. 15. The Angel was leased by Willis, Dr. Peter Eliot, and William Day, a surgeon, in 1662. See Kenneth Dewhurst. Willis's Oxford Casebook. (Oxford: Sandford, 1981), p. 2. 16. Willis. "Epistle Dedicatory" and "Preface to the Reader," in Anatomy of the Brain. 17. Willis. "Epistle Dedicatory," in Anatomy of the Brain. 18. Giovanna Ferrari. "Public Anatomy Lessons and the Carnival: The Anatomy Theatre of Bologna." Past and Present 117 (1987): 50-106. 19. Jan Rupp. "Matters of Life and Death: The Social and Cultural Conditions of the Rise of Anatomical Theatres, with Special Reference to Seventeenth-century Holland." History of Science xxviii (1990), pp. 263-87. See also Jan Rupp. "Michel Foucault, Body Politics and the Rise and Expansion of Modem Anatomy." Journal of Historical Sociology 5 no. 1 (1992): 31-59. 20. Ferrari. "Public Anatomy Lessons," 50-106. 21. Annals of the Barber Surgeons of London, ed. Sidney Young (London: Blades, East & Blades, 1890), p. 331. 22. Ferrari. "Public Anatomy Lessons," 54. 23. Rupp. "Matters of Life and Death," 268. See also Rupp. "Michel Foucault." 24. Rupp. "Matters of Life and Death," 271. 25. Ruth Richardson. Death, Dissection and the Destitute. (London: Penguin, 1988), p. 32. 26. Anonymous. "News from the Dead, or a True and Exact Narration of the Miraculous Deliverance of Anne Greene." (Oxford, 1651) in Phoenix Britannicus. (London, 1732), vol. 1, pp. 233-40. 27. Annals of the Barber Surgeons, 7/3/1638. 28. Henry I was the first English king to be so divided. His grandson, Richard the LionHearted, directed that his own heart should be buried at Rouen; his brain, blood, and

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29.

30. 31. 32. 33. 34. 35. 36. 37.

38.

39. 40. 41. 42. 43. 44. 45. 46.

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entrails at Charroux; and his body at Fontevrault. See Elizabeth A. R. Brown. "Death and the Human Body in the Later Middle Ages: The Legislation of Boniface VIII on the Division of the Corpse." Viator 12 (1981): 221-70, especially p. 228 and 253. Brown points out that although division of the corpse remained popular in France in the thirteenth, fourteenth, and fifteenth centuries, the practice "declined radically" in England following the issuance of a prohibition on such procedures by Boniface VIII in 1299. Clare Gittings. Death, Burial and the Individual in Early Modern England. (London: Routledge, 1988), p. 166. For an extended discussion of Tudor and Stuart death practice among the gentry and aristocracy, see especially Chapters 8-10. For an illustrated analysis of the visual culture of early modern English death, see Nigel Llewellyn. The Art of Death. (London: Reaktion Books, 1991). Gittings. Death, Burial and the Individual, 167. Ibid. Ibid., 189. Ibid., 190. I am indebted to David Harley for sharing with me his unpublished manuscript, "Political Postmortems and Morbid Anatomy in Seventeenth-Century England." (Draft, February 1993), pp. 4-5. Ibid., 7. Thomas Vicary. The Anatomie of the Bodie of Man. 1548. Reprint (Oxford University Press, 1888), pp. 32-3. Toby Gelfand. "The 'Paris Manner' of Dissection: Student Anatomical Dissection in Early Eighteenth-Century Paris." Bulletin of the History of Medicine 46 (1972): 99130. See also Toby Gelfand. Professionalizing Modern Medicine: Paris Surgeons and Medical Science and Institutions in the Eighteenth Century. (Westport: Greenwood Press, 1980). William Harvey. Prelectiones Anatomiae Universalis. annotated trans. C. D. O'Malley, F. N. L. Poynter, and K. F. Russell. (Berkeley: University of California Press, 1961). In addition to his famous inclusion of postmortem findings on this father, Harvey also mentioned eight named patients, of whom three were baronets and one was a lady. The notes also frequently referred to anatomic findings on animals. In all cases, the mentions were a few lines at most. For more on the Prelectiones, see Luke Wilson. "The Performance of the Body in Renaissance Anatomy." representations 17 (1987): 62-95. William Harvey to Jean Riolan, 1649. trans. Robert Willis (1848). Selected Reading in Pathology, ed. Esmond R. Long (Baltimore: Thomas, 1929), pp. 71-4. See Robert G. Frank, Jr. Harvey and the Oxford Physiologists. (Berkeley: University of California Press, 1980), p. 32. Frank quotes John Aubrey's seventeenth-century account of Harvey. Edmund King. Philosophical Transactions of the Royal Society XV (London: 1685), pp. 228-31. See Richardson. "The Corpse and Popular Culture," in Death, Dissection and the Destitute, 14-20. Michael MacDonald. "The Secularization of Suicide in England, 1600-1800." Past and Present 111 (1986): 50-100, Annals of the College of Physicians, 4:87b. Thomas Sprat. History of the Royal Society, eds. Jackson I. Cope and Harold Whitmor Jones (London: Routledge & Kegan Paul, 1959), p. 403. Willis. Cerebral Anatomy. (1664), p. 134.

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47. Newcastle. Philosophical Letters, 352-77'. 48. See the plates illustrating cross-sections of nerves in Willis. Anatomy of the Brain. For the assertion that Willis was the first European anatomist to employ the microscope regularly in dissection, see Hansreudi Isler. Thomas Willis. (New York: Handford, 1968), p. 53. 49. Samuel Pepys. Diary (1633-1703). (London, 1825), 3 October 1666. 50. King. Philosophical Transactions, 231. 51. John Fell. The Life of the Most Learned Reverend and Pious Dr. H. Hammond (16051662). (London, 1662), pp. 262-5. 52. David Harley. "Political Postmortems," 5. 53. I am indebted to Guenter Risse for sharing with me his unpublished manuscript, "The Anatomical-Clinical Synthesis: From Morgagni to Laennec." (Draft, August 1992), p. 4. 54. Risse. "Anatomical-Clinical Synthesis," 4-5. 55. Newcastle. Philosophical Letters, 377. 56. Cited in Christopher Hill. "The Medical Profession and Its Radical Critics," in Change and Continuity in Seventeenth-Century England. (London: Weidenfeld and Nicholson, 1974), p. 160. 57. See Stephen Shapin. "The House of Experiment in Seventeenth-Century England." Isis 79 (1988): 373-404. See also: Stephen Shapin and Simon Schaffer. Leviathan and the Air-Pump. (Princeton: Princeton University Press, 1985) and Simon Schaffer. "Self Evidence." Critical Inquiry 18 (1992): 327-62. 58. Helkiah Crooke. Mikrokosmo Graphia. (London, 1618), p. 472. 59. Henry Carey. Natural History of the Passions. (London, 1674). British Library (1973) 8403. ee. 14. 60. Ibid., 165. 61. J. L. Gent/ Leonardo di Capria. The Uncertain Art of Physick. (London, 1684), pp. 89, 100-1. 62. King. Philosophical Transactions, 228-31. 63. Ludwig Wittgenstein. Lectures and Conversations on Aesthetics, Psychology, and Religious Belief, ed. Cyril Barrett (Los Angeles: University of California Press, n.d.). 64. John Ray. The Wisdom of God Manifested in the Works of Creation. (London, 1691), pp. 36, 38, 208-9. On Ray and Willis, see. W. F. Bynum. "The Anatomical Method, Natural Theology, and the Functions of the Brain." Isis 64, no. 224: (1973): 445-68, 65. Anonymous. Anatomy of Humane Bodies Epitomized. (London: M. Fleshier, 1682) British Library 1039, pp. 324, 336. 66. Ibid., Book III, "Of the Head." 67. J. Trevor Hughes. Thomas Willis 1621-1675. (London: Royal Society of Medicine, 1991), p. 3. 68. Seth Ward, who had lost his Cambridge fellowship in the mid 1640s on account of his staunch Anglicanism and Royalist sympathies, moved near Oxford. After gaining his academic post in 1649, he accepted Parliamentary rule sufficiently to take the Oath of Engagement in 1650. Ward was self-taught in mathematics and astronomy. 69. Frank. Harvey and the Oxford Physiologists, 64-7. 70. In his 1696 census of England, Gregory King counted 960 families headed by baronets or above, and 26 families headed by "spiritual lords," which meant bishops. An additional 15,600 families, from a total English family count of 1,360,586, were headed by "Gentlemen, Esquires, or Knights." Gregory King. Natural and Political Observations and Conclusions upon the State and Condition of England. (London, 1696).

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71. 72. 73. 74. 75.

76. 77. 78.

79. 80. 81. 82. 83. 84. 85.

86. 87. 88. 89.

90. 91.

92.

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Ibid. Pepys. Diary, I: 322. Bishop Burnet, quoted in the Encyclopedia Britannica, 1748, entry on Sheldon. Victor Sutch. Restoration of the Church of England 1646-1689. (New Haven: Yale University Press, 1992), p. 42. King was given a Lambeth degree, which he incorporated at Cambridge in 1671. William Munk. Roll of the College of Physicians. (London: Longman, Green, 1861), vol. 1, pp. 115-6. Peter Sutcliffe. Oxford University Press: An Informal History. (Oxford: Clarendon Press, 1978), p. xix. R. Hutton. The Restoration: A Political and Religious History of England and Wales, 1658-1667. (Oxford: Oxford University Press, 1985), p. 176. Gilbert Sheldon. Letter of (n.d.). Sheldon Letters. MS Carte 45, fol. 151. Bodleian Library, Oxford, England. Also in John Spurr. The Restoration Church of England. (New Haven: Yale University Press, 1991), p. 47. Sheldon. Letter of 7 July 1665. MS Add. C. 308. Bodleian Library. Sheldon. Letter of 24 March 1665. MS Add. c. 308. Bodleian Library. John Fell. The Life of the Most Learned Reverent and Pious Dr. H. Hammond, 262-5. Henry Hammond. Practical Catechisme. (1649 ed.), pp. 300-2. Richard Hooker. Of the Laws of Ecclesiastical Polity (1592), Ib. 1, VIII.9. Cited by Henry McAdoo. The Spirit of Anglicanism. (New York: Scribners, 1965), p. 7, n. 8. Edward Stillingfleet. "Preface," in A Rational Account. (London, 1681). Cited by McAdoo. Spirit of Anglicanism, 388. John Calvin. The Institutes of the Christian Religion, I xiv, 4. trans. John Allen (Philadelphia, 1921). Cited by Michael Walzer. The Revolution of the Saints. (Cambridge: Harvard University Press, 1965), p. 24, n. 4. McAdoo. Spirit of Anglicanism, 4. Walzer. Revolution of the Saints, 26-8. Margaret Baily. Milton and Boehme. (New York: Oxford University Press, 1914), p. 28. Winthrop Papers. 1498-1628. (Boston: Massachusetts Historical Society), vol. 1, p. 413. J. G. A. Pocock and Gordon Schoet. "Interregnum and Restoration," in The Varieties of British Political Thought, 1500-1800. eds. J. G. A. Pocock, Gordon Schochet, and Lois Schwoerer (Cambridge: Cambridge University Press, 1993), pp. 150-1. See also Jean Bodin. Six Books of a Commonweale. trans. Richard Knolles (London, 1606). Facsimile reprint, ed. and intro. Kenneth McRae (Cambridge: Harvard University Press, 1962), I, viii, p. 84. Pocock and Schoet. Varieties of British Political Thought, 150. Christopher Hill. Intellectual Origins of the English Revolution. (Oxford: Oxford University Press, 1965); Christopher Hill. Change and Continuity in SeventeenthCentury England. (Cambridge: Harvard University Press, 1975); Robert K. Merton, "Science, Technology, and Society in Seventeenth-Century England," Osiris IV (1938): 360-567; Charles Webster. The Great Instauration. (London: Duckworth, 1975); Charles Webster, ed. The Intellectual Revolution of the Seventeenth Century. (London: Routledge, 1974). Max Weber. The Protestant Ethic and the Sprit of Capitalism, trans. Talcott Parsons (New York: Charles Scribner, 1958), first published as a two-part article in 1904-5 in Archiv fiir Sozialwissenschaft und Sozialpolitik, of which Weber was an editor.

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93. James R. Jacob and Margaret C. Jacob. "The Anglican Origins of Modern Science: The Metaphysical Foundations of the Whig Constitution." Isis 71 (1980): 251-67, especially pp. 253-9. 94. Peter Elmer. "Medicine, Religion, and the Puritan Revolution," in The Medical Revolution of the Seventeenth Century, eds. Roger French and Andrew Wear (Cambridge: Cambridge University Press, 1989), p. 16. Also Christopher Hill. "The Medical Profession and Its Radical Critics," Change and Continuity in Seventeenth-Century England. (London: Weidenfeld and Nicholson, 1974), p. 160. 95. For more on medical reformers, see Charles Webster. "English Medical Reformers of the Puritan Revolution: A Background to the Society of Chymical Physitians." Ambix 14(1967): 16-41. 96. Edward Reynolds. "The Author and Subject of Healing in the Church." Sermons before Parliament at St. Margaret's, Westminster, 25 April 1660. Wellcome Library of the History of Medicine, London. 97. Edward Reynolds. Sermon before House of Peers, Westminster, 30 April 1660. (London, 1660), p. 6. Earlier in his career, Reynolds also authored a psychological work entitledA Treatise of the Passions and Faculties of the Soule of Man. (London, 1640). 98. Harold Cook. Decline of the Old Medical Regime in Stuart London. (Ithaca, N.Y.: Cornell University Press, 1986). 99. Ibid., 178-80. The Sheldonian Theatre was Sheldon's personal gift to the University of Oxford. See Biographia Britannia (London, 1766), s.v. "Gilbert Sheldon." 100. Regarding the Paracelsian tradition in England before the Revolution, see Allen G. Debus. The English Paracelsians. (London: Oldbourne, 1965), especially chapters 1, 4, and 5. For matter theory in the Restoration, see Jacob and Jacob. "Anglican Origins," 251-67, especially pp. 243-59. 101. Ibid., 259. 102. Betty J. T. Dobbs. "Newton's Copy of 'Secrets Reveal'd' and the Regimens of the Work," Ambix 26 (1979): 145-69, especially p. 153. 103. Robert Sharrock. De Finibus Virtutis Christianae. (Oxford: Sheldonian Theatre, 1673), pp. 114-5. Cited in Frank. Harvey and the Oxford Physiologists. Resident at Oxford during the years of the experimental clubs, Sharrock authored a History of the Propagation and Improvement of Vegetables by the Concurrence of Art and Nature (London, 1660). 104. Richard Allestree. "Why will ye dye?" in Forty Sermons, 2 vols. (Oxford, 1684), vol. 1, pp. 57-68.1 am grateful to Scott Mandelbrote for suggesting the importance of casuistry in Restoration Anglican thought. Allestree (1619-81) and Willis were friends from their student days at Oxford. One of his relatives, the London bookseller James Allestry, printed several of Willis's books. For more on Willis's religious acquaintance, see J. Trevor Hughes. Thomas Willis, 1621-1675: His Life and Work. (London: Royal Society of Medicine, 1991), pp. 32-35. 105. Webster, ed. Intellectual Revolution, 19-27. The chronology and character of millenarial thinking has been a controversial topic in seventeenth-century historiography. For views contrary to Webster's, see Bernard Capp. "The Millennium and Eschatology in England," in Intellectual Revolution, 427-34. See also "Richard Baxter, the Apocalypse, and the Mad Major," in Intellectual Revolution, 399-426. 106. See Jacob and Jacob. "Anglican Origins," 259. 107. For additional background, see John Spurr. '"Virtue, Religion, and Government': The Anglican Uses of Providence," in The Politics of Religion in Restoration England, eds. Tim Harris, Paul Seaward, and Mark Goldie (Oxford: Blackwell, 1990).

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108. 109. 110. 111.

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See also Andrew Wear. "Puritan Perceptions of Illness in Seventeenth-Century England," in Patients and Practitioners: Lay Perceptions of Medicine in Pre-Industrial Society, ed. Roy Porter (Cambridge: Cambridge University Press, 1985), pp. 55-100. See John Spurr. "Anglican Apologetic and the Restoration Church." (D. Phil. Dissertation, Oxford, 1985). See also Richard S. Westfall. Science and Religion in Seventeenth-Century England. (New Haven: Yale University Press, 1958). Richard Allestree. "Preface," in The Ladies Calling. (Oxford: Sheldonian Theatre, 1673). Nicolas Barker. The Oxford University Press and the Spread of Learning 1478-1978. (Oxford: Clarendon, 1978). Thomas Willis. Diatribe duae Medicophilsophicae. (London, 1659).


6 TTTT OF HUMAN CONDUCT

What do Euripides' Medea and the Virgin Mary have in common? Or, to minimize gender considerations, Odysseus, Medea, and the Virgin Mary? Separated by time and culture, not to mention behavior, they form an incongruous trio, to put it mildly. And yet, in terms of causal explanations their contemporaries might have advanced for crucial moments in their respective lives, they share an important dimension. Specifically, the timing of Odysseus' homecoming rout of his enemies, Medea's revengeful slaughter of her children, and Mary's conception of Jesus, so unlike each other in moral content, nonetheless depended more or less on their respective responses to spirit-like factors existing within them as well as outside of them. Medea and the Virgin Mary acceded to these forces; Odysseus did not. According to Homer, Odysseus finally arrived home in darkness only to observe unruly suitors seeking the hand and fortune of his presumptive widow, Penelope. Initially planning to wait until dawn for his attack, Odysseus almost succumbed to the desire for instant revenge. To quiet his rage and regain reason: "He smote his breast, and thus reproached his heart, Endure my heart; far worse hast thou endured."1 In a sense Odysseus was lucky; his breast-beating proved just sufficient to quell the furious thumos (also thymos in English), riling his praecordia and heart and thus threatening to overcome his judgment. Related to the concept of pneuma, the literal "breath" that activated life in ancient Greek thought, thumos potentially controlled a waking human's sensation and feelings.2 Usually resident in the body, 129

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it could also enter the body from without, like pneuma, and its power could overwhelm a person's rational faculty. Unlike Odysseus, Medea did not have the good fortune of controlling her thumos. Instead, the momentum of the thumos in her for vengeance against her husband, Jason, for his infidelity overcame her moral sense so much she murdered their children even though she knew she was committing evil: "I know the wickedness I am about to do ... but the thumos is stronger than my purposes, thumos, the root of man's worst acts."3 Of course, in ancient Greek culture the gods also could affect human experience profoundly, not to mention impulsively. In the Iliad, for example, Agamemnon explained his kidnap of Achilles' mistress as the result of Zeus' insertion of ate, or infatuated mad impulse, into his consciousness.4 Personified occasionally by the Greeks as a goddess of mischief and authoress of rash destructive deeds, ate, although less ubiquitous and more extreme than thumos, shared the latter's properties of subtle materiality, penetrability, and the capacity to destabilize judgment.5 By the time Christianity had spread across Europe and the Middle East, thumos was no longer part of the literate cultural landscape. Nonetheless, one can find thematic continuities between the Christianized animus spiritus, or Holy Spirit, and pantheistic pre-Christian Greek conceptions of thumos and ate; notably that each of them was thought to possess material reality despite intangibility and penetrability. Believers assumed that each also possessed transformational capability. Like thumos, animus spiritus usually resided within one's body but could come from without. And the Holy Spirit too had the power to alter any other human faculty. Moreover, in the typical fifteenth-century Annunciation portrayals that depicted the Virgin in a walled garden learning from the angel Gabriel of her Immaculate Conception through the physiologic agency of the Holy Spirit, almost every detail from Gabriel's lilies through the occasionally present unicorn bespoke links between the microcosm of the Virgin and God's perfect macrocosm.6 Unlike pagan spirits, however, the Holy Spirit activated only morally perfect actions. The anecdotes sketched above illustrate in another register the cultural ubiquity of humoral thinking I described briefly in Chapter 1. Until the middle of the seventeenth century, the major belief systems in the West shared the assumption that everyone's body was porous and capable of extreme behavior due to the potentially overwhelming influence of external spirits or spirit-like forces. Given the pneumatic and hydrostatic physics of spirits and humors and their affects on the passions in humoral models, it is not surprising that early modern healers and their predecessors characterized intense affective states as potentially dangerous imbalances of spirited passions. Rational thought could vanish in a moment, a person seemingly taken over from without. Consequently, practitioners of all stripes emphasized the importance of moderation in diet, exercise, rest, and sexual activity so as to keep the passions in check.

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Sometime in the late eighteenth or early nineteenth century, European writers began using the word emotions to distinguish mental feelings from cognitive states. During the early modern period, however, European texts still characterized human affective states much as had their Greco-Roman antecedents, as passions (Latin passio; Greek pathos), or the experiences of a person's body and psyche being acted on by powerful impulses, such as anger. In Latin before 600 C.E., passio conveyed passive suffering and endurance of suffering as much as or more than it did strong affections. For early and medieval Christians, passion's primary reference was to the trial, death, and resurrection of Jesus, or the Passion of Christ. Only during the past few centuries have the primary meanings of passion shifted to "barely controllable emotion" and "intense sexual love."7 Post-Enlightenment historians and others have often used emotion and passion as synonyms, but in terms of passion's pre-Enlightenment meanings, they convey different notions of affective reality. Indeed, to assume a broad overlap of their meanings may distort historical understanding as much as assuming that science and natural philosophy mean and have meant almost the same thing. At least it may obscure what I view as a crucial cultural transition that took place among certain groups in early modern literate Europe, which was the gradual shift from ancient and early modern emphasis on the human body as porous and open (and hence subject to passions) to the recognizably modern Western assumption that individual human bodies are more or less self-contained and generators of their own emotions. A corollary is that only during the past few centuries has orthodox culture assumed that a person's affective state is more or less in his or her control. In this chapter, I explore some important consequences of that shift in emphasis at the moment it was occurring: the mid-seventeenth-century sharpening of distinctions between reason, passion, and spirit as the human body became its own new world in the natural philosophies of brain and nerve. Descartes and Willis and their respective cohorts played key roles in shaping the natural philosophy supporting the shift. As Descartes's work occurred before Willis's, I take Descartes up first. As in previous chapters, I let Descartes and Willis stand for the groups they led as well as wider audiences who considered therri authorities. Descartes's Physiology of Passion Descartes made it clear in the first lines of Passions of the Soul (1649) that traditional authorities such as Plato and Aristotle had nothing to tell him about the passions: "Defects of the sciences we have from the ancients are nowhere more apparent than in their writings on the passions."8 Unlike the "ancients" and most of his contemporaries, who tended to describe the soul in terms of discrete parts, Descartes saw unity: There is "no distinction of parts within the soul."9 However, like virtually every other pre-Enlightenment natural philosopher, he characterized the soul as immortal, albeit in his distinct way: "the soul takes its leave when we

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die only because this heat ceases and the organs which bring about bodily movement decay."10 Descartes's commitment to a unified soul that was also immortal set him apart from those like Willis, who followed Plato in emphasizing the immortality of the Sensitive Soul and/or Rational Soul while remaining diffident on the longevity of the other souls. Also, in comparison to his antecedents and contemporaries, Descartes gave his unified soul an expansive role: "The soul is united to all parts of the body conjointly."11 Nonetheless, he found the soul more present in the pineal gland, than elsewhere, as it was "where the soul exercises its functions more particularly than in the other parts of the body." Indeed, in functional terms, Descartes commonly wrote about the soul as if it were the pineal: "And the activity of the soul consists entirely in the fact that simply by willing something it brings it about that the little gland to which it is closely joined moves in the manner required to produce the effect corresponding to this volition."12 Descartes often referred to the pineal as "the little gland," but he let readers know its functions were large. It could act on "the rest of the body by means of the animal spirits, the nerves, and even the blood, which can take on the impressions of the spirits. . .. "13 In other passages in the Passions, he distinguished between soul and body while highlighting the potential importance of the body to the soul's function: "To understand the passions of the soul we must distinguish its functions from those of the body. Next I note that we are not aware of any subject which acts more directly upon our soul than the body to which it is attached."14 The upshot of the rhetorical moves noted above was that the Cartesian soul, which Descartes often equated with mind, was hardly remote from the body. During his life and since, many have criticized Descartes for divorcing mind from body. Indeed, many discussions of the "mind-body problem" of Western modernity take Cartesian philosophy as their starting point. Granted, as I noted earlier, in his discussions of philosophical method, Descartes repeatedly asserted the independence of the human mind and mental function from the body. However, when it came to the physiology of thinking, his linkage of a unitary soul, when combined with the pineal's sovereignty over bodily functions, had the effect of virtually uniting mind and body. Except that he never said so; the assumption remained tacit. Given Descartes's overarching philosophical commitment to the independent existence of mind, how could he have been explicit and yet maintained the integrity of his philosophy? Regardless of Descartes's inconsistencies concerning the independent existence of mind, in the Passions, if not elsewhere, he steadfastly argued for the vulnerability of the soul to passions: "of all the kinds of thought which the soul may have, there are not that agitate and disturb it so strongly as the passions."15 Disturbance could come from a variety of sources. In discussing the soul's relation to the heart, he posed the question, "What prevents the soul from having full con-


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trol over its passions?" He answered that the "Passions [were]. .. maintained and strengthened by spirits," and their movement was often "accompanied by some disturbance which takes place in the heart and consequently also through the blood. . . . "16 The passions could lodge anywhere in the body. The more "primitive" passions, such as love, hatred, desire, joy, and sadness, often originated in the "heart, the spleen, the liver, and all the other parts of the body."17 In this instance Descartes used "body" in a manner that suggests to me he did not mean it to include the head. While the soul might be vulnerable to bodily passions, it could also control the body, and hence at least the "primitive" passions, through the soul's "will," a term he left undefined. According to Descartes, the "strongest souls belong to those in whom the will by nature can most easily conquer the passions and stop the bodily movements which accompany them."18 As I noted earlier, the will exercised its control through the pineal, an assertion that Descartes used as support for his optimism that mind could prevail over passions: "There is no soul so weak that it cannot, if well directed, acquire an absolute power over its passions."19 Achievement of control, he argued, required constant vigilance by the soul of the body and observance of a strict regimen. Like Willis and the ancient and contemporary authorities he drew upon, Descartes described human reason and passion in oppositional terms. If the Cartesian body did not experience Willis's later analogy of a constant "war" between "flesh and spirit," nonetheless Descartes considered the body a place where "All the conflicts usually supposed to occur between 'sensitive' and the ... 'rational' part of the soul—or between the natural appetites and the will—consists simply in the opposition between the movements which the body [by means of its spirits] and the soul [by means of its will] tend to produce at the same time in the [pineal] gland. . . . It is to the body alone that we should attribute everything that can be observed in us to oppose our reason."20 I think here, as before, Descartes meant "body" to mean the lower body not including the head. He thought even nonhuman animals experienced the same physiological constraint. According to Descartes, nonhuman animals, "although they lack reason, and perhaps even thought, all the movements of the spirits and of the gland which produces passions in us are nevertheless present in them too. .. ."21 To maintain control of the passions, Descartes wrote that most people needed to establish and maintain a "habit" of virtue. "It should be noted," he observed, "that what we commonly call 'virtues' are habits in the soul [and] it often happens that some movement of the spirits strengthens them. . . ."22 Descartes's use of the word habit in this passage to characterize the soul's potential for controlling passion was not an isolated use. In several places he used habit in the context of achievement and maintenance of control, such as when he wrote, "although nature seems to have joined every movement of the [pineal] gland to certain of our thoughts from the beginning of our life, yet we may join them to others through

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habit."23 Descartes's use of habit in this context echoes Willis's use of the term, as we will see in the next section. Both relied, I think, on a medieval meaning of habit as a behavior pattern acquired by frequent repetition that could be physiologic, by which I mean due to spirit/humoral flows in regular channels. In this and other ways, humoral frameworks continued to shape the physiology of those who, like Descartes and the Oxford physiologists, self-consciously sought to move beyond them. One consequence, of which they may or may not have been aware, was that their preventive and corrective recommendations carried strong echoes of the Stoics and other ancients who emphasized rigorous self-discipline as necessary for a good life. It was not that Descartes denigrated the existence of the passions themselves. Although nominally he derided Platonic and Aristotelian treatments of the passions, he sounded remarkably Aristotelian in his characterization of passions as necessary for a creature's ability to discriminate between the helpful and noxious. The six passions he identified as "primitive"—wonder, love, hatred, desire, joy, and sadness—served a crucial survival function, which "consists solely in this, that they dispose our soul to want the things which nature deems useful for us. . . ,"24 If this was not acceptance of an overlap between cognition and passion that echoed Aristotelian natural philosophy, then what was it? Nonetheless, Descartes located only "wonder," which he defined as the "first encounter with an object [that] surprises us," in the brain; the balance of the passions usually resided in the spirits and other organs.25 In Passions, Descartes did not address directly any social implications of his theories. Instead, he wrote in the third person as though he were speaking to one reader at a time, a format that recalled, perhaps unintentionally, Renaissance guides to good living, such as Ermasmus of Rotterdam's guide to young men's conduct, De Civilitante Morum Puerilium of 1530.26 Near the end of Passions, Descartes digressed from explicating the passions per se to introduce additional advice on living wisely. The secret to life, he opined, lay in practicing "true generosity," for it "causes a person's self-esteem to be as great as it may legitimately be. . . ." Moreover, to pursue generosity, he counseled, was to "pursue virtue in a perfect manner." The benefit was that truly generous individuals would "have complete command over their passions. In particular, they have mastery over their desires. . . ,"27 Had he stopped there, a reader plausibly might have assumed that Descartes was convinced that passions were the bete noir of goodness. However, in the closing section of his treatise, he concluded by according the passions a higher value than his earlier remarks suggested: It is on the passions alone that all the good and evil of this life depends. For the rest, the soul can have pleasure of its own. But the pleasure common to it and the body depend entirely on the passions, so that persons whom the passions can move most deeply are capable of enjoying the sweetest pleasure of this life. It is true that they may also experience the most bitterness when they do not know how to put these passions to good use


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and when fortune works against them. But the chief use of wisdom lies in its teaching us to be masters of our passions and to control them with such skill that the evils which they cause are quite bearable, and even become a source of joy.28

As we will soon see, despite their many differences, Willis and Descartes agreed on the crucial point that a human's rational faculty needed to master and control the passions. Although Descartes suggested his view was new, this was hardly a new philosophical position. What had shifted was not the philosophical assumption but rather the locus of the passions and their control. Ironically, Descartes, in his tendency to locate the passions throughout the body, echoed the ancients even though his emphasis on the "little gland" as their nexus of control was new. Aside from his physiologic descriptions, however, Descartes wrote relatively little on how one was to achieve and maintain control or what to do when control slipped away. Indeed, compared with Willis and others who placed themselves primarily in the anatomic tradition, Descartes remained vague about the very lower body that remained for him, as it had for Plato and the early Christian fathers, so problematic. But then, unlike Galen, Harvey, or Willis, Descartes was not a physician and so may not have felt the intellectual burden of a medical tradition that almost invariably valued knowledge only so far as it might relate to praxis.

Willis's Physiology of Passion and Reason Although Descartes relied on his general philosophical method to generate his belief in the sovereignty of the pineal gland over the passions, Willis relied on empirical experience, specifically, comparative anatomy and his medical practice, as the key support for his doctrine of the primacy of the cerebral hemispheres and cranial nerves in controlling the passions. He began his brain project probably with some dissections performed in the late 1650s and took it up in earnest after the Restoration, when he secured a lucrative professorship. Largely as a reward for his political and religious loyalty to crown and church during the Interregnum, a few months after the monarch's return, Willis gained appointment as Sedleian Professor of Natural Philosophy at Oxford. This position was one of England's two endowed professorships in natural philosophy at the time.29 Willis, who originally had intended a religious vocation, suddenly had the opportunity to augment his clinical and chemical practice with philosophical lectures on the nature of the soul. Nominally mandated by the terms of the Sedleian bequest to lecture from traditional Aristotelian texts,30 Willis instead followed the example of his fellow experimentalists John Wallis and Seth Ward—the Savilian Professors of Geometry and Astronomy, respectively—and fashioned his own curricular mission: "I should Comment on the offices of the Senses, both external and also internal, and of the Faculties and Affections of the Soul, as also of the Organs and various Provisions of all these."31

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I should emphasize at the outset that Willis and his colleagues never abandoned their attachment to the blood. Indeed, as indicated in the injection and transfusion experiments conducted by Lower, Wren, and King (a surgical collaborator with Willis in his London years), Willis's colleagues seemed to have maintained their own independent interests in the heart and blood at the same time they worked on the brain and nerves. Lower, who was Willis's principal collaborator on Anatomy, also authored a major work on the heart in the late 1660s, his Tractatus de Corde. If this reflects a continuation of the collegial and fluid associations characteristic of the Oxford experimental clubs of the 1640s and early 1650s, it also reflects the multipart nature of the soul that Willis adapted from Plato. According to Willis, humans were "imbued with many distinct Souls."32 Man possessed both a Rational Soul and a Sensitive Soul. The Rational Soul was equivalent to the human mind.33 It was "Superior and Immaterial," an "incorporeal substance, and therefore Immortal, which is Created Mediately by God, and infused into the Body."34 In comparison, the Sensitive Soul, which Willis also termed the "animal soul" and the "Corporeal Soul" in man, was shared by humans and other animals. He made further division, albeit inconsistently, in the Corporeal Soul between the "vital Portion living in the Blood" and a "Sensitive" portion, which contained "an heap of animal spirits everywhere diffused throwo the brain and Nervous Stock." Both man and brute had a "Soul Co-extended to the whole body, and Parts not only many and distinct, but after a manner dissimilar." Only humans, however, had a Rational Soul.35 Willis viewed human character as being "of a middle nature and order, between angels and brutes."36 Man's uniquely Rational Soul was able to fashion the sense impressions delivered to it by the Corporeal Soul into abstract and pure thoughts. These included such categories as rationality, fortitude, spirituality, the quality of whiteness, and temperance as well as contemplation of God, eternity, and "many other notions, far remote from sense and imagination."37 Willis assumed that both animals and man possessed natural instincts, which came from God and consisted of the practical knowledge by which creatures knew what was useful and hurtful.38 Although his examples mainly featured mammals, Willis wrote that all animals could learn and remember, which he argued was why the more clever ones were often thought capable of reasoning. Although Willis believed the Rational Soul was immaterial and "survives [bodily death] and is Immortal,"39 he believed it enjoyed intimate links with the mortal "Corporeal Soul," especially in "sicknesses," when it could be affected by a body's disease. He opined that this truth had not been established by anatomic study, but instead by the study of "moral and theological writings" and the experience of a "good Life and Pious Institutions."40 According to Willis, the duality of humans' material and immaterial souls matched the duality of human reality, where we constantly experienced "Wars and Strivings between our two Appetites, or between the Flesh and Spirit."41 If the Rational Soul by definition always was "striving


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after a divine state," the Sensitive Soul or Corporeal Soul was a bundle of appetites as it tended to drive one toward "infinite wishes" based on "emotional custom." Too much influence from the body could be dangerous, as these "wishes," when "at full liberty," would lead humans to "role in the mud of sensual pleasure."42 Willis adapted much of his framework of soul-body relations from Galen, whom he frequently acknowledged as a source. Galen, in turn, had leaned on Plato as his source. According to Plato's Socrates in the Phaedo: "The body is a source of endless trouble to us [because] it fills us full of loves, and lusts, and fears, and fancies of all kinds, and endless foolery, and in fact, as men say, takes away from us the power of thinking at all."43 Elsewhere Plato asserted a causal link between chronically ill bodies and bad behavior when he wrote in the Timaeus: "No man is voluntarily bad; but the bad become bad by reason of an ill disposition of the body and bad education."44 His characterization of the reasoning portion of the soul as immaterial—a conviction Descartes shared—was expressed by the Pythagoreans before Plato, although Willis did not note this. As historian Diane Puklin has noted, Galen, who argued for strong links between body and psyche in health and disease, cited the above passage from the Timaeus in support of his arguments for the role of the medical arts in the care of the soul.45 However, Galen relied on Aristotle for his assertion that strong affective states expressed the temperament of the heart, not the brain, which was the seat of reason. Given their humoral nature and cardiac locus of activity, Galen thought that feelings could be manipulated through the usual medical arts of regimen and proper drugs. He also thought temperamentally induced affective states could alter other bodily systems by the mere agency of matter acting on matter.46 In terms of mind-body-God relations, Willis owed larger intellectual debts, which he acknowledged, to Pierre Gassendi (1592-1653), the French priest and natural philosopher of whom the Oxford physiologists made much use in their formulations of corpuscular matter theory during the 1650s. Likewise placing humans "a little less than the angels," Gassendi argued for a dual human soul consisting of a Rational Soul, or animus, which was immaterial and immortal, and a Sentient Vegetative Soul, or animal Sounding every bit as tortuous in his reasoning as Willis, Gassendi also located the immaterial but rational soul or mind in the brain: "Because of the influence of ... the nerves from all the senses and parts of the body is in the brain, the seat of the Phantasy is established in the brain. . . . It seems congruous that also the mind or rational soul... is united not without another corporeal or sensitive soul so that it can think and understand by the intervention of the Phantasy; it is congruous, I say, that it has the same seat as the Phantasy, the brain."48 Despite his placement of the Rational Soul in the brain, Gassendi's schema maintained some loyalties to the cardiocentric models of scholastic Aristotelianism. Affective states, for instance, might originate in the operations of the fantasy and imagination in the brain, but they were to be experienced by the

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body through the agency of the heart's contraction or expansion in response to the messages carried to it by the nerves from the brain.49 Gassendi may not have provided Willis an elaborate theory of cerebral localization, but he did outfit him with concepts of dual souls that mediated their bodily messages through transmission of a juice which flowed from blood to brain to nerves and thence to the body. If Gassendi maintained a loyalty to old Aristotelian ideas about the centrality of the heart, it is worth recalling that Willis located his vital flame there too during the 1650s. Willis turned to comparative anatomy for a key support for his argument for the primacy of the cerebral hemispheres and cranial nerves in controlling emotions. Although most of his comparative anatomies of human and mammalian brain and nerve structures persuaded him of the similarities between man and brute, he proposed that what he viewed as a distinction between human and other animal versions of the "intercostal" nerve—today known as the sympathetic chain of ganglion—explained why reason could triumph in humans. Elaborating on Gassendi's idea that the intercostal was an important link between the brain and the heart, Willis asserted that the nerve had a dual origin in the fifth and sixth cranial nerves of the cerebellum. In addition to the vagus nerve, the intercostal provided a "quick commerce" between the brain and the intercostal's main terminations in the heart, viscera, and face. Moreover, at the time he wrote the following statement, Willis believed the intercostal innervation of the heart and abdomen was limited to man and "most four-footed beasts." He also believed that intercostal innervation of the diaphragm was uniquely human. This finding, which he later retracted upon finding intercostal innervation of the diaphragm in monkeys, indicated to Willis man's special place in the chain of beings. It also was "certainly the cause why risibility is the proper affection of man." As Willis summarized the matter: For as much as this nerve reaching forth into the praecordia [heart] and viscera of the whole Abdomen is continued by its superior ramification also into the eyes, as also into the parts of the Mouth and Face: Certainly from hence a true and genuine reason may be given wherefore in every passion the Eyes, Face, and Mouth do so correspond with the affections of the Praecordia, often unknown to us or against our minds, that often times we are compelled to betray the most intimate sense of the heart by the countenance and aspect.50

