Michael Malinzak

The Medical System of Paracelsus

Keywords: Paracelsus, medical system, alchemy, renaissance, medicine, philosophy, astrology, Christian, light of nature, signatures, Galenic

I. Abstract

Paracelsus developed an approach to medicine which defied the accepted Galenic system employed by physicians during the first half of the sixteenth century. He emphasized that personal experience was a more powerful measure of validity than accepted tradition; this doctrine depended on the constancy of natural processes as required by the existence of an all powerful and perfect Christian God. Much of the system’s argumentation was based on conclusions drawn from “the Light of Nature.” Essential for understanding nature, three of the four central “pillars” of the Paracelsian approach were alchemy, philosophy, and astronomy. The fourth pillar was a set of virtues required of a true physician. Paracelsus also claimed that illnesses were the results of several categories of causal forces, each of which stemmed from God, called the Entia. While it made use of several methods of medical understanding and discovery, the Paracelsian system was fundamentally based upon the view that God was ultimate cause of all things and thus the sole reservoir of healing power and truth.

II. Scope and Purpose of the System

Paracelsus is perhaps most renowned for his emphatic and often offensive rejection of the accepted European medical tradition at the beginning of the sixteenth century. He insisted that the classical medical teachings, which relied heavily upon the concept of humors as the cause of disease, were useless on the basis of the amount of suffering that persisted despite the efforts of physicians. While Galenic medicine explained remedy in terms of balancing the four humors of the body, Paracelsus insisted that this approach served to treat a symptom and not the cause of the disease. He saw the Christian God as the sole causal factor of states of health and devised a range of approaches and methods which he held to be a guidance system for the education and practice of truly good physicians.

Paracelsus also found many of the conventional physicians guilty of greed and conceit. In contrast, he claimed his services were available to anyone who was in need and that his charges could be waved for the poor. Thus, his medical system was intended to be accepted and used by physicians for the benefit of all people. Paracelsus offered the belief that there must be a cure for every disease. His goal was realization of both physical and spiritual health and the prolongation of human life by any means necessary.

God and efficacy were the most essential bases of his medical philosophy. Paracelsus insisted that true medical art was learned only through experience and that blindly trusting books and the words of teachers, as he accused his contemporaries of doing, was foolish and conceited. Emphasizing that God was the original and only true healer, Paracelsus believed that true human doctors were instruments of God’s will. As such, physicians could best serve their divine calling by deducing the best approach to a malady from what they observed in all of God’s creation. Thus, Paracelsus considered reflection upon the “Light of Nature” to be a central method of gaining true medical understanding.

III. Authority Structure

A. Sources and Criteria of Valid Knowledge

The absolute validity of Christianity and its scriptures is one of two fundamental bases of the Paracelsian medical approach. Because scripture claims that God and his creation are perfect, Paracelsus emphasized the “Light of Nature” as a key to knowledge. Since God was seen as all powerful, the physician was ultimately helpless and required God to affect cures. Based upon Christian lessons that toil is a fundamental part of man’s duty as demanded by God’s will, Paracelsus concluded that physicians existed because God wanted man to play a role in the process of healing (Jacobi trans. 126). In this way, Paracelsus compared the physician’s preparation of cures from herbs with the farm work and baking needed to prepare food; both necessitate work to yield a useful product because God willed it so.

Paracelsus also placed the Christian God at the base of his medical system by demanding that all true physicians were specially selected by God. As a result, those physicians that were preordained (i.e. practicing in a manner approved of by Paracelsus) were described as acting as instruments of God. Thus, the true physicians became special reservoirs of truth and indirectly divine healing power for their patients.

The second fundamental basis of the Paracelsian approach was the superiority of observation and experience over other means of establishing credibility. Paracelsus reasoned that man can have no better instructor than experience because it is incorruptible by its direct nature. He explained that words and writings could be misleading but observations would never lie (Jacobi trans. 124). This claim, reinforced by the theological argument that God would not let cause and effect be a haphazard relationship, provided support for the use of inductive reasoning in applying observations of nature. Specifically, Paracelsus recognized experience as a means for gaining confidence in decision making and as an important criterion for establishing or rejecting the efficacy of supposed cures.

