Boerhaave, Hermann

(b. Voorhout, Netherlands, 31 December 1668; d. Leiden, Netherlands, 23 September 1738)

medicine, botany, chemistry.

Boerhaave was the son of the Reverend Jacobus Boerhaave and of his second wife, Hagar Daelder. The boy’s mother died when he was five years old; his father then married Eva Dubois, the daughter of a Leiden clergyman, who proved to be a devoted stepmother. The elder Boerhaave personally saw to his son’s upbringing, supervising his physical, as well as moral and intellectual, education. Boerhaave also spent three years in the grammar school in Leiden.

Boerhaave’s father died in 1683; in accordance with his wish, Boerhaave applied himself to the study of theology and philosophy upon his matriculation at the University of Leiden in 1684. As a student, Boerhaave distinguished himself by a series of five disputations, three of which dealt with the human mind. He also delivered an oration on Cicero’s view of Epicurus’, concept of the summum bonum, for which the governors of the university awarded him a gold medal. He earned a degree in philosophy in 1690 with a thesis on the distinction of mind from body.

Upon graduation, Boerhaave continued to study theology. At the same time, however, his interest began to turn to medicine. He attended the yearly public dissections conducted by Anton Nuck and independently studied the works of Hippocrates, Vesalius, Fallopio, Bartholin, and Sydenham. In 1963 he took a medical degree at the academy of Harderwijk, having presented a thesis, De utilitate explorandorum in aegris excrementorum ut signorum.

Unfounded rumors had raised the suspicion that Boerhaave was a secret adherent of Spinoza: since such an allegation could only damage his ecclesiastical career, he turned definitly to a medical one. He settled in Leiden, augmenting the income from his small practice by giving lessons in mathematics. In 1701 he was appointed a lecturer in medicine by the University of Leiden; in his inaugural public address he advocated the study of the works of Hippocrates. He lectured on the institutiones medicae at the university, and gave private lectures on the theory and practice of medicine (for which he was paid by his students). In addition, he began to lecture on chemistry at the request of foreign (probably English) students.

Boerhaave restored the declining prestige of the Faculty of Medicine at Leiden, and in 1703 he was offered a professorship at the University of Groningen. He rejected the offer, and the governors of Leiden, anxious to retain him, promised him the first chair to become vacant there. At the same time, he was authorized to give an academic oration. This address, De usu ratiocinii mechanici in medicina, was his iatromechanistic credo.

Boerhaave’s lectures became the basis for several textbooks. His Institutiones medicae was published in 1708 and his Aphorismi de cognoscendis er curandis morbis appeared in 1709. These books were largely responsible for Boerhaave’s European reputation; indeed, pirated editions appeared both in the original Latin and in modern languages.

In 1709 the chair of botany and medicine fell vacant at Leiden, and Boerhaave was immediately appointed to it. He thus entered into a new field of science. As professor of botany, he was ex officio supervisor of the university’s botanical garden and was given an official residence and an allowance for foreign correspondence and the exchange of seeds and plants. He hastily drew up a new catalog of plants for the garden (Index Plantarum, 1710)—the previous list dated from 1687. During the next ten years, Boerhaave made extensive additions to the botanical garden, and the second edition of his catalog (Index alter, 1720) listed 5,846 species, more than 2,000 more than his earlier index. Although he was totally untrained in botany, Boerhaave recognized the need for a new system of classification; he was aware of his own limitations, however, and made no attempt to provide one. Rather, he helped Linnaeus in every way that he could.

On 14 September 1710 Boerhaave married Maria Drolenvaux, the daughter of a rich merchant. They had four children, of whom one daughter, Maria Joanna, lived to adulthood.

In 1714 Boerhaave was appointed vice-chancellor of the university, a position that he again filled in 1730. The same year he was, perhaps by his own request, charged with clinical teaching, which in Leiden had been practiced since 1637 but had fallen into neglect. Boerhaave revivified bedside teaching (for which two six-bed wards, one for men and one for women, of the Caecilia Hospital were reserved) and raised it to new heights, attracting students from all over Europe. His oration De comparando certo in physicis, made 8 February 1715, marked the end of his first term as vice-chancellor.

