Essays of Michel de Montaigne - 073

My ancestors had an aversion to physic by some occult and natural
instinct; for the very sight of drugs was loathsome to my father. The
Seigneur de Gaviac, my uncle by the father’s side, a churchman, and a
valetudinary from his birth, and yet who made that crazy life hold out to
sixty-seven years, being once fallen into a furious fever, it was ordered
by the physicians he should be plainly told that if he would not make use
of help (for so they call that which is very often an obstacle), he would
infallibly be a dead man. That good man, though terrified with this
dreadful sentence, yet replied, “I am then a dead man.” But God soon
after made the prognostic false. The last of the brothers--there were
four of them--and by many years the last, the Sieur de Bussaguet, was the
only one of the family who made use of medicine, by reason, I suppose, of
the concern he had with the other arts, for he was a councillor in the
court of Parliament, and it succeeded so ill with him, that being in
outward appearance of the strongest constitution, he yet died long before
any of the rest, save the Sieur de Saint Michel.
‘Tis possible I may have derived this natural antipathy to physic from
them; but had there been no other consideration in the case, I would have
endeavoured to have overcome it; for all these conditions that spring in
us without reason, are vicious; ‘tis a kind of disease that we should
wrestle with. It may be I had naturally this propension; but I have
supported and fortified it by arguments and reasons which have
established in me the opinion I am of. For I also hate the consideration
of refusing physic for the nauseous taste.
I should hardly be of that humour who hold health to be worth purchasing
by all the most painful cauteries and incisions that can be applied.
And, with Epicurus, I conceive that pleasures are to be avoided, if
greater pains be the consequence, and pains to be coveted, that will
terminate in greater pleasures. Health is a precious thing, and the only
one, in truth, meriting that a man should lay out, not only his time,
sweat, labour, and goods, but also his life itself to obtain it;
forasmuch as, without it, life is wearisome and injurious to us:
pleasure, wisdom, learning, and virtue, without it, wither away and
vanish; and to the most laboured and solid discourses that philosophy
would imprint in us to the contrary, we need no more but oppose the image
of Plato being struck with an epilepsy or apoplexy; and, in this
presupposition, to defy him to call the rich faculties of his soul to his
assistance. All means that conduce to health can neither be too painful
nor too dear to me. But I have some other appearances that make me
strangely suspect all this merchandise. I do not deny but that there may
be some art in it, that there are not amongst so many works of Nature,
things proper for the conservation of health: that is most certain: I
very well know there are some simples that moisten, and others that dry;
I experimentally know that radishes are windy, and senna-leaves purging;
and several other such experiences I have, as that mutton nourishes me,
and wine warms me: and Solon said “that eating was physic against the
malady hunger.” I do not disapprove the use we make of things the earth
produces, nor doubt, in the least, of the power and fertility of Nature,
and of its application to our necessities: I very well see that pikes and
swallows live by her laws; but I mistrust the inventions of our mind, our
knowledge and art, to countenance which, we have abandoned Nature and her
rules, and wherein we keep no bounds nor moderation. As we call the
piling up of the first laws that fall into our hands justice, and their
practice and dispensation very often foolish and very unjust; and as
those who scoff at and accuse it, do not, nevertheless, blame that noble
virtue itself, but only condemn the abuse and profanation of that sacred
title; so in physic I very much honour that glorious name, its
propositions, its promises, so useful for the service of mankind; but the
ordinances it foists upon us, betwixt ourselves, I neither honour nor
esteem.
In the first place, experience makes me dread it; for amongst all my
acquaintance, I see no people so soon sick, and so long before they are
well, as those who take much physic; their very health is altered and
corrupted by their frequent prescriptions. Physicians are not content to
deal only with the sick, but they will moreover corrupt health itself,
for fear men should at any time escape their authority. Do they not,
from a continual and perfect health, draw the argument of some great
sickness to ensue? I have been sick often enough, and have always found
my sicknesses easy enough to be supported (though I have made trial of
almost all sorts), and as short as those of any other, without their
help, or without swallowing their ill-tasting doses. The health I have
is full and free, without other rule or discipline than my own custom and
pleasure. Every place serves me well enough to stay in, for I need no
other conveniences, when I am sick, than what I must have when I am well.
I never disturb myself that I have no physician, no apothecary, nor any
other assistance, which I see most other sick men more afflicted at than
they are with their disease. What! Do the doctors themselves show us
more felicity and duration in their own lives, that may manifest to us
some apparent effect of their skill?
