Observationes Medicae (Tulp)

Title page from Prof. Tulp's 1641 book, published by Lodewijk Elzevir.

Page from Prof. Tulp's book with illustration of the chimpansee.

Same page from 1740 Wolzogen edition.

Observationes Medicae is the title commonly used by early Dutch doctors in the 16th and 17th centuries who wrote up their cases from private practise in Latin to share with contemporary colleagues. This is therefore a common title, but this page is devoted to the 1641 book by Nicolaes Tulp. Tulp is primarily famous today for his central role in the 1632 group portrait by Rembrandt of the Amsterdam Guild of Surgeons, which commemorates his appointment as praelector in 1628.

Professor Tulp

Though already well known at the time his book was written, Professor Tulp enjoyed international fame after publishing this book, and in 1652 a second edition was printed, highly unusual at that time. His book comprises 164 cases from his practise, kept in a diary from his early career onwards. His book was illustrated with plates, and it is not clear who drew these or engraved them. According to various sources, he drew many of these himself. His birth name was Claes Pietersz. He adopted the name Tulp when he had a Tulip shaped sign placed outside his door when he set up shop in Amsterdam. Many of his early patients could not read or write. He soon no longer needed to advertise his services, however, and his many duties as Praelector, and later, mayor of the city of Amsterdam, prevented him from spending so much time on his practise. He published the book 5 years after the Amsterdam Pharmacopoeia was completed, which was his own personal initiative, and that helped to set intercity medical standards in the region known as the United Provinces.

Vondel

Tulp had a reputation for a moral upstanding character, and Joost van den Vondel wrote poetry extolling his virtue. He later also wrote a poem in honor of the second edition of this book^[1].

Earliest illustration of a Chimpanzee

Tulp's book has various accounts of unusual illnesses and primarily growths or carcinomas, but also has accounts of creatures brought back from Dutch East India Company ships. His drawing of a Chimpanzee is considered the first of its kind^[2]. This creature was called an Indian Satyr, since all ships cargo was considered Indonesian. However, the accompanying text claims the animal came from Angola. This drawing was copied many times and formed the basis for many theories on the origin of man. Most notably, Tulp's work and that of Jacob de Bondt (alias Jacobus Bontius) was copied and republished by Linnaeus to show a link between apes and man^[2].

Jan de Doot

Story from Prof. Tulp's book with illustration of the knife and kidney stone (publication 1740)

One of the interesting cases is the story of how Jan de Doot performed a bladder operation on himself.

But this stone weighing 4 ounces and the size of a hen's egg was a wonder how it came out with the help of one hand, without the proper tools, and then from the patient himself, whose greatest help was courage and impatience embedded in a truly impenetrable faith which caused a brave deed as none other. So was he no less than those whose deeds are related in the old scriptures. Sometimes daring helps when reason doesn't.^[3]

Ludovicus Wolzogen

Observationes Medicae became so popular, that a hundred years later a translated version was published. Professor Tulp never wanted to publish in Dutch for fear of hypochondriac behavior. He was very against quacks and self-medication and it was for this reason that he worked on the Amsterdam Pharmacopoeia. This second version therefore, would have been against his wishes. However, the book was prefaced by a long lykoratie, or ode to his memory, in which Ludovicus Wolzogen explains what a wonderful man Tulp was, and everything that he did for the city of Amsterdam and medicine in general. He claims to have made an accurate translation from the Latin, but the flowery language is so different from Tulp's terse descriptions, that this is highly unlikely. After this edition, the number of cases went up from 164 to 251,

Index Capitvm Libri I

The chapters and accompanying plates of the 1641 and 1740 editions of Book one are the same, only four extra chapters appear in the later version.

1 Calvaria fracta. 2 Occulta capitis rima 3 Fractura ossis cuneiformis 4 Fractura capitis sanata 5 Salutaris modioli usus. 6 Morbus attonitus 7 Morbus attonitus a sanguine 8 Morbus comitialis sponte sanatus 9 Morbus comitialis a splene 10 Morbus comitialis a vulva 11 Epilepsia fexies cottidie accedens 12 Tremor periodicus 13 Reciprocus capitis dolor 14 Convulvsio sedentaria 15 Praesagium convulsionis periodicae 16 Viti saltus 17 Malleatio 18 Imaginaria ossium mollities 19 Mola imaginaria 20 Aquaemetus 21 Senexrabiosus 22 Catalepsis ex amore 23 Pollicis tremor, a detractione sanguinis 24 Hydrocephalus 25 Hydrocephalus dimidiati capitis 26 Polypus narium 27 Polypus cordis 28 Oculiprocidentia

29 Encanthiscancrosa 30 Vulnus pupillae sanatum 31 Caecitas a veneno 32 Dolor capitis a natura devictus 33 Dolor inter caput, ac pedem reciprocus 34 Pedes talpini 35 Respiratio per aures 36 Mors a dente genuino 37 Ulera palati 38 Prolapsus palati 39 Vox a febre intercepta 40 Idem silentium a pituita 41 Mutus loquens 42 Gula resoluta 43 Inedia undecim dierum 44 Lethalis gula tumor 45 Idem tumor a pituita 46 Strumarum anatome 47 Cancer quinquaginta annos innoxius 48 Arteriotomia 49 Sanguis ex dente 50 Vulnus aspera arteriae 51 Angina interna 52 Ranula 53 Cancer mammarum 54 Evanidae mammarum pustulae 55 Livor ex tusst

Index Capitvm Lib. II

The chapters and accompanying plates of the 1641 and 1740 editions of Book two are the same, only one extra chapter appears in the later version.

