Department of History
University of California, Irvine
Instructor: Dr. Barbara J. Becker
OR CERTAINE PISSEPOT LECTURES (1637)
by Thomas Brian, M.P. (c.1600-?)
Wherein are newly discovered the old
By THO. BRIAN, M.P. lately in the Citie
Never heretofore published by any man
To the Right Honourable, right Worshipfull, whether more or less dignified, who have been or hereafter may be my Patients, as also to the courteous or discourteous Reader.
Your Honour, Worship, or other Worthinesse whatsoever (good Reader) hath often heard it spoken from the mouth of many a well-read and experienced man in Physicke, That ... the Urine is an Harlot, or a Lier; and that there is no certaine knowledge of any Disease to be gathered from the Urine alone, nor any safe judgement to be exhibited by the same: You have been (likewise) often told, by Physicians, that it were farre better for the Physician to see his Patient once than to view his Urine twenty times. But yet this hath not gained so much credit with you as it ought to have done, because you see the most of them (who tell you so) to entertaine the Urine as the onely Index and discoverer of Diseases to pronounce their opinion of the sicke parties Disease by it, and to accept of being accounted skilfull in the judgement of water.
Divers learned Physicians have likewise written divers Tracts therein discovering the dangers of taking Physick prescribed onely by the sight of the Urine, to this end that they might dispossesse men of that fond opinion, of a Physicians discerning diseases by it, wherewith they have been so long time deluded. To this purpose hath Dr. Cotta written a Booke (called, A short discoverie of the unobserved dangers of severall sorts of ignorant and inconsiderate practisers of Physicke in England) wherein, amongst other Tracts of the severall abusers of Physicke, he hath written one Tractate of the Conjectours of Urines: therein shewing the falshood, and incertain judgment of Diseases by the Urine. He hath also therein set downe the ingenuous confession of a dying Physician (made to him being then present with him some three or foure dayes before his departure) who, being requested to commend unto posterity that skill by which hee had beene so much admired and esteemed, for judging women to be with childe by their Urine, made this answer. I have (saith he) long with the felicity of a good opinion exercised it, and with tryed certainty know it to be uncertainty, and certaine deceit: It is therefore unworthy posterity, and the name of Art.
Reade the tract above mentioned, and you shall see this confession further amplified. If you please to take my confession too, you shall have it: I for mine owne part have been so fortunate herein, that I have seldome failed in my predictions of determining a woman to be with childe by the Urine, as I have made them beleeve, when the messenger hath been able to certifie me of the state of the Womans body, and could answer me to certaine other questions touching other signes of conception.
Above all the rest, I was once magnified by a Counsellors wife for this cunning cozenage (I am not ashamed to terme it so) at a festivall meeting at Canterbury , in the presence of two (as I take it) other Doctours of Physicke: She told them to their faces that I was the cunningst Doctour in all the Towne, for I had told her by her water that she was with child, and just how long it was since she conceived of it. But had the woman shew'd me (that brought it) no more than the Urine did I should scarce have adventure to have pronounced her to have been with childe: Yet I might (knowing the Gentlewoman, how long it was since she had a child, and the distance that she commonly kept in childbearing, as also that she nursed her children her selfe) have prounounced her, and that upon some probable conjecture, to have beene with child, though the messenger could not have answered me to such interrogatives (as we use to demand of them before we pronounce a woman to be with childe) nor the Urine shew (as it doth not) any thing concerning conception at all. I dare say, that the good Gentlewoman is very confident that I determined her to be with childe by the sight of her Urine onely, because I did not intimate any thing to the contrary: Neither is she to be so much blamed for her credulity, as I for my jugling.
But to make her and other good women amends (whom I have thus beguil'd) I have in this ensuing Tract set downe the fallacies, by which I judged her, and every other Physician doth judge every other woman to be with childe; as also, by which we give judgement of the Disease, Sex, and the like, seeming to doe it onely by the Urine: which have not heretofore beene published (though too much practized of most) by any man in the English tongue.
Doctour Hart (in his Booke intituled The Anatomie of Urines ) hath by sufficient argument and demonstration, confused the Pisse-Canons, or Conjectures of Urines, taken from the severall accidents of the same (as the severall colours, parts, contents, substance, quantity, smell) and shewed their falsehood in all these, and the many absurdities that have been committed by pretending knowledge of Diseases by all these; I thought it likewise fit to set downe the fallacies, by which judgement of Diseases is given by the Urine, to the end that the writings of other men (who have written against this base custome of water-prophesying) may gaine the more credit, and for the further satisfaction of such as yet remaine doubtfull whether there be any judgement to be taken from the Urine sufficient to determine the disease.
To this end therefore I have set downe the fallacies which have upheld this custome of prating, and predicating strange things by the Urine: And I have pen'd them in the English tongue, because that meere Englishmen (I meane the common people) who understand English only, are and ever have ben most subject to be deceived and deluded. I hope therefore that no Artist will be offended hereat, for I dare say that there is no igenuous man, but is of mine opinion, and would as gladly (as I myselfe) that this base custome, of lecturing upon the Urine, were overthrowne and abrogated.
What I have therefore done to this purpose, I intreat the courteous Reader to accept in as good part, as I have been willing to impart the same: And for as much as I have been guilty of this fraud, though I have not long used it, let it suffice that it repenteth me of the same, for I meane never hereafter to shew my cunning, or rather cozening, upon the water, and hope that other men will helpe to beate down this custome, or else all that I have written will be to little purpose. However it will some thing delight the understanding and impartiall Reader, and might profit the ignorant, if they would make use of it to that end for which it was penn'd.
As for the stile, and method of it, it is poore and meane; but such as best sutes with such a poore, base, and stinking subject. I have been enforced a little beyond my own nature, and disposition, to bee somewhat youthfull in lecturing upon the Urine, for which cause I may incurre censure of the graver and more modest people: If I have herein offended, I crave their pardon, for I could not well avoid it: And let them not taxe me of levity, or Lasciviousnesse, for my life and conversation hath, and shall for ever testifie the contrary.
Howbeit I can claime no priviledge from backbiters, nor immunity from malignant tongues; I refuse to be tryed by a prejudicate opinion, or the malignant spirit of contradiction; and appeale unto the learned, judicious, and impartiall Reader, to whom (if I have erred) for it is Humanum errare) I submit for censure; if need be, for correction. And for as much as (I feare) that the greatest detractours that I shall finde (though it be an old saying that the Arts ... have no enemy but the ignorant man) are offenders in this kinde; I admonish you (brother Pisse-Prophet) that you be not too busie in playing the Criticke upon mee, because I have (in confessing mine owne folly) reproved your wickednesse, which you will hardly forsake.
As for the censure of the ignorant (whom you help to retain in this prejudicate opinion) I regard it not.
