The Complete Essays

by Michel de Montaigne

  [A] Though it is possible that I inherited this natural aversion from my ancestors I would have assayed ways of countering it if that had been the only factor, since all non-rational inborn tendencies are a kind of disease which ought to be fought against. It may well be that I inherited the disposition, but I have supported it, fortified it, and corroborated my opinions, by reasoned argument: I loathe such motives as refusing medicine just because it tastes bitter. My temperament is not at all like that: I believe health to be so precious that I would buy it at the cost of the most agonizing of incisions and cauterizations. [C] Following Epicurus I believe pleasures are to be avoided if they result in greater pain, and pain is to be welcomed if it results in greater pleasure.10

  [A] Health is precious. It is the only thing to the pursuit of which it is truly worth devoting not only our time but our sweat, toil, goods and life itself. Without health all pleasure, scholarship and virtue lose their lustre and fade away. The most firmly supported arguments against this that Philosophy seeks to impress on us can be answered by this hypothesis: imagine Plato struck down by epilepsy or apoplexy; then challenge him to get any help from all those noble and splendid faculties of his soul.

  No road leading to health can be called rough or expensive for me. But there are other likely reasons too which make me suspicious of all such trafficking. I do not deny that there may be an element of art in medicine. It is quite certain that among all the works of Nature things may be found with properties which can preserve our health. [B] I mean that there are simples which moisten and desiccate; I know from experience that horseradish produces flatulence and that senna-pods act as an aperient. Experience has taught me other things too; so that I know that that mutton nourishes me and wine warms me (Solon used to say that eating was like other remedies: it was a cure for a disease called hunger).11 I do not reject practices drawn from the natural world; I do not doubt the power and fecundity of Nature nor her devotion to our needs. I can see that the pike and the swallows do well under her. What I am suspicious of are the things discovered by our own minds, our sciences and by that Art of theirs in favour of which we have abandoned Nature and her rules and on to which we do not know how to impose the limits of moderation.

  [C] What we call justice is a farrago of any old laws which fall into our hands, dispensed and applied often quite ineptly and iniquitously; those who mock at this and complain of it are not reviling that noble virtue itself but only condemning the abuse and the profanation of that venerable name of justice. So too with medicine: I honour its glorious name, its aim and its promises, so useful to the human race; but what that name actually designates among us I neither honour nor esteem.

  [A] In the first place experience makes me afraid of it, for as far as I can see no tribe of people are more quickly ill nor more slowly well than those who are under the jurisdiction of medicine. The constraints of their diets impair and corrupt their health. Doctors are not content with treating illness; they make good health ill too so as to stop us ever escaping from their jurisdiction. Do they not assert that long and continuous good health argues future illness?

  I have been ill quite frequently; without help from doctors I have found my illnesses – and I have assayed virtually all of them – quite easy to bear and as short-lasting as anyone else’s; and I have done this without bringing in the bitter taste of their prescriptions. My health is complete and untrammelled, with no rule but my habits, no discipline but my good pleasure. Any place is good enough for me to stay in: I need no more comforts when I am ill than when I am well. I do not get worked up because there is no doctor or no apothecary nearby to come to my aid (something which I can see to be a greater affliction for some people than the illness itself). Yet are the lives of doctors themselves so long and so happy that they can witness to the manifest effectiveness of their discipline?

  Every nation existed without medicine for centuries (that was the first age of Man, the best and the happiest centuries); even now less than a tenth of the world makes use of it. Nations without number have no knowledge of medicine and live longer and more healthily than we do here. And among us the common folk manage happily without it. The Roman People were six hundred years old before they adopted it; then, having assayed it, they drove it out of their city at the instance of Cato the Censor who showed how easily he could do without it, having lived to be eighty-five himself and helping his wife to live to an extreme old age – not without medicine but without medical practitioners. (Anything at all which promotes good health can be called medicine.)