The final and perhaps most readily accessible of Paracelsus’s knowledge sources was the “Light of Nature.” This indirect source of knowledge appears to result from Paracelsus combining his fundamental beliefs in experience and God. The basis for gaining truth through observing nature required the Christian view of nature as a perfect part of God’s creation. Through experience and observation of nature, the physician was able to learn about God’s methodology in all of nature and thus gain insight into a completely pure and true function. Such knowledge could then be applied toward understanding God’s healing processes.

B. Methods of Inquiry

Paracelsus presented several methods by which one could acquire knowledge from the fundamental sources listed above. Obtaining true knowledge of God’s hidden healing ways was accomplishable through a set of disciplines and methods for considering the Light of Nature. One of Paracelsus’s most relied upon conceptual approaches was that of the relationship of the microcosm, meaning man, to the macrocosm, or the whole universe. Paracelsus insisted that every part or function of macrocosm was directly related to, and even influential upon, analogous parts or functions within the microcosm (Swainson 18). As a conceptual tool, this relationship was used to extend the relevance of observations made upon any aspect of the natural universe to a corresponding part or function of the human body.

In accordance with this view of a correlated man and universe, Paracelsus subscribed to the doctrine of signatures. He reasoned that since the microcosm is inherently connected with the macrocosm, things of similar essential properties must show tangible manifestations of this relationship (Swainson 22). As a result, herbs could have their associated heavenly bodies identified by inspection of their physical aspects. This reasoning was extended to medicine by using signatures in a plant to identify its essential invisible relation to a human organ, or indirectly link an herb with its analogous organ through an associated heavenly intermediate (Hartman 245).

In his writings, Paracelsus repeatedly enumerated what he considered to be the “four pillars” of gaining a true understanding of medicine. First, philosophy was an important tool for the physician. Paracelsus explained that the term philosophy actually includes both a physical philosophy and a spiritual philosophy. The physical aspect is similar to natural philosophy and relates to gaining knowledge as discussed before in the sense of studying nature to understand God (King 4). Spiritual philosophy involved the direct understanding of the soul. This was relevant to medicine because some diseases were thought to have a spiritual cause.

Second, an understanding of alchemy was important because Paracelsus saw the processes of digestion and medicinal preparation as extensions of alchemical principles. Paracelsus observed that alchemy, pharmacology, and digestion each sought to purify essences for functional use in part through the application of heat (Waite trans. 148). Paracelsus also argued that the body could be reduced to the components of mercury (liquids), sulfur (liquids heated to dryness), and salt (that which remains after the sulfur is burned) (King 134). He based these distinctions on alchemical principles of purification through heating. These alchemical terms were also used for describing the make up of the physical body and the mechanisms of certain diseases (e.g. the formation of tartars).

Another method of understanding disease was through astronomy. The influence of heavenly bodies upon the health of men and the effectiveness of treatments was particularly relevant with regard to Paracelsus’s belief in the interconnections of the microcosm and macrocosm. A disease could be considered to result from a heavenly body emitting a poison which could affect patients differently depending on an individual’s spiritual state. The physician could then select the proper cure by identifying the relationships between the essences of herbs, heavenly bodies, and effected organs through the doctrine of signatures.

Paracelsus’s final pillar dealt with the qualities of the individual physician. This is related to the concept of divine selection of true physicians. Similarly, a physician without certain virtues, faith, and a divine calling was powerless because he lacked God’s support.