...I passe by these barking Curres (as the Lion doth) with disdaine. But if you kick (whose gall'd back I have rub'd, and whose sore I have lanced) who are conscious to your selfe of your owne guiltinesse herein, I shall rub harder and lance deeper: and yet (if you kick over-much) I shall finde a Lash to quiet you. I pray therefore let me have your good word, lest you need mine. And so in hope that the learned, judicious, and impartiall Reader will pardon my errours, and that the ignorant Reader will become wiser, and that the delinquent Reader will become honester, I rest
Wherein is shew'd the errour of the common people (who thinke that Diseases are to be discerned by the Urine) and the fallacies of the Physician, who intimate the same unto them: As also, what is to be considered of the Physician before he pronounce his judgement of an Urine.
The vulgar sort are so strongly prepossest (by reason of their ignorance) that Physicians can discerne (by the Urine) the Disease, the conception, the sexe, the parties age, with many other such absurdities that I feare it will bee an hard matter to dispossesse them of that opinion. And Physicians (the more too blame they) have intimated and pretended this knowledge unto them so farre, as that they will hardly acknowledge their errours, and relinquish this basery. But when it shall appeare that the Urine is altogether deceitfull, and the Physician (that pretendeth knowledge of Diseases thereby) to give his judgement of it by such fallacies and jugling as shall be shewed and set forth by me in this ensuing Discourse: Let the ignorant choose whether he will believe his lying oracle or no, and let the Physician choose whether hee will be honester than to use such deceit.
Yet (I hope) the one will blush to have been so deluded, and the other to have his conjecturing discovered. And now mee thinks you long to heare how it is (the Urine giving no certaine knowledge of any Disease in the world) that Pisse-mongers (for they deserve not the name of a Physician that pretend knowledge of Diseases by it) doe give judgement of it, and make thee beleeve that they discerne Diseases by it, than the which nothing in the world is more false.
But would you so faine know how this can be? Why thus it is, for I will now hold you no longer in expectation; I must therefore give unto your speciall consideration two things, (and then I will descend to all the particular Quillets and fallacies that deceive the ignorant) used in the contemplation and beholding of an Urine, which make a man presume to give judgement of Diseases by it.
Observe now with me, that the two things to be considered are these; namely, that Diseases are either acute, sharpe, and violent, as the Plurisie, Peripneumonia (which is the Apostumation, and inflamation of the Lungs) the Phrenzie, Iliaca Passio, the small Pox, Pestilence, and every sharp Fever; Or else diseases they are Chronicall (that is of continuance) and lingring, such as proceed from the ill temperature of the humours and disposition of the constitution of the body, such as are the Consumption, Dropsie, Melancholy, Gout, Palsie, Falling-Sicknesse, Chachexia (which is a depravation of the humours of the body, whereby it taketh away, in man or woman, the appetite for meat, makes the body unfit for exercise, and marres the livelinesse of the spirits and countenance) and this disease in women is commonly called the Greene-Sicknesse, and it makes both men and women Greene indeed.
But (to omit all circumstances that may be) the Physician alwayes beares these two considerations in minde, namely, that diseases are either Acute, Sharpe, and Violent, or Chronicall, and of continuance, and more gentle, as aforesaid, &c.
Now, for the most part, the common sort of people come or send their Waters unto Physicians for Acute, Sharpe, and Violent diseases: as the Countrey-man or Handycrafts-man (who use to labour) for some Surfet (as they call it) taken by catching cold (as they thinke) after sweating at their severall labours, and your better sort of people (as they thinke themselves, because they use no labour) for a Surfet taken by idlenesse, as sitting in the Sunne, walking, sporting, drinking of Wine, eating over-much, or such meate as their stomach hath not well digested, and the like.
You must likewise note, that every sharpe disease hath an hot and burning Fever joyned with it, and that the Urine (for the most part) in a burning Fever, is of an intense high red colour; and this colour, amongst all the other uncertain signes of Urine (which seeme to shew a disease, to put a difference betweene sharpe and Chronicall diseases and to discover a Fever only) is the most certaine of all other, and yet uncertaine in it selfe.
Such a Urine being brought unto a Physician to cast (as they call it) and being of a red high colour (as I said before) he presently conceives it to be a sharpe and violent disease, and then knowes for certaine, that there is a Fever joyned with it; so he is now quickly prepared to give his judgement of it, and needs now to doe no more, but to give a description of a Fever, to make the messenger beleeve that he perceives the disease in the Water; but yet he comes to the true knowledge of the disease, by some such parly and expostulation had with the messenger, as shewes the symptomes and affects of the sick partie (though he seeme to have named them in the description of the disease to the messenger) which truly determine the disease: and then he names the disease, looking upon the Water (as if it were there to be found) in such manner as shall be hereafter shewed; which makes the messenger beleeve so indeed.
Now the description of a Fever (and indeed one description will serve for any Fever, and for all sharpe and violent diseases) is but to reckon up the Symptomes and signes of a Fever (the which we know before that ever we looke upon the Water) which are these: namely, great oppression of the stomach by choler, or some other humour, which causeth want of appetite to meat; oppilation and obstruction of the liver and spleene, causing great heat (which causeth great drought, and much desire of drinke) causing great paine in the head and backe, which likewise causeth want of sleepe and rest, from whence proceedeth (oftentimes) raving, franticke doting, senseless and idle talke.
Now to say that the sicke party is thus affected (for indeed so they are for the most part in every respect, but at the least in some kinde, in every violent disease) makes the messenger to thinke, that the Doctour doth perceive (that the partie is so affected) by the Urine, which (by Yea and by Nay) is no such matter: for he dares not alway trust to this high red Urine, as an infallible signe of a Fever; for it may chance to be of such a colour by some other accident, when the partie that made it, is free from a Fever.
But admit that the high red colour of the Urine did alway (as it doth for the most part) import a Fever, yet the Symptomes and companions of a Fever (as heat, drought, thirst, paine in the head, want of sleepe, oppression of stomach, want of appetite, oppilation of the liver and spleene, or any one of these) are not therein to be seene, though it please his worship to play the Anticke with the Water, pretending that there are such marks in it, as shew all these things that I have named.
Neither doth he presume to name these Symptomes (as heat, drought, thirst, &c.) from any signes thereof in the Urine, but for that he knoweth by dayly experience, that the fore-named Symptomes and companions of a Fever (as heat, drought, thirst, &c.) are necessarie consequences, and inseparable concomitants of a Fever: And yet (oh the pride of man, in seeming to be what he is not!) the Pisse-Prophet doth pretend, that he perceiveth all these things in the Water.
These things being premised, I hope thou wilt be the better able to judge of that which followeth, and perceive how easie a thing it is to give judgement of diseases by the Urine (though it be not there to be seene) and wilt conceive the fallacies that uphold this custome, and so learne to put a difference betweene an honest learned plaine-dealing Physician and a prating Empirick, and a Rogue. I will now (for this once) imagine my selfe to be one of them, and to be in my Chamber or Study ready addressed to come forth, to give my judgement upon that high red Water (that importeth a Fever, and so a violent disease) that I last spake of, and will plainely shew you (by the examination of three such severall Urines, brought by three severall messengers) in three severall Chapters, how to give judgement of all acute, sharpe, and violent diseases, by the last description of the Symptomes of a burning Fever.
