Precepts (1-5)

Time is that wherein there is opportunity, and opportunity is that wherein there is no great time. Healing is a matter of time, but it is sometimes also a matter of opportunity. However, knowing this, one must attend in medical practice not primarily to plausible theories,[*] but to experience combined with reason. For a theory is a composite memory of things apprehended with sense-perception. For the sense-perception, coming first in experience and conveying to the intellect the things subjected to it, is clearly imaged, and the intellect, receiving these things many times, noting the occasion, the time and the manner, stores them up in itself and remembers. Now I approve of theorising also if it lays its foundation in incident, and deduces its conclusions in accordance with phenomena. For if theorising lays its foundation in clear fact, it is found to exist in the domain of intellect, which itself receives from other sources each of its impressions. So we must conceive of our nature as being stirred and instructed under compulsion by the great variety of things; and the intellect, as I have said, taking over from nature the impressions, leads us afterwards into truth. But if it

But conclusions which are merely verbal cannot bear fruit, only those do which are based on demonstrated fact. For affirmation and talk are deceptive and treacherous. Wherefore one must hold fast to facts in generalisations also,[*] and occupy oneself with facts persistently, if one is to acquire that ready and infallible habit which we call the art of medicine. For so to do will bestow a very great advantage upon sick folk and medical practitioners. Do not hesitate to inquire of laymen, if thereby there seems likely to result any improvement in treatment. For so I think the whole art has been set forth, by observing some part of the final end in each of many particulars, and then combining all into a single whole. So one must pay attention to generalities in incidents, with help and quietness rather than with professions and the excuses that accompany ill-success.

Early determination ofthe patient’s —since only what has actually been administered will benefit; emphatic assertion is of no use—is beneficial but complicated. For it is through many turns and changes that all diseases settle into some sort of permanence.[*]

This piece of advice also will need our consideration, as it contributes somewhat to the whole. For should you begin by discussing fees, you will suggest to the patient either that you will go away and leave him if no agreement be reached, or that you will neglect him and not prescribe any immediate treatment. So one must not be anxious about fixing a fee. For I consider such a worry to be harmful to a troubled patient, particularly if the disease be acute. For the quickness of the disease, offering no opportunity for turning back,[*] spurs on the good physician not to seek his profit but rather to lay hold on reputation. Therefore it is better to reproach a patient you have saved than to extort money from[*] those who are at death’s door.

And yet some patients ask for what is out of the way and doubtful, through prejudice, deserving indeed to be disregarded, but not to be punished. Wherefore you must reasonably oppose them, as they are embarked upon a stormy sea of change.