textfiles/etext/NONFICTION/faculties

                                     170 AD
                            ON THE NATURAL FACULTIES
                                    by Galen
                     Translated by Arthur John Brock, M.D.
  BOOK ONE

  1. Since feeling and voluntary motion are peculiar to animals,
whilst growth and nutrition are common to plants as well, we may
look on the former as effects of the soul and the latter as effects of
the nature. And if there be anyone who allows a share in soul to
plants as well, and separates the two kinds of soul, naming the kind
in question vegetative, and the other sensory, this person is not
saying anything else, although his language is somewhat unusual. We,
however, for our part, are convinced that the chief merit of
language is clearness, and we know that nothing detracts so much
from this as do unfamiliar terms; accordingly we employ those terms
which the bulk of people are accustomed to use, and we say that
animals are governed at once by their soul and by their nature, and
plants by their nature alone, and that growth and nutrition are the
effects of nature, not of soul.
  2. Thus we shall enquire, in the course of this treatise, from
what faculties these effects themselves, as well as any other
effects of nature which there may be, take their origin.
  First, however, we must distinguish and explain clearly the
various terms which we are going to use in this treatise, and to
what things we apply them; and this will prove to be not merely an
explanation of terms but at the same time a demonstration of the
effects of nature.
  When, therefore, such and such a body undergoes no change from its
existing state, we say that it is at rest; but, not withstanding, if
it departs from this in any respect we then say that in this respect
it undergoes motion. Accordingly, when it departs in various ways from
its preexisting state, it will be said to undergo various kinds of
motion. Thus, if that which is white becomes black, or what is black
becomes white, it undergoes motion in respect to colour; or if what
was previously sweet now becomes bitter, or, conversely, from being
bitter now becomes sweet, it will be said to undergo motion in respect
to flavour; to both of these instances, as well as to those previously
mentioned, we shall apply the term qualitative motion. And further, it
is not only things which are altered in regard to colour and flavour
which, we say, undergo motion; when a warm thing becomes cold, and a
cold warm, here too we speak of its undergoing motion; similarly
also when anything moist becomes dry, or dry moist. Now, the common
term which we apply to all these cases is alteration.
  This is one kind of motion. But there is another kind which occurs
in bodies which change their position, or as we say, pass from one
place to another; the name of this is transference.
  These two kinds of motion, then, are simple and primary, while
compounded from them we have growth and decay, as when a small thing
becomes bigger, or a big thing smaller, each retaining at the same
time its particular form. And two other kinds of motion are genesis
and destruction, genesis being a coming into existence, and
destruction being the opposite.
  Now, common to all kinds of motion is change from the preexisting
state, while common to all conditions of rest is retention of the
preexisting state. The Sophists, however, while allowing that bread in
turning into blood becomes changed as regards sight, taste, and touch,
will not agree that this change occurs in reality. Thus some of them
hold that all such phenomena are tricks and illusions of our senses;
the senses, they say, are affected now in one way, now in another,
whereas the underlying substance does not admit of any of these
changes to which the names are given. Others (such as Anaxagoras) will
have it that the qualities do exist in it, but that they are
unchangeable and immutable from eternity to eternity, and that these
apparent alterations are brought about by separation and combination.
  Now, if I were to go out of my way to confute these people, my
subsidiary task would be greater than my main one. Thus, if they do
not know all that has been written, "On Complete Alteration of
Substance" by Aristotle, and after him by Chrysippus, I must beg of
them to make themselves familiar with these men's writings. If,
however, they know these, and yet willingly prefer the worse views
to the better, they will doubtless consider my arguments foolish also.
I have shown elsewhere that these opinions were shared by Hippocrates,
who lived much earlier than Aristotle. In fact, all those known to
us who have been both physicians and philosophers Hippocrates was
the first who took in hand to demonstrate that there are, in all, four
mutually interacting qualities, and that to the operation of these
is due the genesis and destruction of all things that come into and
pass out of being. Nay, more; Hippocrates was also the first to
recognise that all these qualities undergo an intimate mingling with
one another; and at least the beginnings of the proofs to which
Aristotle later set his hand are to be found first in the writings
of Hippocrates.
  As to whether we are to suppose that the substances as well as their
qualities undergo this intimate mingling, as Zeno of Citium afterwards
declared, I do not think it necessary to go further into this question
in the present treatise; for immediate purposes we only need to
recognize the complete alteration of substance. In this way, nobody
will suppose that bread represents a kind of meeting-place for bone,
flesh, nerve, and all the other parts, and that each of these
subsequently becomes separated in the body and goes to join its own
kind; before any separation takes place, the whole of the bread
obviously becomes blood; (at any rate, if a man takes no other food
for a prolonged period, he will have blood enclosed in his veins all
the same). And clearly this disproves the view of those who consider
the elements unchangeable, as also, for that matter, does the oil
which is entirely used up in the flame of the lamp, or the faggots
which, in a somewhat longer time, turn into fire.