The concept of “Entia ” as causes of disease was also an important tool in Paracelsian medicine. Paracelsus maintained that rather than seeking the cause of disease in humoral imbalance, the true physician should consider five underlying causes for every disease. The Ens Astrale caused those diseases induced by heavenly bodies. The Ens Naturale produced “natural” diseases, such as the effects felt from overuse of the stomach or genitals (Hartman 251); in general, this was the cause of afflictions believed to have mundane or even mechanical causes. The Ens Venenale included cases of poisoning with special reference to tartaric diseases. Paracelsus held that foods produced their own excrements (called stercors) in the form of tartar which could build up in the body and cause disease (King 128). The Ens Spirituale and Ens Deale were supernatural causes described as bodily harm inflicted by spirits and disease caused by direct divine punishment respectively. Through seeking a cause within these five possibilities, the Paracelsian physician could better focus his search for cures through employing signatures and his understanding of philosophy, alchemy, and astronomy. Paracelsus stated that his concept of the five Entia was artificial, and that in reality the only true cause was God. However, because employing the system of Entia aided in the human understanding of disease, it was retained as tool because of its efficacy (Hartman 240).

While much of Paracelsus’s philosophy has been abandoned by the current medical establishment, his emphasis on the need for observation, experience, exploration of nature, and use of chemical and herbal remedies is in accordance with current thought. The reasons for using these tools, however, differs today in its divergence from the Paracelsian focus on God. Because divine will and constancy was intertwined with observation, conclusions of the Paracelsian system were essentially irrefutable and non-scientific by current standards.

C. Institutions and Professional Structure

Paracelsus never established a lasting institution in which he corporally participated. There are references to him gathering small followings of students, but these groups never persisted long enough to be considered a true institution. For example, Paracelsus was popular among many of his students at the University of Basle, but he only served as a professor of medicine from 1527 until July of 1528 when he fled the city in secrecy (Hartman 9). Establishing himself in opposition conventional medicine, Paracelsus produced his set of criteria and suggestions for obtaining true medical understanding; this is as close as he ever came to founding an institution.

In Paracelsian theory, physicians served as the preordained agents of divine healing for anyone in need. They had a firm understanding of the medical texts and instructions produced by others, but each physician had to accept and reject each healing protocol he received on the basis of his own experiences. In this sense, Paracelsus’s written arguments were intended to inspire improved medical learning on an individual basis.

It does not appear that Paracelsus wished to entirely decentralize medical schooling, but rather to influence the personal philosophy and thus medical approaches of each practitioner. He set forth no rituals for attaining the true physician’s status, but he listed the qualifications which he considered the signs of a true doctor. For example, he required, “Regarding his innate temper: A clear conscience, desire to learn and to gather experience, . . .(etc.),” and extensively covered such attributes under the headings of “Regarding knowledge of the body,” and “Regarding the practice of his art,”(Jacobi 126-7). Aside from enumerating many categories of medical art in this list, he also included important virtues such as lack of conceit, lack of greed, purity in chastity or in healthy marriage, and faith in God. Although there were followings of Paracelsians established later in Europe, Paracelsus did not live to see the realization of any such organizations.

IV. History

The course of events in Paracelsus’s life must have influenced his theories and often had a direct impact upon his efforts to spread his beliefs. Paracelsus was named Theophrastus von Hohenheim when he was born in Eiseideln, Switzerland in 1493. It should be noted that Paracelsus was Catholic and that his knowledge of Christian scriptures formed the basis for much of his medical theory. His early education is believed to have been directed by his father who was a physician. He changed his surname to Paracelsus in shortly after enrolling in the University of Basle. Paracelsus studied magic in Wurtzburg (Swainson 8), and he may have completed a medical degree in Italy (Wightman 47). His background in alchemy, astronomy, and philosophy later became central to his approach to healing.

After completing his formal education, Paracelsus worked as a physician and conducted alchemical experiments at a silver mine near his home (Swainson 9). He soon became disillusioned with the established medical system and its emphasis on classical, primarily Galenic medical theory. At the age of twenty-three, he began a nine year pilgrimage which was the first of a series of life long European travels in search of medical truth and acceptance. He served as a physician for the Dutch army and traveled extensively in Austria, France, Italy, Spain, Granada, England, the Netherlands, Denmark, Sweden, Prussia, Bohemia, Poland, Transylvania, Wallachia, Croatia, Russia, Germany, and Switzerland (Swainson 9-10).