When Le Mort, the professor of chemistry, died in 1718, Boerhaave was chosen to succeed him, and for the next ten years he held simultaneously three of the five chairs that constituted the whole of Leiden’s Faculty of Medicine. Boerhaave assumed his new duties with the oration De chemia suos errores expurgante. He lectured with extraordinary zeal and energy, four or five hours a day, until he was halted by a severe, painful illness (which he himself diagnosed as lumbago rheumatica, as described by Sydenham) that confined him to bed for five months in 1722. In January 1723 the students and citizens of Leiden celebrated his recovery and return to teaching with illuminations of the university building and a large part of the city.

Boerhaave was undeniably a great teacher. His lecture room was crowded with students from several countries from several countries (all lectures were given in Latin, of which Boerhaave had an easy mastery). Often many students had to stand, and some young noblemen were known to hire men to get to the classroom early to reserve their seats. Haller called Boerhaave communis Europae praeceptor; in the years of his tenure, 1,919 students were enrolled in the Medical Faculty, of whom 659 came from English-speaking countries. Many of his students copied out their lecture notes copied by others in some instances; several exercise books containing unpublished lectures are thus extant, in addition to his lectures as published by some pupils.

Boerhaave’s influence spread throughout Europe. His textbooks were published in Great Britain, France, Germany, and Italy, among other countries, and his students transmitted his teachings (even to later generations, since after Boerhaave’s death Haller published a seven-volume edition of the Institutiones, and Gerard van Swieten published a five-volume commentary on his Aphorismi). The medical faculties of the uniersities of Vienna, Göttingen, and Edinburgh were begun or reformed after the system that Boerhaave instituted at Leiden. Indeed, the modern medical curriculum—with its emphasis on natural science, anatomy, physiology, pathology, and, in particular, clinical training—owes much to Boerhaave. His little book Atrocis, nec descripti prius, morbi historia (1724) made a twofold contribution to medicine. In this case history—that of Baronet Wassenaer, Admiral of the Republic, who ate a heavy meal, experienced severe chest pains, and died the next day—Boerhaave, who performed the post mortem examination himself, made the first diagnosis of a spontaneous rupture of the esophagus. Moreover, in his presentation, he established the classic form for a morbid history—anamnesis, physical examination, diagnosis, history of the disease, and autopsy findings.

Boerhaave’s interest in, and influence on, systematism extended to the synthesis of older and newer theories of medicine. Medical science was in a state of confusion at the beginning of the eighteenth century: the heritage of old Greek medicine was still honored, but no attempt had been made to reconcile it with the medical discoveries of the previous century. Boerhaave attempted to build a comprehensive medical doctrine. To this end he published a new edition of the works of Aretaeus of Cappadocia, which he furnished with a valuable critical apparatus, and reedited or wrote new prefaces for editions of the works of Prospero Alpini, Eustachius, Bellini, Carolus, and Nicholas Piso. With his younger colleague B. S. Albinus he reedited the Opera omnia of the great anatomist Vesalius. Another work on anatomy is his Opusculum anatomicum de fabrica glandularum (1722), in which he defended Malpighi’s concept of the structure of the glands against that of Fredrik Ruysch.

He further collected the iatromechanical theories of the late seventeenth century—most notably those of Willis, Baglivi, Borelli, and Bellini—and merged them into a creative synthesis. For example, Boerhaave, like Baglivi, stressed the pathological and therapeutic significance of mechanically deranged body fibers, but at the same time he joined Borelli’s and Bellini’s iatromechanical theories to Willis’ detailed discussions of nervous disorders. In attempting to develop a satisfactory theory of a self-regulating bodily machine, Boerhaave manipulated the older ideas—without, however, entire success.

Accepting Leeuwenhoek’s faulty interpretation of the process of hemolysis, he held that, in the blood, the red globules could be broken up into six yellow globules, which in turn consisted of six very small pellucid spherules, thought to be made up of particles too small to be visible through the microscope. Boerhaave made appropriate distinction of orders of vessels into sanguiferous arteries, of which the smallest would admit one red globule; serous capillaries, of which the smallest would admit one yellow globule; lymphatic vessels, which would admit nothing larger than the pellucid spherules; and a series of still smaller vessels, in descending order of diameter, which would admit specific particles. In his attempt to explain the vital phenomena, Boerhaave rejected the hypotheses of the iatrochemical school and used hydraulic and mechanical principles, taking into account the velocity of the blood, the angle and diameter of the vessels, the size and shape of the particles, the viscosity of the blood, and so forth. He interpreted inflammation, for example, as the result of stagnation of the blood in the smallest capillaries combined with an increased velocity of the blood, leading to increased pressure on the obstructing matter. Moreover, the smallest elements of the walls of the vessels might be too rigid and stiff or too weak and lax, which could produce pathological conditions. (Since Boerhaave could not know of the microbiological causes of disease, he attributed many of them to insufficient digestion of food, from which an acid or alkaline putrid acrimony might arise, for which he advised proper therapeutic measures.) Thus he devised a doctrine that was generally accepted for some time—although it failed him as an explanation for specific secretion of the glands.

