A short history of alchemy, transdisciplinary quests, and reductionism in science - towards new solutions in health

When the old medieval societal structures were falling apart, during the Renaissance in Basel (Switzerland), the associated visible burden it created for the less fortunate inspired many intellectuals to search for new meaning, answers, questions, and ways of thinking. This also affected medicine, an area that was basically divided between academic theoreticians who were trained to highly respect ancient Greek medical theories, while the more practically oriented patient-centric self-appointed experts out in the field were a lot less academic, focusing on more mundane topics, opportunities, problems and sources of income around things like wounds, infections, herbs and baths. Or the power of poisons, if used carefully. With new trade routes around the world, new exotic medical products were now on offer as well, in increasingly awe-inspiring city pharmacies with scary animals hanging from the roof, and other oddities that can attract the right customers into a healthy shopping experience.

At the same time there was a network of transdisciplinary scholars that were a bit detached from those theoretical or practical medical communities, which called themselves alchemists. More than just a precursor of the modern chemical or biochemical laboratory with its apparatus and practical knowledge, those alchemists were often fascinated by the idea of learning from nature, by understanding its often mysterious and awe-inspiring dynamics. Inheriting ancient holistic world views that playfully connected all kinds of things that happen ‘above’ (in the spiritual / heavenly world, symbolized by the sky, the stars and symbols of astrology in the old cosmologies), with those that happen between us here below, on earth (such as the continuity of living beings across generations, creative tensions between opposites, and the biochemistry that enables life in a food-dependent way), they also added a very practical, experimental way of learning in the lab, to better understand how things change, and how to catalyze change in creative ways. Heat seemed to help in many cases when the ingredients were a bit reluctant to engage in such fusion experiments. They may even look with open, curious eyes at a baker baking bread in the early morning, creating a fresh dough from many materials, which after baking in heat becomes a wonderfully tasty bread that is so much more than just the sum of its parts. Or deal with the extraction of pure metals from what the miners could bring up. This process of change that creates things that are more than the sum of its original parts fascinated them deeply, so they recognized it wherever they looked carefully, searching for ways of describing and communicating what is happening, and also generating new questions for the next experiment in the lab. Of course it was quite tempting to search for general principles in all this diversity of changes that could be used to predict the outcome of an experiment. It was indeed a very diverse bunch of truth-seeking geeks as well as their more opportunistic imitators that did not always agree on many things outside maybe the basic vocabulary for sourcing lab apparatus, some generally useful ingredients for experimentation, and some of the basic aspects of that comprehensive world view they inherited from their pioneers in Old Egypt, Arabia and beyond. Many of the ancient wisdoms of this alchemic mindset were captured in rare and precious handwritten paper documents, which could easily get lost in history or even end up in the wrong hands. Even if you got hold of one with some effort that did not mean that you could actually understand what the text means, as the symbolisms used by ancient alchemy authors were full of complex meanings. From here you can imagine how fascinating those texts could be for a curious mind in those days, and how diverse the interpretations can be. But then came book printing, and the intellectual excitement around publishing, illustrating basic concepts in new ways, and the joy of rediscovery of many puzzling old texts that were almost forgotten.

In that context we can then witness a fateful gathering of a successful book publisher who knows many high-quality authors, and a young nomadic physician who focused on the use of alchemy for finding new kinds of medicines for all kinds of patients, rich and poor. It is during the early part of the 16th century, in 1527, when Paracelsus and Froben meet in Basel, with Froben being the desperate patient with the smelly wound that looks really bad (can he keep that leg?), and Paracelsus being the famous unorthodox physician who, they say, has cured many patients that other physicians were struggling to help using the classic, approved methods. Paracelsus is an odd man, neither a classic, beautifully speaking theoretical academic MD, nor a typical down-to-earth practitioner as they were commonly seen in those days. He also talks about things they never thought about. Which makes people curious, of course. He also meets the highly respected philosopher and moderator Erasmus of Rotterdam, who is a regular visitor in Basel in those days. After meeting the important people and debating his New Medicine with them, he is soon offered the position of a city physician with an academic teaching role included. To take care of any patient in and near the city, in a way that inspired many that came after him. Beyond the practical part of medicine, and the application of alchemy to separate key ingredients from less important ones (clearly his strong suit), this challenges the self-confident, young medical innovator to work on better communicating the theory he developed to underpin his New Medicine, to a next generation of future medical innovators that may later follow in his footsteps. By crossing the mental borders that their professors did not cross, and experiment with medicine in ways that they never considered. In other words, he becomes a disrupter, as we would say in our modern language, resulting in the usual reactions that disrupters can cause, including the more visible and less visible ones. Therefore, it is no surprise that after about one year in Basel, and a series of obstacles they put into his way, to prevent an uncontrollable amount of diversity in the field that scared many experts, he finally needs to run from the city and find shelter elsewhere, continuing his life-long nomadic journey of learning, teaching and practicing, including the amalgamation of the alchemy mindset, the practical things he learned on his many travels from all kinds of people, the teachings of his father (also a physician with alchemy knowledge, in the Alps) and the desire to find new solutions that really help patients.

