As to what Erasistratus maintains; in the first place, plain fact contradicts his opinion; because a distemper very seldom happens, unless after some of these occurrences, that have been mentioned. And then it does not follow, that what does not affect one person, may not hurt another; nor what does not affect the same person at one time, may not hurt him at another; for there may be some latent circumstances in a body, either in respect of weakness, or some disorder, which either are not in another, nor were in the same body at a different time; and these, though of themselves not considerable enough to cause a distemper, yet may render a body more liable to other injuries: but if he had been sufficiently skilled in the contemplation of the works of nature (which the physicians with very good reason endeavour to attain) he must have known this also, that nothing happens from one single cause; but that is to be taken for the cause, which seems to have contributed most to the effect. Now it is possible, that what does not move at all while alone, may in conjunction with other things excite a great commotion. Besides, Erasistratus himself, who says, that a fever arises from a transfusion of the blood into the arteries, and that this happens in a plethoric body, can assign no reason, why of two persons equally plethoric, the one should fall into a distemper, and the other be free from all danger, which manifestly happens every day. From hence it appears, that supposing this transfusion to be real, nevertheless, when there is a plethora, it does not happen of itself, but when some one of the conditions above-mentioned goes along with it.
But the followers of Themison, if they assert their maxims to hold universally, are still more rationalists than those, that pass under that name; for though one rationalist does not maintain all that another approves, there is no necessity to invent a new appellation for him; provided, which is the principal thing, he does not proceed upon memory alone, but takes in reason too. But if, which is nearer to the truth, the art of medicine hardly admits of any universal precepts, then they are in the same class with those, who depend upon experiments alone: and the more so, because any unskilful person can discover, whether a distemper has bound up a man, or rendered him lax. Now if what relaxes a constringed body, or restrains a loose, be drawn from reason, such a practitioner is a rational physician: but if from experience, as he must confess, who will not allow himself to be a rationalist, then he is an empirick. And so, according to him, the knowledge of the distemper is foreign to the art, but the remedy lies within the bounds of experience. Nor is any improvement made by them upon the profession of the empiricks, but on the contrary, something is taken from it; the empiricks attending with great circumspection to many circumstances; whereas these regard only the easiest, and no more than the common things. For in like manner those, who are employed in curing cattle, since it is impossible for them to be informed by the dumb animals, what is peculiar in the case of each, regard only what is common to them all: and foreign nations, as they are not acquainted with any subtile theory of medicine, take notice only of the common symptoms: those also, who take under their care a great number of patients, because they are not able to consult the distinct necessities of each with the utmost attention, have respect only to those generals. Nor indeed were the ancient physicians ignorant of this method, but they were not content with it; for even the most ancient writer Hippocrates said, that in practice it is necessary to regard both the general and peculiar circumstances. Nor is it possible even for them to confine themselves within the narrow limits of their own profession; for there are different kinds both of the bound, and lax disorders; which is more easily observed in the lax, for it is one thing to vomit blood, another to vomit bile, and another to vomit the food: and there is also a difference betwixt labouring under a simple purging, and a dysentery; between being weakened by sweats, and wasted by a consumption. A humour also breaks out upon particular parts, as the eyes, for instance, and the ears; and no member of the human body is free from that danger. Now not one of these disorders is cured exactly in the same manner as another; so that in these, medicine descends from the general observation of the lax kind, to the peculiar. And in this again another kind of knowledge of peculiarity is often necessary; because the same thing will not relieve all, that labour under similar distempers. For though there are certain things, which either bind the belly, or open it in most people; yet some are to be met with, in whom the same intention is gained by means contrary to the common. So that in such, the general observation is hurtful, and the peculiar only salutary. And a right apprehension of the cause often removes a distemper. Upon this account it was, that the most ingenious physician of our age, the late Cassius, being called to one in a fever distressed with violent thirst, when he found, that his