第43章

Inearnest，theyhavereasontorequireaveryfavourablebelieffromtheirpatients;and，indeed，itoughttobeaveryeasyone，toswallowthingssohardtobebelieved。Platosaidverywell，thatphysiciansweretheonlymenwhomightlieatpleasure，sinceourhealthdependsuponthevanityandfalsityoftheirpromises。

AEsop，amostexcellentauthor，andofwhomfewmendiscoverallthegraces，pleasantlyrepresentstousthetyrannicalauthorityphysiciansusurpoverpoorcreatures，weakenedandsubduedbysicknessandfear，whenhetellsus，thatasickperson，beingaskedbyhisphysicianwhatoperationhefoundofthepotionhehadgivenhim:"Ihavesweatedverymuch，"saysthesickman。"That’sgood，"saysthephysician。Anothertime，havingaskedhowhefelthimselfafterhisphysic:"Ihavebeenverycold，andhavehadagreatshiveringuponme，"saidhe。"Thatisgood，"repliedthephysician。Afterthethirdpotion，heaskedhimagainhowhedid:"Why，Ifindmyselfswollenandpuffedup，"saidhe，"asifIhadadropsy。"Thatisverywell，"saidthephysician。Oneofhisservantscomingpresentlyaftertoinquirehowhefelthimself，"Truly，friend，"saidhe，"withbeingtoowellIamabouttodie。"

TherewasamorejustlawinEgypt，bywhichthephysician，forthethreefirstdays，wastotakechargeofhispatientatthepatient’sownriskandcost;but，thosethreedaysbeingpast，itwastobeathisown。Forwhatreasonisitthattheirpatron，AEsculapius，shouldbestruckwiththunderforrestoringHippolitusfromdeathtolife:

"NamPateromnipotens，aliquemindignatusabumbrisMortaleminfernisadluminasurgerevitae，Ipserepertoremmedicinaetalis，etartisFulminePhoebigenamStygiasdetrusitadundas;"

["ThentheAlmightyFather，offendedthatanymortalshouldrisetothelightoflifefromtheinfernalshades，struckthesonofPhoebuswithhisforkedlightningtotheStygianlake。"

——AEneid，vii。770。]

andhisfollowersbepardoned，whosendsomanysoulsfromlifetodeath？

Aphysician，boastingtoNicoclesthathisartwasofgreatauthority:

"Itisso，indeed，"saidNicocles，"thatcanwithimpunitykillsomanypeople。"

Astowhatremains，hadIbeenoftheircounsel，Iwouldhaverenderedmydisciplinemoresacredandmysterious;theybegunwell，buttheyhavenotendedso。Itwasagoodbeginningtomakegodsanddemonstheauthorsoftheirscience，andtohaveusedapeculiarwayofspeakingandwriting，notwithstandingthatphilosophyconcludesitfollytopersuadeamantohisowngoodbyanunintelligibleway:"Utsiquismedicusimperet，utsumat:"

"Terrigenam，herbigradam，domiportam，sanguinecassam。"

["Describingitbytheepithetsofananimaltrailingwithitsslimeovertheherbage，withoutbloodorbones，andcarryingitshouseuponitsback，meaningsimplyasnail。"——Coste]

Itwasagoodruleintheirart，andthataccompaniesallothervain，fantastic，andsupernaturalarts，thatthepatient’sbeliefshouldprepossessthemwithgoodhopeandassuranceoftheireffectsandoperation:aruletheyholdtothatdegree，astomaintainthatthemostinexpertandignorantphysicianismoreproperforapatientwhohasconfidenceinhim，thanthemostlearnedandexperiencedwhomheisnotsoacquaintedwith。Nay，eventheverychoiceofmostoftheirdrugsisinsomesortmysteriousanddivine;theleftfootofatortoise，theurineofalizard，thedungofanelephant，theliverofamole，blooddrawnfromundertherightwingofawhitepigeon;andforuswhohavethestone（soscornfullytheyuseusinourmiseries）theexcrementofratsbeatentopowder，andsuchliketrashandfoolerieswhichrathercarryafaceofmagicalenchantmentthanofanysolidscience。Iomittheoddnumberoftheirpills，thedestinationofcertaindaysandfeastsoftheyear，thesuperstitionofgatheringtheirsimplesatcertainhours，andthatsoaustereandverywisecountenanceandcarriagewhichPlinyhimselfsomuchderides。Buttheyhave，asIsaid，failedinthattheyhavenotaddedtothisfinebeginningthemakingtheirmeetingsandconsultationsmorereligiousandsecret，wherenoprofanepersonshouldhaveadmission，nomorethaninthesecretceremoniesofAEsculapius;forbythereasonofthisitfallsoutthattheirirresolution，theweaknessoftheirarguments，divinationsandfoundations，thesharpnessoftheirdisputes，fullofhatred，jealousy，andself—consideration，comingtobediscoveredbyeveryone，amanmustbemarvellouslyblindnottoseethatherunsaverygreathazardintheirhands。Whoeversawonephysicianapproveofanother’sprescription，withouttakingsomethingaway，oraddingsomethingtoit？bywhichtheysufficientlybetraytheirtricks，andmakeitmanifesttousthattheythereinmoreconsidertheirownreputation，andconsequentlytheirprofit，thantheirpatient’sinterest。

