Introduction

Where there are three physicians,

there are two atheists
Andrew Cunningham
Historical categories, valuable as they are, bring as many problems as they solve.
The Enlightenment has more problems than most, problems of definition, problems
of dating, problems of participation, problems of outcomes. What was it, when was
it, who joined in and what difference did it make?
In our old-fashioned and simplistic account everything was straightforward. The
Enlightenment was the movement which secularised and rationalised our worldview (for the better), it ran from Locke to Kant (c. 16501800), it was strongest
in France, England and Scotland, and the future Germany, and everyone sensible
joined in, leaving only the religious bigots outside in their intellectual and moral
darkness, and the long-term result was freedom of thought and happiness for all.
And above all it was an intellectual event, led by philosophers and with no pertinent
social or political context.
When it came to medicine, this old interpretation put most of the doctors,
anatomists and physiologists on the side of reason against superstition, of sense
against nonsense, of experiment against authority, and ultimately of scientific
medicine against folk-cures and quacks.
With time, however, every aspect of this sharp account has become nuanced and
more ambiguous, and it is more and more difficult to pronounce with confidence on
any aspect of the Enlightenment. But one thing we can say with certainty, and which
is borne out by the papers in this volume, is that religious sensitivity and sensibility
was still everywhere around the eighteenth century physician, Enlightenment or no
Enlightenment.
The old medieval saying had it that physicians always ran the risk of atheism,
on account of their studies: ubi tres medici, ibi duo athei, where there are three
physicians, there are two atheists. Sir Thomas Browne in the seventeenth century
called it the scandal of my profession, the view that physicians were tantamount
to atheists. This was still the case in the eighteenth century, and medical men were
certainly among the leaders when it came to flirting with atheism. The mechanistic
approach to the body the view that the body works solely in terms of matter in
motion, with no soul governing it all had been begun by Descartes in the 1630s.
Isaac Newton, though personally perhaps the most devout man of his age, had
challenged Descartess godless mechanistic approach with a new physics of forces
acting across distance with no contact. Followers such as Hermann Boerhaave the
great medical teacher at Leiden, who trained a generation of physicians from all over
Europe, adopted this Newtonian version. So it certainly was true that at the very
heart of medical study in Europe, a (relatively) godless form of physics underlay
physiology and pathology. But as Newton said, with action comes an equal and

Medicine and Religion in Enlightenment Europe

opposite reaction, and not only within the medical profession but also outside it there
were self-appointed guardians of Christianity who tried to keep the medic on the
path of righteousness, or to damn him if he wavered.
The clash or confrontation between such opposed views are clearly in evidence
in the opening chapter. Jonathan Israel, following up his own ground-breaking work
on the Dutch Enlightenment, puts the philosophy back into the discussion in his very
rich contribution to this volume. He can demonstrate more confrontations between
religious and medical interests than hitherto believed, because he is able to show that
in addition to what he calls the moderate Enlightenment reformers, there was also a
radical tradition, whose members were positively keen to challenge religious belief.
These radicals were freethinkers and even atheists, and many of them were followers
of Descartes and Spinoza, whether they publicly admitted it or not. In Leiden, The
Hague, Amsterdam and elsewhere these radicals were promoting medical reform
that is, reform in the understanding of how the body works, in what disease consists
and how to treat diseases more effectively. This was a central concern of certain
Dutch doctors who had become convinced believers in the mechanical philosophy.
Exported to London, this philosophy encouraged the physician Bernard Mandeville
to turn his interests toward treating melancholy and other mental conditions without
recourse to the concept of the soul. Via the French refugee physician La Mettrie,
this radicalism reached Berlin and Germany, while Spinozan ideas spread among
physicians in Altona, a suburb outside Hamburg, which offered religious tolerance.
It was here while city-physician that the later physician to the Danish court, Johann
Friedrich von Struensee, was won over to the radical Enlightenment.
Beyond Israels contribution on some of the centres of Enlightenment thinking,
we have tried to achieve coverage of one aspect or another of most of the regions
of western Europe, beginning with a tour around the Catholic heartlands. We begin
in the old centres of empire Portugal and Spain now sinking in the west under
the weight of Counter-Reformation Catholic orthodoxy, despite some of their
medical intellectuals looking toward more progressive medical environments in
Europe for inspiration. We then turn to Italy, where again the contradictions between
well-meaning Enlightenment reform ran up against the reefs of an aggressive
Catholicism.
A most curious state of affairs a seeming contradiction in Portugal concerning
medicine and religion in the Enlightenment (o Illuminismo) is revealed by Timothy
Walker. He shows that the greatest period of witch-hunting of popular healers
coincides exactly with the development of more rational approaches to medicine
there. Regularly licensed physicians were used by the Inquisition to persecute heresy
and other crimes against God, but equally these same physicians used the Inquisition
to persecute the practitioners of popular medicine in the name of reason and
progress! The antiquated educational system in medicine in Portugal did not change
until that great son of the Enlightenment, Pombal, made his reforms in the 1770s.
Turning to Spain, Jos Pardo Toms and lvar Martines Vidal discuss the
arguments over who was competent to be a birth-assistant: women or the new manmidwife. The Catholic clergy had a major role in making claims on one side or
another, not just on the need for someone competent to perform baptism on a dying
infant, but also on the natural capacities of men and women to learn. The authors

