History of Medicine: Infectious diseases, vivisection and biological warfare in the Eighteenth Century.
Pieter van Woensel’s publications are a much underresearched field in the history of medicine of infectious diseases, maritime medicine, vivisection, and biological warfare in the eighteenth century. Below is a brief survey of his medical career. (This is a (paraphrased) anthology by author and exclusive copyright owner Laban Kaptein, based on text sections from his 3-vols. publication: Laban Kaptein (ed.), Pieter van Woensel, Remarks, Part I (translation of Remarks, 1791), and Commentary, Part II and III.)
After having discontinued his study of theology at the Remonstrant Seminary, Pieter van Woensel began studying medicine at Leiden University, thus following in the footsteps of his father Joan. He officially matriculated on 19 September 1768. On 23 November 1770 he obtained his Doctor of Medicine degree with the dissertation Specimen academicum inaugurale sistens quaedam miscellanea medica.
That same year, he submitted a manuscript essay Discourse on the art of observation (Proeve ener verhandelinge over de konst van waarnemen) in a prize contest held by the Dutch Society of Sciences in Haarlem. To his lasting chagrin, he did not win (which would have secured him the free publication of the treatise), but in 1772 an entirely reworked version appeared under the title The art of observation (De konst van waarnemen).
One especially salient difference between the manuscript version and the book, is the addition of the section ‘The dissection of living persons’ (Ontleden van levende menschen), where he argues the case of vivisection and medical experiments on criminals sentenced to death. According to Van Woensel, perfectly innocent dogs and other creatures suffer tremendously in dissecting rooms as ‘anatomicorum martyres’, whereas their non-human anatomy can only yield imprecise insights. Therefore, ‘(…) dissecting the bodies of living persons is by far the best way to gain knowledge of their action, if only this way was permitted. (…) many such operations are or can be made less painful than the sentences the criminals are submitted to, for there is a class of drugs in the Materies Medica called Anodyna. (…) I reason thus: capital punishment is necessary or not in a society; if unnecessary, it must be abolished; and even if it were unnecessary, it is not for the anatomists to pronounce on this; that is the judges’ job to decide. But if it is necessary, and if the pain of the dissection is no crueler than that of other sentences, then the dissection of living people should be permitted. In case the pain of the dissection was sharper, yet did not entail death, one could compensate for the surplus suffering by letting the person live. Who is a criminal? Somebody who has offended all of society by violating public safety. Now what is more reasonable: to have the person in question suffer a pain which is of no direct use for anybody, or have him suffer for the benefit of all society, so that a life that is anyway to be cut short by law, is used to repay the damage and sorrow it caused others? This is not new, Erasistratus and Herophilus were already of this opinion.’
(It is of notice that in 1772, the same year that The art of observation appeared, the Moscow authorities used convicts to experiment with plague victims’ clothes that had first been exposed to the freezing cold – an example cited by Van Woensel many years later in his Seaman’s medical guide. And of course, Nicolas Gabriel Clerc, while working in Moscow, had already broached the subject of vivisection on criminals in 1764. When Andrej Mejer translated Van Woensel’s The art of observation into Russian, he faithfully reproduced the proposal, albeit with a Translator’s warning: ‘Judging by the rights of nature, Mr. Van Woensel’s (…) advice does not deserve acceptance. For it is enough for a forlorn man that he loses his life.’)
Whooping cough in the eighteenth century.
The next step in Van Woensel’s career came when Catherine the Great requested the Netherlands, through Prince Gallitsin, to send Leiden-trained medical men to Russia. One of Van Woensel’s professors, Hieronymus David Gaubius, himself a former pupil of Herman Boerhaave, recommended Pieter van Woensel, Jacobus Dietz, and Frederik Albert Scheidius. Van Woensel left for St. Petersburg where he became physician at the Noble College of Land Cadets. It was the beginning of a lifelong relation with Russia, and of his lasting occupation with highly infectious and epidemical diseases, such as smallpox, measles, whooping cough, yellow fever, and the plague.
Confronted with the high mortality rate of whooping cough among the young cadets in St. Petersburg (the children were admitted to the Corps between the age of five and seven), he vainly tried the existing treatments. Following a recommendation he read in Linnaeus, he administered a decoction of lichen pyxidatus mixed with mint syrup, apparently with great success. His findings attained international renown, and were still cited in the specialist literature thirty years after his untimely dead.
In the late 1770s Pieter van Woensel was clearly also interested in epizootics— (highly contagious) disease epidemics among animals, witness his French translation (from the German original) of Henri (Heinrich, or Andrej) Bacheracht, Dissertation sur la maladie épizootique du bétail (1777).
Sauerkraut against scurvy.