Hewasamuchwisermanoftheirtribe，whoofoldgaveitasarule，thatonlyonephysicianshouldundertakeasickperson;forifhedonothingtopurpose，onesingleman’sdefaultcanbringnogreatscandalupontheartofmedicine;and，onthecontrary，theglorywillbegreatifhehappentohavesuccess;whereas，whentherearemany，theyateveryturnbringadisreputeupontheircalling，forasmuchastheyoftenerdohurtthangood。Theyoughttobesatisfiedwiththeperpetualdisagreementwhichisfoundintheopinionsoftheprincipalmastersandancientauthorsofthisscience，whichisonlyknowntomenwellread，withoutdiscoveringtothevulgarthecontroversiesandvariousjudgmentswhichtheystillnourishandcontinueamongstthemselves。

Willyouhaveoneexampleoftheancientcontroversyinphysic？

Herophiluslodgestheoriginalcauseofalldiseasesinthehumours;

Erasistratus，inthebloodofthearteries;Asclepiades，intheinvisibleatomsofthepores;Alcmaeon，intheexuberanceordefectofourbodilystrength;Diocles，intheinequalityoftheelementsofwhichthebodyiscomposed，andinthequalityoftheairwebreathe;Strato，intheabundance，crudity，andcorruptionofthenourishmentwetake;andHippocrateslodgesitinthespirits。Thereisacertainfriendoftheirs，——[Celsus，PrefacetotheFirstBook。]——whomtheyknowbetterthanI，whodeclaresuponthissubject，"thatthemostimportantscienceinpracticeamongstus，asthatwhichisintrustedwithourhealthandconservation，is，byillluck，themostuncertain，themostperplexed，andagitatedwiththegreatestmutations。"Thereisnogreatdangerinourmistakingtheheightofthesun，orthefractionofsomeastronomicalsupputation;buthere，whereourwholebeingisconcerned，’tisnotwisdomtoabandonourselvestothemercyoftheagitationofsomanycontrarywinds。

BeforethePeloponnesianwartherewasnogreattalkofthisscience。

Hippocratesbroughtitintorepute;whateverheestablished，Chrysippusoverthrew;afterthat，Erasistratus，Aristotle’sgrandson，overthrewwhatChrysippushadwritten;afterthese，theEmpiricsstartedup，whotookaquitecontrarywaytotheancientsinthemanagementofthisart;whenthecreditofthesebeganalittletodecay，Herophilussetanothersortofpracticeonfoot，whichAsclepiadesinturnstoodupagainst，andoverthrew;then，intheirturn，theopinionsfirstofThemiso，andthenofMusa，andafterthatthoseofVectiusValens，aphysicianfamousthroughtheintelligencehehadwithMessalina，cameinvogue;theempireofphysicinNero’stimewasestablishedinThessalus，whoabolishedandcondemnedallthathadbeenheldtillhistime;thisman’sdoctrinewasrefutedbyCrinasofMarseilles，whofirstbroughtallmedicinaloperationsundertheEphemeridesandmotionsofthestars，andreducedeating，sleeping，anddrinkingtohoursthatweremostpleasingtoMercuryandthemoon;hisauthoritywassoonaftersupplantedbyCharinus，aphysicianofthesamecityofMarseilles，amanwhonotonlycontrovertedalltheancientmethodsofphysic，butmoreovertheusageofhotbaths，thathadbeengenerallyandforsomanyagesincommonuse;hemademenbatheincoldwater，eveninwinter，andplungedhissickpatientsinthenaturalwatersofstreams。NoRomantillPliny’stimehadevervouchsafedtopractisephysic;thatofficewasonlyperformedbyGreeksandforeigners，as’tisnowamongstusFrench，bythosewhosputterLatin;for，asaverygreatphysiciansays，wedonoteasilyacceptthemedicineweunderstand，nomorethanwedothedrugsweourselvesgather。Ifthenationswhencewefetchourguaiacum，sarsaparilla，andChinawood，havephysicians，howgreatavaluemustweimagine，bythesamerecommendationofstrangeness，rarity，anddearpurchase，dotheysetuponourcabbageandparsley？forwhowoulddaretocontemnthingssofarfetched，andsoughtoutatthehazardofsolonganddangerousavoyage？

