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philosophies which physicians, whether regular practitioners or chemists, rely upon (and medicine not founded on philosophy is a weak thing) are themselves of little worth. Wherefore if generalities, though true, have the fault that they do not well lead the
way action ; surely there is greater danger in those generalities which are in themselves false, and instead of leading mislead.
Medicine therefore (as we have seen) is a science which has been hitherto more professed than laboured, and yet more laboured than advanced; the labours spent on it having been rather in a circle, than in progression. For I find in the writers thereon many iterations, but few additions. I will divide it into three parts, which I will term its three offices; the first whereof is the Preservation of Health, the second the Cure of Diseases, and the third the Prolongation of Life. But this last the physicians do not seem to have recognised as the principal part of their art, but to have confounded, ignorantly enough, with the other two. For they imagine that if diseases be repelled before they attack the body, and cured after they have attacked it, prolongation of life necessarily follows. But though there is no doubt of this, yet they have not penetration to see that these two offices pertain only to diseases, and such prolongation of life as is intercepted and cut short by them. But the lengthening of the thread of life itself, and the postponement for a time of that death which gradually steals on by natural dissolution and the decay of age, is a subject which no physician has handled in proportion to its dignity. And let not men make a scruple of it, as if this were a thing belonging to fate and Divine Provi
dence which I am the first to bring within the office and function of art. For Providence no doubt directs all kinds of death alike, whether from violence or disease or the decay of age; yet it does not on that account exclude the use of preventions and remedies. But art and human industry do not command nature and destiny; they only serve and minister to them. Of this part however I will speak hereafter; having in the meantime premised thus much, lest any one should in ignorance confound this third office of medicine with the two former, as has been done hitherto.
With regard to the office of the preservation of health (the first of the three), many have written thereon, very unskilfully both in other respects and especially in attributing too much as I think) to the choice of meats and too little to the quantity. Moreover with regard to quantity itself they have argued like moral philosophers, too much praising the mean; whereas both fasting, when made customary, and a generous diet, to which one is used, are better preservatives of health than those mediocrities, which only make nature slothful and unable to bear either excess or want when it is necessary.
Nor have the kinds of exercises which have most power to preserve health been by any physician well distinguished and pointed out; although there is scarcely any tendency to disease which may not be prevented by some proper exercise. Thus playing at bowls is good for diseases of the reins, archery for those of the lungs, walking and riding for weakness of the stomach, and the like. But as this part touching the preservation of health has been handled as a whole, it is not my plan to pursue the minor defects.
With regard to the cure of diseases, much labour has been bestowed on this part, but with slight profit. To it belongs the knowledge of the diseases to which the human body is subject; with their causes, symptoms, and remedies. In this second office of medicine there are many deficiencies; a few of which, but those the most glaring, I will propound; thinking it sufficient to enumerate them without any law of order or method.
The first is, the discontinuance of the very useful and accurate diligence of Hippocrates, who used to set down a narrative of the special cases of his patients; relating what was the nature of the disease, what the treatment, and what the issue. Therefore having so notable and proper an example in a man who has been regarded as the father of his art, I shall not need to go abroad for an example from other arts; as from the wisdom of the lawyers, who have ever been careful to report the more important cases and new decisions, for instruction and direction in future cases. This continuance of medicinal history I find deficient; especially as carefully and judiciously digested into one body; which nevertheless I do not understand should be either so copious as to extend to every common case of daily occurrence (for that would be something infinite, and foreign to the purpose), or so reserved as to admit none but wonders and prodigies, as has been done by some. For many things are new in the manner and circumstances which are not new in the kind ; and if men will apply themselves to observe, they will find even in things which appear commonplace much that is worthy of observation.
Likewise in anatomical inquiries, those things which
pertain to man's body in general are most diligently observed, even to curiosity and in the minutest particulars; but touching the varieties which are found in different bodies, the diligence of physicians falls short. And therefore I say that Simple Anatomy is handled most lucidly, but that Comparative Anatomy is wanting. For men inquire well of the several parts, and their substances, figures, and collocations; but the «liversities of the figure and condition of those parts in different men they observe not. The reason of which omission I judge to be no other than that the former inquiry may be satisfied by the view of one or two anatomies, whereas the latter (being comparative and casual) requires the view and attentive study of many. The first likewise is a subject on which learned men may display their knowledge in lectures and before audiences; but the last is only to be gained by silent and long experience. Meanwhile there is no question but that the figure and structure of the inward parts is but little inferior in variety and lineaments to the outward; and that the hearts or livers or stomachs of men differ as much as their foreheads or noses or ears. And in these very differences of the internal parts are often found the “causes continent” of many diseases ; which not being observed by the physicians, they quarrel many times with the humours, which are not in fault, the fault being in the very mechanical frame of the part. In the cure of which diseases it is lost labour to employ medicines alterative (for the part admits not of alteration); but the thing must be corrected, and accommodated or palliated by diets and medicines familiar. To Comparative Anatomy belongs likewise the accurate observation as well of all kinds of hu
mours, as of the footsteps and impressions of diseases in various dissected bodies. For the humours are commonly passed over in anatomies with disgust as purgaments; whereas it is of the first importance to observe of what sort and how manifold the different kinds of humours are (not relying too much on the common divisions of them) which are sometimes found in the human body; and in what cavities and receptacles each of them is most apt to lodge and nestle, and with what benefit or injury, and the like. So again the footsteps and impressions of diseases and the injuries and devastations they cause in the inward parts, ought in different anatomies to be diligently observed ; namely imposthumations, exulcerations, discontinuations, putrefactions, corrosions, consumptions, contractions, extensions, convulsions, loosenings, dislocations, obstructions, repletions, tumours ; together with all preternatural substances that are found in the human body as stones, carnosities, excrescences, worms, and the like); all these, I say, and the like of them ought by that Comparative Anatomy which I have spoken of, and the collation of the several experiences of many physicians, to be carefully searched out and compared. But this variety of accidents is either slightly handled in anatomics or else passed over in silence.
Of that other defect in anatomy (that it has not been practised on live bodies) what need to speak ? For it is a thing hateful and inhuman, and has been justly reproved by Celsus. But yet it is no less true (as was anciently noted) that many of the more subtle passages, pores, and pertusions appear not in anatomical dissections, because they are shut and latent in dead bodies, though they be open and manifest in live.