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" M A R V E L L O U S P A R A C E L S U S . " ~

B y KATHLEEN MURPHY,

E ARLY in the sixteenth century there swaggered (or staggered, as his enemies would have said) across the European stage one of the most spectacular figures in the

history of medicine, " Marvellous Paracelsus, always drunk and always lucid, like the heroes of Rabelais ". To-night we com- memorate the four hundredth anniversary of his death.

Philip Aurelius Theophrastus Bombast von Hohenheim was born at the village of Einsideln near Zurich on December 12th, 1493, but there was nothing fin de si~cle about Theophrastus. His mother was a hospital matron, his father a physician. He was a delicate rickety baby but, as he was fortunate enough to have the constant attention of a nurse and doctor, he grew to be a healthy boy. His mother died when he was yourLg, and although his father had a hard struggle to make a subsistence, yet he found time to teach his son medicine, surgery and alchemy.

From the first, Theophrastus questioned everything; and doubtless it was with a feeling of relief that his father sent him to study medicine at the University of Basle at the age of sixteen. It was about this time that Theophrastus changed his name to Paracelsus (greater than Celsus). He did not remain long at the University. Other people's books did not interest him. " Study nature," was his assertion, " for in her mysteries you will have enough to last you all your life without referring to paper books. This has been my academy, not Athens or Paris or Toulouse."

It is difficult to know the course that was .prescribed for a medical student four centuries ago, and little is known of his activities for the next six years beyond a reference to his stay at Wurzburg, where he studied astrology and alchemy under the Abbot Hans Trithemius. By fair means or foul, in 1515, he took his doctor's degree at Ferrara, where he had studied under Leonicenus. He was twenty-two years of age.

Having obtained his d~gree he started out on a twelve years' postgraduate course in the Academy of Nature. He went first to the mining school of Fugger in the Tyrol. Here he studied chemistry in the properties of the metals; and surgery and medi- cine in the accidents and diseases of the miners; while from the ]earned abbots in the country round he studied alchemy and astrology. From the Tyrol he wandered all over Europe; travel- ling through Germany, Italy, France, the Netherlands, England, Denmark, Sweden, Russia, Turkey, Egypt, Tartary, and possibly India. He associated with all sorts and conditions of people, physicians, alchemists, astrologists, apothecaries, miners, gypsies, hangmen, adepts of occult science and old women, and with them he discussed diseases and their treatment. He believed that the more one knew of other countries and peoples, the more one understood their diseases and methods of treatment, the more one

* Communicated to the Irish Paediatr ic Society, Oct. 6th, 1941.

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knew of one's own country. He wrote, during this period: " A

doctor must be a traveller because he must inquire of the world. Experiment is not sufficient. Experience must verify what can be accepted and not accepted. Knowledge is experience."

It was during this time he joined the army of the Emperor Charles V, as a surgeon, and acquired the famous sword which apparently became part of his equipment, because it was believed that in its pommel he carried the elixir of life.

In 1~26, at the age of thirty-three, he returned to Germany. The fame of his skill as a physician had gone before him, so that Frobenius, a well known printer ~of Basle, whose home was a centre of culture, being ill at this time, sent for Paracelsus. He came to Basle and cured him. Some short time afterwards, Erasmus, a friend of Frobenius, being also in need of a physician, wrote to Paracelsus: " I cannot offer thee a reward .equal to thy art and knowledge; I surely offer thee a grateful heart; thou hast recalled from the shade Frobenins, who is my other half. I f thou restorest me also, thou restorest each through the other. May fortune favour that thou remainest in Basle." Erasmus was cured, and shortly afterwards Paracelsus was offered the post of town physician and lecturer in medicine in Basle.

At this point ia our research it would seem advisable to pause and consider what sort of man these good burghers of Basle had, all unsnspectingly, " invited by an ample salary " as Paracelsus himself said, to be their M.O.H. and to lecture to their medical students.

I think I am right in saying that what they knew of him is what we ourselves already know, that he had travelled extensively, and so profited by his journeyings that his skill as a physician was recognised all over Europe.

In A l i ' s W e l l t h a t E n d z l W e l l Shakespeare, in reply to Lafew's reference to the King's case as incurable, makes Parolles reply: " So I say both of Galen and of Paracelsus." What the town authorities did not know was that Paracelsus had come to his own very definite conclusions as a result of his studies and experiments in the Academy of Nature. He was determined to teach his students his own opinions rather than those of the accepted authorities. He intended to expound to them, to quote his own words, " the books both of practical and theoretical medicine, physics and surgery whereof I myself am author, with the greatest diligence and to the great profit of my hearers. I have not patched up these bo_oks after the fashion of others; from Hippocrates, Galen or anyone else, but by experience, the Great Teacher, and by labour have I composed them. Accordingly if I wish to prove anything, experiment and reason for me tak.e the place of authorities. Wherefore, most excellent readers, if anyone is delighted with the mysteries of this Appollonian Art ; if anyone lives and desires i t , if anyone longs in a brief space of time to acquire this whole branch of learning, let him forthwith betake himself to us at Basle, and he will attain to 'far greater things

"MARVELLOUS PARACELSUS " 637

than I can describe in a few words. The ancients gave wrong names to almost all diseases; hence no doctors, or at least very few at the present day, are fortunate enough to know exactly diseases, their causes and critical days. Let these proofs be suffi- cient, notwithstanding their obscurity. I do not permit you to rashly judge them before you have heard Theophrastus. Farewell. Look favourably at this attempt at the restoration of medicine."

