Examples and experience: On the uncertainty of medicine

British Journal for the History of Science

Volumn 39, Issue 1, 2006, Pages 1-28

  Pender, Stephen ^a  

^a UNIVERSITY OF WINDSOR   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HISTORY; HISTORY OF MEDICINE; PHILOSOPHY;

HISTORY OF MEDICINE; HISTORY, 15TH CENTURY; HISTORY, 16TH CENTURY; HISTORY, 17TH CENTURY; PHILOSOPHY, MEDICAL;

EID: 33644506483     PISSN: 00070874     EISSN: 1474001X     Source Type: Journal    
DOI: 10.1017/S0007087405007582     Document Type: Article

References (215)

1. Erasmus, Declamatio in laudem artis medicae (tr. B. MacGregor).
2. in Erasmus idem, Literary and Educational Writings, Volume 7 (ed. Elaine Fantham et al.), Volume 29 of The Collected Works of Erasmus (ed. Alexander Dalzell et al.) Toronto, 1989, 31-50, 39.
3. Perhaps Erasmus had Plutarch's comments on medicine in mind - 'Of the liberal arts, medicine is inferior to none in elegance, distinction, and the satisfaction which it yields' (Moralia, 122e)-which he translated in 1514; see Erika Rummel, Erasmus as Translator of the Classics, Toronto, 1985, 72-5.
4. On this and other medical orations see Nancy G. Siraisi, 'Oratory and rhetoric in Renaissance medicine', Journal of the History of Ideas (forthcoming; I thank Dr Siraisi for kindly sharing her work).
5. Erasmus, Journal of the History of Ideas op. cit. (1), 42, 42-3, 46-8.
6. In his introduction to the oration MacGregor notes, 'In writing to Botzheim on 30 January 1523, he refers to the Encomium medicinae as having been written twenty-three years earlier, at the request of a friend [Ghisbertus, physician at St Omer] who subsequently became physician to Charles V.' On Ghisbertus see Peter Krivatsy, 'Erasmus' medical milieu', Bulletin of the History of Medicine (1973), 47, 113-54; 129. The comparison between medicine and law is traditional.
7. Erasmus, Bulletin of the History of Medicine op. cit. (1), 40-1.
8. Erasmus has the Republic, 431a, 442c, 443d, in mind. For the ancient notion that dietetics could alter the mental faculties see Owsei Temkin, Hippocrates in the World of Pagans and Christians, Baltimore, 1991, 13.
9. Erasmus is very close to Galen in De sanitate tuenda 1.8, quoted and translated in Owsei Temkin, Galenism: Rise and Decline of a Medical Philosophy, Ithaca and London, 1973, 39.
10. On the relationship between medicine and morality in early modern England see Andrew Wear, Knowledge and Practice in English Medicine, 1550-1680, Cambridge, 2000, 154-209, 178-84.
11. Erasmus, Knowledge and Practice in English Medicine, 1550-1680, op. cit. (1), 39-40, 45.
12. On the ways in which theologians and physicians shared obligations to diligence, competence and beneficence see D. W. Amundsen, Medicine, Society, and Faith in the Ancient and Medieval Worlds, Baltimore, 1996, 253ff.
13. and W. R. Albury and G. M. Weisz, 'The medical ethics of Erasmus and the physician-patient relationship', Journal of Medical Ethics (2001), 27, 35-41.
14. Erasmus, Journal of Medical Ethics op. cit. (1), 47, 39.
15. 'Nor is it fair', Erasmus writes, 'to impugn the profession because some of its practitioners cheat the unwary' (39; cf. 49). See the Rhetorica ad Herennium (tr. H. Caplan), Cambridge, MA, 1954, 2.27.44;
16. cf. Quintilian, Institutio Oratoria (tr. H. E. Butler), 4 vols., Cambridge, MA, 1963, 12.1.32. Philip Melanchthon exhibits similar concerns in his 1548 oration on medicine;
17. see 'On the merit of the art of medicine (1548)', in Orations on Philosophy and Education (ed. Sachiko Kusukawa, tr. Christine F. Salazar), Cambridge, 1999, 169-74.
18. On the ancient status of medicine and physicians see Darrel W. Amundsen and Gary B. Ferngren, 'Evolution of the patient-physician relationship: antiquity through the Renaissance', in The Clinical Encounter: The Moral Fabric of the Patient-Physician Relationship (ed. Earl Shelp), Dordrecht, 1983, 3-46
19. and sources. On the medieval status of medicine in relation to philosophy and university study see Roger French, 'Where the philosopher finishes, the physician begins: medicine and the arts course in thirteenth-century Oxford', Dynamis (2000), 20, 75-106.
20. See Rudolf Schmitz and Gundolf Keil (eds.), Humanismus und Medizin, Weinheim, 1984;
21. A. Wear, R. K. French and I. M. Lonie(eds.), The Medical Renaissance of the Sixteenth Century, Cambridge, 1985;
22. Nancy G. Siraisi, 'Medicine, physiology, and anatomy in early sixteenth-century critiques of the arts and sciences', in New Perspectives in Renaissance Thought: Essays in the History of Science, Education, and Philosophy (ed. John Henry and Sarah Hutton), London, 1990, 214-29, 216;
23. and especially Ian Maclean, Logic, Signs, and Nature in the Renaissance: The Case of Learned Medicine, Cambridge, 2002, 14-67.