1 Dolor pleuriticus e bile 2 Sanguis octies puerperaemissus 3 Pleuritis sanguinem venis subtrahens 4 Pleuritis suppurata 5 Legitima thoracis sectio 6 Pus thoracis per umbilicum 7 Rara difficilis spiritus caussa 8 Marcor ostreis sanatus 9 Idem successus a sola natura 10 Vomica pulmonis 11 Sputum sanguinis triginta annorum 12 Surculus, venae arteriosae, expectoratus 13 Integra vena a pulmone rejecta 14 Frustum pulmonis, fauces occludens 15 Turunda ore rejecta 16 Hydrops thoracis 17 Pulmp praecisus 18 Vulnus cordis 19 Cordis palpitatio a Liene 20 Ira puerperis noxia 21 Vomitus bilis atrae 22 Vomitus octodecim mensium 23 Vomitus pituitae concretae 24 Praegnans edensmille quadringentos haleces 25 Calculus arterialis 26 Fibrae jocinoris vulneratae 27 Pus Iocinoris, peros, ac alvum

28 Lien verberans 29 Lien disruptus 30 Magnus lien 31 Sanguis cutem transudans 32 Steatoma mesenterii 33 Steatoma cum ulcere, & aqua 34 Hydrops cum vesiculis mesenterii 35 Tympanites cum ascite 36 Morbus regius, cum hydrope 37 Abscessus mesenterii, a partu disruptus 38 Ventrissectio 39 Perforatio scroti 40 Mors ex depresso ventre 41 Volvulus ex ira 42 Caput lumbrici lati 43 Ischuria lunatica 44 Calculus renum 45 Calculus ureterem obturans 46 Diabetes 47 Mictus lapidosus 48 Membrana lapidescens 49 Mictus vermis cruenti 50 Unde viginti vermiculi emicti 51 Cottidianus vermium mictus 52 Periodicus capillorum mictus 53 Ulcus vesicae sanatum

Index Capitvm Lib. III

The chapters and accompanying plates of the 1641 and 1740 editions of Book three are the same, the Indisch Satyr is also the last plate in the later version.

1 Misera, virginis gibbosa, conditio 2 Vesica a calculo consumpta 3 Gangraena umbilici 4 Lapides bezoarticiin homine 5 Calculus vesica adnatus 6 Calculus vesica arcte circumdatus 7 Calculus trium unciarum sponte excretus 8 Modus eximendi calculum ex urethra 9 Turunda lapidescens 10 Lethalis ani tumor 11 Dolor ani quarta hora a solut a alyo 12 Lumbricus ex inguine 13 Periculosa hernia sanata 14 Sapientia juvenilis 15 Praeposterum silentium 16 Immoderatus clysteris usus 17 Interior intestini tunica excreta 18 Adepscottidie ab alvo prodiens 19 Idem adeps, ab alvo, ac vesica 20 Vulnus, latioris intestini sanatum 21 Valvula intestinalis 22 Convulsio abdominis 23 Abscessus inguinum, a vulva 24 Tabes dorsalis 25 Coxa dolor adscessu fanatus 26 Coxa ferramento exusta 27 Vulnus spinalis medullae 28 Fistula insanabilis

29 Lethalis lumborem tumor 30 Spina dorsibifida 31 Vulva bili innatans 32 Hydrops uteri 33 Fungus ex vulva excifus 34 Major fungus ibidem excifus 35 Terus sive fricatrix 36 Menstrua puellae quadrimae 37 Partus monstri bicipitis 38 Dissectio monstribicipitis 39 Coles incurvatus 40 Pediculi pubis 41 Mors ex flore calcis 42 Sudor septem annorum 43 Excoriatio ab oleo Vitrioli 44 Exedenspraecordiorum herpes 45 Pulfus arteriae extracarpum, explorandus 46 Gangraena universalis 47 Gangraena pedis 48 Sphacelus brachii, a febre 49 Atrophia brachii suctu sanata 50 Rotundum vulnus 51 Carcinoma fremoris 52 Febris quintana 53 Cibi abstinentia quartanae lethalis 54 Error naturae compensatus 55 Incredibile corporis humani incrementum 56 Indisch Satyr

Index Capitvm Lib. IV

There is no Book four in the original version, but the later version calls it Register der Hoofdstukken van het vierde boek. The sixty chapters and accompanying plates are some of the most popular in Dutch medical literature, however, including the Jan de Doot (or Jan Lethaus, a bastardized version of the Latin for lethal - lethalis), ending with a chapter on Tea.

References

1. ^ Op de Bespiegelingen der Geneeskunste Van den E. Heere, Dr. Nikolaes Tulp, Burgermeester en Raet van Amsterdam, by Joost van den Vondel,DBNL
2. ^ ^{a b} University of Amsterdam (2008) Bijzondere collecties - Aap, vis, boek - Linnaeus in de Artis Bibliotheek, Amsterdam.
3. ^ Nicolaes Tulp (1740) Geneeskundige Waarnemingen van Nicolaas Tulp. Jurriaan Wishoff, Amsterdam.

External links

• Observationes Medicae -- Full Latin text in Google books of Amstelredamensis Observationes Medicae, Nicolai Tulpii, Amsterdam Elzevier, 1652 edition, digitalized from a copy in the possession of the Bavarian State Library
• Geneeskundige Waarnemingen -- Copies in Google books on the Dutch translation Geneeskundige Waarnemingen van Nicolaas Tulp
• Illustrations from Medical Observations by N. Tulpius on UNESCO site
• Explanation of Rembrandt's painting in the Mauritshuis museum [1]