In other words, Paracelsus was a reformer; in violent opposition to the medical opinion of his day. He had come to the conclusion that man was a chemical compound, and that the logical treat- ment of a patient was to dose him with inorganic salts and to abandon the herbs and extracts chiefly used by the physicians of his time. But we are running too far ahead and must now return to our lecturer, and describe his first appearance before his students.

It was certainly a dramatic introduction to public life in Basle. He appeared before his students at his first lecture with a brass pan containing the works of Galen and Avicenna, the most revered medical authorities of the time. In the brass pan were also some sulphur and nitre, and he set fire to the books, express- ing the hope that their authors were in like circumstances. He then ,proceeded to lecture in German to the great astonishment of his hearers, as up to this time all lectures had been delivered in Latin. " All universities," he said, " have less experience than my beard, and the down on my neck is more learned than my auditors ". He proceeded to attack the physicians and apothe- caries of the town and their methods of treating the sick with herbs, roots and syrups. " The physician's duty is to heal the sick " he cried, " not to enrich the apothecaries " ; and, still speaking of his colleagues, he continued: " They think it suffices if, like the apothecaries, they jumble a lot of things together and say ' fia, t ung~n tum ' ."

His colossal conceit, his hot tongue, and his contemptuous attitude to his brother physicians were not calculated ~ endear him to the hearts of the prominent doctors in the town. But ~his did not trouble Paracelsus. He despised contemporary opinion, and all the wrath of his colleagues did not deter him from his efforts at reforming medicine in accordance with his own ideas. As town physician he visited the apothecaries' stores and jeered 'at their collections of herbs, syrups and decoctions. He drew the attention of the town authorities to the lamentable state of their wares and the inadequacy of their drugs in the treatment of disease. He declared : " The apothecaries are my enemies, because I will not empty their boxes. My recipes are simple and do not call for 40 or 50 ingredients." His vituperation did not confine itself to general attacks on the whole body of physicians. Indi- vidual members felt the venom of his tongue. To one of them he begins a letter: " So then, you wormy and lousy Sophist".~ No wonder he laid of himself: " I please no one but the sick whom I heal."

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For two years this bombastic, arrogant seeker after truth, thin fearless reformer, this man of powerful and persistent convictions, this roysterer in taverns (with a permanent taste for low company), this experimental chemist, this successful physician and surgeon, this friend of the poor was a thorn in the sides of his colleagues and of the apothecaries. At last an opportunity arose in which public opinion could express itself. A certain Canon Cornelius yon Lichenfels fell ill. All the other doctors had given up his case. Paracelsus was called on. The Canon promised him a fee of one hundred gulden if he cured him. Paracelsus came and saw and conquered the disease; but his treatment was too simple; it consisted of three small pills. If you think the Canon was going to pay a hundred gulden for three small pills, you are mistaken. I myself feel convinced that if Paracelsus had had a good bedside manner, had paid several and lengthy visits, and skilfully inserted the three small pills into a course of herbs and decoctions, the Canon would have paid the promised fee without hesitation. But Paracelsus was a plain, blunt man ; and the Canon offered him a fee of five gulden. Enraged by the injustice of such treatment, Paracelsus sued the Canon for his fee. Public opinion, which he never attempted to conciliate, was against him and. to the discredit of his judges, he lost his case. Paracelsus then told them, in the way that Paracelsus could, what he thought of the whole case and of their notions of justice and, indeed, of their private characters. So little doubt did he leave on the subject that his friends advised him to leave Basle at once, as he would undoubtedly be severely punished for his attack on the authori- ties. In 1529 Paracelsus fled from the wrath of the outraged municipal dignitaries, having spent two years in Basle, the longest stay he is known to have made in any one place.

Paracelsus, the wanderer, started on his travels again, and this time he went to Nuremberg. Here he prepared to publish another medical work. The medical faculty brought pressure to bear on the authorities and the sale of the work was prohibited. Even free Nuremberg was not free to Paracelsus. He went to Ratisbon, where he spent some time in writing several of his works. Later he went to .St. Gall, where he ministered to the health of the poor free of charge and continued his writing. He spent the following three years travelling in Switzerland. He then journeyed to Innsbruck, to Stretzing, to Ulm and on to Vienna, practising medicine and writing. At length he was invited to Salzbur,g by the Prince Palatine, Duke Ernest of Bavaria. Here he seems to have found a restful and congenial atmosphere, but he was destined to enjoy it for a short time only. On September 24th, 1541, he died. Several authorities say that his death was the result of a drunken brawl; but one author suggests that he was thrown down from a steep place by the emissaries of the enraged physicians and apothecaries. He died, then, at the early age of 48 years, a comparatively young man, worn out by the restless and strenuous life he had led, ahd disappointed by his failure ~o

" M A R V E L L O U S PARACELSUS " 639

reform medicine and by the fact that his teachings were held in contempt by the large majority of medical men and students.

