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The first is the discontinuance of the ancient and tiones me 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 alledge 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 the manner, which are not new in the kind; and if men will intend to observe, they shall find much worthy to observe.
Anatomia In the inquiry which is made by anatomy, I find Comparata, 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 subtile of them appear not in anatomies, because they are shut and latent in dead bodies, though they be open and manifest in live: 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 ob serve, 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 mens 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.
In the inquiry of diseases they do abandon the Inquisitio cures of many, some as in their nature incurable, and ulterior others as past the period of cure; so that Sylla and insanabili the triumvirs never proscribed so many men to die, bus. as they do by their ignorant edicts, whereof numbers do escape with less difficulty, than they did in the Roman proscriptions. 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.
Nay farther, I esteem it the office of a physician De euthanot only to restore health, but to mitigate pain and nasia ext dolors, and not only when such mitigation may con
duce 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 sleep. 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 asswaging of the pains and agonies of death.
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 quo, 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 appropriated 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, besides their own conjectural and magistral descriptions. For as they were the men of the best composition in the state of Rome, which either being consuls inclined to the people, or being tribunes inclined to the senate; so in the matter we now handle, they be the best physicians, which being learned, incline to the traditions of experience, or being empirics, incline to the methods of learning.
In preparation of medicines, I do find strange, Imitatio especially considering how mineral medicines have naturæ in been extolled, and that they are safer for the outward balneis, et aquis than inward parts, that no man hath sought to make median imitation by art of natural baths, and medicinable cinalibus. fountains; which nevertheless are confessed to receive their virtues from minerals; and not so only, but discerned and distinguished from what particular mineral they receive tincture, as sulphur, vitriol, steel, or the like; which nature, if it may be reduced to compositions of art, both the variety of them will be increased, and the temper of them will be more commanded.
But lest I grow to be more particular than is agree- Filum meable, either to my intention or to proportion; I will dicinale, conclude this part with the note of one deficience vicibus more, which seemeth to me of greatest consequence; medicinawhich is, that the prescripts in use are too compendious to attain their end; for to my understanding, it is a vain and flattering opinion to think any medicine can be so sovereign, or so happy, as that the receipt or use of it can work any great effect upon the body of man: it were a strange speech, which spoken, or spoken oft, should reclaim a man from a vice to which he were by nature subject; it is order, pursuit, sequence, and interchange of application, which is mighty in nature; which although it require more exact knowledge in prescribing, and more preeise obedience in observing, yet is recompensed with the magnitude of effects. And although a man would think by the daily visitations of the physicians, that there were a pursuance in the cure; yet let a
man look into their prescripts and ministrations, and he shall find them but inconstancies, and every day's devices without any settled providence or project; not that every scrupulous or superstitious prescript is effectual, no more than every strait way is the way to heaven, but the truth of the direction must precede severity of observance.
For Cosmetic, it hath parts civil, and parts effeminate for cleanness of body was ever esteemed to proceed from a due reverence to God, to society, and to ourselves. As for artificial decoration, it is well worthy of the deficiences which it hath; being neither fine enough to deceive, nor handsome to use, nor wholesome to please.
For Athletic, I take the subject of it largely, that is to say, for any point of ability, whereunto the body of man may be brought, whether it be of actívity, or of patience; whereof activity hath two parts, strength and swiftness: and patience likewise hath two parts, hardness against wants and extre mities, and indurance of pain or torment, whereof we see the practices in tumblers, in savages, and in those that suffer punishment: nay, if there be any other faculty which falls not within any of the former divisions, as in those that dive, that obtain a strange power of containing respiration, and the like, I refer it to this part. Of these things the practices are known, but the philosophy that concerneth them is not much inquired; the rather, I think, because they are supposed to be obtained, either by an aptness of nature, which cannot be taught, or only by continual custom, which is soon prescribed; which though it be not true, yet I forbear to note any deficiences, for the Olympian games are down long since, and the mediocrity of these things is for use; as for the excellency of them, it serveth for the most part but for mercenary ostentation.
For arts of Pleasure sensual, the chief deficience in them is of laws to repress them. For as it hath been well observed, that the arts which flourish in times while virtue is in growth, are military, and