24. See, for example, Brian Vickers, In Defence of Rhetoric, Oxford, 1988, 54-62 and sources. Of course, one would include, in order to refute, counter-arguments and counter-opinions, but the epideictic had overtly ethical tones; as Aristotle insists, to 'praise a man is in one respect akin to urging a course of action' (Rhetoric, 1367b35).
25. Erasmus's purpose is clearly didactic; the Declamatio, op. cit. (1).
26. is a non-technical treatise grouped with other works pertaining to instruction in the Opera (33-4, 32). Like Agrippa after him, Erasmus probably mingled rhetorical exercise and serious purpose in his declamation; see Marc van der Poel, 'The Latin "Declamatio" in Renaissance humanism', Sixteenth Century Journal (1989), 20, 471-8;
27. and Marc van der Poel, idem, De declamatio bij de humanisten: bijdrage tot de Studie van de functies van de rhetorica in de renaissance, Nieuwkoop, 1987.
28. On medicine in the universities see Maclean, De Declamatio Bij de Humanisten: Bijdrage Tot de Studie Van de Functies Van de Rhetorica in de Renaissance op. cit. (6).
29. Erasmus, De Declamatio Bij de Humanisten: Bijdrage Tot de Studie Van de Functies Van de Rhetorica in de Renaissance op. cit. (1), 37.
30. have slightly modified MacGregor's translation. For the various divisions of medicine in the early modern period see Heikki Mikkeli, Hygiene in the Early Modern Medical Tradition, Helsinki, 1999, 32-40.
31. Erasmus, Hygiene in the Early Modern Medical Tradition op. cit. (1), 45.
32. Erasmus, it seems, was a hypochondriac; his immense correspondence includes letters to numerous physicians, many of which refer to his own health. See Krivatsy, Hygiene in the Early Modern Medical Tradition op. cit. (2).
33. These Erasmus addresses in part through his translations of three Galenic texts in the 1520s, also dedicated to a physician friend, later published in the 1542 Galeni opera omnia; see Galen, Exbortatio ad bonas artes, praesertim medicinae, De optimo docendi genere, Qualem oporteat esse medicum (tr. Erika Rummel), in The Collected Works of Erasmus, op. cit. (1), 220; in the latter work, to avoid errors in nosology, Galen recommends the study of logic; the proper physician not only loves justice, temperance and truth, and shuns lethargy, drunkenness and greed, but is a philosopher in the 'full sense', versed in both theory and practice (245, 247-8).
34. For early humanist critiques of medicine see, for example, Katharine Park, Doctors and Medicine in Early Renaissance Florence, Princeton, 1985, 225-36.
35. See Nancy G. Siraisi, The Clock and the Mirror: Girolamo Cardano and Renaissance Medicine, Princeton, 1997, 46-52 and sources, especially 245 n. 5;
36. for medieval critiques see Roger French, Medicine Before Science: The Rational and Learned Doctor from the Middle Ages to the Enlightenment, Cambridge, 2003, 65ff.
37. See Siraisi, Medicine before Science: The Rational and Learned Doctor from the middle Ages to the Enlightenment, op. cit. (6), 219, 217.
38. There is a tradition of the therapeutic word, ably investigated by Pedro Lain Entralgo, The Therapy of the Word in Classical Antiquity (tr. L. J. Rather and John M. Sharp), New Haven, 1970;
39. this history is adumbrated by Robert Burton in The Anatomy of Melancholy (ed. Floyd Dell and Paul Jordan Smith), New York, 1927, 475 (2.2.6.2), in which he claims, 'Many, saith Galen, have been cured by good counsel and persuasion alone'.
40. For Petrarch see George McClure, Sorrow and Consolation in Italian Humanism, Princeton, 1991, 49-54.
41. Park, Sorrow and Consolation in Italian Humanism, op. cit. (12).
42. Early modern debates about the status and certainty of medicine are conditioned by the recovery of classical texts, most of which, especially non-medical writing, class medicine as a techne, a craft, an identity which medicine maintained throughout antiquity and the Middle Ages into the early modern period. See Amundsen and Ferngren, Sorrow and Consolation in Italian Humanism, op. cit. (5), 18-25;
43. and Siraisi, Sorrow and Consolation in Italian Humanism, op. cit. (6), 219.
44. The distinctions 'medical' and 'non-medical' are at best amorphous, at worst empty, but there is widespread, though varied, awareness of this difference in early modernity.
45. We should not endorse these interventions uncritically, of course, for there were many who trumpeted the progress in several branches of medical theory and practice, and physicians were never as benighted as their non-medical critics claim. I thank Randall Packard for reminding me of this point.
46. Wear, Sorrow and Consolation in Italian Humanism, op. cit. (3);
47. Mikkeli, Sorrow and Consolation in Italian Humanism, op. cit. (9);
48. and Maclean, Sorrow and Consolation in Italian Humanism, op. cit. (6). However, it should be noted that Maclean not only allows for the possibility of localized or marginal voices in medical discourse (11), he investigates several (passim).
