Moreover their authors maintain that there is no medicine without harmful side-effects: if those which do us some good do us some harm as well, what must the other ones do when applied to us quite abusively?
As for those who loathe the taste of medicine, I personally feel that, even if for no other reason, it would be dangerous and harmful for them to make themselves force it down at so inappropriate a time: just when they need rest it constitutes, I think, an unacceptable assay of their strength. Besides when I consider the factors which are said to occasion our illnesses I find them so slight and so specific that I am forced to conclude that even a tiny error in the prescribed dosage could do us great harm.
Now things go very bad indeed for us if our doctor’s mistake is a dangerous one, for it is difficult for him not to go on falling into yet more errors. To aim at the right target his treatment must embrace very many factors, circumstances and elements: he must know his patient’s complexion, his temperament, his humours, his inclinations, his actions, even his thoughts and his ideas; he must take into account external circumstances such as the nature of the locality, the condition of the air and the weather, the position of the planets and their influences; then he must know what causes the illness, its symptoms and their effects and the day when the crisis is reached. Where the drugs themselves are concerned he must know their dosage and their strength, their country of origin, appearance and maturity as well as the right prescription. And then he must know how to combine those elements together in the right proportions so as to produce a perfect balance. If he gets any one of them slightly wrong, or if one of his principles is slightly awry, that is enough to undo us. Only God knows how difficult it is to understand most of these elements; for example, how can a doctor discover the proper symptoms of your illness when each illness can comport an infinite number of them? How many hesitations and disputes do they have over the analysis of urines? Otherwise, how could we explain their ceaseless wranglings over their diagnoses? How else could we excuse their ‘mistaking sables for foxes’ – the fault they fall into so often? In such illnesses that I have had, as soon as there was the slightest complication I never found three doctors to agree.
I am most impressed by the examples which could affect me.
Recently there was a nobleman in Paris who was cut on doctor’s orders: the surgeon found he no more had a stone in his bladder than in the palm of his hand.
Then there was a close friend of mine, a bishop; most of the doctors he consulted urgently pressed him to be cut; trusting in the others, I too joined in the persuasion; once he was dead they opened him up and found he only had vague kidney trouble. They have less excuse in the case of the stone, which, to some extent, can be felt by probing. That is why surgery always seems to me to be more exact: it sees and feels its way along; there is less conjecture and guesswork: medicine has no vaginal prod which can open up the passages of our brains, our lungs or our livers.
The very promises of medicine pass belief; for doctors have to treat several maladies which afflict us at the same time and which, almost of necessity, are interconnected – for example, a heated liver and a chilled stomach; they try to persuade us that some of their ingredients warm the stomach while others refresh the liver: one is said to go straight to the liver or even to the very bladder without displaying its powers on the way and while conserving its efficacity and virtues throughout that long journey with all its pitfalls, until it arrives where its occult properties are destined to apply. This one desiccates the brain while the other humidifies the lungs. Is it not a kind of raving madness to think you can mix a draught out of all those remedies and then hope that all the virtues of the drugs contained in that chaotic mixture will split themselves up, sort themselves out and rush each to its divergent task? I would have endless fears that the instructions on their labels might get lost or switched round so that they confuse their destinations! And how can anyone think that the various properties in that liquid jumble would not corrupt, counteract and subvert each other? Then again the prescription has to be made up by another expert and our lives placed at the mercy of his good faith too.
[C] When it comes to clothing ourselves we have tailors specializing in doublets or breeches; they serve us better because each sticks to his trade and his restricted area of competence; when it comes to food, great households employ cooks who are specialists in soups or in roasts: no cook with an overall responsibility can make them so exquisitely. The same applies to cures: the Egyptians were right to reject general practitioners and to split the profession up, one man working on each illness and each part of the body, which were then treated more appropriately and less indiscriminately since each doctor was only concerned with his speciality.26 Our doctors never realize that he who provides for all provides for none and that the overall organization of our human microcosm is too much for them to digest. While they were frightened to stop a dysentery lest it brought on a fever, they killed a friend of mine who was worth more than the lot of them, however many there may be. They attach more weight to their guesses about the future than to present illnesses; so as not to cure the brain at the expense of the stomach, they harm the stomach and aggravate the brain with their tumultuous and dissident drugs.
[A] The rational bases of this particular Art are more feeble, clearly, and contradictory than those of any other: aperient substances are good for a patient suffering from colic paroxysm, because they dilate and distend the tubes and so facilitate the passage of the glutinous matter which can build up into gravel or stone, so evacuating whatever is beginning to gather and to harden in the kidneys; aperient substances are dangerous for a patient suffering from colic paroxysm, because by dilating and distending the tubes they facilitate the passage towards the kidneys of substances whose property is to build up the gravel, for which the kidneys have a propensity, so that it is difficult to stop them retaining much of what passes through them; moreover if there should happen to be some solid body a trifle too large to pass through the narrows which have to be navigated if the gravel is to be expelled, this body may be set in motion by the aperient and forced into these narrow channels, bunging them up and causing inevitable and painful death.
