Losing One’s Temper: Contingency in Early Modern Medicine

How scientific knowledge relates to medical practice is not always straightforward. On the one hand, natural philosophers deal with the universal, with what is true regardless of all circumstances; on the other hand, physicians struggle with the immediate and pressing needs of the individual patient. Yet, in Galenic medicine there were three ways of dealing with various forms of life: the notion of temperament, a fluid understanding of disease, and a rigid method of semiotics. These three fields were interconnected; the contingencies of one were the foundations of another. Together, they bridged the gap between the universe and the patient, taming the four primary qualities of the material world for use in medical practice. Indeed, they also took on a moral dimension, providing rules of conduct to help physicians face the unknown. So when Galenic medicine fell in the seventeenth century, the delicate union between knowledge and practice fell with it. Through the works of William Harvey (1578-1657), Richard Lower (1631-1691) and John Locke (1632-1704), this chapter examines how each one of these Galenic connections was questioned and replaced with an understanding consistent with the new experimental philosophy. However, as the works of Friedrich Hoffman (1660-1742) illustrate, this did not create a more rational medicine – in fact, the opposite. More rigorous philosophical standards only led to a proliferation of sometimes contradictory medical theories; the practicing physician left with no means to decide between them. Contingency was still central to medicine but hidden from view

From Locke to Materialism: Empiricism, the Brain and the Stirrings of Ontology

My topic is the materialist appropriation of empiricism – as conveyed in the ‘minimal credo’ nihil est in intellectu quod non fuerit in sensu (which interestingly is not just a phrase repeated from Hobbes and Locke to Diderot, but is also a medical phrase, used by Harvey, Mandeville and others). That is, canonical empiricists like Locke go out of their way to state that their project to investigate and articulate the ‘logic of ideas’ is not a scientific project: “I shall not at present meddle with the Physical consideration of the Mind” (Essay, I.i.2, in Locke 1975; which Kant gets exactly wrong in his reading of Locke, in the Preface to the A edition of the first Critique). Indeed, I have suggested elsewhere, contrary to a prevalent reading of Locke, that the Essay is not the extension to the study of the mind of the methods of natural philosophy; that he is actually not the “underlabourer” of Newton and Boyle he claims politely to be in the Epistle to the Reader (Wolfe and Salter 2009, Wolfe 2010). Rather, Locke says quite directly if we pay heed to such passages, “Our Business here is not to know all things, but those which concern our Conduct” (Essay, I.i.6). There would be more to say here about what this implies for our understanding of empiricism (see Norton 1981 and Gaukroger 2005), but instead I shall focus on a different aspect of this episode: how a non-naturalistic claim which falls under what we now call epistemology (a claim about the senses as the source of knowledge) becomes an ontology – materialism. That is, how an empiricist claim could shift from being about the sources of knowledge to being about the nature of reality (and/or the mind, in which case it needs, as David Hartley saw and Denis Diderot proclaimed more overtly, an account of the relation between mental processes and the brain). (David Armstrong, for one, denied that there could be an identification between empiricism and materialism on this point: eighteenth-century history of science seems to prove him wrong: see Armstrong 1968 and 1978.) Put differently, I want to examine the shift from the logic of ideas in the seventeenth century (Locke) to an eighteenth-century focus on what kind of ‘world’ the senses give us (Condillac), to an assertion that there is only one substance in the universe (Diderot, giving a materialist cast to Spinozism), and that we need an account of the material substrate of mental life. This is neither a ‘scientific empiricism’ nor a linear developmental process from philosophical empiricism to natural science, but something else again: the unpredictable emergence of an ontology on empiricist grounds