49. Wear, Sorrow and Consolation in Italian Humanism, op. cit. (3), 154, 184-90.
50. Wear, Sorrow and Consolation in Italian Humanism, op. cit. (3), 154-209.
51. See in general Rudolph M. Bell, How to Do It: Guides to Good Living for Renaissance Italians, Chicago, 1999.
52. Temkin, Galenism, op. cit. (3), 161-2.
53. has argued that 'the decline of scientific Galenism enhanced the prestige of Hippocrates'; see also Erwin H. Ackerknecht,' The end of Greek diet', Bulletin of the History of Medicine (1971), 45, 242-9.
54. Maclean, Bulletin of the History of Medicine, op. cit. (6), 2-9;
55. Anthony Grafton and Nancy Siraisi (eds.), Natural Particulars: Nature and the Disciplines in Renaissance Europe, Cambridge, MA, 1999.
56. and Nancy G. Siraisi, 'Medicine and the renaissance world of learning', Bulletin of the History of Medicine (2004), 78, 1-36. Siraisi suggests (ibid., 3) that medical humanism usually refers to 'enthusiasm for ancient Greek medical texts that inspired both imitation and, in some celebrated instances, critical confrontation with nature among Renaissance physicians'.
57. Temkin, Galenism, op. cit. (3). Temkin is clear (ibid., 165), though, that it is a crisis of theory rather than of practice: 'the fall of the Galenic science of medicine was not identical with the fall of the Galenic practice of medicine'.
58. J.-P. Pittion, 'Scepticism and medicine in the Renaissance', in Scepticism from the Renaissance to the Enlightenment (ed. Richard H. Popkin and Charles B. Schmitt), Wiesbaden, 1997, 103-32, 105.
59. Maclean, Scepticism from the Renaissance to the Enlightenment, op. cit. (6), 10, 34-5.
60. Pittion, Scepticism from the Renaissance to the Enlightenment, op. cit. (26), 110.
61. argues that early modern medicine was thrust towards empiricism in part by scepticism. Roger French, Scepticism from the Renaissance to the Enlightenment, op. cit. (13), 157, 169, argues that Galenism and Aristotelianism are both in 'crisis' by the 1630s.
62. Andrew Wear, 'Galen in the Renaissance', in Galen: Problems and Prospects (ed. Vivian Nutton), n. p., 1981, 229-67.
63. Peter Dear, Discipline and Experience: The Mathematical Way in the Scientific Revolution, Chicago and London, 1995, 13;
64. original emphasis. Compare Owsei Temkin, 'The scientific approach to disease: specific entity and individual sickness', in idem, The Double Face of Janus and other Essays in the History of Medicine, Baltimore, 1977, 441-55, 446.
65. Carlo Ginzburg, 'Clues: roots of an evidential paradigm', in idem, Myths, Emblems, Clues (tr. John and Anne C. Tedeschi), London, 1990, 114.
66. Michel Foucault, in The Birth of the Clinic: An Archaeology of Medical Perception (tr. A. M. Sheridan Smith), New York, 1975, 197-8, argues for the 'fundamental place of medicine in the over-all architecture of the human sciences' because 'it is closer than any of them to the anthropological structure that sustains them all'.
67. Pliny, Naturalis Historiae (tr. W. H. S. Jones), 10 vols., London, 1938, 29.1-8 is the locus classicus for discussions of the uncertainty of medicine.
68. See Philemon Holland's translation of Pliny's History of the World, Commonly Called, The Natural History of C. Plinius Secundus, London, 1601, 343-9.
69. As Roger French, History of the World, Commonly Called, the Natural History of C. Plinius Secundus, op. cit. (13) and citations, notes, 'Pliny's criticism of doctors may well have shaped later attacks' on medicine.
70. Agrippa, Of the Vanitie and Uncertaintie of Artes and Sciences (ed. Catherine M. Dunne), Northridge, 1974, 308.
71. These comments are drawn chiefly from Chapters Eighty-two and Eighty-three of Agrippa's text, 'Of Physicke', 'Of Phisicke, that consisteth in practice', 295-313.
72. with page references incorporated into the text. Agrippa sent the work to Erasmus for an opinion, who clearly liked De incertitudine, although Erasmus took care to distance himself from Agrippa's anticlericalism. See Krivatsy, Of Physicke', 'Of Phisicke, That Consisteth in Practice, op. cit. (2), 148-9;
73. and Charles Nauert, Agrippa and the Crisis of Renaissance Thought, Urbana, IL, 1965, 109-10; cf. 219. Agrippa assured Erasmus that he was a 'loyal Erasmian'.
74. Unlike Erasmus, Agrippa studied and practised medicine. No doubt he was exposed to sectarianism, incompetence and greed, all of which added fuel to his invective.