What manner of persons your Pisse-messengers are, how they are handled, deluded, and made to shew how the sicke partie is affected, and yet to beleeve that the Doctour perceiveth the Disease by the Urine.
I have here already such a Messenger (attending my leisure to give my judgement upon such a Urine) who, being conducted to my presence, salutes my worship with good morrow Master Doctour, and indeed the morning is the most usuall and fit time for the viewing of Urines: The Queane at Darkin hath gotten that Art, that she would not prophesie thereof after eleven of the clocke: And having thus saluted me, presents me the Urine, saying, Sir I desire your opinion of this water, and to tell me (though the sick partie know that too too well already) what the partie styleth, and what the Disease is; and the messenger (whether man or woman) you must note, is one who is, as it were, made out of waxe, whom a Physician cannot deceive (neither would hee if he could) nor yet learne anything out of him couching the Disease, unlesse hee himselfe first have named it, and yet hee will make a shift to mould him into any forme that shall fit his purpose best, and make him by impertinent questions (as he shall thinke) to tell him any thing, concerning the sicke partie, that hee shall desire to know, and yet (like Hocus Pocus who makes his ignorant spectatours to thinke that the Balls are under the Cups, though hee have conveyed them away by sleight of hand, and when they see that, to deeme him a Conjurer) to thinke that he hath discovered nothing, and me to be a skilfull Physitian and an honest man, when as indeed there is no such matter; for neither is Hocus Pocus a Conjurer, though by his nimble conveyance he have deluded his silly beholder, or so much a knave as they thinke him, because he hath not done it by any unlawfull assistance; neither am I so skilfull a Physitian, though I have made the messenger beleeve that I perceive strange things by the Water, because I doe but deceive the messenger; nor so honest a man as I am esteeemed, though I carry the matter very faire, because I doe not ingenuously confesse to the messenger, and so to every body else when I shall have occasion to discourse about it, that there is no certaine judgement of any disease by the Urine but out of pride pretend knowledge of diseases by it, and to backe this knowledge blush not to use such deceit and fallacies as hereafter follow.
But now to returne to the Urine from the Physician and the fool, the Messenger: This Urine brought out of the Countrie, is for the most part in a glasse-bottle, but (if ones in the City) it brought in an Urinall; it is likewise red and high of colour, and that (for the most part) betokeneth a Fever.
I now therefore (before that ever I can poure the water out of the bottle, or take the Urinall out of the Case) rip up all the Symptomes of a Fever, and say, This partie hath a great oppression of stomach and no appetite to meat, a great oppilation and obstruction of the Liver and Spleene, is very hot and dry, desireth much to drinke, hath a great paine in the head and can take no rest, and was taken in the manner of an Ague with a grooving in the backe and paine in the head, first cold and then hot, reckning up all these things (as if I saw them there so soone as ever I looke into the water) so fast as ever I can make my tongue belie my heart.
And with this description I have made the messenger admire my readinesse and skill in judging of Urines, and he verily beleeves that I have espied these things in the water; but it is farre otherwise; for these things (that I have reckoned up) are but the usuall Symptomes and companions of a Fever, and the most of them are joyned with every Fever and all of them and many moe at once are complicate with many a Fever.
These things being so, I cannot but have hit the nayle on the head, for some of those Symptomes that I have reckoned up, must needs accompany the disease; and when I have once named them, the messenger presently answers, that the partie is just so affected as I have said: But (as yet) I have not named the disease, and perhaps omitted something which is expected that I should have named: and the messenger is as ready then to aske me if I perceive nothing else by the water, as I was to pronounce my judgment of it before: To whom I answere, yes if you will give me leave to tell you; and then perchance askes me if I doe not perceive a stitch, and whether the party have not a Plurisie, I answer (looking upon the water as if it were there to be perceived) yes I well perceive the stitch, and some cough too; and I say, that when the cough takes the partie, the partie is much pained in the side; and for as much as I did not name the stitch at first, I tell the messenger that we use first to declare the cause of the disease before we come to every passion or affect of the disease, or before we name it: I further adde that I was not yet come to speake of the stitch (no nor should never have found it out of the water, had not the messenger bolted it out) because I had named the cause therof, namely, the oppression of the stomach and obstruction of the Spleene, and mesentery, and that the stitch was nothing else but a flatuous and windie humour proceeding from thence to the place affected; so now I determine the disease to be (as they suppose) a Plurisie; And indeed they can better define their owne diseases by the Symptomes and passions that they suffer than any Physician can doe by the water onely.
But now as I have been happy in my predictions of the disease, and rightely determined it to be (as it is indeed) a Plurisie; so now I must proceed to the prescription (as it is required) of such remedies as may cure this Plurisie: And now I am here as farre to seeke (though I know the disease to be a Plurisie) as if I knew not the disease at all, not had seen the Urine, because I doe not therein perceive the scope and grounds of prescribing fit remedies (according to the rules of Art) in every respect proper to the disease; The which scope and grounds are these (namely) the parties age, the sexe, the constitution of the body, and the strength of it at this time, with divers other accidents, as whether the party be bound in his body, or have a flux and scouring, or the like: All the which nor any one of them can be discerned by the Urine, & yet I must finde them there if the messenger refuse to tell me (but that they seldome refuse to doe after that I have given them a description of the disease, and shewed them in some part how the partie is affected) or else I must needs erre in my prescription; for if I should prescribe (not knowing the age of the partie) such a quantitie of blood to be taken away from a young youth (suppose ten or twelve ounces) in a Pluresie, which is the disease in hand, as should be taken from a man in his full strength, the partie might perish thereby; or if I should take but foure or five ounces of blood from a lusty young man (in this disease) at his full strength, I should doe him no good, and so he might perish on the other side: I might likewise erre in the dose, if (not knowing the parties age) I should prescribe more or lesse than were proportionable to the parties age in prescribing purging Potions or Clysters in this case; I might likewise commit no less errour if (not knowing the sexe) I should in the aforenamed disease prescribe blood-letting to a woman, her naturall courses being broke forth upon her; for I might by that accident expect a solution of the disease without blood-letting.
I might likewise erre, if (knowing the sexe) I should prescribe purging Physicke for a woman in this case (not knowing whether she be with child or no) of such a quality as might cause her to miscarry: I might erre concerning the constitution of body which were fitter for a robustuous and strong constitution: and so on the contrary.
I might likewise erre if I should (not knowing the strength of the body at this time) prescribe too strong a Potion, or too much blood to be taken away, when the disease hath overcome the strength and the partie is too much debilitated, or if I should prescribe too gentle a potion, or too little blood to be taken away when the strength is not yet dejected, but stands in equall contestation with the disease.
