Herman Boerhaave (December 31, 1668 - September 23, 1738) was a Dutch humanist, philosopher, and physician, regarded as the founder of clinical teaching and of the concept of the modern teaching hospital. Originally prepared by his father for the ministry, Boerhaave found himself fascinated by science and medicine. He made a methodical study of both, reading and cataloging all the available knowledge on those subjects. His hard work won him a position at the University of Leyden, in 1701, as a medical lecturer; he remained there until his retirement in 1729, as a professor of botany, chemistry, and medicine, rector and governor.
Boerhaave emphasized the importance of careful scientific experimentation and of the clear organization of scientific knowledge. Skilled in anatomy, botany, and chemistry, he combined these disciplines in an effort to advance scientific and medical knowledge. During his tenure, Leyden became the medical center of Europe, attracting students from all over Europe. Boerhaave revived the Hippocratic tradition of teaching students at the patients’ bedsides. He also insisted on performing autopsies in order to understand the connection between symptoms and lesions. Boerhaave was a devout Christian, and it was said that throughout his life, he began each day with meditation and prayer. He maintained that God and spiritual knowledge alone can give one peace of mind; while rigorous scientific studies are indispensable in solving problems and finding cures for patients.
Herman Boerhaave was born at Voorhout, near Leyden, Netherlands, early on December 31, 1668, to Hagar Daelder, a tradesman’s daughter, and James Boerhaave, minister of Voorhout. His mother died in 1678, when he was ten years old, and his father, left with seven young children to raise, married a second time to Eve du Bois, the daughter of a minister from Leyden. She was kind and impartial, and all the children came to regard her as their own mother. In his autobiography, Herman Boerhaave described his father as amiable, prudent, and tender towards his children, and a frugal manager of the meager family fortune. James Boerhaave, who was knowledgeable in history and genealogy, and versed in the Latin, Greek, and Hebrew languages, educated his nine children at home. He intended for Henry to become a minister like himself, and by the age of eleven the boy could read and translate Latin. The father also encouraged his children to spend time working in the fields, so that Boerhaave developed a lifelong love of botany and horticulture.
When he was twelve, Hermann began to suffer from a malignant ulcer on his left thigh, which caused excruciating pain and did not respond to the agonizing treatments of the surgeons. He suffered from this condition for five years, until he finally undertook his own treatment and managed to heal the ulcer by cauterizing it with salt and urine. The experience taught Boerhaave to empathize with those who were sick and in pain. When he was fourteen, his father brought him to attend school in Leyden, so that he could be nearer the surgeons who were treating him. He was entered in the public school there, where he won several prizes and was quickly advanced to the sixth and final year. In November, 1682, a few months before Henry was to enter the university, his father died, leaving a very slender provision for the sustenance of his widow and nine children, of which the eldest was not yet seventeen years old. Henry, faced with poverty, determined not to abandon his studies and received permission from his guardians to continue at school as long as his patrimony would support him.
He entered the University of Leyden, and with the encouragement of several professors who had been friends of his father, continued to pursue his studies in divinity. In 1689, he took his degree in philosophy with a dissertation De distinctione mentis a corpore, in which he attacked the doctrines of Epicurus, Thomas Hobbes, and Spinoza. He continued to study the writings of the early Christian fathers, and became conscious of the ways in which their ideas had been changed and adapted by later Christian scholars. In order to support himself, he tutored a small group of mathematics students. He began to be drawn to the study of medicine, and still intending to become a minister, began to study anatomy, chemistry, and the medical works of Hippocrates and of more modern physicians such as Sydenham. In 1693, he took his medical degree at the University of Harderwijk in present-day Gelderland, with a thesis, "de utilitate explorandorum excrementorum in ægris, ut signorum."
Returning to Leyden, he found rumors circulating that he was an atheist and a “Spinozist,” and realized that he would have difficulty realizing his ambitions to become a minister. Instead, he began to practice medicine. In 1701, he was appointed lecturer on the institutes of medicine at Leiden; in his inaugural discourse, De commendando Hippocratis studio, he recommended to his pupils that great physician as their model. He began lecturing on chemistry, organizing the conclusions that had been drawn from certain experiments around specific principles. His reputation began to grow. In 1703, he refused a lucrative offer of a professorship at Groningen; out of gratitude, the governors of the University of Leyden raised his salary and promised him the next open chair. On this occasion he gave a lecture recommending that application of scientific method to the inquiry into the causes of disease and the structures of the body, denouncing the misleading medical jargon of Paraclesus and Helmont.
His reputation was so wide-spread that The Gentleman's Magazine described him as such:
He was of a robust and athletick constitution of body, so hardened by early severities, and wholesome fatigue, that he was insensible of any sharpness of air, or inclemency of weather. He was tall, and remarkable for extraordinary strength. There was, in his air and motion, something rough and artless, but so majestick and great, at the same time, that no man ever looked upon him without veneration, and a kind of tacit submission to the superiority of his genius.
The vigour and activity of his mind sparkled visibly in his eyes; nor was it ever observed, that any change of his fortune, or alteration in his affairs, whether happy or unfortunate, affected his countenance.
He was always cheerful, and desirous of promoting mirth by a facetious and humorous conversation; he was never soured by calumny and detraction, nor ever thought it necessary to confute them; "for they are sparks," said he, "which, if you do not blow them, will go out of themselves."