  I said, however, that I was not going to enter into an argument with
these people, and it was only because the example was drawn from the
subject-matter of medicine, and because I need it for the present
treatise, that I have mentioned it. We shall then, as I said, renounce
our controversy with them, since those who wish may get a good grasp
of the views of the ancients from our own personal investigations into
these matters.
  The discussion which follows we shall devote entirely, as we
originally proposed, to an enquiry into the number and character of
the faculties of Nature, and what is the effect which each naturally
produces. Now, of course, I mean by an effect that which has already
come into existence and has been completed by the activity of these
faculties- for example, blood, flesh, or nerve. And activity is the
name I give to the active change or motion, and the cause of this I
call a faculty. Thus, when food turns into blood, the motion of the
food is passive, and that of the vein active. Similarly, when the
limbs have their position their position altered, it is the muscle
which produces, and the bones which undergo the motion. In these cases
I call the motion of the vein and of the muscle an activity, and
that of the food and the bones a symptom or affection, since the first
group undergoes alteration and the second group is merely transported.
One might, therefore, also speak of the activity as an effect of
Nature- for example, digestion, absorption, blood-production; one
could not, however, in every case call the effect an activity; thus
flesh is an effect of Nature, but it is, of course, not an activity.
It is, therefore, clear that one of these terms is used in two senses,
but not the other.
  3. It appears to me, then, that the vein, as well as each of the
other parts, functions in such and such a way according to the
manner in which the four qualities are mixed. There are, however, a
considerable number of not undistinguished men- philosophers and
physicians- who refer action to the Warm and the Cold, and who
subordinate to these, as passive, the Dry and the Moist; Aristotle, in
fact, was the first who attempted to bring back the causes of the
various special activities to these principles, and he was followed
later by the Stoic school. These latter, of course, could logically
make active principles of the Warm and Cold, since they refer the
change of the elements themselves into one another to certain
diffusions and condensations. This does not hold of Aristotle,
however; seeing that he employed the four qualities to explain the
genesis of the elements, he ought properly to have also referred the
causes of all the special activities to these. How is it that he
uses the four qualities in his book "On Genesis and Destruction,"
whilst in his "Meteorology," his "Problems," and many other works he
uses the uses the two only? Of course, if anyone were to maintain that
in the case of animals and plants the Warm and Cold are more active,
the Dry and Moist less so, he might perhaps have even Hippocrates on
his side; but if he were to say that this happens in all cases, he
would, I imagine, lack support, not merely from Hippocrates, but
even from Aristotle himself- if, at least, Aristotle chose to remember
what he himself taught us in his work "On Genesis and Destruction,"
not as a matter of simple statement, but with an accompanying
demonstration. I have, however, also investigated these questions,
in so far as they are of value to a physician, in my work "On
Temperaments."
  4. The so-called blood-making faculty in the veins, then, as well as
all the other faculties, fall within the category of relative
concepts; primarily because the faculty is the cause of the
activity, but also, accidentally, because it is the cause of the
effect. But, if the cause is relative to something- for it is the
cause of what results from it, and of nothing else- it is obvious that
the faculty also falls into the category of the relative; and so
long as we are ignorant of the true essence of the cause which is
operating, we call it a faculty. Thus we say that there exists in
the veins a blood-making faculty, as also a digestive faculty in the
stomach, a pulsatile faculty in the heart, and in each of the other
parts a special faculty corresponding to the function or activity of
that part. If, therefore, we are to investigate methodically the
number and kinds of faculties, we must begin with the effects; for
each of these effects comes from a certain activity, and each of these
again is preceded by a cause.
  5. The effects of Nature, then, while the animal is still being
formed in the womb, are all the different parts of its body; and after
it has been born, an effect in which all parts share is the progress
of each to its full size, and thereafter its maintenance of itself
as long as possible.
  The activities corresponding to the three effects mentioned are
necessarily three- one to each- namely, Genesis, Growth, and
Nutrition. Genesis, however, is not a simple activity of Nature, but
is compounded of alteration and of shaping. That is to say, in order
that bone, nerve, veins, and all other [tissues] may come into
existence, the underlying substance from which the animal springs must
be altered; and in order that the substance so altered may acquire its
appropriate shape and position, its cavities, outgrowths, attachments,
and so forth, it has to undergo a shaping or formative process. One
would be justified in calling this substance which undergoes
alteration the material of the animal, just as wood is the material of
a ship, and wax of an image.
  Growth is an increase and expansion in length, breadth, and
thickness of the solid parts of the animal (those which have been
subjected to the moulding or shaping process). Nutrition is an
addition to these, without expansion.
  6. Let us speak then, in the first place, of Genesis, which, as we
have said, results from alteration together with shaping.
