Brian Altonen, MPH, MS

Daniel Turner, Hon. Yale MD

To understand the education an apprentice undergoes, one typically has to look at writings that were published about 10 or 20 years earlier.  We then need to review at the classics in medicine that people normally perused for the time, regardless of any intellectual or professional study routine.  Osborn was of course familiar with the classics of Hippocrates and perhaps heard about Galen.  Although no evidence has even been found suggesting he had the opportunity to review these authors, the association of the books of some of Osborn’s other  recommended authors suggests he may have had access to a number of classics, even if only for a short while.   The source for classics and timely writings in medicine in the New York region are few and far between and the location of a local library on this topic for Osborn to review has never been found.  More than likely the medical school that opened in New York City known as King’s College had a sizeable collection of medical writings.  But more than likely if Osborn was able to take a look at such a collection it would more than likely be found in Connecticut at Yale College.

Yale College began its operation during the late 17th century.  It wasn’t until about the time that Osborn was born that it made a substantial effort to develop a library devoted to medicine for its Medical Institute to own and circulate.    The Yale College would not bestow an actual MD degree on anyone for years to come during Osborn’s childhood.  But it was able to provide an Honorable MD degree to someone who later would become one of Osborn’s primary authors references in his vade mecum–Daniel Turner.

Most likely Osborn did see the writings of his primary references noted at the beginning of his vade mecum.  This means that he was certainly familiar with the writings of  Robert James, Peter Shaw and Thomas Sydenham (or as he wrote: “James Shaw or Sidenham”).  In his writings about Consumption, he mentions “Lemery” (Nicolas Lemery, the chemist, whose lengthy reviews of medicines are reprinted as adjuncts to Pierre Pomet’s writings on the same materia medica).    In his discussion of “3rd Day Agues” Osborn mentions “Huxom”, referring to John Huxham, author of the first extensive detailed essay on the use of Cinchona for treating specific forms of fever. 

In the case of severe consumption with the body filled with fluids, Osborn refers the reader to Turner thusly (misspellings fixed): “if you must come to tapping [I] should refer you to Sharp, Turner or Shaw.”  

There are few well-established physicians during the 1730s making it somewhat easier to identify who Osborn was probably referring to when he penned “Turner” into his vade mecum. 

In fact there were two such writers in the field of medicine around the time of Osborn’s apprenticeship.   At the beginning of this study the primary question was: which ‘Turner’ was Osborn referring to in his 1768 writings?   

According to Garrison’s History of Medicine, there is William Turner the Father of Botany, whose works were published in the 16th century.  It is possible that Osborn is referring to Turner’s writings since he is discussing the uses of medicines for clearing the lungs and the body of its  excess fluids related to consumption, the main subject of Osborn’s writing for the moment.   Yet it seems more likely that Osborn was referring to a more contemporary writer for his time, since he refer to Turner along with two others–Sharp and Shaw.   Each of these authors provided new books for physicians to learn from that would have been placed either into the own personal library of the master of an apprenticeship or in the possession of a local medical library constantly referred to during this unique period of medicine in the British Colonies.  Most likely the second “Turner” discussed in Garrison’s History of Medicine, Daniel Turner, was the contemporary writer Osborn was referring to along with two other contemporary writers for the time–Samuel Sharp and Peter Shaw.  

Daniel Turner was a self-trained physician who obtained a license to practice medicine from the Royal College of Physicians in 1711.  He was granted this license without fully engaging in the traditional apprenticeship or university method of becoming a physician.  Turner’s overall practice often included surgery and some historians suggest Turner spent a lot of time trying to work equally as both a physician and a surgeon.   Still other historians suggest Turner spent more time trying to obtain a full membership of the Royal College of Physicians for his efforts, much of which concentrated on his writing and publishing of medical books.

Turner’s practice of medicine without going through the full apprenticeship was not unusual for the time in England.  It was possible for  doctors to receive their training, prove their knowledge, and perform their skills successfully through some informal form of an apprenticeship.  So long as this was done according to standards, an individual could obtain a license to practice without the need to go through the various forms of teaching and practice then being developed for the more effectively trained MD physician or surgeon.  

Turner’s writing and publication experience includes the following:

1. A vindication of the Nobel Art of Chirurgery . . . 1695.
2. A remarkable case in surgery, 1709.
3. De Morbis Cutaneis . . . 1714.
4. The Modern Quack . . . 1718.
5. On the Force of Mother’s Imagination on the Foetus in Utero . . . , 1726.
6. The Ancient Physicians Legacy Partially Survey’d . . . , London, 1733.
7. A Discourse Concerning Fevers . . . 1 ed 1727, 3ed 1739.
8. A discourse concerning Gleets, London, 1729.
9. The Drop and Pill of Mr. Ward, 1735,
10. Aphrodisiacus, 1736.
11. Syphilis, a practical dissertation on the venereal disease, 1737.
12. Syphilis, the second part, 1739.