In 1709, he became professor of botany and medicine, and gave a lecture promoting clarity and organization in medical science, and declaring that in order for science to be admired, it had to be understood. He doubled the size of the botanic garden of Leiden with his improvements and additions to it, and contributed to botanical science by the publication of numerous works descriptive of new species of plants. On September 14, 1710, Boerhaave married Maria Drolenvaux, the daughter of a rich merchant, Alderman Abraham Drolenvaux. They had four children, of whom one daughter, Maria Joanna, lived to adulthood.
In 1714, when he was appointed rector of the university, he succeeded Govert Bidloo in the chair of practical medicine, and in this capacity he introduced the modern system of clinical instruction. The same year, he was made physician of St. Augustin's hospital in Leyden, into which the students were admitted twice a week, to learn the practice of medicine at the bedsides of patients. Four years later he was also appointed to the chair of chemistry.
When he had laid down his office of governor of the university in 1715, Boerhaave gave an oration upon the subject of "attaining to certainty in natural philosophy;" strongly supporting experimental knowledge and criticizing philosophers for being too impatient with the slowness of scientific experimentation; for substituting their imaginations for inquiry into nature; and for preferring to form hypotheses, rather than conduct scientific observations. He declared that all the knowledge people have is only of such qualities as are discoverable by experience, or as may be deduced from experience by mathematical demonstration. This speech offended a professor of Franeker, who spoke out in vehement defense of Descartes and accused Boerhaave’s views of bordering on atheism. The governors of the University resented this professor’s treatment of Boerhaave, and demanded a recantation of his criticisms. When asked if there was any additional compensation which could be made for the insult, Boerhaave replied that "that he should think himself sufficiently compensated, if his adversary received no further molestation on his account."
Boerhaave’s reputation so increased the fame of the University of Leyden, especially as a school of medicine, that it became popular with visitors from every part of Europe. All the princes of Europe sent him pupils, who found in this skillful professor not only an inexhaustible teacher, but an affectionate guardian. When Peter the Great went to Holland in 1715, to study maritime affairs, he also took lessons from Boerhaave. Linnaeus traveled to see him, as did Voltaire. His reputation was not confined to Europe; a Chinese mandarin sent him a letter addressed to "the illustrious Boerhaave, physician in Europe," and it reached him in due course. The operating theater of the University of Leyden in which he once worked as an anatomist is now at the center of a museum named after him: The Boerhaave Museum.
In 1722, Boerhaave began to suffer from an extreme case of gout, which left him bedridden and motionless in excruciating pain for five months, but recovered the next year. He related to one of his friends, that when he lay whole days and nights without sleep, he diverted his thoughts by meditating upon his studies, and that he often relieved and mitigated his torments, by the recollection of what he had read, and by reviewing his knowledge.
In 1726, his affliction recurred and he was forced to resign his professorships in 1729, due to ill health. His farewell sermon asserted that the wonders of the human body demonstrate the power and wisdom of the Creator, and that science and art can produce nothing equal:
One instance I shall mention, which is produced by him [Boerhaave], of the vanity of any attempt to rival the work of God. Nothing is more boasted by the admirers of chymistry, than that they can, by artificial heats and digestion, imitate the productions of nature. "Let all these heroes of science meet together," says Boerhaave; "let them take bread and wine, the food that forms the blood of man, and, by assimilation, contributes to the growth of the body: let them try all their arts, they shall not be able, from these materials, to produce a single drop of blood. So much is the most common act of nature beyond the utmost efforts of the most extended science!" (Johnson, 154-184).
In 1728, he was elected into the French Academy of Sciences, and two years later into the Royal Society of London. Boerhaave continued his private medical practice for as long as he was able to, and died of a lingering and painful illness on September 23, 1738.
Hermann Boerhaave began his academic career as a theologian and philosopher, but is best known as a physician and scientist. He was one of the most influential clinicians and teachers of the eighteenth century, and helped to revive the Hippocratic method of instructing students at patients’ bedsides. He frequently performed postmortem examinations of patients, in order to demonstrate the relation of symptoms to lesions.
Boerhaave was the first to describe Boerhaave's Syndrome, which involves tearing of the esophagus, usually a consequence of vigorous vomiting. He notoriously described, in 1724, the case of Baron Jan von Wassenaer, a Dutch admiral who died of this condition following a gluttonous feast and subsequent regurgitation. This condition was uniformly fatal prior to modern surgical techniques allowing repair of the esophagus.
Whether studying philosophy, theology, or science, Boerhaave’s method was the same. He performed a methodical reading of all the recognized texts and documents on a subject, often in the original Latin, Greek, or Hebrew; organized and categorized the information; and followed this with careful experimentation. He did not tolerate “obscurity,” but sought clear understandings and explanations, and encouraged scientific investigation in order to discover the truth. Boerhaave believed that only those things which could be verified through scientific experimentation could be considered true knowledge.
Boerhaave was a devout Christian all of his life, beginning each day with an hour of meditation and prayer. He upheld the divine authority of the holy scriptures, maintaining that they alone taught the way of salvation, and that they only could give peace of mind. He was, however, critical of the ways in which philosophy had been applied to theology by the Scholastics. His lectures often referred to nature as the work of God.
His principal works are textbooks that were widely used during the eighteenth century:
All links retrieved February 14, 2013.
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