  The seed having been cast into the womb or into the earth (for there
is no difference), then, after a certain definite period, a great
number of parts become constituted in the substance which is being
generated; these differ as regards moisture, dryness, coldness and
warmth, and in all the other qualities which naturally derive
therefrom. These derivative qualities, you are acquainted with, if you
have given any sort of scientific consideration to the question of
genesis and destruction. For, first and foremost after the qualities
mentioned come the other so-called tangible distinctions, and after
them those which appeal to taste, smell, and sight. Now, tangible
distinctions are hardness and softness, viscosity, friability,
lightness, heaviness, density, rarity, smoothness, roughness,
thickness and thinness; all of these have been duly mentioned by
Aristotle. And of course you know those which appeal to taste,
smell, and sight. Therefore, if you wish to know which alterative
faculties are primary and elementary, they are moisture, dryness,
coldness, and warmth, and if you wish to know which ones arise from
the combination of these, they will be found to be in each animal of a
number corresponding to its sensible elements. The name sensible
elements is given to all the homogeneous parts of the body, and
these are to be detected not by any system, but by personal
observation of dissections.
  Now Nature constructs bone, cartilage, nerve, membrane, ligament,
vein, and so forth, at the first stage of the animal's genesis,
employing at this task a faculty which is, in general terms,
generative and alterative, and, in more detail, warming, chilling,
drying, or moistening; or such as spring from the blending of these,
for example, the bone-producing, nerve-producing, and
cartilage-producing faculties (since for the sake of clearness these
names must be used as well).
  Now the peculiar flesh of the liver is of this kind as well, also
that of the spleen, that of the kidneys, that of the lungs, and that
of the heart; so also the proper substance of the brain, stomach,
gullet, intestines, and uterus is a sensible element, of similar parts
all through, simple, and uncompounded. That is to say, if you remove
from each of the organs mentioned its arteries, veins, and nerves, the
substance remaining in each organ is, from the point of view of the
senses, simple and elementary. As regards those organs consisting of
two dissimilar coats, of which each is simple, of these organs the
coats are the are the elements- for example, the coats of the stomach,
oesophagus, intestines, and arteries; each of these two coats has an
alterative faculty peculiar to it, which has engendered it from the
menstrual blood of the mother. Thus the special alterative faculties
in each animal are of the same number as the elementary parts; and
further, the activities must necessarily correspond each to one of
the special parts, just as each part has its special use- for example,
those ducts which extend from the kidneys into the bladder, and which
are called ureters; for these are not arteries, since they do not
pulsate nor do they consist of two coats; and they are not veins,
since they neither contain blood, nor do their coats in any way
resemble those of veins; from nerves they differ still more than from
the structures mentioned.
  "What, then, are they?" someone asks- as though every part must
necessarily be either an artery, a vein, a nerve, or a complex of
these, and as though the truth were not what I am now stating, namely,
that every one of the various organs has its own particular substance.
For in fact the two bladders- that which receives the urine, and
that which receives the yellow bile- not only differ from all other
organs, but also from one another. Further, the ducts which spring out
like kinds of conduits from the gall-bladder and which pass into the
liver have no resemblance either to arteries, veins or nerves. But
these parts have been treated at a greater length in my work "On the
Anatomy of Hippocrates," as well as elsewhere.
  As for the actual substance of the coats of the stomach,
intestine, and uterus, each of these has been rendered what it is by a
special alterative faculty of Nature; while the bringing of these
together, the therewith of the structures which are inserted into
them, the outgrowth into the intestine,* the shape of the inner
cavities, and the like, have all been determined by a faculty which we
call the shaping or formative faculty; this faculty we also state to
be artistic- nay, the best and highest art- doing everything for
some purpose, so that there is nothing ineffective or superfluous,
or capable of being better disposed. This, however, I shall
demonstrate in my work "On the Use of Parts."

  *By this is meant the duodenum, considered as an outgrowth or
prolongation of the stomach towards the intestines.

  7. Passing now to the faculty of Growth let us first mention that
this, too, is present in the foetus in utero as is also the
nutritive faculty, but that at that stage these two faculties are,
as it were, handmaids to those already mentioned, and do not possess
in themselves supreme authority. When, however, the animal has
attained its complete size, then, during the whole period following
its birth and until the acme is reached, the faculty of growth is
predominant, while the alterative and nutritive faculties are
accessory- in fact, act as its handmaids. What, then, is the
property of this faculty of growth? To extend in every direction
that which has already come into existence- that is to say, the
solid parts of the body, the arteries, veins, nerves, bones,
cartilages, membranes, ligaments, and the various coats which we
have just called elementary, homogeneous, and simple. And I shall
state in what way they gain this extension in every direction, first
giving an illustration for the sake of clearness.
  Children take the bladders of pigs, fill them with air, and then rub
them on ashes near the fire, so as to warm, but not to injure them.
This is a common game in the district of Ionia, and among not a few
other nations. As they rub, they sing songs, to a certain measure,
time, and rhythm, and all their words are an exhortation to the
bladder to increase in size. When it appears to them fairly well
distended, they again blow air into it and expand it further; then
they rub it again. This they do several times, until the bladder seems
to them to have become large enough. Now, clearly, in these doings
of the children, the more the interior cavity of the bladder increases
in size, the thinner, necessarily, does its substance become. But,
if the children were able to bring nourishment to this thin part, then
they would make the bladder big in the same way that Nature does. As
it is, however, they cannot do what Nature does, for to imitate this
is beyond the power not only of children, but of any one soever; it is
a property of Nature alone.