There is not a nation in the world that has not been many ages without
physic; and these the first ages, that is to say, the best and most
happy; and the tenth part of the world knows nothing of it yet; many
nations are ignorant of it to this day, where men live more healthful and
longer than we do here, and even amongst us the common people live well
enough without it. The Romans were six hundred years before they
received it; and after having made trial of it, banished it from the city
at the instance of Cato the Censor, who made it appear how easy it was to
live without it, having himself lived fourscore and five years, and kept
his wife alive to an extreme old age, not without physic, but without a
physician: for everything that we find to be healthful to life may be
called physic. He kept his family in health, as Plutarch says if I
mistake not, with hare’s milk; as Pliny reports, that the Arcadians
cured all manner of diseases with that of a cow; and Herodotus says, the
Lybians generally enjoy rare health, by a custom they have, after their
children are arrived to four years of age, to burn and cauterise the
veins of their head and temples, by which means they cut off all
defluxions of rheum for their whole lives. And the country people of our
province make use of nothing, in all sorts of distempers, but the
strongest wine they can get, mixed with a great deal of saffron and
spice, and always with the same success.
And to say the truth, of all this diversity and confusion of
prescriptions, what other end and effect is there after all, but to purge
the belly? which a thousand ordinary simples will do as well; and I do
not know whether such evacuations be so much to our advantage as they
pretend, and whether nature does not require a residence of her
excrements to a certain proportion, as wine does of its lees to keep it
alive: you often see healthful men fall into vomitings and fluxes of the
belly by some extrinsic accident, and make a great evacuation of
excrements, without any preceding need, or any following benefit, but
rather with hurt to their constitution. ‘Tis from the great Plato, that
I lately learned, that of three sorts of motions which are natural to us,
purging is the worst, and that no man, unless he be a fool, ought to take
anything to that purpose but in the extremest necessity. Men disturb and
irritate the disease by contrary oppositions; it must be the way of
living that must gently dissolve, and bring it to its end. The violent
gripings and contest betwixt the drug and the disease are ever to our
loss, since the combat is fought within ourselves, and that the drug is
an assistant not to be trusted, being in its own nature an enemy to our
health, and by trouble having only access into our condition. Let it
alone a little; the general order of things that takes care of fleas and
moles, also takes care of men, if they will have the same patience that
fleas and moles have, to leave it to itself. ‘Tis to much purpose we cry
out “Bihore,”--[A term used by the Languedoc waggoners to hasten their
horses]--‘tis a way to make us hoarse, but not to hasten the matter.
‘Tis a proud and uncompassionate order: our fears, our despair displease
and stop it from, instead of inviting it to, our relief; it owes its
course to the disease, as well as to health; and will not suffer itself
to be corrupted in favour of the one to the prejudice of the other’s
right, for it would then fall into disorder. Let us, in God’s name,
follow it; it leads those that follow, and those who will not follow, it
drags along, both their fury and physic together. Order a purge for your
brain, it will there be much better employed than upon your stomach.
One asking a Lacedaemonian what had made him live so long, he made
answer, “the ignorance of physic”; and the Emperor Adrian continually
exclaimed as he was dying, that the crowd of physicians had killed him.
A bad wrestler turned physician: “Courage,” says Diogenes to him; “thou
hast done well, for now thou will throw those who have formerly thrown
thee.” But they have this advantage, according to Nicocles, that the sun
gives light to their success and the earth covers their failures. And,
besides, they have a very advantageous way of making use of all sorts of
events: for what fortune, nature, or any other cause (of which the number
is infinite), products of good and healthful in us, it is the privilege
of physic to attribute to itself; all the happy successes that happen to
the patient, must be thence derived; the accidents that have cured me,
and a thousand others, who do not employ physicians, physicians usurp to
themselves: and as to ill accidents, they either absolutely disown them,
in laying the fault upon the patient, by such frivolous reasons as they
are never at a loss for; as “he lay with his arms out of bed,” or “he was
disturbed with the rattling of a coach:”
“Rhedarum transitus arcto
Vicorum inflexu:”
[“The passage of the wheels in the narrow
turning of the street”--Juvenal, iii. 236.]
or “somebody had set open the casement,” or “he had lain upon his left
side,” or “he had some disagreeable fancies in his head”: in sum, a word,
a dream, or a look, seems to them excuse sufficient wherewith to palliate
their own errors: or, if they so please, they even make use of our
growing worse, and do their business in this way which can never fail
them: which is by buzzing us in the ear, when the disease is more
inflamed by their medicaments, that it had been much worse but for those
remedies; he, whom from an ordinary cold they have thrown into a double
tertian-ague, had but for them been in a continued fever. They do not
much care what mischief they do, since it turns to their own profit.