complaints began after hard drinking, ordered him to drink plentifully of cold water. When his patient had drank this, and by the mixture had weakened the force of the wine, he was presently freed from the fever by a sleep, and a sweat. Which remedy the physician very judiciously adapted to the case, not from the consideration of his body being either bound or loose, but from the cause that had preceded. There is also another peculiarity to be regarded, which is that of place and season, according to these authors themselves; who, when they are giving directions for the management of the healthy, order them more carefully to avoid cold, heat, satiety, labour, and venery, in sickly places or seasons; and to take more rest in such seasons or places, if they have any sense of weight hanging upon their body; and in such circumstances neither to disturb the stomach by vomiting, nor the belly by purging. These things indeed are certain; yet they descend from generals to some things that are particular: unless they would have us believe, that healthy men should observe the temper of the air, and the season of the year, and that sick people don’t need to take that care, to whom all precaution is so much the more necessary, by how much an infirm state of health is more liable to receive injury. Besides, there are very different properties of distempers in the same person. And one, who has been sometimes unsuccessfully tried by medicines, which seemed proper for his disorder, is often recovered by the contrary. There are also many distinctions to be observed in the giving of food, of which I shall only name one instance. A youth bears hunger more easily than a boy; better in a thick, than a clear air; more easily in winter than summer; with more ease, one, that is accustomed to a single meal, than another, who eats a dinner also[(15)]; a sedentary person more easily, than one that takes exercise. Now generally food ought to be prescribed so much the sooner, as the person is less able to bear the want of it in health. For these reasons I am apt to think, that he, who is not acquainted with the peculiarities, ought only to consider the general: and that he, who can find out the peculiar, ought not to neglect, but take them in too for the direction of his practice. And therefore, where the knowledge is equal, yet a friend is a more useful physician, than a stranger. To return to my point then, my opinion is, that medicine ought to be rational, but to draw its methods from the evident causes, all the obscure being removed, not from the attention of the artist, but from the practice of the art. Again, to dissect the bodies of living men is both cruel and superfluous. But the dissection of dead subjects is necessary for learners: for they ought to know the position and order of the parts, which dead bodies will show better, than a living and wounded man. But as for the other things, which can only be observed in living bodies, practice itself will discover them in the cure of the wounded, somewhat more slowly, but with more tenderness. Having delivered my sentiments upon these points, I shall lay down the proper rules for the management of people in health, and then proceed to what relates to diseases and their cure.
CHAP. I. RULES FOR THE HEALTHY.
A sound man, who is both in health, and his own master, ought to confine himself to no rules; and neither call for the assistance of a physician nor an iatroalipta[(16)]. ’Tis good for him to diversify his way of life; to be sometimes in the country, sometimes in the city, and frequently in the fields; to sail, to hunt; sometimes to rest, but exercise himself frequently: for indolence enervates the body, labour strengthens it: the first brings on a quick old age, the other makes a long youth. ’Tis also proper to make use sometimes of the warm bath[(17)], and sometimes of the cold; to anoint sometimes, and at other times to neglect it; to avoid no kind of food, that may be in common use; sometimes to eat in company, at other times to retire from it; sometimes to eat more than is sufficient, and at other times no more; to take food rather twice in the day than once; and always as much as he can, provided he concoct it. But as exercise and food of this kind are necessary, so the exercise and diet of wrestlers are inconvenient: both because the order of exercise being interrupted by some necessary business of life, hurts the body; and because those bodies, which are very high fed, like their’s, soonest decay, and are most liable to diseases.
Of Coition.
Coition is neither to be too much desired, nor too much feared. Seldom used, it excites the body; frequent, relaxes. But as the frequency is to be judged of, not by the number of repetitions, but by nature, regard being had to the age and constitution, we may know it not to be useless, when it is neither followed by a languor of the body, nor pain. It is worse in the day-time, but safer in the night; but the general rule will hold for both, if neither meat be taken after the first, nor the other be followed by wakefulness and labour. These things are to be observed by strong people; and care must be taken, that the reliefs of sickness be not wasted in good health.