I could shew a thousand wayes more how I could erre, and how most Physitians doe erre that prescribe Physicke by the sight of the Urine only: But my intent is to shew how many thousand wayes I could deceive thee and make thee beleeve that I discerne all these things by the Urine (as you thinkst I do) namely the disease, the parties age, sexe, strength, constitution of body, and the like: I have therefore digressed herein from my purpose (since my intent was not to shew the errors that are committed by such as pretend knowledge of diseases by the Urine, but to shew the fallacies and jugling that they use in giving judgment of it) and so frustrated thy expectation of this dainty Art; but I hope it shall be to thy profit, for thou shalt hereby be the better able to give thy Physitian such instructions as he shall require, and shalt perceive the danger of taking Physick prescribed by the sight of the Urine only: And now to the purpose indeed; but first imagine with me, that the last messenger, having received good satisfaction by the description of the parties disease for whom he came, was ready to certifie me of all the forenamed circumstances that were requisite for me to inquire of, as the parties age, sexe, constitution of body, present strength, how long the partie had been sicke, &c.
And I have sent him away with such remedies as were most proper for his Pleurisie, directions for blood-letting to mitigate his Fever, some pectorall Physick to ease his cough, with a Liniment to mollifie, and to dispell wind, to anoynt his side withall for his stitch, and with him to repaire unto me again within a day or two to certifie me of the successe of the Physicke, and how the partie stands now affected, that if need require, I may supply him with further advise.
Now in all this (I hope) I have not erred, save only that I forgot to tell the messenger that the partie was very dangerously sicke, and would hardly recover, but yet I have prescribed him the best meanes that can, by the art of man, be for his recoverie, and I pray God to give his blessing, and so I have quite dispatched this messenger. And now whether the partie live or dye I shall be sure to be magnified for my skill; if he die, for that my predictions prove true; and if he live, for that I recovered him of so dangerous a disease.
And now I am ready to encounter with the next messenger, who likewise brings me another Urine of a high red colour, in giving judgement upon which I will plainely shew how a man may give judgement of all other sharpe and violent diseases by the water (though it doe not certainely shew any Symptomes of any disease, which determine the same) and how thou shalt get out of the messenger every circumstance necessary to the judging and determining of a disease, as the age, sexe, and strength of the partie, and to the guiding of a man in prescribing of fit remedies, and yet he shall not perceive but that thou findest them in the Urine;... but this is to juggle, and not to judge.
The craftiest messengers must be the more craftily handled: the action and gesture of the Physician in giving judgement of an Urine: that we come to the knowledge of the disease, and sex by impertinent questions (as they thinke) put to the messengers, and not by the Urine: the cunning tricks that Physicians have to make the messengers confident of their (falsly) pretended skill; and the flammes that they have to evade consure, if they chance to erre in the pronouncing of their judgement.
Suppose this next messenger to be some Nurse or tender of sick persons, who is commonly versed, and accustomed in carrying sick folks Urines unto Physicians; and she salute me, with Master Doctor, I have brought you a Water, and desire your opinion of it: and now I am like to have a hard taske of it, and to be so put to my trumps, that (if I play not my cards sure) I shall lose the set, miscarry in my judgement, be accounted a dunce, and lose my patient for ever; but I will be aware of that, I warrant you. I now therefore take this crafty wench to doe, and I will handle her as craftily; I take the Urinall of her, and bid her come from the doore of my Parlour, Study, or Chamber (where they commonly stand,) unto the window, or light, where I commonly give my oracle; and indeed, a man had need of a good light, and a better sight, that shall perceive all these things that I must find out of this Urine.
Being come to the light (as I am uncasing the Urinall to looke upon it,) I aske the Nurse a question, not whose water it is (for that she is enjoyned, nay conjured, not to tell me, especially if it be a womans, nor any thing else, unlesse I first find it out of the water) but my question is; How long the party hath beene sick; And she out of modesty and good manners, can doe no lesse but answer me to this question, for she thinkes this question to be but words of course, and that I can gather nothing from hence touching the parties disease; and so she answeres me a weeke, a forthnight, two or three dayes, or more, or lesse.
But from hence I collect and have strong presumptions that it is an acute disease; and if she say, A forthnight, I shall thinke it to be only an acute disease and of the lesse danger, unlesse there have another Physician beene imployed already, the which I shall be sure to know, and if there have, I shall go neere to strike his nose out of joynt, and gaine the patient to my selfe, and then (if I recover him) I shall get immortall fame; but if he chance to die, I will make a shift to shuffle off the disgrace upon my brother Doctor, for that (as I will say) such and such meanes were not used at the first, though haply he have used as good a medthode as my selfe could have done: But if she say that the party hath beene sick a weeke, I shall thinke it is a more acute disease, whether there have another Physician beene imployed or no.
But if she say three or foure dayes, I then presume that it is a most sharpe disease, and now I will so plant and interest my selfe in the party, as that I will prevent anothers comming there, unlesse it be to a person of quality, and then I will be as ready to desire another Physician to be called, as the sick party shall be to request it, not so much that I desire his aide, or would have him partake with me in the booty, as in the disgrace, if the party should chance to die.
And now I know (by this question, as also the Water, being high and red, witnessing the same) that it is an Acute disease: And now I take the Urinall in my hand, and hold it up to the light, and (looking very little upon it) I shake it together, and set it downe very artificially in the window asloop, as if I meant to inquire further of it anone, and that it must stand so a while; and indeed it must stand so a while, and I must looke but lightly upon it at first, or else I shall not have so good an evasion if I erre never so litle, nor so fit an opportunity to propound another question to the setting me forward in the pronouncing of my opinion, or to the inquiry of some other circumstance (necessary to the guiding me in prescribing fit remedies) as the parties Age, Sexe, Strength, and the like, for this wench will be sure to hold me to my text.
And now go along with me still, and conceive with me that it is a sharp disease (as appeareth by her answer) and that I have no sooner asked her how long the party hath beene sick, and set downe the Urinall in the window (as I said before) but that I presently say, This party hath a great oppression of Stomach, no appetite to meate, with a great oppilation of the Liver and Spleene, is very hot, desireth much to drinke, hath a great paine in the head, and can take no rest, and was taken in the manner of an Ague (as they call it) with a grooving in the backe, and paine in the head, first cold and then hot, as I said in giving my judgement upon the last Urine; and indeed this description will serve for any acute disease, whether it be the Pleurisie, the small Pox or Maisels, a fit of the stone in the Kidneis, the Squinancy, Phrensie, Iliaca Passio, the Arthritis, or what other sharp disease soever, wherewith there is a Fever alwayes complicate, or whether it be a simple Fever which is primarily the disease it selfe; but yet I will not alwayes use the same description to all commers, because divers messengers may come to a Physician, and may stay for companies sake to goe away together, and might fall to questioning with each other what the Doctour said unto them, and so might thinke (if I should use the same description unto them all) that I could say nothing else.
I therefore vary my description of the disease, and am sometimes shorter in the same, and then (if I find by expostulation with the messenger that I have omitted any thing that I should have spoken of) I say that it proceeded from such a cause as I had already named, and that I should have come to speake of that anon; I am sometimes likewise larger in my description, as I am here in relating how the party is affected, for whom this Nurse comes: and she is as ready to take me up for the same, and sayes, that it is true indeed, that the party can take no rest, hath no appetite to meate, and was taken (as I said) in the manner of an Ague, but complaines not of her stomach at all, but cries out, My head, my head, and complaines altogether of want of rest; To whom I reply, that the paine in the head is the chiefe of the passions that the party is affected withall, but yet that it proceeded from the oppression of the stomach, and oppilation of the Liver and Spleene, which being obstructed, send a cholericke fume unto the braine, which inflame the Animall spirits, and cause this paine which hindred rest, and that (if rest were not caused) it would make the party rave, be franticke, and burst forth into senseless, and idle talke.