Willis also materialized other mental functions, such as memory, in terms of the gross anatomic characteristics of the cranial nerves. Noting that the seventh cranial nerve had its origins in the cerebellum and innervated the ear and mouth, he argued its cerebellar origin helped explain the differential capacities of humans to remember melody: "Some men learn Musick without any trouble . . . [while others] though very ingenious men and of excellent memory are very Fools at Musick." The reason was that some men had a "harder frame of Cerebellum." As a consequence, they produced no regular "tracts" of melodies, and humans so configured had no "natural memory" of them and could not remember songs or perform them.51


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In terms of the place of emotions in humans as compared to other animals, the structures Willis termed the "orbicular Prominences" and the "annular Protuberance" on the anterior and posterior aspects, respectively, of the cerebellum were of central importance. Acknowledging that he was "proposing] our Opinion, though with an hesitating and doubtful mind," Willis used comparative anatomies on humans, dogs, cats, calves, hares, "and other milder Animals" to establish a relation between the proportionate size of these structures and the creature's crude "wit" and capacity for passion. He claimed that where the annular Protuberance was smaller, the orbicular Prominence was larger, and vice versa. He emphasized the distinction because it supported his claim that the orbicular prominences carried the "forces of the Passions" from the cerebral hemispheres to the cerebellum, where they would travel via the intercostal to the heart. In contrast, the annular protuberance received the "forces of the Passions . . . second-hand from the deputiship of the Cerebellum" only, and from thence "immediately to the heart."52 Given his assumption that the animal spirits that conveyed emotions must, of necessity, be stored in the annular protuberance before being transmitted in the nerves, he argued that the structure "is far greater in Man than in any other Animal." Next, the dog had the greatest capacity for passion and "annular Protuberance," then the cat, and so on. In contract, the orbicular prominences were largest in those animals with an "indocile or dull Brain," such as the sheep, hog, and calf. In man and the more passionate animals, however, the prominences were small. Such precise explication served Willis's larger goal of establishing a distinction between "wit" and "instinct" and, hence, a gradation between man and beast. Indeed, he characterized the orbicular prominences as "another or supplementary Brain, and the chief Organs of the natural instincts."53 Not surprisingly, he found them large in "dull working beasts" and small in more clever and passionate animals.54 In comparison to previous accounts of the passions, which derived from humoral models that permitted unimpeded flow throughout the whole body, Willis's characterization of passions as primarily cerebral and nervous restricted access by the lower body to the whole brain. In his model the brain contained a series of pathways and processes by which passions always remained under the (potential) control of the cerebral hemispheres, and, hence, the Rational Soul or mind. In other words, the physiological distance between mind, now firmly located in the cerebral hemispheres, and body had increased. Even fluid containing diseased material from the lower organs was presented to the brain via mediation of the nerves. Messages in the animal spirits were then processed by the cerebral hemispheres, which then sent its signals back to the cerebellum or lower body via the nerves. Transmission, which I have not discussed in detail, occurred through both particle flow and wave propagation, two mechanisms commonly used in the natural philosophy of the day to explain many phenomena involving action at a distance. By these and other theories, Willis and his collaborators created a matrix of explanations that permitted them to posit a neurological origin for a large number

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of normal and abnormal cognitive, affective, and bodily situations from the autonomic to the volitional whose causes heretofore had been dispersed between nerves, heart, viscera, and humors. Much earlier Platonic thought had located reason in the head. Willis's physiology of reason and passion differed from previous physiologies in that he involved the solid tissues of the cerebral hemispheres of the brain. In Chapter 7,1 discuss some gender implications of the new preference for solid that Willis's work illustrates. Although classical thinkers as well as Descartes ascribed minimal role to the cerebral hemispheres, Willis made them, together with the cranial nerves, supreme in the body. Furthermore, in the apices of the cerebral cortex, he provided a physiologically sophisticated model of reason that existed "free and independent" of the rest of the body and its problematic enthusiasms. Descartes, in comparison, was ambiguous about the location of mind. His overtly philosophical texts, such as his Discourse on Method of 1637, and even his philosophically driven text on physiology, the Treatise on Man, which I discuss in Chapter 3, emphasized the nonembodied nature of mind. Nonetheless, his explication of interactions between the passions, perception, and the mind in Passions repeatedly suggested their interdependence. For example, some perceptions "have the soul as their cause, others the body."55 Although Willis located bodily perception in the nerves and cerebral hemispheres, Descartes argued that they might arise in other areas of the body in addition to the nerves. Perceptions of the soul, for example, "for which we do not normally know any proximate cause... are aroused in us sometimes by the objects which stimulate our nerves and sometimes also by other causes."56 Like Willis, though, Descartes described the physiology of sensation, which for unexplained reasons he distinguished from perception, in the nerves: "the slightest motion . . . where one of the 'nerve' fibres terminates, it thereby causes a movement in the part of the brain just as we make one end of a cord move by pulling the other end."57

Willis and Unreason Willis, unlike Descartes, was a physician, and like experimentalist physicians from Herophilus on, he tended to push knowledge in terms of its potential use in practice. Although a pronounced clinical bias may limit the general applicability of one's knowledge claims—aside from Locke I can think of no physician who has been taken seriously by philosophers—in certain situations, it may provide one with an epistemological advantage over those, like Descartes, who try to adapt abstract language to describe dynamic local situations. Instead, Willis could and did use knowledge of particular situations to support his theories of universal conditions. That display of such knowledge might bolster his professional standing in both camps—natural philosophy and medical practice—and may have provided him additional inducement. In any event, even as Ralph Bathurst was re-


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viewing Willis's manuscript version of Anatomy in 1662-1663, Willis had almost completed what Richard Lower termed his "book of the Diseases of the Head."58 Close links between physiology and pathology were especially important to Willis on both philosophical and clinical accounts. He characterized the Anatomy of 1664 not as a definitive work but rather as a "firm and stable basis" for what he had "long thought upon, the Pathologie of the Brain and nervous stock."59 Willis's principal thoughts on the subject of unreason were published in two texts—the 1667 Pathology of the Brain and Nervous Stock in Which Convulsive Diseases Are Treated O/just mentioned and De Anima Brutorum of 1672, which Pordage entitled The Soul of Brutes in his 1680s translations of Willis's works. If the goal of Anatomy had been to "unlock the secret places of Mans Mind," the purpose of the later texts was to explicate the abnormal anatomy and physiology of those who possessed an "infirm Brain" or souls at "Civil War." When such work was linked to "rational therapeutics" (llpharmaceutice rationalis"), the subject and title of Willis's last book, published posthumously in two volumes in 1675, the potential benefit would be individual and social. Willis always characterized abnormal behavior as both an individual and a family problem and as a disturbance of the social fabric: Those suffering from convulsions, for example, found themselves driven out not only "from the Communion of Saints" but also from the "Society of men." Fortunately, once "growing well," they would leave "both at once their Diseases and Errors, but also should have become wise."60 The upshot of Willis's program was to reclassify a number of human conditions that heretofore were considered heterogeneously as "nervous diseases" and/ or brain abnormalities that might lead to a loss of the "habit of reason." Willis coupled an ambitious approach to diagnosis and treatment with a similarly ambitious nosology regarding the range of nervous disease. In this chapter I discuss only two kinds of unreason that received intense attention from Willis: convulsive conditions, which he also termed epilepsy, and idiocy. As one might expect, Willis classified "convulsive disease" as a nervous disorder, but he also considered seemingly less likely candidates such as scurvy, asthma, and hysteria to be nervous illnesses. In comparison, his antecedents and critics, such as Nathaniel Highmore, a contemporary physician and fellow Harveian whose criticism of the neurocentric model I discuss in Chapter 7, regarded them as manifestations of the physical interaction of a disordered blood with particular end organs. In addition to looking to imbalanced or bad humors and corrupted animal spirits, traditional explanations of convulsive conditions and idiocy also incorporated demonic explanations. Willis supported his neurological etiology with a mix of anatomic and clinical arguments. He found such a mix necessary because neither the "ocular demonstrations" of pathological anatomy nor the "case observations" of his practice on their own achieved the epistemological threshold that Willis wanted for medical knowledge. Echoing the ancient Greeks as well as his near contemporaries such

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as Galileo and Descartes in their placement of mathematics, particularly geometry, as the most reliable knowledge, Willis wanted his discipline—medicine—to "grow to a true Science and be practiced with a certainty no inferior to the Mathematicks."61 But he knew that a mix of "ocular demonstrations" and "case observations" did not meet that standard, which is perhaps why Willis expressed his thoughts in terms of probabilities: "I think it is very likely so," and "We may suppose with very great probability," represent typical examples of his qualifiers. The anatomic limitation was that in convulsive disease, "no marks at all of the morbific matter appear, or are so very obscure, that we may have deservedly suspected it to be an inspiration of an evil spirit."62 As a consequence, Willis admitted that its etiology was "the most difficult to be unfolded"; furthermore, because its symptoms could be so "stupendous," the "prognostification of the Disease . . . is of very difficult cure." Nonetheless, on both medical and theological grounds, one needed to search for its cause(s) as the malady often killed the afflicted or caused permanent injury; additionally, a more exact knowledge would help counter older characterizations of persons subject to convulsions as being "possessed by the Devil."63 Convulsions tended to occur in family clusters, a widely held empirical truth that motivated physicians, patients, and their families to accept aggressive treatments and intense investigatory efforts. Classical physiology provided a two-fold explanation for convulsions. In humoral terms, convulsions derived from an excess of fullness or emptiness in the animal spirits. Alternatively, convulsions resulted when that fullness or emptiness caused the meninges (the covering layers of the brain) to move spasmodically. To knock down the humoral argument, Willis cited his experience of patients in wasting or edematous states: They did not suffer from convulsions. Furthermore, those with convulsions sufficiently mild so that they remained conscious during an attack did not report any perception of their membranes contracting. Also, he had opened a patient's meningeal abscess and expressed "stinking matter," but the person did not experience convulsions before or after. The problem, he countered, was in the nerves, as vivisectional experiments on puppies as well as in "almost every man" had shown that punctures of the nerves and tendons excited muscular spasms.64 When he discussed hysteria and idiocy, Willis was optimistic concerning the anatomic evidence, and he let "ocular demonstrations" establish the reality of those conditions. However, with convulsive illness, given its anatomic murkiness, arguments from pathological anatomy on their own would not work. One result was that theory and practice so penetrated each other in his presentation of convulsive disease that his reason became circular, as the following case report suggests: "A fair maid, sprung from Parents indifferently healthful," developed epileptic symptoms at the onset of puberty. She had seen many physicians, as well as "every Empirick and outlandish Mountebank," before her parents brought her to Willis. He noted that her illness began with symptoms of


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vertigo and progressed to convulsions after the onset of her menstruation. It happened that a "cautery" (the instrumental or chemical application of heat) being accidentally and by chance administered," freed her from fits. Thus, "it may be inferred that fontanels [drains] may be profitably administered . . . for wheresoever an emissary is opened . . . there morbifick particles flow out with it that therefore the brain might remain free."65 At times, his "evidence" reads like a mere recitation of cases; perhaps he hoped sheer numbers of examples might persuade readers when the anatomic support was especially weak. A sixty-seven-year-old "honest woman" complained of vertigo, nausea, and vomiting. Willis diagnosed a convulsive problem and directed a "blistering plaster" to be applied behind her ears. Next, a "noted man" of thirty-three complained of a "thick spitting," night sweats, and vertigo, which progressed to convulsions of the mouth and face. Willis interpreted this development to mean that "morbific matter" had descended from the head into the "pipes of the Nerves" and caused spasms. A "tall and handsome maid, sprung from sound parents" developed "heaviness in her head" after exhausting herself in caring for a sick master. After a year the heaviness degenerated into convulsive fits, which in another year degenerated into a "madness sometimes furious and sometimes plainly stupid and foolish," a progression that suggested to Willis a "contagion or convulsive infection." Finally, due to "convulsive matter being daily increased in the brain," the patient became "debilitated and broken," which demonstrated to Willis how the combination of a "great sadness" and debility could cause nervous disease.66 Like many healers then (and occasionally now), Willis was not shy about using post hoc ergo propter hoc logic (a venerable phrase in medical Latin for a good outcome after a therapeutic intervention that translates literally in English as "after these things, therefore because of them") from his practice to advance his arguments. If such reasoning was not satisfying to his critics, the evidence of a "cured" child must have seemed powerful inducement to parents to accept the doctor's theory. John Locke, who attended Willis's Sedleian lectures in 16631664, recorded this example: There was a woman in this town who had lost three or four fetuses from epleptic attacks immediately after birth. We dissected the fourth, and found no lesion in its brain except that in the fourth ventricle there was a little clot of extravasated blood perhaps brought on by the violent contraction of the brain and was, therefore, the result rather than the cause, of the epilepsy. (For we often find similar clots in the brains of those who had died of apoplexy, which lead doctors falsely to accuse the extravasated blood as the cause of the apoplexy, as will appear later.) It is also clear that those fetuses died from a taint in the blood transmitted to the brain, as in dealing with her next three children, immediately at birth, we had a fontanelle [drain] inserted in the neck and leeches applied behind the ears in order to drain off the impurities from the brain: the result was that they escaped epilepsy and still do to this day. This is clear proof that this condition had stemmed, not from the [brain's] ventricles, but from impurities in the blood.67

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Shortly after this lecture, Willis modified his views in favor of the idea that convulsions were caused by either a defect in brain tissue itself or the effect of tainted blood on the nerves. At the time of the lecture cited above, his particular concern was to de-emphasize the role of the cerebral ventricles and humoral theory.

Stupidity In addition to wanting to correct the propensity of the unlearned to misinterpret the pressured speech of an epileptic as divinely (or diabolically) induced, Willis expressed concern that poorly treated convulsive disease frequently led to permanent loss of reasoning capacity or "stupidity," a condition he regarded as a disease. Sometimes he used "idiocy" as a synonym for "stupidity," although he generally considered the loss of reasoning capacity of "idiocy" as congenital and that of "stupidity" as acquired. Indeed, much of his later work involved extending the rubric of disease to include not only "stupidity" but also "foolishness," a concept he did not define precisely. By extending the concept of disease, I mean that he not only named these conditions as diseases—a first in the instance of idiocy and stupidity—but also provided an explanatory framework that sought to establish them as ontologies, or things-in-themselves. Although Willis wrote at length on stupidity in Chapter 13, entitled "Of Stupidity, or Foolishness," in The Animal Soul of 1672, he provided graphic evidence much earlier, in the Anatomy of 1664. Although that text nominally concerned normal brain and nerve anatomy and function, it contained an engraving by Wren of a brain Willis described in the notes as "effigies of an humane Brain of a certain Youth that was foolish from his birth, and of that sort which are commonly termed Changelings." [Fig. 6.1]68 Willis's mention of "Changelings" merits a brief digression. Although its narrow meaning involved only the practice of secret exchange of one infant with another, in the early modern period the term also commonly conveyed the idea that the Devil was the exchanger. As he did elsewhere in his texts, Willis occasionally went out of his way to debunk notions of nonhuman spiritual beings as active progenitors of illness. Beyond noting that the youth's brain exhibited a general wasting of the cerebral cortices, Willis did not comment on the image. Nonetheless, in Anatomy he occasionally correlated structural change or abnormality in the brain with abnormal behavior. For example, in discussing the function of the brain's internal capsule, he supported his functional argument that it linked the motor functions of cerebral hemispheres by noting that the internal capsule of a deceased patient with long-standing hemiplegia displayed "bodies . .. discoloured, like the dregs of oil."69 Like his contemporaries, including Descartes and Gassendi, and predecessors, Willis tiptoed around issue of the Rational Soul's involvement with illness and defect. Immortal and immaterial, the Rational Soul was also linked, albeit imprecisely in Willis, with the cerebral hemispheres, and they definitely were subject


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FIGURE 6.1 From Willis's Cerebral Anatomy (1664), the "effigies of an humane Brain of a certain Youth that was foolish from his birth." Courtesy of the Clendening Library of the History of Medicine, University of Kansas.

to structural defects and faults of the Animal Spirits. As he put the matter: "Stupidity . . . or Foolishness, although it most chiefly belongs to the Rational Soul . . . is not improperly reckoned among the Diseases of the Head or Brain."70 As with his theories of causation of convulsive diseases and fevers, Willis invoked a variety of structural, physiological, hereditary, and environmental factors for severe loss of reasoning capacity. Stupidity, he argued could be acquired or hereditary, permanent or transient, and the prognosis depended largely on the initial cause. Drunkenness and frequent opiate use, for example, could so dull the Animal Spirits that a person would become stupid; if so, chances of recovery were excellent provided the person stopped partaking of those substances. So too "terror or vehement sadness" could "dissipate the spirits" and thereby diminish one's cognitive function.71 He thought the two most common causes of permanent stupidity were congenital brain malformations and infant convulsions. In describing

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congenital stupidity, Willis distinguished between hereditary situations that carried an increased risk factor of producing an abnormal offspring, and the "accidental" situation of a stupid child, "like a changeling," who might be born to a "wise and highly ingenious" man.72 Risk factors included many of the traditional bugbears of good health: intemperance, luxury, and "evil manners." Parents should be of the right age and conformation. In the birth sweepstakes, the best chance— the value of which was "far beyond a large patrimony"—involved having parents possessed "of a sound mind in a sound body," an observation that echoed the Stoics. Observing that patients afflicted with convulsions on postmortem often exhibited abnormalities in their "streaked bodies . . . in the corpous callosum," Willis accepted that convulsions, if not successfully treated, often led to both stupidity and the "Palsie."73 Moreover, the likelihood of a poor outcome increased with age. In common with Aristotle and Plato, Willis (and Locke) imagined that children and the elderly might have poor memories or wits merely as a consequence of the formation of the spirits or brain structures at their respective life stages.74 Because they were particularly vulnerable, it was crucial to treat childhood epilepsy, for children's already weak spirits, like those of the aged, could be easily damaged for good. Behind this argument lay the notion of a physiological "habit," or regular channel of physiologically active fluid, as I discuss in Chapter 4. Willis expressed pessimism about the mental and motor deficits that frequently accompanied prolonged seizures and brain fevers. However, although traditional medicine and traditional physicians would have had little more to say to a patient once a discouraging diagnosis had been made, just as they became reticent when situations appeared imminently terminal, Willis continued to recommend treatment. Albeit it was treatment of a particular kind: "It must be the work both of a Physician and a Teacher." Whether the patient's stupidity was innate or acquired, the goal was to bring them "use of reason in a little measure." If they could achieve that, they "may be accounted out of the number of Brutes." Such an approach would not do, however, for the extremes of "madness or Stolidity, uncapable of all learning."75 Willis packed much into those pithy comments. For one thing, his recommendation of special education for those with cognitive deficits was novel. The mention of madness also hints at Willis's concern with that subject, which he also treated at length in The Animal Soul and in Pathology. In this chapter, however, I think it would be more useful to pursue the handling of that borderline condition, the mentally handicapped at the margins of the human and the brute, in the work of Willis's one-time student, Locke. It is there, I think, that the ideological implications of the emerging nosology of mental illness and handicap discussed above were most formally realized. As inheritors of the traditions of the cerebral body as I have used the term, readers may be surprised at the thinness of Greek physiological literature concerning what nowadays is considered mental disability. The Greeks recognized dull-wittedness,


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but the subject did not seem to preoccupy them medically or socially. Moreover, they considered it a condition, not a disease. The Hippocratic texts, for instance, discussed the condition of a club foot in five places, but they made only one reference to congenital stupidity.76 When Aristotle or Plato referred to congenital conditions or life stages that might result in loss of intellectual function, their organ of reference was the heart. For example, Aristotle, who thought that "slow-witted" people had a good memory, whereas the "quick-witted" were better at "recollecting," considered that dwarfs and children had "abnormally weak memory" because of the "abnormally large" size of their heads in relation to their trunks, a conformation that meant their comparatively large heads compressed their "organ of perception," the heart.77 In Plato's dialogue Theaetetus regarding knowledge, Socrates described men who were "quick to learn" and possessed of "good memories" as having minds analogous to a "good thick slab of wax" that could take "imprints" that were "clear" and "deep enough to last a long time." His next reference to the wax tablets, however, was that they were "tables of the heart." When persons were "slow" and could not "quickly . . . imprint" their "tablets," Socrates used the image of a "shaggy heart," which he attributed to Homer.78 He defined "stupid" as being "so slow" and tending to "sort things into the wrong places." Galen echoed Plato in characterizing intellectual function with "fast and slow" rhetoric. Regardless of where they located quickness and slowness—and it should be remembered that Aristotle and his intellectual descendants among the Schoolmen maintained a cardiocentric physiology—classical Greek thinkers did not by definition put intellectually dull people on humanity's margin. Instead, according to Plato at least, that space was reserved for "the most expert of calculators" who "hates, not loves, what his judgment pronounces to be noble or good."79 In other words, as Christopher Goodey has pointed out, Plato considered "unvirtuous knowledge nonsensical."80 Furthermore, Plato consistently placed humans in their communities: Calculating but unvirtuous people represented a grave social threat. Thus, the unwise clever were the biggest fools; it was they who needed to be removed for remedial training to be "styled wise."81 In terms of their humanity, the markedly stupid did not fare so well in the theories of Locke and Willis. According to the mature Locke, without perceptions one could not abstract, which for him as well as for Willis, was the sine qua non of humanity. Given his sensate psychology—"Perception then being the first step and degree towards knowledge, and the inlet of all materials [i.e., simple ideas] of it"82—Locke asserted that conditions hindering perception could reduce a human to animal statues. In old age, for instance, when the sense impressions made "are scarcely perceived, or not at all retained," Locke left the reader to consider whether there was any difference between such a person and the "lowest degree of animals," such as an "oyster."83 Indeed, the oyster description would hold if a man had "passed sixty years in such a state." He considered that an inability to

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"distinguish, compare and abstract," which was the defect he found in "naturals," Locke's term for natural fools or congenital idiots, placed one on the dividing line between man and the "species of brutes."84 Like Willis, Locke made a distinction between those with low reasoning ability and those who were insane. I suggest that Willis and Locke introduced a new distinction between those with very low reasoning ability, which they called "stupidity" and "idiocy," and the rest of humanity. According to them, being human depended on possessing a brain and cranial nerves that functioned reasonably well. Willis and those he influenced, such as Locke, reconfigured manifestations of passionate extremes and unusual behaviors from being expressions of the humors whose spirituous components could communicate freely with the outside of the body, including the divine and diabolical, to internal disease states of the brain and nerves. It was a move that might have given pause to Odysseus, Plato, Aristotle, the Virgin Mary, and perhaps even Descartes. If the influence of Willis's model of the cerebral body was limited to an audience of physicians and savvy lay persons during the Restoration, in eighteenth-century Europe it began to assume a broad cultural importance. According to literary scholar George Rousseau: "Slowly but surely, it becomes painfully clear that Richardson, Sterne, Diderot, Rousseau, Mackenzie, and even the Marquis de Sade were the posterity of two generations of thinkers who had increasingly "internalized"—and that is the important word—the new science of man, directing thought about man from his visible eyes and expressive face to his unseen nerves and controlling brain, from what he looks like to what he feels, and from what he feels to what he knows." Rousseau believes these "new assumption(s) about the fundamental anatomy of man arose through Willis's deflection of several generations of scientists, including mechanists, vitalists, and animists of every variety and persuasion."85

Notes 1. Homer. The Odyssey, trans. Richard Lattimore (Evanston, ILL.: Harper and Row, 1967), Book XX, pp. 15-20. 2. Jan Bremmer. The Early Greek Concept of the Soul. (Princeton: Princeton University Press, 1983). See also Bruno Snell. The Discovery of the Mind, trans, from German, T. G. Rosenmeyer (Oxford: Oxford University Press, 1953). 3. Euripides. Medea, XXXX 1078-1080. 4. Agamemnon in Homer's Iliad: "Not I was the cause of this act, but Zeus and my portion and the Erinys who walks in darkness: they it was who in the assembly put wild ate in my understanding, on that day when I arbitrarily took Achilles' prize from him. So what could I do? Deity will always have its way," in E. R. Dodds. The Greeks and the Irrational. (Berkeley: University of California Press, 1973), pp. 1-27. See also Diane Puklin. "Medical Psychology in the Seventeenth Century: The Idea of a Neurological Emotion the Thought of Thomas Willis." Unpublished doctoral dissertation in history. (University of Chicago, 1980), p. 1. Puklin provides excellent


5.

6.

7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29.

30. 31.

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accounts of the thought of Aristotle, the Hippocratics, Galen, Gassendi, and Willis, among others, on relationships between reason, emotion and bodily structures and functions. Supernatural ate co-existed with thumos. At ancient healing temples such as the Epidauros complex, for example, Greek sufferers commonly made sacrifice and prayed to a supernatural power—Asklipios—and sought consultation with healers of a secular bent, such as the Hippocratics. Archeological evidence suggests temple healers often used Hippocratic approaches to manipulating the diet and exercise patterns of the afflicted in addition to guiding them through their incubation and its dreams. Indeed, Hippocratics probably established the Asklipion temple at Cos, putative birthplace of their namesake, in the mid fourth century B.C.E. Brian E. Daley. "The 'Closed Garden' and the 'Sealed Fountain': Song of Songs 4:12 in the Late Medieval Iconography of Mary," in Medieval Gardens, ed. Elisabeth Blair MacDougall (Dumbarton Oaks Colloguium: Washington, D.C.: Harvard University Press, 1986), pp. 253-78. Concise Oxford Dictionary. 10th ed. (Oxford: Oxford University Press, 2001). Rene Descartes. "Passions of the Soul," in Philosophical Writings of Descartes, trans. John Cottingham, Robert Stoothoff, and Duglad Murdoch (Cambridge: Cambridge University Press, 1999), vol. 1, p. 328. Ibid., 352. Ibid., 328. Ibid., 330. Ibid., 343. Ibid., 340. Ibid., 328. Ibid., 339. Ibid., 345. Ibid., 362-3. Ibid., 347. Ibid., 348. Ibid., 345-6. Ibid., 348. Ibid., 387. Ibid., 348. Ibid., 349. Ibid. See Norbert Elias. "The Problem of the Change in Behavior during the Renaissance," in The History of Manners, trans. Edmund Jephcott (New York: Pantheon, 1978), pp. 70-84. Descartes. "Passions of the Soul," in Philosophical Writings of Descartes, 384-5. Ibid., 404. The newly restored Charles II appointed Willis on the recommendation of Gilbert Sheldon, mastermind of the Restoration political settlement and then Warden of All Souls College at Oxford and Bishop of London. A few weeks later Willis received his MD. Seth Ward. Vindiciae Academiarum. (Oxford, 1654), pp. 29-30. See also Robert G. Frank, Jr. Harvey and the Oxford Physiologists. (Berkeley: University of California Press, 1980), pp. 48-9. Thomas Willis. "Preface to the Reader," in Anatomy of the Brain. (1664).

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32. 33. 34. 35. 36. 37.

Thomas Willis, "Epistle Dedicatory," in Two Discourses. (1672), sig. A3. Willis. "Preface to the Reader," in Two Discourses. Willis. Two Discourses, 29-30. Willis. "Preface," in Two Discourses. Willis, Two Discourses, 41. Ibid., 39. See also Puklin. "Medical Psychology in the Seventeenth Century." Chapter IV. Willis. Two Discourses, 34. Willis. "Preface," in Two Discourses. Willis. Two Discourses, 40. Ibid., 41. Ibid., 46, 52. Plato. Phaedo, in The Collected Dialogues of Plato, eds. Edith Hamilton and Huntington Cairns (Princeton: Bollingen, 1961), p. 66. Plato. Timaeus. Dialogues, 86. Puklin. "Medical Psychology in the Seventeenth Century," 12. Ibid., 22. Margaret J. Osier. "Baptizing Epicurean Atomism: Pierre Gassendi on the Immortality of the Soul," in Religion, Science, and Worldview, eds. M. J. Osier and P. L. Farber (Cambridge: Cambridge University Press, 1985), pp. 163-83, especially p. 168. Pierre Gassendi. Opera Omina. II, 446. Quoted by Osier. Religion, Science, and Worldview. Pierre Gassendi. "Syntagma philosophicum," in Opera Omina, 6 vols. (Florence, 1727), vols. I and II, Book X, Chapter 1, 473a. Cited by Puklin. "Medical Psychology in the Seventeenth Century," 184. Thomas Willis. Cerebral Anatomy. (1664), p. 117. Ibid., 119. Ibid., 121-2. Ibid., 122. Ibid., 85. "Passions of the Soul," in Philosophical Writings of Descartes, 335-6. Ibid., 373-88. Ibid., 333. Richard Lower's letter of 24 June 1664 to Robert Boyle: "Dr. Willis will send his book of the Diseases of the Head to the press this winter, if he be no hindered or forced to defend his last. There is not a disease of the head, which he doth not excellently well illustrate with very rare observations and cases; so that it is a pity that the world should be any longer deprived of them." Quoted in "The Origin and Significance of Cerebri Anatome," ed. William Feindel. Thomas Willis. The Anatomy of the Brain and Nerves. (Montreal: McGill Unversity Press, 1965), vol. 1, p. 22. Willis. "Epistle Dedicatory," in Anatomy of the Brain. Thomas Willis. "Epistle Dedicatory," in Soul of Brutes. (1672). Thomas Willis. "Preface to the Reader," in Rational Therapeutics. (1675). Thomas Willis. Pathology. (1667), p. 11. Ibid. Ibid., 3, 11-4. Ibid., 18-9. Ibid., 30-4. John Locke, Bodleian Library, MS Locke, F. 19, pp. 48-50. Quoted in Kenneth Dewhurst. Willis's Oxford Lectures. (Oxford: Sandford, 1980), p. 86.

38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58.

59. 60. 61. 62. 63. 64. 65. 66. 67.


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68. Willis. Anatomy of the Brain, 70. 69. Ibid., 63. The same phrase is used in The Animal Soul (1672), p. 84. See also Alfred Meyer and Raymond Hierons. "On Thomas Willis's Concepts of Neurophysiology, part 1." Medical History 9 (1965): 9. 70. The whole of Pordage's 1683 translation of Chapter XIII is readily available in Paul F. Cranefield. "A Seventeenth-Century View of Mental Deficiency and Schizophrenia: Thomas Willis on 'Stupidity or Foolishness.'" Bulletin of the History of Medicine 35 (1961): 291-316. My reference to Willis in this section will be from this source. In note 3, p. 291, Cranefield notes that this chapter was printed in toto in an influential medical compendium at the end of the seventeenth century. 71. Ibid., 299. 72. Ibid., 297. 73. Ibid., 95. 74. On Willis, see Ibid., 95. For Aristotle, see "Memory and Reminiscence," 450b: 7-14, in Basic Works of Aristotle, ed. and intro. Richard McKeon (New York: Random House, 1941), p. 609. 75. Willis. The Animal Soul, trans. Cranefield. "A Seventeenth-Century View of Mental Deficiency and Schizophrenia: Thomas Willis on 'Stupidity or Foolishness.'" Bulletin of the History of Medicine 35 (1961): 302. 76. Club foot is described extensively in "On Joints." See Hippocrates, trans. W. H. S. Jones (Cambridge: Harvard University Press, 1923), III: 320,346,348,428-30. Christopher Goodey has asserted that there is one reference to a condition of congenital stupidity, but he has not cited the passage, and I cannot find it in the above translation. I am indebted to him for sending me an early draft of his essay, '"Mental Handicap' : The Early History of Some Intellectual Difficulties," unpublished manuscript, 1992, p. 4. 77. Aristotle. "On Memory and Reminiscence," in Parva Naturalia, trans. J. I. Beare. Aristotle, 453b. 78. Plato. Theatetus. trans. F. M. Cornford. Dialogues, 194c. 79. Plato. Laws HI. Dialogues, 689a-d. See also Goodey. "Mental Handicap," 37-8. 80. Goodey. "Mental Handicap," 36. 81. Plato. Laws HI. Dialogues, 689c-e. 82. John Locke. An Essay Concerning Human Understanding, 1690,2 vols. Reprint (New York: Dover, 1959), Book II, Chapter IX, "Faculty of Perception," Section 15. 83. Ibid., Section 14. 84. Ibid., Book II, chapter XI, "Of Abstraction," Section 11-2. 85. George S. Rousseau. "Nerves, Spirits, and Fibres: Towards Defining the Origins of Sensibility." Studies in the Eighteenth Century. Vol. 3. eds. Brissendau and Bade (Canberra: Australia National University Press, 1976), pp. 150, 155.


7 THE TRANSFORMATION OF EVE

In February 1650 a woman "of very good family" complained of "several months of pain" to Thomas Willis, then an advanced Oxford medical student who occasionally consulted with patients. The pain began in her stomach and radiated to her back. It was worse when she lay down, so much so that she spent "whole nights sleepless," according to Willis's report. "Liable to headaches for several years," she suffered pain in her loins and upon urination. The proto-doctor diagnosed her condition as "doubtless hysterical," and attributed its cause to a "foul vapour ascending from the uterus into the praecordia."1 Seventeen years later, Willis, by then Europe's most influential anatomist and England's leading physician,2 had changed his mind. Concerned that "any time a sickness happens in a Woman's Body . . . we accuse the evil influence of the Womb (which for the most part is innocent)," his anatomic studies and medical experiences had convinced him that hysteria was "chiefly and primarily Convulsive, and chiefly depends on the brain and the nervous stock being affected."3 Subsequently, a learned rival interested in hysteria, Nathaniel Highmore, published an account attacking Willis and his doctrine of the nerves. Willis's claim that women's bodies were governed by their brains and nerves and not their wombs and "foul vapours" emanating from them represented a novel departure in learned European accounts of women's physiology.4 In this chapter, I use theories and debates about hysteria as a lens to examine shifts in natural 153

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philosophy concerning not only women's physiology but also underlying assumptions about the nature of reasoned inquiry and what it meant to be male and female. To establish his model of brain and nerves, Willis had to revise traditional concepts of hysteria, and hence of women's physiology. Indeed, I argue that a seventeenth-century debate about hysteria, which at one level concerned the differing nature of fluids and solids in both male and female bodies, was also about characterizing both women's and men's bodies as subject to the "habit of reason" as described in previous chapters. Hysteria, which then loomed large in medical practice and medical texts, represented a last frontier of traditional physiologies of fluids to Willis and colleagues, who promoted a bodily paradigm in which the solid parts of the brain were paramount and the rest of the body and fluids (mainly blood) secondary. If one accepted Willis's view, the result was a human body governed by a cerebral cortex and cranial nerves in which gender differences mattered little. Or did they? Debates about the nature and bodily role of human fluids and solids in turn rested on the place of anatomy, medical chemistry, and physiological experimentation in determining the body's truth. Embedded within these newly prestigious forms of medical knowledge, however, were assumptions about gender that helped shape not only the cerebral model, but also the status of traditionally feminine ways of knowing. One cannot separate the method from the conclusion; at least some of Willis's female contemporaries could not. Both the processes and the conclusions were taken up (or resisted) by a variety of women and men who sought to frame not only the medical but also the social and religious parameters of women's (and men's) behavior and experience. The "nexus among ideologies of woman, nature, and science," to borrow biologist and historian Evelyn Fox Keller's characterization, has received considerable attention from explicitly feminist historians during the past two decades.5 To my knowledge, however, no one has yet attempted to articulate the cultural assumptions and tensions I have been considering in previous chapters in terms of the new theories of nerve, brain, and body as they were taking form in early modern Europe. A brief outline of traditional accounts of differences between the physiology of men and women may aid understanding of the importance of what changed.