Paracelsus’s acceptance by academics and the public was generally short lived in every city where he resided. The best known example of his knack for attaining disrepute probably comes from Paracelsus’s stay in Basle where he served as the city physician and as a professor. With an audience of students, he held a bonfire at which he burned all the Galenic and other classical medical texts he could gather from the university. A clash with the city counsel eventually caused him to flee Basle in 1528, and he never achieved formal academic acceptance again. After fleeing Nuremberg under similar circumstances in 1529, Paracelsus resigned himself to quietly writing in hopes that he might someday be recognized for his works. It was in this period of withdrawal in the towns of Beratzhausen and Saint Gall from 1530 to 1531 that he wrote most of the Paramirum in which he best elucidated his theory of the Entia (Swainson 15).

Paracelsus also insisted on communicating medical knowledge in the local languages rather than through the accepted medium of Latin. The fact Latin lacked names and refused legitimacy for certain regional and newly discovered diseases was one of his primary reasons for lecturing in German while a professor. He also claimed to gain much of his knowledge of herbs by seeking out and investigating the reports of the local people he encountered during his travels (Jacobi trans. 131). Paracelsus spent the last months of his life with the support of a Bavarian Duke until his death in Salzburg in 1541. In 1590, a collection of all his known manuscripts was completed which consisted of 106 works, 57 of which were devoted to medicine (Hartman 31-33). Some of his doctrines are stated to be upheld by the Masonic order and the Rosicrucians, but this does not necessarily refer to his medical teachings.

V. Representative Examples of Argumentation

In his writings, Paracelsus made extensive use of analogies and quotes from scripture. He defended his principles with what he viewed to be their firm basis in the teachings of God. One of the criticisms which he must have encountered was his rejection of accepted medicine on the grounds of observed inefficacy while his own medical treatments did not always work. Paracelsus defended his system through his concepts of the Ens Deale and the true physician as an instrument of God. He claimed that every disease caused through the Ens Deale is a sentence of purgatory from God, and therefore “the physician should know this and bear it in mind, lest he presume to determine in advance the time of recovery or the efficacy of his remedies; for this lies solely in God’s hands” (Guterman trans. 155). In another text, however, he used the Biblical verse, “faith without works is dead,” as a form of divine authority to assert that the established teaching of medicine through texts and lectures was useless because he did not believe its practice was effective (Jacobi trans. 141). Paracelsus draws a thin line between himself and his opponents on the basis of God and efficacy with the stipulation that inefficacy can be perfection if it is the will of God.

In arguing the reasons for the effectiveness of his cures, Paracelsus, by viewing God as the only true and ultimate physician, maintains that his remedies are not unholy because they are natural and therefore produced by God (Jacobi trans. 142). Also, “even if the devil had caused them, the devil can have no power except that which is given to him by God, and so it would be the power of God after all” (Hartman 225). He also argues that his choice of remedies through the doctrine of signatures is valid because it is effective. Paracelsus wrote of a disease in which a woman is deficient in “the element whose essence radiates from Mars, and consequently suffers from poverty of the blood and want of nervous strength,” for which the cure is to give her iron “because the astral elements of iron correspond to the astral elements contained in Mars, and will attract them as a magnet attracts iron” (Hartman 245). This reasoning relates the understanding of the essence of Mars, the macrocosm, to the understanding of the essence of iron which can be used to affect the microcosm of man through blood. Clearly, this example is also representative of the mechanisms by which astral events were considered influential upon health; in this case it is through the interaction of essences. Also, the role of iron in this treatment further demonstrates the importance of alchemy in Paracelsian medicine, while understanding the interactions of essences requires a background in philosophy.

Paracelsus also comments in his description of the treatment for this disease of vitality and the blood that, “a plant which contains iron in an etherealized state,” would be a preferable remedy to the use of metallic iron (Hartman 245). Using the doctrine of signatures, it would not be unreasonable to find an effective herb in this case because any plant whose very essence is tied to that of iron should also bear some physical evidence of this deep connection. Purifying the etherealized iron would probably be accomplished by alchemical means (as it is for rose and almond oils) which often involved heating the raw materials. Paracelsus considered this practice analogous to the preparation necessary for all God-given natural resources before use and therefore as legitimate as baking bread or smelting metals.