  Plutarch says that Cato kept his family in good health by making use, [A1] it appears, [A] of the hare, just as the Arcadians, according to Pliny, cured all illnesses with cow’s milk.12 [C] Herodotus asserts that the Libyan people all enjoy a rare degree of good health owing to their custom of searing the veins in the head and temples of their children with cauteries at the age of four, thus blocking the way for the rest of their lives to all morbid defluxions of mucous. [A] And the villagers round here when they are ill never use anything but the strongest wine they can get, mixed with plenty of saffron and spice. And they all work equally well.

  Truly, among all that confusing diversity of prescriptions is there any practical result except the evacuation of the bowels? Hundreds of homely simples can produce that. [B] And I am not convinced that the action of the bowels is as beneficial as they claim; perhaps our nature needs, Up to a point, the residue of its excreta just as wine must be kept on its lees if you want to preserve it. You can often see healthy men succumbing, from some external cause, to attacks of vomiting or diarrhoea: they have a big turn turn-out of excrement without any prior need or subsequent benefit: indeed it does harm; they get worse. [C] It is from the great Plato himself that I recently learned that of the three motions which apply to men, the last and the worst is the motion of purgations; no man, unless he is a fool, should undergo one except of extreme necessity.13 We set about disturbing and activating our illnesses by fighting them with contraries: yet it ought to be our way of life which gently reduces them and brings them to an end. Those violent clashes between the illness and the medicine always cost us dear since the quarrel is fought out in our inwards, while drugs give us unreliable support, being by their nature the enemy of our health and gaining access into our estates only through disturbances.

  Let us leave things alone for a while: that Order which provides for the flea and the mole also provides for all men who suffer themselves to be governed by it as the flea and the mole are. We shout Gee up in vain: it will make our throats sore but not make that Order go faster, for it is proud and knows no pity. Our fear and despair repel it and delay its help for us rather than summoning it. It owes it to disease as to health that each should run its course. It will not be bribed to favour one at the expense of the rights of the other: for then it would become Disorder. For God’s sake let us follow. I repeat, follow. That Order leads those who follow: those who will not follow will be dragged along,14 medicine, terror and all. Get them to prescribe an aperient for your brain; it will be better employed there than in your stomach.

  [A] When I Spartan was asked what made him live so long, ‘Ignorance of medicine,’ he replied. And the Emperor Hadrian kept repeating as he lay dying that ‘all those doctors’ had killed him.15 [B] When a bad wrestler became a doctor Diogenes said, ‘That’s the spirit. You are right. Now you can pin to the ground all those who used to do it to you.’ [A] But doctors are lucky [B] according to Nicocles: [A] the sun shines on their successes and the earth hides their failures; on top of that they have a way of turning anything which happens to their own advantage: medicine claims the right to take credit for every improvement or cure brought about by Fortune, Nature or any other external cause (and the number of those is infinite). When a patient is under doctors’ orders anything lucky which happens to him is always due to them. Take those opportune circumstances which have cured me and hundreds of others who never call in medical help: in the case of their patients
doctors simply usurp them. And when anything untoward happens they either disclaim responsibility altogether or else blame it on the patient, finding reasons so vacuous that they need never fear they will ever run out of them: ‘he bared his arm’; [B] ‘he heard the noise of a coach’–

  rhedarum transitas arcto

  Vicorum inflexu;

  [wagons passing at the bends in narrow streets;]16

  – [A] ‘somebody opened a window’; ‘he has been lying on his left side’; ‘he has let painful thoughts run through his head’. In short a word, a, dream, a glance, all appear to be sufficient excuses for shrugging off the burden of responsibility.

  Or when we get worse they take advantage of that too if they want to, profiting from another ploy which can never fail: when their poultices merely help to inflame the illness they palm us off with assertions that without their remedies things would have been even worse. They take a man with a bad cold, turn it into a recurrent fever, then claim that without them it would have been a continual fever. No need to worry that business should be bad: when an illness grows worse it means greater profits for them. They are certainly right to require their patients to favour them with their trust. It truly has to be trust – and a pliant trust too – to cling to notions so hard to believe.