Sincetheseancientmutationsinphysic，therehavebeeninfiniteothersdowntoourowntimes，and，forthemostpart，mutationsentireanduniversal，asthose，forexample，producedbyParacelsus，Fioravanti，andArgentier;forthey，asIamtold，notonlyalteronerecipe，butthewholecontextureandrulesofthebodyofphysic，accusingallothersofignoranceandimpositionwhohavepractisedbeforethem。Atthisrate，inwhataconditionthepoorpatientmustbe，Ileaveyoutojudge。

Ifwewereevenassuredthat，whentheymakeamistake，thatmistakeoftheirswoulddousnoharm，thoughitdidusnogood，itwereareasonablebargaintoventurethemakingourselvesbetterwithoutanydangerofbeingmadeworse。AEsoptellsastory，thatonewhohadboughtaMoriscoslave，believingthathisblackcomplexionhadarrivedbyaccidentandtheillusageofhisformermaster，causedhimtoenterwithgreatcareintoacourseofbathsandpotions:ithappenedthattheMoorwasnothingamendedinhistawnycomplexion，buthewhollylosthisformerhealth。Howoftendoweseephysiciansimputethedeathoftheirpatientstooneanother？Irememberthatsomeyearsagotherewasanepidemicaldisease，verydangerousandforthemostpartmortal，thatragedinthetownsaboutus:thestormbeingoverwhichhadsweptawayaninfinitenumberofmen，oneofthemostfamousphysiciansofallthecountry，presentlyafterpublishedabookuponthatsubject，wherein，uponbetterthoughts，heconfessesthatthelettingbloodinthatdiseasewastheprincipalcauseofsomanymishaps。Moreover，theirauthorsholdthatthereisnophysicthathasnotsomethinghurtfulinit。Andifeventhoseofthebestoperationinsomemeasureoffendus，whatmustthosedothataretotallymisapplied？Formyownpart，thoughtherewerenothingelseinthecase，Iamofopinion，thattothosewholoathethetasteofphysic，itmustneedsbeadangerousandprejudicialendeavourtoforceitdownatsoincommodiousatime，andwithsomuchaversion，andbelievethatitmarvellouslydistempersasickpersonatatimewhenhehassomuchneedofrepose。Andmoreover，ifwebutconsidertheoccasionsuponwhichtheyusuallygroundthecauseofourdiseases，theyaresolightandnice，thatIthenceconcludeaverylittleerrorinthedispensationoftheirdrugsmaydoagreatdealofmischief。Now，ifthemistakeofaphysicianbesodangerous，weareinbutascurvycondition;

foritisalmostimpossiblebuthemustoftenfallintothosemistakes:

hehadneedoftoomanyparts，considerations，andcircumstances，rightlytolevelhisdesign:hemustknowthesickperson’scomplexion，histemperament，hishumours，inclinations，actions，nay，hisverythoughtsandimaginations;hemustbeassuredoftheexternalcircumstances，ofthenatureoftheplace，thequalityoftheairandseason，thesituationoftheplanets，andtheirinfluences:hemustknowinthedisease，thecauses，prognostics，affections，andcriticaldays;inthedrugs，theweight，thepowerofworking，thecountry，figure，age，anddispensation，andhemustknowhowrightlytoproportionandmixthemtogether，tobegetajustandperfectsymmetry;whereiniftherebetheleasterror，ifamongstsomanyspringstherebebutanyoneoutoforder，’tisenoughtodestroyus。Godknowswithhowgreatdifficultymostofthesethingsaretobeunderstood:for（forexample）howshallthephysicianfindoutthetruesignofthedisease，everydiseasebeingcapableofaninfinitenumberofindications？Howmanydoubtsandcontroversieshavetheyamongstthemselvesupontheinterpretationofurines？otherwise，whenceshouldthecontinualdebatesweseeamongstthemabouttheknowledgeofthediseaseproceed？howcouldweexcusetheerrortheysooftfallinto，oftakingfoxformarten？InthediseasesIhavehad，thoughtherewereeversolittledifficultyinthecase，Ineverfoundthreeofoneopinion:whichIinstance，becauseIlovetointroduceexampleswhereinI

ammyselfconcerned。

AgentlemanatPariswaslatelycutforthestonebyorderofthephysicians，inwhosebladder，beingaccordinglysocut，therewasfoundnomorestonethaninthepalmofhishand;andinthesameplaceabishop，whowasmyparticularfriend，havingbeenearnestlypressedbythemajorityofthephysicianswhomheconsulted，tosufferhimselftobecut，towhichalso，upontheirword，Iusedmyinteresttopersuadehim，whenhewasdeadandopened，itappearedthathehadnomaladybutinthekidneys。Theyareleastexcusableforanyerrorinthisdisease，byreasonthatitisinsomesortpalpable;and’tisthencethatIconcludesurgerytobemuchmorecertain，byreasonthatitseesandfeelswhatitdoes，andsogoeslessuponconjecture;whereasthephysicianshaveno’specu