Boerhaave belongs, with Stahl and Hoffmann, to the great systematists of the early eighteenth century. Apparently there was a demand for a comprehensive and consistent medical system for the mass of new facts and observations that he had scrupulously collected and attempted to arrange appropriately.

How much his system was appreciated by his pupils may be gathered from the words of one of them, his biographer W. Burton: “It will now perhaps be universally granted that our professor has indeed supplied us with the best system from an unparallel’d fund of medical learning happily digested.”

Boerhaave was influenced by the philosophy of Descartes, but more so by the great English scientists Boyle and Newton. He accepted the corpuscular theory of the structure of matter. In accordance with this, his system was essentially mechanistic, although he acted eclectically and introduced chemical and other viewpoints. Nevertheless, although he avoided the extreme one-sidedness of the iatrochemical school, against which he campaigned, he tried to understand the vital processes and phenomena in the body, using an inanimate model.

In this respect he was in direct opposition to the animistic organicism of his contemporary Stahl, who understood the distinction between an organism and a mechanism better than Boerhaave. (Boerhaave never entered into a discussion with Stahl and he did not even mention Stahl’s well-known phlogiston theory in his chemical textbook.)

The inconsistencies of Boerhaave’s system generated discussion that eventually led, however, to the statement of the problems of animal heat and irritability. Boerhaave’s contribution to physiology thus came as an almost accidental side effect: but there is no doubt that his work served as the stimulus to physiological research of the latter half of the eighteenth century, and that he contributed significantly to the discussion of the important problems that his work raised. Boerhaave’s lasting influence on medicine does not lie so much in his system, or in new discoveries, but in his teaching. In his clinical instruction he indoctrinated his pupils with the old Hippocratic method of bedside observation and taught them to act methodically in the examination of their patients.

Boerhaave’s most important contributions to science, perhaps, were made in chemistry—paradoxically, since his medical system was mainly based on mechanics and he did not think that chemistry was yet an adult science. He introduced exact, quantitative methods into chemistry by measuring temperature and using the best available balances made by Fahrenheit; indeed, he may be considered the founder of physical chemistry as well as a contributor to pneumatic chemistry and biochemistry. He was an indefatigable experimenter, exhibiting an unbelievable tenacity in his experiments on mercury. He introduced biochemical demonstrations into his chemical courses for medical students.

Boerhaave was the first to obtain urea, by a procedure that took more than a year, and to discover its diuretic properties, as well as its cooling effect when dissolved in water. He demonstrated that water could be obtained by condensation from burning alcohol, and described a rapid method of making vinegar—sometimes called Boerhaave’s method.

Boerhaave’s attitude toward alchemy was some-what ambiguous; he did not dogmatically deny a priori the possibility of the transmutation of metals, but examined it in a series of painstaking experiments that lasted over a period of many years. He purified his mercury specimens by forcing them through leather and then washing them in seawater. In one experiment, he used a fulling mill to shake a specimen of mercury, enclosed in a glass bottle, for a period of eight and one-half months; he then distilled it sixty-one times. Other specimens of mercury were variously heated for fifteen and one-half years, boiled 511 times, or mixed with gold and then distilled 877 times. Gold remained gold, and mercury, mercury; he did, however, obtain mercury with the specific weight of 14.1 as the result of one of these year-long experiments. These experiments were published in the Philosophical Transactions of the Royal Society of London (1734–1736).

After his illness of 1722, Boerhaave realized he must take care of his health. In 1724 he bought an estate near Leiden, where he spent his leisure time arranging a great private botanical garden. He published, at the dying author’s request, a splendid edition of Sebastian Vaiilant’s Botanicon Parisiense in 1727. In 1729 he resigned his professorships of botany and chemistry; on this occasion he made a publicoration in which he took a retrospective view on his career and thanked many botanists throughout Europe who had helped him in enriching the garden. He continued, however, to lecture on the theory and the practice of medicine and to give clinical demonstrations until the year of his death. When a spurious edition of his chemical lecture notes was published in 1724 as Institutiones et experimenta chemiae (translated into English by Shaw and Chambers under the captivating title The New Chemistry), he felt impelled to publish a textbook on chemistry, the Elementa chemiae, which was later translated into English and French and remained the authoritative chemical manual for decades. In addition he published the papers of Jan Swammerdam, which he had bought in Paris, in both Dutch and Latin, as Biblia naturae (2 volumes, 1737–1738).