(Hendrik Bacheracht (Генрих (Андрей) Гаврилович Бахерахт; 1724–1806) was born in St. Petersburg as the son of a Dutch broker and former surgeon’s apprentice. He went to Leiden to study medicine under Gaubius c.s., and submitted his dissertation in 1750. (He prided himself on having introduced the Dutch to the use of sauerkraut prepared à la russe to combat scurvy on long sea journeys.) Back in Russia, Bacheracht became a military doctor, and, from 1776 on, a high ranking medical officer in the Russian Navy. In all probability, Van Woensel and Bacheracht knew one another personally.)
Smallpox in the eighteenth century.
In 1778, Pieter van Woensel returned to the Republic, where he became a navy doctor in Amsterdam in 1780. In that capacity, he witnessed first-hand the massive maiming (deliberately) caused by the use of shrapnel in the naval battle of Dogger Bank in 1781, during the Fourth Anglo-Dutch War. In 1780 he also published his treatise on smallpox, Nouvelles expériences faites avec le mercure dans la petite-vérole, lesquelles en démontrent la vertu spécifique dans cette maladie. The publication attracted international attention, and was translated into German, as Neue mit dem Merkur in den Blattern gemachte Erfahrungen, welche dessen specifische Kraft in dieser Krankheit beweisen, and into English in 1793, by William Fowle, ‘M.D. Fellow of the Edinburgh Royal Physical Society’, as New experiments with mercury in the small-pox, by which is demonstrated its specific virtue in that disease.
Western physicians in the Ottoman Empire.
In the years 1784–1788, he travelled extensively in Turkey, the Crimea, and Russia, to study, among other things, the endemic plague. During the months he stayed in Constantinople, he at times helped as a physician for members of the Dutch (diplomatic) community, but also for locals, both in the city, and later, en route, in Anatolia. Among his patients were Ambassador Van Dedem’s wife, who had fallen very seriously ill (but eventually recovered), and an Ottoman official, whose gout affected foot he treated with electricity. In Erzurum the population expected the foreign doctor to work miracles, and he was so deluged with patients he had to eject them in batches. Looking back at his days as a practitioner without interpreter in Anatolia, it gnawed at his conscience that lives might have been lost in translation by his mistaking ‘cows for cherry trees’. Shortly before leaving for the Crimea, he visited plague-stricken Trabzon on the Turkish Black Sea coast, where he ‘saw several dead and dying people lying about in the streets’.
In the Crimea, he entered the Russian service, and worked for two years as a navy doctor again, based at Sevastopol. He then returned to his familiar St. Petersburg, where he published two medical treatises at the Imperial Academy of Sciences Press, at the time under the direction of Princess Dashkova, of his acquaintance: Mémoire sur la peste (1788), and Mémoire (…) sur le local de Sevastople (1789).
Campaign against burials inside church.
In 1791 he published his Remarks, made on a journey through Turkey, Natolia, the Crimea and Russia, in the years 1784–89. (Aanteekeningen, gehouden op eene reize door Turkijen, Natoliën, de Krim en Rusland, in de jaaren 1784-89) One aspect in the Ottoman Empire that greatly pleased him, was that the so-called ‘ignorant, uncivilised, barbarian, un-Christian Turks’, buried their dead in outlying cemeteries, and not inside their mosques – much in contrast to ‘several supposedly enlightened nations [that continue to bury the dead within the city walls and churches, and] have developed the bad habit of tainting the air inhaled by thousands with fetid fumes, as if trying to play into the hands of the grave-diggers by assisting mortality!’ In fact, many of his later publications were to appear under the Turkish nom de plume “Hekim-Bachi Amurath-Effendi”, Mr. Amurath, Chief of the Physicians, a name, he wrote, he had assumed, ‘half from whimsicality, half from a pleasant memory of my Musulman friends.’
Plague epidemic: history of biological warfare.
Remarks was followed by a second tome in 1795, in which Pieter van Woensel integrated a large section, in the original French, of his earlier Mémoire sur la peste (1788). In both Mémoire, and the first volume of Remarks, is a discussion of the possible instrumentalisation of the plague as a biological weapon of mass destruction, for smaller, weaker countries to deter conquest-lusting powerful nations. (In particular, for the Turks against the overwhelming might of Russia; that allusion was entirely suppressed, without leaving a trace, by Andrej Mejer in his Russian translation of Mémoire sur la peste …)
In his publications on the plague, Pieter van Woensel ardently defended the germ theory, which was still very much in disfavour among European physicians. Central to his argument is ‘that plague will never manifest itself in a human body, unless by contamination with its germ brought from outside.’ And so, by isolation, strict quarantine and cordons sanitaires, ‘it is possible to totally extirpate the pestilential virus from the face of the earth.’ He often used the Dutch term ‘zaad-stoffe’, as well as the French and Latin terminology: ‘le germe de ces maladies pestilentielles’, ‘le virus pestilentiel’, ‘le miasme’, ‘seminia’, ‘seminium’.
History of medicine: leprosy and slavery in Suriname.