In earnest, they have reason to require a very favourable belief from
their patients; and, indeed, it ought to be a very easy one, to swallow
things so hard to be believed. Plato said very well, that physicians
were the only men who might lie at pleasure, since our health depends
upon the vanity and falsity of their promises.
AEsop, a most excellent author, and of whom few men discover all the
graces, pleasantly represents to us the tyrannical authority physicians
usurp over poor creatures, weakened and subdued by sickness and fear,
when he tells us, that a sick person, being asked by his physician what
operation he found of the potion he had given him: “I have sweated very
much,” says the sick man. “That’s good,” says the physician. Another
time, having asked how he felt himself after his physic: “I have been
very cold, and have had a great shivering upon me,” said he. “That is
good,” replied the physician. After the third potion, he asked him again
how he did: “Why, I find myself swollen and puffed up,” said he, “as if
I had a dropsy.”--“That is very well,” said the physician. One of his
servants coming presently after to inquire how he felt himself, “Truly,
friend,” said he, “with being too well I am about to die.”
There was a more just law in Egypt, by which the physician, for the three
first days, was to take charge of his patient at the patient’s own risk
and cost; but, those three days being past, it was to be at his own. For
what reason is it that their patron, AEsculapius, should be struck with
thunder for restoring Hippolitus from death to life:
“Nam Pater omnipotens, aliquem indignatus ab umbris
Mortalem infernis ad lumina surgere vitae,
Ipse repertorem medicinae talis, et artis
Fulmine Phoebigenam Stygias detrusit ad undas;”
[“Then the Almighty Father, offended that any mortal should rise to
the light of life from the infernal shades, struck the son of
Phoebus with his forked lightning to the Stygian lake.”
--AEneid, vii. 770.]
and his followers be pardoned, who send so many souls from life to death?
A physician, boasting to Nicocles that his art was of great authority:
“It is so, indeed,” said Nicocles, “that can with impunity kill so many
people.”
As to what remains, had I been of their counsel, I would have rendered my
discipline more sacred and mysterious; they begun well, but they have not
ended so. It was a good beginning to make gods and demons the authors of
their science, and to have used a peculiar way of speaking and writing,
notwithstanding that philosophy concludes it folly to persuade a man to
his own good by an unintelligible way: “Ut si quis medicus imperet, ut
sumat:”

“Terrigenam, herbigradam, domiportam, sanguine cassam.”
[“Describing it by the epithets of an animal trailing with its slime
over the herbage, without blood or bones, and carrying its house
upon its back, meaning simply a snail.”--Coste]
It was a good rule in their art, and that accompanies all other vain,
fantastic, and supernatural arts, that the patient’s belief should
prepossess them with good hope and assurance of their effects and
operation: a rule they hold to that degree, as to maintain that the most
inexpert and ignorant physician is more proper for a patient who has
confidence in him, than the most learned and experienced whom he is not
so acquainted with. Nay, even the very choice of most of their drugs is
in some sort mysterious and divine; the left foot of a tortoise, the
urine of a lizard, the dung of an elephant, the liver of a mole, blood
drawn from under the right wing of a white pigeon; and for us who have
the stone (so scornfully they use us in our miseries) the excrement of
rats beaten to powder, and such like trash and fooleries which rather
carry a face of magical enchantment than of any solid science. I omit
the odd number of their pills, the destination of certain days and feasts
of the year, the superstition of gathering their simples at certain
hours, and that so austere and very wise countenance and carriage which
Pliny himself so much derides. But they have, as I said, failed in that
they have not added to this fine beginning the making their meetings and
consultations more religious and secret, where no profane person should
have admission, no more than in the secret ceremonies of AEsculapius; for
by the reason of this it falls out that their irresolution, the weakness
of their arguments, divinations and foundations, the sharpness of their
disputes, full of hatred, jealousy, and self-consideration, coming to be
discovered by every one, a man must be marvellously blind not to see that
he runs a very great hazard in their hands. Who ever saw one physician
approve of another’s prescription, without taking something away, or
adding something to it? by which they sufficiently betray their tricks,
and make it manifest to us that they therein more consider their own
reputation, and consequently their profit, than their patient’s interest.
He was a much wiser man of their tribe, who of old gave it as a rule,
that only one physician should undertake a sick person; for if he do
nothing to purpose, one single man’s default can bring no great scandal
upon the art of medicine; and, on the contrary, the glory will be great
if he happen to have success; whereas, when there are many, they at every
turn bring a disrepute upon their calling, forasmuch as they oftener do
hurt than good. They ought to be satisfied with the perpetual
disagreement which is found in the opinions of the principal masters and
ancient authors of this science, which is only known to men well read,
without discovering to the vulgar the controversies and various judgments
which they still nourish and continue amongst themselves.
