The Advancement of Learning
So that it is no marvel though the soul so placed enjoy no rest, if that
principle be true, that _Motus rerum est rapidus extra locum_, _placidus
in loco_. But to the purpose. This variable composition of man’s body
hath made it as an instrument easy to distemper; and, therefore, the
poets did well to conjoin music and medicine in Apollo, because the
office of medicine is but to tune this curious harp of man’s body and to
reduce it to harmony. So, then, the subject being so variable hath made
the art by consequent more conjectural; and the art being conjectural
hath made so much the more place to be left for imposture. For almost
all other arts and sciences are judged by acts or masterpieces, as I may
term them, and not by the successes and events. The lawyer is judged by
the virtue of his pleading, and not by the issue of the cause; this
master in this ship is judged by the directing his course aright, and not
by the fortune of the voyage; but the physician, and perhaps this
politique, hath no particular acts demonstrative of his ability, but is
judged most by the event, which is ever but as it is taken: for who can
tell, if a patient die or recover, or if a state be preserved or ruined,
whether it be art or accident? And therefore many times the impostor is
prized, and the man of virtue taxed. Nay, we see [the] weakness and
credulity of men is such, as they will often refer a mountebank or witch
before a learned physician. And therefore the poets were clear-sighted
in discerning this extreme folly when they made Æsculapius and Circe,
brother and sister, both children of the sun, as in the verses—
“Ipse repertorem medicinæ talis et artis
Fulmine Phœbigenam Stygias detrusit ad undas.”
And again—
“Dives inaccessos ubi Solis filia lucos,” &c.
For in all times, in the opinion of the multitude, witches and old women
and impostors, have had a competition with physicians. And what
followeth? Even this, that physicians say to themselves, as Solomon
expresseth it upon a higher occasion, “If it befall to me as befalleth to
the fools, why should I labour to be more wise?” And therefore I cannot
much blame physicians that they use commonly to intend some other art or
practice, which they fancy more than their profession; for you shall have
of them antiquaries, poets, humanists, statesmen, merchants, divines, and
in every of these better seen than in their profession; and no doubt upon
this ground that they find that mediocrity and excellency in their art
maketh no difference in profit or reputation towards their fortune: for
the weakness of patients, and sweetness of life, and nature of hope,
maketh men depend upon physicians with all their defects. But,
nevertheless, these things which we have spoken of are courses begotten
between a little occasion and a great deal of sloth and default; for if
we will excite and awake our observation, we shall see in familiar
instances what a predominant faculty the subtlety of spirit hath over the
variety of matter or form. Nothing more variable than faces and
countenances, yet men can bear in memory the infinite distinctions of
them; nay, a painter, with a few shells of colours, and the benefit of
his eye, and habit of his imagination, can imitate them all that ever
have been, are, or may be, if they were brought before him. Nothing more
variable than voices, yet men can likewise discern them personally: nay,
you shall have a _buffon_ or _pantomimus_ will express as many as he
pleaseth. Nothing more variable than the differing sounds of words; yet
men have found the way to reduce them to a few simple letters. So that
it is not the insufficiency or incapacity of man’s mind, but it is the
remote standing or placing thereof that breedeth these mazes and
incomprehensions; for as the sense afar off is full of mistaking, but is
exact at hand, so is it of the understanding, the remedy whereof is, not
to quicken or strengthen the organ, but to go nearer to the object; and
therefore there is no doubt but if the physicians will learn and use the
true approaches and avenues of nature, they may assume as much as the
poet saith:
“Et quoniam variant morbi, variabimus artes;
Mille mali species, mille salutis erunt.”
Which that they should do, the nobleness of their art doth deserve: well
shadowed by the poets, in that they made Æsculapius to be the son of
[the] sun, the one being the fountain of life, the other as the
second-stream; but infinitely more honoured by the example of our
Saviour, who made the body of man the object of His miracles, as the soul
was the object of His doctrine. For we read not that ever He vouchsafed
to do any miracle about honour or money (except that one for giving
tribute to Cæsar), but only about the preserving, sustaining, and healing
the body of man.
(3) Medicine is a science which hath been (as we have said) more
professed than laboured, and yet more laboured than advanced; the labour
having been, in my judgment, rather in circle than in progression. For I
find much iteration, but small addition. It considereth causes of
diseases, with the occasions or impulsions; the diseases themselves, with
the accidents; and the cures, with the preservations. The deficiences
which I think good to note, being a few of many, and those such as are of
a more open and manifest nature, I will enumerate and not place.
(4) The first is the discontinuance of the ancient and serious diligence
of Hippocrates, which used to set down a narrative of the special cases
of his patients, and how they proceeded, and how they were judged by
recovery or death. Therefore having an example proper in the father of
the art, I shall not need to allege an example foreign, of the wisdom of
the lawyers, who are careful to report new cases and decisions, for the
direction of future judgments. This continuance of medicinal history I
find deficient; which I understand neither to be so infinite as to extend
to every common case, nor so reserved as to admit none but wonders: for
many things are new in this manner, which are not new in the kind; and if
men will intend to observe, they shall find much worthy to observe.