Traditional Economies of Female Moisture According to Aristotelian theory, a central issue in animal reproduction, including human, was heat. Males by definition possessed more, females less. The heat differential depended largely on the amount of moisture a body contained. Traditional accounts held that women, especially those of childbearing years who were not pregnant or infertile, held much more moisture than men.6 The uterus was considered to be not only a cold organ, it was also the transit area and storage

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vessel for large quantities of fluid. Unlike men, women regularly produced so much fluid, both menstrual blood as well as ejaculate during orgasm. Moreover, tradition held that women were the only female animals who menstruated.7 Not only were men thought to have less fluid, but traditional theories accorded them more means of fluid elimination. Men could get rid of excess moisture by sweating, ejaculation, or extrude it to the skin's surface through their larger pores, where it would turn into hair on contact with the air: Women, after all, did not have beards. Women's coolness, however, made such coctions, or transformations, unlikely. Men's situation was akin to that of other animals, who extruded their excess fluids through their pores, where the residue became fur, horns, or claws, or burned them up through intense physical activity.8 In addition, both classical and medieval medical authorities thought that the normally flowing menstrual blood, being "waste," was foul or worse. According to an influential medieval French text on women's physiology, the Secrets des Dames: "And whosoever were to take a hair from the pubis of a woman and mix it with menses and then put it in a dung-heap, would at the end of the year find wicked venomous beasts."9 Stories of the Venomous Virgin, widespread at the end of the thirteenth century, portrayed the blood of menstruating women as a poison capable of widespread mischief.10 Much of this kind of thinking, if not its overt misogyny, carried over into seventeenth-century thought regarding the etiology of hysteria. The anonymous author of The Compleat Doctoress (1656) divided female disease into four classes: (1) those common to all, (2) those affecting widows and virgins, (3) those affecting the barren and fruitful, and (4) women with child. Hysteria, the author argued, was the chief medical problem for women in all categories but especially for those in category 2. "Stoppage of courses is the cause: ill vapours travel from matrix [uterus] to brain."11 Nicholas Fontanus argued much the same in his The Woman's Doctour of 1652: "by reason of the moisture wherewith those parts abound, the matrix is loosened, and exceedingly stretched: and this is the truth of the whole matter."12 If traditional wisdom held that the cause of woman's distress was almost exclusively a disorder of genital fluids and/or flesh, traditional therapies were directed to the same location. Achievement of female orgasm (ejaculation) was considered the best therapy. For treatment of "fits of the mother"—a synonym for hysteria—the prolific medical popularizer and herbalist Nicholas Culpeper in 1655 advised prompt marriage "to a lusty young man." If that was not feasible, he suggested in his Practice of Physick: "that the genital Parts should be by a cunning Midwife so handled and rubbed as to cause an evacuation of the overabounding sperm. But that being a thing not so allowable, it may suffice whilst patient is in bath to rub her belly in the region of the Womb."13 According to the book's publisher, that advice went through eight printings totaling 15,000 copies at a time when England contained perhaps 200,000 literate women.14 Medical writers used such mid-seventeenth-century characterizations of women's bodies to support their arguments for a natural basis for division of labor

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between men and women. According to The Compleat Doctoress: "Women were made to stay at home and look after household employments . .. accompanied without any vehement stirring of the body . . . therefore hath provident Nature assigned them their monthly courses, that by the benefit of these evacuations, the feculent and corrupt blood might be purified, which otherwise, being the purest part of blood, would turn to rank poyson."15 Wives were more healthful than virgins and (chaste) widows because they were "refreshed with man's seed, and therefore ejaculate their own, which being excluded, the cause of evil is taken away."16 Women were also thought to be fundamentally similar to men. Belief in the similarity and difference of female and male physiology and anatomy had coexisted at least since Hippocratic times. Specifically, that strain of Platonic thought that emphasized continuities fostered the tendency to conflate the sexes.17 In this schema, women were physiologically like men, but less "perfect" because they possessed less heat. It may surprise us, but traditional authorities also agreed that women and men's genitalia were homologues: The female genitalia were but the male inverted.18 Indeed, as late as Vesalius, anatomists tended to depict male and female genitalia isomorphically.19 In comparison, Aristotelian thought, particularly the neo-Aristotelian thought of the thirteenth and fourteenth centuries, was more comfortable with differences: Women and men did not have the same seed, for instance. Man's seed was active; woman's, passive. Consensus between elite and popular cultures on the nature of women's physiology was reflected in the lack of substantial difference between Latin and vernacular medical texts on women's health issues. When an elderly William Harvey asked rhetorically, "How many incurable diseases are brought about by unhealthy menstrual discharges?" he did not sound very different from the popular authors cited above.20 Common sense, empiric and folk treatments, and attention to astrological conditions characterized the content of texts on women's health. By and large, women were taken care of by women, or by women or men who read women's health guides authored by men who pretended to be women.21 The knowledge of midwives was on the same plane as the knowledge of university-educated (and hence male) physicians. Both the model and the consensus, however, were about to change.

Medical Knowledge and Gender In formulating his broad program of human endeavor, Francis Bacon at one point made explicit a credo of male dominance/female submission in terms of man's relation to nature. Writing his "straight answer from my most inmost heart," Bacon averred: "My intention is to impart to you, not the figments of my own brain, nor the shadows thrown by words, not a decoction of religion.. .. No: I am come in


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very truth leading to you Nature with all her children to bind her to your service and make her your slave . . . so may I succeed in my only earthly wish, namely to stretch the deplorably narrow limits of man's dominion over the universe to their promised bounds. . . ,"22 Originally, Bacon entitled his text, which consists of a prayer and two chapters he wrote in his forties, as The Greatest Birth of Time (Temporis Partus Maximus), but he later retitled it The Masculine Birth of Time (Temporis Partus Masculus). So too for Willis, who, like many early members of the Royal Society was perceived by his contemporaries as a "Baconian,"23 the body was an entity whose "secrets lay hidden."24 Resolving in the 1660s to believe only "nature and ocular demonstrations," Willis began an extensive series of anatomies of invertebrates, mammals, and humans in preparation of Anatomy: "I addicted my Self to the opening of Heads especially."25 His goal, as I noted in previous chapters, was to accumulate "ocular demonstrations" that would provide a "firm and stable basis" for a "more certain Physiologic."26 So equipped, the anatomically informed philosopher would be able "to unlock the secret places of Mans Mind." In this formulation, reason was female and Willis the man-midwife who delivered her from Zeus' brain: "Minerva was born from the Brain, Vulcan with his Instruments playing the Midwife: For either by this way, by Wounds and Death, by Anatomy, and a Caesarean Birth, Truth will be brought to Light, or for ever lye hid."27 In retelling the myth of Minerva's birth this way, I would argue that Willis's prose demonstrates an important shift regarding the relations of male and female in reference to each other that was occurring at many levels during the early modern period. In the classical versions of the story, Minerva sprang fully formed and armored from Zeus' head. According to Willis, though, she was passive during her birth, which required help from a man and his instruments. Moreover, it was only by this process, the violent but dispassionate methods of surgical obstetrics or anatomy, that reliable knowledge could be obtained.28 Attempting to reshape the gender of philosophy itself, apologists for the "new" experimental natural philosophy commonly argued that aspects of character such as deep feeling, sensitivity, and the capacity for poetry should give way to the "solid" pursuits of invention and scientific investigation. Willis turned to anatomy, for instance, to overcome his previous reliance on the "suspicions and guesses of my own mind."29 These in turn had been like "a poetical philosophy and physick," no more real that a "painter's fancy."30 Poets might talk of moral wisdom and the virtues of poverty, scoffed Thomas Sprat, a self-appointed spokesperson for the Royal Society. Substantial men and men of property, he declared, followed natural philosophy, which he characterized as the activity of prosperity.31 According to Abraham Cowley, whose "Ode to the Royal Society" appeared in the dedicatory section of Sprat's authorized History of the Royal Society, philosophy itself had become an exclusively male pursuit:

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Philosophy, I say, and call it He For Whatever the Painters Fancey be, It a Male Virtue seems to me.

Although Willis had identified Minerva with a reason that needed male intervention to become present, Cowley characterized the pursuit of reliable knowledge itself as male. What had happened to the feminine, the Minerva, if you will, in natural philosophy? According to Cowley, to be feminine in terms of natural philosophy meant losing one's potency, a trend Jonathon Sawday has analyzed at length in his The Body Emblazoned?2 In his allegorical "Ode to the Royal Society," Cowley bemoaned a feminine philosophy's diet of "Deserts of Poetry." Instead, philosophy needed the "solid meats t'encrease his force," an allusion that aligned "solid" with the male ability to sustain an erection.33 If a philosopher ate the correct food, then he would be able to see: The Riches which do hoorded for him lye In Natures endless Treasury34

A few years earlier in the Restoration, Cowley advocated for an "experimental philosophy" of "vertous covetousness."35 It is not difficult to hear Bacon echo in the background. Sprat's exemplary natural philosopher, incidentally, was Christopher Wren, chief illustrator of the Anatomy of the Brain and the recipient of considerable architectural patronage from Gilbert Sheldon, as noted in Chapter 5. Poised as she was between the Court and her writing desk, Margaret Cavendish, Duchess of Newcastle, was alert to the shift in the ideology of male character reflected in Cowley's lines. Contrasting her husband to natural philosophers who spent "most of their time in Dioptrical (microscopical) inspections," she praised the Duke for not busying himself "much with this brittle Art."36 She noted his collection and use of "optick glasses," but she expressed admiration for the fact that he used "most of your [his] time in the more Noble and Heroick Art of Horsemanship and weapons, as also in the sweet and delightful Art of Poetry, and in the useful Art of Architecture, etc."37 Newcastle's rhetoric recalls an idealized blend of the knightly male character and courtier as described by Norbert Elias in his historical account of European taste and manners.38 However, just as Newcastle's husband did not get the post he coveted as Charles IPs military chief, so too a new male ethos of cool and rational aggression was beginning to displace older norms of male being. Thus, I want to suggest that in this new physiology of reason, the transformation of Eve went hand in hand with a transformation of Adam. Eve became "reasonable" in a way women were not in traditional formulations of a womb-dominated body, but she also became something of a physiological void. Curiosity, that delightful, fluid, and occasionally troublesome character trait that had been ascribed to Western women since Genesis, had been universalized only to be appropriated


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by men, who then celebrated it as a male character trait essential to the success of the "new" male natural philosophy. I suggest that the convergence in the "new" philosophy of a bodily paradigm that emphasized the primacy of the solid parts of the brain and nerves with rhetoric that emphasized the male nature of the "solid" enquiry that produced the model constituted a virtual male homoerotic. Ironically, the convergence presented new challenges to intellectually active women even as it seemingly freed them from venerable constraints. An important consequence of this convergence was the tension it set up about the status of curious women. The shutout was not lost on intellectually active women. Aware that the deck had been stacked, some, such as Margaret Cavendish, chose to participate in natural philosophy. Speaking for her sex in 1668, she wrote: "many of our Sex may have as much wit, and be capable of learning as well as Men, but since they want instruction, it is not possible they should attain to it."39 Known for her erudition, extravagant dress, and devotion to her husband at the court of Charles II, Margaret Cavendish was also known as "mad Madge." More telling, perhaps, of the polarization of gender and knowledge was Horace Walpole's eighteenth-century dismissal of her as a "fertile pedant" with an "unbounded passion for scribbling."40 Harsh words, indeed, for an author who wrote poems and "fancies" on natural philosophy as well as natural philosophy itself, especially the "new" philosophy of the body. Occasionally Cavendish's rhetoric seems to subvert the new male homoerotic of reason, as when she penned the following lines on the brain in her 1653 poem, "Nature's Oven:" The Braine is like an Oven, hot, and dry, Which bakes all sorts of Fancies, low, and high. .. .41

At the everyday level of health care as an artisanal undertaking, the investigational methods that underwrote the cerebral body devalued the intellectual contributions of healers who were not university trained. Learning of the kind Willis promoted was essential, he argued, for the "unlearned" prescribed like "people shooting at random." That was a practice of "quacking Jugglers and old Women." It did not seem to matter to Willis that he spent his formative years learning medical recipes from the wife of his college canon.42 Anatomically uninformed practice left medical knowledge "as if it were a Mystery," and it was no wonder that "cynicks" as well as the "vilest scum of the people fling dirt upon Physick."43 Apologists for the new philosophy of the body articulated by Harvey, Willis, and their cohort in effect declared that custom and intuitive knowledge, the traditional stock-in-trade of female healers of all kinds, including midwives, were no longer sufficient in the care of women. Her physiology no longer defined in terms of her sex, woman was presented as needing the advice of skillful male physicians. Medical understanding depended on whole-body investigations of healthy and sick bodies and the "rational therapeutics" derived from their lessons. In other

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words, to manage their minds and bodies, women required the authority of a newly masculinized natural philosophy and the control of its elite medical practitioners. However, to these spheres even elite women had no access, for the university and the professions were closed to them, a subject that Cavendish treated at length.44 Jane Sharp, a midwife and author of the Midwives Book in 1671, protested this shift. In a phrase that ironically recalled the Royal Society's motto—"nullius in verba" or "not by words alone"—she wrote: "words are but the shell. . . . It is commendable for men to empty their spare time in some things of deeper speculation than is required of the female sex, but the art of midwifery chiefly concerns us."45 Sharp was responding to another development in seventeenth-century medical treatment of women. If learned medicine as a system of thought was elevating the role of the brain and nerves in women's conduct while devaluing the importance of the womb, male-authored empiric medicine, or medicine as practice, simultaneously asserted claims for control of that womb during the birthing process. Folding obstetrical forceps, the "instruments of Vulcan" alluded to by Willis, began being deployed by the Chamberlen dynasty of male midwives in the middle decades of the seventeenth century. Existing on the margins of both elite medicine and midwifery, the Chamberlens and their followers nonetheless represented increasing competition to midwives who served genteel women. It was not that midwives did not try to organize on their own. In England, two petitions for incorporation of midwives as a self-regulating body were presented to the Court in the first half of the century. The first, organized by Chamberlen pere in 1616, failed through a combination of opposition from the College of Physicians and several midwives. Organizing on their own in 1634, the midwives' petition for self-regulation was successfully opposed by the College of Physicians.46 With the revival of episcopal licensing of crafts and professions in the Restoration, midwifery came under control of the church.47 Subsequently, the plan of midwife Elizabeth Cellier in the 1680s to establish a self-regulating college for midwives also failed to gain Crown support.48 It was only in the eighteenth century that formal instruction in anatomy and obstetrics for midwives emerged in English lying-in hospitals, and then the initiators were male physicians who sought trained female assistants.

Blood versus Brain When he took up the question of hysteria in earnest in 1667, Willis had already published his major text—Anatomy—on the normal (nonsexed) brain and nervous system. In that text Willis and his collaborators did not differentiate between women's brains, nerves, and bodies and those of men. Instead, a nonsexed human body was presented as a complicated contrivance whose cerebral cortex, cerebellum, and cranial nerves presided over interplay between its end organs, chemical


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processes, and the ebb and flow of its many fluids. The physiological ground had been laid, in other words, for women to be viewed no longer primarily as expressions of their wombs. For a moment, perhaps, in the mid to late seventeenth century in England one could say that the new cerebral body was relatively nonsexed.49 Contemporaries thought differential capacity existed, but its magnitude was insufficient to constitute a difference in kind. Mary Astell, a seventeenth-century advocate for women's education, agreed. Writing "An Essay in Defence of the Female Sex" in 1696, she noted: "If there be any defect in women it cannot be in the Body, (if I may credit the report of learned Physicians) for there is no difference in the Organ of those Parts, which have any relation to, or influence, over the Minds."50 In this regard, it was not so much that Willis did away with the potential for visceral organs, including the womb, to cause illness; instead, he proposed anatomic and clinical findings to suggest that women's passions, like men's, were products of their brains and cranial nerves. It was an important paradigm that shaped learned English medical thought well into the eighteenth century. Working in an Enlightenment era dominated by a Newtonian worldview, physicians such as George Cheyne and Nicholas Robinson— fashionable "nerve doctors" of early Georgian England—adopted enthusiastically the cerebral body first proposed by Willis and colleagues. According to Cheyne, hysteria, a symptom cluster in which he included everything from "yawning and stretching up to a mortal Fit of an Apoplexy," was a nervous disease due to a "relaxation and the Want of a sufficient Force and Elasticity in the Solids in general and the Nerves in particular."51 At the time Willis was proposing his model, however, not everyone accepted the concept of nervous disease, especially as an explanation for hysterical symptoms. Perhaps the strongest contemporary learned challenge to the neurocentric woman—and an indication of its controversial debut—was provided by Nathaniel Highmore (1613-1684), an Oxford-trained physician who knew Willis from student days. As I noted in previous chapters, Willis received considerable criticism in England for his studies on the blood. Also, as I discuss subsequently, other anatomists, such as Niels Stensen, criticized him as well. Highmore's attack differed from others on two counts: First, he came from the same professional circle as Willis; second, unlike most of Willis's critics, Highmore not only attacked Willis's ideas but also put forward his own model of a woman's body. The son of an Anglican minister, Highmore trained in medicine at Oxford in the 1630s and remained there until about 1650, after which he developed a successful practice in Dorsetshire.52 Befriending Harvey in Oxford in 1646, Highmore collaborated with him on anatomic projects until Harvey left Oxford in 1650. As a result of their collaboration, Highmore published two books in 1651. The first, which he prepared in the mid 1640s, was an illustrated folio that sought to unite anatomy and physiology within a Harveian paradigm.53 Emphasizing the violent motion of the blood in cardiac systole (contraction), Highmore also took pains to

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establish the paniculate nature of the blood, a belief Harvey never held. The illustrations in Highmore's book were based on Vesalius. Highmore's other early book, his History of Generation, pushed the concept of the particulate nature of the blood even farther. Highmore also used a microscope to discover that in contrast to Harvey's view, the heart of a chick embryo did appear as early as its blood. I provide some details of these early works not so much to begin a biographical sketch of Highmore as to point out that he was well versed in the latest physiological knowledge and technique. Indeed, in his anatomy book he made reference to a human postmortem in a manner that suggests he performed it with either Willis or Ralph Bathurst.54 Also, although Highmore was loyal to Harvey and may be considered as one of his disciples, his early work indicates that the student was capable of establishing independent opinions. Highmore published twice on hysteria and hypochondriasis, first in 1660 and then in response to Willis in 1670. The former may have stimulated Willis to consider hysteria to the extent he did in Pathology, for he made several references to Highmore and his arguments. Highmore's fullest account of hysteria is in his 1670 Latin text, De Passione Hysterica et Affectione Hypochondriaca, which ran approximately 10,000 words. Willis responded promptly with a published rebuttal in 1670, and it is that debate which I consider here.55 Ironically, Highmore, who wrote his text in the format of a published letter to Willis, used the latter's chemical explanations, such as fermentation, to enhance the role of the blood at the expense of the nerves. In a manner that recalled his earlier modifications of Harveian circulation theory, Highmore accepted Willis's early theories but shifted their meanings subtly. For example, Willis in the 1650s talked about fermentation as a gentle heat whose particles caused the blood to "ascent" to the heart, where the circulation made it go around the body. He reserved violent imagery, such as the "explosive copula" of muscle contraction, for actions involving the nerves. In contrast, Highmore used the rhetoric of fermenting blood but shifted its meanings so as to stand Willis's arguments on their head. For Highmore, fermenting blood behaved with violent and unceasing motion. As long as this circulation was "regular," it would not cause "any of the parts to swell beyond what is natural."56 However, when it was blocked or underwent a chemical change because of some introduction of "matter," the blood would go "into a frenzy." Hysteria was a consequence of that frenzy as it began "rushing more violently into the lungs."57 According to Highmore, fermenting blood "swells exceedingly"; it emits "flatulence"; it "boils up."58 It was this physical expansion of the blood that led it to fill the vessels of the lungs and then obstruct them, thereby causing a sense of suffocation. Instead of offering "experimental" proofs, Highmore supported his argument by analogy to "new beer." According to Highmore, the nerves, far from controlling affairs, were secondary. In many ways they just did not have the same large capacity as the circulating blood, a finding Willis had worked the other way in his Anatomy to support


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his argument for their role as controllers of baser functions. To Highmore, the blood was a "general treasury, quite full, from which all the costs and expenses could be defrayed for the needs and requirements of the whole body."59 In comparison, the nerves were narrow; furthermore, in talking about them Willis had failed to show that the transmission process on which his theory of brain preeminence depended—cerebral and nerve secretion of the nervous juice—actually occurred. As Highmore pointed out, in Willis's schema, the nervous fluid "is always invisible."60 If this juice were so important, Highmore asked, why could one not see it? Additionally, it seemed "improbable" that such a nebulous fluid would have the function of nourishment of such important organs when "lesser" organs were supplied with an "ocean" of "magnificent and rich" blood.61 In support of his argument, Highmore argued empirically that when actual nerves were severed, so much fluid poured out that "it is impossible for a continuous amount to be supplied by the brain."62 Even though it was almost colorless, Highmore believed that fluid derived from arterial blood. What Highmore omitted from his 1660 and 1670 accounts of women's physiology and pathology were two areas that loomed large in Willis and Descartes's work: the physiology of the soul(s) and the neurology of affective states. Highmore's one mention of the soul was in reference to the "control" of the "spirited elements" by the vital soul, by which he meant the heart and blood.63 "Depression" was the only affective state he mentioned directly, and he included it with sighing, a sense of suffocation, and chest spasm as a symptom of hysteria. Instead, he emphasized the motions, membranes, and ligamentous connections of the chest and abdominal contents during a hysterical attack. Convulsions were not a necessary component of hysteria or even a consequence of nerve stimulation of the muscle according to Highmore; instead, they resulted from the mass effect of expanded and "violently" moving blood on visceral organs. One may say without exaggeration that Highmore's hysteric patients—and by extension the healthy "Highmore woman"—were almost completely body. However, they possessed a body different from that of the traditional womb-dominated constructions of humoral physiology. For one thing, Highmore ascribed the causes of hysteria to the blood alone; at least his references to the womb were minimal. Instead, he provided patient anecdotes that indicated hysteria arose from inordinate fermentation secondary to hemorrhoids, external abscesses, and stomach pains, not missed menses or lack of regular sexual activity.64 Presumably, a uterus that was not properly functioning and therefore "blocked" would cause a fermentative storm to ensue in the blood, thereby driving it to the lungs, but Highmore did not make the point explicitly. The visceral organ that did interest Highmore was the spleen. Protesting that "the spleen always gets a bad reputation,"65 Highmore attempted to counter the other Oxford physiologists' characterization of that organ as a processing center for blood excrement that had the potential of harming the nerves and brain. In

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comparison, Highmore argued that the spleen was responsible for "active ferment." It provided a "conjoined, moderated, and proportional heat" that permitted digestion to be "happily carried on."66 Significantly, in talking up the spleen, Highmore made no reference to van Helmont and other alchemical healers who championed its role. Indeed, rather than anoint van Helmont's "duumverate" of stomach and spleen as the body's noble organs, Highmore attributed visceral bad behavior to the stomach. One is left with the impression that for Highmore, the circulating and fermenting particulate blood was sufficient. He made one reference—the only attribution to any person besides Willis—to Galen, but it was to Galen's theory of inflammation, not his physiology of passions or convulsions. It was as though Highmore was creating his version of the elderly Harvey's belief that the soul was in the blood by using that notion metaphorically and literally to construct a body based on blood chemistry and fluid mechanics and little else. Yet his result did not resemble the body of Descartes or Hobbes, and Highmore made no reference to machines. Of antique precursors, perhaps Highmore's theory most echoed Democritus, whose atomism endowed spherical particles with a fiery soul as well as a mind.67 Despite Highmore's stated determination to "bring down and destroy" Willis's theory,68 his references to Willis, and those of Willis to him, were couched in polite terms: Willis was "the celebrated London Physician"; Highmore was the "most learned Highmore." Neither resorted to the scurrilous references that Willis, Lower, and their allies used when attacking their non-Oxford critics. Reviewing the controversy, the Royal Society's Philosophical Transactions declined to take a position, instead encouraging the reader to "find the best satisfaction in perusing the Writings themselves of both parties."69 The mutual politeness of the exchange as well as the Royal Society's demurral prompts me to offer two interpretations of the controversy. First, Willis and Highmore were both established members of the medical elite, albeit in different venues. Nonetheless, their differing characterizations of hysteria pointed to different treatments. Highmore expressed concern that the doctrine of the nerves undercut his treatment rationale of phlebotomy for hysteria. For him, phlebotomy was a "forced aggression" that often succeeded. Why then, he asked rhetorically, did Willis denigrate him and other physicians who relied on phlebotomy when they "really wanted to help?"70 In short, at one level the dispute may have been little more than an effort by both parties to differentiate themselves in a competitive medical marketplace.71 Second, the controversy illustrates the reality that physiological explanations of what contemporaries considered a common cause of unreason were by no means settled in the seventeenth century. Willis's new cerebral model of hysteria deflected medical theory regarding women, but it did not achieve hegemony. Contemporary physicians were not only divided among themselves, but even those sympa-


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thetic to Willis's nascent neurology often held positions that were internally inconsistent. The casebook of Willis's surgical collaborator, Edmund King, for example, included entries on 277 women patients from 1676 to 1696. King described nineteen as hysterical, with sixteen of them carrying hysteria as their primary diagnosis. Six of the sixteen complained of fits, but only one of a sense of suffocation. Two had fevers and one a kidney stone. King thought only two were emotionally upset. Moreover, an autopsy on one of the distraught, Lady Clynton, who had experienced fevers and pains as well as a "violent hysteric fitt," displayed abnormalities only in the viscera, not the brain or cranial nerves. Others who did have "violent fitts" but no affective distress and a fairly obvious organic cause were not labeled hysteric.72 The Stratford-on-Avon diaries of John Ward, an Anglican divine and physician who was acquainted with the Oxford physiologists from their student days together, reinforce the impression that contemporaries often entertained multiple explanations of a clinical situation. Ward's entries, which span twenty-five years, included a grab bag of interpretations of hysteria including those of Highmore, Willis, Sennert, Bartholin, Culpeper, and others. Noting at one point that a physician who could "cure ye minde . . . deserves" to have his name "blown up" in fame, Ward nonetheless remained uncertain regarding the etiology of women's passionate distresses as well as hysteria.73 For example, although Ward believed that problems in the sixth cranial nerve "may be a cause of many headaches and distempers of ye brain," he also maintained: "There is nothing better for a married woman in case of suffocation of ye matrix than for her husband to annoit ye top of his yard (penis) with a little oil of cloves . . . and so ly with her for this will assuredly bring down ye matrix againe."74 Willis was an optimist concerning therapy for people troubled with hysteria. His treatment regimen, Highmore's protestations to the contrary, included all of the traditional learned standbys of purgings, clysters, vomits, and phlebotomies. The difference was one of emphasis: Willis cautioned that all these should be "gentle," and his bleedings were often at the neck instead of the loins. Willis's preference for "gentle" regimens did not go unnoticed by his contemporaries, a fact that suggests that today what may seem only nuances of therapy may have had more resonance with doctors and patients then. Ward, for example, contrasted Willis's "very gentle" purges with those of another physician.75 Willis also added "Cephalic and properly anti-convulsive medicines" to his hysteria treatments. These included steel medicines (for strength) as well as the root of the male peony.76 In keeping with the learned medical tradition regarding regulation of the body's non-naturals, he made additional suggestions to individuals regarding proper diet, rest, and exercise. He elided the issue of therapeutic venery, however. In this regard he may have been only a more accurate observer of his patients' lifestyles. In contrast to traditional attributions of high risk of hysteria for virgins and widows, extant case records and women's recipe books indicate that hysteria afflicted

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THE BRAIN TAKES SHAPE 77

mostly married women who were often pregnant. Worth noting, however, is historian Lawrence Stone's calculation that the percentage of unmarried English women rose from ten percent in the sixteenth century to nearly twenty-five percent in the period 1675-1799.78

Alternative Visions: The Case of Anne Conway One of Willis's longest extant case notes79 concerned Viscountess Anne Conway (nee Finch) (1631-1679), the noted vitalist natural philosopher80 and correspondent whose household became a meeting place for "establishment" notables as well as religious dissidents during the 1670s.81 Conway also spent virtually all her adult life in or near her bed. The sufferer of intense headaches from the age of twelve to her death, she was the recipient of medical attention from diverse healers and physicians, including her kinsman, William Harvey, as well as Willis, Robert Boyle, Valentine Greatrakes, F. M. van Helmont, and two presidents of the College of Physicians. Near the end of her life she became a religious "enthusiast," joining the Society of Friends (Quakers) in 1677. Placed in the context of her philosophical writings, her own experience of her illness, when contrasted with Willis's interpretations, offers potential insight into the intersection of gender, nature, and the new medical natural philosophy in the life of an intellectual woman who interacted frequently with diverse Restoration notables. For Willis, Conway's headaches represented an acquired structural abnormality in the meninges of her brain. Using military rhetoric to describe them, his language established the headache as an "other" that was separate from Conway the person. The headaches were "convulsive distempers" that "having pitched the[ir] tents near the confines of the Cerebral Hemispheres, had so long besieged its regal tower, yet had not yet taken it; ... for the sick lady . . . found the chief faculties of her soul sound enough."82 Valuing her as a "most noble Lady . . . of a most beautiful form, and great wit, so that she was skilled in the Liberal Arts, and in all sorts of Literature, beyond the condition of her sex," he found her so favored "as if it were thought too much by Nature, for her to enjoy so great endowments, without some detriments, she was extremely punished with this Disease."83 Tracing the origins of her headaches to a "meningeal fever" she experienced when she was twelve, Willis thought her meninges had "contracted an habitual and indelible vice." Assuming the problem to be a consequence of meningeal scarring in dura mater, "the Pia mater being in the meantime safe," Willis described the meningeal disruption as the "invincible and permanent . . . yet not deadly causes."84 This conception was consistent with Willis's description of another woman whom he had treated for recurrent severe headaches. Unlike Conway, however, the other woman died six months after the onset of symptoms. Opening her skull on postmortem, Willis found a tumor "three fingers broad" in her "third sinus," which "grew to the membranes" including the pia mater. Willis concluded

thetythtyuiiiiituututututuut

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"from these observations the invincible and at length mortal cause of that Disease may plainly appear."85 Most of Conway' s extant letters contain at least one reference to either her pain or her current therapeutic regimen. In common with wealthy patients who suffer from chronic problems in many eras, she saw a variety of healers. In a letter of May 9, 1662, to her sister, Lady Rawdon, in Dublin, she shared a recipe for a "cordiell water" with "excellency for men and children in all distempers," before referring to "my Doctoress" in a context that suggests she saw a woman healer when she visited her sister previously. In any case, Conway had "not found any benefit from her prescriptions, they having neither kept off any fitts nor eased my ordinary paines."86To her brother-in-law, Lord Rawdon, she requested in a letter of December 8, 1663, that he: "send the valiere [? Spelling] this enclosed, whom I have given order to send downe to me yr French women you mention, which I have promised to send againe to Dublin if I doe not like her upon try all. I perceive she is not very proper for me, but if she can only dresse my head, she may serve my [indistinct writing] wch I can provide my self better for I do not love to be wholly destitute."87 In both Conway's life and natural philosophy, illness was part of the mystery of God's plan. Writing to George Rawdon on September 25, 1674, she thanked him for: "A feeling concern for my suffereing it commonly hapnin at yr greatest affections by long continuance grows unresponsive and expectations of a change being long frustrated the patience is tired and the pity ceases in persons unconcerned, to those under ye pressure of great sufferings the weight is much augmented by continuance, as our strengths to bear does daily decrease. God Almighty who disposes all things for ye best, can & I hope will afford it support. . . . I desire to be humbled under His righteous hand & wholly resigned to His good pleasure."88 She seemed to derive some benefit from the presence of the alchemical healer Francis Mercury van Helmont, J.B. van Helmont's son. The younger van Helmont also shared her interest in mystical Christianity and for a brief time joined her at meetings of the Friends. In the same 1674 letter to her brother George, she acknowledged: "I must give you this account, my paines & weakness does certainly increase daily, but yet I doubt not, but I have had some relief (God bee thanked) from his medicines, I am sure more that I ever had from ye endeavours of any person whatsoever else, but yet I have had much more satisfaction I his company. He has yet ye patience to continue with my in my solitude, whch makes it ye easier to me, noe of my own relations having ye leasure to afford me yet comfort. .. ,"89 Conway's affirmation of the value of patience and humility was in accord with her monistic theory of matter. Although her mentor and nephew, the Cambridge Neoplatonist Henry More (1614-1687), maintained a distinction between matter and spirit, which he characterized as ubiquitous but immaterial, Conway joined the two: "every Body is a Spirit, and nothing else, neither differs any thing from spirit, but that it is more dark; therefore by how much the thicker and grosser it is

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become, so much the more remote is it from the degree of a spirit, so that this distinction is only modal and gradual, not essential or substantial."90 Additionally, Conway believed matter was not only interconvertible with spirit, it was also interconnected. Indeed, the "Reasons and Causes of Thing" depended on the fact that "all Creatures form the highest to the lowest are inseparably united one with another."91 If that was understood, one might "easily see into the most secret and hidden Causes of things, which ignorant Men call occult Qualities."92 For Conway, matter also tended to become good. Even when it went into "eternal Torments" for an "infiniteness of Ages . . . Reason teacheth us [that] it must at length return unto Good."93 "Punishment," by which Conway meant suffering, was "medicinal," as it tended to restore goodness.94 Regarding the explicit gender of matter, a theme that underlay the alchemical theories with which she was familiar, Conway believed that matter, or a "Body and Spirit," consisted of a "more Active and a more Passive Principle, which may fitley be termed Male and Female."95 In contrast to Bacon's gender relations, however, she did not characterize active and passive principles as dominant and submissive, but rather in terms of "Conjuncton" and "Cooperation."96 The Quaker leader George Fox (1624-1691), who visited Conway twice in March 1678, put the matter of "seed," by which he meant Christ's presence in the body, in female terms. Commenting in his Journal on the "hurtful" behavior of the Quaker foe Rice Jones to some Friends, he recounted that he told Jones, "If he did wait in the fear of God for the Seed of the woman, Christ Jesus ... coming into him," that he "might gather them [the Quakers] again." A few lines later he reiterated the female nature of the divine: "the Seed, Christ Jesus, the Seed of the woman."97 Although Willis promoted a cerebral body, Conway, like many others of diverse philosophical and political outlooks, believed that the essence of the body was in the blood.98 Her belief in the fundamental unity of spirit and matter did not lead her to devalue reason, but she, like her fellow Friends, believed that access to the highest consciousness was through attention to an "inner light." Reason and goodness were inseparable. Indeed, to carry her thought on the ubiquity of life and potential goodness in all matter to its logical end point, Conway's vitalism made universal what the Friends discussed primarily in reference to humans. Perhaps the most striking difference between Conway's characterization of the material soul and Willis's was her confidence that the soul's fundamental tendency was to goodness. The mature Willis, whose chemical ideas increasingly departed from the alchemical concepts that had been popular in the Oxford of his student days, had no such confidence in the ability of a person's innate nature to seek the good. Both within the individual human body and within the community, Conway and the Friends favored a conjunction of the sexes that minimized the opposition between figure (male/active/artificer) and ground (female/passive/nature) that had

thyyyyyyyyyyyyyyyyyyyyyyttytu

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been central in Bacon's thought, the Royal Society's self-promotion, and Willis's approach to anatomy. As Carolyn Merchant has noted, the Quakers, "far more than the other Protestant sects, gave both men and women full equality."99 Compared with Baconian "interrogations" of (female) nature and Willis's anatomical "conquering" of the "martial field of the body," Quaker rhetoric emphasized cooperation: "we shall be preserved near unto the ocean of all love. . . ."10° Conway' s burial directions give a sense of what she finally may have made of her long experience as an object of attention from male orthodox religious (Henry More) and elite male medical advisers (Harvey, Willis, and others). She stipulated "rites and ceremonies of the so called Church of England may be wholly forborne at my buryall."101 Conway's final directive was that she "would have no Cerecloth to avoid the coming of any men about hir, but desired that only Her Woman with the two maids should lay her in the Coffin, and to be kept here in the house till [Viscount Conway's] farther order."102 Conclusion Taken nominally—medical science is what it says it is—the theory that women were brain and nerve directed and not womb directed sought to overturn longstanding physiological ideas that characterized the nonreproducing adult woman as dangerous, unstable, and demented. The new "neurocentric" model of women was part of a larger natural philosophical program that sought to characterize female and male bodies as being under the leadership of the (unsexed) solid portions of the cerebral hemispheres. At a deeper level, however, the epistemological methods used in developing this new model were based on assumptions about gender that promoted dominance and submission as ideal relations between the (solid) brain and (fluid) body, reliable male knowledge and feminine intuitive and customary knowledge, and male enterprise and non-human and passive female nature. Additionally, the tendency to reify disease and mind as structural entities increased the imaginative space between what patients experienced (illness) and what physicians diagnosed and treated (disease).103 For English women in the late seventeenth century, I have suggested that the new engendering of the mind and natural philosophy led to a new form of alienation even as it seemed to free women from older constraints. In the new world of "reasonable" humanity, their persistent exclusion from advanced educational institutions meant that they could not aspire to the same level of reason as men. At the same time, the new standard of reason devalued the intuitive and customary knowledge base had had been a mainstay of female midwives and healers. Educated women, the primary female audience for these formulations, responded in a variety of ways. The Duchess of Newcastle supported the methods of the "new" philosophy even as she bemoaned some of their implications for

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women (and perhaps went "mad"). Women midwives protested, sought professional autonomy, and coped as well as they could when their bid for incorporation was successfully repressed. Some, like Conway, developed alternative philosophies that guided them into religious sects that attempted to practice a communal life based on cooperation between the sexes and intense spiritual practice unmediated by male hierarchies. Notes In 1992 I presented an earlier version of this chapter as a talk with the same name at a conference—Alienation and the Production of Strangers—organized by James Turner in the Department of English at the University of California-Berkeley. I published a version of that talk with the same name in Sexual Knowledge, Sexual Science, eds. Roy Porter and Mikulas Teich (Cambridge: Cambridge University Press, 1994), pp. 107-34. 1. Thomas Willis. Willis's Oxford Casebook, ed. Kenneth Dewhurst (Oxford: Sandford, 1981), pp. 92-94. 2. According to Willis's contemporary, Anthony Wood, "Never any physician before went beyond him, or got more none yearly than he." Anthony Wood. Athenae Oxonienses: An Exact History of All the Writers and Bishops Who Have Their Education in the University of Oxford. To Which Are Added the Facti or Annals of the Said University. 5 vols. ed. Philip Bliss (London, 1813-20), vol. 3, col. 1051. 3. Thomas Willis. An Essay of the Pathology of the Brain and Nervous Stock in which Convulsive Diseases Are Treated of. (London, 1667). Originally published in Latin as Pathologiae Cerebri et Nervosi Generis Specimen, in Dr. Willis's Practice of Physick. trans. Samuel Pordage (London, 1684), p. 70. 4. Ilza Veith. Hysteria: The History of a Disease. (Chicago: University of Chicago Press, 1965), pp. 128-9. 5. Evelyn Fox Keller. Reflections on Gender and Science. (New Haven: Yale University Press, 1985), p. 61. See also Monica H. Green, Women's Healthcare in the Medieval West. (Aldershot UK: Ashgate, 2000); idem, ed. and trans. The Trotula: a Medieval Compendium of Women's Medicine. (Philadelphia: University of Pennsylvania, 2001); Laurinda S. Dixon. Perilous Chastity: Women and Illness in F're-Enlightenment Art and Medicine. (Ithaca, NY: Cornell University Press, 1995); Sara Mendelson and Patricia Crawford. Women in Early Modern England. (Oxford: Clarendon, 1980); Roy Porter, ed. Rewriting the Self: Histories from the Renaissance to the Present. (London: Routledge, 1996). 6. Danielle Jacquart and Claude Thomasset. Sexuality and Medicine in the Middle Ages. trans. Matthew Adamson (Princeton: Princeton University Press, 1988), pp. 48-78. 7. Ibid., 72. 8. Ibid., 73, n. 76, 77. 9. Les Secrets des Dames, ed. E. Rauneyre (Paris, 1880), pp. 65-6. Cited in Jacquart and Thomasset. Sexuality and Medicine, 76, n. 89. 10. Jacquart and Thomasset. Sexuality and Medicine, 75, n. 85. 11. Anonymous. The Compleat Doctoress or, a Choice Treatise of All Disease Incident to Women. (London, 1656), p. 4. Huntington Library 478273. 12. Nicholas Fontanus. The Woman's Doctour, or an Exact and Distinct Explanation of


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All Such Diseases as Are Peculiar to that Sex with Choice and Experimental Remedies against the Same. (London, 1652), p. 51. 13. Nicholas Culpeper. Practice of Physick. (London, 1655), p. 419. Wellcome Library 44145/C. 14. Estimating female literacy in early modern England is notoriously imprecise. 15. The Compleat Doctoress, 1. 16. Ibid., 4. 17. Plato. Republic, in The Collected Dialogues of Plato, eds. Edith Hamilton and Huntington Cairns (Princeton: Bollingen Press, 1961). 18. Thomas Laqueur. Making Sex: Body and Gender from the Greeks to Freud. (Cambridge: Harvard University Press, 1990), pp. 63-96. See also Thomas Laqueur and Catherine Gallagher, eds. The Making of the Modern Body: Sexuality and Society in the Nineteenth Century. (Berkeley: University of California Press, 1987), pp. 5-14, especially Laqueur and Gallagher. "Orgasm, Generation, and the Politics of Reproductive Biology," and Londa Schiebinger. "Skeletons in the Closet: The First Illustrations of the Female Skeleton in Eighteenth-Century Anatomy." 19. For extended development of this point, see Laqueur. Making Sex. 20. William Harvey. Anatomical Exercitations Concerning the Generation of Living Creatures. (London, 1653). 21. John F. Benton. "Conclusion," in "Trotula, Women's Problems, and the Professional ization of Medicine in the Middle Ages." Bulletin of the History of Medicine 59 (1985): 30-53, especially p. 52. 22. Benjamin Farrington. "Temporis Partus Masculus: An Untranslated Writing of Francis Bacon." Centaurus 1 (1951): 193-205, especially p. 197. Also see Fox Keller. Reflections on Gender and Science, 48. 23. Willis. Dr. Willis's Practice of Physick, 53. For Bacon and nature, see Carolyn Merchant. The Death of Nature: Women, Ecology, and the Scientific Revolution. (New York: Harpers, 1980). 24. Thomas Willis. "Preface to the Reader," in Cerebri Anatome. (London, 1664). 25. Ibid. 26. Ibid. 27. Ibid. 28. Calvin used an image of God as midwife. See J. Jempsey Douglas. "Calvin's Use of Metaphorical Language for God: God as Enemy and God as Mother." Archiv fur Reformationsgeschichte 87 (1986): 131, 133. 29. Willis. "Epistle Dedicatory," in Cerebri Anatome. 30. Willis. "Preface," in Cerebri Anatome. 31. Thomas Sprat. History of the Royal Society of London. (1667). eds. Jackson Cope and Harold Jones (London: Routledge, 1959), p. 403. 32. Jonathan Sawday. The Body Emblazoned: Dissection and the Human Body in Renaissance Culture. (London: Routledge, 1995). 33. Abraham Cowley. Works, 7th ed. (London, 1681), p. 38. Also in Sprat. History of the Royal Society. Also see Sawday. '"Royal Science,'" in Body Emblazoned, 237. 34. Cowley. Works, 38. 35. Abraham Cowley. The Advancement of Experimental Philosophy. (London, 1661), sig. A5, quoted in Sawday. Body Emblazoned, 232. 36. Margaret Cavendish, Duchess of Newcastle. "Dedication," in Observations upon Experimental Philosophy to which Is Added the Description of a Blazing New World. (London, 1668).

