The Anatomy of Melancholy

The Arabs received medicine from the Greeks, and the Latins did likewise, adding new precepts and medicines of their own. Yet it remains so imperfect that practitioners’ ignorance, impostors, mountebanks, empirics, the disagreements of sects—almost as numerous as diseases—envy, greed and the like cause much harm among us. They differ so greatly in their consultations and prescriptions, often misunderstanding the patient’s constitution, disease and its causes, that they prescribe wholly contrary medicines. “One says this, another that,” from a desire to be different or simply to contradict. As someone said of Hadrian, “a multitude of doctors killed the ruler”: a multitude of physicians killed the emperor. “There is more danger from the physician than from the disease”—more danger from the doctor than the illness.

Besides, there is much deceit and malice among them. “All arts,” says Cardano, “admit cheating; medicine, among the rest, makes it peculiarly its own.” He tells of a physician named Curtius in Venice: because he was an outsider practising among them, the other physicians continually contradicted all his instructions.

If he prescribed hot medicines, they prescribed cold ones, “mixing cold remedies in place of hot, moist in place of cold, astringents in place of purgatives”—binding medicines instead of purges; “they threw everything into confusion.” If the patient died, “they condemned Curtius”: Curtius, who disagreed with them, had killed him. If he recovered, then they themselves had cured him.

There is much rivalry, deceit and malice among them. Even if they are honest and mean well, a dishonest apothecary who prepares and administers the medicine may do boundless harm through stale, outworn preparations, adulterated drugs, bad mixtures, substituting one ingredient for another, and so on. See Fuchs, book 1, section 1, chapter 8; Cordus’s Dispensatory; and Brasavola’s Examination of Simples, among others.

But their ignorance does more harm than their rashness. Their art—if it is an art—is wholly conjectural, uncertain, imperfect, and learned by killing people. They are a sort of butchers, leeches and killers, especially surgeons and apothecaries, who are indeed the physicians’ hangmen, “executioners,” and public headsmen. Yet, to tell the truth, physicians themselves are not far behind. For, according to that witty epigram by Maximilianus Urentius, what is the difference?

How does a surgeon differ from a physician? In this: The physician kills with drugs, the surgeon with his hand. Both seem to differ from the executioner only in this: They do more slowly what he does quickly.

But I return to their skill. Many diseases they cannot cure at all: apoplexy, epilepsy, stone, strangury, gout,

Medicine cannot remove the knotted swellings of gout.