His popularity was now at its highest: he was created a foreign member of the Académie Royale des Sciences of Paris (1728) and elected a fellow of the Royal Society of London (1730); the czarina of Russia invited him to become her court physician, and royalty and members of the nobility sought his advice. He was now the most famous man of science in Europe and was considered an oracle. The secret of his influence lay in the conjunction of a universal scholarship with a cheerful personality and impeccable character.

In autumn 1737 Boerhaave began to show symptoms of serious heart failure. Dyspnea forced him to interrupt a bedside lecture in April 1738; he made his will, advised the governors of the university about the choice of his successor, and died in his house in Leiden, after an illness of several months. He was buried in St. Peter’s Church, and the whole scholarly community of Europe mourned him. On 4 November 1738 his friend Albertus Schultens delivered a eulogy based, in part, upon autobiographical notes left by Boerhaave.

BIBLIOGRAPHY

I. Original Works. Boerhaave’s Atrocis, nec descriptiprius, morbi historia, a facsimile of the first edition (1724) and first French translation, with an introduction by G.A. Lindeboom, appeared as the ninth volume in the series Dutch Classics in the History of Science (Nieuwkoop, 1964).

A complete list of all works written, edited, or provided with a preface by Boerhaave, as well as of the works based on his textbooks, lectures, etc., is in G.A. Lindeboom, Bibliographia Boerhaaviana (Leiden, 1959). See also Lindeboom, ed., Boerhaave’s Correspondence, 2 vols. (Leiden, 1962–1964).

II. Secondary Literature. Further works on Boerhaave are [W. Burton] An Account of the Life and Writings of Herman Boerhaave (London, 1743); F. W. Gibbs, “Boerhaave and the Botanists,” in Annals of Science13 (1957), 47–61, and “Boerhaave’s Chemical Writings,” in Ambix, 6 (1958), 117–135; F.R. Jevons, “Boerhaave’s Biochemistry,” in Medical History, 6 (1962), 343–362; Lester S. King, The Medical World of the Eighteenth Century (Chicago, 1958), chs. 3 and 4, and The Growth of Medical Thought (Chicago, 1963), pp. 177–185; G.A. Lindeboom, Iconographia Boerhaavii (Leiden, 1963), and Herman Boerhaave. The Man and His Work (London, 1968); M. Maty, Essai sur le caractère du grand mèdecin ou Éloge de Mr. Herman Boerhaave (Cologne, 1747); and D. Schoute et al., Memorialia Hermanni Boerhaave (Haarlem, 1939), lectures given at the 1938 international Boerhaave commemoration.

G. A. Lindeboom

Hermann Boerhaave

1668-1738

Dutch Physician and Chemist

The Dutch physician and professor of medicine Hermann Boerhaave was widely known and revered for his exemplary role in teaching clinical, or "bedside," medicine. Although Boerhaave is not associated with any major discoveries in medicine or chemistry, his reputation as a teacher and writer was so great that his contemporaries considered him comparable to Sir Isaac Newton. He was considered the greatest clinical teacher of his time and the most eminent of European physicians.

Boerhaave, the son of a minister, was born in Verhout, Holland. He was expected to follow in his father's profession, but he became fascinated by chemistry and decided on a career in medicine. In 1684 he became a student at the University of Leiden and took courses in chemistry, botany, medicine, philosophy, languages, and philosophy. He graduated in natural philosophy in 1687. After qualifying in medicine at the University of Harderwijk in 1693, he returned to Leiden, where he began taking private pupils and teaching medicine and chemistry. He was offered a professorship at the University of Groningen in 1703 but declined it so that he could wait for an appointment to the University of Leiden. In 1709 he was appointed to the chair of medicine and botany at the University of Leiden. Boerhaave dedicated the rest of his professional life to the University of Leiden. In addition to serving as professor of chemistry, botany, medicine, and clinical medicine, he was also rector of the university.

