Complete Works of Celsus, Vitruvius, Censorinus, and Frontinus

CELSUS.

is most suitable to the case at hand. The physician, therefore, in such a circumstance, discovers methods of treatment which, without being infallible, show themselves to be most often effective. He must also take counsel, not from hidden causes, since they remain wrapped in doubt and uncertainty, but from those that exploration can reach, that is to say, from evident causes. For it is important to know if it is fatigue, thirst, cold or heat, insomnia, abstinence, excess in drinking and eating, or the abuse of pleasures that gave birth to the disease. It is necessary to know, furthermore, the constitution of the patient, and to see if he is of a dry or moist constitution, weak or robust; if he is habitually well or ill, and if, when his health is disturbed, his diseases are serious or slight, short or of long duration; finally, if the life he leads is filled with work or leisure, and if his food is frugal or sophisticated. It is upon such investigations that one can often found a new treatment.

We cannot, however, pass over these considerations as if they suffered no controversy; for Erasistratus has maintained that diseases must have another origin, for the reason that different people, or the same individuals placed at different times in the indicated circumstances, have had or have not had a fever. Physicians of our day, jealous of putting forward the authority of Themison founder of the Methodic school, also maintain that there is not a single cause whose knowledge is important to practice, and that it suffices to grasp in diseases certain conditions that are common to them. These conditions are of three types: the first consists in constriction, the second in relaxation, and the third is mixed. In effect, sometimes patients do not evacuate enough and sometimes they evacuate too much, or else their evacuations, insufficient in one part, will be exaggerated in another. Diseases thus divided can be acute or chronic, become more serious, remain stationary, or decline. It is therefore necessary, when one has recognized one of these states, to keep the body relaxed if there is constriction; if there is relaxation, to bring about the contrary effect; and if the affection is of the mixed type, to provide for the most pressing malady. It is also necessary to vary the treatment according to whether the diseases are acute or chronic, whether they are in their period of growth, remain stationary, or approach their decline. For them, medicine resides in the observation of these precepts, for it is, according to their definition, only a certain manner of proceeding that the Greeks name methodos method, and whose goal is to observe the relationships of diseases among themselves. These Methodists do not wish to be confused either with the dogmatists or with the empirics; they distinguish themselves from the former in that they do not admit that conjectures about occult causes can serve as a basis for medicine, and they separate themselves from the latter because they believe that the art should not be reduced to mere experimentation. As for Erasistratus, evidence itself is contrary to his opinion, for it is rare that a disease declares itself in the absence of the causes stated above; and because they do not act on one person, it does not follow that they are without action on another, or that the very person who resisted them cannot yield to their influence later. In an individual, for example, there may exist a state of weakness or malaise that one does not observe in another, or that the same person did not have be-