Disputing Santorio: Johannes de Gorter’s Neurological Theory of Insensible Perspiration

Verwaal, Ruben E.

doi:10.1007/978-3-030-79587-0_12

Ruben E. Verwaal⁵

Part of the book series: Palgrave Studies in Medieval and Early Modern Medicine ((PSMEMM))

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Abstract

In the early modern period perspiration played a pivotal role in the preservation of one’s health. How that exactly worked, however, changed significantly at the turn of the eighteenth century. For much of the seventeenth century the study of insensible perspiration had mostly focused on digestion. Santorio’s practice of quantification may appear modern in hindsight, but his approach to insensible perspiration was firmly grounded in ancient humoral theory. But around 1700 medical perceptions of insensible perspiration experienced a transformation. Physicians began to focus on the role of microscopic nerves and arteries, as well as the nature of bodily fluids. Johannes de Gorter (1689–1762) continued to make his measurements with the help of the weighing chair. But contrary to Santorio de Gorter incorporated neurological descriptions of the internal functioning of perspiration into his medical treatises. The study of perspiration shifted in emphasis from balance and digestion, to mechanical and chemical explanations of the motion of the fluids and the nerves. To explain an outbreak of the epidemic disease of catarrh de Gorter formulated an intricate pathological theory in which the obstructed “nervous juice” (liquor nervosus) could not be perspired, stagnated, and turned sharp.