In November 1792, doctor Van Woensel left for a six-month journey to Suriname, Demerara and Berbice in the Dutch West Indies. On 5 March 1793, he visited the leper-house ‘Voorzorg’ on the river Saramacca. In his In his report on the journey, he showed himself undecided on whether continued mixed-race interbreeding might eventually result in lower or no fertility. Possibly Van Woensel, despite all the physical evidence before his eyes, was influenced by the definition by French naturalist Georges Louis Leclerc, Comte de Buffon – whom he greatly admired – of species as positive “entities of nature” based on the criterion of the sterility of hybrids. Another observation about genetics is in his Remarks: ‘It would be most interesting to conduct a chemical analysis of Turkish and Greek blood. The latter must contain entirely different components to which they owe that fire, that vivacity.’
Maritime medicine in the eighteenth century.
In ca. 1803 Pieter van Woensel published a two-volume book of instructions for seamen’s health, Seaman’s medical guide, in particular for those sailors who find themselves entirely or largely deprived of medical and surgical care. (Raadgeevingen voor de gezondheid der zeevaarenden, bijzonder der zulken, die of in ’t geheel of grootendeels verstooken zijn van genees- en heelkundige hulpe.) It also contained an Appendix on yellow fever. The idea was to have a (first) print run of 1,000 copies, and eventually for this self-help book to be carried in every ship’s medicine chest. Clearly, this plan never materialised. To the contrary, Seaman’s medical guide completely vanished from the face of the earth, and was considered lost by Neerlandici and (book) historians, until Laban Kaptein sourced the perhaps sole surviving copy of it.
Till then, all that was known about its content came from the only existing, and devastating, critique. The upset reviewer observed that Van Woensel did not even flinch from entrusting a surgical procedure like tracheostomy to a rough sailor’s tar-stained hands. And he judged that the Doctor’s proposal to promote the Islamic institution of temporary marriage in The Netherlands, in the form of ‘rental wives’ for needy mariners, ought ‘to deny him all contact with decent women. (…) We conclude by saying that, since this publication by Dr. Van Woensel is devoted to the sea-service, we know no better way for it but to be made into paper cartridges. Along with putting it to at least some use, it would prevent it from staining the honour and glory of our fatherland’s morals and medicine!’
Indeed it would seem that the naval authorities resolved to shred the book. In the prelims of the only known copy of Seaman’s medical guide, a later hand has written the note: ‘Sole remaining copy. The others were destroyed before they came onto the market.’
The incident seems not to have dented the career of the well-connected Van Woensel at all. In fact, he became the first incumbent of the post of Medical Inspector General of the Dutch Navy (Doctor-Generaal der Marine), and it is fair to say that the office was really created – officially only on 22 December 1806, with him in mind. One lifelong foe mocked: ‘Now that I, Doctor Woenselius, thanks to favouritism and base manoeuvres, have been appointed Doctor of the Navy (…), I will, having brought it this far, and prompted by my desire for novelties, tour all the public fairs with a spectacle this year. This is announced here beforehand, that the ladies and gentlemen will not mistake me for other quacksalvers (…).’
The irony is that it was usually Pieter van Woensel who scolded medical authorities in his various publications, and in no uncertain terms. For example, he accused the Collegium Medicum of Amsterdam, a time-honoured institution which consisted of six Inspectores Collegii Medici (four physicians and two apothecaries), of inactivity, lack of integrity, and neglect of duty. And if such people act with negligence, what does this make them? People who practise medicine while unqualified, he wrote, ‘are no different than just as many murderers. (…) So, what about those expressly commissioned by the authorities to prevent [quackery]? If, in the case of theft, the receiver is as bad as the thief, what then in the case of murder?’
Pieter van Woensel’s untimely death in April 1808 shortly after his appointment may help explain why so little of him remains from his time as Medical Inspector General of the Dutch Navy. One of Van Woensel’s successors to the post in the 1870s, Gerrit Frans Pop, a leading historian of Dutch maritime medicine, wrote that the only evidence he could find of Van Woensel’s legacy was a report about the Navy hospital at Helvoetsluys. Pop was clearly also wholly unaware that Seaman’s medical guide ever existed. But over the course of time, more reports have come to light in archives and printed sources, with material ranging from ‘red trots’ (the highly contagious dysentry that posed a deadly thread especially aboard (war)ships); quarantine measures; the promotion of (rescue) swimming, as well as the use of the tobacco smoke clyster (enema) for the recovery of drowned persons; the importance of personal hygiene; et cetera.
When Pieter van Woensel, 61 years old, broke his leg as the result of a fall, he insisted on treating it himself. But the fracture deteriorated into gangrene, and he died on Sunday 17 April 1808. This sudden change of events left his siblings without any instructions. In the absence of a Will, it was decided that Pieter van Woensel, the atheist, and life-long advocate of open air cemeteries, was to be buried within the Kloosterkerk, in The Hague. His estate was auctioned, combined in a sales catalogue with the estate of the recently deceased professor of anatomy and obstetrics, and Inspector of apothecaries in The Hague, Cornelis Hendrik Velse.