  [B] Plato put it well when he allowed freedom to lie to no one but doctors, since their promises are empty and vain but our health depends on them.17

  [A] Aesop is an author of the choicest excellence, though few people discover all his beauties; he agreeably portrays the tyrannous authority which doctors usurp over wretched souls weakened by sickness and prostrated by fear when he tells how a patient was asked by his doctor what effects he felt from a medicine he had given him: ‘I sweated a lot,’ said the patient. ‘Good,’ said the doctor. Another time he asked him how he had fared since then: ‘I felt extremely cold and shivery,’ he said. – ‘Good,’ replied the doctor. On a third occasion he again asked him how he felt: ‘All puffy and swollen up,’ he said, ‘as though I had dropsy.’ – ‘Excellent!’ said the doctor. Then one of the patient’s close friends came to ask how things were with him. ‘I am dying of good health, my friend,’ he replied.18

  They used to have a more equitable contract in Egypt: for the first three days the doctor took on the patient at the patient’s risk and peril: when the three days were up, the risks and perils were the doctor’s. Is it right that Aesculapius, the patron of medicine, should have been struck down by a thunderbolt for having brought the dead [’95] Hippolytus19 [A] back to life –

  [B] Nam pater omnipotens, aliquem indignatus ab umbris

  Mortalem infernis ad lumina surgere vitæ,

  Ipse repertorem medicinæ talis et artis

  Fulmine Phæbigenam stygias detrusit ad undas

  [For the Father Almighty, angry that a mortal should rise from the Shades of the Underworld to the light of the living, struck down the discoverer of the Art of Medicine, the son of Apollo, and with his thunderbolt cast him into the waters of Styx]

  – [A] while his followers who send so many souls from life to death find absolution! [B] A doctor was boasting to Nicocles that his Art had great prestige. Nicocles retorted: ‘It must indeed be so, if you can kill so many people with impunity.’

  [A] Meanwhile if they had asked my advice I would have rendered their teachings even more mysterious and awesome. They began well but did not keep it up to the end. A good start that, making gods and daemons the authors of their doctrines and then adopting a specialized language and style of writing – [C] even though Philosophy may think that it is madness to give a man good counsel which is unintelligible: ‘Ut si quis medicus imperat ut sumat: “Terrigenam, herbigradam, domiportam, sanguine cassant”…’ [As though a doctor’s prescription for a diet should say: ‘Take terrigenous herbigressive autodomiciled desanguinated gasteropods…’]20

  [A] It has proved a rule good for the Art (found in all vain fantastical supernatural arts) that the patient must first trust in the remedy with firm hope and assurance before it can work effectively. They cling to that rule so far as to hold that a bad doctor whom a patient trusts is better than the most experienced one whom he does not know.

  The very constituents selected for their remedies recall mystery and sorcery: the left foot of a tortoise, the urine of a lizard, the droppings of an elephant, the liver of a mole, blood drawn from under the right wing of a white pigeon; and for those of us with colic paroxysms (so contemptuously do they abuse our wretchedness) triturated rat-shit and similar apish trickery which look more like magic spells than solid knowledge. I will not even mention pills to be taken in odd numbers; the designation of particular days and festivals as ominous; the prescribing of specific times for gathering the herbs for their ingredients; and the severe, solemn expression on doctors’ faces which even Pliny laughs at.

  Where doctors went wrong (I mean after such a good start) is that they did not also make their assemblies more religious and their deliberations more secret: no profane layman ought to have access to them, no more than to the secret ceremonies of Aesculapius. Because of this error their uncertainties and the feebleness of their arguments, of their guesswork and of their premises, as well as the bitterness of their disagreements (full of hatred, of envy and personal considerations), have all been revealed to everybody, so that a man must be wondrously blind if he does not feel at risk in their hands.