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Notes

1.
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2.
Lucia Dacome, “Living with the Chair: Private Excreta, Collective Health and Medical Authority in the Eighteenth Century,” History of Science, 39 (2001): 467–500; ead., “Balancing Acts: Picturing Perspiration in the Long Eighteenth Century,” Studies in History and Philosophy of Biological and Biomedical Sciences, 43 (2012): 379–91; Lois N. Magner, A History of Medicine, 2nd ed., 263–66 (Boca Raton, 2005); Nancy G. Siraisi, “Medicine, 1450–1620, and the History of Science,” Isis, 103 (2012): 491–514, at 504–05; Fabrizio Bigotti, “Mathematica Medica: Santorio and the Quest for Certainty in Medicine,” Journal of Healthcare Communications, 1 (2016): 39.
3.
Andrew Cunningham, The Anatomical Renaissance: The Resurrection of the Anatomical Projects of the Ancients (Aldershot: Routledge, 1997).
4.
Santorio Santori, Ars de statica medicina, sectionibus aphorismorum septem comprehensa (Venice: N. Polo, 1614).
5.
On premodern notions and medical perceptions of sleeping and digestion, see Sasha Handley, Sleep in Early Modern England (New Haven and London: Yale University Press, 2016); Sandra Cavallo and Tessa Storey, Healthy Living in Late Renaissance Italy (Oxford: Oxford University Press, 2013), 113–44.
6.
Santorio Santori, De statica medicina et de responsione ad staticomasticem (Leiden: D. L. De Haro, 1642), 55–80; id., De ontdekte doorwaasseming des menschen lichaams, ed. Heydentryck Overkamp, 66–100 (Amsterdam: T. ten Hoorn, 1686). The ounces refer to weight, not volume.
7.
Santorio Santori, Commentaria in Artem medicinalem Galeni (Venice: G. A. Somascho, 1612); id., Commentaria in primam Fen primi libri Canonis Avicennae (Venice: G. Sarzina, 1625); id., Commentaria in primam sectionem Aphorismorum Hippocratis (Venice: M.A. Brogiolo, 1629).
8.
See preface in Santorio, Ars; id., De ontdekte doorwaasseming.
9.
Ephraim Chambers, Cyclopaedia, or, An Universal Dictionary of the Arts and Sciences, 2 vols (London: A. Hogg, 1728), vol. 2, 359.
10.
On Santorio’s long-term influence, see Dacome, “Living with the Chair”; id., “Balancing Acts”; and outside the realm of medicine, Lucia Dacome, “Resurrecting by Numbers in Eighteenth-Century England,” Past and Present, 193 (2006): 73–110.
11.
Santorio Santori, De ontdekte doorwaasseming of de leidstar der genees-heeren, trans. Philippe La Grue (Amsterdam: J. Rieuwertsz, 1683); id., De ontdekte doorwaasseming des menschen lichaams, ed. Steven Blankaart, trans. Philippe La Grue, 2nd ed. (Amsterdam: J van Royen, 1684).
12.
Thomas Secker, Disputatio medica inauguralis de medicina statica (Leiden: L. Mulhovium, 1721); Hermannus Hulshof, Dissertatio medica inauguralis sistens febrem diariam benignam ex suppressa Sanctoriana perspiratione ortam (Groningen: H. Spandaw, 1740).
13.
As quoted in Edward T. Renbourn, “The Natural History of Insensible Perspiration: A Forgotten Doctrine of Health and Disease,” Medical History, 4, (1960): 135–52, at 135–36.
14.
Albrecht von Haller, ed. Praelectiones academicae in proprias institutiones rei medicae, 6 vols (Göttingen: J. vander Linden, 1739–1744), vol. 3, 576; id., Dr. Boerhaave’s Academical Lectures on the Theory of Physic: Being a Genuine Translation of his Institutes and Explanatory Comment, 6 vols (London: W. Innys, 1742–1746), vol. 3, 307.
15.
Dacome, “Living with the Chair”; ead., “Balancing Acts”.
16.
Antonio Clericuzio, “Chemical and Mechanical Theories of Digestion in Early Modern Medicine,” Studies in History and Philosophy of Biological and Biomedical Sciences, 43, (2012): 329–337.
17.
‘Vita auctoris’ in Johannes de Gorter, Praxis medicae systema, ed. David de Gorter, 2nd ed. (Harderwijk, 1767), [**4r].
18.
Johannes de Gorter, De perspiratione insensibili Sanctoriana-Batava tractatus experimentis propriis in Hollandia (Leiden: J. van der Aa, 1725).
19.
Anita Guerrini, “James Keill, George Cheyne, and Newtonian Physiology, 1690–1740,” Journal of the History of Biology, 18, (1985): 247–66; ead., “Keill, James (1673–1719),” in Oxford Dictionary of National Biography (Oxford: Oxford University Press, 2004); James Keill, Tentamina medico-physica ad quasdam quaestiones quae oeconomiam animalem spectant, accomodata: quibus accessit Medicina statica Britannica (London: G.W. Innys, 1718).