  It will now, therefore, be clear to you that nutrition is a
necessity for growing things. For if such bodies were distended, but
not at the same time nourished, they would take on a false
appearance of growth, not a true growth. And further, to be
distended in all directions belongs only to bodies whose growth is
directed by Nature; for those which are distended by us undergo this
distension in one direction but grow less in the others; it is
impossible to find a body which will remain entire and not be torn
through whilst we stretch it in the three dimensions. Thus Nature
alone has the power to expand a body in all directions so that it
remains unruptured and preserves completely its previous form.
  Such then is growth, and it cannot occur without the nutriment which
flows to the part and is worked up into it.
  8. We have, then, it seems, arrived at the subject of Nutrition,
which is the third and remaining consideration which we proposed at
the outset. For, when the matter which flows to each part of the
body in the form of nutriment is being worked up into it, this
activity is nutrition, and its cause is the nutritive faculty. Of
course, the kind of activity here involved is also an alteration,
but not an alteration like that occurring at the stage of genesis. For
in the latter case something comes into existence which did not
exist previously, while in nutrition the inflowing material becomes
assimilated to that which has already come into existence.
Therefore, the former kind of alteration has with reason been termed
genesis, and the latter, assimilation.
  9. Now, since the three faculties of Nature have been exhaustively
dealt with, and the animal would appear not to need any others
(being possessed of the means for growing, for attaining completion,
and for maintaining itself as long a time as possible), this
treatise might seem to be already complete, and to constitute an
exposition of all the faculties of Nature. If, however, one
considers that it has not yet touched upon any of the parts of the
animal (I mean the stomach, intestines, liver, and the like), and that
it has not dealt with the faculties resident in these, it will seem as
though merely a kind of introduction had been given to the practical
parts of our teaching. For the whole matter is as follows: Genesis,
growth, and nutrition are the first, and, so to say, the principal
effects of Nature; similarly also the faculties which produce these
effects- the first faculties- are three in number, and are the most
dominating of all. But as has already been shown, these need the
service both of each other, and of yet different faculties. Now, these
which the faculties of generation and growth require have been stated.
I shall now say what ones the nutritive faculty requires.
  10. For I believe that I shall prove that the organs which have to
do with the disposal of the nutriment, as also their faculties,
exist for the sake of this nutritive faculty. For since the action
of this faculty is assimilation, and it is impossible for anything
to be assimilated by, and to change into anything else unless they
already possess a certain community and affinity in their qualities,
therefore, in the first place, any animal cannot naturally derive
nourishment from any kind of food, and secondly, even in the case of
those from which it can do so, it cannot do this at once. Therefore,
by reason of this law, every animal needs several organs for
altering the nutriment. For in order that the yellow may become red,
and the red yellow, one simple process of alteration is required,
but in order that the white may become black, and the black white, all
the intermediate stages are needed. So also, a thing which is very
soft cannot all at once become very hard, nor vice versa; nor,
similarly can anything which has a very bad smell suddenly become
quite fragrant, nor again, can the converse happen.
  How, then, could blood ever turn into bone, without having first
become, as far as possible, thickened and white? And how could bread
turn into blood without having gradually parted with its whiteness and
gradually acquired redness? Thus it is quite easy for blood to
become flesh; for, if Nature thicken it to such an extent that it
acquires a certain consistency and ceases to be fluid, it thus becomes
original newly-formed flesh; but in order that blood may turn into
bone, much time is needed and much elaboration and transformation of
the blood. Further, it is quite clear that bread, and, more
particularly lettuce, beet, and the like, require a great deal of
alteration, in order to become blood.
  This, then, is one reason why there are so many organs concerned
in the alteration of food. A second reason is the nature of the
superfluities. For, as we are unable to draw any nourishment from
grass, although this is possible for cattle, similarly we can derive
nourishment from radishes, albeit not to the same extent as from meat;
for almost the whole of the latter is mastered by our natures; it is
transformed and altered and constituted useful blood; but, not
withstanding, in the radish, what is appropriate and capable of
being altered (and that only with difficulty, and with much labour) is
the very smallest part; almost the whole of it is surplus matter,
and passes through the digestive organs, only a very little being
taken up into the veins as blood- nor is this itself entirely
utilisable blood. Nature, therefore, had need of a second process of
separation for the superfluities in the veins. Moreover, these
superfluities need, on the one hand, certain fresh routes to conduct
them to the outlets, so that they may not spoil the useful substances,
and they also need certain reservoirs, as it were, in which they are
collected till they reach a sufficient quantity, and are then
discharged.
  Thus, then, you have discovered bodily parts of a second kind,
consecrated in this case to the [removal of the] superfluities of
the food. There is, however, also a third kind, for carrying the
pabulum in every direction; these are like a number of roads
intersecting the whole body.