Thus having answered this objection, I now beign to touch the Urinall, to see if it have setled enough, but finding it not to have setled enough to my purpose, and to shew me those things that I must finde out of it, I set it downe againe very tenderly, saying, it must yet settle a little better; and then I fall to questioning with the Nurse concerning something that may shew me the sexe, for I must find that out of the water too; and now I aske her, what the party useth to doe in the time of health, and this is a question that may (she thinkes) as well be answered without giving me any light of the sexe, as the former question (which was, How long the party had beene sicke) of giving me any light of the disease; but you shall heare what I collect from thence.
She answers, I demanding what the party useth to do, that the party useth to do little, save onely to goe up and downe the house, to worke about the home, to walke up and downe abroad, to keep a shope, to labour, or the like; and from all these I have my several collections.
Now if she say, that the party useth to doe little, I presume that it is the Mistresses of the house, or the good-wifes, or one of their daughters, or some Gentlewoman in the house, but for certaine, that it is a womans water, or a maides, for they should, and commonly doe (if their shooes be not made of running leather) keepe their house, and their worke is to walke up and down the house; but if she say the party useth to doe such worke as is to be done in or about the house, it is most likely that it is a maid-servant, but if she say to walke abroad, I then presume that it is a mans water, and that it may be Master of the house, or his sonnes, or some other Gentlemans, whose worke and imployment is onely to walke abroad and take his pleasure; but if she say, to keepe a shop, I suppose it to be the Masters thereof, or an he Apprentice his; or if she say, that the party useth to labour, I imagine it to be a man-servant, or some hired labouring mans; so by her answer to this question, namely, what the party useth to doe in the time of health, I discerne the sexe.
And now I take the Urinall againe in my hand (for by this time it hath stood long enongh [sic] to settle) and now I say that it is a womans water, suppose that her answer to my question (What the party used to doe in the time of health) did inferred as much, that she hath a burning Fever, is so dangerously sicke that she will hardly recover, unlesse such and such speedy meanes be used, and yet that All will scarce doe; and this danger I will alwayes pretend in every Violent disease, though there be no deadly signe at all; but not to the sicke parties (for that they cannot indure to heare of) but secretly to the messenger, or some neere friend, or by-stander, if I be present with them; and then if the party live, I shall not so much as have my judgement called in question, for saying the party would die, but be magnified for that I have recovered her of a dangerous disease; nay, to be sure to be happy in my predictions and prognosticks concerning the life and death of my Patients (for they must alwayes have a hint of that, although the thought of death be an unwelcome guest) I will deliver mine opinion both wayes; I will threaten, or rather pretend the danger of death to the sicke party (if my opinion be desired,) with a But if such and such meanes be used, you may haply recover: and to some by-stander or hanger on, I will secretly whisper that there is no danger at all: or else I will promise life to the Patient, which is altogether wished, and threaten death to some other inquisitour: and thus was a learned Doctour in Physicke over-matched by a meaner Practicant in Physicke, at Ashford in Kent who used this policy in his prognosticks.
I have for mine owne part and office, herein delivered my selfe well enough to this Nurse in my prognosticks concerning the event of the womans sicknesse, for whom she is come: I have told her how the woman is affected, what the disease is, and what will be the event; and the Nurse is reasonable well satisfied herewith, but yet I have omitted something, that she will be sure to tell me of, for since she hath undertaken the matter, she will not goe without her errand.
So, now she asks me if I perceive nothing else by the water, and I imagine well enough what it is else that I should perceive by it, for when that question is propounded, it is to know whether the woman be with child or no: to whom I answer that there are many moe things to be perceived by the water (but not at all times) as whether a woman were with child or no, which is that you looke for; but it is not now to be seene in this water, because her body is all out of temper, and her water troubled and discoloured, but yet I thinke her to be, and well I may, if she her selfe thinke so; I further tell her, that I could have certainely told, (but yet I lie,) if she had brought her water in the time of her health: and so she is satisfied for that matter, and confesseth that she is with child indeed. Having thus satisfied her in all these things, told her that it is a womans water, in what manner she was sicke, what was her disease, that it was likely that she was with child (which proves true) and that she would scarce recover (which is no great matter whether she doe or no) I now begin to close with her and aske her whose water it is; but she will not tell me, and I commend her for it, for she was forbid, and therefore hath vowed the contrary; and indeed she was sent onely to heare mine opinion of the water, the which, if she like, shall haply heare further from the party, but if not, she hath order to goe to another Pisse-Prophet, and so if she like not his opinion neither, from him to another, untill she come to him that hits the disease rightest (as she conceives) by the water, and he (I daresay, the most foole and knave of all the three) is the man that shall be made chose of to cure this woman; and this is thought great policy in making choice of an able Physician.
It behooves me therefore to be my crafts master in this Art, for else you see here how I am like to be nosed of a Patient, and to have my skill call'd in question; for (if I cannot finde the disease by the water) they will soone conclude that I know not how to cure it. This nurse tells me indeed (but if she had not told me, I should have perceived it) that she came to heare mine opinion of the water, and that the sicke party would send to me againe, when she had heard (she should have said, If she liked it) what was mine opinion, and I thinke I have fitted her, and now tell the Nurse, that it had been fitter they had sent for some present remedies, than to know the disease, or to heare mine opinion of it, so I hast her away with her oracle, bid her to be sure to deliver it so as I had told her, and tell (but not to the sicke party) to some of her neere friends, how dangerously she is sicke, and that I would (if she thinke good to make use of me) use the best meanes to recover her that Art could lead me unto; and now I bid her make all the hast that may be, but yet (before I let her goe) I thus bespeake her; in faith Nurse, I commend thee that thou wilt doe they errand handsomely, and make a Physician finde the disease out of the water, and not be gull'd (to tell how the party was affected) as many a foole would have done, but I hope I have shewed thee truly how the party is affected, and what is her disease, and given thee such satisfaction as will content them that sent thee: loe therefore here is for thy paines, because thou hast put me to it so handsomely, and so I give her, (fearing lest I should have erred, that she may maintaine my credit, and in hope of receiving a better fee, for being sent for) the crackd groat, or the Harry groat that was sent in stead of sixe pence, for casting this water; nay, if it chance to be sixe pence indeed, she shall have it all, and so I shall be sure to have my message well done, and perhaps she will tell me that which she denied before; but if not, she will magnifie me for my skill, and I shall be sure to heare further from the party, and have the casting of all the waters that she can bring me; so I now send her away and laugh at her, and the Devill at us both: I laugh at her because I have cozend her, and the Devill, that he hath cozend us both, by making her to believe that I discerne all those things by the water that I told her, and making me to back my pretended knowledge by such fallacies.