20.
De Gorter, De perspiratione insensibili, 10–11. De Gorter compared his measurements to those found in Santorio’s Ars and Keill’s, Medicina statica Britannica.
21.
De Gorter, De perspiratione insensibili, 12–13.
22.
Mieneke te Hennepe, “Of the Fisherman’s Net and Skin Pores: Reframing Conceptions of the Skin in Medicine 1572–1714,” in Blood, Sweat and Tears, ed. Manfred Horstmanshoff, Helen King, and Claus Zittel, 523–48 (Leiden and Boston: Brill, 2012).
23.
Govard Bidloo, Anatomia humani corporis (Amsterdam: heirs of J. van Dyk, H. Boom and widow of Th. Boom, 1685), Tabula 4.
24.
While Ruysch maintained that the glands functioned mechanically, Boerhaave perceived them as follicles in which chemical processes occurred. Herman Boerhaave and Frederik Ruysch, Opusculum anatomicum de fabrica glandularum in corpore humano (Leiden: C. Haak, 1722); de Gorter, De perspiratione insensibili, 20. Rina Knoeff, “Chemistry, Mechanics and the Making of Anatomical Knowledge: Boerhaave Vs. Ruysch on the Nature of the Glands,” Ambix, 53, (2006): 201–19.
25.
De Gorter, De perspiratione insensibili, 19–22.
26.
Herman Boerhaave, Institutiones medicae in usus annuae exercitationis domesticos digestae, 5th ed. (Rotterdam: Apud J. D. Beman, 1734), 224; von Haller, Academical Lectures, vol. 3, 306.
27.
On Abraham Kaau, see Irina Sjtsjedrova, “Abraham Kaau-Boerhaave: Bladzijden uit de biografie van een academicus,” in Noord- en Zuid-Nederlanders in Rusland, ed. Emmanuel Waegemans, J.S.A.M. (Hans) von Koningsbrugge, and Nadja Louwerse, Baltic Studies (Groningen: INOS [Instituut voor Noord and Oost Europese Studies], 2004), 293–312; Luuc Kooijmans, De geest van Boerhaave: Onderzoek in een kil klimaat (Amsterdam: Prometheus, 2014).
28.
Abraham Kaau, Perspiratio dicta Hippocrati per universum corpus anatomice illustrata (Leiden: Luchtmans, 1738). This title, ‘Perspiration over the Whole Body, as called by Hippocrates’, was a double reference: a paraphrase of Galen’s discussion of the expiration and inspiration of the body which, in turn, was referencing Hippocrates’ Epidemics, VI.6.
29.
Ibid., 251–2.
30.
Albrecht von Haller, Primae lineae physiologiae, 2nd ed., 265–6 (Göttingen: A. Vandenhoeck, 1751); id., Physiology: Being a Course of Lectures upon the Visceral Anatomy and Vital Oeconomy of Human Bodies, trans. Samuel Mihles, 2 vols (London: W. Innys and J. Richardson, 1754), vol. 2, 4.
31.
Thomas Willis, Cerebri anatome: Cui accessit nervorum descriptio et usus (Amsterdam: J. Martyn and J. Allestry, 1664), 149–89; J. Trevor Hughes, Thomas Willis, 1621–1675: His Life and Work (London: Royal Society of Medicine Services, 1991).
32.
De Gorter, De perspiratione insensibili, 20–21; idem, Morbi epidemii brevis descriptio et curatio per diaphoresin (Harderwijk: W. Brinkink, 1733), 14–16. For his anatomical knowledge, de Gorter relied on the work of other anatomists and his own observations. The University of Harderwijk had had a dissection room since the early eighteenth century, and de Gorter himself specialised in teaching anatomy and surgery to surgeons. For his anatomical lectures, de Gorter commented on the Anatomische Tabellen (first published in 1725) by Johann Adam Kulmus (1689–1745), the Leiden alumnus and professor of medicine at the Akademische Gymnasium in Danzig. See the lecture notes of Gerhardus Vermeer, ‘Comentaria ex ore Clarissimi Viri J. De Gorter excerpta’, Harderwijk, c. 1740. Leiden, University Library, BPL 1478.
33.
Herman Boerhaave, ‘Praelectiones publice habitae de morbis nervorum’, Leiden, 1730–1735. S.M. Kirov Military Medical Academy, St Petersburg, MS XIII 11. Microfiche copy stored at University Library, Leiden, F 699. These lecture notes were transcribed, annotated, and translated by Benedictus P.M. Schulte, Hermanni Boerhaave Praelectiones de morbis nervorum, 1730–1735: Een medisch-historische studie van Boerhaave’s manuscript over zenuwziekten (Leiden: Brill, 1959).
34.
Boerhaave, ‘De morbis nervorum’, 21 March 1732 in ibid., 152–5; Rina Knoeff, Herman Boerhaave (1668–1738): Calvinist Chemist and Physician (Amsterdam: Royal Netherlands Academy of Arts and Sciences, 2002), 191–2.
35.
Boerhaave, ‘De morbis nervorum’, 1 April 1732 in Schulte, De morbis nervorum, 154–5.
36.