  Thus there is one entrance- that through the mouth- for all the
various articles of food. What receives nourishment, however, is not
one single part, but a great many parts, and these widely separated;
do not be surprised, therefore, at the abundance of organs which
Nature has created for the purpose of nutrition. For those of them
which have to do with alteration prepare the nutriment suitable for
each part; others separate out the superfluities; some pass these
along, others store them up, others excrete them; some, again, are
paths for the transit in all directions of the utilisable juices.
So, if you wish to gain a thorough acquaintance with all the faculties
of Nature, you will have consider each one of these organs.
  Now in giving an account of these we must begin with those effects
of Nature, together with their corresponding parts and faculties,
which are closely connected with the purpose to be achieved.
  11. Let us once more, then, recall the actual purpose for which
Nature has constructed all these parts. Its name, as previously
stated, is nutrition, and the definition corresponding to the name is:
an assimilation of that which nourishes to that which receives
nourishment. And in order that this may come about, we must assume a
preliminary process of adhesion, and for that, again, one of
presentation. For whenever the juice which is destined to nourish
any of the parts of the animal is emitted from the vessels, it is in
the first place dispersed all through this part, next it is presented,
and next it adheres, and becomes completely assimilated.
  The so-called white [leprosy] shows the difference between
assimilation and adhesion, in the same way that the kind of dropsy
which some people call anasarca clearly distinguishes presentation
from adhesion. For, of course, the genesis of such a dropsy does not
come about as do some of the conditions of atrophy and wasting, from
an insufficient supply of moisture; the flesh is obviously moist
enough,- in fact it is thoroughly saturated,- and each of the solid
parts of the body is in a similar condition. While, however, the
nutriment conveyed to the part does undergo presentation, it is
still too watery, and is not properly transformed into a juice, nor
has it acquired that viscous and agglutinative quality which results
from the operation of innate heat; therefore, adhesion cannot come
about, since, owing to this abundance of thin, crude liquid, the
pabulum runs off and easily slips away from the solid parts of the
body. In white [leprosy], again, there is adhesion of the nutriment
but no real assimilation. From this it is clear that what I have
just said is correct, namely, that in that part which is to be
nourished there must first occur presentation, next adhesion, and
finally assimilation proper.
  Strictly speaking, then, nutriment is that which is actually
nourishing, while the quasi-nutriment which is not yet nourishing
(e.g. matter which is undergoing adhesion or presentation) is not,
strictly speaking, nutriment, but is so called only by an
equivocation. Also, that which is still contained in the veins, and
still more, that which is in the stomach, from the fact that it is
destined to nourish if properly elaborated, has been called
"nutriment." Similarly we call the various kinds of food
"nutriment," not because they are already nourishing the animal, nor
because they exist in the same state as the material which actually is
nourishing it, but because they are able and destined to nourish it if
they be properly elaborated.
  This was also what Hippocrates said, viz., "Nutriment is what is
engaged in nourishing, as also is quasi-nutriment, and what is
destined to be nutriment." For to that which is already being
assimilated he gave the name of nutriment; to the similar material
which is being presented or becoming adherent, the name of
quasi-nutriment; and to everything else- that is, contained in the
stomach and veins- the name of destined nutriment.
  12. It is quite clear, therefore, that nutrition must necessarily be
a process of assimilation of that which is nourishing to that which is
being nourished. Some, however, say that this assimilation does not
occur in reality, but is merely apparent; these are the people who
think that Nature is not artistic, that she does not show
forethought for the animal's welfare, and that she has absolutely no
native powers whereby she alters some substances, attracts others, and
discharges others.
  Now, speaking generally, there have arisen the following two sects
in medicine and philosophy among those who have made any definite
pronouncement regarding Nature. I speak, of course, of such of them as
know what they are talking about, and who realize the logical sequence
of their hypotheses, and stand by them; as for those who cannot
understand even this, but who simply talk any nonsense that comes to
their tongues, and who do not remain definitely attached either to one
sect or the other- such people are not even worth mentioning.
  What, then, are these sects, and what are the logical consequences
of their hypotheses? The one class supposes that all substance which
is subject to genesis and destruction is at once continuous and
susceptible of alteration. The other school assumes substance to be
unchangeable, unalterable, and subdivided into fine particles, which
are separated from one another by empty spaces.
  All people, therefore, who can appreciate the logical sequence of an
hypothesis hold that, according to the second teaching, there does not
exist any substance or faculty peculiar either to Nature or to Soul,
but that these result from the way in which the primary corpuscles,
which are unaffected by change, come together. According to the
first-mentioned teaching, on the other hand, Nature is not posterior
to the corpuscles, but is a long way prior to them and older than
they; and therefore in their view it is Nature which puts together the
bodies both of plants and animals; and this she does by virtue of
certain faculties which she possesses- these being, on the one hand,
attractive and assimilative of what is appropriate, and, on the other,
of what is foreign. Further, she skilfully moulds everything during
the stage of genesis; and she also provides for the creatures after
birth, employing here other faculties again, namely, one of
affection and forethought for offspring, and one of sociability and
friendship for kindred. According to the other school, none of these
things exist in the natures [of living things], nor is there in the
soul any original innate idea, whether of agreement or difference,
of separation or synthesis, of justice or injustice, of the
beautiful or ugly; all such things, they say, arise in us from
sensation and through sensation, and animals are steered by certain
images and memories.