Founded in 1575 by William of Orange, the University of Leiden was, by the seventeenth century, highly respected as a center of learning in theology, science, and medicine. During the eighteenth century, thanks largely to Boerhaave, the University of Leiden also achieved distinction in the study of medicine. Students came from all parts of Europe to the University of Leiden in order to hear Boerhaave's lectures. His students carried word of Boerhaave's brilliant lectures to their own medical communities. Many of his best pupils became teachers at prestigious medical schools, where they exerted a profound influence on the teaching of medicine. Boerhaave is generally credited with establishing the system of teaching medical students at the bedside of the patient. Boerhaave also published medical textbooks that were widely used long after his death.

Boerhaave's major works were Medical Principles (1708), Aphorisms on the Recognition and Treatment of Diseases (1709), Index plantarum (1710), and Elements of Chemistry (1734). Some of his lectures were published in unauthorized versions by his students, including Historia plantarum and one version of Principles and Experiments in Chemistry. Boerhaave explicitly repudiated the latter text. His own Elements of Chemistry was considered one of the most learned works on chemistry ever published. It was translated into many languages and remained in use for almost 100 years.

Physicians throughout the world were guided by Boerhaave's teachings and his published aphorisms. (Aphorisms are concise or pithy expressions of doctrines or generally accepted truths.) Since the time of Hippocrates, aphorisms dealing with the symptoms, diagnosis, and prognosis of diseases had been used as guides to students and physicians. Boerhaave's collection of medical aphorisms provides a valuable summary of essentially all the medical knowledge available at the time.

With his colleague Bernard Siegfied Albinus (1697-1770), Boerhaave also edited the writings of Andreas Vesalius (1514-1564) and William Harvey (1578-1657). Albinus was the first anatomist to demonstrate the connection between the vascular systems of the mother and the fetus. He had been appointed to the chair of anatomy, surgery, and medicine at Leiden in 1721.

As both a teacher and a writer, Boerhaave was respected for his ability to systematize and convey to his students and readers all the useful medical information that was available at the time. Boerhaave was so famous that a letter bearing only the address "To the Greatest Physician in the World" was delivered to him.

LOIS N. MAGNER

Hermann Boerhaave

The Dutch physician and chemist Hermann Boerhaave (1668-1738) was the leading medical teacher of the early 18th century. His works on medicine and chemistry had widespread use as basic textbooks.

Hermann Boerhaave was born on Dec. 31, 1668, at Voorhout, Holland, the son of a minister in the Dutch Reformed Church. A painful leg ulcer which affected him for 5 years during his youth excited his interest in medicine. He aimed first to combine a career as a pastor and physician. After entering the University of Leiden in 1684, he took courses in mathematics, natural philosophy, botany, and languages, as well as in theology.

In 1690 Boerhaave obtained the degree of doctor of philosophy and began medical studies. As a physician, he was almost entirely self-taught, medical instruction at Leiden being at a low ebb. He obtained his medical degree in 1693 from the University of Harderwijk.

Having come under suspicion of being sympathetic to the doctrines of Spinoza, Boerhaave abandoned the idea of an ecclesiastical career and began to devote himself exclusively to medicine and science. His private practice in Leiden was not lucrative but left him time to continue his studies and begin extensive experiments in chemistry.

His highly successful teaching career began in 1701. He taught medicine at the University of Leiden and gave private courses in chemistry. During the next 8 years he published in Latin his two major medical works, The Institutes of Medicine and The Aphorisms concerning the Knowledge and Cure of Diseases. Numerous editions were produced and the works were widely translated, even into Japanese. They continued to be used as textbooks for at least 50 years after his death.

Boerhaave was appointed professor of medicine and botany in 1709. In this post he greatly improved the collection of the celebrated botanical garden of the University of Leiden and carried out an extensive correspondence with the world's leading botanists. In 1714 he became professor of medicine and a physician to St. Cecilia Hospital in Leiden. There in his small clinic he established the value of bedside teaching for medical training.

He obtained the chair of chemistry in 1718 and for 11 years held three chairs simultaneously. His definitive Elements of Chemistry (1732) became very famous and was the source of his influence on 18th-century chemistry.

A tall and robust man of immense erudition, Boerhaave was a superb teacher. He was patient, unaffected, and readily approachable by his students. They flocked from all parts of Europe to hear his lectures, thereby increasing the renown of the University of Leiden. Boerhaave died, universally esteemed, in 1738 of heart disease.

Further Reading

The definitive study of Boerhaave is G. A. Lindeboom, Herman Boerhaave: The Man and His Work (1968). A good background book is Douglas Guthrie, A History of Medicine (1945; rev. ed. 1958). □