But doe not now imagine that I have been so long in hand with this Nurse, in giving judgement of this Urine, as I have been in penning the circumstances with the several actions and gestures that I use in the examination of a Pisse pot, which I have set downe to helpe thy understanding, or so long as thou hast been in reading them; but that (as if she had been but now new come in) I take the Urinall of her, propound the first question, set downe the Urinall in the window, and pronounce a description of the disease: then propounding the other questions in order (as I have done before) I define or determine the disease, tell her that such and such meanes ought suddainly to be used, and so send her away; suppose therefore that she came but newly in, and is but now new gone out, and so I have done with her, and sent her away in a trice, and am ready for the next commer.
But stay here a little, let that messenger tary, and conceive with me how one may give his judgement of any sharpe disease by the water, (though it be not there to be seene,) in pronouncing my judgement upon this last Urine, for I cannot stand to instance upon many particulars: marke therefore the description that I gave to the Nurse of the last disease, which I determined to be a Fever, after that I perceived by the Nurses answer to my first question (which was, how long the party had been sicke) that it was a sharpe disease; now my description was this: that the party had a great oppression of stomach and no appetite to meate, a great oppilation of the Liver and Spleene, was very hot, desired much to drinke, had a great paine in the head, and could take no rest, and was taken in the manner of an Ague with a paine in the head, and grooving in the backe, first cold and then hot, the which description may serve for any sharpe disease in giving judgement of a water; yet I doe not affirme, that in every sharpe disease the party is just thus affected in every respect, but for the most part, for if it chance to faile and be excepted against, I have shewed how to make it good to the messenger, and to serve the turne to satisfie him, and not the Physician and practicant in Physicke.
Marke further, that in describing the disease, and shewing how the party is affected, I doe not yet define, determine, or name the disease, till I have expostulated with the messenger so farre, that I perceive the disease from thence, and have sounded enough out of him, to tell him any thing that he shall desire to know of me; and then I determine the disease to be (as the symptomes, when I have strictly examined them, shall agree with the messengers relation.)
A Fever, the small Pox, or Maisels, a Pleurisie, or the like, looking still upon the Urine, as if I found it there, whereas I hope you well perceive my fetches, which helpe me out, or else Dun might have stucke full fast in the mire.
I hope also, that you perceive how easily a man may give his judgement of any other acute disease by the water, though it doe not shew it; and now a word or two with this other messenger, and then I shall have done with acute, sharpe, and violent diseases.
The rude simplicity of such as send their Urine unto a Physician without any instructions how the party is affected: And the desperate hazzard, that they put their lives in, who adventure to take Physicke prescribed only by the sight of the Urine.
Now this messenger is as rough-hewed as he that sent him, and is a very plain fellow in his holy-day Jacket and his busking Hose; he was call'd from making of Faggots, or from thrashing, to goe to the Doctour and carry this Pisse that is put up in the Vinegar bottle, and brought to me to judge of; and it is a very turbid water of a very high, darke, red colour, by which as also by the messenger, (for I can better tell, by the messenger, his gesture, time of coming, haste to be gone, and other circumstances, what the partie ayleth, how long he hath beene sicke, and whether it be a mans or womans water, than I or any Physician can doe by the Urine, especially if I lived in a Towne or Citie where I had much Country practice) I conceive it to be some Countrie Farmers, his sonnes, or mans, his Hubber de boy which is his man-boy, or halfe a man and halfe a boy: But which of them soever it be, hee hath borne it out with head and shoulders (for so your Country people use to doe before they send to a Doctour) and wrastled so long with the disease, and been so often foyled out, for they doe not observe the orders in Moore or Lincolns-Inne fields, where if a man be three times foyled out, it is to stand for a fall, and he is to wrastle no more for that time, as that he can no longer stand, and yet he is to have one bout more with the disease who hath a cruell second in this Duell, even death it selfe: And now (if nature be not assisted by Art) this fellow, whose second I must be, is like to be put to the worst, and the disease is like to give him a flat fall upon his backe in his Grave, never to rise againe untill the resurrection.
Therefore if I have any skill, I must shew it now or never: I now therefore take the water to examine it, and thinke to question with this messenger (as with the former) How long the partie hath been sicke, whose water it was, and to put him such other questions as might shew me such other circumstances which might shew mee the disease, and guide me in the prescribing fit remedies for the same; but he cannot answer mee one question, not whose water it is, nor how long the party hath been sicke, no nor whether it be a mans or a womans water; much lesse the constitution of the body, the present strength of it at this time, or whether the partie be bound or loose in his body, with divers other such circumstances, all the which are so necessary for me to know, as that without the knowledge thereof I cannot safely prescribe any Physicke, and yet this fellow cannot tell me one word, for he saith that he was not told, but was onely hired to bring me the water, and to bid me send something to help the partie, and hath brought eighteene pence or two shillings with him to pay for that which I shall prescribe or send; and all that he can say, is, that such a mans servant came to him to get him to come, but did not tell him whose water it was, nor how long the partie had beene sicke.
And now what, on Gods Name, shall I doe in this case, for it is presumed that I know the disease by the water, and all other circumstances belonging to the same, which are requisite for to guide me in the prescribing of fit remedies, and I have pretended as much, and holpen to nurse up folkes in this folly, (as other Physicians have done before mee) by giving my judgement of diseases by the sight of the Urine, and backing my pretended knowledge by such fallacies as I have spoken of, without the which neither I nor any Physician in the world can give any judgement of a disease, nor come to the kowledege of such circumstances (unlesse the messenger, that brings it, tell us) as may guide us in the prescribing of safe medicines every way proper unto the disease.
I must tell you therefore (for mine own part) that I have already, and doe for ever hereafter meane to steere a new course; yet I must, for this one time, prescribe for this fellow, who (being all this while out of breath with his last Arthleticke combate, and having caught such a wrinch, (though he played strong play, as that he will goe neere to fall the next bout) is expected to enter the sands, to revive the quarrell, and to undertake the last encounter.
I now therefore take the Urinall (since the messenger can tell me nothing) and looke better upon the water, as if I could tell miracles by it, for I must now make all the haste that may be to set him on foot, since he is so earnestly expected by his adversarie: Now looking upon the water, I perceive it to be very crasse, thicke, and turbid, in all places alike, of an intense, high, darke, red colour; and from thence I conceive, that according to the fopperous Pisse-maximes, and rules of our great Pisse-prognosticatours, there is a great commixture of superabundant humours, which the substance of it (as they say) being crasse, thicke, and turbid, sheweth; and that nature is not yet able to concoct these humours, for then there would be some separation in the Urine, and it would not be in all places alike, but would have sediment in the bottome, and be transparent in the upper part; I conceive also that he hath a great Fever, for that the colour sheweth, being red and high, and that there is a great danger, for it is of an high darke red colour, tending to blacknesse.