  Some of these people have even expressly declared that the soul
possesses no reasoning faculty, but that we are led like cattle by the
impression of our senses, and are unable to refuse or dissent from
anything. In their view, obviously, courage, wisdom, temperance, and
self-control are all mere nonsense, we do not love either each other
or our offspring, nor do the gods care anything for us. This school
also despises dreams, birds, omens, and the whole of astrology,
subjects with which we have dealt at greater length in another work,
in which we discuss the views of Asclepiades the physician. Those
who wish to do so may familiarize themselves with these arguments, and
they may also consider at this point which of the two roads lying
before us is the better one to take. Hippocrates took the
first-mentioned. According to this teaching, substance is one and is
subject to alteration; there is a consensus in the movements of air
and fluid throughout the whole body; Nature acts throughout in an
artistic and equitable manner, having certain faculties, by virtue
of which each part of the body draws to itself the juice which is
proper to it, and, having done so, attaches it to every portion of
itself, and completely assimilates it; while such part of the juice as
has not been mastered, and is not capable of undergoing complete
alteration and being assimilated to the part which is being nourished,
is got rid of by yet another (an expulsive) faculty.
  13. Now the extent of exactitude and truth in the doctrines of
Hippocrates may be gauged, not merely from the way in which his
opponents are at variance with obvious facts, but also from the
various subjects of natural research themselves- the functions of
animals, and the rest. For those people who do not believe that
there exists in any part of the animal a faculty for attracting its
own special quality are compelled repeatedly to deny obvious facts.
For instance, Asclepiades, the physician, did this in the case of
the kidneys. That these are organs for secreting [separating out]
the urine, was the belief not only of Hippocrates, Diocles,
Erasistratus, Praxagoras, and all other physicians of eminence, but
practically every butcher is aware of this, from the fact that he
daily observes both the position of the kidneys and the duct (termed
the ureter) which runs from each kidney into the bladder, and from
this arrangement he infers their characteristic use and faculty.
But, even leaving the butchers aside, all people who suffer either
from frequent dysuria or from retention of urine call themselves
"nephritics," when they feel pain in the loins and pass sandy matter
in their water.
  I do not suppose that Asclepiades ever saw a stone which had been
passed by one of these sufferers, or observed that this was preceded
by a sharp pain in the region between kidneys and bladder as the stone
traversed the ureter, or that, when the stone was passed, both the
pain and the retention at once ceased. It is worth while, then,
learning how his theory accounts for the presence of urine in the
bladder, and one is forced to marvel at the ingenuity of a man who
puts aside these broad, clearly visible routes,* and postulates others
which are narrow, invisible- indeed, entirely imperceptible. His view,
in fact, is that the fluid which we drink passes into the bladder by
being resolved into vapours, and that, when these have been again
condensed, it thus regains its previous form, and turns from vapour
into fluid. He simply looks upon the bladder as a sponge or a piece of
wool, and not as the perfectly compact and impervious body that it is,
with two very strong coats. For if we say that the vapours pass
through these coats, why should they not pass through the peritoneum
and the diaphragm, thus filling the whole abdominal cavity and
thorax with water? "But," says he, "of course the peritoneal coat is
more impervious than the bladder, and this is why it keeps out the
vapours, while the bladder admits them." Yet if he had ever
practised anatomy, he might have known that the outer coat of the
bladder springs from the peritoneum and is essentially the same as it,
and that the inner coat, which is peculiar to the bladder, is more
than twice as thick as the former.

  *The ureters.

  Perhaps, however, it is not the thickness or thinness of the
coats, but the situation of the bladder, which is the reason for the
vapours being carried into it? On the contrary, even if it were
probable for every other reason that the vapours accumulate there, yet
the situation of the bladder would be enough in itself to prevent
this. For the bladder is situated below, whereas vapours have a
natural tendency to rise upwards; thus they would fill all the
region of the thorax and lungs long before they came to the bladder.
  But why do I mention the situation of the bladder, peritoneum, and
thorax? For surely, when the vapours have passed through the coats
of the stomach and intestines, it is in the space between these and
the peritoneum that they will collect and become liquefied (just as in
dropsical subjects it is in this region that most of the water
gathers). Otherwise the vapours must necessarily pass straight forward
through everything which in any way comes in contact with them, and
will never come to a standstill. But, if this be assumed, then they
will traverse not merely the peritoneum but also the epigastrium,
and will become dispersed into the surrounding air; otherwise they
will certainly collect under the skin.
  Even these considerations, however, our present-day Asclepiadeans
attempt to answer, despite the fact that they always get soundly
laughed at by all who happen to be present at their disputations on
these subjects- so difficult an evil to get rid of is this sectarian
partizanship, so excessively resistant to all cleansing processes,
harder to heal than any itch!