75. Siraisi, Agrippa and the Crisis of Renaissance Thought, op. cit. (6), 222-3;
76. Nauert, Agrippa and the Crisis of Renaissance Thought, op. cit. (32), 315.
77. The relationship between scepticism and medical knowledge is discussed briefly in Popkin, particularly in relation to later seventeenth-century figures like Gassendi. Popkin suggests that although Agrippa's work 'does not present any sceptical analysis of human knowledge, it represents a facet of the revival of ancient scepticism' (Richard H. Popkin, The History of Scepticism from Erasmus to Spinoza, 2nd edn, Berkeley, 1979, 23-5).
78. See Siraisi, The History of Scepticism from Erasmus to Spinoza, 2nd Edn, op. cit. (6), 222-3
79. and sources, and 227, where the object of Agrippa's reformist agenda is pharmacology; on Agrippa, his treatise and his knowledge of medicine see Nauert, The History of Scepticism from Erasmus to Spinoza, 2nd Edn, op. cit. (32), 10-11, 85;
80. and Marc van der Poel, Cornelius Agrippa, the Humanist Theologian and his Declamations, Leiden, 1997.
81. Bacon knew Agrippa, while Montaigne frequently borrows from De certitudine; see Nauert, Cornelius Agrippa, the Humanist Theologian and His Declamations, op. cit. (32), 195, 197, 298 (on Montaigne), 322-34 (on Agrippa's reception).
82. These are numerous but see, for example, F. H. and John Oberndorff, The Anatomyes of the True Physician, and Counterfeit Mounte-Bank (tr. F. H.), London, 1602;
83. John Cotta, A Short Discoverie of the Unobserved Dangers of Severall Sorts of Ignorant and Unconsiderate Practisers of Physicke in England, London, 1612;
84. and Jonathan Goddard, A Discourse Setting Forth the Unhappy Condition of the Practice of Physick in London, London, 1670.
85. See, for example, Christopher Hill, 'The medical profession and its radical critics', in idem (ed.), Change and Continuity in Seventeenth-Century England, New Haven, 1991, 157-78;
86. and Harold J. Cook, The Decline of the Old Medical Regime in Stuart London, Ithaca and London, 1986.
87. Lucinda Beier usefully summarizes the issues in her Sufferers and Healers: The Experience of Illness in Seventeenth-Century England, London, 1987, 154-81, 242-59.
88. r.
89. Robert Underwood, A New Anatomie. Wherein the Body of Man is Fit and Aptly (Two Wayes) Compared: 1 To a Household, 2 To a Cittie, London, 1605, 22.
90. Geoffrey Goodman, The Pall of Man, or the Corruption of Nature, Proved by the Light of our Natural Reason, London, 1616, 97.
91. George Herbert, 'A Priest to the Temple', in idem, Herbert's Remains, London, 1652, 97.
92. For similar critiques see Philip Barrough, The Method of Physick, 2nd edn, London, 1610
93. (frequently reprinted), sigs. A5v-A6r; and Harvey Cushing, A Bio-Bibliography of Andreas Vesalius, New York, 1943, 18
94. Theodore Turquet de Mayerne, BL Sloane MS 1697, f 42ff.
95. quoted in Geoffrey Keynes, The Life of William Harvey, Oxford, 1966, 138ff.
96. translated by Norman Moore in The History and Study of Medicine in the British Isles, Oxford, 1908, 97-106;
97. see also Brian Nance, Turquet de Mayerne as Baroque Physician, Amsterdam, 2001, 183ff.
98. Keynes, Turquet de Mayerne as Baroque Physician, op. cit. (44), 142.
99. Anthony Raspa (ed.), Devotions Upon Emergent Occasions, New York, 1987, 51-2.
100. Susan James, in Passion and Action: The Emotions in Seventeenth-Century Philosophy, Oxford, 1997, 13.
101. also mentions 'storms, torrents, tempests' within the body, citing Bacon, Charleton and Spinoza. The phrase quoted is from Helkiah Crooke's Microcosmographia: A Description of the Body of Man, London, 1615.
102. Cotta, Microcosmographia: A Description of the Body of Man, op. cit. (38), 17.
103. Robert Burton, The Anatomy of Melancholy (ed. Thomas C. Faulkner, Nicolas K. Kiessling and Rhonda L. Blair), 3 vols., Oxford, 1989-90, ii, 381ff.
104. Raspa, The Anatomy of Melancholy, op. cit. (46), 29;
105. John Donne, The Sermons of John Donne (ed. Evelyn M. Simpson and George R. Potter), 10 vols., Berkeley, 1953-62, ii, 62.
106. James J. Bono, The Word of God and the Languages of Man: Interpreting Nature in Early Modern Science and Medicine, 1: Ficino to Descartes, Madison, WI, 1995, 134.
107. Edward May, A Most Certaine and True Relation of a Strange Monster or Serpent Found in the left Ventricle of the heart of John Pennant, Gentleman, of the age of 21. yeares, London, 1639, 24-7. The text is dedicated to Mayherne.
108. In 'A Letter to a Friend, Upon Occasion of the Death of his Intimate Friend', 1690 (composed in the 1640s), Browne advises that some diseases, such as 'extreme Consumption', do not send out 'Sigils' as others do (Sir Thomas Browne: Selected Writings (ed. Geoffrey Keynes), London, 1968, 95).