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37. Ibid. 38. Norbert Elias. The History of Manners. (New York: Urizen, 1978), pp. 191-217. 39. Margaret Cavendish, Duchess of Newcastle. "To the Reader," in Observations. See also Londa Schiebinger. The Mind Has No Sex? (Cambridge: Harvard University Press, 1989), pp. 47-59. 40. Encyclopaedia Britannica. (New York: Scribner, 1884), vol. XVII, p. 381. 41. Margaret Cavendish, Duchess of Newcastle. Poems and Fancies. (London, 1653), p. 128. 42. J. Trevor Hughes. Thomas Willis 1621-1675. (London: Royal Society of Medicine, 1991), pp. 9-10. 43. Thomas Willis. "Preface to the Reader," in Rational Therapeutics, the First and Second Part (1675), in Dr. Willis's Practice of Physick. 44. Margaret Cavendish, Duchess of Newcastle. Philosophical Letters; or Modest Reflections upon Some Opinions in Natural Philosophy. (London, 1664). See also Margaret Cavendish, Duchess of Newcastle. The Description of a New World, called the Blazing World, (London, 1666). 45. Jane Sharp. The Midwives Book. (London, 1671). See Hilda Smith. "Gynecology and Ideology in Seventeenth-Century England," in Liberating Women's History: Theoretical and Critical Essays, ed. Berenice A. Carroll (Westport, Conn.: Greenwood, 1978), p. 112. 46. Thomas Forbes. "The Regulation of English Midwives in the Sixteenth and Seventeenth Centuries." Medical History 8 (1964): 235-44. 47. John R. Guy. "The Episcopal Licensing of Physicians, Surgeons and Midwives." Bulletin of the History of Medicine 56 (1982): 528-42. 48. Schiebinger. Mind Has No Sex, 108-9. 49. Thomas Willis. Willis' Oxford Lectures, trans, and ed. Kenneth Dewhurst (Oxford: Sandford Publications, 1980), p. 87. 50. Mary Astell. "An Essay in Defence of the Female Sex." (London, 1696), pp. 12-3. Cited in Schiebinger. "Skeletons in the Closet," 47. 51. George Cheyne. The English Malady. (London: Strahan and Leake, 1733). Quoted in Richard Hunter and Ida Macalpine. Three Hundred Years of Psychiatry, 1535-1860. (London: Oxford University Press, 1963), p. 184. 52. Dictionary of National Biography, eds. Leslie Stephen and Sidney Lee. (London: Smith, Elder, 1908), vol. 9, pp. 829-30. 53. Nathaniel Highmore. Corporis Humani Disquisitio Anatomica in qua Sanguinis Cirulationem Prosequutus est. (The Hague, 1651). 54. Ibid., pp. 178-9. Cited by Robert G. Frank, Jr. Harvey and the Oxford Physiologists. (Berkeley: University of California Press, 1980), p. 100. 55. Nathaniel Highmore. De Passione Hysterica etAjfectione Hypochondriaca. (London: Robert Clavel, 1670). I will be relying on an English translation by Richard Trapp and myself. 56. Ibid., 3. 57. Ibid., 1. 58. Ibid., 7. 59. Ibid., 19. 60. Ibid., 17. 61. Ibid., 18. 62. Ibid., 17. 63. Ibid., 20.


64. 65. 66. 67. 68. 69. 70. 11.

72.

73.

74. 75. 76. 77. 78.

79. 80. 81.

82. 83. 84. 85. 86. 87. 88. 89. 90. 91.

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Ibid., 4. Ibid., 35 Ibid., 27. For a summary of antique Greek conceptions of the soul, see Aristotle. On the Soul, in The Basic Works of Aristotle, book 1, chapter 2. trans. J. A. Smith and ed. Richard McKeon (New York: Random House, 1941), 405a-5b. Ibid., pp. 7, 16. Philosophical Transactions of the Royal Society 54 (13 December 1669), pp. 108991. Highmore. De Passione Hysterica, 5. Andrew Wear has argued that professional differentiation was virtually the whole point of learned disputes in seventeenth-century medicine. See Andrew Wear. "Medical Practice in Late Seventeenth and Early Eighteenth-Century England: Continuity and Union," in The Medical Revolution of the Seventeenth Century, eds. Roger French and Andrew Wear (Cambridge: Cambridge University Press, 1989). Edmund King. "Medical Casebook, 1676-96." British Library. Sloane ms. 1589, fo. 35. For a summary, see Katherine Williams. "Hysteria in Seventeenth-century Case Records and Unpublished Manuscripts." History of Psychiatry 1 (1990): 383-401, especially 391-9. John Ward. "Diaries (1647/8-1673)," p. 407 (1663). Typescript by Sir D'Arcy Power (1920) for Medical Society of London. Now in possession of Wellcome Library. Originals in Folger Library. Ibid., 875, 895. Ibid., 623. Willis. Pathology, 80. Williams. "Hysteria in Seventeenth-century," 400. Lawrence Stone. The Family, Sex and Marriage in England 1500-1800. (Oxford: Clarendon Press, 1977), p. 44. On the increasing loosening of control by propertied parents of their children's marriage plans in the early seventeenth century, see Lawrence Stone. The Crisis of the Aristocracy. (London: Oxford University Press, 1976), pp. 279-80. Thomas Willis. Two Discourses, in The Remaining Medical Works of. . . Dr. Thomas Willis. (London, 1681). Quoted in Gilbert Owen. "The Famous Case of Lady Anne Conway." Annals of Medical History 4 (1937): 567-71. Anne Conway. The Principles of the Most Ancient and Modern Philosophy. (1692). ed. Peter Loptson (The Hague: Martinus Nijhoff, 1982). Anne Conway. The Conway Letters: The Correspondence of Anne, Viscountess Conway, Henry More, and Their Friends 1642-1684. ed. Marjorie Hope Nicolson. rev. Sarah Hutton (Oxford: Clarendon Press, 1992), pp. 309-22, 378-84. Willis. Two Discourses. Cited in Owen. "The Famous Case," 570. Ibid., 569. Ibid., 570. Willis. London Practice of Physick. (London, 1685), p. 283. Anne Conway to Lady Rawdon. 9 May 1662. Huntington Library #14330. Anne Conway to George Rawdon. 8 December 1663. Huntington Library #14332. Anne Conway. Huntington Library no. 14333. Ibid. Conway. Principles, 164. Ibid., 193.

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92. 93. 94. 95. 96. 97. 98. 99. 100. 101. 102. 103.


Ibid., 164. Ibid., 193 Ibid., 188. Ibid. Ibid. George Fox. Journal, rev. ed., ed. John L. Nickalls (Cambridge: Cambridge University Press, 1952), pp. 336-9. Conway. Principles, 218. Merchant. Death of Nature, 256. Robert Barrow, letter of 16 November 1690, regarding the 4,000 persons at George Fox's funeral. Huntington Library # 27045. Conway. "Will," in Principles, 481. Ibid. Leon Eisenberg. "Disease and Illness: Distinctions between Professional and Popular Ideas of Sickness." Culture, Medicine and Psychiatry 1 (1977): 1-23.

8 MIND WITHOUT BRAIN: JOHN LOCKE, THOMAS SYDENHAM, AND THE CONSTITUTIONAL BODY OF THE BRITISH ENLIGHTENMEN

Metaphysics and Strangeness What is out there? What does it mean? And how far should one go in explaining the mysterious? People in diverse places and times have been asking these questions for as long as human culture has existed. But in cultures experiencing consensus concerning the grounds of knowledge, perhaps not with any urgency. The questions would occur, but the culture would handle them through its existing codes of signification. In early modern Europe, however, the facts were often not "just the facts," especially from the mid sixteenth century to the beginning of the eighteenth, heydays of the Scientific Revolution and Protestant and Catholic reformations. Then, prominent natural philosophers, theologians, politicians, and ordinary people debated, often acrimoniously, appropriate ways of interpreting the Book of Nature and the Book of God, to use their terms. Consider the following. Sometime in 1650 Anne Greene, a young servant woman who lived near Oxford, became pregnant by the son of her employer. She carried the pregnancy to term and delivered a live infant whom someone else found dead shortly thereafter. In 1651 an Oxford court found her guilty of infanticide and its judge sentenced her to death by hanging. Thomas Willis, surgeon William Day, and their friend William Petty, who then practiced anatomy and later organized a detailed census of Ireland, attended the execution with the intention of dissecting Greene's corpse 175

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afterward. When they removed her body they thumped Greene's chest and otherwise attempted to revive her, and she woke up soon after. Subsequently, the court granted Greene clemency, and the anonymous pamphleteer who published the account locally described her death-into-life experience as a "miraculous deliverance."1 Three years later, Seth Ward, then the Savilian Professor of Astronomy at Oxford and an Anglican bishop during the Restoration, described Greene's experience as an example of the "true naturall Magick," which he defined as "applying agent and Materialll causes to produce effects." According to Ward, Harvey's discovery of the circulation of the blood as well as all the natural philosophy it had inspired provided the basis of "naturall Magick," which was why Willis et al. deserved credit for Greene's recovery of consciousness.2 In the meantime, John Webster (1610-1682), who earned his living practicing medicine and surgery after serving in the Parliamentary army during the Civil War, attacked Ward. For Webster "true natural Magicians" practiced the "Mystical anatomy" they learned in his proposed university courses in the "science of physiognomy,"3 not in some Harveian "speculative understanding" they might gain in an Oxford anatomy club.4 At least on the surface, Webster's recommendations for curricular reform contained many of the same elements as those that John Wilkins and Seth Ward encouraged in the Oxford extracurricular clubs where physiologists of Willis's generation found their first intellectual homes. According to Webster, students must "learn to inure their hands to labour," which was why the colleges were to have "Laboratories as well as Libraries,"5 a recommendation no different in form than Ward's call for increased "observation and experiment."6 In Chapter 2,1 suggested that the difference between the alchemical mystics and practitioners of the "new" natural philosophy did not so much concern the existence of occult forces as it was over who was qualified to speak about them and how the discourse should be managed—in short, over discernment and control. In refuting Webster on his discussion of natural magic, for example, Ward did not assert that natural magic did not exist, but rather that Webster's approach was a false path toward learning the "true naturall Magick."7 Ward and Webster's debate over natural magic and its proper cultivation occurred in the early 1650s, when English people were in the midst of experiencing cultural and social disruption occasioned by the Parliamentary victory in the Civil War. Politically, religiously, and philosophically, adherents of enthusiasm were in the ascendant, though their triumph was to be short lived. In the meantime, leaders of the Church of England went semi-underground and experimental natural philosophy developed privately in clubs, as I discussed in previous chapters. If the Restoration did nothing else intellectually, it did restore a middle ground of sorts. The tensions about the role of spirit and other unseen forces did not disappear, they just relaxed slightly, as I think the following anecdote suggests. In Bakewell Parish in Devonshire during the Restoration, a young woman seemed

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to be able to live without food for months according to an unsigned and undated manuscript letter to an Anglican bishop in Gilbert Sheldon's papers in the Bodleian Library. To find out the "truth" of the "strainge thing," the narrator, who may have been John Beardman, recorded that: there hath been greater resource to her by persons of all persuasions but especially of non conformists, which they say by so much magnifying her and their own manner of applications to her, have something altered her . . . that I discovered to keep her in especially . . . the present vicar there having infused all manner of ministration to her otherwise than according to the office of visitations in the Book of Common Prayer. But for ought I can understand, she is pretty modest in matters of religion and not so much influenced by those of that gang as one would think such an unwary Soul might bee considering the multitude of them that swarm to her. Hearing that there were some printed narratives, I [?] write this to satisfy such as I should occasionally converse with, the very truth (as I conceived) of the matter. It is a matter of which my slender Philosophy, considering that her pain causeth such perspiration will [?] not enable me to give a naturall account, but I beseech your opinion of it, and withal whether yr Books can present it by any narratives worthy of [?] . .. About November last my Ld. Devonshire visited her himself with his Chaplain and diverse others and received a narrative from her of her condition. And after sent one of your Profession, 2 Apothecaries and [?] 2 Midwives tho Doctors only felt her; but the Midwives had ocular inspection and nothing was found diagnosable to her informations. Also he sett a watch upon her for a weeke, night and day, the persons employed aver that she took no food, but water.8

The narrator's "Philosophy," however "slender" and unable to provide a "naturall account" it might have been, would have contained an important place for metaphysics. Within academic philosophy networks nowadays metaphysics may be little more than an intellectual cul-de-sac. Before the long eighteenth century, however, metaphysics, from the Greek ta meta ta Physika, still meant mostly its literal definition, the work after Aristotle's Physics. Gottfried Wilhelm Leibniz (1646-1716), the German philosopher and mathematician who became notorious in England for disputing Newton's claim to priority in inventing the calculus, considered metaphysics to be the "prince of the sciences" and the "First Philosophy" and believed it was the primary method for developing an adequate account of substance.9 In developing her natural philosophy, Anne Conway corresponded regularly with Leibniz as well as her kinsman Henry More regarding the metaphysics of matter. For them and for others, finding reliable methods for understanding the seemingly inexplicable remained problematic. Nonetheless, thinkers of many persuasions shared the assumption, as do most Westerners in the twenty-first century, that truth is unitary. According to Leibniz, assessment of truth claims involved determining the truths of reason, which he and his contemporaries assumed must be true in all possible worlds, and truths of fact. As I have argued earlier, the nature and role of spirit played important roles in formulations of truth on both sides of this binary characterization of reality. But so, too, did other preoccupations. Importantly, these

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preoccupations often transcended debates about the appropriate architectonics of the human body or the relative importance of fluids and solids discussed in previous chapters. Determination of correct medical knowledge proved especially difficult on several counts. Unlike mathematics, which Descartes and others celebrated for the ease with which it accepted an ontology of abstract, and hence universal, entities, medical accounts of substance by definition referred to the nature and care of something at the same time concrete, dynamic, and ineluctably variant—the human body. In this chapter I explore how medical notions of reason and fact changed in the later seventeenth century as Cartesian and Oxford medical philosophy gradually gave way to new methods of apprehending human likeness.

Empiricism Becomes Respectable Much as Willis and Descartes might want learned medicine to approach the certainty of mathematics, achievement of "rational therapeutics," to cite the partial title of Willis's final texts, remained elusive. Instead, healers of all stripes employed a hodge-podge of treatments, most of them dressed in the scantiest of logical garb in relation to theories of underlying illness. "Empiricism" in one form or another had been central in learned medicine since Hippocratic times, which is merely another way of saying that medical knowledge was (and is) invariably evaluated in terms of praxis. If a treatment "works," patients and physicians tend to use it regardless of the plausibility of its explanatory construct. In terms of professional status, however, few early modern healers wished to be labeled as an "empiric" or "empirick." Usually, physicians used the term scornfully in reference to healers with little formal education, and unlicensed healers seldom referred to themselves as "empirics." Indeed, the learned often used the terms "empiric" and "Mountebank," or one who beguiles by trickery, as synonyms. Nonetheless, as we have seen earlier, Vesalius, Fuchs, Bacon, Harvey, Willis, and many others, including the Royal Society, championed the value of experiments and "ocular demonstrations" for their ability to provide direct, or empirical, experience of nature. Unlike Leibniz, they sought to avoid obvious recourse to metaphysical "first principles" in building their accounts of natural phenomena. Even Descartes went to extensive lengths to present his natural philosophy of the human body, which relied largely on abstract concepts and entities, in empirical terms, as I discussed in Chapter 3. Although few early modern natural philosophers acknowledged the rift explicitly, empiricism, though still a pejorative word professionally, at least in medicine, gradually was pushing metaphysics to the margins as "philosophical speculation," to use a then common phrase, became increasingly suspect. Intellectual tensions in learned medicine between metaphysics and empiricism and between different versions of empiricism increased dramatically in the late sev-

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enteenth century. Perhaps the thorniest problem early modern medicine faced was the epistemic status of medical knowledge itself. Even if one granted empiricism considerable intellectual license, learned medicine's claim to intellectual legitimacy derived from its links to traditional natural philosophy. Those links were what put medicine into the universities in the first place, and from Aristotle on through his Christian interpreters in the medieval universities, natural philosophy had constituted itself in terms of causes and their explanations. However, in the late seventeenth century, especially in England, a rising group of intellectuals began challenging the very notion of cause in both medicine and the larger culture as they advanced their concepts of empiricism in opposition to the anatomical versions of empiricism dear to the Oxford physiologists and others. In doing so, they set the stage for important aspects of our modern notions of mind and body.

Continental Challenge Even some of those who tended to accept the anatomic method criticized Willis's models. The peripatetic Danish anatomist Niels Stensen, or Steno, provided one of the more rigorous critiques that Willis and Descartes received. In 1669 at the Parisian salon of Monsieur Thevenot, Steno spoke on the subject of brain anatomy in general and specifically on the work of Willis and Descartes, and his comments were reprinted in several editions running into the 1730s.10 Sounding much like the Oxford physiologists, Steno began his lecture by asserting that human and comparative anatomy would lead to better physiology, which would lead to better medical practice. He expressed confidence about the "sure knowledge of anatomical parts" that dissection and illustrated anatomies had the potential to provide. What was required, he argued, was a "convincing certainty of dissections."11 Probably, Steno assumed that these dissections would be performed on the bodies of executed criminals or deceased indigent patients from civic clinics and hospitals. According to Steno, the problem with anatomical knowledge was that the "evidence of demonstration" that "would oblige everyone else to agree to it" was often wanting. Brain dissections in particular were "subject to so many errors."12 The brain was literally so "soft" that it could be "molded" to fit the "systems" put forward by anatomists. Moreover, the brain "subsides after preparation before the diagram is drawn." Steno thought Willis and his colleagues had provided the "best diagrams to date," but even with them Steno found that "errors creep in here and there."13 Importantly, these errors reached a magnitude that made the truth of Willis's "hypotheses" not provable.14 Nonetheless, Steno held out hope that anatomy could deliver certain knowledge. Resorting to mechanical analogy, he argued that the human body was a "machine," whose operations could be known through knowledge of the forms and functions of its parts. But such knowledge would only come into formation

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when research was properly organized in a well-financed institutional framework. Even though Steno maintained that "almost all the new discoveries of the century" were "owe[d] to the dissection of animals," he despaired that anatomy could provide certain knowledge unless it was the product of a team of investigators who had the leisure to develop the proper methods without the distractions of patient care or of public demonstrations, a position that echoed Bacon's enthusiastic call of decades earlier for a Utopian Solomon's House of natural investigators.15 If that were somehow the case, then "all anatomists would demonstrate these things in the same fashion, if they used the same method." Consequently, their interpretive "systems," which currently were too speculative, would be capable of withstanding strong criticism.16 Unlike in England, the French monarchy financially supported natural philosophy from 1666 on, when Louis XIV and his minister, Jean-Baptiste Colbert, founded the Academie Royale des Sciences.17 Writing in 1669, the optimistic Steno was not aware of what was about to transpire in England.

Locke, Sydenham, and Their Revival of Hippocratic Empiricism In a sense, Willis, who died in 1675, and his great patron Sheldon, who died in 1677, departed at the right time. In their emphasis on the importance of explicit hierarchies, whether physiological or ecclesiastical, and tight control of spirit, both represented a cultural vision that had reached its fullest expression at the height of their respective careers. For them God had not been crossed out of the body. Indeed, in various ways they and their colleagues argued that God's presence in man's solid brain meant that religion remained an individual and social activity that needed to be controlled carefully. Like their intellectual predecessor Hooker, they saw no need for a complete separation between the natural world and the social world even as Willis's models helped establish human brains and nerves as separate things-in-themselves. Both Willis and Sheldon as well as their allies believed in a professional order and an order of knowledge that faced increasing challenges by liberal movements in religion and politics and by empiricism in natural philosophy and medicine. Whereas Harvey, Willis, and the Oxford physiologists had looked to reason, experiment, anatomical investigation, and clinical correlation for understanding healthy and sick bodies, Locke and Sydenham emphasized experience alone. According to Sydenham and possibly Locke, "old women's experience" formed a better basis of medical knowledge than "learned mens theories."18 Sydenham maintained that medicine had no need to pay attention to cause; indeed, he declared that nature was "an abyss of cause."19 In language that initially echoed Willis's preface to his Anatomy of the Brain, Sydenham described the human brain as an example of the "method of the Supreme Artificer in his wondrous and wise machinery." Anatomists, however, he declared incapable of achieving an under-


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standing of the brain, as "no diligent contemplation of its structure will tell us how so coarse a substance (a mere pulp, and that no over-nicely wrought), should subserve so noble an end."20 Sydenham believed that God made man so as to perceive only the superficial aspects of reality, the "outer husk of things."21 Ironically, "husk" was an early modern trope for the alchemists, who declared that alchemical fire would burn through the "husk" of superficial reality to reveal the "kernel" of truth.22 Reformist theologians, such as Calvin, made similar use of husk and kernel analogies. Because human perception was limited and superficial, Sydenham argued that the appropriate metaphor for reliable medical knowledge was no longer mathematics but botany: "It is necessary that all diseases be reduced to definite and certain species and that, with the same care which we see exhibited by botanists in their phytologies."23 Sydenham's embrace of worldly appearance in preference to investigation of deep structure and cause illustrates a general preference among society's upper reaches in the later Restoration for worldly pursuits in preference to natural philosophy and theology. The sons of the gentry who had flooded Oxbridge from the late 1630s through the mid 1650s were sending an increasing proportion of their sons and grandsons in the 1680s to London to study finance and law.24 Locke probably met Sydenham in London in 1667 after he left Oxford for the capital to serve as physician to Lord Ashley Cooper, who later was created the first Earl Shaftesbury and became a foundational figure in Whig political circles in the 1680s. During the period of Locke and Sydenham's intense association, from 1667 to 1672, the two visited often, with Locke accompanying Sydenham frequently on medical consultations. When Locke made extensive travels/exiles to the Continent and especially Holland, during the 1670s and early 1680s, he actively promoted Sydenham's theories, a public relations effort that helped gain Sydenham a favorable reputation abroad before he enjoyed one at home. For Locke, who had been interested in iatrochemistry and anatomy at Oxford and a lecture student of Willis's, association with Sydenham may have increased his caution regarding all medical theories. Writing in 1692-1693 to Dr. Thomas Molyneux, for example, Locke stated that he could say "nothing" regarding Sydenham's "late book of Fevers" because he had not yet read it. Nonetheless, he averred that, regarding his friend's "phenomena of Diseases and the cure of Them," Sydenham's emphasis on "observation] of History of Diseases" formed "a better Way" than "that Romance Way of Physick" that had been practiced by Galenists, Helmontians, or "Chymists."25 Sydenham and Locke as well as other self-styled learned empirics thought that medicine should be content to remain an art and not aspire to be a science. Sydenham used the word science in reference to medicine only once in his extant writings.26 Although Locke in his student days and up until his thirties participated in many anatomies and vivisections, he later despaired that investigation

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and experiment could obtain certain or "scientifical" knowledge of "natural bodies," a category that included all forms of unprocessed matter. Try as we might, he wrote, humans could not even know "so much as their very outward shapes, or the sensible and grosser parts of their constitutions."27 Locke did not use the term science in connection with medical knowledge.28 But then neither did the mature Robert Boyle. In common with many clerics and members of the gentry, Boyle had an amateur medical practice of sorts. As they did, he treated and consulted patients while also experimenting regularly with chemicals, drugs, and animals.29 He expended most of his effort toward improving therapy through chemical medicines. And in terms of therapy, Boyle believed that knowledge of cause did not count for much. What mattered was effect: "Why should we hastily conclude against the efficacy of specifics, taken into the body, upon the bare account of their not operating by any obvious quality, if they be recommended unto us upon their own experience by sober and faithful persons?"30 Boyle devoted considerable effort to improving the therapeutic potency of "Butler's stone," a metallic compound promoted originally by van Helmont for its "specificall virtues" in curing a variety of ailments.31 Yet Boyle did not pretend that "Butler's stone" or his own "Boyle's red powder" represented science, or reliably certain knowledge. As did others who embraced learned empiricism, the middle-aged Boyle argued that research that was not immediately directed toward therapy was less important. Abandoning his youthful rapture for the power of "anatomical knives" to discover truth, as I discussed in Chapter 5, the later Boyle thought anatomy would require a "process of time" before its "historia facti" would be "fully and indisputably made out" so that the resulting "theories" would have sufficient form to "highly conduce to the improvement of the therapeutical part of physick. . . ,"32 Although the Oxford physiologists and Sprat, among others, were more confident of anatomy's epistemic authority, a number of prominent laymen shared Boyle's sentiments. Edward, second Viscount Conway (and Anne Conway's father-in-law), considered Harvey's De Motu a "masterpiece." However, this did not mean that he found Harvey to be the best physician. The problem according to Conway was that anatomic work might be too hypothetical. He expressed concern that Harvey might be "too much, many times governed by this Phantasy" (of anatomy), which could be risky because anatomical knowledge might not help the physician guide the "ship" containing an ill patient safely through the "storm" of disease.33 Locke and Sydenham expressed their doubts about anatomy in the context of their general belief that sensory impressions, the basis of all knowledge according to Locke, were often faulty.34 Even if witnesses validated a recitation of observations, Locke thought their collective perceptions probably did not penetrate to the cause. Regarding knowledge of "particular external objects," Locke argued that humans might have "three degrees of knowledge, viz. intuitive, demonstra-


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tive, and sensitive; in each of which there are different degrees and ways of evidence and certainty."35 Anatomic knowledge proved problematic on two counts, he maintained. Even when human sensory apprehension was amplified by a device such as a microscope—an instrument Willis and his colleagues praised as helpful in their search for cause—Locke thought knowledge of structure too uncertain to lead to knowledge of operation: For after all the fine discourses of the ... changes he [the anatomist] supposes to be the cause of this or that disorder in the body, it is certainly something more subtle and fine than what our senses can take cognizance of that is the cause of the disease, and they are the invisible and insensible parts that govern preserve and disorder the oeconomie of the body.... Hence a fright which causes such diseases as epilepsy, hysterical fits, and fatuity often cures others... and 'its probable n these cases 'twould puzzle the quickest sighted anatomist, assisted boo by the best microscope to find any sensible alteration made either in the juices or solid parts of the body."36

Furthermore, because the value of such knowledge was low, it could not aid practice, which was why physicians should not devote great effort to anatomic study: "The laborious anatomist I will not deny knows more, but not more to the purpose, for if he cannot come to discover these little differences which preserve health or make a disease, if he cannot possibly see how nature prepares those juices . . . he may perhaps be the better anatomist by multiplying dissections, but not a better physician, of poreing and gazeing on the parts which we dissect without perceiving the very precise way of their working is but still a superficial knowledge. . . ,"37 Thus left treading the epistemological low road, the only knowledge physicians could have of the "Constitution of Health and the Operations of our own Bodies" was by "sensible Effects." According to Locke, there was "nothing left for a Physician to do, but to observe well, and so by Analogy argue the like Cases, and thence make to himself rules of Practice."38 Such rules would not have the status of "Philosophical Truths to a Naturalist," but they might serve as heuristic devices—"artificial Helps"—for practicing physicians. By emphasizing the uncertainty of any particular observation, Locke and Sydenham used the physiology and pathology of mind provided by Willis and his colleagues to stand the latters' claims to a high-truth content on their heads. Had not Willis's group explicated just how fragile and problematic the sensory operations of the brain and nerves were? By so firmly fixing "the secret places" of the human mind to its brain—by making understanding limited to fallible organic operations—Willis rendered his epistemologic stance vulnerable to the very attack on the limits of medical science that Locke and Sydenham launched. Concerning general knowledge of nature, Sydenham maintained that not only was cause not knowable almost by definition, but also that such knowledge was not useful in the practice of medicine. In a passage from the 1666 edition of his Methodus that may have referred to Willis directly, Sydenham explicitly denigrated

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the natural philosophy approach to medical knowledge: "For my own part, I am not ambitious of the name of a philosopher, and those who think themselves so, may, perhaps, consider me blamable on the score of my not having attempted to pierce into these mysteries. Now writers like these I would just recommend, before they blame others, to try their hand upon some common phenomena of Nature that meet us at every turn. . .. Aetiology is a difficult, and perhaps, an inexplicable affair; and I choose to keep my hands clear of it."39 Locke and Sydenham's no-nothing posture concerning cause or etiology in medical natural philosophy left them and their fellow empiricists in a curious position regarding the architectonics of the body. By declaring anatomy and experimental study as being of little value, learned empiricists as well as their unlearned empirical competitors set themselves up as vulnerable in two significant ways. First, by giving up any significant claim to knowledge of the body's interior or its operations, they became dependent on the anatomic and physiological arguments of others. In discussing the etiology of hysteria, for example, Sydenham drew on many different physiological traditions.40 Nerves, fibers, spirits, and muscles all played a role in his account, and his explanation of the behavioral phenomena sounded by turns Galenic, Helmontian, and like Willis. Culpeper in the Interregnum faced an analogous situation, which he resolved by providing popular translations of Galen and others. But then he and other popularizers made no pretensions to original medical knowledge. Instead, they sought to refashion and edit traditional learned physiology and therapy so that ordinary people could diagnose and treat themselves. No Body but a "Constitution" Sydenham, however, did not present himself as a mere popularizer of the ideas of others. Instead, he promoted himself and was appreciated by contemporaries as an innovative thinker. For him, the overarching biological and medical concepts became the "species" and the "constitution." He maintained that a physician's diagnostic task involved recognizing patterns of interaction between kinds of fever and "constitutional" factors in particular environments and individuals. Although Sydenham did not use the term "species" until his later work, the Observationes Medicae of 1676, as early as 1666 he described fevers in species-like terms. The differentiating factors of a particular fever might be unknown and among nature's secrets, but they possessed stable dimensions in terms of timing and stages.41 Although Sydenham used "constitution" in a few places in a limited way to refer to an individual's conformation, age, sex, and general health, the more common use of the term referred to those conditions that made fevers appear in large numbers at certain times from year to year.42 Although his use of the term "constitution," and particularly the phrase "epidemic constitution," recalled the Hippocratic books on epidemic fevers—one of


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the few connections to ancient authority Sydenham acknowledged—his characterization of disease in terms of a broad cluster of conditions, among which fever figured prominently, represented a synthesis of Paracelsian and Helmontian notions of disease as an invading it. Sydenham, however, did not acknowledge any alchemical sources. Nonetheless, he characterized hysteria, among other conditions, as an alien force that molested parts of the body so as to induce a pathological conversion. Concerning hysteria, he wrote: "Few of the maladies of miserable mortality are not imitated by it. Whatever part of the body it attackes, it will create the proper symptom of that part."43 His tone was secular—the machinery of the Archei had been discarded—but he maintained an alchemical image of invasion and an ontology of hysteria as a thing-in-itself. It frequently attacked the head, he wrote, at which time it caused an "apoplexy," and it was almost invariably associated with a sinking of the spirits, which was why afflicted women pointed to their chests. It could also "take possession of the external" parts, such as the muscles of the jaws, shoulders, hands, where it "sometimes causes pain, sometimes swelling."44 Sydenham often portrayed febrile diseases as being the consequence of the interaction of an alien something with the blood. In these dramas, the blood behaved very much like a molested Archeus in the Helmontian and Paracelsian conceptions I discussed in Chapter 2. Writing in 1666 in the Methodus, Sydenham described the situation of an initial encounter between fever and blood as follows: "the febrile matter which . . . has been imperfectly assimilated dilated with the volume of the blood, has become, not only useless, but inimical to Nature whom it frets and vexes. She, on her part, stirred up by what we may call a natural sense, and planning, as it were, an escape, creates a shivering and a shaking throughout the body, as the evidence and the measure of her aversion."45 Such a simplistic physiology did not mean that Sydenham or his followers in the eighteenth century necessarily promoted mild treatments. Indeed, although he used a different therapeutic program than the Helmontians for fevers, he was no less aggressive in his approach. However, whereas they eschewed bloodletting and promoted vigorous bowel evacuations, Sydenham relied on phlebotomy. Given that his goal of fever treatment was to return an individual's blood from "ebullition" to its normal state, he advocated vigorous bleeding.46 Describing the appropriate treatment for pleurisy, for example, Sydenham recounted that he "seldom abstained" from drawing blood until the amount equaled "forty-two ounces or thereabouts."47 Given that the normal human blood volume is approximately twelve pints (192 ounces), Sydenham's phlebotomies must have had a significant physiological effect, a reality he acknowledged with his cautionary to physicians to ascertain in advance of treatment "the patient's strength." My point in recounting this anecdote on therapeutics is not to indict Sydenham, but to suggest that his assertive uncoupling of therapy from the "new" experimental philosophy of Harvey, Willis, and their cohort had significant implications for

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therapy. Often what mattered finally was not the body as such, but only the blood as it was affected by fever. By renouncing an intellectual commitment to apprehension of the body's inner structure and function, Sydenham and his followers passed up a significant check on their therapeutic aggressiveness. Hoping to have it both ways—the body as a "black box" and disease as an "it"—they also tended to bypass the ancient Hippocratic cautionary to healers to "First do no harm." In doing so, they became the first of the numerous Enlightenment "Hippocratics," including Benjamin Rush in the United States, to recommend the highly aggressive, or "heroic therapies," which nineteenth-century physicians such as Oliver Wendell Holmes and the French "therapeutic nihilists" later sought so diligently to debunk.48

Hippocrates, Galen, and the Politics of Medical Knowledge While Sydenham was busy fashioning himself as "the English Hippocrates," to quote the honorific accorded him often in the eighteenth century, the Oxford physiologists from Harvey through Willis and Lower tended to prefer Galen among the ancients. Harvey's De Motu, for example, contained only one reference to Hippocrates, which occurred in Chapter 17, when Harvey noted him as the author of a brief 800-word text, De Corde, which Harvey cited as Hippocratic support of his view of the heart as a muscle.49 In comparison, he made many references to Aristotle and Galen among the ancients as well as to his experimentalist contemporaries. Willis in his Anatomy of 1664 made no references to Hippocrates, although he spoke of him favorably in some of his other texts. Why did the Oxford physiologists pay comparatively little attention to Hippocrates? Early in his career, Willis provided a straightforward reason why investigative physicians of his era tended to refer not to the ancients but instead to their contemporaries: It was because Harvey's circulation theory had completely upset conventional wisdom on disease causation and treatment. As Willis expressed the issue in his fever treatise originally published in the mid 1650s: "because the Antients relying on a false Position concerning the Motion of the blood . . . often fell foully and dangerously; wherefore it is not wonder . . . for the thorough Instauration of Physick, and for the re-Edifying the Building . . . on that which or most Famous Harvey hath laid, the Circulation of the Blood . . . and it is granted us to know the Causes of things before hidden."50 Not only did Harvey's circulation theory stimulate a reconceptualization of diseases and treatments, his reliance on anatomic methods showed that: "naked Experience, without the helps of Method and Reason, avails little, yea very often doth much hurt. . . . He seems to have hit the maker, who joyns both together, that reason may not pervert Experiments, and Nature itself, not that this may remove reason from its place."51 In short, for Harvey as well as his followers, Hippocrates as a cognitive guide verged on being irrelevant in terms of their natural philosophy. By contrast, they