Kaau, Perspiratio dicta Hippocrati. On Albinus’ and von Haller’s work on the nerves and ideas of nervous juice, see Hendrik Punt, Bernard Siegfried Albinus (1697–1770) on “Human Nature”: Anatomical and Physiological Ideas in Eighteenth Century Leiden (Amsterdam: B.M. Israël, 1983); Hubert Steinke, Irritating Experiments: Haller’s Concept and the European Controversy on Irritability and Sensibility, 1750–1790 (Amsterdam and New York: Rodopi, 2005), 68, 110.
37.
Anita Guerrini, The Courtiers’ Anatomists: Animals and Humans in Louis XIV’s Paris (Chicago and London: The University of Chicago Press, 2015).
38.
Abraham Kaau occasionally used the term “transpirare” in his Perspiratio dicta Hippocrati. Some medical students preferred the term “transpiratio insensibilis”, see for example in Henricus Petrus Sigismundus Zehenphenningh, Dissertatio medico therapeutica inauguralis sistens quaedam therapiae specialis notamina circa abusus remediorum vomitoriorum, laxantium et sudoriferorum (Leiden: C. de Pecker, 1750), 10; Arthurus Magenis, Dissertatio medica inauguralis de urina (Leiden: G. Potvliet, 1753), 10. According to a contemporary English-Dutch dictionary, “perspiration” and “transpiration” were translated similarly. Compare ‘to Perspire, Uitwaassemen, uitdampen door de zweetgaten’ with ‘Transpiration, De ongevoelige uitwaasseming door de Huid’ in Willem Séwel, A Compleat Dictionary English and Dutch ed. Egbert Buys, 2 vols (Amsterdam: K. de Veer, 1766), vol. 2, 575, 851.
39.
Ursula Klein, “Experimental History and Herman Boerhaave’s Chemistry of Plants,” Studies in History and Philosophy of Biological and Biomedical Sciences, 34, (2003): 533–67, at 543.
40.
Herman Boerhaave, A New Method of Chemistry: Including the Theory and Practice of that Art: Laid down on Mechanical Principles, and Accommodated to the Uses of Life, trans. Peter Shaw and Ephraim Chambers, 2 vols (London: J. Osborn and T. Longman, 1727), vol. 1, 150–62; idem, Institutiones et experimenta chemiae, 2 vols (Paris: s.n., 1724), vol. 1, 121–7.
41.
Boerhaave, A New Method, vol. 2, 8; idem, Institutiones et experimenta chemiae, vol. 2, 14.
42.
Boerhaave, A New Method, vol. 1, 379–80.
43.
Ibid., vol. 2, 13. See also Alain Corbin, Le miasme et la jonquille: l’odorat et l’imaginaire social, 18e–19e siècles (Paris: Flammarion, 1982).
44.
Boerhaave, A New Method, vol. 2, 12–13, 18.
45.
Ibid., vol. 1, 168.
46.
Cultural historians have studied the human experience of smell and stench, such as Corbin, Le miasme et la jonquille. But the case of spiritus rector shows how smell was not just a sensation in individuals, but rather considered a real, material thing.
47.
Boerhaave, A New Method, vol. 2, 18.
48.
Von Haller, Academical Lectures, vol. 3, 325. Boerhaave also shared the anecdote that a dog can distinguish a single deer from the herd solely on the basis of the smell of its perspiration. Boerhaave, ‘De morbis nervorum’, 1 April 1732 in Schulte, De morbis nervorum, 154–5.
49.
Jan Ingenhousz, Experiments upon Vegetables (London: P. Elmsly and H. Payne, 1779), 47–9; Handley, Sleep, 42. See also Geerdt Magiels, From Sunlight to Insight: Jan IngenHousz, the Discovery of Photosynthesis and Science in the Light of Ecology (Brussels: VUB Press, 2010).
50.
Catrien Santing, “Sleeping and Waking,” in Gelukkig Gezond! Histories of Healthy Ageing, ed. Rina Knoeff (Groningen: Barkhuis - Universiteitsmuseum, 2017), 80–97.
51.
Boerhaave ‘De morbis nervorum’, 13 May 1732 in Schulte, De morbis nervorum, 164–5.
52.
Michael Stolberg, “Sweat: Learned Concepts and Popular Perceptions, 1500–1800,” in Blood, Sweat and Tears, ed. Manfred Horstmanshoff, Helen King, and Claus Zittel, 503–22 (Leiden: Brill, 2012), at 510–11.
53.
Henricus Buisen, Verhandelinge van de uitwerpingen des menschelyke lighaams, bestaande in pis, afgang, zweet, kwyl; en braaking (Rotterdam: H. Kentlink, 1731), 115–16.
54.
Ibid.
55.
Von Haller, Academical Lectures, vol. 6, 111.
56.
Boerhaave, ‘De morbis nervorum’, 12 May 1732 in Schulte, De morbis nervorum, 162–3.
57.
Buisen, Uitwerpingen, 115–16.
58.
De Gorter, Praxis medicae systema, 171–2.
59.
See, for example, Joseph Franz von Jacquin, Leerboek der algemeene en artsenijkundige scheikunde, trans. Gerardus Plaat, 2 vols (Leiden: A. and J. Honkoop, 1794), vol. 2, 3.
60.
