IN SICKNESS AND IN HEALTH

Meditations for patients & their doctors

An edited version from the original by Dr Donne

Dean of St Pauls

MDCXXIV

.

.

.

.

.

.

.

A full version of the original is available here

Donne's Meditations on sickness & health, life & death, are firmly rooted in the then prevailing medical model of humours.

There was a very interesting discussion of these on the BBC Radio 4 programme In Our Time broadcast today

Details, including how to download a free podcast, are available here

1 We Study Health

.
O miserable condition of Man!

One minute I was well, now I am ill. I am surprised by a sudden change for the worse and can impute it to no cause, nor call it by any name.

We study health. We think about our food and drink and air and exercises. Our health is a long and regular work.

But in a minute a cannon batters all, overthrows all, demolishes all.

A sickness unprevented for all our diligence, unsuspected for all our curiosity, nay undeserved, seizes us, possesses us, destroys us in an instant.

O miserable condition of Man!

God, who is immortal himself, put a spark of immortality into us. We might have blown it into a flame but blew it out by our first sin.

We beggared ourselves by chasing after false riches and infatuated ourselves by believing false ideas.

So now we not only die but die upon the rack, die by the torment of sickness.

We are pre-afflicted, super-afflicted with fear of sickness before we are even ill.

We are not sure what is wrong with us. One hand asks the other by the pulse, and our eye asks our own urine how we do.

O multiplied misery!

We die and we cannot enjoy death because we die in this torment of sickness.

We do not even wait until the torment comes, but prophesy it and induce that death.

The moment we are ill, we are convinced we are dying.

Man is a little world.

He has these earthquakes in himself, sudden shakings; these lightnings, sudden flashes; these thunders, sudden noises; these eclipses, sudden obfuscations and darkenings of his senses; these blazing stars, sudden fiery exhalations; these rivers of blood, sudden red waters.

Is he a world to himself only therefore, that he has enough in himself to destroy and execute only himself? To assist the sickness, to anticipate the sickness, to make the sickness the more irremediable by fear?

As if he would make a fire the more vehement by sprinkling water upon the coals, so he wraps a hot fever in cold melancholy lest the fever alone should not destroy him fast enough.

O perplexed discomposition, O riddling distemper, O miserable condition of Man!

2 Strength fails

.
The heavens are not the less constant because they move continually, because they move continually the same way.

The earth is not the more constant because it lies still continually, because continually it changes and melts in all its parts.

Man, who is the noblest part of the earth, melts as if he were made not of earth but of snow. His own envy melts him, he grows lean with that.

He will say anothers beauty melts him. But he feels that a fever does not melt him like snow but powers him out like lead, like iron, like brass melted in a furnace. Fever not only melts him but calcines him, reduces him to atoms and to ashes, not to water but to lime.

And how quickly? Sooner than you can receive an answer, sooner than you can conceive the question.

Earth is the centre of my body, Heaven is the centre of my soul.

My body falls down without pushing, my soul does not go up without pulling. Ascension is my souls pace and measure, but precipitation my bodys.

Even Angels, whose home is Heaven and who have wings too, had a ladder to go to heaven by steps.

The sun goes many miles in a minute, the stars of the firmament go even quicker. Neither goes as fast as my body falls to the earth. From the first moment that I feel ill I feel the disease will win.

In the twinkling of an eye I can barely see. Taste is insipid and fatuous, appetite is dull and desireless.

My knees are sinking and strengthless.

And in an instant sleep, which is the picture, the copy of death, is taken away.

Death itself may succeed so that I might have death to the life

It was part of Adams punishment: In the sweat of thy brows thou shalt eat thy bread.

My punishment is even greater. I have earned bread by the sweat of my brows in the labour of my calling, and I have it. Now I sweat again and again, from the brow to the sole of the foot, but I cannot eat bread, I taste no sustenance

Miserable distribution of mankind, where one half lacks meat and the other stomach

3 The patient takes to his bed

We attribute but one privilege and advantage to Mans body above other moving creatures: that he is not grovelling, but of an erect, an upright form, naturally built and disposed to the contemplation of heaven.

Indeed it is a thankful form, and rewards the soul by carrying it so many foot higher towards Heaven.

Other creatures look to the earth, and even that is no unfit object, no unfit contemplation for Man, for thither he must come. But Man does not stay there forever, so in his natural form he is carried upright in contemplation of that place which is his home, Heaven.

This is Man's prerogative, but what is this dignity worth?

A fever can flip him down, a fever can depose him, a fever can bring that head, which yesterday carried a crown of gold five foot towards a crown of glory, as low as his own foot today.

When God came to breathe into Man the breath of life he found him flat upon the ground. When God comes to withdraw that breath from him again he prepares him to it by laying him flat upon his bed.

Even prison gives the prisoner space to take two or three steps. The Anchorites that barked themselves up in hollow trees and immured themselves in hollow walls, that perverse man who barrelled himself in a tub, all could stand or sit and enjoy some change of posture.

A sick bed is a grave.

Every nights bed is a type of the grave.

At night we tell our servants at what hour we will rise, but on our bed of sickness we cannot tell ourselves at what day, what week, what month. Here the head lies as low as the foot, the Head of the people as low as they, whom those feet trod upon. And that hand that signed pardons is too weak to beg his own.