(5) In the inquiry which is made by anatomy, I find much deficience: for
they inquire of the parts, and their substances, figures, and
collocations; but they inquire not of the diversities of the parts, the
secrecies of the passages, and the seats or nestling of the humours, nor
much of the footsteps and impressions of diseases. The reason of which
omission I suppose to be, because the first inquiry may be satisfied in
the view of one or a few anatomies; but the latter, being comparative and
casual, must arise from the view of many. And as to the diversity of
parts, there is no doubt but the facture or framing of the inward parts
is as full of difference as the outward, and in that is the cause
continent of many diseases; which not being observed, they quarrel many
times with the humours, which are not in fault; the fault being in the
very frame and mechanic of the part, which cannot be removed by medicine
alterative, but must be accommodated and palliated by diets and medicines
familiar. And for the passages and pores, it is true which was anciently
noted, that the more subtle of them appear not in anatomies, because they
are shut and latent in dead bodies, though they be open and manifest in
life: which being supposed, though the inhumanity of _anatomia vivorum_
was by Celsus justly reproved; yet in regard of the great use of this
observation, the inquiry needed not by him so slightly to have been
relinquished altogether, or referred to the casual practices of surgery;
but might have been well diverted upon the dissection of beasts alive,
which notwithstanding the dissimilitude of their parts may sufficiently
satisfy this inquiry. And for the humours, they are commonly passed over
in anatomies as purgaments; whereas it is most necessary to observe, what
cavities, nests, and receptacles the humours do find in the parts, with
the differing kind of the humour so lodged and received. And as for the
footsteps of diseases, and their devastations of the inward parts,
impostumations, exulcerations, discontinuations, putrefactions,
consumptions, contractions, extensions, convulsions, dislocations,
obstructions, repletions, together with all preternatural substances, as
stones, carnosities, excrescences, worms, and the like; they ought to
have been exactly observed by multitude of anatomies, and the
contribution of men’s several experiences, and carefully set down both
historically according to the appearances, and artificially with a
reference to the diseases and symptoms which resulted from them, in case
where the anatomy is of a defunct patient; whereas now upon opening of
bodies they are passed over slightly and in silence.
(6) In the inquiry of diseases, they do abandon the cures of many, some
as in their nature incurable, and others as past the period of cure; so
that Sylla and the Triumvirs never proscribed so many men to die, as they
do by their ignorant edicts: whereof numbers do escape with less
difficulty than they did in the Roman prescriptions. Therefore I will
not doubt to note as a deficience, that they inquire not the perfect
cures of many diseases, or extremities of diseases; but pronouncing them
incurable do enact a law of neglect, and exempt ignorance from discredit.
(7) Nay further, I esteem it the office of a physician not only to
restore health, but to mitigate pain and dolors; and not only when such
mitigation may conduce to recovery, but when it may serve to make a fair
and easy passage. For it is no small felicity which Augustus Cæsar was
wont to wish to himself, that same _Euthanasia_; and which was specially
noted in the death of Antoninus Pius, whose death was after the fashion,
and semblance of a kindly and pleasant sheep. So it is written of
Epicurus, that after his disease was judged desperate, he drowned his
stomach and senses with a large draught and ingurgitation of wine;
whereupon the epigram was made, _Hinc Stygias ebrius hausit aquas_; he
was not sober enough to taste any bitterness of the Stygian water. But
the physicians contrariwise do make a kind of scruple and religion to
stay with the patient after the disease is deplored; whereas in my
judgment they ought both to inquire the skill, and to give the
attendances, for the facilitating and assuaging of the pains and agonies
of death.
(5) In the consideration of the cures of diseases, I find a deficience in
the receipts of propriety, respecting the particular cures of diseases:
for the physicians have frustrated the fruit of tradition and experience
by their magistralities, in adding and taking out and changing _quid pro
qua_ in their receipts, at their pleasures; commanding so over the
medicine, as the medicine cannot command over the disease. For except it
be treacle and _mithridatum_, and of late _diascordium_, and a few more,
they tie themselves to no receipts severely and religiously. For as to
the confections of sale which are in the shops, they are for readiness
and not for propriety. For they are upon general intentions of purging,
opening, comforting, altering, and not much appropriate to particular
diseases. And this is the cause why empirics and old women are more
happy many times in their cures than learned physicians, because they are
more religious in holding their medicines. Therefore here is the
deficience which I find, that physicians have not, partly out of their
own practice, partly out of the constant probations reported in books,
and partly out of the traditions of empirics, set down and delivered over
certain experimental medicines for the cure of particular diseases,