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regularly praised the ancient anatomists Herophilus, Erasistratus, and above all Galen. Hippocrates, however, received high praise for his accessible and practical knowledge from several mid-century English healers who published inexpensive medical self-help books. For example, Nicholas Culpeper, the popularizer most noted for his inexpensive herbals published during from the 1630s onward, regularly praised Hippocrates as the supreme medical authority. During the Restoration, other popular medical writers continued to express a preference for Hippocrates over Galen. In 1664, the same year in which Willis published his Anatomy, the anonymous author of The Method of Chemical Philosophy and Physick, which was a text that blended religious mysticism, alchemy, and medical aphorisms, revered Hippocrates for recognizing that "Nature[is] the governor of Man." But he or she expended more effort on denigrating Galen: "Let us pardon Galen, I pray you, for he is ignorant of the Spagyrical" who "hath never attained unto the secrets of Hippocrates, whereby he hath left the essence of Nature untouched and uncomprehended."52 In 1667, Conlan Cashin, a traditional humoralist physician practicing in Ireland, published an attack on Willis and Lower that criticized their use of ancient medical authorities. Although he expressed anger that Willis had ignored Hippocrates, he was even more critical of Willis and Lower's use of Paracelsus and van Helmont and medical chemistry in general.53 Unlike earlier self-styled Hippocratics, however, Sydenham and Locke did not bemoan the social inutility and injustice of the professional medical, religious, and legal hierarchy. Indeed, both Sydenham and Locke found their medical—and occasionally literal—homes among the nascent Whig gentry and aristocracy. Sydenham sought full entry into the College of Physicians, although he succeeded only to the level of Licentiate, not Fellow, or full member, probably because of his political outspokenness. Locke maneuvered for lucrative government posts and colonial investment opportunities.54 The shift in political content of medical empiricism in the late seventeenth century reflects a broader cultural shift among many literate Englishman away from a desire for broad-scale social reform toward a quest for modest private improvements. Unlike the millenarian Puritan reformers of the 1640s and 1650s, latitudinarian reformers such as Locke did not intend the prospect of a final Judgment to hasten reform of social injustices; instead, they directed their political and religious aims toward achievement of limited religious tolerance and enhanced protection of private activity and property. Although Sydenham characterized himself in terms that Culpeper might have used in self-description—as "dedicated to the welfare of the public"55—he couched his objections to anatomically based medicine solely in epistemological terms. At least he made it clear he was not writing popular texts for a lay audience. Complaining about the practice of prescribing "heating" medicines in pleurisy, Sydenham in his Methodus specifically criticized "certain women of rank" for the practice of helping the poor. Instead of practicing medical care, such women "would be bet-

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ter employed in feeding the poor than in physicking them."56 Furthermore, he followed learned medical convention by publishing in Latin (with the help of Locke), joining the College of Physicians, and attempting to merge with and influence the mainstream of elite medical thought. Boyle was descended from a landed, albeit nouveau riche, aristocrat, and Locke, who came from prosperous yeoman stock, was the confidante of highly placed Whigs. With regard to the epistemic divide between anatomy and the natural philosophy method, more than class was at sake, an opinion supported by the fashion among genteel Whigs in early Georgian London for Locke and Sydenham' s approach to medical knowledge. By the closing decades of the seventeenth century and continuing through the eighteenth, Hippocrates, thanks largely to his singular prominence in Sydenham's writings, likewise ascended to prominence among orthodox physicians. Meanwhile, Galen (and Aristotle) went into eclipse as Georgian publishers reissued Culpeper's herbals in deluxe hand-colored formats and referred to the long-deceased populist author as Nicholas Culpeper, "Gent." Nonetheless, during the mid eighteenth century fashionable Londoners crowded William Hunter's anatomy demonstrations in his theatre at Great Windmill Street.57 What interests me most is not so much why early Georgian elite medicine jettisoned the anatomic tradition and its emphasis on etiology and structure-function relationships in favor of a refurbished Hippocratic empiricism, but rather why influential physicians and natural philosophers thought they had to choose. With the exception of the alchemists, including Paracelsus and J.B. van Helmont, who favored Hippocrates, no significant medical figures from Galen onward expressed a strong preference for Hippocrates at the expense of anatomical approaches or vice versa. Indeed, Galen absorbed Hippocratic approaches even as he transformed them into his own accounts. Renaissance and early modern authorities tended to lump Hippocrates and Galen together as luminaries when they referred to them. With the exception of the alchemists, even Continental medical writers in the mid seventeenth century tended not to divide themselves into Hippocratic and Galenic camps in terms of their attitude to medical knowledge making. But they did in England. Why? I speculate that an important reason a general preference for superficial observation over deep inquiry occurred earlier in England than elsewhere has to do with the extended period of major religious, professional, and political tumult that seventeenth-century English people experienced. The persistent and profound conflicts that occurred concerning all aspects of knowledge and appropriate behavior made slippages visible in what previously seemed relatively seamless: the coexistence of vernacular and intellectually modest approaches (read Hippocratic in medicine) with those that were learned and universalist (read Galen and the "new" philosophy of Oxford anatomic experiment). These disputes between those who championed simple vernacular methods above learned experimentalist approaches parallel a venerable fault line in West-


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ern Christianity that experienced heightened tension in England as the century wore on. In contrast to the Oxford physiologists, who, as I noted earlier, mostly came from High-Church Anglican backgrounds, those who identified themselves as Hippocratic during the seventeenth century tended to dissent from HighChurch Anglicanism. Theological dispute, in other words, found its counterpart in disputes about medical knowledge. In terms of theology, one need read only the direct and simple language of Jesus in the accounts of Matthew, Mark, and Luke and compare it with the rest of the New Testament, redolent of Greek philosophy, to have a sense of the divided legacy that Reformation Christianity inherited. Knowing that I oversimplify matters considerably, I suggest that the historical formation of Christianity left the West with two somewhat distinct versions of being Christian, not to mention a propensity to dispute between them that became acute during the Reformation: a simple and direct way for ordinary people to find spiritual comfort in a harsh world, and an intellectual demanding set of issues concerning God's relation to nature and man. If this is so, drawing parallels between theology and medical theory seems plausible for this period. Throughout England's tumultuous middle decades one finds on one side dissenters who favored scriptural authority, plain religious spaces and services, an absence of church hierarchy, and modest explanatory and professional apparatus in medicine (the Hippocratics) and on the other those who favored Episcopal order, complicated theology and church tradition, and rationalist anatomy (the Galenists). Aside from the fact that by the late 1680s almost all the Oxford physiologists had died, an important clue to the rise in intellectual prestige of a refurbished Hippocratism and the decline of the physiological/anatomic approach may lie in the emergence of the word "constitution" and its cognates in many English contexts, not only medical, from the 1680s on. By the late 1680s, the increasingly brittle Restoration political and religious settlement finally fell apart in a bloodless revolution as the nation exchanged the absolute monarchy of James for the constitutional monarchy of William and Mary. Locke and Sydenham, by the way, actively supported the change, as did their patrons. In the meantime, few English physicians from the late seventeenth century until the late eighteenth carried out the kind of rigorous investigations that earned Harvey and Willis and their cohort extensive international influence. Instead, around the 1690s the center of gravity in medical knowledge-making shifted from England to the Continent, especially Holland. Some late-seventeenth- and early-eighteenthcentury British medical theorists, notably Archibald Pitcairn and James Keill, glossed their histories and observations with Newtonian rhetoric, but the experimental component of their work was minor.58 Furthermore, anecdotal evidence suggests that the basis of professional success among elite physicians also shifted. English anatomical knowledge, backward in every respect compared to that on the Continent at the beginning of the seventeenth century, improved dramatically

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with Harvey and the Oxford physiologists. Most of them earned large sums in practice partly because of their reputations for experimental accomplishment. By the 1690s, however, England's then most prosperous physician John Radcliffe, like Locke a religious dissenter and politically active as a Whig, boasted that he did not experiment and said he read few medical books other than, ironically, Willis's.59 If pressed to explain these wholesale shifts in sensibility with one phrase, I would invoke, without being able to prove it here, "exhaustion with the search for cause," or perhaps more accurately, exhaustion with efforts to enforce public consensus about absolute causes, indeed, about absolutes in general. Sydenham's characterization of nature as an "abyss of cause," which echoed Paracelsus and Reformists such as Calvin, and his and Locke's denigration of anatomy in favor of aphorisms based on superficial observations, reflected and, perhaps, helped shape a widely held sentiment among late-century Whigs of various religious outlooks to give up any hope of achieving consensus concerning reliably certain knowledge—literally scientia—concerning medical diagnosis and treatment, the mysteries of the human body, theology, and church governance, or the body politic. Instead, this growing group embraced "constitutional" models made up of several factors that related dynamically to each other without any one factor having absolute control. Importantly, the model permitted considerable latitude in private behavior including religious observance, professional approach, and political arrangements. To arrange things differently, their nation's recent historical experience suggested, made politics of all kinds almost impossible because the metaphysical beliefs that sustained different absolutist accounts had proven to be irreconcilable. Increasing acceptability of medicine as an empirical undertaking akin to botany helped facilitate the general relaxation of professional standards that characterized British medicine in the eighteenth century. Also, it suited early Georgian attitudes among the genteel toward learning. According to sociologist Nicholas Jewson, professional success in the eighteenth-century medical marketplace turned increasingly on one's success in passing as a gentleman.60 Attention to superficial appearance, as it were, displaced mid-seventeenth-century preoccupation with cause and mechanism. I find it interesting that Oxford and Cambridge enrollments during the late 1600s declined substantially from their levels of the 1640s; indeed, they did not return to them until the 1880s.61 In the meantime, enrollments grew rapidly at the Inns of Court in London. With regard to religion, tactics used by Sheldon and his allies to assure tight control of expressions of religious enthusiasm in worship in the 1660s and 1670s gave way to "latitudinarian" relaxation concerning forms of observance and the natural theology espoused in the Boyle lectures of the 1690s.62 In broad terms, early eighteenth-century England achieved closure of its seventeenth-century schisms through a widespread, if occasionally testy, toleration of plurality in many areas of civic, religious, and professional life. National leaders in politics, reli-


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gion, and commerce deliberately sought to refocus public awareness on expansion of trade at home and abroad and away from differences that historically had proven irreconcilable and profound.63

Willis, Locke, and Smuggled Mental Baggage If the foregoing is true concerning English learned medicine's late-seventeenthcentury turn to a refurbished Hippocratic empiricism, it raises the question of how Willis's cerebral model and anatomic method maintained their influence into the eighteenth century. A partial answer lies, I think, in Locke's work on human psychology, mainly his An Essay Concerning Human Understanding, first published in 1690. If only because numerous eighteenth-century learned medical writers cited Willis for his doctrine of the nerves, it would be historically inaccurate to tie Willis's intellectual fate solely to Locke's. However, Locke's texts on psychology, religion, and government reached influential eighteenth-century audiences who probably did not read seventeenth-century medical books written in Latin. Also, in Britain and on the Continent, many intellectual leaders in the eighteenth century celebrated John Locke as emblematic of British thought on religion, politics, and the human mind. On the American side of the Atlantic, Locke's influence was even more widespread than on the Continent, perhaps, because the Founding Fathers made generous use of Lockean theories of consent, religious plurality, property, and limited central authority.64 Even though the student did not acknowledge his teacher, many of Locke's psychological premises find their origin in Willis. During the eighteenth century and later, therefore, I expect that many readers absorbed Willis through Locke. Like Boyle, Locke as a youth participated in experimental anatomy only to turn away from it as an adult. In this sense the mature Locke, who regarded philosophical speculation on the soul as "gibberish,"65 was one of the first, as well as the most influential, of those medically informed writers publishing after Willis to make use of his cerebral model while dispensing with the major epistemological assumptions of its originator(s). For example, Locke's famous description of the nascent human mind in section 15 of Book 1 of An Essay Concerning Human Understanding as an "empty cabinet" first occurred in his notes from a lecture by Willis he attended in 1664.66 Willis, in turn, may have found his source in Richard Hooker (1554-1600), the Anglican intellectual I noted in Chapter 5, whose Treatise on the Laws of Ecclesiastical Polity sought to establish natural law and church tradition as crucial bases of Church behavior. Hooker wrote in opposition to early English Calvinists who argued for the absolute authority of scripture alone.67 Writing on the human mind in the fourth edition of his Essay, Locke opined, much as had Willis in his Anatomy, that "habits of thinking" as well as "motions of the body" were but "trains of motions in the animal spirits, which, once set a

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going, continue in the same steps they have been used to ... this may serve to explain their following one another in an habitual train . . . as well as it does to explain such motions of the body."68 Immediately after this section, which followed closely Willis's exposition in his Anatomy of the relation of the intercostal nerves and the viscera, Locke used the example of a musician's ability to play by memory as an indication of the habitual motion of the animal spirits. Willis used the musician example in the same place in his lecture as well as in the Anatomy. Although Willis presented these speculations as fact, however, Locke qualified them: "Whether the natural cause of these ideas . . . I will not determine, how probably soever, by this instance, it appears to be so."69 Even though the mature Locke barely mentioned the brain in his long exposition of mind, when he did so, the physiological concepts almost without exception came from Willis.70 Locke's increasing influence internationally from the early eighteenth century onward helped Willis's theories secure broad cultural influence in the Enlightenment among audiences that would not have embraced their overt insistence on hierarchy, control, and order. Along the way, Locke's deft smuggle managed to do for mind and brain what his early mentor would not have wanted, which was to bury Willis's spiritual and theological premises out of sight in the interior of Locke's new "psycheology," to use the archaic spelling of the word that made its first appearance in English in the 1680s. In so doing, I think Locke helped advance a crucial notion of modernity, which is that while spirituality may be culturally presentable, and indeed, God all powerful in an individual's mind, God no longer needs to exist simultaneously as a dual social and natural construction.71 One can be, like Locke, both pious and secular. By eschewing Willis's preoccupation with cause and deep structure, Locke's psychology made it possible to retain some of his mentor's notions while dispensing with Willis's underlying commitment to a cosmology that inevitably harkened back to a mythical High-Church Anglican past. As a result, Locke and Sydenham's new constitutional model of mind and body was able to contain enthusiasm, the bugbear of orthodox England in the seventeenth century, without seeming to squelch it or even to acknowledge that it had once posed a philosophical, religious, and political dilemma. In philosophical terms, their move, which was shared by others, succeeded in transforming the basis of acceptable knowledge itself. In the new constitution the old Christianized Aristotelian metaphysics, which always included God as an active component of natural law as well as the laws of the republic, morphed into a hybrid: the new empiricism, which dealt in probable knowledge, and a new attenuated metaphysics that did not presume to provide full accounts of God's agency in nature or society. Natural philosophy, now freed of overt concern with theological issues, could transform itself into our modern notions of science. In exploring notions of Western modernity, the anthropologist of science Bruno Latour also argues that the essential step occurred in the emergence of the con-


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cept of constitution in mid-seventeenth-century English natural philosophy.72 Latour does not mention Sydenham or Locke's use of the term; instead, he examines the debate that occurred between Robert Boyle and Thomas Hobbes concerning the status of experimental knowledge in the context of Boyle's air-pump. Building on Steven Shapin and Simon Schaffer's analysis of that debate in their influential Leviathan and the Air-Pump: Hobbes, Boyle and the Experimental Life of 1985,73 Latour attempts to generalize their findings in order to find the "secret of the modern world."74 As English thinkers successively "crossed-out" God's involvement in external affairs in natural philosophy and society, Latour argues that English thinkers set up three "guarantees" of the "constitution" of modernity. In a table he labels the "paradoxes of Nature and Society," Latour lists them as follows: "First guarantee: even though we construct Nature, Nature is as if we did not construct it. Second guarantee: even though we do not construct Society, Society is as if we did construct it. Third guarantee: Nature and society must remain absolutely distinct."75 In retrospect, we can see this seventeenth-century development as the "conjoined invention of scientific facts and citizens."76 I suggest that Lockean psychology played a central role in codifying these new arrangements at all levels, and it is through Locke and his allies that Willis's cerebral body and doctrine of the nerves imbricated themselves in the modern edifice. By concealing his intellectual debts to Willis and other tactics, Locke was able to continue his early mentor's effort to present the cerebral body as fully natural—just like us—not merely as one theory among others of the human condition, a feat that Willis never quite accomplished. But then for Locke to admit otherwise would have been for him to make public acknowledgment of the arbitrariness of the psychological theory that lay at the center of his entire philosophical enterprise, which perhaps is why he kept quiet about Willis's rather baroque mental furniture. Thanks in part to Willis and Locke and their respective cohorts, in other words, Stuart England gradually transformed itself into a recognizably modern Britain with a new constitutional model of sovereignty in the human body and the body politic that at once managed to seem old, new, and true to nature.77 It would take at least another book to outline developments in neurology between the eighteenth century and now and more than one for changes in methods of generating medical knowledge. Here I will mention just two main points. First, the predominant eighteenth-century version of empiricism,78 which held, pace Locke and Sydenham, that deep investigations of structure were not capable of understanding the causes of nature, including human health and sickness, gradually gave way to the idea that observation, deep investigation of structure, and experimental manipulation each had their place in medicine. Galen, if you will, came back into a picture in which Hippocrates still had a prominent position. According to Claude Bernard (1813-1877), a prominent nineteenth-century physician-physiologist: "Observation, then, is what shows facts; experiment is what

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teaches about facts and gives experience in relation to anything."79 Secondly, it is worth noting that as the epistemological pendulum swung between mere experience and experimentally induced experience, the cerebral model first articulated by Willis and his colleagues maintained its prestige. Prominent eighteenth-century "nerve doctors," such as George Cheyne, framed their theories in terms consistent with its main precepts even though they did not always acknowledge their source. Phrenology busts of heads, which sold widely in Britain and the United States from the mid nineteenth century onward, suggest the extent to which the cerebral model had become tacit knowledge in Victorian culture. Those of Lorenzo Niles Fowler (1811-1896), who was active on both sides of the Atlantic, devoted the top of the skull to two areas of similar size. Fowler located "moral and religious sentiments" on the right and "veneration," which he subdivided into "respect, worship, antiquity" on the left. Abutting "veneration" on its posterior aspect, Fowler placed "perserverence, stability, power of will."80 In the twentieth century neurologist Sir Charles Sherrington (1857-1952), who in 1932 shared a Nobel Prize in Physiology or Medicine for his work on the neuron, spoke for many when he praised Willis as the founder of modern neurology.81 Notes 1. Anonymous. "News from the Dead, or a True and Exact Narration of the Miraculous Deliverance of Anne Greene," (Oxford, 1651) in Phoenix Britannicus. (London, 1732), vol. 1, pp. 233-40. 2. Seth Ward. Vindicae Academiarum. (London, 1654), p. 35. 3. John Webster. Academiarum Examen, or the Examination of Academies. (London, 1653), p. 106. 4. Ibid., 74. 5. Ibid., 106. 6. Ward. Vindicae Academiarum, 34. 7. Ibid. 8. Sheldon MS. Bodleian Library. Add. C. 87. I have placed a question mark where I cannot decipher the handwriting. 9. Gottfried Leibniz. Monadology and Other Philosophical Essays, ed. Oskar Piest (New York: The Library of Liberal Arts, 1953). 10. Frans Djorup. "Steno's Ideas on Brain Research," in Steno and Brain Research in the Seventeenth Century, ed. Gustav Sherz (Oxford: Pergamon, 1968), p. 111. 11. Steno. "A Lecture on the Anatomy of the Brain." (Paris, 1669). Reprinted in 1965. intro. Gustav Sherz (Copenhagen: Nyt Nordisk Forlag, 1965), p. 144. 12. Ibid., 133. 13. Ibid., 134. 14. Ibid., 127. 15. Ibid., 151-3. 16. Ibid., 126. 17. Roger Hahn. The Anatomy of a Scientific Institution: The Paris Academy of Sciences, 1666-1803. (Berkeley: University of California Press, 1971). 18. Attributed to Thomas Sydenham, the lines may have been authored by John Locke.


19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33.

34. 35. 36. 37. 38. 39. 40. 41.

42. 43. 44. 45.

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John Locke. "Anatomie." (1668). Mss. in Public Record Office, 30/24/47/2, fols. 31r38r. Sydenham first published such sentiments in Observationes Medicae. (1676). Thomas Sydenham. The Works of Thomas Sydenham. 2 vols. ed. R. G. Latham (London: Sydenham Society, 1848), vol. 1, p. 102. Ibid., vol. 2, p. 84. Ibid., vol. l,p. 171. J. A. Mendelsohn. "Alchemy and Politics in England, 1649-1665." Past and Present 135 (1992): 30-79, especially pp. 46-7. Sydenham. Works, vol. 1, p. 13. Lawrence Stone. The Crisis of the Aristocracy, 1558-1641. (Oxford: Oxford University Press, 1976), chapter 12. John Locke. Familiar Letters between Mr. John Locke and Several of His Friends. 4th ed. (London, 1742), pp. 223^1. Cited by Kenneth Dewhurst. Dr. Thomas Sydenham: His Life and Work. (Berkeley: University of California Press, 1966), p. 179. Thomas Sydenham. "Preface," in Methodus curandi febres . .. (1666), section 1. John Locke. An Essay Concerning Human Understanding. (1692). Reprinted (New York: Dover, 1959), book IV, "Extent of Human Knowledge," chapter III, section 25-7. Locke. Essay Concerning Human Understanding, book IV, chapter III, section 26, "Hence No Science of Bodies within Our Reach." For a review of this side of Boyle's work, see Lester S. King. "Robert Boyle As an Amateur Physician," in Medical Investigation in Seventeenth-Century England. (Los Angeles: Clark Library, University of California, 1968), pp. 29-49. Robert Boyle. "On the Usefulness of Natural Philosophy," in The Works of the Honourable Robert Boyle, ed. Thomas Birch (London, 1772), vol. II, p. 183. Quoted in King. Medical Investigation, 44. King. Medical Investigation, 41-3. Boyle. Works, 163-4. See also King. Medical Investigation, 45-6. Lord Conway to Anne Conway, 1 July 1651, in Anne Conway. The Conway Letters: The Correspondence of Anne, Viscountess Conway, Henry More, and Their Friends 1642-1684. ed. Marjorie Hope Nicholson, rev. Sarah Hutton (Oxford: Clarendon Press, 1992), pp. 29-30. Locke. Essay Concerning Human Understanding, book II, chapter IX, "Of Perception." Locke. Essay Concerning Human Understanding, book IV, "Extent of Human Knowledge," chapter II, section 14. Locke/Sydenham. "Anatomie," in Dewhurst. Sydenham, 91. Ibid., 88. Locke to Dr. Thomas Molyneux, 20 January 1692/3, in Dewhurst. Sydenham, 176-7. Sydenham. Methodus, II.VI.3.3. Sydenham. Methodus, III.I.5.5. On the inchoate notion of species, see Sydenham. Methodus, III.I.5.5. and III.I.5.27. For its development in Sydenham's mature work, see Don Bates. "Part III: Sydenham's Species Concept," in "Thomas Sydenham: The Development of His Thought, 16661676." Unpublished doctoral dissertation. (Johns Hopkins University, 1975), especially chapters 7-9. Bates. "Thomas Sydenham," p. 63. Sydenham. "Epistolary Dissertation to Dr. Cole," in Works, vol. 1, p. 85. Ibid., 87. Thomas Sydenham. Methodus Curandi Febres Propriis Observationibus Super-

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46. 47. 48. 49.

50.

51.

52. 53.

54.

55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66.

67.


structura. English translation from Latham's edition of Works (1848). (Folkestone, U.K.: Winterdown Books, 1987), "Section Three: Of Intermittent Fevers," p. 99. Ibid., "Of Continued Fevers," section 1.4.9, p. 25. Sydenham used "ebullition" and "fermentation" synonymously. Ibid., "Of Symptoms," VI.3.4., p. 75. See, for example, Oliver Wendell Holmes. Medical Essays. (Boston: Houghton Mifflin, 1911). For the only extant translation of De Corde of which I am aware, see Frank Hurlbutt Jr. "Peri kardies: A Treatise on the Heart from the Hippocratic Corpus." Bulletin of the History of Medicine 7 no. 9 (1939): 1104-13. Thomas Willis. "Preface," in Dr. Willis's Practice ofPhysick, Being the Whole Works of that Renowned Physician, trans. Samuel Pordage (London: T. Dring, C. Harper, and J. Leigh, 1684). For a recent view on the limits of using "epistemology" and its cognates in reference to early modern medical knowledge, see Andrew Wear. "Epistemology and Learned Medicine in Early Modern England," in Knowledge and the Scholarly Medical Traditions, ed. Don Bates (Cambridge: Cambridge University Press, 1995), pp. 151-75. Anonymous. The Method of Chemical Philosophy and Physick. (London, 1664). Huntington Library #474249. Conio Cassinius. Willisus male vindicatus. (Dublin, 1667). Cited by Kenneth Dewhurst. "Epilogue," in Richard Lower. Vindicatio. (1665). Facsimile. (Oxford: Tempest, 1983), p. 296-7. Despite its hagiographic tone, Fox-Bourne's nineteenth-century biography of Lockee provides the fullest extant narrative of the latter's career moves and worldly ambitions. See Henry Fox-Bourne. The Life of John Locke. (London, 1876). Sydenham. "Epistolary Dissertation to Dr. Cole," in Works, vol. 1, p. 57. Sydenham. Methodus, II.VI.3.3. W. F. Bynum and Roy Porter, eds. William Hunter and the Eighteenth-Century Medical World. (Cambridge: Cambridge University Press, 1985). See, for example, James Keill. Medicina Statica Britannica. 3rd ed., ed. J. Quincy (London: J. Newton, 1723). John Radcliffe. Memoirs of the Life of John Radcliffe. (London, 1715). Nicholas D. Jewson. "Medical Knowledge and the Patronage System in 18th-century England." Sociology 8 (1974): 369-85. Stone. Crisis of the Aristocracy, chapter 12. John Spurr. The Restoration Church of England, 1646-1689. (New Haven: Yale University Press, 1991). Richard Westfall. Science and Religion in Seventeenth-Century England. (New Haven: Yale University Press, 1958). Don Herzog. Happy Slaves. (Chicago: University of Chicago Press, 1989). Locke. Essay Concerning Human Understanding, book III, chapter X, "Abuse of Words," section 14. From a 1664 lecture by Willis on sense (attended by Lower and Locke): "When a similar movement is repeated in these orbits memory is evoked as the cerebrum in infants is a tabula rasa." Willis' Oxford Lectures, trans, and ed. Kenneth Dewhurst (Oxford: Sandford Publications, 1980), p. 66. In his annotated edition of Locke's An Essay Concerning Human Understanding, (New York: Dover, 1959), Alexander Fraser argues in note 2 on p. 48 of vol. 1 that Locke might have been thinking of Hooker, not Willis. However, I think Locke's lecture


68.

69. 70.

71. 72. 73. 74. 75. 76. 77.

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note speaks for itself. In any event, according to Hooker, humans are born "without understanding or knowledge at all. Nevertheless, from this utter vacuity, they grow by degrees . .. the soul of man being therefore at the first as a book wherein nothing is, and yet all things may be imprinted. . . ." Richard Hooker. Treatise on the Laws of Ecclesiastical Polity, book 1, section 6. John Locke. "Of the Association of Ideas," a chapter that was inserted into 4th ed. Essay Concerning Human Understanding as Chapter XXXIII in Book II. Quote is from paragraph 6. For a different viewpoint on the origin of the concept of tabula rasa in Locke's Essay Concerning Human Understanding, see Nicholas G. Petryszak. "Tabula Rasa—Its Origins and Implications." Journal of the History of the Behavioral Sciences 17 (1981): 15-27. Petryszak does not mention Willis. Locke. Essay Concerning Human Understanding. 4th ed., book II, chapter XXXIII, section 6. This point has been made emphatically, but in an undocumented way, by George Rousseau. "Nerves, Spirits, and Fibres: Towards Defining the Origins of Sensibility," in Studies in the Eighteenth Century, vol. 3, eds. Brissenden and Fade (Canberra: Australian National University Press, 1976), pp. 137-57. Bruno Latour. We Have Never Been Modern. (Cambridge: Harvard University Press, 1993), p. 33. Ibid. Steven Shapin and Simon Schaffer. Leviathan and the Air-Pump: Hobbes, Boyle and the Experimental Life. (Princeton: Princeton University Press, 1985). For a similar account of the importance of the debate between Thomas Hobbes and Robert Boyle on experimental evidence, see Latour. We Have Never Been Modern, 30. Ibid., 32. Ibid., 33. See also Elizabeth Eisenstein. The Printing Press as an Agent of Change. (Cambridge: Cambridge University Press, 1979). Shapin and Schaffer provide a nice summary of their view of similar themes: "Neither our scientific knowledge, nor the constitution of our society, nor traditional statements about the connections between our society and our knowledge are taken for granted any longer. As we come to recognize the conventional and artifactual status of our forms of knowing, we put ourselves in a position to realize that it is ourselves and not reality that is responsible for what we know. Knowledge, as much as the State, is the product of human actions. Hobbes was right." Shapin and Schaffer. Leviathan and the Air-Pump, 334. See also Latour. We Have Never Been Modern, 25-7.


9 ON THE PERSISTENCE OF THE CEREBRAL BODY AND ITS ALTERNATIVES Perception is not a science of the world, it is not even an act, a deliberate taking up of a position; it is the background from which all acts stand out, and is presupposed by them .. . The world is inseparable from the subject, but from a subject which is nothing but a project of the world, and the subject is inseparable from the world, but from a world which the subject itself projects. —Maurice Merleau-Ponty, Phenomenology of Perception (1962)

The Cerebal Body and the Logic of Biomedicine To the degree we accept biomedicine as a science, we believe by definition that its investigative practices and the knowledge they produce or will produce or might produce constitute what scientia literally means: reliably universal knowledge. In this enterprise, physiology, now carried on at the additional level of the gene, has managed to not only maintain its epistemological prestige compared with early modern times but also to increase it. Physiology, after all, is one of the few areas in medicine that deals with laws. In this its position in the life sciences is akin to that of physics in the physical sciences. As such both have remained simultaneously transparent, by which I mean seemingly self-evident and universal, at least to their initiates, and relatively opaque to analyses that rely on historical or cultural relationships to probe claims to universal truth. According to physiologist Walter B. Cannon, who in 1929 coined the term homeostasis and whom most physiologists regard as the modern founder of their discipline: "In other parts of our central nervous system we may not be very unlike lower animals, but in the cerebral hemispheres we are almost incomparably different. . . . On this elaborate organization of the nerve connections in the cerebral cortex is based the much superior intelligence of man as compared with other mammals, and his ability to modify the external environment in extraordinary ways."1 199

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Cannon in 1929 sounds remarkably like Willis in 1664, does he not? He is merely reiterating a simple biological truth. This is not to say that during evolution culture has not shaped biology. I support the view of Geertz and others that Ice Age culture was "centrally ingredient" in the development of the "large-brained fully human Homo sapiens" out of what had been a "small-brained protohuman Australopithecus."2 If we were to stop our analysis here, we might say the matter is closed, that science and Ice Age culture alone, not science and the present-day humanities and social sciences, can provide a sufficiently robust account of what we take for granted in modern human physiology, which is that members of H. sapiens, the name that physician-naturalist Karl Linnaeus (1707-1778) bestowed on us in the mid eighteenth century, possess a cerebral body in the manner Willis and Cannon and their intellectual kin say we do. To argue thus is to make unproblematic the persistence of the past—Willis's account of the cerebral body—in present day physiology. He and his colleagues did something akin to discovering a law, like Boyle's Law concerning pressure-volume relationships of a gas at a constant temperature. I think matters are more complicated, however. For one thing, the foregoing does not explain the persistence within Western thought into the modern day of alternative versions of healing knowledge and the human body. To explain their persistence, let alone the present-day popularity of non-Western approaches among the ethnically European, I want to begin by exploring one seemingly small historical anomaly. Consider the visual persistence of Willis's model in the present. With the exception of mathematicians, perhaps, few working in the sciences today make use of the remote past of their disciplines. Yet, if one wanted to learn about brain anatomy and went to a medical school bookstore to find a visual aid, the sales clerk likely would offer a laminated sheet with a central colored image of the brain-from-below that bears an eerie resemblance to Wren's black-and-white engraving of 1664 (Fig. 9-1). If so, it must be one of the few adaptations of a tool from the Scientific Revolution in modern science. After all, Boyle's air-pump is long gone, and present-day astronomers do not study the heavens with Galileo's telescopes. Why does such an antique image continue to guide present-day thought? It is not because the image guides contemporary exploration of the brain or diagnosis of its diseases. In learning and performing their actual work, those in contemporary neurology, neurosurgery, and the neurosciences use other images generated by technologies such as positron emission tomography scans, microsurgical technologies, and/or biochemical and electronic measurements. However, most medical students still start out on the brain with the image Willis engaged Wren to draw almost 350 years ago. Perhaps it is merely another form of homage, an unacknowledged tribute to Willis's foundational role in the field of neurology, not to mention his description of the collateral circulation at the base of the brain that subsequently has become eponymous.

FIGURE 9.1 "Brain. Inferior View" by Luis Amendolla Aasparo in Luis Lopez-Antunez, MD, PhD. Atlas of Human Anatomy, translated by Harry Monsen (Philadelphia: WB Saunders, 1971).

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Biomedicine may persist with Wren's image of the brain-from-below, but not primarily for instrumental reasons. Aside from demonstrating collateral circulation of the mainstem I think the image replicates because it provides a key support to biomedicine's social claim to be the sole guarantor of valid knowledge about its account of the human body. If what the image represents is true, by which I mean transcendentally true although subject to revision in the ordinary course of science, then biomedicine is also true and other healing systems, whether vernacular or literate, are not. Moreover, as I discussed in previous chapters, the image is more than just a depiction of a body part from a certain perspective; it also bespeaks assumptions about mind-body relations as well as valid methods for obtaining medical knowledge. In other words, to accept the cerebral body is to accept both a particular account of the human condition and the assumptions and methods that produced it, as I discussed in previous chapters. When one puts together these assumptions and portrayals, Wren's brain-from-below image functions almost as a cultural hologram. One can extrapolate from its two dimensions a good deal of biomedicine's particular cultural vision, or at least that portion that established its modern path beginning in the Scientific Revolution. Analyzing particular cultural visions, according to Geertz, involves "sorting out the structures of signification—what Gilbert Ryle called established codes,3 a somewhat misleading expression, for it makes the enterprise sound too much like that of the cipher clerk when it is much more like that of the literary critic—and determining their social ground and import."4 This is what I have tried to do in previous chapters. Unlike an ethnographer dealing with a tribe whose members share homogeneous "structures of signification," however, I have attempted to sort out differences in codes among groups of what on the surface may appear as one culture, the early modern European literate. An ethnographer studying a single tribe does not have to deal with the dynamics of different codes among subtribes of a larger group, but I think historians of many early modern European subjects are obliged to do so. As I have argued earlier, in large part the Reformation accounts for this. The multiple schisms it revealed and helped accentuate and the permanent fault line between likeness and presence the Reformation occasioned mean, among other things, that one cannot analyze any one early modern group in isolation from another, at least not the ones I have been analyzing. As I hope I have demonstrated in previous chapters, many early modern thinkers, and presumably many ordinary people, self-consciously shaped their thoughts oppositionally, by which I mean they often assumed that believing this meant rejecting that or perhaps that and that.

Sectarianism Persists Of course, sectarianism is nothing new in medicine or religion or politics. Galen railed against the self-styled empiricists and others who attacked his "rationalist" accounts. The salient difference in professional formations between the ancient

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world and the early modern is that early moderns began to have state-sponsored institutions beyond a state religion and sovereign, in England's case the Royal College of Physicians and the Royal Society. It is when institutions and other social apparatus of the professions enter the picture that the question of which form of public knowledge is correct becomes crucial. Still, institutionalization would not present a public problem if only one set of "codes of signification" existed, but the English situation, which compressed many of the various Reformation schisms into a few decades on a medium-sized island, forced the issue of choice. It is here, I think, at the historic intersection of state-sponsored institutions, biomedical research, oppositionalism, and likeness and presence that we can begin to tease out the past in the present. None of these cultural features has disappeared; each remains active. In other words, ever since Western medicine self-consciously sought to become scientific concerning the human body, healers have not agreed about that body or the means whereby it might be known or cared for. Moreover, a comparative analysis of then and now permits us to discern that factors present-day healers and patient/consumers cite for their choices resemble the factors their early modern counterparts often cited. The reasons people chose to be orthodox or alternative then closely resemble the factors their counterparts cite now. At least in the areas of the Western cultural map, if you will, that concern knowledge and care of the human body, the intersection has changed little over the preceding three and one-half centuries. This is the line of argument I mean to advance. First, let me suggest how prevalent alternative care has become. On January 28, 1993, The New England Journal of Medicine (hence, NEJM), perhaps the world's most prestigious general journal of biomedicine, published a "special article" entitled "Unconventional Medicine in the United States" that detailed that among 1,539 American adults surveyed, one in three respondents had used "unconventional therapies," which the authors defined as "medical interventions not taught widely at U.S. medical schools or generally available at U.S. hospitals" in the preceding twelve months.5 Usually, the authors write, people seek alternative care for chronic conditions such as headaches or back pain, not for acute illnesses such as bacterial pneumonia. Subsequently, other studies suggest that alternative approaches, which often are also called "complementary" approaches, have become more popular. Furthermore, during the past decade the National Institutes of Health, largely in response to calls from politicians, not scientists or physicians, has rapidly increased funding of alternative medicine research. Leaders in biomedicine have accompanied this formal recognition of alternative approaches with frequent encouragements to physicians to care for the "whole patient," which is what New England Journal of Medicine editor Edward Campion, MD, suggested in the editorial that accompanied the 1993 article cited above.6 Why might Campion's call be difficult, if not impossible, to satisfy? Because of the codes of signification built into its conceptual foundations, I suggest biomedicine by itself at best can achieve but a dim apprehension of what a whole

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person might be, let alone a whole patient. At least as it has constituted itself to date, biomedicine from an alternative perspective just seems to ignore or ablate too many dimensions of human lived experience. At least three related factors merit consideration. The first has to do with the model of the cerebral body itself. Even as the model provided a satisfying explanation to some during the decades when it first took cultural form, it failed to satisfy others. Many people then, even intellectuals such as Anne Conway, experienced themselves and the world in a manner the cerebral model suggested was not legitimate. Usually, the issue turned on the role of spirit, which the model maintained needed tight control. Nonetheless, these people, even the religiously enthusiastic, did not experience themselves as unreasonable. I suggest this tension continues today, and not merely among contemporary persons who take their spiritual life seriously. A large number of people believe that biomedical accounts of mind and body, indeed, about brain and mind, simply leave too little room for spirit. At least in its present form, biomedicine compared with Eastern literate traditions, such as traditional Chinese medicine, is markedly antivitalistic. Indeed, some who prefer alternative approaches find the cerebral model does not leave sufficient room for the emotional dimensions of intelligence, or at the least the model's insistence on materialistic dichotomies of mind-body seems beside the point. For skeptics, one might say that the body is not always looking up at its virtually separate brain. Nor do skeptics accept that the brain, particularly the solid portions of its cerebral cortex, is a distinct thing in itself, which is part of the second difference. Reification of body parts, including the brain, does not seem to contain people's entire experience whether they are well or sick. According to physician and anthropologist Arthur Kleinman: This radically reductionistic and positivistic value orientation is ultimately dehumanizing. That which has been such a successful blueprint for a biochemically oriented technology in the treatment of acute pathology places biomedical practitioners into a number of extremely difficult situations when it comes to the care of patients with chronic illness; situations which . .. offer obdurate resistance to affirmation of the patient's experience of the illness; to understanding of social, psychological, and moral aspects of physiology; and ultimately to the humane practice of medicine. These extreme situations are not created, at least with the same regularity and intensity, by other healing traditions described in the cross-cultural record.7 Third, regardless of biomedicine's particular characterization of the function of any particular body part, some who embrace alternative approaches take issue with the very methods by which biomedicine constitutes its truth. Some want more holistic investigation, which they often also couple with a desire for less aggressive methods. In the seventeenth century, objectors phrased their opinions in terms of respect for nature. According to the anonymous author of The Method of Chemical Philosophy and Physick of 1664, "What can Philosophers perform, or what can M.D.s, or what can chemists, unless they kiss this Virgin [Nature] with a sweet kiss?"8


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It does not surprise me that present-day alternative health approaches seem most prevalent in social groups that have also embraced environmental sustainability and community health, such as the Greens in Western Europe. Biomedicine, on the other hand, for the past 25 years firmly in the hands of corporations in the United States and elsewhere,9 has become a biomedical-industrial complex that often conflates health care with its own disciplinary perspectives and interests. Many who seek alternative care do not approve of this move or the oligarchical and hierarchical worldviews that support it. Compounding the power of these three areas of resistance to biomedicine is the therapeutic reality that in many chronic situations, biomedicine has little or nothing better to offer than other approaches. Furthermore, by simultaneously making extraneous the humanity of the sufferer and the healer because their personal agency cannot be quantified or made visible, biomedicine discards therapy's last resort, the healing potential of one person caring for another.