Where there are three physicians, there are two atheists

comment on what they call the eloquent silence of the midwives in this whole
discussion, unable to speak out because of their social position, their lack of formal
education, and lest they get mired in the religious arguments.
In southern Italy the Inquisition continued to be active in Naples, still at this
time Europes second largest city. The more liberal or progressive thinkers, medics
among them, still had to be cautious in what and how they wrote. Maria Conforti
discusses the engagement of medical men in Naples in the writing of history, indeed
shows that the celebrated Giambattista Vicos famous Scienza nuova was in part a
product of his association with medical men. She attributes the interest of Neapolitan
medical men in human history and the history of disciplines, as deriving, at least in
part, from their medical interest in patients histories and in the establishing of facts
in medicine. Her chapter points to the need to address the relation of naturalistic
Neapolitan histories of all kind to contemporary religious narratives.
If there was ever a pope who can be said to have been enlightened in the sense
that he was in favour of systematic and experimental investigation of nature, it must
be Benedict XIV. While Cardinal in Bologna he had very actively promoted such
studies, equipping a whole building with instruments and investigators. However,
as Catrien Santing shows, when it came to his duties within the Church, one thing
he had to do was establish and maintain new, stricter, standards for the declaration
of sainthood. That a candidate had performed miracles (that is, beyond the power
of nature) would no longer ensure their sanctity; instead, they had to have shown
heroic devotion something which, amazingly, could be demonstrated by witnessed
accounts of their capacity to fly, and their insensitivity to pain when in a devotional
ecstasy!
Although the Enlightenment in France is generally taken to be the most anticlerical and hostile to religion, L.W.B. Brockliss cautions us against assuming that
French physicians were typically enlightened and against religion and the Catholic
Church. By a painstaking analysis of catalogues of personal libraries of several
physicians he explores the committed Christian faith of most of them, together with
their interest in moral and social improvement: this Catholic enlightenment was
this-worldly and humanist, he concludes.
Anatomical representation is not an area where one might at first glance expect
to see the influence of religious commitment: anatomical art is surely independent of
religion? But Rina Knoeff, in her study here of two very famous Dutch anatomical
atlases, shows that the two anatomists portray their subjects quite differently: dead
on the one hand, seemingly alive on the other. Knoeff finds the decision about how
to depict the human body comes from the different religious commitments of each
anatomist. Govard Bidloo was a Mennonite, an extremely sober sect practising
the theology of martyrdom, and constantly resisting the vanities of this world and
conscious of the imminence of death. His anatomical images are of suffering and
torment. Reciprocally, the atlas of Bernard Siegfried Albinus, portrays his subjects
as if joyfully alive, and here Knoeff shows that this was a consequence of the Dutch
Enlightenment which was, in its very essence, Calvinist!
Dutch physicians and surgeons, together with Dutch publishers, were pre-eminent
in the making of natural history collections and of illustrating the visual images of
the exotic things explorers found. Benjamin Schmidt explores the extensive role

Medicine and Religion in Enlightenment Europe

that physicians had in collecting exotic natural historical items all around the world,
itself an Enlightenment phenomenon discovering, ascertaining and naming all the
various productions of Nature, as Oliver Goldsmith said. Schmidt claims it was the
sheer exotic nature of the items gathered, illustrated and published that fascinated
the Dutch medics, and that this put this fascination with natural history way beyond
any more local religious concern.
Bavarias most enlightened physician was put in a strange position: his own
daughter was exorcised in his presence, and the devil expelled from her, by a
Catholic priest in 1774. Yet the physician welcomed this event, since he saw it as
a counter to the materialistic tendencies of current philosophers, especially David
Hume. Claudia Stein shows that, surprisingly, a Catholic theologian who was also
present, was unpersuaded that the exorcism was anything but a trick. Stein uses this
moment to open new questions about the Bavarian Catholic Enlightenment, and the
relation of religion to natural philosophy.
Still in the German lands, Robert Jtte deals with the persistent miraculous story
of the boy who grew a golden tooth, discussed repeatedly from the late sixteenth
century well into the eighteenth. Doctors, dentists, philosophers, through Fontenelle
to Voltaire, all participated in this story at the beginning, or in its later uses as an
expos of superstitious Catholic practices by Protestant and other critics.
Then there is the strange case of the Danish Lutheran anatomist, son of a pastor,
who went to Paris where he practised anatomy most successfully, but also became
a Catholic. And it all happened not once but twice, with both conversions involving
the same great Catholic preacher, Bossuet. Ole Grell explores what was common
and what was specific to these two cases, Nicolaus Steno and his great-nephew
Jacob Winslw. How and why was Paris and anatomy dangerous to the religious
commitment of good Lutheran lads from the north?
Peter Elmer suggests that Spinoza so central to radical religious and
philosophical speculation in the Netherlands and elsewhere in the Enlightenment
may have been indebted in the first place for some of his thinking to physician
collaborators in the 1650s in the United Provinces. This radical stance by physicians
is in marked contrast to the situation in England, where even dissenting physicians
do not appear to have taken radical positions on religion, despite so many of them
having learned their medicine in the Netherlands. They were not even opposed to
the belief in witchcraft indeed they often invoked diabolism in cases of mental
disturbance, which appears to have had a high incidence amongst dissenters.
Finally, in Scotland, John Henry, on the search for the origins of modern
psychology, epitomises the complexity of the situation with respect to religion and
medicine that this volume is devoted to. For he claims that the Scottish commonsense school of philosophers developed a view that the mind operates according to
natural laws the essence of the scientific approach, one might think but that they
did so because they were trying to protect religion! For laws of nature guaranteed the
existence of an omnipotent God.
Together these chapters demonstrate the diversity and complexity of the
Enlightenment with respect to medicine, and the continued significances and roles
of religion right to the end of the eighteenth century.