109. In 1654 Walter Charleton identified 'sigillation'with indication. Sigillation allowed 'Occult qualities'to be 'made manifest' (Physiologia Epicuro-Gassendo-Charltoniana, London, 1654, 364).
110. William Petty to Robert Boyle, 15 April 1653, in Robert Boyle, The Works of the Honourable Robert Boyle (ed. Thomas Birch), 2nd edn, 6 vols., London, 1772, i, 138-9.
111. Robert Boyle, The Works of the Honourable Robert Boyle (ed. Thomas Birch), 2nd edn, 6 vols., London, 1772, ii, 89-90.
112. William A. Wallace, 'Traditional natural philosophy', in The Cambridge History of Renaissance Philosophy (ed. Charles B. Schmitt and Quentin Skinner), Cambridge, 1988, 201-35; 207.
113. Douglas Patey, Probability and Literary Form: Philosophic Theory and Literary Practice in the Augustan Age, Cambridge, 1984, passim; Lamy quoted at 64.
114. Lionardo di Capoa, The Uncertainty of the Art of Physic (tr. John Lancaster), London, 1684, 31.
115. The Works of Francis Bacon, Baron of Verulam, Viscount of St. Alban, and Lord Chancellor of England (ed. James Spedding, Robert L. Ellis and Douglas D. Heath), 14 vols., London, 1857-74, iv, 265-70;
116. The Works of Francis Bacon, Baron of Verulam, Viscount of St. Alban, and Lord Chancellor of England, iii, 371;
117. The Works of Francis Bacon, Baron of Verulam, Viscount of St. Alban, and Lord Chancellor of England, iv, 63, 381, with further references incorporated into the text citing the volume and page number.
118. 'A Briefe of the Art of Rhetorique', in The Rhetorics of Thomas Hobbes and Bernard Lamy (ed. John T. Harwood), Carbondale, 1986, 65.
119. Edward, Lord Herbert of Cherbury, De Veritate [1633] (tr. Meyrick H. Carré), Bristol, 1937, 247, 314, 319.
120. Dr Mee, The Character of a Compleat Physician, or Naturalist, London, 1680, 2, 6-7.
121. Cotta, The Character of a Compleat Physician, or Naturalist, op. cit. (38), 2-3;
122. Thomas Sydenham, Works (ed. R. G. Lantham), 2 vols., London, 1848, ii, 102.
123. Charles Webster, The Great Instauration: Science, Medicine and Reform 1626-1660, London, 1975, 267ff.
124. Olav Thulesius, Nicholas Culpeper, English Physician and Astrologer, New York, 1992.
125. Michael Heyd, 'Be Sober and Reasonable'; The Critique of Enthusiasm in the Seventeenth and Early Eighteenth Centuries, Leiden, 1995.
126. Cook, 'Be Sober and Reasonable'; The Critique of Enthusiasm in the Seventeenth and Early Eighteenth Centuries, Leiden, op. cit. (39), 150-1, 184ff., 189.
127. passim; and Jeffrey Boss, 'The Methodus Medendi as an index of change in the philosophy of medical science in the sixteenth and seventeenth centuries', History and Philosophy of the Life Sciences (1979), 1, 13-42.
128. Robert G. Frank, 'Viewing the body: reframing man and disease in Commonwealth and restoration England', in The Restoration Mind (ed. W. Gerald Marshall), Newark, 1997, 66-7;
129. and French, The Restoration Mind, op. cit. (13), 113-14, 215-17.
130. Thomas Sydenham and John Locke, Anatomie (1668), PRO 30/24/47/2, ff. 60-67.
131. printed in Kenneth Dewhurst, Dr Thomas Sydenham (1624-1689);
132. His Life and Original Writings, London, 1966, 87-8, 91, 79.
133. Mee, His Life and Original Writings, op. cit. (62), 1, expresses the same opinion: 'Anatomy is of the greatest fame and repute, tho not of much real use to the curing [of] Mankind'.
134. Di Capoa, His Life and Original Writings, op. cit. (58), 17, preface sig. B2r, 4. Original emphasis.
135. The Life of Edward, first Lord Herbert of Cherbury, Written by Himself (ed. J. M. Shuttleworth), London, 1976, 21;
136. Friedrich Hoffmann, Fundamenta Medicinae ex Principiis Naturae Mechanicis in Usum Philiatrorum Succinte Proposita [16951 (tr. Lester S. King), London, 1971, 115.
137. John Stuteville to Sir Justinian Isham, 12 January 1656, in Frances Parthenope Verney, Memoirs of the Verney Family, 3 vols., London, 1892-9, iii, 200.
138. Michel de Montaigne, 'Of the resemblance of children to fathers', in The Complete Essays of Michel de Montaigne (tr. Donald M. Frame), Stanford, 1958, 585.
139. with page references incorporated into the text. Most of Montaigne's comments on medicine are contained in the above essay and in 'Of experience', 815-57. On ancient controversy about generation and the soul, following similar exegesis in Agrippa, see 417-18. The Essays were widely available, extremely popular and often imitated in early modern England; they were Englished in 1603 by John Florio. On Montaigne and medicine see François Batisse, Montaigne et la Médicine, Paris, 1962;
140. Jean Starobinski, 'The body's moment', Yale French Studies (1983), 63, 273-305.
141. and Eric Aaron Johnson, Knowledge and Society: A Social Epistemology of Montaigne's Essais, Charlottesville, 1994, 105-14.