Allegiances and Medical Choices Mary Douglas, whose work strides the overlap of aesthetics and anthropology, has schematized some of the foregoing in terms of a general anthropology of consumer choice. At the center of her theory lies the premise that consumer choice, including choice of type of healing tradition, is at once an "act of allegiance and a protest against the undesired model of society."10 When people choose "spiritual medicine," which Douglas also calls gentle medicine and holistic medicine and, less often, alternative medicine, she maintains that: . . . we need to set it in the whole context of their other preferences and attitudes to authority, leadership, and competition. Cultural conflict is part of the explanation of their choice. .. . The adepts need not be very articulate in reproaching modern industrial society for its violence and aggressive wars, they may tacitly disapprove the social inequalities, and the unequal distribution of wealth and income; they may privately deplore the destruction of earlier more egalitarian social forms and cherish the traditions of more peaceful epochs. It is not necessarily an overtly political protest, nor does the person who takes these views need to put them more clearly into words about politics. It is enough that they are saying that they believe that all bodies and their own need a gentle therapy.11

Invoking the "principle of opposition," she continues: The idea is that in all their behaviour persons are continuously engaged in trying to realize an ideal form of community life and trying to persuade one another to make it actual. Little that is done or said is neutral, every aspect of living and all choices are tested in the struggle to make a cultural ideal come true. On this approach each cultural type is in conflict with the others and there is no line to be drawn between symbolic behaviour and the rest. Everything is symbolic and it is all heavily engaged. The same analysis that applies to the choice between religion applies to the choice of foods and of medical methods.12

Douglas is writing about the present, not the past. Nonetheless, I hope readers agree that her cultural analysis speaks trenchantly to the past I have presented in

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previous chapters. Because I think it does, I have borrowed her concept of a cultural map (Fig. 9.2). According to Douglas, "There are four distinct kinds of culture, no one of which can flourish in the conditions predicated for any of the others. ... Any choice which is made in favour of one is at the same time a choice made against the others."13 Although I think Douglas overstates the ubiquity and influence of her principle of opposition, it is not difficult to locate the cerebral body and its adherents on her map in the upper right-hand corner, as members of strongly incorporated groups with complex structure and conservative hierarchy. That was Willis and Sheldon's genius—to make the interior of the human body express in its own terms the interests and cosmological assumptions of the external group that supported it without ever having to acknowledge their artifice. But then the upper right-hand corner probably also would contain someone like Highmore, conservative and hierarchical, to be sure, but with a different theoretical slant than Willis. Also, it is easy to locate those who formed groups that dissented to the cerebral model and High-Church Anglicanism. They are down in the right corner, in the dissident enclave of strongly incorporated groups with weak structure, such as the Quakers and other egalitarian sects. Other actors can be placed in the different areas according to some calculus of their individual mix of vectors. What matters here is not so much the precise location of any historical actor on Douglas's map or even some of the map's details,

Backwater isolation B

Conservative hierarchy C

Isolates, by choice or compulsion, literally alone or isolated in complex structures (eclectic values)

Strongly incorporated groups with complex structure (e.g. hierarchies)

Weak structure, weak incorporation (competitive individualism)

Strongly incorporated groups with weak structure (e.g. egalitarian sects)

A Active individualism

D Dissident enclave

FIGURE 9.2 Mary Douglas's "cultural map" of four distinct cultures in the context of orthodox and alternative medicine, or what she considers "the choice between gross and spiritual" in professional health care. Thought Styles (London: Sage, 1996).


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but rather the map's ability to show how older norms and alternatives may have persisted to the present. Wren's image of the brain-from-below still works because in broad terms it signifies a worldview—the upper right-hand corner—that many people, especially those wielding social and economic power, including biomedical leaders, hold dear. Its very hegemony, which I will discuss shortly, stimulates formation of its main counter, the spiritual critique to which Conway gave poignant voice. Her alternative vision still works, too. New methods of knowledge dissemination with parallels to the Reformation also favor continued utility for Douglas's cultural map of medical preference. Early modern religious reformers sought widespread distribution of vernacular Bibles because they wanted believers to read scripture directly, not just know God's word through hearing selected portions in Latin from a priest in church. So too the proliferation of medical and scientific information on the Internet favors a democratization of today's important knowledge. Active individualists and eclectic isolates—Margaret Cavendish might serve as their antique model—likely will proliferate as a result.

Medical Modernity as a Shotgun Marriage If the foregoing analysis is even partly correct, it suggests that the modern world, at least the world of bodily knowledge that can trace its origins to the Scientific Revolution and the Reformation, is not and has never been a unified whole. That is, in broad terms, the needs of all participants have not been parts of a structure that obeys one basic condition. Instead, the intellectual constructs of post-Reformation health and disease knowledge and practice may comprise a unity of sorts, but its unity resembles that of the shotgun marriage. In writing on structure from the perspective of gestalt psychology, Rudolf Arnheim describes the shotgun marriage version of a whole in terms of "separate structures, each consistent within itself but leaving in their fusion an unremedied flaw. The strivings of each partner are disturbed or impeded by those of the others. The tension created by the discord may lead to a more unified whole, but it may also produce an explosion. Obviously, the desirable and more interesting solution is one in which the needs of all partners are fitted to a whole, leaving them without unresolved tensions."14 Although Arnheim's desire for unresolved tensions may be plausible in terms of visual structures, I think those who wish for medicine to be at some level conceptually unified are naive. So are those who fear an explosion. It is true that until the past decade or so, biomedicine had valid reasons for representing itself in triumphalist terms. For a time after the Second World War, it seemed as though medical knowledge and technology would soon conquer both acute and chronic serious illness or, in the case of chronic illnesses, tame them. Bactericidal antibiotics, which began to appear widely in the 1940s with penicillin and streptomycin, and vaccines would take care of serious acute infections. In the meantime, drugs such as corticosteroids

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and insulin would forestall the devastation of chronic illnesses such as rheumatoid arthritis and diabetes mellitus. Technologies such as hemodialysis would step in to extend life when chronic illness eventually wreaked its havoc on an organ, such as the kidneys. Indeed, today biomedical apologists present new technologies like embryonic stem cell research in familiar triumphalist rhetoric. And why should they not? As everyone knows, biomedicine has much to celebrate. Nonetheless, we are more aware now than we were fifty or twenty years ago that high-technology medicine may relieve one kind of suffering—end-stage renal failure associated with diabetes mellitus, for example—only to permit another to emerge later—the slow and agonizing death that often accompanies aggressive treatment of multiple organ system failure associated with serious chronic illness. I just hope biomedicine becomes more aware that no matter what it accomplishes along the lines of extreme instrumental rationality,15 alternative approaches are not going to disappear. In biomedicine, unlike in Arnheim's visual structure, there is no "flaw" whose remedy will resolve the conflict between unlike conceptions because opposition is a vital part of the process that constitutes each of the disparate realities.

The Cerebral Body and Public Policy In any event, where and how does the cerebral body figure in this shotgun marriage of medical modernity? In terms of actual living bodies themselves, consider briefly as an example the controversy over the legal status of those in persistent vegetative states (PVSs), which is a condition in which the brain stem and end organs, unless otherwise damaged, maintain their vital functions and the cerebral cortex does not function. To be with a person in a PVS is to be with someone warm and pulsing and breathing and excreting and even, if young, growing, who nonetheless is regarded by some biomedical leaders as dead. Can one be simultaneously dead and alive and not Jesus? Yes, it seems, if one accepts that a functioning cerebral cortex is the sine qua non of human life. When the cortex goes, so the argument runs, then the body is dead, at least for legal purposes. Being dead but breathing and pulsing, the body is now eligible to be legally killed by physicians interested in taking its vital organs to place them into another human before the organs spoil. Two of the main characters in Spanish filmmaker Pedro Almodovar's recent movie, Talk to Her (Hable con Ella, originally), portray people ostensibly in PVSs, although one of them eventually wakes up. They look like normal people sleeping, which is how I have experienced some people in a PVS in real life, although others in a PVS appear to be seriously impaired and need more technology to survive. Recent bioethical focus on PVS patients and their status as humans who are both dead and alive extends earlier thought from the late 1960s concerning humans who have experienced whole-brain death but whose vital functions can be maintained artificially for indefinite periods. According to the Harvard Medi-


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cal School's Ad Hoc Brain Death Committee, whose 1968 report strongly influenced subsequent state laws concerning the legal status of people with nonfunctioning whole brains, the absence of whole-brain function was a more reasonable criterion of the end of life than was cessation of cardiopulmonary activity, which has been the existing criterion in almost every cultural tradition.16 Physicians and institutions interested in performing more organ transplants, a technology that developed rapidly from the 1970s on, have provided the main impetus for redefining the divide between human life and death from possession of a functioning heart to a functioning whole brain and now, perhaps, merely a functioning cerebral cortex. As might be expected, bioethicists express opinions on all sides. Regardless of one's ethical position concerning the deliberate killing of PVS humans by licensed healers to gain their vital organs to save the lives of other humans, I venture that aesthetically, many in PVS do not seem dead, especially to those subscribing to alternative approaches of diverse kinds. I wonder how historians 200 or 300 hundred years hence will regard this new definition of death and the activity it permits if it, in fact, commences. Will they see it as a continuation of some Enlightenment and utilitarian notions of progress and beneficence, or as a barbaric cultural ritual of human sacrifice, or a combination of the two? For a less melodramatic example of the puissance of the cerebral body, we might consider a relatively recent eugenics move by a leader of American biomedicine. Writing on "The Responsibility of the Individual" in 1977,17 physician John Knowles, who served as a leader at the Massachusetts General Hospital and the Rockefeller Foundation, discussed the need for pregnant women to use a thennew technology, amniocentesis, to detect the fetal presence of Down's syndrome. Knowles's overall focus in the article was on preventive medicine at the individual level. He assumed that if a woman knew her fetus had the genetic profile commonly known as Down's syndrome, she would, of course, obtain a therapeutic abortion. His tacit assumption was that any fetus with the genetic profile of Down's was less than legitimately human.18 I present these anecdotes not because I wish to engage in ethical debate here but rather to demonstrate two things: the influence of the cerebral model on public policy and law and the cerebral model's existence as a taken-for-granted piece of cultural furniture in biomedicine. Furthermore, I wanted to do so without recourse to examples drawn from the history of what is now known as psychiatry, which would be an obvious resource. Indeed, private madhouses first began appearing in England in the 1680s.19

Tracing Descartes Today In comparison to the influence on the biomedical present wielded by the cerebral model of Willis and his colleagues, Cartesian neurophysiology, at least in

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its strict sense, comes up a distant second. Nothing crucial these days depends on Descartes's beloved pineal gland, which contemporary medical students and neurologists may note only in passing as a midline cerebral structure. When Descartes's name is invoked at all in clinical medicine these days, often it is to fill a role of bogeyman for something alleged to be lacking in biomedicine's emotional and/ or cultural dimensions. In his recent book, Descartes' Error, physician and neurobiologist Antonio Damasio speaks for many when he blames a "Cartesian view of humanity" for "an amputation of the concept of humanity with which medicine does its job."20 By divorcing the mind from the body, the argument runs, Descartes has made modern medicine, in Damasio's words, "slow to realize that how people feel about their medical condition is a major factor in the outcome of treatment."21 Anthropologist Anne Fadiman's recent exploration of a tragic cultural collision between the family of a Hmong child with seizures and her Californian doctors, published in 1997 as The Spirit Catches You and You Fall Down, provides an example of how commonplace medical disparagement of Descartes has become. While explicating the gulf between Hmong cultural perspectives and those of biomedicine, Fadiman in her concluding chapter out of the blue invokes Descartes as the cause: "Of course, the Lees' perspective might have been as unfathomable to the doctors as the doctors' perspective was to the Lees. Hmong culture . . . is not Cartesian. Nothing could be more Cartesian than Western medicine."22 Such casually invoked dismissals—Fadiman does not mention Descartes otherwise—do not do either the issues or the historical Descartes justice. Other influences, some of which this book has discussed, come into play, and blaming Descartes for biomedicine's alleged lack of cultural and psychological richness may divert attention from more salient factors. Also, such characterizations are not accurate in terms of Cartesian medicine. As far as I am aware, Descartes's modern-day medical critics, who cite only his philosophical writings, do not refer to Descartes or his associates' medical texts or the written traces of Descartes's amateur practice of medicine by correspondence. Some neurobiologists mount a related but distinct critique. According to Damasio: This is Descartes' error: the abyssal separation between body and mind, between the sizable, dimensioned, mechanically operated infinitely divisible body stuff, on the one hand, and the unsizable, undimensioned, un-pushpullable, nondivisible mind stuff; the suggestion that reasoning, and moral judgment, and the suffering that comes from physical pain or emotional upheaval might exist separately from the body. Specifically: the separation of the most refined operations of mind from the structure and operation of a biological organism.23

In making the above indictment, Damasio, like others who find similar fault, begins by citing Descartes's (in)famous line "I think therefore I am" from his Discourse on Method of 1637 and Principles of Philosophy of 1644. For Damasio, "Taken literally, the statement illustrates precisely the opposite of what I believe to be true about the origins of mind and about the relation between mind


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and body." Indeed, he continues, "Versions of Descartes' error obscure the roots of the human mind in a biologically complex but fragile, finite, and unique organism."24 Although the boldness of some of Descartes's assertions on mind and body—and in the history of philosophy little is bolder than "I think therefore I am"—invites bold counter-assertions, a subtler response would be more apposite. As I noted in Chapter 6, in Descartes's Passions of the Soul, which was first published in 1649 shortly before his death, Descartes repeatedly suggested the interdependence of passions, perception, and the mind. At that stage he thought perceptions ". .. for which we do not normally know any proximate cause . . . are aroused in us sometimes by the objects which stimulate our nerves and sometimes also by other causes."25 What Damasio and others seeks to establish in place of the assumption of a simplistic mind-body dualism is a conviction, in Damasio's words, "that the comprehensive understanding of the human mind requires an organismic perspective; that not only must the mind move from a nonphysical cogitum to the realm of biological tissue, but it must also be related to a whole organism possessed of integrated body proper and brain and fully interactive with physical and social environment."26 Damasio's "organismic perspective" echoes Walter Cannon's earlier twentieth-century concept of homeostasis, which he defined, like Damasio, in environmental terms. In Descartes' Error, however, Damasio does not go as far in the environmental direction as Cannon, whom he does not cite. At the end of Wisdom of the Body Cannon outlines an expansive social homeostasis in terms of a socialist Utopia. Instead, Damasio puts forward the seemingly modest hope that neurobiology's "gradual accrual of knowledge about human beings can help us find better ways for the management of human affairs."27 Although Damasio's language is modern, the social goal it expresses harks back to that of Willis and his High Church allies. However, Damasio, who like Willis seeks to make mind adhere to brain, differs from him in his desire to put emotion on a biological par with reason. Such a move recalls, inadvertently I think, Aristotelian and Galenic notions of a cognitive emotion, which I touched on in earlier chapters; indeed, Damasio opens his "Postcriptum" with a section entitled "The Human Heart in Conflict." Citing poet Paul Eluard's (1895-1952) poem "Liberte," which Eluard wrote during World War II when he was a member of the French Communist Resistance, Damasio uses the heart analogy to express his optimism that "deeper knowledge of brain and mind will help achieve the happiness whose yearning was the springboard for progress, two centuries ago."28 In the notes he commends the writings of biologists Jonas Salk and Richard Lewontin for expressing similar affirmations for a "comprehensive human biology."29 Significantly, Damasio expresses his enthusiasm for a neurobiological version of the Enlightenment with only passing mention of possible unspecified social "risks" that are in any case minor compared to the "enormous risks in not doing anything."30

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Even though Damasio includes social and environmental perspectives as desiderata for neurobiology, he and his colleagues are fully committed to the notion that biology, especially neurobiology, drives culture, and in a good direction: "The immune system, the hypothalamus, the ventromedial frontal cortices, and the Bill of Rights have the same root cause."31 Were Descartes alive, I doubt he would agree. He might well have argued to the contrary. After all, he was determined philosophically to preserve a conceptual space for human nature that was outside what is now called biology. And despite his self-promotional cultivation of collegial networks, a common activity then and now for ambitious intellectuals, he did not publish explicitly political texts. The construction of Utopia, a project that appealed to contemporaries such as Thomas Hobbes, seems not to have engaged him. I remain skeptical of the social wisdom of neurobiological Utopias on multiple counts, though for space reasons I will cite just two here. First, I am not persuaded that human nature's trajectory, if you will, always proceeds from the biological to the cultural and social, as Damasio's quote above asserts. Humanities and social science perspectives, some noted earlier, suggest otherwise. Second, I remain fearful of scientistic Utopias, by which I mean deterministic material conceptions that also seek to be totalizing social frameworks. Science is the product of scientists, to be sure, and within that tight limit it may be ideologically more or less neutral. But scientists, like other professionals, require financial patronage, and patrons, whether political or entrepreneurial, will have their say. It is likely that not all of manifestations of patron interest will be beneficent. Even more darkly, Western society has experienced several scientistic Utopias since the Enlightenment, and the most extensively realized have been moral, social, and cultural disasters. Would a large-scale biological or neurobiological Utopia necessarily— and that is the key word—fare differently? If Descartes figures in present-day medicine largely in negative terms, he exists in cognitive science, the interdisciplinary matrix of thought collectives that bridges neuroscience, cognitive philosophy, and computing science, as a foundational figure. Not surprisingly, they cite his simultaneous embrace of logic and mathematics as primary tools for understanding nature as the philosophical anchor for their early characterizations of cognition in the cybernetics era of the 1940s and 1950s. In their seminal paper 1943 paper, "A Logical Calculus of Ideas Immanent in Nervous Activity," Walter Pitts and Warren McCulloch proposed two hypotheses about the brain and mental activity that shaped early investigation in Cartesian terms: first, they asserted that logic was the proper discipline for analysis and second, that the brain's neurons acted upon logical principles.32 In 1956 others, including Herbert Simon, Noam Chomsky, Marvin Minsky, and John McCarthy, amended earlier formulations by arguing that intelligence in essence could be described as computations of symbolic representations, which shortly became the hypothesis that cog-


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nition occurred through the brain's manipulation of symbolic codes. Contemporaneous developments in computer technology provided an apt mechanical model for how mental operations, so framed, might take place. Moreover, early cognitivists had Descartes in mind as they framed their disciplinary outlook. Chomsky, for example, referred in the 1960s to his own rationalist program for language generation as a "Cartesian lingistics."33 Since then, cognitive science has grown enormously in many dimensions, but its major moves from artificial intelligence through systems theory to connectionism can easily trace their conceptual origins to the early propositions (and their intellectual cousins) noted above. Philosophers interested in representation and cognition from the early twentieth century onwards readily have acknowledged Descartes as an intellectual parent. In 1913, for example, Edmund Husserl (1859-1938) described his version of phenomenology as a "twentieth century Cartesianism."34 In his pithy assessment of the intellectual origins of cognitive science, cognitivist Jerry Fodor agrees: "In intellectual history, everything happens twice, first as philosophy and then as cognitive science."35 Expanding on Fodor's comment, philosophers Francisco Varela, Evan Thompson, and Eleanor Rosch declare: "Were we to entertain the idea that there is no hard and fast distinction between science and philosophy, then philosophers such as Descartes, Locke, Leibniz and Hume, Kant and Husserl. . . could be seen . . . as proto cognitive scientists."36 But Descartes also left cognitive science with an ongoing issue that does not admit of easy resolution. Descartes's crucial move, according to some presentday cognitive philosophers, was his premise that ideas did not exist solely in the mind of God, which was the traditional Christian position, but that ideas also referred to the operations of the human mind.37 According to philosopher Richard Rorty, by doing so Descartes invented the "mind as a mirror of nature,"38 a development that continues to generate serious tension today about the character of human perception. According to Varela et al: This feeling of (Cartesian) anxiety arises from the craving for an absolute ground. When this craving cannot be satisfied, the only other possibility seems to be nihilism or anarchy. The search for a ground can take many forms, but given the basic logic of representationism, the tendency is to search either for an outer ground in the world or an inner ground in the mind. By treating mind and world as opposed subjective and objective poles, the Cartesian anxiety oscillates endlessly between the two in search of a ground.39

For Varela and others, the difficulties in cognitive science of finding a place for human experience turn on "our grasping after a ground, whether inner or outer" for the embodied human mind.40 To me this sounds like a version of the cleavage between likeness and presence I have explored in previous chapters. As I noted above, neurobiologists such as Damasio seek to resolve this dilemma by advancing a "comprehensive biology" whose intentions are ultimately therapeutic at the individual and social levels. In comparison, cognitivist philosophers

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such as Varela et al. insist that they "are not dependent on neuroscience to validate experience," a project that Varela et al. characterize at one point as "scientific imperialism."41 Varela et al. propose instead the quietist path of individual meditation according to the Madhyamika or "middle way" school of the Buddhist tradition.42 Setting aside the merits of electing a particular form of resolution, Madhyamika, one is left with a widely felt conviction among current cognitive philosophers of the need to find ways for "the new sciences of mind . . . to enlarge their horizon to encompass both lived human experience and the possibilities for transformation in inherent in human knowledge."43 They seek, in other words, pragmatic ways to open conceptual spaces whereby humans can "see our bodies both as physical structures and as lived experiential structures"—in short, as both "outer" and "inner," biological and phenomenological.44 Now that, I submit, is a sentiment Descartes, were he alive, might share. Whether it is conceptually possible for the culture of science, including biomedicine, to accept such a proposition remains an open question, however. On its face, reconciliation of proposals for "comprehensive biology" of human minds and bodies, however ecumenically they may be packaged, seems not possible with a philosophical position that divides human knowledge in its broad sense into the biological and phenomenological. Prior to the Scientific Revolution and the Protestant and Catholic Reformations—movements that dwarf in importance the contributions of any one person, including Descartes—one might argue that likeness and presence, which I have been using as conceptual forerunners in some ways for biology and phenomenology, were not too far apart. Indeed, their boundaries overlapped in many places. But the gradual transformation of natural philosophy into science that this book has explored—the Scientific Revolution as it pertained to the human body—was predicated partly on likeness being a category of experience and knowledge that differed fundamentally from experience and knowledge of presence. Recent calls for a "comprehensive" human biology carry the suggestion of something even more ambitious for likeness: that its explanatory power surpasses presence or should at some unspecified future time be capable of subsuming presence.

Conclusion I want to close by restating my premise that I have considered a particular set of physiological ideas hand-in-hand with analysis of their context of production. I have been inspired in this by the work of social and cultural historians but also by ethnographers and anthropologists of contemporary Western culture. Although they wrestle with their own methodological conundrums, anthropologists from Franz Boas and Ruth Benedict forward have been willing to take on the task of understanding a remote group as both strange and meaningful in its own terms. Everything is open to inspection and little is taken for granted. In exploring the cerebral


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body's origins, that has been my operational goal as well. From his anthropological perspective, Geertz provides an apposite mission statement for my intentions: Our ideas, our values, our acts, even our emotions, are, like our nervous system itself, cultural products—products manufactured, indeed, out of tendencies, capacities, and dispositions with which we were born, but manufactured nonetheless. Chartres is made of stone and glass. But it is not just stone and glass; it is a cathedral, and not only a cathedral, but a particular cathedral built at a particular time by certain members of a particular society. To understand what it means, to perceive it for what it is, you need to know rather more than the generic properties of stone and glass and rather more than what is common to all cathedrals. You need to understand also—and, in my opinion, most critically—the specific concepts of the relations among God, man, and architecture that, since they have governed its creation, it consequently embodies. It is no different with men: they, too, every last one of them, are cultural artifacts.45 I hope I have shown you in this book something of how and why we in the West have the bodies and minds we think we have, and some of their crucial features. Then I have attempted to demonstrate why others, even many in our midst, might not share the conventional wisdom that the dominant model—the cerebral body—is transcendentally real. For some the cerebral body may be like Geertz's Chartres, a unique and glorious expression of humanity, but nonetheless but one version among other possibilities. If so, then even about something as basic as the human brain and nerves, we might say without irony, as did Ludwik Fleck, a bacteriologist and philosopher of science who wrote in 1935: "In science, just as in art and in life, only that which is true to culture is true to nature."46 Notes 1. Walter B. Cannon. The Wisdom of the Body. (London: Kegan Paul, 1932), p. 234. 2. Clifford Geertz. The Interpretation of Cultures. (New York: Basic Books, 1973), p. 48. 3. Gilbert Ryle. Collected Papers, vol. 2, Collected Essays, 1929-1968. (London, 1971), p. 465-96. See also Stephen Greenblatt. "The Touch of the Real." representations 59 (1997): 14-29. 4. Geertz. Interpretation of Cultures, 9. 5. David Eisenberg, Ronald Kessler, Cindy Foster, et al. "Unconventional Medicine in the United States." New England Journal of Medicine 328 no. 4 (1993): 246-52. 6. Edward Campion. "Why Unconventional Medicine?" New England Journal of Medicine 328 no. 4 (1993): 282-3. 7. Arthur Kleinman, "What Is Specific to Western Medicine?" Companion Encyclopedia of the History of Medicine. (London: Routledge, 1993), vol. 1, p. 18. 8. Anonymous. The Method of Chemical Philosophy and Physick, introduction (London, 1664), Huntington Library CH 474249. 9. Sheldon Krimsky. Science in the Private Interest. (Lanham, MD: Rowman and Littlefield, 2003). 10. Mary Douglas. Thought Styles. (New York: Basic Books, 1979; reprint, London: Sage, 1996), p. 43. (Page citations are to reprint edition.) 11. Ibid., 41.

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12. Ibid., 42. 13. Ibid., 42. See also Mary Douglas and Baron Isherwood. The World of Goods: Towards an Anthropology of Consumption. (London: Routledge, 1996). 14. Rudolf Arnheim. The Split and the Structure. (Berkeley: University of California Press, 1996), p. 4. 15. Byron J. Good. Medicine, Rationality, and Experience. (Cambridge: Cambridge University Press). 16. Henry Beecher, Raymond Adams, A. Clifford Barger, et al., "Report of the Ad Hoc Committee of the Harvard Medicine School to Examine the Definition of Brain Death," published as "A Definition of Irreversible Coma," Journal of the American Medical Association 205 no. 6 (5 August 1968): 85-8. Gary S. Belkin, "Brain Death and the Historical Understanding of Bioethics." Journal of the History of Medicine 58 (2003): 325-361. 17. John Knowles. "The Responsibility of the Individual." Daedelus 106 (winter, 1977): 57-80. 18. Michael Macdonald. Mystical Bedlam. (Cambridge: Cambridge University Press, 1981); Jonathan Andrews and Andrew Scull. Undertaker of the Mind: John Monro and Mad-Doctoring in Eighteenth-Century England. (Berkeley: University of California Press, 2001). 19. Antonio R. Damasio. Descartes' Error: Emotion, Reason, and the Human Brain (New York: GP Putnam, 1994), p. 255. 20. Ibid. p. 256. 21. Anne Fadiman. The Spirit Catches You and You Fall Down (New York: Noonday, 1997). 22. Damasio. Descartes' Error, pp. 249-50. 23. Ibid. p. 248. 24. Ibid. p. 251. 25. Rene Descartes. "Passions of the Soul, " in Philosophical Writings of Descartes, trans. John Cottingham, Robert Stoothoff, and Dugald Murdoch. (Cambridge UK: Cambridge University Press, 1999). pp. 373-88. 26. Damasio, Descartes' Error, p. 252. 27. Ibid., p. 254. 28. Ibid., p. 253. 29. Ibid., p. 291 n. 3. Note 3 mentions writings of Lewontin and Salk "cited above," but I cannot find citations to specific works. In the "Further Reading" section of the book, Damasio lists Richard Lewontin. Biology as Ideology; the Doctrine of DNA (NY: Harper, 1991) and Jonas Salk. Survival of the Wisest (New York: Harper Row, 1973) and idem. The Anatomy of Reality (New York: Praeger, 1985). 30. Ibid., p. 254. 31. Ibid., p. 262. 32. Warren S. McCulloch and Walter Pitts. "A Logical Calculus of Ideas Immanent in Nervous Activity." Bulletin of Mathematical Biophysics 5. Reprinted in WS McCulloch. Embodiments of Mind (Cambridge MA: MIT Press, 1965). Francisco J. Varela, Evan Thompson, and Eleanor Rosch provide a concise historical outline of cognitive science, including McCulloch's foundational position, in chapter 3 of their The Embodied Mind: Cognitive Science and Human Experience (Cambridge: MIT Press, 1991). 33. Howard E. Gardner. The Mind's New Science: A History of the Cognitive Revolution (New York: Basic Books), ch. 5. Cited in Varela et al, Embodied Mind, p. 40.


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34. Edmund Husserl. Ideas: General Introduction to a Pure Phenomenology, trans. WR Boyce Gibson (London: Allen and Unwin, 1931). Cited by Varela et al. Embodied Mind, p. 17. 35. Jerry Fodor. "The present status of the innateness controversy." in idem. Representations: Philosophical Essays on the Foundations of Cognitive Science. (Cambridge: MIT Press, 1981), p. 298. 36. Varela, Thompson, Rosch, The Embodied Mind, p. 21. 37. Ibid., p. 141. 38. Richard Rorty, Philosophy and the Mirror of Nature (Princeton: Princeton University Press, 1979). 39. Varela, Thompson, Rosch, The Embodied Mind, p. 141. 40. Ibid., p. 141. 41. Ibid., p. xix. 42. Ibid., Introduction and Section 4. 43. Ibid., p. xv. 44. Ibid., pp. xviii-xix. 45. Geertz, Interpretation of Cultures, 51. 46. Ludwik Fleck. The Genesis and Development of a Scientific Fact, trans. Fred Bradley and Thaddeus Trenn (Chicago: University of Chicago Press, 1979), p. 35. (Published originally in German in 1935.)


Index

Page numbers followed by "f" indicate figures.

Aasparo, Luis Amendolla, 201f Abortion, therapeutic, 209 Academic Royale des Sciences, 180 Achilles, 130 Acid-alkali reaction, van Helmont, 31 Adam, in new physiology of reason, 158 Advancement of True Religion, Act of, xxiv Agamemnon, 130 Air, as element, 12, 31 Air-pump, Boyle's, 193 Alchemical healers and blood, 24 petition for royal charter, xxvii, 39-40, 111 Alchemical imagery, in Willis, 89 Alchemical mystics, and new natural philosophers, 176 Alchemical schemes, of stomach and spleen, xxiii Alchemical theory and F. Bacon, 28-30 and More, 28 and Oxford physiologists, 39 Paracelsian, 2, 26-28, 117 and radicals of mid seventeenth century, 118 during Restoration, 39 and spirit, and God's presence in, 3 and Willis, 118

Alchemists, 30, 115, 188 Alchemy and blood and heart, 25, 26 and Christianity, 18 and new natural philosophy, 26 and Willis, adeptness in, xxvi Allestree, Richard, 112, 119-120 The Ladies Calling, 119 The Whole Duty of Man, 119, 120 Allestry (Allestree), James, 120 Almodovar, Pedro Talk to Her, 208 Alternative healing, 200, 203-207 Alternative health approaches, and Greens in Western Europe, 205 Alternative medicine, vi Alternative perspectives, to cerebral body model, 204 Alternative philosophies, 170 Amniocentesis, 209 Anatomical knowledge. See Knowledge, anatomical Anatomies. See also Anatomy, Autopsy, Dissection, and Postmortem subjects of, 103, 106-107 by Willis, 99 Anatomies, as literary genre, x

219

220 Anatomists Alexandrine, 96 and new natural philosophy, 108 Sydenham's critique of, 180-181 Anatomy. See also Anatomies, Autopsy, Dissection, and Postmortem Bacon on, xxv, 1 and Barber-Surgeons, 102 and Boyle, 191 in Christian terms, 97 demonstrations, 99-101, 188 without dissection, 10 of Hammond, by Willis, 112 and Harvey, xxv, 105 and knowledge, 95-96 and Locke, 182-183, 191 meaning of, ix-xi, xxiv, 2 rationalist, decline of, 189 Steno on, 179-180 andSydenham, 182-183, 191 theaters, xxiv, 99-100 and Vesalius, 61 Willis on, 80 Anatomy Act of 1832, 101 Anatomy, comparative and Aristotle, 5 and Galen, 5, 6, 15 Steno on, 179-180 and Vesalius, 50 and Willis, 81-83, 82f, 87, 88, 138, 139 Andres, Richard, 102 Angels, 81, 137 Anglican bishops, and Restoration, 111 Anglican, High-Church clergy, and arguments about social body of England, 87 conduct guides, 119-120 on cultural map, 206 "habit of reason," as aid to conversion, 119 orthodoxy of, and hegemony in 1660s, 118 and Oxford physiologists, background of, 109 proper living and dying, 119 in Restoration, 109-121 and Willis's cerebral body model, 118 Anglicans, High-Church as bodies for anatomies, 103-104, 106107 Anitna, 137 Animal injection experiments, 40 Animal spirits. See Spirits, animal Animate and inanimate forms, x, 29, 36, 56

INDEX Animus, 137 Animus spiritus, 130. See also Holy Spirit Annunciation, 130 Antibiotics, 207 Antiochus of Ascalon, 12 Apothecaries, 40 Aquinas, St. Thomas, ix, 13, 114 Archei, 27 Archeus, 31-32 Aristocracy, bodies of, 104 Aristotle and Aquinas, ix and brain, as coldest part of body, 14 cardiocentric model of, 137-138 on cause and natural philosophy, 5, 179 and dissection of animals, 5 on the heart, xxiii, 13-14 on heart as organ of perception, 147 on heart and soul, 16 and humoralism, 11, 148 and influences on Boyle, 97 Descartes, 134 Galen, 137 Gassendi, 137 Harvey, 23, 186 Willis, 76 on liver, of little importance, 14 on memory, 146, 146n74 and natural philosophy, ix, 4-5 and noble parts, 13 Physics, 111 Aristotelian theory, of male and female differences, 154-156 Arnhein, Rudolf, 207, 208 Arteries, 15-16 Arthritis, 208 Artifice, 83 Artificial intelligence, 213 Ashmole, Elias, 36 Astell, Mary, 161 Asthma, 141 Astrology, 12, 15 Ate, 130 Atheism, 115-116 Atomic philosophy, 32-33, 34 Atomism, 25, 26, 39 Augustine, St., 27 Autopsy, 102, 105. See also Anatomies, Anatomy, Dissection, and Postmortem Avicenna, 47 Ayurvedic thought, Indian, 11, 95, 96, 96n4, 97

INDEX Bacon, Francis on animate and inanimate, no distinction between, x, 29 on artifice, human, 83 and brain, ventricles of, 30 on dissection and anatomy, understanding with, xxv, 1 Great Instauration, 29 The Greatest Birth of Time, 157 Historia Vitae et Mortis, 29 The Masculine Birth of Time, 157 matter-spirit theory of, 28-30 Natural History in Ten Centuries, x on nature, 156-157, 157n23 and nature (female), interrogations of, 169 Novum Organum, 29 and ocular demonstrations and experiments, 178 and Oxford group, 29 and Paracelsus, similarities and differences with, 30 and Sharrock, 31 Solomon's House Utopia, 30, 180 "De Viis Mortis," 28-30 Bacon, Sir Nicholas, 101 Bacon, Robert, 105, 108 Baillet, Adrien, 54 Barber-Surgeons Company, 100, 101, 102 Bartholin, 165 Bartisch, Georg On the Care of the Eye, 91 Bates, Don, 37 Bathurst, Ralph, 40, 76, 109, 140-141, 162 Baxter, Richard, 118 Beardman, John, 177 Belting, Hans on Christian scripture and images, xxivnl on images, 4 on presence and likeness, in Reformation, 3 Benedict, Ruth, 214 Benivieni, Antonio Hidden Cause of Disease, 106 Bernard, Claude, 193-194 Bible. See also God, Book of as Book of God, separate from Book of Nature, 10-11 Calvin on, xxiv, 9 distribution of, 115, 207 in Hippocratic humoral model, 12 New Testament of, 189 reading of, limited to believers and elite men, xxiv Biology, 200, 211-214, 212n32