  Thus, one of our Sophists who is a thoroughly hardened disputer
and as skilful a master of language as there ever was, once got into a
discussion with me on this subject; so far from being put out of
countenance by any of the above-mentioned considerations, he even
expressed his surprise that I should try to overturn obvious facts
by ridiculous arguments! "For," said he, "one may clearly observe
any day in the case of any bladder, that, if one fills it with water
or air and then ties up its neck and squeezes it all round, it does
not let anything out at any point, but accurately retains all its
contents. And surely," said he, "if there were any large and
perceptible channels coming into it from the kidneys the liquid
would run out through these when the bladder was squeezed, in the same
way that it entered?" Having abruptly made these and similar remarks
in precise and clear tones, he concluded by jumping up and
departing- leaving me as though I were quite incapable of finding
any plausible answer!
  The fact is that those who are enslaved to their sects are not
merely devoid of all sound knowledge, but they will not even stop to
learn! Instead of listening, as they ought, to the reason why liquid
can enter the bladder through the ureters, but is unable to go back
again the same way,- instead of admiring Nature's artistic skill- they
refuse to learn; they even go so far as to scoff, and maintain that
the kidneys, as well as many other things, have been made by Nature
for no purpose! And some of them who had allowed themselves to be
shown the ureters coming from the kidneys and becoming implanted in
the bladder, even had the audacity to say that these also existed
for no purpose; and others said that they were spermatic ducts, and
that this was why they were inserted into the neck of the bladder
and not into its cavity. When, therefore, we had demonstrated to
them the real spermatic ducts entering the neck of the bladder lower
down than the ureters, we supposed that, if we had not done so before,
we would now at least draw them away from their false assumptions, and
convert them forthwith to the opposite view. But even this they
presumed to dispute, and said that it was not to be wondered at that
the semen should remain longer in these latter ducts, these being more
constricted, and that it should flow quickly down the ducts which came
from the kidneys, seeing that these were well dilated. We were,
therefore, further compelled to show them in a still living animal,
the urine plainly running out through the ureters into the bladder;
even thus we hardly hoped to check their nonsensical talk.
  Now the method of demonstration is as follows. One has to divide the
peritoneum in front of the ureters, then secure these with
ligatures, and next, having bandaged up the animal, let him go (for he
will not continue to urinate). After this one loosens the external
bandages and shows the bladder empty and the ureters quite full and
distended- in fact almost on the point of rupturing; on removing the
ligature from them, one then plainly sees the bladder becoming
filled with urine.
  When this has been made quite clear, then, before the animal
urinates, one has to tie a ligature round his penis and then to
squeeze the bladder all over; still nothing goes back through the
ureters to the kidneys. Here, then, it becomes obvious that not only
in a dead animal, but in one which is still living, the ureters are
prevented from receiving back the urine from the bladder. These
observations having been made, one now loosens the ligature from the
animal's penis and allows him to urinate, then again ligatures one
of the ureters and leaves the other to discharge into the bladder.
Allowing, then, some time to elapse, one now demonstrates that the
ureter which was ligatured is obviously full and distended on the side
next to the kidneys, while the other one- that from which the ligature
had been taken- is itself flaccid, but has filled the bladder with
urine. Then, again, one must divide the full ureter, and demonstrate
how the urine spurts out of it, like blood in the operation of
vene-section; and after this one cuts through the other also, and both
being thus divided, one bandages up the animal externally. Then when
enough time seems to have elapsed, one takes off the bandages; the
bladder will now be found empty, and the whole region between the
intestines and the peritoneum full of urine, as if the animal were
suffering from dropsy. Now, if anyone will but test this for himself
on an animal, I think he will strongly condemn the rashness of
Asclepiades, and if he also learns the reason why nothing regurgitates
from the bladder into the ureters, I think he will be persuaded by
this also of the forethought and art shown by Nature in relation to
animals.
  Now Hippocrates, who was the first known to us of all those who have
been both physicians and philosophers in as much as he was the first
to recognize what Nature effects, expresses his admiration of her, and
is constantly singing her praises and calling her "just." Alone, he
says, she suffices for the animal in every respect, performing of
her own accord and without any teaching all that is required. Being
such, she has, as he supposes, certain faculties, one attractive of
what is appropriate, and another eliminative of what is foreign, and
she nourishes the animal, makes it grow, and expels its diseases by
crisis. Therefore he says that there is in our bodies a concordance in
the movements of air and fluid, and that everything is in sympathy.
According to Asclepiades, however, nothing is naturally in sympathy
with anything else, all substance being divided and broken up into
inharmonious elements and absurd "molecules." Necessarily, then,
besides making countless other statements in opposition to plain fact,
he was ignorant of Nature's faculties, both that attracting what is
appropriate, and that expelling what is foreign. Thus he invented some
wretched nonsense to explain blood-production and anadosis, and, being
utterly unable to find anything to say regarding the clearing-out of
superfluities, he did not hesitate to join issue with obvious facts,
and, in this matter of urinary secretion, to deprive both the
kidneys and the ureters of their activity, by assuming that there were
certain invisible channels opening into the bladder. It was, of
course, a grand and impressive thing to do, to mistrust the obvious,
and to pin one's faith in things which could not be seen!
