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Longer Rules

St Basil the Great, tr. Lowther Clarke, 1925

Rule 55: Whether the Use of Medical Remedies is Consistent with the Ideal of Piety

Just¹ as each of the arts has been given us by God as a help to supplement the deficiencies of nature—for instance, agriculture, because what grows out of the earth of itself is not sufficient to relieve our necessities; weaving, because the need of coverings is paramount in view both of decency and the damage inflicted by the weather, and similarly with building—so it is with the medical art. Since our body, so subject to disease, is liable to various kinds of harm, both what attacks it from without, and what arises from within by reason of the foods we eat, and is distressed by both excess and deficiency, the medical art—a type in this respect of the healing of the soul—has been given us ‘by God Who directs all our life to advise the removal of what is in excess or the addition of what is wanting. For just as, if we were still in the Paradise of delight, we should have no need of the cares and toils of agriculture, so too if we enjoyed freedom from disease according to the gift bestowed before the Fall at our creation we should be needing no medical remedies to relieve us. But just as after we were exiled to this place and were told: “In the sweat of thy brow shalt thou eat thy bread,”² then by long experience and painful toil on the earth we contrived the art of agriculture to relieve the ills which came from the curse, God having given us understanding and apprehension of this art—so also when we were bidden to return again to the earth from which we were taken and were yoked to the painful flesh, condemned to destruction because of sin and therefore subject to these diseases, so also has been given us the help which is afforded, in a measure at least, by the healing art.

For the herbs which are appropriate to each disease did not grow out of the ground automatically, but, to be sure, were produced by the will of the Creator with the object of benefiting us. So the natural forces which reside in roots, flowers, leaves, fruits, or juices, or whatever is found in metals or in the sea to have properties beneficial to the body, fall into line with the things to eat and drink which we find. But whatever is cunningly contrived and can be dispensed with, and causes much trouble, and as it were turns our whole life into one long providing for the flesh, is to be shunned by Christians; and we must take care so to use the art of medicine, if need arise, as not to assign to it the whole cause of health or sickness, but to accept the use of its remedies as designed for the glory of God and a type of the care of souls. But when we are deprived of medical assistance, let us not put all our hope for the alleviation of our ills in this art, but know that either He will not allow us to be tempted above what we are able to bear, or just as the Lord in those days now made clay and anointed and bid wash in Siloam, and now was content with the mere command, saying, I will, be thou clean,³ whereas He left some to contend against afflictions, making them better tested as a result of their trial, so now it is in our case. At one time He touches unseen and secretly when He knows this to be expedient for our souls, at another time He thinks fit to use material help for our diseases, making the remembrance of His grace more lasting by postponing the cure, or, as I said, giving us a type of the care of the soul. For as with the flesh both the putting away of foreign elements and the addition of what is lacking are necessary; so also with our soul, it is fitting that what is alien be removed and what is according to our nature be received. Because “God made man upright,”⁴ and created us for good works, that we should walk in them.

And just as in the one case we put up with operations and cauterisings and the taking of bitter drugs for the treatment of the body, so also in this case we must receive the cutting effects of words of rebuke and the bitter drugs of blame for the cure of the soul. This is what the prophetic word says by way of rebuke to those who have not received correction: “Is there no balm in Gilead? Is there no physician there? Why has not the healing of the daughter of my people gone up?⁵ And when in long illnesses we await the cure during a protracted period, using methods both painful and various, that shows us that we ought to correct the sins of the soul by laborious prayer and protracted repentance and more severe discipline than reason would suggest to us as sufficient for a cure. Because some make a wrong use of the medical art, that is no reason why we should shun all benefit derived from it. For when the intemperate followers of pleasure abuse the arts of cooking or baking or weaving to devise luxury, overstepping the bounds of what is necessary, we should not then shun all these arts alike: on the contrary, by using them rightly, we show up the corrupt use of them. So also in the case of medicine, it is wrong to slander God’s gift because of the evil use made of it. For to put the hope of one’s health in the hands of doctors is worthy of the lower animals—which we see happening in the case of some wretches, who do not shrink from calling them Saviours! While to avoid entirely the benefit of medicine shows a contentious spirit. But just as Hezekiah did not think the cake of figs the prime cause of his recovery, nor ascribe to it the cause of the healing of his body, but added to his praise of God his thanksgiving for the creation of the figs; so also we, receiving blows from God Who so kindly and wisely contrives our life, ask from Him first that we may know the reason why He inflicts stripes, then relief from pain and endurance, so that with the temptation He may also give us a way out, that we may be able to bear it.