Will you have one example of the ancient controversy in physic?
Herophilus lodges the original cause of all diseases in the humours;
Erasistratus, in the blood of the arteries; Asclepiades, in the invisible
atoms of the pores; Alcmaeon, in the exuberance or defect of our bodily
strength; Diocles, in the inequality of the elements of which the body is
composed, and in the quality of the air we breathe; Strato, in the
abundance, crudity, and corruption of the nourishment we take; and
Hippocrates lodges it in the spirits. There is a certain friend of
theirs,--[Celsus, Preface to the First Book.]--whom they know better
than I, who declares upon this subject, “that the most important science
in practice amongst us, as that which is intrusted with our health and
conservation, is, by ill luck, the most uncertain, the most perplexed,
and agitated with the greatest mutations.” There is no great danger in
our mistaking the height of the sun, or the fraction of some astronomical
supputation; but here, where our whole being is concerned, ‘tis not
wisdom to abandon ourselves to the mercy of the agitation of so many
contrary winds.
Before the Peloponnesian war there was no great talk of this science.
Hippocrates brought it into repute; whatever he established, Chrysippus
overthrew; after that, Erasistratus, Aristotle’s grandson, overthrew what
Chrysippus had written; after these, the Empirics started up, who took a
quite contrary way to the ancients in the management of this art; when
the credit of these began a little to decay, Herophilus set another sort
of practice on foot, which Asclepiades in turn stood up against, and
overthrew; then, in their turn, the opinions first of Themiso, and then
of Musa, and after that those of Vectius Valens, a physician famous
through the intelligence he had with Messalina, came in vogue; the empire
of physic in Nero’s time was established in Thessalus, who abolished and
condemned all that had been held till his time; this man’s doctrine was
refuted by Crinas of Marseilles, who first brought all medicinal
operations under the Ephemerides and motions of the stars, and reduced
eating, sleeping, and drinking to hours that were most pleasing to
Mercury and the moon; his authority was soon after supplanted by
Charinus, a physician of the same city of Marseilles, a man who not only
controverted all the ancient methods of physic, but moreover the usage of
hot baths, that had been generally and for so many ages in common use; he
made men bathe in cold water, even in winter, and plunged his sick
patients in the natural waters of streams. No Roman till Pliny’s time
had ever vouchsafed to practise physic; that office was only performed
by Greeks and foreigners, as ‘tis now amongst us French, by those who
sputter Latin; for, as a very great physician says, we do not easily
accept the medicine we understand, no more than we do the drugs we
ourselves gather. If the nations whence we fetch our guaiacum,
sarsaparilla, and China wood, have physicians, how great a value must we
imagine, by the same recommendation of strangeness, rarity, and dear
purchase, do they set upon our cabbage and parsley? for who would dare
to contemn things so far fetched, and sought out at the hazard of so long
and dangerous a voyage?
Since these ancient mutations in physic, there have been infinite others
down to our own times, and, for the most part, mutations entire and
universal, as those, for example, produced by Paracelsus, Fioravanti, and
Argentier; for they, as I am told, not only alter one recipe, but the
whole contexture and rules of the body of physic, accusing all others of
ignorance and imposition who have practised before them. At this rate,
in what a condition the poor patient must be, I leave you to judge.