They show the same certainty in the advice they give us about healthy living: it is good to pass water frequently, for experience shows us that by allowing it to stand we let its lees and impurities settle; they then serve to build up stones in the bladder; it is good not to pass water frequently: since the heavier impurities borne along in the urine will be discharged only if evacuated violently (we know from experience that a rushing torrent scours the bed it passes through more thoroughly than a sluggish, debilitated stream). Similarly: it is good to lie frequently with our wives, because it dilates the tubes and carries away the sand and gravel; but it is bad, since it overheats the kidneys, tires them and weakens them.27
[Al] It is good to take hot baths at the spas, because they relax and soften the places where the sand or stone is lurking: it is bad, because such an application of external heat encourages the kidneys to concoct, harden and then petrify the matter which is deposited therein. Once you are at the spa, it is healthier to eat little during the evenings, so that when you take the waters in the morning they can work more effectively because they encounter a stomach empty and unclogged; but, on the contrary, it is better not to eat much at midday, so as not to confuse the workings of the spa-water which are not yet completed and so as not to overload the stomach too soon after such a labour: it is wiser to allow food to digest overnight, which is better than the daytime, during which the mind and body are in ceaseless movement and agitation.
That is how they juggle and trifle with reason – to our detriment. [B] They cannot give me a single proposition against which I could not construct an opposing one equally valid. [Al] Stop railing then at those who, amid such confusion, allow themselves to be gently led by their feelings and by the counsels of Nature, entrusting themselves to common fate.
My travels have p
rovided occasions for seeing virtually all the famous baths of Christendom; I have been using them for some years now, for I reckon that bathing in general is salubrious and I believe that our health has suffered several quite serious inconveniences since we lost the habit (which was formerly observed by virtually all peoples and still is by many) of washing our bodies every day; I can only think that we are all the worse for having our limbs encrusted and our pores blocked up with filth.
As for drinking the waters, fortunately that is in the first place not inimical to my taste; secondly it is both natural and simple and so, at the very least, not dangerous even if it does no good. To support that I can refer to the huge crowds which assemble there, people of every condition and every complexion. Although I have never seen any miraculous or extraordinary cures there – on the contrary whenever I have bothered to investigate a little more carefully than is usual I have found all the rumours of cures which are scattered about such places to be ill-founded and false (despite their being believed, since people easily deceive themselves when they want to) – nevertheless I have also hardly met anyone who was made worse by taking the waters; and you cannot honestly deny that they stimulate the appetite, help the digestion and liven us up a bit (unless you are already too weak when you go there, something I would advise you against). They cannot rebuild massy ruins but they can shore up a tottering wall or forestall the threat of something worse.
If you cannot come with enough spriteliness to enjoy the company gathered there or the walks and relaxations to which we are tempted by the beauty of the countryside in which most of these spas are situated, you certainly lose the better and surer part of their effect. For this reason I have so far chosen to stay and take the waters at the more beautifully situated spas where you find more pleasant lodgings, food and company, such as the baths at Bagnères in France, Plombières on the border between Germany and Lorraine, Baden in Switzerland and Lucca in Tuscany (especially the Spa at Della Villa, which I have used most often and at various seasons).
Each country has its own peculiar opinions about how to make use of the waters as well as their own rules and methods. In my experience the effects are virtually identical. In Germany it is not done to drink them; for all illnesses people stay in the waters from sunrise to sunset like frogs. In Italy, for every nine days they drink they bathe at least thirty; they usually drink the waters mixed with additional medicinal substances to help them to work. Here in France people are told to go for a walk to help digest the water; elsewhere they make you stay in the bed where you drank it until you have voided it, while keeping your stomach and feet warm. The peculiarity of the Germans is to use cupping-horns or cupping-glasses in the bath, accompanied by scarification; the Italians have their doccie, which are showers of hot water conveyed through pipes; for a whole month they douse their head or their stomach, or whatever part is to be treated, for an hour in the morning and the same in the afternoon. There are innumerable differences in the customs of each country or, more correctly, virtually no agreement whatsoever between them.
So much then for the only branch of medicine which I have frequented; it is the least artificial but has its fair share of the confusion and uncertainty you see everywhere else in that Art.28
[A] Poets can choose how to say it with more eloquence and grace; witness these two epigrams:
Alcon hestemo signum jovis attigit. Ille,
Quamvis marmoreus, vim patitur medici.
Ecce hodie, jussus transferri ex æde vetusta,
Effertur, quamvis sit Deus atque lapis.
[Alcon touched Jove’s statue yesterday. It was of marble, but it felt that doctor’s power! You see, god of stone though it was, they bore it out of its hallowed temple today and buried it.]
And the second one:
Lotus nobiscum est hilaris, cæavit et idem,
Inventus mane est mortuus Andragoras.
Tarn subitæ mortis causam, Faustine, requins?
In somnis medicum viderat Hermocratem.