221 Biomedicine. See also Medicine, Western and body and mind, accounts of, 204 as Cartesian, 210 and Cartesian neurophysiology, 209-210 and Chinese medicine, traditional, 204 cultural vision of, 202 definition of, v, vnl and knowledge, sole guarantor of, 202 and rationality, instrumental, 208 as a science, 199, 202, 204, 205, 207 triumphs of, 207-208 Western, 95 and whole person, dim apprehension of, 203-204 witnessing and reproducibility, reliance on, 96 Biomedical-industrial complex, 205 Black bile, 12 Blood and alchemical healers, 24 and Alexandrians, 16 and Cartesians, theories of, 38 and Descartes, 59-60, 132 and Galen, 16 and Harvey's model of circulation, 24, 35, 186 van Helmont's conception of, 31, 32 Highmore on, 161-164 in Hippocratic humoral model, 12 and hysteria, 162-165 and Oxford physiologists, 35, 37, 38 primacy of, 23-24 and Sydenham, 185 as thing-in-itself, 40-41 and Willis and circulation in brain, 83, 84, 85, 105 impurities of, as cause of death, 143 Blood and body in Christianity, 97 Conway on, essence of, 168 Blood experiments, 33-34, 39 Blood and ferment, in Cartesian model, and Oxford group, 37-38 Willis and Highmore on, 162 Willis's theory of, 91 Blood and heart Harveian and Cartesian models of, 33 Harvey on, 23 Highmore on, as spirited elements, 163 Lower on, 34 vital soul of, 42 Willis's attachment to, 136 Blood, menstrual, 155, 156

222 Bloodletting, 32, 37, 185 Boas, Franz, 214 Bodies of aristocracy, anatomies of, 104 Bodin, Jean, 116 Body in cerebral body model, as fluid and submissive, 169 in Christianity, divinity of, xi Conway on, 167-168 cultural transition of, 131 images of, 2-3 meaning of, xi, 1 Plato on, as source of trouble, 137 structure and function of, 96 Body and blood, in Christianity, 97 Body and head, theme of English life, 117 Body, human care of, disagreement about, 203 medical knowledge of, 178 in Willis's Anatomy, as non-sexed, 160 Body and mind in biomedicine, accounts of, 204 and culture, 215 and Descartes, relationship of, 52, 53, 55, 57 and Gassendi, and God relations, 137 separation of, 210-211 and Willis, and God relations, 137 Body and soul and Descartes, distinction of, 132 framework of, 137 Boehme, Jacob De Signatura Rerum, 36 Book of God. See God, Book of Book of Nature. See Nature, Book of Bostocke, Robert, 27 Botany medicine akin to, 190 Sydenham on, as reliable knowledge, 181 Boyle, Robert as aristocrat, 188 and Aristotle, 97 on books of nature and God, 97-98, 98n6 Certain Physiological Essays, x and Conway, 166 against cosmological claims about natural investigators, 35 and experiments, 29, 31-32, 33-34, 40 and Harvey, 97 and van Helmont, 97 and Hobbes, debate about air-pump experiment, 193 and mechanist theories, 117 and More, 28

INDEX and natural theology, espousal of, 190 and Paracelsus, 27, 97 and phosphorus, 42 on physiology, ix-x The Sceptical Chemist, ix on structure and matter, xi and texts on blood, 35 on therapy through chemistry, less interest in anatomy, 182 and transfusions, support of, 41 Uncertain Art of Physick, dedicated to, 108 Boyle's air-pump, 200 Brain alternative perspective of, not as distinct thing-in-itself, 204 in anatomy, present-day, visual aid, 200, 202, 201f Aristotle on, 14 in cerebral body model, solid and dominant, 169 Crooke on, as having dignity, xxv Damasio on, knowledge of, and happiness, 211 and Descartes, wonder located in, 134 dissection of, 50 dissections of, critique of Willis, by Steno, 179 Galen on, 15, 16 in anatomical triumvirate, xxiii heating and cooling properties of, 84 model of, three-cell, 47-48 and senses and cranial nerves, proximity to, 84 Gassendi on, as location of rational soul or mind, and fantasy and imagination, 137-138 Hippocrates on, as messenger of understanding, 14 in Hippocratic texts, 84 and logical principles, acting upon, 212 and medieval and Renaissance conceptions of, 47, 48f Plato's description of, 84 and reason, seat of, 137 removed from skull, shape not retained, 107 as solid tissue, 140 Sydenham on, as example of "Supreme Artificer in his wondrous and wise machinery," 180 Varolio, depiction of, outside skull, xxiv whole, cessation, as criterion for death, 209 and Willis illnesses in, 118

INDEX images of, long accepted, 108-109 material connections with blood and mind, 105 model of, 139-140 pathology of, 141-148 project of, 135 out of skull, 83 as solid, 84, 85, 86, 105 solid parts paramount, 154 Willis's circle in, 200 Brain and cranial nerves, and Willis, xxvii, 161 Brain Death Committee, Harvard Medical School's, 208-209 Brain and Descartes, 59-60, 60f, 61, 62, 6364, 63f, 65f, 68, 69, 69f Brain and heart, Crooke on, 16 Brain, illustrations of by Descartes, 60f, 63f, 65f, 69f in 1500s, early 1600s, 47-51, 48f, 49f, 51f present-day, "Inferior View," by Aasparo, 201f in Willis's Anatomy of foolish youth's, 145f human, 77f sheep's, 82f Brain and mind, accounts of, in biomedicine, 204 Brain and nerve doctrine of Restoration, 121 of Willis, 76 models of Willis, 78-79, 86, 87-90 Brain and nerves governing women's bodies, 153-154 learned medicine's elevation of, 160 and new natural philosophy, 112 Brain structure, of Willis, 78, 80-81, 84, 86-87 Brain, ventricles of Bacon on, 30 in humoral theory, as container, 13 Plato on, 84 Willis on, unimportance of, 85 Braine, in "Nature's Oven," Cavendish, 159 Brandenburg, Margrave of, 7 Buddhism, 97, 214 Burial, 101, 103 Burnet, Bishop, 110 Burton, Robert, x Butler's stone, 182 Butterfield, Herbert, 2

223 Callous body. See Corpus callosum Calvin, John on Bible and images, xxiii-xxiv and husk and kernel analogies, use of, 181 Institutes of the Christian Religion, 1 on religious imagery, 9-10 and Sydenham, echoed by, on nature as "abyss of cause," 190 Calvinism, 113, 114, 115 Calvinist absolute scriptural authority, opposed by Hooker, 191 Cambridge University, 190 Campion, Edward, 203 Cannon, Walter B., 199-200 Wisdom of the Body, 211 Capitalism, and Protestant values, Weber on, 117 di Capria, Leonardo Uncertain Art of Physick, 108 Cardiocentric model. See also Heart of Aristotle, influence on Gassendi, 138 Cardiocentric physiology, of ancient Greeks, 147 Carey, Henry (second Earl of Monmouth) Natural History of the Passions, 107, 107n59 Carlino, Andrea, vii da Carpi, Berengario, 61 Cartesian. See also Descartes linguistics, 213 neurophysiology, and biomedicine, 209210 philosophy, and orthodox theological concern, 115 physiology and experimentation, weakness in, 38 of heart and blood, 33, 38 and heat, attention to, 37-38 Cashin, Conlan, 187 Cathars, ix Catherine of Braganza, 116 Catholic Church, xxvii, 3 Catholic humanist tradition, 114 Catholic studies of nature, in thirteenth century, ix Catholicism, and Charles II, 116 Cause exhaustion with search for, 190 and Locke, 183, 193 and medicine and natural philosophy, challenged in, 179, 182 and structure, 193 and Sydenham, and nature, and usefulness in medicine, 180, 183-184

224 Cavendish, Margaret (Duchess of Newcastle) on dissection to advance medical knowledge, 98-99 as isolate, active, individualist, and eclectic model, 207 on male character, shift in ideology of, 158 on microscopy, disparagement of, 106 on natural philosophy, xxvii, 169-170 "Nature's Oven," 159 and Newcastle, Duke of, praise for, 158 Philosophical Letters: or Modest Reflections upon Some Opinions in Natural Philosophy, xxvii on refinement linked to frailty, 104 on university and professions closed to women, 160 on women, as capable of learning as men, 159 Cellier, Elizabeth, 160 Celsius, 11 Censorship, English, collapse of, xxvi Cerebellum in Vesalian imagery, 50, 5If and Willis and cerebral hemispheres, 86-89 and hard frame of, harder to learn music, 138 and orbicular prominences and annular protuberance of, 139 Cerebral body model alternative perspectives to, 204 in biomedicine, 209 on cultural map, 206 of hysteria, 164-165 and medical modernity, 208-209 not for unlearned and vulgar, 107 as one vision among other possibilities, 215 origins of, vii, xi persistence of, 200-202, 20If and public policy and law, influence on, 209 and Restoration, 106 and solid brain, dominance of, over fluid body, 169-170 and spirit, control of, 204 as unsexed, 160-161 and Willis, 118, 148, 154, 191-194 Cerebral cortex alternative perspective of, not as distinct thing-in-itself, 204 Cannon on, nerve connections in, and cerebral hemispheres, and superior intelligence of man based in, 199

INDEX functioning of, divide between life and death, 208, 209 for integrity of mind, sound functioning of solid tissues of, v in persistent vegetative states, not functioning, 208-209 and Willis and cranial nerves, gender differences in, 154 dominance over rest of brain and lower body, 91 passions subservient to, 121 and reason, model of, 140 Cerebral hemispheres and Cannon, superior intelligence of man based in, 199 and Willis bodily primacy of, xxvii as castle, with towers of defense, 81 and cerebellum, 86-89 on Conway's, as besieged by convulsive tempers, 166 and cranial nerves, primacy of, 135, 138, 140 Cerebrum Descartes's use of term, 63-64 Willis on, as "chapel of the Deity," 98 Cerebri, as brain, 78 Chamberlen, male midwives, 160 Chandler, John, 35 Changelings, 144, 146 Charles I, King, xxv, xxvi, 23, 52, 110 Charles II, King and anatomy lectures by Ent, 104 and Catholicism, 116 death of, xxvii fickleness of, 118 and Helmontian healers, 111 and Hobbes, 24 and King, 108, 110 and natural philosophy, interest in, especially chemistry, 38, 111 and Newcastle, Duke of, 158, 159 and Restoration, xxvi and Sheldon, 111 and Uniformity, Act of, 111 Charleton, Walter, 35, 36 Chemical Philosophy and Physick, Method of, 187, 204 Chemical (Chimical) Physicians, Society of, 39-40, 111 Chemistry, 118 Cheyne, George, 161, 194

INDEX Chillingworth, William The Religion of Protestants a Safe Way of Salvation, 120 Chomsky, Noam, 212-213 Christ, Jesus, 97, 98, 131, 168. See also Jesus Christian mystics, 115 Christianity, xi, 18, 97, 130, 188-189 Church of England and Anglican reason vs. Puritanism reform, 113-114 as Calvinist, 113 during Interregnum and Restoration, 176 and King James II, xxvii Circle of Willis, 81 Civil War. See English Civil War Clement I, Pope Ad Corinthios Epistola, 120 Clerselier, Claude, 57 Clowes, William, 28 Clubfoot, 147, 147n76 Clynton, Lady, 165 Clysters (enemas), 165 Coga, Arthur, 41 Cognitive science, and Descartes, 52 Cognitive science and philosophy, 212-213, 214 Colbert, Jean-Baptiste, 180 College of Physicians and anatomy demonstrations, 100, 104, 118 and apothecaries, 40 and Charles II, 104, 118 and Conway, 166 and drugs, approved formulary of, xxv, 28 and Glisson, commission to write on liver, 90 and knowledge accumulated by members, 30 and midwives, opposition to incorporation of, 160 as model for healing nation ravaged by disputes, 117 as state-sponsored institution of research, 203 and Sydenham as licentiate, 187 Colombo, Realdo, 11 De Re Anatomica, 106 Common sense, 47, 156 Communion, Christian, 97 Comparative anatomy. See Anatomy, comparative Complementary approaches to healing, 203. See also Alternative healing Complexio, 12-13 Computing science, and Descartes, 212-213

225 Conduct guides, 119-120, 134, Constitution, Sydenham on, 184 Constitutional model, 189, 190, 192-193 Conversion, 115, 119 Convulsive disease, 141-146, 153 Conway, Lady Anne alternative vision, persistence of, 207 and blood, primacy of, 24 burial directions, 169 and Christian mystics and enthusiasts, 115 experience of world, not as cerebral body explained, 204 and Fox, 168 and Harvey, 169 and headaches and natural philosophy, 166-169, 170 on metaphysics of matter, 177 and More, 169 and Willis, 169 Conway, Edward, 182 Cook, Harold, 40 Cooper, Lord Anthony (Earl of Shaftesbury), 118, 181 Copernicus, Nicholas, 2 Revolutions of the Heavenly Spheres, xxiv, 6-7 Coroners' courts, 103 Corpse bleeding, if touched by killer, 103 burial of nobles', in parts, 101 division of, 104 embalming of, 104 Corpus callosum, and Willis, 86, 119, 146 Corticosteroids, 203 Cowley, Abraham "Ode to the Royal Society," 157-158 Cranial nerves primacy of, with cerebral hemispheres, in controlling passions, 135 and Willis and brain, first text on, xxvii and cerebral cortex, gender difference in, 154 on seventh, origin in cerebellum, innervating ear and mouth, 138, 140 Crisis of seventeenth-century England, 115117, 188-189, 190 Cromwell, Oliver, xxvi, 118 Crooke, Helkiah and brain dissection, 107 on brain having greatest dignity, xxv A Description of the Body of Man, 16 on heart as greatest necessity, xxv Mikrokosmo Graphia, 102

226 Croone, William, 41 Crosse, Joshua, 110 Culpeper, Nicholas and College of Physicians' formulary of drugs, translation into English of, 28 and Galen, translation of, 184 herbals reissued, 188 on hierarchies, professional, elimination of, xxvi, 106 on Hippocrates, praise for, 187 on hysteria, in J. Ward's diaries, 165 and popular medical texts, xxvi Practice of Physick, 155 Cultural map, 203, 206-207, 206f Culture and nature, body and mind, 215 shaping biology, 200 Cuningham, Andrew, ix, 5 Curiosity, 158-159

Damasio, Antonio, 210-212, 213 Descartes' Error, 210 Day, William, 101, 175 Death and life, divide, and functioning cerebral cortex, 208, 209 and sin, Allestree, 119 Democritus, 32, 164 Descartes, Rene and anatomy, and dissection, xxv, 54 and animal spirits, 56, 59-60, 61, 62, 63, 64-65, 88 on body and soul, 132 and the brain, 59-60, 60f, 61, 62, 63-64, 63f, 65f, 68, 69, 69f, 78 and cognitive philosophers, present-day, 214 and cognitive philosophy and science, neuroscience, and computing science, foundational figure in, 212-214 on cosmological themes about nature of spirit and matter, 35 death of, xxvi and Democritus' atom theory, amendment of, 32 Description of the Human Body, 52, 53 Dioptrique, 58-59 Discourse on Method, 53, 140, 210 and empirical terms, use of, for natural philosophy of human body, 178 on fermentation, 56

INDEX and Galileo, and Inquisition's condemnation of, effect on, xxv, 57 and Gassendi, 52, 53 on God, 56 and Greek atomism, refurbishment of, 25 and Harvey's blood circulation theory, acceptance of, 33 and Harvey's physiology of the blood and heart, criticism of, 52 and heart, 59-60, 60f, 62, 64, 66, 67f, 69 and Hobbes, 52 on human intellect, xi, 57-59 on human nature, conceptual space, outside biology, 212 humoral framework in physiology of, 134 humoral thinking of, 148 and hydrostatics, as metaphor for brain and nerve physiology, 59, 60f, 63, 64 "I think therefore I am," 210-211 on independence of images from objects, 57-59 and likeness, 55, 59, 78 and lung and heart, 66, 67f on mathematics and optical principles cosmology of, 66, 68f, 70f illustration of refraction in crystalline humor of eye, 68, 70f on mathematics as most reliable knowledge, 142, 178, 212 and mechanical treatments of nature, 55-56 and physiology of perception, xxv matter theory of, different from Gassendi's, but not differentiated thus by Oxford group, 32-33 and medicine, concern with, 53-54 Meditations on First Philosophy, 52, 53, 59,65 and mind the human, 213 location of, ambiguous about, 140 non-material nature of, 91 and mind and body blamed for biomedicine's divorce of, 209-212 effect of uniting, with pineal gland's sovereignty, 132 relationship of, resonating in presentday cognitive science, 52 as natural philosopher, 91 and nerves, 62, 63, 64f, 65f, 64, 66, 78 and Oxford physiologists, influence on, 33-34, 35, 53, 57

INDEX

on passions, 132-135 on passions, perception, and mind, interdependence between, 211 Passions of the Soul, xxvi, 52, 53. 131135, 140, 211 on philosophy, 53-54 and pineal gland, 58f, 59-60, 60f, 61-63, 63f, 65, 66, 68, 69f, 88, 132 and planetary orbits, 66-68, 68f, 69f Principles of Philosophy, 53-54, 210 provoking debate, 53, 65 publication of work, and influence of, xxvi, 52-71 on reason, passion, and spirit, and distinction between, 131-135 on sensation, physiology of, as distinguished from perception, 140 on the soul, 56, 131-135 on spirit, agency of, 53, 55 Treatise on Light, 55-56, 66, 68, 68f, 69f The Treatise on Man, (also De Homine, L'homme), xxv, xxvi, 52, 53, 5455, 56-57, 58f, 59, 60f, 62, 63, 63f, 64, 64f, 65, 65f, 66-68, 67f, 68f, 69f, 70f, 140 Willis's case against, 85-87 Desjarlais, Robert, viii Diabetes, 208 Diderot, Denis, 148 Dioscorides, 6 Diaphragm, 138 Disease and fever, 38 Galen on, and health, body-psyche link, 137 van Helmont on, as seed, 32 Locke on, cause of, 183 and Paracelsus, macrocosmic influences on, 32 treated by physicians, distant from illness experienced by patients, 169, 169nl03 Dissection. See also Anatomies, Anatomy, Autopsy, and Postmortem by Alexandrians, of humans, 15 and Aristotle, of animals, 5 F. Bacon on, xxv, 1 of R. Bacon, by King, 108 and Boyle, of flounder, in blood circulation experiment, 33-34 and Descartes, 54 of executed criminals and deceased indigent patients, 179 and Galen, 5, 6 by Lower, of cows' eyes, 105

227 and medical knowledge, advance of, 99 by Pepys, of cows' eyes, 105 as ritual, 108 and Vesalius of humans, value of, 4, 5-6 paper, of human bodies, 8-9 and Willis, performance of, 99 Dissenters vs. Episcopalians, and Hippocratics vs. Galenists, 189 and medicine, 189, 190 Doctoress, The Compleat, 155-156 Dog, experiments, 34, 41 Douglas, Mary, 205-207, 206f Down's Syndrome, 209 Drunkenness, 145 Duden, Barbara, vii Duhem, Pierre, 2 Earth, as element, 12, 37 Egenolff, Christian, 7-8 Eisenberg, Leon, 169nl03 Elements, 12, 15, 31 Elias, Norbert, 158 Elizabeth I, Queen, 101 Elizabeth of Bohemia, Princess, 52 Eluard, Paul "Liberte," 211 Embalming, 101, 104 Emetics, 32, 37 Emotions, 131 Empiricism eighteenth-century version of, 193 learned, 182, 184 and learned medicine, 178-179 in natural philosophy and medicine, 180 new, 192 English Civil War aftermath of, 110 and Charles I, xxv, xxvi and crisis of English people, vii, 176 as marker for end of consensus, 25 and Oxford group, 26 Enlightenment and Newton, 2 Ent, George, 35, 104 Apologia Pro Circulatione Sanguinis, 35 Enthusiasm and constitutional model of mind and body, 192 and crisis of mid-seventeenth-century England, 24-25 and Oxford physiologists, 42, 38, 38n64 religious, containment of, 25

228 Enthusiast Descartes criticized as, 55 Enthusiasts ardent Calvinists as, 113 and Christian dissenters, 24 and Cromwell, suppression of, xxvi and reason, valuing of, for amplifying inner light, 115 religious, ascendancy during Interregnum, 176 religious, and Sheldon, control of, 190 Epilepsy, 143, 146 Episcopacy Calvinist opposition to, 115 in Restoration, 111 Episcopal licensing, in Restoration, of midwives, 160, 160n47 of professions and trades, 112 order, complicated theology and church tradition, and rationalist anatomy (Galenists) vs. dissenters, 189 Episcopal Party, 111 Episcopalians vs. dissenters, and Galenists vs. Hippocratics, 189 Equality, of men and women, and Quakers, 169 Erasistratus, 15, 61, 63, 187 Erastus, 27 Ermasmus of Rotterdam De Civilitante Morum Puerilium, 134 Euripides, 129 Eustachius, 106 Eve, in new physiology of reason, 158 Evelyn, John, 42 Evolution, and culture, shaping biology, 200 Experimental philosophy, 118 Experimentalism, and English natural philosophers, 31, 33 Experimentation, 38 Experiments, and ocular demonstrations, valued by Vesalius, Fuchs, Bacon, Harvey, Willis, and Royal Society, 178 Eye, illustration, Descartes, 70f Fabricius of Aquapente, 11 Fadiman, Anne The Spirit Catches You and You Fall Down, 210 Fallopius, 87 Familists, 115 Feelings, 137

INDEX

Feindel, William, vii Fell, John, 105, 110, 112, 120 Fell, Mary, 112, 120 Fell, Samuel, 120 Female in cerebral body model healers, not university trained, and devalued, 159 intuition, submissive to reliable male knowledge, 169 nature, submissive to male enterprise, 169 Conway on, cooperation, and passive principle, 168 ground, passive, and nature, 168-169 and male differences Aristotelian theory of, 154-156 Quakers and Conway on, 168-169 Ferment and blood, in Cartesian model, and Oxford group, 37-38 Helmontian, 31 Fermentation, 31, 36-37, 56, 162-164 Fernel, Jean, 35 Fever and disease, 38 Sydenham on, 181, 184, 185 and Willis, 37, 145 Le Fevre, Ni?aise, 38 Fiat, prime matter of world, and Paracelsus, 27 Fibers, 63, 85 Fibres. See Nerve fibres Ficino, Marsilio, 83 Figure, male, active, artificer, and ground, 168-169 Finger, Stanley, vii Fire, 12, 31 Fire of London. See London fire of 1665 Fleck, Ludwik, 215 Fludd, Robert, 27 Fluids, blood, secondary to solid brain, Willis on, 154 Fodor, Jerry, 213 Folk treatments in texts on women's health, 156 Fontanus, Nicholas The Woman's Doctor, 155 Foolishness. See Stupidity Forceps, obstetrical, and Chamberlen male midwives, 160 Fowler, Lorenzo Niles, 194 Fox, George, 168 Frank, Robert, 109, 109n69 Free will, and Christian mystics, and enthusiasts, 115

INDEX

Friends, Society of, 166, 167. See also Quakers Fuchs, Leonhart and artifice, 83 and Egenolff, criticism of, 7-8 and Galen, veneration of, as medicinal plant authority, 6 herbal of, 6 and illustrations, xxiv, 3, 8 medical botany (herbal) illustrations, first in print culture, xxiv and medicine and natural philosophy, 2 and Melancthon, 10 Notable Commentaries on the History of Plants, (also De Historia Stirpium Commentarii Insignes), xxiv, 6, 7 and ocular demonstrations and experiments, 178 and visual likeness of natural bodies vs. Protestant reformers jettisoning images in favor of words, 17 Funerals, 101, 104 Gabriel, angel, 130 Galen and Alexandrian belief that arteries contain only pneuma and veins contain only blood, amendment of, 15-16 Anatomical Procedures, 61 anatomical works of, triumvirate of heart, brain, and liver, xxiii on animal spirits, 59, 59n36, 85 and Aristotle, 137 on the brain, 84 model of, three-cell, 47, 49, 50 rational faculty in, 15 Complete Works, in Latin, xxiv Construction of the Embryo, 15 and Culpeper, 184 dissection of non-humans, Barbery apes, and large ungulates, 6, 15 against empiricists who attacked rationalism, 202 and experiments with nerves, 16 and Harvey, 186, 187 and Hippocrates, 188, 189 and Hippocractic model of humoral bodies, codification of, 11 on humors aligned with elements, 12 inflammation theory of, referred to by Highmore, 164 on intellectual function, 147

229 and Lower, 186 and materialism, 96 and medical natural philosophy, 5 as medicinal plant authority, 1, 6 and Melancthon, 10 and methods of generating medical knowledge, continuing influence on, 193 on nerves, 63 and nerves, arteries, and veins, emphasis on, 15 and noble parts, 13 on "physick" as beneficiary of divine grace, 117 on pineal gland, 61-62 and Plato's tripartite division of soul, acceptance of, 15 and popular medical writers, denigrated by, in Restoration, 187 on rete mirabile (amazing net), 60-61 soul-body framework of, 137 and Sydenham, 184 translated from Greek to Latin, 5, 12 and Willis, 76, 80, 87, 186 Galenic humoralism, 5, 11-12, 105 Galenists Locke on Sydenham better than, 181 Galileo and Inquisition's condemnation of, effect on Descartes, xxv, 57 on mathematics as most reliable knowledge, 142 and Scientific Revolution, place in, 2 and telescope, 200 Ganglion, sympathetic chain of. See Intercostal nerve Gassendi, Pierre and Aristotle, 137-138 and Democritus' atom theory, amendment of, 32 and Descartes, 52, 53, 65 and Greek atomism, refurbishment of, 25 on heart, nerves, and brain relationship, 137-138 on intercostal nerve, as link between brain and heart, 138 matter theory of, 33, 35, 36 on mind-body-God relations, rational soul or mind, and sentient vegetative soul, and humans less than angels, 137 Mirror of True Nobility and Gentility, 36 and Oxford group, 33, 35, 53

230 Gassendi, Pierre (continued) and soul, characterization of, 113 on soul, rational, located in brain, 137138 and Willis, 76, 112 Geertz, Clifford, viiin4, 98, 200, 202, 215 Local Knowledge, 95 Gender differences in bodies, 154-158. See also Women's bodies, Women's physiology and new natural philosophy, Conway on, 166, 168 Genitalia, 156, 156nl8 Genomics, 96 Gent, J.L. Uncertain Art of Physick, 108 Geometry. See Mathematics Gibson, Thomas Anatomy of Human Bodies Epitomized, 109 Glisson, Francis, 35, 90 Anatomia de Hepatis, 90 De Hepatis, 37 Glorious Revolution, vii, 116 God all-powerful in individual mind, no longer existing in dual social and natural construction, 192, 193 in Descartes's theology, 56 in Gassendi's matter theory, not in Descartes's, 33 in Paracelsian and alchemical theory, presence in nature of, 3 and Willis, and mind and body relations, 137 God, Book of. See also Bible and Book of Nature as complement to, 97 debate over interpretation, 175 divergence from, 10, 17-18 and Protestant reformers, 6 Goodey, Christopher, 147 Goodness, and reason, as inseparable, Conway, 168 de Graaf, Regnier, 35 De Mulierum Organis Generationi Inservientibus, 90 Great Artificer, 83 Greatrakes, Valentine, 166 Greeks, ancient, 142, 146-147 Greene, Anne, 175-176 Greens in Western Europe, 205

INDEX

Ground, female, passive, and nature, and figure, 168-169 Guinta of Venice, xxiv, 5 Guinther of Andernach, 5 Habit, 133-134, 141 Habits of thinking, 191 Hammond, Henry, 105, 112-113, 114, 120 Harley, David, 105 Harvard Medical School's Brain Death Committee, 208-209 Harvey, William Anatomical Exercise (or Experience) on the Motion of the Heart and Blood in Animals, (also De Motu), 16, 17, 23, 33, 182, 186 and Aristotle, 23, 186 blood circulation theory of, 33, 35, 186 on blood, more physiological agency to, 34 and Boyle, 97 and Butterfields's Scientific Revolution, exclusion from, 2 in di Capria's Uncertain Art of Physick, 108 and Civil War, loss of papers during, 80, 103, 103n40 and Conway, 166 and Descartes's criticism of, response to, 52,52nll and Erasistratus, 186-187 and experiment, anatomical investigation, and clinical correlation, for understanding bodies, by reason, 180 and Galen, 186-187 on the heart, comparison to King Charles I, xxv, 23 and heart, model of, as pump circulating blood, xxv, 16, 24, 33 and Herophilus, 186-187 and Highmore, 161-162, 164 on Hippocrates, irrelevance of, 186-187 influence of, 189-190 Lumleian lectures of, 34, 102 on lungs, 34 and materialism, 96 on menstrual blood and disease, 156 On the Motion of the Heart and Blood in Animals, xxv and ocular demonstrations and experiments, 178 and Oxford group, 24, 26

INDEX

and Riolan, letter to, 103 on sick patients, usefulness for understanding bodies, 102-103, 105 on soul in blood, 164 and S. Ward, on blood circulation model of, and natural magic, 176 Head and body, English theme, 117 Head, diseases of, 141, 145 Headaches, 166-167 Heads, phrenology busts of, 194 Healing alternatives. See Alternative healing experience, 205 in Restoration, of sick nation, and Reynolds, 117 Health and disease, body-psyche link, and Galen, 137 Health guides, women's, 155-156, 156n21 Heart and Aristotle in embryo, 15 emphasis on, xxiii, 13-14 as experiencer of affective states, 137-138 as organ of perception, and memory, 147 and "soule" in, 16 and Cartesians, 38 Crooke on as greatest necessity of life, xxv and "soule" in, 16 Damasio on, as expressing optimism, 211 and Descartes, 59, 60f, 62, 64, 66, 67f, 69,132-133 Galen on in anatomical triumvirate, xxiii in embryo, 15, 137-138 as experiencer of affective states, 137-138 as site of emotion, 15 Gassendi on, contraction and expansion of, in response to messages from brain, 137-138 and Harvey and comparison of King Charles I to, xxv, 23 in embryo, 15 as muscle, citing Hippocrates, 186 as pump in model of, xxv, 17, 24, 66 functioning, as criterion for life, 209 and Hippocrates, "soule" in, 16 in Hippocratic texts, 14-15 in humoral theory, as container, 13 and Lower, 66, 136 and Oxford physiologists, 38

231 and Plato and Socrates, as organ of perception and memory, 147 shape retained outside body, 107 and soul, relation to, and origin of passions, Descartes, 132-133 Willis on, as location of vital flame, 138 Heart and blood Cartesian model, 33, 34 Harveian model of, 23, 33, 34 Highmore on, as spirited elements, 163 Lower, experiments of, 34 vital soul of, 42 and Willis, 136 Heart and brain Crooke on, 16 Heart and lung illustration of, Descartes, 66, 67f Heartmind, vi, vin2 Heat, 38, 154-155 van Helmont, Francis Mercury, 166, 167 van Helmont, Jan Baptista Archeus, Archei, immaterial spirit, 31, 32 and Boyle, 97 and Butler's stone, promotion of, 182 cosmological assumptions of, shared by enthusiasts and Christian mystics, 115 on cosmological themes about nature of spirit and matter, 35 diseases, concept of, as specific entities, 32 on fermentation, 31, 37 and fever, humors, and blood, little emphasis on, 32 and Hippocrates, 188 matter-spirit theory of, 31 and Oxford physiologists, 31 on spirit and water, primacy of, 32 on stomach and spleen, 31, 32 and Sydenham, 184, 185 willow tree experiment, 31-32 Helmontian healers, 32, 111 Helmontians, 40, 181 Hemorrhoids, 163 Henri IV, King of France, 105 Henry VIII, King, xxiv Henry, Prince of Wales, 102 Herbals, xxiv, 6, 7-8 Heroic therapies, 186 Herophilus, 5, 15, 60, 61, 63, 186-187 Heyd, Michael, 25 Hierarchy in English life, 116-117 and Sheldon, and order, 180 and Willis, 87-90, 116, 180

232 Highmore, Nathaniel on blood, 35, 161-164 on cultural map, 206 and Democritus' atomism, 164 and Galen's theory of inflammation, 164 and Harvey's belief that soul is in blood, 164 History of Generation, 162 on hysteria, 162-165 life, and works published, 161-165 and microscope, use of, 162 on nervous illness, 141 De Passione Hysterica et Affectione Hypochondriaca, 162 and physiology of soul(s), omission of, 163 and Vesalius' illustrations, 162 and Willis's doctrine of nerves, attack on, 153 and Willis's hysteria model, attack on, 153, 161-165 and women's physiology and pathology, accounts of, 163 Hill, Christopher, viii, 23 Hinduism, 97 Hippocrates De Corde, 186 and Culpeper, and other popular medical writers, 187 and Galen, 188, 189 on the heart and soul, 16 and methods of generating medical knowledge, continuing influence on, 193 and orthodox physicians at end of seventeenth century, ascendancy among, 188-190 and Oxford physiologists, 186 The Sacred Disease, 84 Sydenham, "the English," 186 and Willis, 76 Hippocratic caution, "First do no harm," 186 Hippocratic empiricism, 191 Hippocratic medicine, and superficial description, 96 Hippocratic texts Diseases of Maidens, 15 On the Heart, 14 and Plato, 15 On the Sacred Disease, 14 on stupidity, congenital, and clubfoot, 147 Hippocratic theory on epidemic fevers, and Sydenham, 184185

INDEX

Hippocratics and humoralism, 11 and humors, four-fold model of, 12 and medical natural philosophy, 5 and noble parts, 13 Hippocratism, refurbished, rise in intellectual prestige in 1680s, 189 Hobbes, Thomas on blood, 24 and Boyle, debate with, 193 and Descartes, 52 Leviathan Or the Matter, Forme and Power of a Commonwealth Ecclesiasticall and Civil, xxvi, 33 and orthodox and theological concerns, 115 on sovereignty, absolute, xxvi on Utopia, 212 Hodges, Devon L., x Holmes, Oliver Wendell, 186 Holy Spirit, 9, 130 Homeostatsis, 199 Homer, 129, 147 Homo sapiens, 200 van Hooghelande, Cornelius, 35 Hooker, Richard, 114, 120, 180, 191 Hmong, 210 Humans, as microcosms of the macrocosm, 13 Hume, David, 213 Humor, definition, 12 Humoral framework, of Descartes and Oxford group, 134 Humoral model in ancient Greek natural philosophy, 12 and body's hollow spaces, 13 and noble parts, 11 and passions, 139 physiology of, fluids and containers, 47 Humoral theory and astrology, 12 reigning for more than one thousand years, xxiii repudiated by Harvey's model of heart, 16 Humoral thinking and animal spirits, and convulsive disease, 142 and bodies, as porous and subject to passions, 130-131 and Willis's cerebral body model, overcome by, 148 Humoralism and blood and heart, new conceptions of, 25

INDEX

Galenic, 11-12, 105 in nineteenth-century American medical opinion, 11-12 Hunter, William, and anatomy demonstrations, 99, 100, 188 Husk, 181 Husserl, Edmund, 213 Hysteria, 141, 142-143, 153-155, 153n4, 160-165, 184-185 Hyde, Henry (Earl of Clarendon and Lord High Chancellor), 39 Hydrostatics, 59, 64, 60f, 63 latrochemistry. See Chemistry Idiocy, 141, 142, 144, 148 Iliad, 130 Illness, 169, 169nl03, 204 Illustration by Bartisch, of eye, 91 in European homes, xxiv, 2-3 and Fuchs, xxiv, 2-3, 8 in Harvey's De Motu, 17 in natural philosophy texts, 4 of Vesalius, 2-3, 8-9 Image, and word, conflict, 9, 10 Images. See also Illustration of bodies, in pictures and books, 2-3. destruction of, by Reformists, 3 and Reformation, 3 of saintly bodies, and Catholic Church, 3 Immaculate Conception, 130 Injection, and transfusion, experiments, 136 Inner light. See Light, inner Inns of Court in London, 190 Instrumental rationality, and biomedicine, 208 Insulin, 208 Intellect, human, and Descartes, 57-59 Intercostal nerve, 138 Interregnum, and crisis of English people, vii, 24 Islam, 97 Islamic medicine, 11 Islamic natural philosophy, 13

Jacobs, James, 33, 117, 118 Jacobs, Margaret, 33, 117, 118 James I, King, 101, 102 James II, King, xxvii, 116, 189 Jason, 130 Jesus. See also Christ, Jesus as dead and alive, simultaneously, 208

233 language of, in New Testament of Bible, 189 Mary's conception of, 129 Jewson, Nicholas, 190 John IV, King of Portugal, 116 John, Gospel of, 27 Judaism, 97 Juxson, Archbishop, 110 Kant, Immanuel, 213 Keill, James, 189 Keller, Evelyn Fox, 154 Kidney, failure, 208 King, Edmund and R. Bacon, dissection of, 105, 108 and Charles II, physician to, 110 and dissection of brains, 103 and experiments, injection and transfusion, 136 with Lower, performing transfusion between sheep and human, 41 medical casebook of women patients, 165 and Sheldon, 110 Kleinman, Arthur, 95, 204 Knowledge and Aristotle, natural, and primary cause, 5, 5n5 bodily, xi and Damasio, of brain, and mind, and happiness, 211 human, biological, and phenomenological, 214 of human body, as focal point of cultural tension, in mid seventeenth century, 17 and human transformation, possibilities for, 214 and Locke, 182-183 reliable, produced by investigative practices, 199 and Sydenham, 183 Knowledge, anatomical, English, 189-190 Knowledge, medical determination of, difficulty, 178-179 disputes, counterpart in theological disputes, 188-190 dissemination of, on Internet, 207 Locke on, by observation, 183 -making, shifting to Continent in 1690s, 189 methods of generating, changes in, 193-194 of ordinary people, 25 Sydenham on, and botany, 181

234 Knowles, John, 209 Kuhn, Thomas, 24 Kuriyama, Shigehisa, vii

Laqueur, Thomas, vii Latitudinarian Anglicans, 117 Latitudinarian reformers, 187, 190 Latour, Bruno, viii, 192-193 Laud, William (Archbishop of Canterbury), xxv, 110, 112-113, 114, 120 Laxatives, in Helmontian healing, 32 Leibniz, Gottfried Wilhelm, 177, 213 Lesch, John, ix Lewontin, Richard, 211 Life, and death, 208, 209 Light, inner, of Quakers, 168 Likeness and anatomists' quest, 18 and biology, 214 definition of, 3 and Descartes, 55, 59, 66, 78, 79 and Fuchs, 79 in Harvey's De Motu, 17 and Melancthon, 10 and Vesalius, 8, 79 in Western medicine, framed in anatomical terms, as basis for knowledge, 96 in Willis's model of brain and nerves, 78, 79 Likeness, and presence anatomists vs. reformist theologians and alchemists, 17 Belting on, 3 of embodied human mind, 213 fault line between, 202 and healing approaches to human body, 203 in natural philosophy texts, 4 tensions of, in mid sixteenth century, 10 Linnaeus, Karl, 200 Literacy, and Calvinists, 115 Liver and Aristotle, of little importance to, 14 Descartes on, as origin of primitive passions, 133 Galen on in anatomical triumvirate, xxiii as seat of desires, 15 Glisson on, 90 Harvey on, 34 in humoral theory, as container, 13 as noble part, 90