142. Montaigne echoes Agrippa's comment (op. cit. (32), 312) that 'shoppe Phisicke ... is altogeather for the moste parte devinatorie'; on Montaigne's borrowings see Essais (ed. Maurice Rat), 2 vols., Paris, 1962, ii, 649. From the early essays through to the late, Montaigne is consistent in his scepticism about the benefits of learned medicine, in one case drawing a distinct parallel between therapies of the soul and therapies of the body; the 'arts that promise to keep our body in health and our soul in health promise us much; but at the same time there are none that keep their promise less' (ibid., 827).
143. Cotta, Knowledge and Society: A Social Epistemology of Montaigne's Essais, op. cit. (38), 2-3. Cotta advertises his own text: 'He that considereth the multitude of causes in diseases, their infinite kindes, manners, and natures, the varietie of accidents, their sodaine and variable mutations, the soone lost occasions, and hardly gained opportunities, the wisedome which circumstances require, the care and vigilance which the subject exacteth, the doubts which repugnances bring, the resultions which necessities urge; shall find the most exquisite powers of understanding, judgement, wit, discretion, and learning herein exactly sifted.' Diseases differ in 'manner, quantity, qualitie, and times of remedies: every one requiring a separate and distinct respect and dispensation, even in the same disease and person' (ibid., 2-3).
144. Gerard Paul Sharpling, 'Towards a rhetoric of experience: the role of Enargeia in the essays of Montaigne', Rhetorica (2002), 20, 173-92; 180.
145. The paradeigma is 'a variety of induction which brings out the meaning of a thing by comparing it with one or more other things which are like it but clearer or better known' (Gerald F. Else, Aristotle's Poetics: The Argument, Cambridge, MA, 1957, 19;
146. original emphasis). On exemplarity in Montaigne see John D. Lyons, Exemplum; The Rhetoric of Example in Early Modern France and Italy, Princeton, 1989, 118-53.
147. John D. Lyons, 'Circe's drink and sorbonnic wine: Montaigne's paradox of experience', in Unruly Examples: On the Rhetoric of Exemplarity (ed. Alexander Gelley), Stanford, 1995, 86-103. Lyons's essay came to my attention too late for me to fully address its claims, although I agree that Montaigne first treats the example as lame only to endorse the access it allows to human experience (ibid., 102).
148. Yet Montaigne's particular ailment (bladder stone) offers little to 'guess about'. Although nature has 'utterly unknown ways of her own', with a simple illness we 'are freed from the worry into which other diseases cast us by the uncertainty of their causes and conditions and progress'. Mitigating his earlier scepticism, Montaigne asserts that, with the stone, 'the senses reveal to us what it is, and where it is' (839-40). Illness in general, however, offers no such certainty (838-9).
149. Timothy Hampton, Writing from History: The Rhetoric of Exemplarity in Renaissance Literature, Ithaca and London, 1990, 193, cites the relevant literature and argues that the final pages of the Essays are 'structured on the paradoxical relationship between a judgement that becomes ever finer and a body that slips ever deeper into infirmity'.
150. I borrow the term from Michel Foucault, Writing from History: The Rhetoric of Exemplarity in Renaissance Literature, op. cit. (30).
151. Foucault argues that the symptom is 'the first transcription of the inaccessible nature of the disease'; 'of all that is visible', he writes, 'it is closest to the essential'. The problem of reasoning from symptoms to causes necessitates a form of inference that derives the obscure from the manifest, a process which Foucault calls repérage, or an anticipation of the invisible (disease, in this case) by a 'visible mapping out' (90-1; cf. 159-72). On Montaigne and repérage see Starobinski, Writing from History: The Rhetoric of Exemplarity in Renaissance Literature, op. cit. (72).
152. When it comes to the passions, for example, Montaigne is quite clear: 'If each man watched closely the effects and circumstances that dominate him, as I have done with the ones that I have fallen prey to, he would see them coming and would check their impetuosity and course a bit' (823).
153. See Michel de Certeau, The Practice of Everyday Life (tr. Steven Rendall), Berkeley and Los Angeles, 1984, 126ff.
154. and Hampton, The Practice of Everyday Life, op. cit. (79), 174.
155. As Jean Starobinski has shown (The Practice of Everyday Life, op. cit. (72)).
156. the essay 'Of experience' is organized around the non-naturals and, as Timothy Hampton The Practice of Everyday Life, (op. cit. (79), 171)
157. argues, 'the body emerges [throughout the Essays] as the material signifier of the condition of the soul'. 'By following the degeneration of his own body', Hampton writes, 'Montaigne breaks loose once and for all from memory, narrative, and history, organizing his text on the immediacy of bodily sensation, ... The "useful" knowledge which he gives his readers stems ... from reading the signs of the body' (ibid., 194). Indeed, Montaigne is well aware of the grands débats about dietetics in the sixteenth century; see Jean Céard, 'La Culture du corps: Montaigne et la diété tique de son temps', in Le Parcours des Essais de Montaigne 1588-1988 (ed. Marcel Tetel and G. Mallary Masters), Paris, 1989, 83-96; 86-7.