It is important to note that his first two books published focused on the Art of Surgery, for which he obtained substantial amounts of gratuities for due to its importance to members of Royalty, but especially Queen Anne.  Turner began his profession primarily working as a surgeon.  According to medical historian Munk, Turner was bred a surgeon and practiced in that capacity for several years, until he became disenfranchised by his company, after which he went to the Royal Academy and was admitted to Licentiate.

As demonstrated by his 1718 publication, Turner was strongly against the common practices of quackery for the time.  In his book on this topic, he defines the dealers of quackery as four types: those who make claims to possessing secret remedies, those who advertise and make their sales by the use of testimonials, those who resort to uroscopy to support most of their claims, and those who make heavy use of public display to promote their products.  He would once again return to this moral medical issue in his much later 1735 publication The Drop and Pill of Mr. Ward.

There are several major and very important contributions to medicine that Turner made.  The first pertained to his essay on cutaneous diseases, in which he defined to his readers his personal philosophy on the origins of disease.  Second, Turner produced an important series of writing, sequels and updates on the impacts of “imagination” of the mother on her fetus in utero.  Thirdly, Turner’s writings brought to the forefront certain undiscussed medical issues pertaining to sex, the use of condoms and diseases that many were by then perceiving as being sexually-transmitted, namely syphilis.  

Turner’s philosophy was defined succinctly by historian Niebyl who wrote:  “For Turner, the skin served as an external manifestation of internal humoral disease.”  This philosophy was then modified by another highly popular system of defining disease also popular for the time–17th century iatrochemistry.  Another possible interpretation of Turner’s philosophy is that his philosophy is both humoral and miasma-based, allowing for the effects of the surrounding environment to impact the health of the body’s internal processes, as depicted by the condition and health of the surface and skin.    At a philosophical (natural philosophical) level, we can related this very well to Porta’s renditions of the body’s gnomics in or signs regarding personal health and the propensity for one’s body to suffer from specific medical conditions impacting certain organ systems.    (NB: This would later be redefined as part of the physiognomic  and phrenology professions of the early to mid, and even late 19th century.  Physiologists would later use somatic (body) form to determine if particular diseases were being suffered by a patient, usually those endocrine of hormonal in nature.  Psychiatrists and Criminal psychologists would attempt to use this philosophy to predict criminal tendencies, forms and possible biological reasons.)

Although he was never officially trained in medicine and therefore did not obtain an MD degree before involving himself in this profession, Turner’s insights into disease and medicine in general enabled him to develop a significant stronghold in a field developing a strong scientific basis for knowledge and disease for the first time.  For Dr. Osborn, his most important writings probably pertained to the fever, for which Turner wrote an important treatise on. 

In a  more general sense, Turner’s first and most important writing was his   English monograph on skin diseases entitled De morbus cutaneis . . . published in 1714.   This is preceded only by a Latin monograph on skin disease entitled De Morbis Cutaneis, (Venice, 1585) by the Professor of Medicine at Bologna Girolamo Mercuriali (1530-1606).  In this book, Turner discusses the methods by which certain diseases erupt, in particular making use of the humoral theory to detail how contact with certain substances and imbalances in the body within can lead to the development and display of diseases at the cutaneous or skin (superficial and external) level.   This  philosophy relies strongly upon the notion of a “seed” for disease that may be manifesting itself  at times in the skin.  This “seed” theory for disease is somewhat similar to much later theories for disease that evolved, such as the notion that worms could be the cause for disease, a notion published in certain 16th century writings (nearly two hundred years after the African Tape Worm was discovered), and ultimately the animalcule and germ theories for disease of the early and late 1800s respectively. 

In the 12th chapter of De morbus cutaneis, Turner introduces to the reader the notion that the imagination of a woman expecting a baby is not necessarily responsible for creating the monstrous births at times witnessed by physicians and midwives.  This was a very popular belief for the time, more popular to the less educated folklore- and superstition-focused settings of domestic life.  During the eighteenth century, this notion of predisposition to malformation due to maternal imagination was reduced in credibility and popularity by the mid 1700s.  This philosophy would gradually be rejected  by the more popular medical and natural philosophy teachers of the time. 

