The Herbalist: Nicholas Culpeper and the Fight for Medical Freedom. Benjamin Woolley

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СКАЧАТЬ like William Attersoll – for their calloused knees, the stigmata of their overearnest piety.⁴⁵ He told the story of Sir William Rigdon, whose stomach filled with yellow bile, as a result of which he died hiccoughing. He noted that ‘in [men with] effeminate constitution the breasts [may be enlarged]; and in some milk’, citing as an example Sir Robert Shurley (c.1518–1628), envoy to the Shah of Persia and a kinsman of William Attersoll’s patron. Commenting on the anatomy of the penis, he noted that Lord Carey, presumably another aristocratic client, had a ‘pretty bauble, a whale’, and that a man who lived ‘behind Covent Garden’ to the west of the City had one ‘bigger than his belly … as if for a buffalo’.⁴⁶ He observed how ‘fecund’ the penis is in ‘giving birth to so many names for itself: twenty in Greek, sixteen in Latin. He dwelt on the nature of sexual urges, estimating that a healthy man can achieve up to eight copulations a night, though ‘some lusty Laurence will crack … 12 times’. ‘Few pass 3 in one night,’ he added, more realistically.⁴⁷ He also asserted that males ‘woo, allure, make love; female[s] yield, condescend, suffer – the contrary preposterous’. There were not, of course, any women in Harvey’s audience to challenge these assertions.⁴⁸

      The lectures were broken into three ‘courses’ performed ‘according to the [hour]glass’, in other words to a strict schedule: ‘1st lower venter [belly], nasty yet recompensed by admirable variety. 2nd the parlour [thorax or chest]. 3rd divine Banquet of the brain.’⁴⁹ The first course was completed in December 1616, the second in January 1618, the third, the ‘divine Banquet of the brain’, in February 1619. The exact date of the lectures depended on the availability of specimens and the weather, which had to be cold enough to prevent the body from decomposing before the dissection was complete.⁵⁰ Harvey reckoned that in the right conditions he had three days to complete a lecture before the body would start to ‘annoy’.⁵¹

      The proceedings would have been conducted with ceremony and decorum. Harvey was no foppish ‘gallant’ and disliked fancy clothes – ‘the best fashion to leap, to run, to do anything [is] strip [ped] to ye skin,’ he would tell his audience during the section on the epidermis.⁵² Nevertheless, he would have felt obliged to wear a purple gown and silk cap, the College livery for such occasions. He also carried a magnificent whalebone probe tipped with silver, which he used to point out parts of the body.

      His lectures would begin with a few philosophical observations. Harvey adopted the strictly scholastic view of anatomy, that it was first philosophical (concerned with revealing universal truths about nature and the cosmos), then medical (demonstrating medical theory), and finally mechanical (showing how the body worked). When it came to the philosophy, Harvey’s authority was Aristotle, his intellectual hero. Aristotle taught that knowledge was derived from observation and experimentation. He also taught that the cosmos had an order and unity. Every physical entity, including every organ of the body, had its place and purpose in this greater scheme, which he called nature. ‘The body as a whole and its several parts individually have definite operations for which they are made,’ he wrote in On the Parts of Animals.⁵³ Time and again in his lectures, Harvey would remind his audience of this. ‘Nature rummages as she can best stow’ in the way she arranges the organs, ‘as in ships’, adding that this arrangement was upset during pregnancy by ‘young girls … lacing’ their girdles too tight, which was why they should be told to ‘cut their laces’. Nature had also created ‘divers offices and divers instruments’ in the digestive tract, so that it could act like a chemical still, with ‘divers Heats [temperatures], vessels, furnaces to draw away the phlegm, raise the spirit, extract oil, ferment and prepare, circulate and perfect’. Considering genitalia, he noted that nature made sex pleasurable, even though it was ‘per se loathsome’. This was so that humans could produce ‘a kind of eternity by generating [offspring] similar to themselves through the ages’. Harvey, whose marriage produced no children, added in a strikingly poetical aside that we are ‘by the string [umbilical cord] tied to eternity’.⁵⁴

      Having covered the philosophical issues, he would move on to the medical ones. His lecture on the thorax would thus begin with some general and orthodox remarks about its function and anatomy, quoting Galen’s observation that the chest provides for the heart, lungs, respiration, and voice. Before it was cut open, he would invite the audience to note the flatness of the human thorax compared to that of the ape and dog, which protrude like a ship’s keel.

      Then he threw out a question to his audience: What is the connection between the width of the chest and the ‘heat’ or vital spirit of the animal? ‘Wherefore [do] butterflies in the summer flourish on a drop of blood?’ Because, would come the answer, the heart and lungs act like a furnace, heating the blood that suffuses energy through the body. The potency of that blood is demonstrated by its effect on the cold-blooded butterfly. ‘Especially in the summer the newt is hotter than the fish,’ he added, gnomically.

      The shape of the chest also revealed important truths about rank. Roman emperors, Harvey noted, were distinguished by having broad chests, which explained their exceptional ‘heat, animation [and] boldness’. His authority for this claim was the Roman biographer Gaius Suetonius Tranquillus, though the only broad chest mentioned in Suetonius’ On the Lives of the Caesars was that of the ‘well chested’ Tiberius, better known for his hot pursuit of young boys than political or military objectives.⁵⁵

      With the medical remarks concluded, it was the time to open up the body, and reveal the mechanics. Traditionally, physicians did not perform the actual dissection, leaving that job to a surgeon. But Harvey believed in getting his hands dirty. His method was to start with the general and work towards the specific, ‘shew as much in one observation as can be … then subdivide according to sites and connections’. Speed and dexterity were essential, not just to complete the course before the body began to putrefy, but to prevent the audience from losing the thread of the argument. There was no time to ‘dispute [or] confute’. ‘Cut up as much as may be,’ he commanded, ‘so that skill may illustrate narrative.’⁵⁶

      Harvey evidently enjoyed playing on the squeamishness of his audience. As a waft of flatus permeated the room, he would recall for the assembled physicians, many of whom had no practical experience of dissections, how cutting up parts of the body, particularly of abscessed livers, provoked ‘nausea and loathing and stench’. The interior of the chest would prove less noxious than the liver, however. Cutting through the ‘skin, epidermis, membrana carnosa’, penetrating ‘sternum, cartilages, ribs’, piercing ‘breasts, nipples, emunctory [lymphatic] glands’,⁵⁷ touching upon respiration, ingestion, hiccoughs, and laughter – prompting a digression on Aristotle’s observation ‘that when men in battle are wounded anywhere near the midriff, they are seen to laugh’ – he would finally come to the pericardium. This was the ‘capsule’ surrounding the heart.⁵⁸ He would make some remarks about the structure and use of the pericardium, and respectfully correct errors made by Vesalius relating to the mediastinum (the compartment between the lungs). He discussed the humour or fluid which ‘abounds’ within the percardial sac, a liquid like ‘serum or urine’, which is ‘provided by nature lest the heart become dry; therefore water rather than blood [issued] from Christ’s wounds’, adding that it was ‘wasted away … in persons hanged in the sun’. Then he revealed the organ within.

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