INDEX Locke, John and anatomies, participation in, 181 and anatomy, denigration of, 190, 191 on cause, no-nothing posture concerning, 184 and cognitive philosophy and science, 213 on disease, cause of, 183 An Essay Concerning Human Understanding, xxvii, 191 and experience, emphasis on, 180 and van Helmont, 35 influence of, 191-193 on knowledge, 182-183 and medical care of aristocracy, as Whig, 187, 188 and medical knowledge, approach to, fashionable, 188 and medical science, attack on, 183 on medicine as art, not science, 181-182 on mind as "empty cabinet," 191 and modernity, advance of, 192 on musical ability, 192 on perception, and human reasoning, 147-148 on soul, and philosophical speculation on, as "gibberish," 191 and Sydenham, 193 on Sydenham's better way, 181 on tabula rasa, of infants' cerebrum, xxvii and William and Mary, support of constitutional monarchy of, 189 on Willis, on blood as oil, heart as lamp, echoing Bacon, 29 and Willis's dissection of fetuses, record of, 143 and Willis, influence of, xxvii, 191-192, 193 Logic and brain, 212 Logic and Descartes, 212 London College of Physicians. See College of Physicians London fire of 1665, xxvii, 110 Louis XIV, King of France, 180 Lower, Richard and Boyle, letter to, regarding Willis's Anatomy, 141, 141n58 and Cartesian natural philosophers, 35 and Cashin, criticized by, 187 and Continental alchemists, 35 and Descartes, attack on, 86 and experiments heart and blood, 34 injection and transfusion, 136 vascular mapping, 41 and Galen, 186

INDEX

on heart as muscular pump, 66 with King, performing transfusion between sheep and human, 41 with Pepys, dissecting cows' eyes, 105 and Sheldon, 110 Tractatus de Corde, 34, 136 Treatise on the Heart, 86 and Willis, 110 and Willis's Anatomy, 76, 136 Loyola, Ignatius Spiritual Exercises, 1 Lungs, 34, 67f Luther, Martin, xxiii, xxiv, 3, 10 Lyly, John, x-xi MacDonald, Michael, 24-25 Macrocosm, of universe, and microcosm of man, 24 Madhouses, private, xxvii, 209 Madhyamika, 214 Magic, natural, 176 Magnetic resonance imaging (MRI), 96 Magnus, Albertus, ix Malachi 4:2-3, 117 Male Cavendish on, idealized character of, 158, 158n38 in cerebral body model, enterprise, dominant, and reliable knowledge of, 169 character of, changes in, 157 Conway on, conjunction, and active principle, 168 ethos of, cool, rational aggression, in new physiology of reason, 158 figure, active, and artificer, 168-169 physicians, and control of medicine, 159160 Male, and female differences. See Female, and male differences Malpighi, Marcello, 35 Martyn (Martin), John, 120 Mary, Queen, vii, xxvii, 116, 189 Mary, Virgin, 129-130, 148 Materialism, as basis for knowledge in Western medicine, 96 Mathematics and Descartes, 79, 212 as most reliable knowledge, 142 and Willis, 79-80 Matter in ancient natural philosophy, 5

235 and Paracelsus' theory of, 27 and structure, xi Matter, and spirit in alchemical theory, as interconvertible, 28 Bacon's theory of, 28-30 Conway on, as interconnected, and good, 168 crisis concerning roles of, 24-25 Descartes on, 35 Gassendi on, 35 van Helmont on, 35 More on, 167 Oxford physiologists' theory of, 33, 42 Paracelsus on, 35 relationships of, 1 in Restoration, 39 McCarthy, John, 212 McCulloch, Warren, 212 Medea, 129-130 Medical arts, 137 Medical botany. See Herbals Medical knowledge. See Knowledge, medical Medical science, and Locke and Sydenham attack on, 183 Medical writers, popular, in Restoration, 187 Medicine as art, not science, Sydenham and Locke, 181-187 as empirical undertaking, akin to botany, 190 and Fuchs, 2 and Vesalius, 2 Willis on, as true science, 142 Medicine, Arab-Islamic, 11, 95, 96n4 Medicine, Chinese, 95, 96, 96n4, 97, 204 Medicine, gentle and holistic. See Medicine, spiritual Medicine, history of, 2 Medicine, learned and brain and nerves, elevation of, in women's conduct, and devaluation of womb, 160 disputes in seventeenth century, 164, 164n71, 165 and Hippocratic empiricism in late seventeenth century, 191 and metaphysics and empiricism, tension between, 178-179 and natural philosophy, traditional, link to, 179 and Willis's cerebral body model, adoption of, 161

236 Medicine, spiritual, 205. See also Alternative healing Medicine, Western, 203, 210. See also Biomedicine Melancthon, Philipp, 10 Memory, 146-147 Meninges of brain, 63, 65f, 142, 166 Menstrual blood, 155, 156 Mental illness and disability, 146-148 Merchant, Carolyn, 169 Mercury, 28, 29 Merleau-Ponty, Maurice Phenomenology of Perception, 199 Mersenne, 54, 57n30, 62 Merton, Robert, viii, 117 Metaphysics, 177, 178, 192 Microcosm, of man, and macrocosm of universe, 24 Microscope, 105, 106, 162, 183 Microsurgical technologies, 200 Midwives, 155, 156, 159, 160, 160n46, 160n47, 160n48, 170 Military metaphors, and Willis, 166 Millenarianism, 119 Millington, Thomas, 76 Mind in biomedicine, and body, and brain, accounts of, 204 and body culture, 215 -body problem, of Western modernity, link to Cartesian philosophy, 132 and body, separation of, 210-211 Damasio on, 211 Descartes on and body relationship, 52, 53, 55, 59, 132 human, ideas referring to operations of, 213 as mirror of nature, 213 non-material nature of, 91 and Gassendi, and rational soul, 137 of God, in Christianity, xi Locke on, as "empty cabinet," 191 and Willis and body, and God relations, 137 and brain, adhering to, 87-88, 87n49 and material connections with solid tissues of brain and blood, 105 and "secret places of," in brain, Willis, 183 Minerva, 157, 158 Minsky, Marvin, 212 Modernity, and Locke, 192-193 Modernity, medical, and cerebral body model, 208-209

INDEX

Moisture, and fluid, Aristotelian theory, 154-155, 154n6 Molyneux, Thomas, 181 Montague, James (Bishop of Winchester), 101 More, Henry, 28, 167, 177 Multiple sclerosis (MS), 96 Musical ability, 87, 138, 192 Mystics, Christian. See Christian mystics National Institutes of Health, 203 Natural magic, 176 Natural philosophers Descartes and Willis's shared ambition to be authority on human condition, 91 and orthodox English body, in Restoration, proper composition of, 120-121 reading spirit out of universe, 115 Natural philosophy. See also Natural philosophers, New natural philosophy, and New Philosophy ancient, and theories of matter, 5 Cavendish on, xxvii of Descartes, 53 and French monarchy, support of, 180 and Fuchs, 2 about God's presence, historical definition of, ix and images, 4 learned, and medicine, and popular culture, 25 learned medicine's link to, traditional, 179 and nature, operating according to single truth, 96-97 and Oxford group, 53 and print culture, viii and religion, 1, 17-18 and reproducibility and witnessing, 96 during Restoration, prestige of, 104 and science, 1, 192, 214 and sovereignty, hierarchy, and power, religious and political themes of, 117 and spiritual agency in, 24-25 and teleology, 97 and theology, 11, 91 and Vesalius, 2 and Willis, 78, 91 Nature and Bacon, 157, 157n23

INDEX

and Catholic teaching in thirteenth century, study of, ix and culture, 215 and science, and women, ideologies of, 154n5 and society, paradoxes of, 193, 193n76 and Willis, 157 Nature, Book of and Book of God, 10, 17-18, 97, 175 and Ray, 109 and Vesalius, 6 Nemesius, 47 Nerve. See also Nerves and brain, doctrine, 76, 121 Cannon on, connections, in cerebral cortex in cerebral hemispheres, and superior intelligence of man, 199 and Willis and brain model of, 78-79, 86, 87-90 corpus striatum, theory of, 119 transmission, 108 Nerve doctors, 161 Nerve fibres, 140 Nerve, intercostal. See Intercostal nerve Nerve, vagus. See Vagus nerve Nerves. See also Intercostal nerve, Cranial nerves, and Vagus nerve and ancient anatomists, 63 and Descartes, 62, 63, 64, 64f, 65f, 66, 132 Galen on, 15, 16, 63 Gassendi on, as carrying messages from brain to heart, 137-138 Highmore on, as secondary to circulating blood, 162 and Willis as controllers of baser functions, 162163 and convulsions, 142, 143-144 "Description and Use of," 87, 90 doctrine of, and influence on eighteenth-century medical writers, 191 as solid, and made of fibers, 85 Nerves, and brain learned medicine's elevation of, 160 new natural philosophy of, and Sheldon and Anglicans, 112 Willis on as governing women's bodies, 153-154 as producing women's (and men's) passions, 161 Nervous disease, 141-143, 161

237 Neurobiology, 211-212, 212n32, 213 Neurocentric model, of women, 169 Neurology, xxvii, 76, 194, 200 Neuroscience, 76, 200, 212-213, 214 Neurosurgery, 200 New England Journal of Medicine, 203 New natural philosophy. See also Natural Philosophers, Natural Philosophy, and New Philosophy and alchemical mystics, 176 and anatomists, 108 and Anglicans, 112 and brain, emphasis on, primacy of solid parts, 159 and Conway and gender, 166, 168 and illness as part of God's plan, 167 and Descartes, 55 and experiments and ocular demonstrations, xxvi and male character, 157-158 as male pursuit of investigation, 157-158, 159 masculinized, 160 of mind, alienating women while freeing some constraints, 169-170 and Oxford experimental clubs, 26 and Puritan values, as expression of, 117 and reason, in Restoration, 114 and Royal Society, and microscopes, and telescopes, 105 and Sheldon, 112 New philosophy matter theory of, 118 and Willis, term of Wallis's, 37 Newcastle, Duchess of. See Cavendish, Margaret Newcastle, Duke of, 54, 158, 159 Newton, Isaac, 2, 117, 118, 177 Noble parts, 11, 13 Nutton, Vivian, 12 Ocular demonstrations and Bacon, 178 and experimental activity, as term for, 54 and Fuchs, 178 and Harvey, 178 and new natural philosophy, xxvi and Pordage, 79, 79n9 and Royal Society, 178 and Vesalius, 178 and Willis, xxvii, 99, 107, 141-142, 157, 178

238 O'Dowde, Thomas, 39-40 Odysseus, 129-130, 148 Oldenburg, Henry, 38 Philosophical Transactions of Royal Society, 120 O'Meara, Edmund, 24 Opiate use, 145 Oppositionalism, 202, 203, 205-206 Optic nerve, 50, 62, 63f Organ transplants, 209 Organismic perspective, 211 Orgasm, female, 155 Oxford experimental clubs, 26. See also Oxford extracurricular clubs, Oxford group, and Oxford physiologists Oxford extracurricular clubs, curriculum of, 176 Oxford group and Bacon, 29 and Descartes, 53, 57 and Gassendi, 53, 57 and Harvey, 24, 26 as natural philosophers, formation of experimental clubs, exclusion of politics and religion, 26 and Paracelsus, 27 Oxford physiologists and alchemical theory, 39 Anglican background of, 109-110, 109n69, 109n70 and atomic philosophy, 32-33 and blood, 34, 35, 38, 40-41, 121 and Cartesian natural philosophers, 35 and Cartesian natural philosophy, opposition to, 86 on chyle and liver, 34 and Continental alchemists, 35 and Descartes, 54 and experiment, anatomical investigation, and clinical correlation, for understanding bodies, by reason, 180 and experimental clubs, formation of, xxvi and experiments, animal injection, 40-41 and enthusiasts, 38, 38n64, 42 and influences, foreign, 105 and Galen, 186 and Gassendi, 33 and heart, importance of, 38 and heat, attention to, 37-38 and van Helmont, 31 and Hippocrates, little attention to, 186 humoral framework of, 134

INDEX

and Pecquet's discovery of thoracic duct, 34 and religious text, use of, 97-98 and Restoration, 109 on the spleen, 163 Oxford physiology, and spirituous particles in, 118 Oxford University, 190 Oxford University Press, 111, 120 Pagel, Walter, 27, 30 Palsie, 146 Paracelsian healers, akin to charismatic priests, 30 metallic compounds, in College of Physicians' formulary of approved drugs, xxv notion of disease, and Sydenham, 185 Paracelsus (Theophrastus Bombastus of Hohenheim) and Bacon, similarities and differences, 30 Book on Minerals, 27 and Boyle, 97 cosmological assumptions of, and enthusiasts, and Christian mystics, 115 on cosmological themes about nature of spirit and matter, 35 death of, xxiv, 2 on diseases as seeds, 32 English translation of, xxiv, 35 and Hippocrates, 188 influence of, 26-27, 28 and macrocosmic influences—the stars—in disease creation, emphasis on, 30 matter, theory of, 26-27 Opus Paramirium, 27 and Oxford group, 27, 35 Philosophia ad Athenienses, 27 and Plato, echoing seed concept of, 27-28 principles: salt, sulfur, and mercury, 27 and pyrotechnical anatomy, 2 on spirit and God's presence in nature, 3, 27,35 on spiritual agency in prime matter, 27 and Sydenham, echoed by, in nature as "abyss of cause," 190 Particle flow, 139 Passio, (Pathos), 131 Passion, xxvii, 131, 133, 135-140 Passions Descartes on dependence of good and evil of life on, 134-135

INDEX

as located throughout body, 135 perception and mind, interdependence with, 140 primitive: love, hatred, desire, joy, sadness; originating in heart, spleen and liver, 133, 134 and soul's vulnerability to, 132 and human affective states, 131 and humoral models of, 139 and spirits, strengthened by, 133 Willis on and brain and cranial nerves, as product of, 161 and cerebral hemispheres, and rational soul, or mind, under control of, 139 Patients, and experience of illness, 204 Pecquet, Jean, 34, 35, 90 Penelope, 139 Penicillin, 207 Pepys, Samuel, 41, 105, 110 Perception and Descartes and passions and mind, interdependence with, 211 physiology of, xxv and Locke, theory of, xxvi Persistent vegetative states, 208-209 Personhood, v-vi Petty, William, 41, 111, 175 Phenomenology, and presence, 214 Philosophical Transactions of the Royal Society, 38, 108, 120, 164 Phlebotomy, 164, 165, 185 Phlegm, 12 Phosphorus, 39, 40 Phrenology, 194 Physician-as-priest metaphor, 117 Physicians and Christ, as healers, 98 and Locke, on knowledge of, 183 Physicians, College of. See College of Physicians Physick, 117, 119 Physiognomy, 176 Physiology and anatomy, as interchangeable terms, xi in biomedicine, 199 definition of, early modern, ix-x and Descartes of perception, xxv of sensation, 140 of thinking, 132 Highmore on, women's, 163

239 and structure and function, distinction between, 76 and Willis, of reason, 119 Pineal gland and ancient anatomists, 61 Descartes on, 59-60, 60f, 61-63, 63f, 66, 68, 69f as fountain for animal spirits, 88 and importance to, 132, 133, 135 in present-day medicine, as midline cerebral structure, 210 and Willis's case against Descartes's, 8587 Pitcairn, Archibald, 189 Pitts, Walter, 212 Plague, London, xxvii, 40 Planetary motion, illustrations, of Descartes, 69f Plants, illustrations, and Fuchs, and Egenolff, 8 Plants, medicinal. See Herbals Plato on bodies made of fiber, 63n52 bodily architectonics of, 15 on body as source of trouble, 137 on brain's ventricles, and head as vessel of the seed, activating intellectual function, 84 and humoral thinking, 11, 148 influence of, in early universities, 4 on memory and the heart, 147 and noble parts, 13 Phaedo, 137 on physiology, female and male, 156 and rational soul, 15 The Republic, 15 seed concept of, 27-28, 28n21 sensitive soul/rational soul, 132 Theaetetus, 147 Timaeus, 28, 84, 137 Pleurisy, 185, 187 Pneuma, 13, 16, 63. 84, 129-130 Pocock, John, 116 Pordage, Samuel, 78 Positron emission tomography scans, 200 Postmortem. See also Anatomies, Anatomy, Autopsy, and Dissection and Bathurst, 162 on elite, 105-106 on Henry IV, in Paris, 105 and Highmore, 162 on soldiers, in English Civil War, 103 and Willis, 162, 166-167 Presbyterians, 111, 118

240 Presence and ardent Calvinists, 113 definition of, 3 and van Helmont, of spirit, and Archeus, 31 in Paracelsian theory of matter, of God, 27 and phenomenology, 214 and Sheldon, 180 and Willis, 78, 180 Presence, and likeness. See Likeness, and presence Print culture, xxiv, 7, 8n22 Prominence, orbicular, of cerebellum, and Willis, 139 Proper living and dying, Anglican, 119-120 Protestant churches, first built, 3 conversion experience, similar for Calvinists and Christian mystics, in Reformation, 115 move from visual to literal, 6 reformers breaking religious imagery, 9, 17 exhortation to followers to know Book of God themselves, 6 jettisoning images in favor of words, 17 Protestantism, Weber on, Calvinism, and capitalism, 117 Protuberance, annular, of cerebellum, and Willis, 139 Psalms 104:24, 98 Psychology, xxvii, 192, 193, 207 Puklin, Diane, 137 Punishment, as suffering, Conway on, 168 Purgation, as therapy for fever, 37 Purgatives, in Helmontian healing, 32 Purgings, as treatment for hysteria, 165 Puritans, xxv, 113-114 Pythagorean thought, 15

Quakers, 115, 116, 168, 169, 206

Radcliffe, John, 190 Radical sectarians, 118 Rational soul. See Soul, rational Rational therapeutics, 159 Rationality, instrumental, and biomedicine, 208 Rattansi, Piyo, 40 Rawdon, George (Lord), 167 Rawdon, Lady, 167 Ray, John The Wisdom of God Manifested in the Works of Creation, 109

INDEX Reason in cerebral body model, and order, 118119 Conway on, and goodness, as inseparable, 168 Descartes on, as opposed to passion, 133 Leibniz on, truths of, 177 and new natural philosophy, in Restoration, 114 and passion and spirit, distinct from, 131 physiology of, 119, 158-159. See also New natural philosophy and Willis, and passion, xxvii, 135-140 Reason, habit of, 119, 154 Rees, Graham, 29 Reformation Belting on, 3 and images, 3 schisms of, 202-203 and Scientific Revolution, vi-vii and theology, and medical theory, 189 Reformist churches, and blank walls, 3 religious enthusiasts, destroying images in Catholic churches, 3 Regius, Henry, 35 Reisch, Gregor Margarita Philosophica (Pearl of Philosophy), iif, 47-49, 48f Religion and natural philosophy, 1, 17-18 and science, 1, 108 and scientists, 97-98 and Sheldon, control of, 180 and Willis, 98 Religious conflict, and pluralism, xxvii enthusiasts, 113, 115. See also Enthusiasts imagery, 9-10, 98 Reproducibility, and natural philosophy, and Western science, 96 Research, state-sponsored institutions of, 203 Restoration and brain model of solid, cerebral cortex, and authority, and sovereignty of church and monarchy, 120-121 and cerebral body model, 106 and Charles II, xxvi and crisis concerning roles of matter and spirit, 24 and episcopal licensing of professions and trades, revival of, 112

INDEX

later, preference for worldly pursuits over natural philosophy and theology among elite, 187 and midwifery, under control of church, 160 and Oxford physiologists, 109 and Reynolds, and need for healing of sick nation, 117 and Sheldon, and ejection of moderate and nonconformist clergy, 110, 110n74 and spirit, role of, 176-177 Resurrection, 118-119 Rete mirabile, 60-61 Reuchlin, Johann, 10 Reynolds, Edward, 117 Richardson, Samuel, 148 Richmond, Duchess of, Frances, 101-102 Riolan, Jean, 103 Risse, Guenter, 106n53 Robinson, Nicholas, 161 Rorty, Richard, 213 Rosch, Eleanor, 213 Rose, Clifford, vii Rosicrucians, 115 Rousseau, George, 148 Rousseau, Jean Jacques, 148 Royal College of Physicians. See College of Physicians Royal Society and anatomy demonstrations, 100 and knowledge accumulated by members, 30 of London, formation of, xxvi, 38-39 and new philosophy, and use of microscopes and telescopes, 105 and ocular demonstrations and experiments, 178 and Philosophical Transactions, publisher of, 120 and phosphorus, 39, 42 and politics and religion, exclusion of, 26 and Sharp, echo of motto "not by words alone," 160 and Sprat, 98 as state-sponsored institution of research, 203 Rupp,Jan, 100-101 Rush, Benjamin, 186 Ryle, Gilbert, 98, 202 de Sade, Marquis, 148 Salisbury, John of, 87

241 Salk, Jonas, 211 Salt, 27, 29, 36-37 Savilian Professor of Astronomy, 110, 135 Savilian Professor of Geometry, 135 Sawday, Jonathan, vii The Body Emblazoned, 158 Schaffer, Simon, viii, 193 Schiebinger, Londa, vii Schochet, Gordon, 116 Schuyl, Florentio, 57, 66 Science culture of, 214 definition of, viii-ix and God's presence, as not necessarily about, ix history of, 2 and natural philosophy, 1, 91, 192 and nature, and women, ideologies of, 154n5 and religion, 1, 108 Western, and reproducibility, and witnessing, 96 Scientia, 190, 199 Scientific imperialism, 214 Scientific Revolution, vi-vii, viii, 214 Scientists financial patronage of, 212 and religion, 97-98 Scurvy, 141 Sedleian Professor of Natural Philosophy, 135 Seed Fox on, as Christ's presence in body, as woman, 168 in neo-Aristotelian thought, male and active, female and passive, 156 and Paracelsus, concept of prime matter, 27-28 and Plato as activating intellectual function, 84 and concept of prime matter, 27-28 Seeds, primigeneous, of Willis, 36 Sennert, Daniel, 27, 35, 165 Sensation, physiology of, Descartes, 140 Settlement, Act of 1660, 111 Shaftesbury, Earl of (Lord Ashley Cooper), 118, 181 Shapin, Steven, viii, 193 Sharp, Jane Midwives Book, 160 Sharrock, Robert, 31-32, 119 Sheldon, Gilbert (Archbishop of Canterbury) and Allestree, 112 and Charles I, xxv

242 Sheldon, Gilbert (Archbishop of Canterbury) (continued) and Charles II, xxvi, 118 and Chemical Physicians' petition for royal charter, 39, 111 and control, of religion, and enthusiasts, 180, 190 on cultural map, 206 death of, xxvii, 180 andJ. Fell, 112 and Hammond, 112, 120 and Hooker, 120 and King, 110 and Lower, 110 and natural philosophy, unpublished manuscript on, 110 and new natural philosophy of brain and nerves, 112 and Oxford University Press, forerunner, and gift to, 111, 120 and reason, theology of, 114 in Restoration, xxvi, 110, 111-112, 120 and Willis, xxvi, xxvii, 110 Willis's Anatomy dedicated to, 78 and woman who lived without food and water, 177 and Wren, xxvii, 111 Sheldonian Theatre, 118 Sherrington, Sir Charles, 194 Signification, structures of, 202, 203 Simon, Herbert, 212 Sin, and death, Allestree on, 119 Slare, Frederick, 42 Society, and nature, paradoxes of, 193, 193n76 Society of Chemical Physicians. See Chemical Physicians, Society of Socrates, 137, 147 Soul ancient Greek conceptions of, 164n67 Conway on, tendency to goodness of, 168 and Locke, philosophical speculation on, as "gibberish," 191 and Lower, multi-part, adapted from Plato, 136 parts of, discrete, 131 and Willis multi-part, adapted from Plato, 136 in neurological terms, 112 resurrection of, 118-119 Soul, and body and Descartes, distinction of, 132 framework of, 137

INDEX

and Newton, and spirit, and resurrection, 118 Soul, of Descartes and heart, relation to, 132-133 and mind, equated with, 132 and passions primitive, control of, 133 vulnerability to, 132 in pineal gland, 132 rational, 56 unity, and immortality of, 131-132 and will, 133 Willis's case against, pineal as seat of, 86 Soul, rational and Gassendi, animus, as immaterial and immortal, 137 and Hammond, and corporeal, 113 and Plato, 15 and Willis and cerebral hemispheres, link with, 145 and mind, equivalent to, 136 immortality of, and divinely created, 91 and passions, in control of, 139 Plato's, followed by, 132 and sensitive, corporeal, 136-137 Soul, sensitive, 132, 136 Soul, sentient, vegetative, anima, and Gassendi, 137 Soul, vital Highmore on, in control of spirited elements,, heart and blood, 163 models of, 25, 26 Souls, of Plato, 15 South, Robert, 118 Sovereignty, 116-117, 121 Sparrow, John, 36 Species, Sydenham on, 184 Spinal cord, 16 Spirit in biomedicine, role of, 204 Conway on, as body, 167-168 and Descartes, 53, 55, 56, 91 Harvey on, 34 and van Helmont, and immaterial, Archeus, 31, 32 More on, as distinct from matter, 167 and Oxford physiologists, definition of, 36-37, in Paracelsian and alchemical theory, 3 and reason, and passion, distinct from, 131 during Restoration, role of, 176-177 Willis on, 36-37, 91

INDEX

Spirit, and matter. See Matter, and spirit Spirituous particles, of Oxford physiologists, 118 Spirits, animal and Descartes and blood, produced from, 59-60 and brain activity, and nerve transmission, stuff of, 56, 59 and pineal gland, 62, 63, 88, 132 substitution of meaning for, 64-65 Galen on in the cerebral ventricles, 88 coining term, and psychic pneuma, citing Herophilus, 59n36 and nerve transmission, stuff of, 59 and Willis in the brain, 136 and callous body, mingling in, 86 and cerebellum, manufacturing of, 88 and emotions, conveyance of, stored in annular protuberance before being transmitted in nerves, 139 and head or brain, diseases of, link to, 145, 146 nature of, 109 and nerve transmission, theories of, 108 and pathways, invisibility of, 79 role of, limit, 89 as "subtil," and needing no cavity, 85 in humoral thinking excess of, and convulsive disease, 142 and Locke habits of thinking, and motions of the body, in trains of motion of, 191192 Spiritual agency, in prime matter, Paracelsian theory, 27 Spleen in alchemical schemes, xxiii Aristotle on, 14 Descartes on, as origin of primitive passions, 133 and van Helmont, importance to, 31, 32, Highmore on, 163-164 in humoral theory, as container, 13 Oxford physiologists on, 163 Sprat, Thomas, 98, 104 History of the Royal Society, 157 Spurstowe, William, 13 Starkey, George Natures Explication, and Helmonts Vindication, and Pyrotechny Asserted and Illustrated, 36

243 Steno (Niels Stensen) on anatomy, 179-180 and Descartes, 179 and Oxford physiologists, 35 and Willis, 161, 179 Sterne, Laurence, 148 Stillingfleet, Edward, 114 Stoics, 134, 145 Stomach, xxiii, 31, 32, 164 Stone, Lawrence, 166 Streptomycin, 207 Structure and cause, 193 and matter, xi Stupidity, 144, 145f, 148 Substance, 177, 177n9 Suffering, as punishment, Conway on, 168 Sulfur, 27, 36-37 Sun, position and motion, illustrations of, Descartes, 69f Sweating, 37 Sydenham, Thomas, 180-186 and anatomists, critique of, 180-181 and anatomy, denigration of, 190 on botany, as reliable knowledge, 181 on cause, no-nothing posture concerning, 184 on "constitution," 184 on disease, as an invading it, 185 and experience, emphasis on, 180 on fever, 184, 185, 186 and Galen, 184 and van Helmont, 184, 185 and Hippocratic theory on epidemic fevers, 184-185 on hysteria, 185 and Locke, 193 in medical aristocracy, 187-188 and medical science, attack on, 183 on medicine as art, not science, 181 Methodus, 183, 185, 187 on natural philosophy and medical knowledge, 183-184 on nature as "abyss of cause," 180, 190 Observationes Medicae, 184 and Paracelsian notions of disease, 185 and phlebotomies, 185 on pleurisy, treatment of, 185 on "species," 184 on structure and cause, 193 on therapy, uncoupled from experimental philosophy, 185-186 and Willis, 184 Sylvius, (de la Boe, Franciscus), 35

244 Sylvius, Jacobus (Jacques de Bois), 5 Sympathetic chain of ganglion. See Intercostal nerve Tabula rasa, xxvii, 191n66 Teleogy, and natural philosophy, 97 Testicles, as primary noble part, 16 Theology, and natural philosophy, 91 Theophrastus, 6 Therapeutic nihilists, French, 186 Therapies, heroic, 186 Thevenot, Monsieur, 179 Thinking, habits of, Locke on, 191 Thinking, physiology of, and Descartes, 132 Thompson, Evan, 213 Thomson, George, 24, 39 Thoracic duct, discovery by Pecquet, 90 Thoughts, abstract and pure, Willis on, 136 Thumos (thymos), 129-130 Toleration Act of 1689, xxvii Transfusions, 41, 136 Uniformity, Act of 1662, 111 Upton, Christopher, 29 Uterus, 90, 154-155, 163. See also Womb Utopias, scientific, 212 Vaccines, 207 Vagus nerve, 138 Varela, Franciso, 213-214 Varolio, Costanzo, xxiv, 11, 50 Veins, 15-16 Ventricles, of brain, 84, 85 Vesalius, Andreas van Wesele on anatomy, human, x and artifice, 83 and Book of Nature, 6 brain illustrations of, 49-51, 49f, 5If and Butterfield's Scientific Revolution, exclusion from, 2 on dissection and illustration of human bodies, xxiv, 3, 4, 5-6, 8-9 Epitome, 4, 5, 8-9 and Galen editor of, xxiv, 5, 61 influence of, 12 and rete mirabile of, 61 and genitalia, isomorphic depiction of, 156 and Guinther of Andernach, 5 and Highmore's illustrations, 162 and humoral theory, 13

INDEX

and and and and

likeness, 17 materialism, 96 medicine and natural philosophy, 2-3 ocular demonstrations and experiments, 178 and pathological organs, 106 and Prince Philip, son and heir of Emperor Charles V, dedicatory epistle of Fabrica to, 4 On the Structure of the Human Body (Fabrica), x, xxiv, 4, 7, 8, 49-50, 49f, 51f, 61, 102 and Willis, 80, 87 Vicary, Thomas Anatomic of the Bodie of Man, 102 Villiers, George (Duke of Buckingham), 39 da Vinci, Leonardo, 50 Vitalism, 39, 168 Vulcan, instruments of, obstetrical forceps, Willis, 157, 160 Wales, Prince of, Henry, 102 Wallis, John, 26, 37, 135 Walpole, Horace, 159 Ward, John, 109, 165 Ward, Seth, 109, 135, 176 Water, as element, 12, 31, 32, 37 Wave propagation, 139 Wear, Andrew, 164n71 Weber, Max, viii, 117 Webster, Charles, 117 Webster, John, 176 Wepfer, Johann, 76 Western medicine, 95-96, 97. See also Biomedicine Westfall, Richard, 119 Wharton, Thomas Adenographia, 90 Whigs, 188 Whitaker, Jeremy, 103 Whitteridge, Gywneth, 23 Wilkins, John against cosmological claims about natural investigators, 35 and experiments, 29, 40 Mathematical Magick, Mercury: or the secret messenger, and Discourse Concerning the Possibility of Passage to the World in the Moon, 26 and Oxford experimental clubs, sponsor of, 26, 176 and transfusions, support of, 41

INDEX

William, King, xii, xxvii, 116, 189 Willis, Mary Fell, 112, 120 Willis, Thomas Affectionum quae Dicunter Hystericae et Hypochondriachae, 75, 120 and alchemy, xxvi, 35, 89, 117-118 and anatomy (and autopsy, dissection, and postmortem) abnormality in, "infirm Brain" or soul at "Civil War," 141 of brain and nerves, 80 comparative, 81-83, 82f, 87, 88, 138 as "conquering martial field of body," 169 of elite, 104, 106-107 of fetuses, recorded by Locke, 143 goal of, to "unlock secret places of Mans Mind," 141, 157 of Anne Greene, 101, 175-176 of Hammond, 105, 112 and medical knowledge, as true science, 141-142 performance of, 99 ritual different from Continental anatomy theaters, 107 of woman headache sufferer, 166-167 Anatomy of the Brain, x, xxvii, 75-90, 77f, 82f, 98, 99, 109, 136, 141, 144, 145f, 160, 162, 180, 186, 187, 191, 192 Anglican background of, 109 The Animal Soul, 144, 146 on animal spirits, 79, 85, 86, 88-89, 109, 139 and Aristotle, 76 as Baconian, 157 and Bathurst, 76 and blood and alchemists and natural philosophers, influence of, 35 on fermentation of, 162 and Harvey's circulation theory of, 186 and heart, 136 and humors, 37 and the brain from blood toward, 39 and blood and mind, and material connections with, 105 cerebral cortex and cranial nerves in, gender differences, 154 and cerebral hemispheres as castle, divided into towers of defense, 81 and cerebellum, 86-89

245 and cranial nerves, primacy of, in controlling passions, 135, 139 and rational soul's link with, 144-145 on solid portions of, primacy of, xxvii circle of, 81 on fluids (blood), secondary to, 154 on God's presence in, 180 illness of, and "evil conformation" theory, 118 illustrations of, 77f, 82f, 145f images of, long accepted, 108-109 on mind adhering to brain, 88, 87n49 and Minerva, retelling of myth, 157, 158 and nerve model of, 78-79, 86, 87-90, 139-140 orbicular prominences and annular protuberance of, 139 and "secret places" of human mind in, 183 out of the skull, 83 as solid, 84-85, 86, 154 structure of, 80-81, 84, 86-87 and ventricular circulation model of, demolition of, 85 on women's bodies governed by, and nerves, 153-154 and Cannon, 200 and Cashin, 187 and cerebral body model, xi, 118-119, 120-121, 148 on cultural map, 206 and gender assumptions in, 154 and influence on Sterne, Diderot, Rousseau, Richardson, MacKenzie, and de Sade, 148 and medicine, learned, 161 in physiology and neurology, presentday, xxvii, 76, 200, 20If, 202 as unsexed, 160-161 Cerebri Anatome, 120 during Civil War, clandestine Anglican services in Oxford lodgings, 112 and Conway's headaches, use of military rhetoric, 166 and Damasio, 211 death of, xxvii, 180 and Descartes, 53, 85-87, 135 Diatribae, 36 Diatribae duae Medico Philosphicae, 120 and empirical evidence, comparative anatomy, and medical practice, reliance on, 135

246 Willis, Thomas (continued) and experimental clubs, formation of, xxvi and experiments, animal injection and vascular mapping, 40-41 on Fallopius, as authority, 87 and Margaret Fell, marriage to, 112 on fermentation, 36-37 On Fermentation, 37 On Fevers, 37 and Galen, 76, 80, 87, 186 and Gassendi, 76 112 and Hammond, 105, 112, 113 on heart, as location of vital flame, 138 and hierarchy, in physiology, counterpart in social and political arenas, 116 and Hippocrates, 76 on humans in middle zone between angels and lower animals, 81 on hysteria, 160-164, 165-166 influence of, 189-194 and Locke, xxvii, 181, 183-184, 192, 193 and Lower, 76, 110 and materialism, 96 and mathematics, 79-80 on medical practice, "unlearned," 159 on mental functions, materialization of, 138 and microscope, 105, 183 and military and governmental metaphors, use of, 87-90 and Millington, 76 on musical ability, 87, 192 and nature, and ocular demonstrations, belief in, 157 on nerves and baser functions, controllers of, 162-163 corpus striatum and corpus callosum of, 119 "Description and Use of," 87, 90 fibers of, 85 on intercostal innervation of diaphragm, and intercostal nerve as "quick commerce" between brain and heart, and why reason triumphs, 138 on women's bodies governed by, and brain, 153-154 and ocular demonstrations and experiments, 178 and Paracelsus, 27

INDEX Pathologic Cerebri, 120 Pathology of the Brain and Nervous Stock in Which Convulsive Diseases Are Treated Of, xxvii, 75, 76, 98, 99, 141, 146, 162 patronage of, 109 Pharmaceutice Rationalis, 75, 120 as physician, prosperous, pious, xxvii, 78-79 on physicians, as Christ-like, 98, 117 on physiology of passion and reason, 135-140 and pathology, links between, 141-148 and rational therapeutics, 178 Rational Therapeutics, xxvii, 98 and reason, and experimental and anatomical investigation, emphasis on, 180 and religion, 98 and Royalist forces, xxv as Sedleian Professor of Natural Philosophy at Oxford, 110, 135 and Sheldon, xxvii, 110 on the soul of Galen, and body framework, 137 and Hammond's characterization of, 113 in neurological terms, 112 and Plato's sensitive and/or rational, and multi-part, 132, 136 rational, 139, 144-145 and resurrection of, 118-119 On the Soul of Brutes, or De Anima Brutorum, xxvii, 75, 108, 120, 141 and Steno, 179 and Sydenham, 183-184 on tabula rasa, in infants' cerebrum, 191n66 in Uncertain Art of Physick, 108 and Vesalius, 80, 87 on "war" between flesh and spirit, 133, 136-137 and Wepfer, 76 work, publication of, xxvii, 75, 120 and Wren, 76 Willis's circle, collateral circulation at base of brain, 200, 202 Winthrop, John, 115 Witnessing, 96, 97, 107 Wittgenstein, Ludwig, 108 Woman, as Seed, as Christ's presence in body, Fox, 168 Womb, 153, 155, 158, 160, 161. See also Uterus

247

INDEX

Women practicing medical care, criticized by Sydenham, 187-188 and science, and nature, ideologies of, 154n5 Women's bodies, 153-154, 155-156 Women's health texts, 155-156, 156n21 Women's physiology, 153-156 and pathology, Highmore, 163 Wonder, located in brain, Descartes, 134 Word, and image, conflict, 9, 10 Wren, Christopher Anglican, High-Church, background of, 109 architectural commission for London churches, xxvii, 110-111 and brain, illustrations of, xxvii, 76, 77f, 82f, 109, 144, 145f

brain-from-below illustration, and present-day visual aid, 200-202, 20If, 207 brain-from-below image, on cultural map, 207 and experiments, injection and transfusion, 40-41, 136 and Restoration thought, 120 as Savilian Professor of Astronomy at Oxford, 110 and Sheldon, 110 and Sheldonian Theatre, commission to design, 111 as Sprat's exemplary philosopher, 158 Zeus, 130

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