# Reflections upon Ancient and Modern Learning/Chapter 25

CHAP. XXV.
Of Ancient and Modern Physick.
AFter these Mathematical Sciences, it is convenient to go to those which are more properly Physical, and in our Language alone peculiarly so called. What these want in Certainty, they have made up in Usefulness: For, if Life and Health be the greatest good Things which we can enjoy here, a Conjectural Knowledge, that may but sometimes give us Relief when those are in danger, is much more valuable than a certain knowledge of other Things, which can ​only employ the Understanding, or furnish us with such Conveniencies as may be spared; since we see that several Nations which never had them lived very happily, and did very great Things in the World.
Before I begin my Comparison between Ancient and Modern Skill in Physick, it may be necessary to state the Difference between an Empirick, and a Rational Physician; and to enquire how far a Rational Physician may reason right, as to what relates to the curing of his Patient's Distemper, though his general Hypotheses be wrong, and his Theories, in themselves considered, insufficient. An Empirick is properly he who, without considering the Constitution of his Patient, the Symptoms of his Disease, or those Circumstances of his Case which arise from outward Accidents, administers such Physick as has formerly done good to some Body else that was tormented with a Disease which was called by the same Name with this that his Patient now labours under. A Rational Physician is he who critically enquires into the Constitution, and peculiar Accidents of Life, of the Person to whom he is to administer; who weighs all the known Virtues of the Medicines which may be ​thought proper to the Case in hand; who balances all the Symptoms, and, from past Observations, finds which have been fatal, and which safe; which arise from outward Accidents, and which from the Disease it self: And who thence collects, which ought soonest to be removed, which may be neglected, and which should be preserved or augmented; and thereupon prescribes accordingly.
Now it is evident, that such a Man's Prescriptions may be very valuable, because founded upon repeated Observations of the Phaenomena of all Diseases. And he may form Secondary Theories, which, like Ptolemee's Eccentricks and Epicycles, shall be good Guides to Practice; not by giving a certain Insight into the first Causes, and several Steps, by which the Disease first began, and was afterwards carried on; but by enabling the Physician to make lucky Conjectures at proper Courses, and fit Medicines, whereby to relieve or cure his Patient. And this may be equally successful, whether he resolves every Thing into Hot or Cold, Moist or Dry; into Acids, or Alkali's; into Salt, Sulphur, or Mercury; or into any Thing else. He does not know, for Instance, that Spittle, Bile, and the Pancreatick Juice, are the main Instruments of Di​gestion; yet he sees that his Patient digests his Meat with great Difficulty: He is sure that, as long as that lasts, the sick Man cannot have a good Habit of Body; he finds that the Distemper arises sometimes, though not always, from a visible Cause; and he has tried the Goodness of such and such Medicines, in seemingly parallel Cases. He may be able therefore to give very excellent Advice, though he cannot, perhaps, dive into the Nature of the Distemper so well as another Man; who having greater Anatomical Helps, and being accustomed to reason upon more certain Physiological Principles, has made a strict Enquiry into that very Case: And so by Consequence, though he cannot be said to know so much of the Essence of the Disease as that other Man, yet, perhaps, their Method of Practice, notwithstanding the great Disparity of each others Knowledge, shall be, in the main, the same.
Though all this seems very certain, yet, in the Argument before us, it is not an easie Thing to state the Question so equally, as to satisfie all contending Sides. He that looks into the Writings of the Generality of the Rational Physicians, as they called themselves, by way of Eminence; that is to say, of those who, ​about Fifty Years ago, set up Hippocrates and Galen, as the Parents and Perfecters of Medicinal Knowledge, will find, throughout all their Writings, great Contempt of every Thing that is not plainly deducible from those Texts. On the other Hand, If he dips into the Books of the Chymical Philosophers, he will meet with equal Scorn of those Books and Methods, which they, in Derision, have called Galenical. And yet it is evident, that practising Physicians of both Parties have often wrought very extraordinary Cures by their own Methods. So that there seems to have been equal Injustice of all Hands, in excluding all Methods of Cure not built upon their own Principles. Here therefore, without being positive in a Dispute, about which the Parties concerned are not themselves agreed, I shall only offer these few Things. (1.) That if the Greatness of any one particular Genius were all that was to be looked after, Hippocrates alone seems to have been the Man, whose Assertions in the Practical Part of Physick might be blindly received: For he, without the Help of any great Assistances that we know of, did that which, if it were still to do, would seem sufficient to employ the united Force of more than one Age. He was scrupulously ​exact in distinguishing Diseases, in observing the proper Symptoms of each, and taking notice of their Times and Accidents, thereby to make a Judgment how far they might be esteemed dangerous, and how far safe. Herein his particular Excellency seems to have lain; and this, in the