[Andragoras was laughing and bathing with us yesterday; he dined with us too. This morning he was found dead. Do you want to know, Faustinus, why he died so suddenly? He had a dream about Dr Hermocrates.]
I can add two stories to that.
The Baron de Caupène, in Chalosse, is joint patron with me of a benefice called Lahontan at the foot of our mountains; it covers a wide area. There befell to the inhabitants of this region what they also tell of the inhabitants of the valley of Angrougne. Once upon a time there they lived cut off, with their own peculiar ways, dress and manners, ruled by their own peculiar institutions and governed by their own customs which were handed down from father to son and to which they were bound by no constraint other than respect for tradition. This tiny state had lasted from ancient times in such happy circumstances that no neighbouring judge had ever been troubled to inquire into the affairs of its inhabitants, no lawyer had ever earned fees by giving them advice, no outsider had ever been called in to settle a quarrel, and nobody in the whole region was ever known to beg. They avoided all leagues and dealings with the outside world so as not to soil the purity of their institutions, until eventually, so they tell, one of their number, as their fathers could remember, was spurred on by an ambition for nobility and decided to increase the honour and reputation of his name by educating one of his sons to become a lawyer, Maître Jean or Maître Pierre. He had him taught to write in a neighbouring town and turned him into a fine village village notary-public. As he rose higher he began to despise their ancient customs and to stuff the locals’ heads with thoughts of the glorious world beyond. The first of his companions to be tricked out of a goat he counselled to seek satisfaction from the King’s judges nearby; then, from one thing on to another he bastardized everything.
This corruption, so they tell, was soon followed by another with graver results when a doctor conceived a desire to marry one of their maidens and to dwell among them. First he taught them the names of their fevers, rheums and swellings; he told them where their hearts were, their livers and their intestines (something quite unknown to them before). Instead of the garlic which they had formerly used to cure any ills, no matter how harsh or serious they were, he taught them to take strange mixtures for their coughs and colds and began to do good business not only out of their health but out of their deaths.
They swear that only after he came did they realize that the air at nightfall gives them heavy heads,29 that drinking when overheated does them harm, that the winds of autumn are more unhealthy than those of spring. Only since they started following this medicine of his have they found themselves overwhelmed by a legion of unaccustomed maladies and noticed a general decline in their former vigour. Their lives have been shortened by half.
That is the first of my tales.
The other is that, before I fell victim to the stone, I heard a fuss being made about billy-goats’ blood, which many considered to be like manna from heaven vouchsafed to Man in recent centuries to protect and preserve our human lives; many intelligent people talked of it as an infallible wonder-cure. Being a man convinced that I may well fall prey to any misfortune which strikes another, it was my pleasure to produce this wonder while I was yet in full health; I ordered a billy-goat on my farm to be fed as prescribed; it has to be segregated during the hottest months of summer and given only aperient herbs to eat and white wine to drink. I happened to return home the very day it was slaughtered; they came and told me that my cook discovered in its paunch, among all the edible parts, two or three large balls which rattled together. I was careful to have all the entrails brought to me and got them to slit open the great heavy paunch; three large objects fell out; light as sponges, they looked hollow yet were hard and tough on the outside and mottled in several dullish colours. One was perfectly round, as big as a bowling the other two were smaller, not so perfectly round but apparently still growing. When I asked those who regularly slaughter such beasts I was told that such things are unusual and rarely found. It is probable
that they were stones related to our own kind, and that it is vain for a sufferer from the gravel to hope to be cured by the blood of a goat about to die of a similar illness. As for asserting that the blood itself is not affected by such contact and that its usual virtues are not impaired, it is more likely that nothing is engendered within a body but by the conspiring of all the parts working together; the whole mass is involved, although one member may contribute more than another depending on the various ways they work. It seems very probable that in all the members of that billy-goat there was some quality of petrification.
I was curious about this experiment, not so much [C] for myself or from fears of the future [A] but because,30 in my home as in many others, the womenfolk make a store of such remedies to help the local people, prescribing the same remedy for some fifty illnesses; they never take it themselves yet exult when it works well.
In the meanwhile I honour doctors, less as the precept goes ‘for the need’ (since against that may be set the example of the prophet reproving King Asa for having ‘sought to the physicians’) but because I like the men themselves, having known several honourable and likeable ones.31 I have nothing against doctors, only against their Art; I do not blame them much for taking advantage of our follies: most people do; many vocations, both less honourable and more so, have no other base or stay than the abuse of a trusting public. When I am ill I call them in if they happen to be around at the right time: I ask them for treatment and pay up like anyone else. I grant them leave to order me32 [C] to wrap up warm… if I prefer it that way; [A] they can prescribe either leeks or lettuce to make me my broth or can limit me to white wine or claret – and so on, for anything which my appetite or habits judge indifferent. [Al] I know that that does not really help them, since bitterness and rareness are essential properties of all medicines. Why did Lycurgus order sick Spartans to drink wine? Because when in health they hated it, just as a gentleman in my neighbourhood uses wine as a successful cure for fever precisely because by nature he hates the very taste of it.
The Complete Essays Page 105