Strange fetters to the feet, strange manacles to the hands, when the feet and hands are bound so much the faster by how much the sinews and ligaments are slacker.

In the grave I may speak through the stones in the voice of my friends and in the accents of those words which their love may afford my memory. In my sick bed I am mine own ghost and frighten my beholders rather than instruct them.

They think the worst for me now and yet fear worse They give me for dead now and yet wonder how I am when they wake at midnight and ask how I do tomorrow.

Miserable and inhuman posture, where I must practise my lying in the grave by lying still, and not practise my resurrection by rising any more

4 The physician is sent for

It is too little to call Man a little World. Man is a diminutive to nothing except God.

Man consists of more pieces, more parts, than the world. And if those pieces were extended and stretched out, in man as they are in the world, Man would be the Giant and the world the Dwarf, the world but the Map, and the man the World.

If all the veins in our bodies were extended to rivers, and all the sinews to veins of mines, and all the muscles that lie upon one another to hills, and all bones to quarries of stones, the air would be too little for this orb of Man to move in. The firmament would be but enough for this star.

Man has many pieces of which the whole world has no representation.

What creatures inhabit the World that is Man?

Our creatures are our thoughts, creatures that are born giants, that reach from east to west, from earth to heaven, that bestride all the sea and land. They span the sun and firmament. My thoughts reach all, comprehend all.

Inexplicable mystery; I their creator am in prison, in a sick bed. My creatures, my thoughts, are with the sun and beyond the sun, overtake the sun in one pace, one step everywhere.

And then as the other world produces serpents and vipers, malignant and venomous creatures, and worms and caterpillars that endeavour to devour the world which produces them, and monsters compiled of divers parents and kinds, so this world, our selves, produces all these in us.

We produce diseases and sicknesses of all sorts, venomous and infectious diseases, feeding and consuming diseases and manifold and entangled diseases made up of many several ones.

Can the other world name so many venomous, so many consuming, so many monstrous creatures as we can diseases of all these kinds?

O miserable abundance, O beggarly riches! How can we have remedies for every disease when as yet we have not names for them?

But we have a Hercules against these giants, these monsters: the physician. He musters up all the forces of the other world to succour this, all nature to relieve Man.

We have the physician but we are not the physician. Here we are less able than lesser creatures who are physicians to themselves.

The hart that is pursued and shot with an arrow knows a herb which will heal the wounds. The dog knows a grass that will cure his proverbial sickness.

And it may be true that common plants, easy to be had, would cure man, but Man has not that innate instinct to apply those natural medicines to his present danger as those inferior creatures have. He is not his own apothecary, his own physician, as they are.

What has become of Mans great extent and proportion when he shrinks himself and consumes himself to a handful of dust? What has become of his soaring thoughts when he brings himself to the ignorance, to the thoughtlessness of the grave?

His diseases are his own but the physician is not. He must send for the physician

5 The Physician comes

Sickness is the greatest misery.

Its greatest misery is solitude, when the infectiousness of the disease deters from coming those who should assist. Even the physician scarce dares come.

To be completely alone is a torment not even threatened in hell.

Neither God nor Nature will permit a vacuum. And so solitude is unnatural, not loved by God.

When I am dead and my body might infect the doctors have a remedy: they may bury me.
But when I am but sick and I might infect they have no remedy but their absence and my isolation.

It is an excuse to them that are great and pretend and yet are loath to come. It is an inhibition to those who would truly come, because they may be made carriers of the infection to others by their coming.

And it is an excommunication upon the patient and separates him from all civility but charity.

A long sickness will weary friends at last, but a pestilential sickness averts them from the beginning.

Now there is but one God though there is a plurality of persons in God. All his external actions testify a love of society and communion.

In heaven there are orders of angels and armies of martyrs and in that house many mansions.
In earth there are families, cities, churches, colleges, all plural things.

And lest either of these should not be company enough there is an association of the two, a communion of saints which makes the militant and triumphant church one parish, so that Christ was not out of his diocese when he was upon earth nor out of his temple when he was in our flesh

God saw all that he had made was good, but recognised a defect when he saw that it was not good for man to be alone. Therefore he made him a helper, one that could help him to increase the number and give him her own, and more, company.

Angels, who do no propagate nor multiply, were made at first in an abundant number, and so were stars.

But for the things of this world their blessing was increase; for I think, I need not ask leave to think, that there is no phoenix, nothing singular, nothing alone.

Scientists are so far from thinking that there is anything singular in this world as that they will scarce think that this world itself is singular, but that every planet and every star is another world like this.

They find reason to conceive not only a plurality in every species in the world but a plurality of worlds, so that the abhorrers of solitude are not solitary. God and nature agree in this.

Now some men become hermits in pursuit of their religion. They retire completely from the world, do good to no man, converse with no man.

God has two testaments, two wills, but this idea of religion is a a codicil, and not of his will; not in the body of his testaments but interlined by others, that the way to the communion of saints should be by such a solitude as excludes all doing of good here.

That is a disease of the mind, as the height of an infectious disease of the body is solitude, to be left alone. For this makes an infectious bed equal, nay worse than a grave.

Though in both I be equally alone, in my bed I know it and feel it and shall not in my grave. And this too, that in my bed my soul is still in an infectious body and shall not in my grave be so