158. Starobinski, Le Parcours des Essais de Montaigne 1588-1988, op. cit. (72), 276. Original emphasis.
159. Celsus, De Medicina (tr. W. G. Spencer), 3 vols., Cambridge, MA, 1971, 1.1.
160. Elyot writes in The Castell of Helth, London, 1536, 281.
161. paraphrasing Celsus, that a 'man that is hole and well at ease, and is at libertie, ought not to bynde hym selfe to rules, or nede a phisition'. See Mikkeli, The Castell of Helth, op. cit. (9), 92-6.
162. Compare, for example, 'Of Custom and Education', vi, 470-2. Bacon's medical remains contain recipes, rules and regimen (iii, 827-36).
163. Compare Montaigne: 'doctors ordinarily adjust their rules beneficially to the violence of the sharp cravings that come upon sick people' (833).
164. See, for example, Steven Shapin, 'Descartes the doctor: rationalism and its therapies', BJHS (2000), 33, 131-54, 134.
165. For the former tendency see Jeffrey Boss, 'The medical philosophy of Francis Bacon', Medical Hypotheses (1978), 4, 208-20;
166. William A. Sessions, 'Recent studies in Francis Bacon', English Literary Renaissance (1987), 17, 351-71;
167. and, in general, The Cambridge Companion to Francis Bacon (ed. Markku Peltonen), Cambridge, 1996;
168. for the latter see Ian Box, 'Medicine and medical imagery in Bacon's "Great Instauration"', Historical Reflections/Reflexions historiques (1989), 16, 351-65.
169. reprised in Ian Box, idem, The Social Thought of Francis Bacon, Lewiston, 1989, 38ff.
170. Box claims that medicine is the 'vehicle for expressing the goals and methods of the Instauration', that medical images are 'essential to his thinking about the role of science in society' ('Medicine and medical imagery', in ibid., 353).
171. Of course, although Box fails to note this fact, medicine may have provided Bacon with a model for his aphorisms; see Humphrey Rolleston, 'Medical aphorisms, chiefly in English', Bulletin of the History of Medicine (1941), 10, 544-67;
172. and Stephen Clucas, '"A Knowledge Broken": Francis Bacon's aphoristic style and the crisis of scholastic and humanist knowledge-systems', in English Renaissance Prose: History, Language, Politics (ed. Neil Rhodes), Tempe, 1997, 147-72.
173. Box, 'Medicine and medical imagery', English Renaissance Prose: History, Language, Politics, op. cit. (89), 353.
174. See Sachiko Kusukawa, 'Bacon's classification of knowledge', in The Cambridge Companion to Francis Bacon, op. cit. (89), 47-74.
175. Heresies and schisms are the greatest scandals, Bacon writes in 'Of Unity in Religion', for 'as in the natural body a wound or solution of continuity is worse than a corrupt humour; so in the spiritual' (vi, 381). Writing between 1610 and 1614, in Essays in Divinity (ed. Evelyn M. Simpson), Oxford, 1952, 11.
176. Donne uses the same medieval metaphor for schisms in the church: 'the Church is wounded by schismes, which make solutionem continui, (as Chirurgians speak)'. A Physical Dictionary, London, 1657
177. defines the term as 'a division of such parts as naturally ought to be united'. An earlier dictionary defines a solution of continuity (solutio continuitatis) as 'a dissolving of that which necessarily belongeth to another' (Christopher Wirtzung (augmented by Jacob Mason), Praxis Medicinae Universalis; or a Generall Practise of Physicke, London, 1598.
178. the third index). Oddly, Ian Box ('Medicine and medical imagery', Praxis Medicinae Universalis; or a Generall Practise of Physicke. op. cit. (89)) does not mention this metaphor.
179. See Charles Schmitt, 'Aristotle among the physicians', in The Medical Renaissance of the Sixteenth Century (ed. A. Wear, R. K. French and I. M. Lonie), Cambridge, 1985, 1-15.
180. Although Bacon does not mention all divisions of medicine - physiology, pathology, semiology, therapeutics and hygiene, with semiology divided into prognosis and diagnosis and therapeutics into dietetics, pharmacology and surgery (Mikkeli, The Medical Renaissance of the Sixteenth Century, op. cit. (9), 32ff.)
181. - he covers most of these topics except, to my knowledge, surgery. On Descartes see Shapin, The Medical Renaissance of the Sixteenth Century, op. cit. (88).
182. Compare Montaigne; 'there is no way of life so stupid and feeble as that which is conducted by rules and discipline. ... We should conform to the best rules, but not to enslave ourselves to them' (831).