VI. Suggested Position in Comparative Scales

A. tradition (1) ---. experience (10): 8

In comparison to other systems, the medical system of Paracelsus was almost entirely reliant upon the testimony of experience in that it rejected all traditional authority which did not appear efficacious in practice. Fundamental assumptions of Christian traditions were also incorporated, however, so the system was not entirely experience based.

B. centralized authority (1) --- decentralized authority (10): 6

The rejection of pure testimony called for a partial decentralization of medical learning. Less emphasis was placed on institutional instruction and more on individual experience as a means of gaining true medical knowledge. Schooling in the four pillars of Paracelsian medicine was just as important as medical schooling; Paracelsus treats the teachings of medical institutions as a body of suggestions and proposals which need to be individually tested by physicians.

C. Emphasis on the invisible realm (1) ---. visible realities (10): 5

This system is positioned midway between the spiritual/invisible and corporal/tangible realms in terms of its primary emphasis. The doctrine of signatures is very representative of this interplay in that it used to fulfill the physical goal of healing through tangible recognition of properties governed by the non-physical realm.

D. Spiritual/moral goal (1) --- pragmatic objectives (10): 6

Paracelsus’s medical system assumes a similar intermediate position in its goals; while the primary goal of the system is to promote physical health, it requires spiritual health for the realization of this goal because God is the ultimate healer. The astral influence upon health and the Entia Spirituale and Deale clearly expand and demonstrate the direct influence that moral and spiritual well being was supposed to have upon health.

E. Primarily divine power (1) --- individual power (10): 3

Ultimately, all powers of healing were attributed solely to God, but this divine healing process might only have been realized if the ill person was treated by a physician because God wished to use man as an instrument. The balance between the powers attributed to God and those attributed to men is in favor of God in Paracelsian theory.

Bibliography

Primary sources:

Paracelsus. Paracelsus, Selected Writings. Trans. Norbert Guterman. New York:

Pantheon Books, 1951.

This is an excellent source of Paracelsian writings conveniently organized by subject. It contains important examples of Paracelsus's claims to validity and requirements of a true physician.

Paracelsus. Four Treatises of Theophrastus von Hohenheim. Baltimore: The Johns

Hopkins Press, 1941.

The treatise devoted to diseases of miners contains clear examples of medical theory based on alchemy. It also provides representative arguments including a letter written by Paracelsus in defense of his principles.

Waite, Arthur Edward. The Hermetic and Alchemical Writings of Aureolus Phillipps

Theophrastus Bombast, of Hohenheim, called Paracelsus, the Great, now for the

First Time Faithfully and Accurately Translated into English. . . Chicago:

De Laurence, Scott and Company, 1910.

Alchemical preparations for curative purposes are extensively described. Also, discussions of the microcosm’s relationship to the macrocosm and philosophy behind alchemical preparation of medicines are particularly relevant

Secondary sources:

Hartmann, Franz. The Life and Doctrines of Phillippus Theophrastus, Bombast of

Hohenheim, Known by the Name of Paracelsus. New York: Macoy Publishing

and Masonic Supply Company, 1932.

Many extensive quotes from Paracelsus's works and excellent examples of arumentation. A good source for historical events as well.

King, Lester S. The Growth of Medical Thought. Chicago: University of Chicago Press.

This most clearly outlined Paracelsus's theory of tartaric diseases. It also provided insightful review of the four pillars.

Lamber, Samuel W. and George M. Goodwin. Medical Leaders. Indianapolis: The

Bobbs-Merill Company, 1929.

This source provided unique information on Paracelsus's early education. It also outlined some excellent examples of remedies described through Paracelsian theory.

Swainson, William Perkes. Theophrastus Paracelsus, Medieval Alchemist. London: W.

Rider, 1919.

This book was the most useful in its description of Paracelsus's history. It also clearly explains some of his medical doctrines.

Wightman, W. P. D. The Emergence of Scientific Medicine. Edinburgh: Oliver and

Boyd, 1971.

This source was most useful in its description of Paracelsian remedies in reference to the system's theoretical framework.