De Gorter, Morbi epidemii, 5–7; id., Korte beschryving van een algemene doorgaande ziekten, in deze tijd nog woedende, en desselfs genezing door sweetinge, trans. Amos Lambrechts (Amsterdam: G. Bouman, 1733), 10–14.
61.
Oprechte Haerlemsche Courant, 9 February 1709. See also Gebeurtenissen, voorgevallen in de maanden January en February, anno 1740 in, en veroorzaakt door de nooit meer gehoorde vehemente en strenge winter (Enkhuizen H. Callenbach, 1740).
62.
Petrus Belkmeer, Disputatio inauguralis physiologico medica de motu ut causa et curatione generali omnium morborum (Harderwijk Joh. Rampen, 1735).
63.
Johannes de Gorter, De perspiratione insensibili, 2nd ed. (Leiden: J. Vander Aa, 1736), 339–42. A multitude of hygrometer designs circulated, all based on the principle of absorption levels of various materials. See Joachim d’Alencé, Verhandelingen over de barometers, thermometers, en notiometers of hygrometers (The Hague: de Jongh, 1730).
64.
De Gorter, De perspiratione insensibili, 109.
65.
De Gorter, Morbi epidemii, 3; idem, Doorgaande ziekten, 5.
66.
Boerhaave, ‘De morbis nervorum’, 19 January 1731 in Schulte, De morbis nervorum, 88–9; Herman Boerhaave, Praelectiones academicae de morbis nervorum, ed. Jacob van Eems, 74 (Leiden: Vander Eyk and de Pecker, 1761).
67.
Hieronymus David Gaubius, Institutiones pathologiae medicinalis (Leiden, 1758), 208; idem, The Institutions of Medicinal Pathology, trans. Charles Erskine (Edinburgh: C. Elliot and T. Cadell, 1778), 139.
68.
De Gorter, Morbi epidemii, 4; id., Doorgaande ziekten, 7–8.
69.
De Gorter, De perspiratione insensibili, 26–35.
70.
De Gorter, Morbi epidemii, 7; id., Doorgaande ziekten, 15.
71.
Johannes de Gorter, Medicinae compendium in usum exercitationis domesticae digestum, 2 vols (Leiden: J. van der Aa, 1731–1737), vol. 2, 218. See s.v. ‘diaphoretica’ and ‘sudorifera’ in the ‘Index formularum medicinalium generalis’. Johannes de Gorter, Formulae medicinales cum indice virium quo ad inventas indicationes inveniuntur medicamina (Harderwijk, 1750), [H2v], [X4v].
72.
De Farvacques, Medicina pharmaceutica, of Groote algemeene schatkamer der drôgbereidende geneeskonst, 3 vols (Leiden: I. Severinus, 1741), vol. 1, 18.
73.
For numerous other drugs, see Buisen, Uitwerpingen, 184–5; Noël Chomel, Huishoudelyk woordboek: Vervattende vele middelen om zyn goed te vermeerderen, en zyne gezondheid te behouden, Met verscheiden wisse en beproefde middelen, trans. Jan Lodewyk Schuer and A.H. Westerhof, 2 vols (Leiden: S. Luchtmans, and Amsterdam: By H. Uytwerf, 1743), 1455.
74.
De Gorter, Formulae medicinales. Under diaphoretica, it mentioned apozema, bolus, cataplasma, electuarium, emplastrum, epithema, fotus, guttulae, haustus, infusio, lavamentum, mixtura, pilulae, potio, pulveres interni, spiritus, and suffitus.
75.
De Gorter, Morbi epidemii, 20–22; id., Doorgaande ziekten, 71–7.
76.
Boerhaave, A New Method, vol. 2, 224. Emphasis added.
77.
Chambers, Cyclopaedia, vol. 1, 140. See also s.v. ‘Ammoniacum, Sal’, in the ‘Index medicamentorum’ in de Gorter, Formulae medicinales.
78.
As suggested in Henricus Buisen, Practyk der medicine, ofte Oeffenende geneeskunde, 4th ed. (Rotterdam: H. Kentlink, 1743), 1–11.
79.
De Gorter, Morbi epidemii; de Gorter, Doorgaande ziekten, 22.
80.
According to de Gorter, his publisher requested a reprint, but he first wanted to improve and elaborate on the text; de Gorter, De perspiratione insensibili, [‘Preface’].
81.
De Gorter, Medicinae compendium, vol. 2, 215.

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Institute for Medical Humanities, University of Durham, Durham, UK
Ruben E. Verwaal

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Centre for Medical History, University of Exeter, Exeter, UK
Jonathan Barry
Institute for the History of Medicine, Julius Maximilian University, Würzburg, Germany
Fabrizio Bigotti

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Verwaal, R.E. (2022). Disputing Santorio: Johannes de Gorter’s Neurological Theory of Insensible Perspiration. In: Barry, J., Bigotti, F. (eds) Santorio Santori and the Emergence of Quantified Medicine, 1614-1790. Palgrave Studies in Medieval and Early Modern Medicine. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-79587-0_12

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