But yet I cannot tell what manner of Fever it is, for I cannot discerne by the Urine (as common people suppose) the passions and affects of the sicke party, that determine the disease, and should guide me in the prescribing fit remedies, and therefore I cannot tell whether it be best to let him blood, to give hive him a purging potion, or Clyster, or whether his body would not beare any of these, or whether I were best to give him something to make him sleepe, or some cooling Juleb, or some Cordiall Antidote to expell noxious humours from the vitall parts; now which of these methods I shall best use (for the messenger can tell me nothing) I know not, but however the matter is not great, for the party ventureth but his life, and why should not I adventure my skill against it?
I now therefore pronounce the party to be sicke of a bastard Pleurisie (for it is no matter what I say to this messenger,) or a Fever, and that the party would hardly recover, further adding, that hee should have beene let blood a weeke agoe, and that I feared it would now be too late, but yet I wish it to be done, for if any thing in the world recover him, it must be that; and if that do it, it is but Hab, Nab, but yet however, I must put it in practice; so now I hast away the messenger to get a Chirurgion to let him blood; and tell him where, and in what quantity it must be done, and now it is a question whether the disease, or the life be let out by this blood-letting: if blood offending in quantity, or corrupt blood (offending in quality) putrified by choller in the lesser veines, be let out, the disease may chance to be let out with it, and so ... Death may tarry for a sacrifice, till some other sicknesse take him upon more advantage.
But if the good blood, seeming to be inflamed, be let out, when this Fever proceedeth from choller in the greater veins, or from Flegme, or other mixt humours in the stomach, Spleene, or Mesentery, which ought to be purged, the life (insteed of the disease) may be let out, by losse whereof the debt to God and Nature would be paid.
But haply (insteed of blood-letting, I prescribe at randome, (for so I must doe in either) some purging Potion, and so set the disease and a medicine together by the eares, & leave the successe to fortune. And now whether the party live or die, I care not: for if he die, I have taught them to blame their owne negligence, in not sending any sooner; but if Nature be of such force, that she be able to withstand the conflict betweene the disease and the Antidote, and start up, and take part with the Medicine, so that the party recover, I shall have more attributed unto me, (as the onely cause of his recovery) than I have deserved, or than to God, who in his providence, had beene pleased (by the worke of Nature, more than by any skill of mine) to spare and recover him: and thus you use to over-value the meanes, whereby (as you suppose) you have beene recovered, although used so desperatly (as I have prescribed for this fellow) by a methodicall Physician, professing knowledge of diseases by the Urine, or used quite contrary to the rules of Art, by some rude Empiricke and Quack-salving knave, especially, if you chance to recover; and to under-value the best meanes in the world, used by the most grave and learned Physician, if the party chance to die: never satisfying your selves, when things are so come to passe, that it was Gods providence, saying,... it was Gods will it should be so, and so resting your selves contented, but still tormenting your selves further, in thinking that this child, that friend, this brother, or that sister might have beene recovered, if the best meanes had been used, as if God would not have directed thee unto that meanes, had it not beene his will now to take this party unto himselfe.
And now, I hope that you perceive by these few instances, how a man may deceive the wisest messenger that you can send unto a Physician with a water, and shew you the disease by the same, although it be not there to be found, and how great danger they put their lives in, that adventure to take Physicke prescribed by the sight of the Urine only: and so I have done with all sharp and violent diseases, and am now coming to speake of Chronicall, lingring, and diseases of continuance, wherein I meane to shew you how to give judgement of them by the water, though in those diseases, it shew lesse than in sharpe and violent diseases.
A Recapitulation of those things which have beene spoken, touching the giving of judgement of the Urine in Acute and Violent diseases: and a Precapitulation of some things necessary to be premised touching Chronicall and diseases of continuance, before we come to the examination of the Pisse-messengers, as we have done in Sharpe and Violent diseases.
I must now likewise give you to understand (before that I come to examine some few Urines, to shew you how I give my judgement of Chronicall diseases) that in Chronicall diseases (such as are the Dropsie, Gout, Palsey, Falling sicknesse, Scurvey, French Pox, Greene sicknesse, Malacie, which is the disease of women newly conceived with childe, Cough, Head-ach, Mother, and such like) the Urine is no way faulty, but representeth the Urine of healthfull; nay, oftentimes the most healthfull men in the world: And yet the Physician (such a Urine being brought unto him) must sentence the partie that made it, to be sicke, upon no other proofe but onely this lying strumper, and false witnesse (the Urine) suborned by the beguiled and so selfe-conceited vulgar, and connived at by the Pisse-Justice or Judge, before whom shee is brought, who is corrupted for a testar, sometimes for more and sometimes for lesse, and is contented to accept of her evidence for truth, when he knowes it to be a palpable lye that shee comes to affirme.
She is indeed the dumbe messenger betweene the Doctour and his Patient, who (instead of passing the relation of his disease in writing, or by some discreet messenger) pisseth his minde in his water, and expecteth an answer; but if I should write him an answer in a letter written in the same language, I doubt he would scarce read it.
How then shall I doe, who must answer his expectation, since the Urine in this case sheweth no disease at all? Or what oracle shall I give?
Shall I say (such a water being brought unto me) I doe not perceive by this water that the partie that made it is sicke, or ayleth any thing; farre be it from me for thinking so: If I should returene such an honest plaine-dealing answer, both the messenger and he that sent him would perceive me to be diseased in my braine, without the casting of my wqater, and would presently say that I were troubled with the simples: For why (would they say) have I sent or brought this Urine if the partie be not sicke? Is not this a wise Doctour that cannot tell the Disease by the water?
This Doctour shall give me no Physicke, for I have gone to such a Doctour (Rogue or Knave you might call him) that hath told me my disease directly by the water, and he shall be my Doctour; and (for me) so let him: And thus you grumble at your Doctour, if he honestly tell you that the Urine doth not certainly shew any disease, and begin to examine whose water it is, and how the partie is affected, as also the age, sexe, constitution of body, the present strength of it, and such other circumstances as should shew him (he not seeing the partie) the disease, and guide him in the prescribing fit remedies, you presently suspect him of ignorance, and thinke that he should tell you these things by the Urine.
And thus was I lately taxed by a Gossip at East Greensted in Sussex (where I lived and began my practice) because I was strict in examining the state of her bodie that I might not erre in prescribing her something to give her ease of that which shee complained of; for it was very suspitious that shee was with child, and she pretended that she desired to take something by my prescription, but because I asked her so many questions (the which shee thought I should have resolved my selfe by the water) she would none of mine advise, but reported that I had no skill in waters, and said, I asked her many questions, but could tell her nothign from the water.
I spare to name her, yet I wish that she may chance to read this Story, wherein she may perceive that I could have cozen'd her, that she may blush to thinke that she was so much a foole, and thanke me that I have canonized her for a foole-Saint, by no other name, but the name of a Gossip; and so let her know that I wanted not wit to have deceived her, had not my will beene restrained by a better resolution than to the such base deceipt (to fit the humours of my Patients) as is used to delude the vulgar, who think that there is no disease nor symptome thereof, belonging to the body of man or woman, but that it may be discerned in the Urine: Yet it is farre otherwise, for in these Chronicall diseases (for the most part) the water seemeth not to import any disease at all, and yet the partie is irrecoverably sicke: So likewise the Urine is often-times of an high red colour, and seemeth to import a violent disease, as importeth no disease, and yet the partie sicke unto death: for confirmation whereof, I will give you two or three instances out of mine owne experience,....