Turner’s statement regarding his lack of belief in imagination-induced monstrosities set the stage for more than 20 years of published arguments regarding such a claim.  Turner’s statements ultimately resulted in controversy and arguments published his rivals to this philosophy, the most important of which was his primary debater James Augustus Blondel (ca. 1666-1734).   The notion that imagination could cause malformed babies is not new to medicine.  This notion had been around for one or more centuries by this time and had several medical writings produced in exquisite and sometimes gory detail, for example:

1. Antonio Benivieni (1443-1502). De abditis non nullis ac mirandis morborum et sanationum causis. [Florence: Philippi Giuntae Florentini, 1507.]  In his De Abditis…, or On the Several Hidden and Strange Causes of Disease and Cure, Bienveni made special notes about unusual physical conditions, attributing these and many irregularities in human form and function to natural and preternatural cures and causes related to astral influence, the powers of gems, plants and people, and the power of imagination.  He used more than 100 medical cases to make his claims, ending with a review of conjoined twins made famous in Florence by their mother.
2. Pierre Belon (1517?-1564). Les obseruations de plusieurs singularitez et choses mémorables: trouuées en Grèce, Asie, Judée, Egypte, Arabie et autres pays estranges, rédigées en trois livres … Paris: Guillaume Cauellat, 1555.  This writing focused on the most unusual forms  a body can take and the related often to amusing, almost circus-like appearances.

This controversy ultimately resulted in Blondel publishing his arguments in The power of the mother’s imagination over the foetus examin’d. In answer to Dr. Daniel Turner’s book, intitled (sic) A defence of the XIIth chapter of the first part of a treatise, De morbis cutaneis … (London: John Brotherton) in 1729, more than ten years later.   Blondel argued that it was a regular act of nature that produced fetal malformations, claiming that this took place as a physical and/or mechanical consequence of nature’s normal functions.   Blondel used various clinical cases and illustrations to prove his claims, arguing that the “imaginative” theory of monstrous births was not at cause here, claiming this non-scientific argument for its cause was a belief more common to lay people.

The following works detail this ongoing medico-political argument from 1714 to 1740:

1. Daniel Turner, ‘Of Spots and Marks … Imprest upon the Skin of the Foetus, by the Force of the Mother’s Fancy’, De Morbis Cutaneis(1714, 1726)
2.  [James Augustus Blondel], The Strength of Imagination in Pregnant Women Examin’d (1727)
3. Daniel Turner, ‘A Defence of the XIIth Chapter’, A Discourse Concerning Gleets (1729)
4. James Augustus Blondel, The Power of the Mother’s Imagination over the Foetus Examin’d (1729)
5. Daniel Turner, The Force of the Mother’s Imagination upon her Foetus in Utero, Still Farther Considered (1730)
6. John Henry Mauclerc, The Power of Imagination in Pregnant Women Discussed (1740)

Turner’s dispute with Blondel about this the common belief that “imagination” may result in the birth of a child damaged by improper or wrongful thinking made Turner a popular author commonly cited by modern medical historians.  In modern writings we find reference to Turner’s work by historians focused on women’s health issues and in the study of teratogenesis, the means by which a fetus develops in utero and forms the shape and psychological make-up of the child to be born.   Whereas this first contribution  by Turner was of international significance, his second and third contributions to the medical world resulted in more controversial issues to be developed and even led to a certain amount of culturally-defined prejudice and old-timed interventions to reconvene due to his medical writings.  These writings pertained to sex, sexually transmitted disease, and the use of the condom.

The return of the condom issue came about due primarily to Turner’s correct conclusion that disease could be spread from one person to the next through sexual experiences.  This was not any sort of new thinking that Turner had, but Turner made it a priority to focus on this matter with regard to the diseases of the skin, often the first way many sexual diseases first present themselves.  At this time, there was a distinct separation taking place in the medical world when it came to the overall form of practice engaged in by licensed physicians.  There were physicians who received  a true MD license due to their training in the traditional academic fashion, attending classes and working alongside a mentor.  Then there those physicians who were read and learned in the profession, but who obtained much of this knowledge as part of an apprenticeship in the form of a Licentiate obtained in the same way Turner obtained his degree.  The major clinical differences between these two sorts of doctors for the time was that one could work inside the body to manage and eliminate the causes for illness and disease, while the other type of physician worked primarily from the skin out on his patients.   Turner was a self-motivated individual who was first a surgeon and later an MD, so he did not have to feel as limited in his methods of practice as other physicians for his time, those trained mostly in treating the outside body. 