To what then, does Paracelsus owe his honourable position in the history of medicine? The answer to this query lies in his emphatic opinion as to the aim of chemistry: " The object of chemistry is not to make gold but to prepare medicines ". I-Ie was the founder of a new school of medicine ; the first of the iatro- or medical-chemists. The relentless war he waged against con- temporary medicine had the effect of making chemistry an indis- pensable part of medical training. He induced the alchemists to give up their search for gold and to devote their chemical skill to the preparation of remedies, while at the same time he com- pelled the physicians to ]earn a little chemistry. He instituted the practice of ,giving chemical substancr internally as medicines, and employed compounds of antimony, mercury and other metals in this manner. He made opium, mercury, lead, sulphur, iron, arsenic, copper sulphate, and potassium sulphate a part of the pharmacopoeia. Before his time the metals and their preparations were regarded as poisons, and thus as unsuitable for internal administration. He popularised tinctures and alcoholic extracts. That he was an accomplished experimenter is certain; among items of chemical information scattered throughout his books are references to zinc, cobalt and bismuth; to the fact that a gas is given off when iron is dissolved in dilute sulphuric acid and to the bleaching action of sulphur dioxide. He describes a substance as extract of vitriol, which is clearly ether, about which he says: " It possesses an agreeable taste; even chickens will eat it, where- upon they sleep for an immoderately long time and reawake without having been injured." He was the first to isolate hydrogen by the action of iron filings on vinegar. He introduced mineral baths and analysed them. He anticipated Pasteur in his contention that-putrefaction cannot give rise to a new body; the seed, he he!d, must pre-exist.

On the purely medical side he was the first to write on diathetic disease, advancing the theory that in gout there were tartaric deposits in the joints not found in the healthy body. In connec- tion with this theory of tar tar he found it necessary to subject urine to chemical analysis, and perhaps some of my readers can say how far he was pioneer in this respect.

He was the first to show the relation between cretinism and endemic goitre and the first to write on miners' occupational diseases. He was the first physician to describe the stages of syphilis and its transmission to children. He believed there was a specific remedy for each disease, and he used mercury in syphilis.

We are told by a contemporary that Paracelsus was most laborious, that he would often throw himself fully dressed, booted and spurred upon his bed and write ceaselessly for hours. I f anyone would like to read his publications (234 in number, for he w,~s a prolific ~vriter) I would like to warn him that they a~re by no

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means easy to decipher. As Thompson bitterly complains : " How can we look for a regular system of opinions from a man who dictated his work when in a state of intoxication, and thus laboured under an almost constant deprivation of reason?" Baas says that reading Paracelsus is like delving in a mine in a strange world of mystic principles, macrocosms and microcosms, Arch~ei, and Arcana, enlivened by gnomes, sprites and salamanders.

As in his lifetime he made many enemies and had few friends, so, after four hundred years, the students of his character are as hotly divided in their opinions as in his lifetime. Referring to his dispute with the Canon, one author says that it was a scandalous quarr.el over a fee due to Paracelsus' greed for money; yet we know that he treated the poor free of charge in St. Gall. Did he not cure Erasmus who only offered him a grateful heart? Surely with his European reputation it seems reasonable to suppose that he could have been one of the wealthiest practitioners of his time, had he been content to settle down and reap the harvest of his wanderings and privations. Does not the record of his life prove to us that he placed the love of justice and belief in the new gospel of iatro-chemistry before his personal profit? " I t is indeed true," he says, " that those who do not roam have greater possessions than those who do. Those who sit beside the stove eat partridge and those who follow after knowledge .eat milk broth; he who will serve the belly, he will not follow after me." He is referred to, often and disparagingly, as a " quack " ; and only one of many authors gives the date and place of his qualifica- tion; but I t'hink it most unlikely that he would have been appointed town physician and lecturer in medicine if he had not had the usual qualifications necessary at the time. As to his low companions, everything we know of him would suggest that he found the common people much more colourful and interesting than his pompous colleagues.

As for the reproach of constant drunkenness, this does not seem to me to hold water. His publications, his researches, his cures, the absence of any suggestion that his work was seriously im- paired or any of his positions lost through drink, is sufficient to answer his critics on this score.

He was the first popular physician in the broadest sense of the word. He spoke the language of the people. He loved the people and he left his few possessions to the people.

To-day, engTaved on a broken pyramid of white marble in the cemetery of the Hospital of St. Sebastian in Salzburg, may be read :--

" Here is buried Phillippus Theophrastus, the famous doctor of medicine, who by his wonderful art cured dire wounds; leprosy, gout, dropsy and other diseases deemed incurable, and to his honour shared his possessions with the poor."

And to this day the peasants from all over the countryside make pilgrimages to the tomb of Paracelsus to pray for good health.