We receive with thanksgiving the grace of healing that is given us, either by oil and wine as in the case of him that fell among robbers, or by figs, as in the case of Hezekiah. And it will make no difference to us whether the care of God has come to us invisibly or through some bodily means, which often leads us to perceive the grace of the Lord more effectively. Often when we have been allowed to contract illnesses for disciplinary reasons, we have been condemned to endure a cure by painful means as part of the discipline. And so common sense teaches us that we must not shrink from operations or cauterisings or the pains caused by sharp and troublesome drugs or deprivation of food or a strict régime of food or abstinence from harmful things, since all the time—I say it again—the object of benefiting the soul is being secured, for it is being taught by way of example how to take care of itself. But there is no small danger of the mind falling into the error of supposing that every illness needs the aid of medicine. For not all illnesses come naturally, or from errors of diet or any other bodily causes, for which we see that the medical art is sometimes useful. For often illnesses are scourges of sins, sent to convert us. “For whom the Lord loveth, he chasteneth.”⁶ And “For this cause many among you are weak and sickly, and not a few sleep. For if we discerned ourselves, we should not be judged. But when we are judged, we are chastened of the Lord, that we should not be condemned with the world.”⁷ In such cases then we ought to be quiet and forbear medical treatment, and endure what comes upon us, when we have recognised our sins, as (Micah) said: “I will bear the indignation of the Lord, for I have sinned against him”⁸; and we ought to show amendment by doing works worthy of repentance and remembering the Lord’s words: “Behold, thou art made whole; sin no more, lest a worse thing befall thee.”⁹ Sometimes also it happens at the request of the evil one: the Lord Who loves men sends as it were a great antagonist to contend with him in the struggle, and brings down his pride by the resistance to the utmost of His servants. Such we have learned to have been the case with Job. Some again who are able to bear suffering even unto death are brought forward by God as an example to those who are loth to suffer trouble; as Lazarus, who, oppressed by so many wounds, is nowhere recorded to have asked anything of the rich man or to have complained at his fate. Wherefore also he received rest in the bosom of Abraham, as one who had had his evil things in his lifetime. We find yet another cause for illnesses happening to the Saints, as in the case of the apostle. For lest he should seem to surpass the limits of human nature, and lest any one should think that he had something unusual in his natural constitution (as the Lycaonians thought, when they brought him garlands and oxen), illness was his lot continually, to show that his nature was fully human.

What gain then accrues to such men from the medical art? Does not rather danger come, as they are led away from the right principles to valetudinarianism? Those at least who have brought illness on themselves from errors of diet must use the treatment of the body as a kind of type and pattern of the treatment of the soul, as I said before. For abstinence from harmful things according to the principles of medicine is useful to us, so is the choice of profitable things and the keeping of doctors’ orders. And let the very change of the flesh from illness to health be an encouragement to us, so that we do not despair of the soul, as if it were not able to return again by penitence from sins to its proper health. It follows then that we must neither avoid the art completely, nor place all our hopes in it. But just as we use agriculture, but pray for the fruits from God; and we entrust the rudder to the pilot, but pray to God to be preserved from the sea. So by bringing in a doctor when reason allows, we do not cease to hope in God. And to my thinking the art contributes towards continence in no small degree. For I see that it cuts away luxuriousness, and condemns satiety, and banishes varied diet and superfluous devisings of condiments as inexpedient. And in general it calls want the mother of health, so that in this respect its counsels are not useless to us. So whether we use the precepts of medicine or avoid them according to one of the principles laid down above,¹⁰ let us keep the aim of being well-pleasing to God and contrive what is beneficial to the soul, and fulfil the commandment of the apostle who said: “Whether ye eat, or drink, or whatsoever ye do, do all to the glory of God.”¹¹

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