If we were even assured that, when they make a mistake, that mistake of
theirs would do us no harm, though it did us no good, it were a
reasonable bargain to venture the making ourselves better without any
danger of being made worse. AEsop tells a story, that one who had bought
a Morisco slave, believing that his black complexion had arrived by
accident and the ill usage of his former master, caused him to enter with
great care into a course of baths and potions: it happened that the Moor
was nothing amended in his tawny complexion, but he wholly lost his
former health. How often do we see physicians impute the death of their
patients to one another? I remember that some years ago there was an
epidemical disease, very dangerous and for the most part mortal, that
raged in the towns about us: the storm being over which had swept away an
infinite number of men, one of the most famous physicians of all the
country, presently after published a book upon that subject, wherein,
upon better thoughts, he confesses that the letting blood in that disease
was the principal cause of so many mishaps. Moreover, their authors hold
that there is no physic that has not something hurtful in it. And if
even those of the best operation in some measure offend us, what must
those do that are totally misapplied? For my own part, though there were
nothing else in the case, I am of opinion, that to those who loathe the
taste of physic, it must needs be a dangerous and prejudicial endeavour
to force it down at so incommodious a time, and with so much aversion,
and believe that it marvellously distempers a sick person at a time when
he has so much need of repose. And more over, if we but consider the
occasions upon which they usually ground the cause of our diseases, they
are so light and nice, that I thence conclude a very little error in the
dispensation of their drugs may do a great deal of mischief. Now, if the
mistake of a physician be so dangerous, we are in but a scurvy condition;
for it is almost impossible but he must often fall into those mistakes:
he had need of too many parts, considerations, and circumstances, rightly
to level his design: he must know the sick person’s complexion, his
temperament, his humours, inclinations, actions, nay, his very thoughts
and imaginations; he must be assured of the external circumstances, of
the nature of the place, the quality of the air and season, the situation
of the planets, and their influences: he must know in the disease, the
causes, prognostics, affections, and critical days; in the drugs, the
weight, the power of working, the country, figure, age, and dispensation,
and he must know how rightly to proportion and mix them together, to
beget a just and perfect symmetry; wherein if there be the least error,
if amongst so many springs there be but any one out of order, ‘tis enough
to destroy us. God knows with how great difficulty most of these things
are to be understood: for (for example) how shall the physician find out
the true sign of the disease, every disease being capable of an infinite
number of indications? How many doubts and controversies have they
amongst themselves upon the interpretation of urines? otherwise, whence
should the continual debates we see amongst them about the knowledge of
the disease proceed? how could we excuse the error they so oft fall into,
of taking fox for marten? In the diseases I have had, though there were
ever so little difficulty in the case, I never found three of one
opinion: which I instance, because I love to introduce examples wherein I
am myself concerned.
A gentleman at Paris was lately cut for the stone by order of the
physicians, in whose bladder, being accordingly so cut, there was found
no more stone than in the palm of his hand; and in the same place a
bishop, who was my particular friend, having been earnestly pressed by
the majority of the physicians whom he consulted, to suffer himself to be
cut, to which also, upon their word, I used my interest to persuade him,
when he was dead and opened, it appeared that he had no malady but in the
kidneys. They are least excusable for any error in this disease, by
reason that it is in some sort palpable; and ‘tis thence that I conclude
surgery to be much more certain, by reason that it sees and feels what it
does, and so goes less upon conjecture; whereas the physicians have no
‘speculum matricis’, by which to examine our brains, lungs, and liver.
Even the very promises of physic are incredible in themselves; for,
having to provide against divers and contrary accidents that often
afflict us at one and the same time, and that have almost a necessary
relation, as the heat of the liver and the coldness of the stomach, they
will needs persuade us, that of their ingredients one will heat the
stomach and the other will cool the liver: one has its commission to go
directly to the kidneys, nay, even to the bladder, without scattering its
operations by the way, and is to retain its power and virtue through all
those turns and meanders, even to the place to the service of which it is
designed, by its own occult property this will dry-the brain; that will
moisten the lungs. Of all this bundle of things having mixed up a
potion, is it not a kind of madness to imagine or to hope that these
differing virtues should separate themselves from one another in this
mixture and confusion, to perform so many various errands? I should very
much fear that they would either lose or change their tickets, and
disturb one another’s quarters. And who can imagine but that, in this
liquid confusion, these faculties must corrupt, confound, and spoil one
another? And is not the danger still more when the making up of this
medicine is entrusted to the skill and fidelity of still another, to
whose mercy we again abandon our lives?
As we have doublet and breeches-makers, distinct trades, to clothe us,
and are so much the better fitted, seeing that each of them meddles only
with his own business, and has less to trouble his head with than the
tailor who undertakes all; and as in matter of diet, great persons, for
their better convenience, and to the end they may be better served, have
cooks for the different offices, this for soups and potages, that for
roasting, instead of which if one cook should undertake the whole
service, he could not so well perform it; so also as to the cure of our
maladies. The Egyptians had reason to reject this general trade of
physician, and to divide the profession: to each disease, to each part of
the body, its particular workman; for that part was more properly and
with less confusion cared for, seeing the person looked to nothing else.
Ours are not aware that he who provides for all, provides for nothing;
and that the entire government of this microcosm is more than they are
able to undertake. Whilst they were afraid of stopping a dysentery, lest
they should put the patient into a fever, they killed me a friend,
--[Estienne de la Boetie.]--who was worth more than the whole of them.
They counterpoise their own divinations with the present evils; and
because they will not cure the brain to the prejudice of the stomach,
they injure both with their dissentient and tumultuary drugs.
As to the variety and weakness of the rationale of this art, they are