183. Michel Malherbe, 'Bacon's method of science', in The Cambridge Companion to Francis Bacon, op. cit. (89), 83.
184. Malherbe, The Cambridge Companion to Francis Bacon, op. cit. (96), 83-4, 89-90.
185. Jardine, Francis Bacon: Discovery and the Art of Discourse, Cambridge, 1974, 144.
186. Malherbe, Francis Bacon: Discovery and the Art of Discourse, op. cit. (96), 84.
187. For 'transition to the similar' (reasoning from one case to a more or less similar case, from observable to observable) and related issues see Mohan Matten, 'Empiricism and ontology in ancient medicine', in Method, Medicine and Metaphysics (ed. R. J. Hankinson), Apeiron (1988), 21, 99-121, 110-13.
188. On science as venatio see William Eamon, Science and the Secrets of Nature: Books of Secrets in Medieval and Early Modern Culture, Princeton, 1994, 271-300.
189. Jardine, Science and the Secrets of Nature: Books of Secrets in Medieval and Early Modern Culture, op. cit. (98), 147 and 133-68.
190. For an extended treatment of Bacon, analogy and the ars inveniendi see Antonio Pérez-Ramos, Francis Bacon's Idea of Science and the Maker's Knowledge Tradition, Oxford, 1988, 260ff.
191. As Bacon said, 'there is no proceeding in invention of knowledge but by similitude' (iii, 218). See also Brian Vickers, 'Analogy versus identity; the rejection of occult symbolism, 1580-1680', in idem (ed.), Occult and Scientific Mentalities in the Renaissance, Cambridge, 1984, 95-163;
192. and Brian Vickers, idem, 'On the function of analogy in occult science', in Hermeticism and the Renaissance (ed. Allen Debus and I. Merkel), Washington, 1988, 269-82.
193. In The Discourse of Modernism, Ithaca and London, 1982, 202-4, Timothy Reiss concludes that Bacon's experientia literata is 'mightily ambiguous'.
194. On indication as a medical term in use among Bacon's contemporaries see my 'Essaying the body: Donne, affliction, and medicine', in John Donne's Professional Lives (ed. David Colclough), Cambridge, 2002, 215-48.
195. Bacon, Works, op. cit. (59), iv, 51.
196. Aristotle, Rhetoric, 1393a26, 1355b35-40, 1356b14-18.
197. Gerard A. Hauser, 'Aristotle's example revisited', Philosophy and Rhetoric (1985) 18, 171-81;
198. the quotation is from Posterior Analytics, 100b5.
199. Paolo Rossi, Francis Bacon: From Magic to Science (tr. Sacha Rabinovitch), Chicago, 1968, 186-223, 192-3, 219-23.
200. Quintilian, Francis Bacon: From Magic to Science, op. cit. (5), 6.2.32;
201. cf. 8.3.61. See Vickers, Francis Bacon: From Magic to Science, op. cit. (7), 320-2.
202. On the importance of enargeia to early modern thought see, for example, Linda Galyon, 'Puttenham's Enargeia and Energeia: new twists for old terms', Philological Quarterly (1981), 60, 29-40;
203. Pierre Galand, 'L'〈Enargia〉 chez Politien', Bibliothèque d'humanisme et renaissance (1987), 49, 25-53;
204. and Sharpling, Bibliothèque D'humanisme et Renaissance, op. cit. (75).
205. On the importance of enargeia to early modern science, particularly Boyle, see Michael Wintroub, 'The looking glass of facts: collecting, rhetoric, and citing the self in the experimental natural philosophy of Robert Boyle', History of Science (1997), 35, 189-217.
206. Rossi (History of Science op. cit. (107), 181)
207. argues that, for Bacon, one of the functions of rhetoric is to create '"visible" images of moral concepts'; see also Marc Cogan, 'Rhetoric and action in Francis Bacon', Philosophy and Rhetoric (1981), 14, 212-33;
208. and Brian Vickers, 'Bacon and rhetoric', in The Cambridge Companion to Francis Bacon, op. cit. (89), 200-31.
209. As Donne (The Cambridge Companion to Francis Bacon, op. cit. (50), iv, 87)
210. writes in 1622, 'Rhetorique will make absent and remote things present to your understanding". This is a common conception of rhetoric in seventeenth-century philosophy, which derives from Quintilian, The Cambridge Companion to Francis Bacon, op. cit. (5), 6.2.32-36.
211. On prerogative instances see Jardine, The Cambridge Companion to Francis Bacon, op. cit. (98), 124-6; she does not discuss evoking or summoning instances.
212. See Boss, The Cambridge Companion to Francis Bacon, op. cit. (66), 36, 33-42.
213. On the one hand Agrippa condemns physicians for having nothing but experience at their disposal; on the other, in a move that inverts a common defence of learned medicine, he lauds empirics. There is 'nothing more available to the trade of Phisicke then experience', Agrippa writes (The Cambridge Companion to Francis Bacon, op. cit. (32), 309), 'wherein it is manifestly seene, that the beste learned men have beene oftentimes overcome by an olde wife of the Countrie'.
214. See Andrew Wear, 'Epistemology and learned medicine in early modern England', in Knowledge and the Scholarly Medical Traditions (ed. Don Bates), Cambridge, 1995, 161.
215. Foucault, Knowledge and the Scholarly Medical Traditions, op. cit. (30), p. xiv, 195-99.