Order of Knowledge, is the first Thing that a Rational Physician ought to make himself Master of: Which is a sure Argument that Hippocrates throughly understood what Things were necessary for him to study with the greatest Care, in order to make his Writings always useful to Posterity. (2.) That though we should allow the Methods of Practice used by the Ancients, to have been as perfect, nay, perfecter than those now in use, which some great Men have eagerly contended for; yet it does not follow, that they understood the whole Compass of their Profession so well as it is now understood; because it is absolutely impossible to form just Theories of all Diseases, so as to lay down the perfectest Methods of Cure possible, which shall be adapted to all Persons, in all Circumstances, till Anatomy and Physiology are perfectly known; and by Consequence, later Theories are always more esteemable, as they are raised upon newer Discoveries in ​Anatomy and Physiology: So that we may be sure no Ancient Theories can be so excellent as some of those which have been devised by Modern Philosophers. (3.) That if the Addition of every new Medicine be an useful Accession to the Body of Physick, then a new Method of preparing known Medicines; of making those Things profitable and noble Remedies, which before were dreaded as Poysons, or laid by as useless; and of trying such Experiments upon Bodies yet unexamined, as will soon and certainly discover some of their most principal Virtues must be of unspeakable Advantage, and make the Knowledge of those who possess such a Method justly more valuable than of those who want it. But this relates more particularly to Chymistry, of which enough has been said already. (4.) That if the Practice of proper Judges be a reasonable Prejudice for or against any Thing, then this Science has received vast Improvements of late Years: For now the Generality of Physicians acquiesce in Modern Theories, or, which in the present Dispute is all one, advance new ones upon Anatomical and Physical Principles, pursuant to those Discoveries which have been lately made. In their Practice they mix Galenical and Chymical ​Medicines together. They own that Galenical Ways of preparing Drugs, anciently made use of in the Practice of Physick, are, in many Cases, not so valuable as Chymical ones. In short, though they pay a due Respect to the Writings of the Ancients; and in those Things where they find by their own Experience, that the Ancient Observations hold, follow their Directions; yet their constant Language, and as constant Practice, whensoever one opposes Ancient Authorities to them, is, That the Ancients did very well for their Time; but that Experience, and further Light, has taught them better Things. This, I must needs own, has very great Weight with me, who am apt, cæteris paribus, to believe every Man in his own Way; Physicians especially, because their Science is entirely got by a long Series of repeated Experiments and Observations: So that it seems to be almost impossible, but that, in all such Cases, where Men have the Assistance of former Light, and where the Subject upon which they employ their Pains wanted a great deal of that Perfection, which those that study it have an Idea of, as still wanting, and can only be attained by a longer Experience, successive Ages must make great Additions to the former Stock. ​(5.) That though the noble Discoveries of these latter Ages might, possibly, be found in Hippocrates, Aristotle and Galen, yet, since no Interpreters could ever find them there, till they had been discovered anew by Modern Physicians, who followed Nature only as their Guide, these late Discoverers have an equal Right to the Glory due to such Discoveries, as the Ancients could possibly have: They both copied after the same Original; they both decyphered the same Characters, that before were unintelligible; not by reading Books, but by trying Experiments, and making Observations. And therefore Vander Linden, Almeloveen, and the rest of the Bigots for the Ancients, deal very unjustly, when they cry out, upon the Sight of any new Discovery, This Hippocrates knew, This Aristotle taught. Could these Men have made these Discoveries by studying those Ancient Authors, without the Assistance of Dr. Harvey, Asellius, Pecquet, Malpighius, or the rest? This will hold, in case these Things had really been in the Ancients: That they are not, I hope I have proved already. To which I shall only add, that former Commentators wanted neither Greek, nor Skill; and had such Things been in their Writings, they would infallibly have found them there.
​It is easie now to tell what Acquisitions have been made since Galen's Days. When Hippocrates lived, Anatomy was a rude, imperfect Thing: It has since been growing; and the Theories of all Diseases have been proportionably more compleat. Chymistry has been introduced into Physick; thereby the Materia Medica has been enlarged by some as noble Medicines as any the Ancients were acquainted with, the Nauseousness of many Medicines has been removed; and they have been made less clogging, and more efficacious, since they may be taken in lesser Quantities, and in more pleasant Vehicles; to as good, if not better purpose than before. Botanicks have been unspeakably enlarged; and thereby also the Dispensatories have been stocked with some excellent Remedies, that the old World was unacquainted with. If these Particulars be rightly stated, as they seem to be, they will go very far to decide the Question. And so I shall leave it, without determining any Thing positively about it.
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