But is this all still relevant in our days, as we face new opportunities and challenges in the unfolding 21st century, in medicine, health and related innovation spaces? To explore this, let us briefly summarize what happened in the almost 500 years since that year of the fateful meeting between Froben and Paracelsus in the house that now hosts the renowned Pharmacy Museum in Basel. Our ability to do experiments that help us understand the ‘inner workings’ of living systems, human beings and others, as well as the dynamics of complex ecosystems of such living beings, has developed in many ways. Also our ability to model this in computers. From the more superficial mechanistic understanding of the Renaissance, where the digestion of food was often compared to an alchemic process of changes, we have worked our way as a scientific community into an increasingly precise and detailed description of these highly complex living systems at a physiological, cellular and molecular level. This increasing knowledge and broader range of tools has also enabled, in many diseases, quite impressive medical progress that created real impact out there. But there is also a catch. With the separation of the more philosophical alchemic mindset and its laboratory practice and experimentation, from the emerging natural sciences that soon rejected the old philosophical obsessions of the old alchemists, we developed an addiction for reductionism that in hindsight may seem a bit overdone. We can go into more and more detail, with more and more tools, but also seem to get lost there. By now we have so many scientific disciplines with their own knowledge, traditions, tools, social pressures and language that the old metaphor of the Tower of Babel comes to mind. While many wonderful transdisciplinary efforts and forums exist, it has become increasingly difficult to effectively develop meaningful bridges between those scholarly communities, as they develop their own social bubbles like any other group in society in search of identity and belonging. With the huge complexity of health and disease I do wonder if we are on the right track here, if all this Reductionism is enough for making meaningful progress in the next decades. Every few years we can see exciting new technologies emerge that lead us to new opportunities. But how do we facilitate the emergence of a more comprehensive transdisciplinary approach that is firmly rooted in the evolution of science, and the most relevant disciplines, but also engages a diversity of human experiences related to health that exist all around the world? Can we build on our experiences with the role of diversity in innovation to find new answers and a more human-centric approach to health, even if they come from a different corner of the innovation landscape that may not come with high credibility and reputation right away? And how can this help us find a more sustainable approach to science-based innovation in medicine that results in something like a push and pull system of different forces that balance each other in a healthy way? At the moment there seem to be more questions than answers, but hopefully we can at least find promising talents that can over time find better answers. A first step could be to better formulate those questions, perhaps?

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Endlinks

- Movie about Paracelsus, his life, work and way of thinking: https://vimeo.com/343510891

- An excellent, small book about alchemy in Basel, from a real expert (anyone working on an English translation?): Thomas Hofmeier, Hauptstadt der Alchemie, Basel und das alchemische Werk. Leonhard-Thurneysser-Verlag, Berlin & Basel 2017.

- Understanding the history of reductionism and how scientists try to go beyond those mental barriers in emerging disciplines that often focus on puzzling, complex systems (Stanford): https://www.youtube.com/watch?v=_njf8jwEGRo

- The pharmacy museum in Basel, and the place where Froben met Paracelsus: https://pharmaziemuseum.ch/en/

- A half-serious article on Paracelsus’ year in Basel, as an exemplar disruptor: https://www.dhirubhai.net/pulse/renaissance-debates-disruption-early-days-medical-science-rebhan/?trackingId=kmfezEHDSvq1rQ0sl7w5fQ%3D%3D

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