Concerning the Patient.

Concerning the Patient.

     When these precedent cautions are accurately kept, and that we have now got a skilful, an honest physician to our mind, if his patient will not be conformable, and content to be ruled by him, all his endeavours will come to no good end. Many things are necessarily to be observed and continued on the patient's behalf: First that he be not too niggardly miserable of his purse, or think it too much he bestows upon himself, and to save charges endanger his health. The Abderites, when they sent for Hippocrates, promised him what reward he would, "all the gold they had, if all the city were gold he should have it." Naaman the Syrian, when he went into Israel to Elisha to be cured of his leprosy, took with him ten talents of silver, six thousand pieces of gold, and ten changes of raiment, (2 Kings v. 5.) Another thing is, that out of bashfulness he do not conceal his grief; if aught trouble his mind, let him freely disclose it, Stultorum incurata pudor malus ulcera celat: by that means he procures to himself much mischief, and runs into a greater inconvenience: he must be willing to be cured, and earnestly desire it. Pars sanitatis velle sanare fuit, (Seneca). 'Tis a part of his cure to wish his own health, and not to defer it too long.

"Qui blandiendo dulce nutrivit malum,
Soro recusat ferre quod subiit jugum."

"He that by cherishing a mischief doth provoke,
Too late at last refuseth to cast off his yoke,"

"Helleborum frustra cum jam cutis ægra tumebit,
Poscentes videas; venienti occurrite morbo."

"When the skin swells, to seek it to appease
With hellebore, is vain; meet your disease."

     By this means many times, or through their ignorance in not taking notice of their grievance and danger of it, contempt, supine negligence, extenuation, wretchedness and peevishness; they undo themselves. The citizens, I know not of what city now, when rumour was brought their enemies were coming, could not abide to hear it; and when the plague begins in many places and they certainly know it, they command silence and hush it up; but after they see their foes now marching to their gates, and ready to surprise them, they begin to fortify and resist when 'tis too late; when, the sickness breaks out and can be no longer concealed, then they lament their supine negligence: 'tis no otherwise with these men. And often out of prejudice, a loathing, and distaste of physic, they had rather die, or do worse, than take any of it. "Barbarous immanity" ( Melancthon terms it) "and folly to be deplored, so to contemn the precepts of health, good remedies, and voluntarily to pull death, and many maladies upon their own heads." Though many again are in that other extreme too profuse, suspicious, and jealous of their health, too apt to take physic on every small occasion, to aggravate every slender passion, imperfection, impediment: if their finger do but ache, run, ride, send for a physician, as many gentlewomen do, that are sick, without a cause, even when they will themselves, upon every toy or small discontent, and when he comes, they make it worse than it is, by amplifying that which is not. Hier. Capivaccius sets it down as a common fault of all "melancholy persons to say their symptoms are greater than they are, to help themselves." And which Mercurialis notes, consil. 53. "to be more troublesome to their physicians, than other ordinary patients, that they may have change of physic."

     A third thing to be required in a patient, is confidence, to be of good cheer, and have sure hope that his physician can help him. Damascen the Arabian requires likewise in the physician himself, that he be confident he can cure him, otherwise his physic will not be effectual, and promise withal that he will certainly help him, make him believe so at least. Galeottus gives this reason, because the form of health is contained in the physician's mind, and as Galen, holds "confidence and hope to be more good than physic," he cures most in whom most are confident. Axiocus sick almost to death, at the very sight of Socrates recovered his former health. Paracelsus assigns it for an only cause, why Hippocrates was so fortunate in his cures, not for any extraordinary skill he had; but "because the common people had a most strong conceit of his worth." To this of confidence we may add perseverance, obedience, and constancy, not to change his physician, or dislike him upon every toy; for he that so doth (saith Janus Damascen) "or consults with many, falls into many errors; or that useth many medicines." It was a chief caveat of Seneca to his friend Lucilius, that he should not alter his physician, or prescribed physic: "Nothing hinders health more; a wound can never be cured, that hath several plasters." Crato consil. 186. taxeth all melancholy persons of this fault: "'Tis proper to them, if things fall not out to their mind, and that they have not present ease, to seek another and another;" (as they do commonly that have sore eyes) "twenty one after another, and they still promise all to cure them, try a thousand remedies; and by this means they increase their malady, make it most dangerous and difficult to be cured." "They try many" (saith Montanus) "and profit by none:" and for this cause, consil. 24. he enjoins his patient before he take him in hand, "perseverance and sufferance, for in such a small time no great matter can be effected, and upon that condition he will administer physic, otherwise all his endeavour and counsel would be to small purpose." And in his 31. counsel for a notable matron, he tells her, "if she will be cured, she must be of a most abiding patience, faithful obedience, and singular perseverance; if she remit, or despair, she can expect or hope for no good success." Consil. 230. for an Italian Abbot, he makes it one of the greatest reasons why this disease is so incurable, "because the parties are so restless, and impatient, and will therefore have him that intends to be eased," "to take physic, not for a month, a year, but to apply himself to their prescriptions all the days of his life." Last of all, it is required that the patient be not too bold to practise upon himself, without an approved physician's consent, or to try conclusions, if he read a receipt in a book; for so, many grossly mistake, and do themselves more harm than good. That which is conducing to one man, in one case, the same time is opposite to another. An ass and a mule went laden over a brook, the one with salt, the other with wool: the mule's pack was wet by chance, the salt melted, his burden the lighter, and he thereby much eased: he told the ass, who, thinking to speed as well, wet his pack likewise at the next water, but it was much the heavier, he quite tired. So one thing may be good and bad to several parties, upon diverse occasions. "Many things" (saith Penottus) "are written in our books, which seem to the reader to be excellent remedies, but they that make use of them are often deceived, and take for physic poison." I remember in Valleriola's observations, a story of one John Baptist a Neapolitan, that finding by chance a pamphlet in Italian, written in praise of hellebore, would needs adventure on himself, and took one dram for one scruple, and had not he been sent for, the poor fellow had poisoned himself. From whence he concludes out of Damascenus 2 et 3. Aphoris. "that without exquisite knowledge, to work out of books is most dangerous: how unsavoury a thing it is to believe writers, and take upon trust, as this patient perceived by his own peril." I could recite such another example of mine own knowledge, of a friend of mine, that finding a receipt in Brassivola, would needs take hellebore in substance, and try it on his own person; but had not some of his familiars come to visit him by chance, he had by his indiscretion hazarded himself: many such I have observed. These are those ordinary cautions, which I should think fit to be noted, and he that shall keep them, as Montanus saith, shall surely be much eased, if not thoroughly cured.

 

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