  Did you ever find a doctor taking over a colleague’s prescription without putting in something extra or cutting something out? That gives their Art away and reveals that they are more concerned with their own reputation (and therefore with their fee) than with the well-being of their patients. The wisest of them all was he who decreed that each patient should be treated by only one doctor:21 for if he does no good the failure of one single man would be no great reproach to the whole Art of medicine, but if on the contrary he does strike lucky, then great is the glory; whereas when many are involved, they discredit their trade at every turn, especially since they normally manage to do more harm than good. They ought to have remained satisfied with the constant disagreements to be found among the opinions of the great masters and ancient authorities of their Art – only the bookish know about those – without letting everybody know of their controversies and the intellectual inconsistencies which they still foster and prolong among themselves.

  Do we want to see an example of medical disagreement among the Ancients? Hierophilus locates the original cause of illness in the humours; Erasistratus, in arterial blood; Asclepiades, in invisible atoms flowing through the pores; Alcmaeon, in the exuberancy or deficiency of bodily strength; Diocles, in the imbalance of our corporeal elements and the balance of the air that we breathe; Strato, in the quantity, crudity and decomposition of the food we eat; and Hippocrates locates it in our spirits.22

  A friend of the doctors, whom they know better than I do, exclaims in this connection that it is a great misfortune that the most important of all the sciences we use, the one with responsibility for our health and preservation, should be the most uncertain, the most unstable and the one shaken by the most changes.

  There is no great harm done if we miscalculate the height of the sun or the fractions in some astronomical computation: but here, when it is a matter of the whole of our being, there is no wisdom in abandoning ourselves to the mercy of so many contrary gales.

  Nothing much was heard of this science before the Peloponnesian War. It was brought into repute by Hippocrates. Everything he established was overturned by Chrysippus; everything Chrysippus wrote was then overturned by Erasistratus, the grandson of Aristotle. After that lot there came the Empirics who in their Art adopted a method quite different from the Ancients; when their reputation began to grow shaky, Herophilus succeeded in getting a new kind of medicine accepted, which Asclepiades came and attacked, destroying it in his turn. Then successively the opinions of Themison gained authority, then Musa’s, then later still those of Vexius Valens (the doctor famous for his int
imacy with Messalina). At the time of Nero, the empire (of medicine) fell to Thessalus, who condemned and destroyed everything taught before him. His teachings were subsequently struck down by Crinas of Massilia, whose new contribution was to regulate all the workings of medicines by ephemerides and astral movements, making men eat, sleep and drink at the times which suited the Moon or Mercury. His authority was soon supplanted by that of Charinus, also a doctor in Massilia; he not only fought against Ancient medicine but also against the centuries-old public institution of hot baths. He made his patients take cold baths even in winter, immersing the sick in streams of fresh-water.

  Before Pliny’s time no Roman had ever condescended to practise medicine; that was done by Greeks and foreigners – as among us French it is practised by spouters of Latin. As a very great doctor has said, we do not easily accept treatments we can understand, any more than we [C] trust the simples we ourselves gather.23 [A] If those nations where we find our guaiacum, sarsaparilla and china-root have doctors of their own, just think how exoticism and costliness must make them esteem our cabbages and our parsley: who would dare to despise plants sought in such distant lands at the risk of long and perilous journeys!

  Since those medical upheavals among the Ancients there have been innumerable others up to our own times, mostly total fundamental revolutions like those recently produced by Paracelsus, Fioravanti and Argenterius; I am told that they do not only change the odd prescription but the woof and web and the government of the medical corpus, accusing those who professed it before them of being ignorant charlatans.24

  I leave you to imagine where that leaves the wretched patient.

  If we could only be sure that their mistakes did us no harm even if they did no good it would be a reasonable bet to chance gaining something without risk of losing everything. [B] But Aesop tells how a man bought a Moorish slave and thought that his colour was incidental, brought on by ill-treatment from his former master; so he had him carefully physicked with baths and medical concoctions. As a result the Moor was not cured of swarthiness but he did lose his good health. [A] How often have we found doctors blaming each other for the deaths of their patients! I remember the local epidemic a few years ago: it was fatally dangerous. When the storm was over (having swept away innumerable people) one of the most celebrated doctors in the land published a booklet on the subject in which he regretted having prescribed bloodletting, admitting that it was one of the principal sources of the harm that was done.25