Once he was considered an expert in the methods of transmitting certain forms of disease from one individual to the next, Turner began to relate this concept to the process of “seed” development and the resulting sexual transmission that ensued.   At the time it was not uncommon for physicians to suspect that a person could pass a disease along to the other through sexual contact, but to relate this form of disease transmission to certain human behavioral topics such as sex and sexual relationships shed an entirely different light on this overall health care problem.  At the time, such writings seemed somewhat uncommon.  In the least, when included in the domestic medical guides they were added to the back of the book or made to appear as though they were adjuncts to the more common thought processes for the writer.  In Etmuller’s 17th century book on Domestic Medicine for example, the mention of sex, intercourse, and the female or male genitalia is completely absent, and provided instead in some symbolic form, using words that are more streetwise or slang-like in form and symbolism than professionally medical and altruistic in nature.   

So when Turner discussed sex in such a way so as to upset the norm and the practitioners of “special relationships” and extramarital sex, both the rich and the not-so-well-to-do members of society were impacted by these writings.  Such was probably not exactly the plan Turner had in mind when he penned this book.  But this is exactly the outcome of this issue that Turner discussed in his book, once again raising a curtain like he did with the essay on imagination and the newly born child.   Most importantly perhaps is to realize that Turner did not support the use of condoms to prevent sexual transmission,.  Instead, he used his seed argument for disease development to support his claim that condoms may in fact make it more likely that people could pass these diseases on.   In his 1717 treatise, he recommends against the use of condoms due to the premises underlying his “seed” theory, not the condition of the condoms.  At the time, condoms were made from either linen treated with a fluid designed to filled the gaps in the weave, or the less restrictive forms made from animal intestinal linings using a sulphur and lye method of treatment.    Since neither of these forms of condoms were never really favored by men involved in extramarital or private transactions, for performance reasons much less cost related reasons (they were too expensive for the poor or the prostitutes to use or get access to), Turner said everything they needed to hear for yet another reason not to employ the use of the condom.

Now perhaps Turner appropriately determined that condoms were not a perfect form of protection against passing on venereal diseases, in particular for syphilis, the transmission of which certainly had its life-changing consequences.  The identification of syphilis as a disease one has just obtained infers your relationship with someone other than your spouse, but to keep this disease a secret to your spouse meant you took the risk of becoming insane in your later years due to the tertiary manifestation of this problem within the brain itself.  Turner was very much against any proclamations  made stating that condoms would protect the husband from certain domestic or medical tragedies should he practice any sort of infidelity.  In 1717, this type of social and professional argument most likely was an important turning point to Turner’s rapidly growing reputation and career.

Still there is more to Turner’s accomplishments that this part of his life story.  What made Turner such an interesting addition to Osborn’s readings is Turner’s ability to initiate controversy and cause different opinions and new philosophies to begin to develop within the medical profession of the time.  In his 1714 work  De Morbis Cutaneis: A Treatise on Diseases of the Skin. London, 1714, he  is identified as “Daniel Turner, licentiate of the College of Physicians.”  By the 1740s, he was referred to in his books as “Daniel Turner M.D., of the College of Physicians in London, which first appeared in the 7th edition of his The Art of Surgery (London, 1741).   What produced this change in reputation and professional status?

In 1722, Yale College put out a call to physicians requesting a donation of books.  Turner followed up on this request and provided Yale with about 25 books (some estimates are as high as 50).  This in turn led Yale to offer Turner an honorary M.D. in 1723.   First published in 1722, The Art of Surgery  was included in his gifts to Yale College for use by its Medical Institution.    Turner had hoped that by earning this M.D. degree,  that he would be able to become a Fellow of the Royal College of Physicians due to these additional medical credentials.  Such never became the case for Daniel Turner.  Nevertheless he became one of the most influential writers of the 1730s and 1740s in the local colonial history of Yale College.

Following the initiation of  his work as a surgeon a waxed based remedy known as a cerate was produced and named after him, of which Turner stated:

“As I have had ample experience of this cerate, I may be allow’d, I hope, to judge of its singular properties and good effects in all cutaneous ulcerations and excoriations either from scalding, burning, or fretting of the said parts by means of salt, acrid, or sharp humours; upon which accounts, not straining a little beyond its deserved eulogy, I am bold to affirm it will do more in all these superficial hurts of the body than either………and do wish that the Apothecaries would keep it made up in their shops, to deliver, at a suitable price, to indigent or poor people, instead of their ridiculous Locatellus’s Balsam, and other improper medicines which they call for ignorantly to heal their skin-deep maladies….”

Turner’s Discourse on Fevers

(To be continued)

References

I am deeply appreciative of the contributions to this biography provided to me around 1990 by medical history colleague Margaret DeLacy of Portland, Oregon.