Heartbeat:In the Anglo-Saxon world, sudden outbreaks of illness were sometimes ascribed to the victims being afflicted by elf shot. Elves were known to be occasionally malevolent beings, capable of inducing sustained ill luck.
Our ruling elves have taken their time about it but I reckon they are now in their stride and the next few years could see us well and truly peppered with elf shot. I would like to have discussed this annotation with the Chief Elf but, like him, I would be afraid that some lulu might jump out of the bushes and cover me with the offending material. So I let sleeping elves lie.
My thoughts turned in this direction upon reading Hugh Trevor Roper's excellent book, Europe's Physician, the various life of Sir Theodore De Mayerne. This scholarly work covering the life and career of this distinguished Huguenot doctor covers the spectrum of such interaction at that time.
Truth to tell, little seems to have changed over the intervening years. There are always politicians seeking to use healthcare to their own advantage. There are some doctors who seek what they perceive to be the political inside track either for personal or institutional preferment. This has always been the case. An early example was provided by Cato the Censor (c200 BC) who published a book called De agri cultura on the care of cattle and slaves. The principle medicament was cabbage for everything and a slave or cow failing to respond, Cato advised they should simply be got rid of.
The times in which De Mayerne practised were turbulent and unsettled; politically, medically and above all religiously. De Mayerne began his medical career following graduation from Montpelier at the court of Henri III of Navarre, later Henri IVth of France.
As a Huguenot, Henri had been involved in the Wars of Religion before inheriting the French throne in 1589. However, the Catholic League with Spanish help prevented him from taking Paris. In 1593 Henri made his famous statement, "Paris vaut bien une messe," ("Paris is well worth a Mass"), abjurated his Protestantism thus allowing his coronation as king of France in 1594.
This wise man is generally held to have been one of the greatest of the French kings and in 1598 promulgated the Edict of Nantes allowing freedom of religion in the kingdom. Freedom of religion is one thing; freedom from bigotry and discrimination quite another as De Mayerne and his Huguenot colleague du Chesne soon found. Not only did they differ from their fellow doctors in Paris in religion, but also neither had qualified in Paris. Worse still, they built large, lucrative practices while shielded from the establishment by Huguenot politicians and by the king, whom many suspected of being a closet Protestant.
To add insult to injury they practised across the religious divide, treating princes of the Church and Protestant grandees alike. To compound the ire of the Catholic faculty they charged huge fees and became wealthy. It was not only money, religion or politics that separated these doctors from their colleagues. They espoused a different system of medicine from that practised in the French capital and, indeed, in most areas of the known world.
Since the time of Hippocrates, empiricism, regarding experience as the source of medical knowledge had been the foundation of medical treatment and practice. The Hippocratic teachings were augmented by Galen (circa 160 AD). On to the empiricism of Hippocrates was grafted a fanciful edifice of the four humours - black bile, yellow bile, blood and phlegm - and the associated four temperaments - phlegmatic, choleric, melancholic and sanguine. With subsequent modifications, such theories held sway and blighted medical practice until comparatively recent times.
The Swiss physician Paracelsus, the Dane Severinus and now these "chemical" doctors of Paris began to look beyond these parameters and use elements such as antimony, mercury and gold and various compounds like salt in the treatment of sickness. They were remarkably successful, particularly in the treatment of venereal disease.
There was, however, more than a whiff of alchemy among their treatments and furthermore they associated with unsavoury characters like apothecaries and surgeons.
Jean Riolan of the Paris faculty, who was among the most vitriolic and persistent of the detractors of these doctors, wrote a treatise entitled A Comparison of the Physician with the Surgeon, to Chastise the Audacity of Certain Surgeons who can neither Speak Well or be Silent.I can think of several like him today. Oscar Wilde's "I don't believe in progress: but I do believe in the stagnation of human perversity" describes the Paris faculty of the time.
For the "chemical" doctors, time was running out. The soil of toleration cultivated by Henri IVth proved thin and inadequate for the times. The Catholic reactionary parties regained the initiative, the conservative doctors triumphed, the politics of the world hardened into sectarian division and the "chemical" doctors of Paris - De Mayerne and du Chesne - emigrated.
Obscurantist, orthodox treatments still held sway over much of the world, with their attend- ant horrors of blistering, bleeding and purging. But complacency had been shaken and anato- mists such as Vesalius and physiologists such as William Harvey followed the faltering steps of these early questors and heralded the dawn of scientific medicine.
Maurice Neligan is a cardiac surgeon.