Boerhaave en zijn syndroom

Herman Boerhaave (1668-1738), professor of botany, medicine and chemistry at the University of Leyden, attracted students from across Europe, thanks to his didactic qualities, reinforced by bedside teaching. His published writings, often unauthorised, were mainly theoretical and systematic. The more remarkable is the extensive and ‘atrocious’ case history he published about the 51-year-old nobleman Jan Gerrit van Wassenaer. As courtier and admiral of the Dutch fleet Van Wassenaer was a regular attendant at copious banquets, but at home he used to eat sparingly and sometimes he resorted to emetics. One day, having taken several bowls with an extract of Blessed Thistle (Carduus benedictus) and trying to vomit, he was seized by excruciating pain in the chest. The pain continued unabated until his death, the next day. Boerhaave, called to his bedside in the middle of the night, was unable to make a diagnosis from the history and physical examination. Post mortem examination showed the oesophagus had been torn off in the chest. Later generations have linked Boerhaave’s name with spontaneous rupture of the oesophagus.

Conflict of interest: none declared. Financial support: J.P. Gijselhart works part-time for the Association of the Dutch Journal of Medicine (Vereniging Nederlands Tijdschrift voor Geneeskunde), Amsterdam.