I say therefore, that no Physician, nay the Devills (who are ancienter than Aesculapius or Hippocrates , or any of that race) cannot determine the life and death of a man, but upon conjecture, and may be deceived; but yet you looke that a Physician should be able to doe it, and not to erre, because such an event doth oftentimes accidentally follow such a peremptory conclusion as this of mine was, that this partie would dye within such an houre.
It is true indeed, and I might truely say (the nature of the disease, and the strength of the body, with all other signes of death being well considered) that I thought the partie would scarce live untill such an houre: but if I should say (without any qualification of the sense) that the partie would not live untill such an houre, and that he would recover if he should passe that houre, you might thinke that I spake without my booke, for I could not say so, but that I must speake more than I know, and so derogate from the providence of God, in assuming that knowledge unto my selfe that belongs onely to him....
That there is no judgement of diseases to be given by the Urine alone; that the Physician ought not to give judgement of the Urine, before hee have strictly examined how the sicke partie is affected: how this base custome came up.
You will now aske me: What is there no use of viewing the Urine at all? I answer no: there is no use of viewing it alone without the consideration of other signes, symptomes and indications of diseases, which are not therein perceived: neither can a Physician prescribe Physicke (by the sight of the Urine) with less danger than if (it being granted that purging would cure, and blood-letting would kill his Patient) he should notwithstanding cast crosse and pile which of these he should appoint.
You will further object, that you suppose that a Physician will not prescribe before he have examined all circumstances needfull for him to know. I answer, that no messenger can tell us that in all diseases; though (oftentimes) in many cases they can. Nay oftentimes they can not certifie us any thing how the partie is affected; but (with the very hazard of their lives) expect that we should tell them what they ayle by the sight of their Urine alone, and prescribe them Physicke accordingly. But let such messengers learne to give their Physicians better instructions, or stay at home, unlesse the Patient be contented to put his life upon such a desperate chance.
You will further object, that every one is not able to undergoe the charge of sending for a Physician; and then what shall they doe, if it be not convenient to send their water? To this I answer, that it is true, that every one is not able to reward a Physician (especially in the countrie) for comming to see him: Let therefore such an one send for his Minister (who is of duty bound to doe it) to aske his counsell unto what Physician to send, and intreat him likewise to write how hee is affected, what age the partie is of, of what sexe, of what constitution of body, the strength of it at this present time, when the partie was taken sicke, and what other unusuall symptomes the partie now laboureth of: as whether he have a vomiting or loosenesse, or be extremely bound in his bodie, and how long it is since hee was at stoole; as likewise whether he have a cough, or stitch, or can take rest or no, or bleed or sweat, or be grievously pained in the body and where the paine lyeth; or whatsoever passion he suffereth; And then (on Gods Name) let them also send their Urine to a Physician.
And let the Physician (before that ever he vouchsafe to looke upon the water) strictly examine all those, or the like circumstances that I have named: Then let him take the Water and looke upon it, and pronounce the disease: But if he take the water, and begin to pronounce a description of a disease by the sight of the Urine alone, before he have examined those circumstances; he makes but a foole of thee, and is (for his labour) but an impostour and a knave himselfe.
I had not thought that this posture had crept into this Citie, or been connived at by those that have power to suppresse it: But here it is so exercised, that some refuse to be informed of those circumstances (to the end that they may purchase the more fame) till they have shewed their jugling skill upon the Urine....
I should now answer another objection, and question; and they are these, That it may be that I plead for the Physicians profit, to overthrow the judgement of Urines, that our fees may grow the greater for being sent for: To this I answer, Let their monies perish with them that thinke so, rather than I would be enriched by it.
The question is this, How this custome of giving judgement of diseases by it (since it shewes no disease certainely) came up: To this I answer, That covetousnesse in the common people, to save their money (because they saw Physicians to view the water at the Patients owne house) caused them to send their waters likewise unto Physicians: And Pride in the Physicians, to shew more skill than ever they had learned out of their Master Hippocrates, made this to become a custome, which is become a very strong Plea.
I could shew how this custome might be as soone abrogated; but since I have no power to put it into execution, I leave it to them (whose power is sufficient to suppresse it) if their care were correspondent....
Errours committed in the choice and change of Physician: Directions how to avoid these errours: Some Rascalls nominated, who are usurpers upon, and abusers of the noble profession of Physicke, and the honourable Professors thereof.
The errors that you commit in the choice of a Physician, are these: Either you choose an insufficient man, for his knowledge in Physicke; or else one, who (though he be sufficiently qualified for his knowledge) is notwithstanding no fit Physician for thee.
For the first, you are in the time of your sicknesse led either by your owne fancie or by the perswasion of some friend to send for, or send unto such a man, who hath (they tell you) cured such a one of such a disease, when all other Doctours had given him over: or else because he giveth out some great matters of himselfe, and disableth all other honest learned Physicians....
Unto such Knaves, or else to Witches and Conjurers (whom you terme Cunning men and women) you are carried (though they are the most vile and base ignorant Asses in the world) with more confidence than to the most learned honest Physician that can be.
And then if you chance to recover, you impute the cause thereof to such a Rascall, never considering that it was Gods providence not (as yet) to take this partie unto himselfe, and that this rascally Quack (for medicines used by an ignorant Quacke, are said to be pysons; but being used by a skilfull Physician, they are said to be Gods owne helping hand) did not kill this partie, for it was (as they say) but hap hazzard.
But if it happen that one of these Rascalls kill his Patient (for so it falleth out too often) and some of your neighbors or friends question with you, Why you made use of such a Rogue; you are then as ready (to excuse your owne foolery and wickednesse) to excuse him too, and to say that the best Doctours cannot save a mans life when his time is come: and you thinke this is sufficient plea to excuse your selves for not using the best meanes: You will not afford an honest man the like favour, who hath used the best meanes that Art could lead him until, if his patient should chance to dye, and satisfie your selves (as you ought to doe) in this case, that it was Gods providence, but prosecute him with all the scandalls, and slanders that you can, questioning withall his skill, the which you are no more able to judge of than a blinde man of colours....
Take therefore, (and that in time) such a Physician as is authorized and allowed, either by the Universities, or by the learned College of Physicians of London; in the choice of such a one, who is so allowed and approved of, have some respect unto his dwelling, and other imployments; and consider with they selfe whether by remotenesse of place, or multitude of imploiments, he can give that attendance, that they need may require.
For in diseases of danger, it were very convenient that the Physician did see his Patient, (if it were possible) three times in a day: so hee should often observe something or other in the sicke party, that might divert him from his intended purpose, and direct him a safer way. Wherefore an honest neighbour is more convenient than a stranger remote, especially for the meaner sort of people, and those who are so poore, that their purses will not reach to the gratifying of a Physician for comming to see them with a fee: and let no man shake off that Physician whom he hath first entertained; but let him (if he please) take another Physician, or more into consultation with his first elected Physician, retaining him still....