  Also, in the matter of the yellow bile, he makes an even grander and
more spirited venture; for he says this is actually generated in the
bile-ducts, not merely separated out.
  How comes it, then, that in cases of jaundice two things happen at
the same time- that the dejections contain absolutely no bile, and
that the whole body becomes full of it? He is forced here again to
talk nonsense, just as he did in regard to the urine. He also talks no
less nonsense about the black bile and the spleen, not understanding
what was said by Hippocrates; and he attempts in stupid- I might say
insane- language, to contradict what he knows nothing about.
  And what profit did he derive from these opinions from the point
of view of treatment? He neither was able to cure a kidney ailment,
nor jaundice, nor a disease of black bile, nor would he agree with the
view held not merely by Hippocrates but by all men regarding drugs-
that some of them purge away yellow bile, and others black, some again
phlegm, and others the thin and watery superfluity; he held that all
the substances evacuated were produced by the drugs themselves, just
as yellow bile is produced by the biliary passages! It matters
nothing, according to this extraordinary man, whether we give a
hydragogue or a cholagogue in a case of dropsy, for these all
equally purge and dissolve the body, and produce a solution having
such and such an appearance, which did not exist as such before!
  Must we not, therefore, suppose he was either mad, or entirely
unacquainted with practical medicine? For who does not know that if
a drug for attracting phlegm be given in a case of jaundice it will
not even evacuate four cyathi* of phlegm? Similarly also if one of the
hydragogues be given. A cholagogue, on the other hand, clears away a
great quantity of bile, and the skin of patients so treated at once
becomes clear. I myself have, in many cases, after treating the
liver condition, then removed the disease by means of a single
purgation; whereas, if one had employed a drug for removing phlegm one
would have done no good.

  * About 4 oz., or one-third of a pint.

  Nor is Hippocrates the only one who knows this to be so, whilst
those who take experience alone as their starting-point know
otherwise; they, as well as all physicians who are engaged in the
practice of medicine, are of this opinion. Asclepiades, however, is an
exception; he would hold it a betrayal of his assumed "elements" to
confess the truth about such matters. For if a single drug were to
be discovered which attracted such and such a humour only, there would
obviously be danger of the opinion gaining ground that there is in
every body a faculty which attracts its own particular quality. He
therefore says that safflower, the Cnidian berry, and Hippophaes, do
not draw phlegm from the body, but actually make it. Moreover, he
holds that the flower and scales of bronze, and burnt bronze itself,
and germander, and wild mastich dissolve the body into water, and that
dropsical patients derive benefit from these substances, not because
they are purged by them, but because they are rid of substances
which actually help to increase the disease; for, if the medicine does
not evacuate the dropsical fluid contained in the body, but
generates it, it aggravates the condition further. Moreover, scammony,
according to the Asclepiadean argument, not only fails to evacuate the
bile from the bodies of jaundiced subjects, but actually turns the
useful blood into bile, and dissolves the body; in fact it does all
manner of evil and increases the disease.
  And yet this drug may be clearly seen to do good to numbers of
people! "Yes," says he, "they derive benefit certainly, but merely
in proportion to the evacuation."... But if you give these cases a
drug which draws off phlegm they will not be benefited. This is so
obvious that even those who make experience alone their starting-point
are aware of it; and these people make it a cardinal point of their
teaching to trust to no arguments, but only to what can be clearly
seen. In this, then, they show good sense; whereas Asclepiades goes
far astray in bidding us distrust our senses where obvious facts
plainly overturn his hypotheses. Much better would it have been for
him not to assail obvious facts, but rather to devote himself entirely
to these.
  Is it, then, these facts only which are plainly irreconcilable
with the views of Asclepiades? Is not also the fact that in summer
yellow bile is evacuated in greater quantity by the same drugs, and in
winter phlegm, and that in a young man more bile is evacuated, and
in an old man more phlegm? Obviously each drug attracts something
which already exists, and does not generate something previously
non-existent. Thus if you give in the summer season a drug which
attracts phlegm to a young man of a lean and warm habit, who has lived
neither idly nor too luxuriously, you will with great difficulty
evacuate a very small quantity of this humour, and you will do the man
the utmost harm. On the other hand, if you give him a cholagogue,
you will produce an abundant evacuation and not injure him at all.
  Do we still, then, disbelieve that each drug attracts that humour
which is proper to it? Possibly the adherents of Asclepiades will
assent to this- or rather, they will- not possibly, but certainly-
declare that they disbelieve it, lest they should betray their darling
prejudices.
  14. Let us pass on, then, again to another piece of nonsense; for
the sophists do not allow one to engage in enquiries that are of any
worth, albeit there are many such; they compel one to spend one's time
in dissipating the fallacious arguments which they bring forward.
  What, then, is this piece of nonsense? It has to do with the
famous and far-renowned stone which draws iron [the lodestone]. It
might be thought that this would draw their minds to a belief that
there are in all bodies certain faculties by which they attract
their own proper qualities.
  Now Epicurus, despite the fact that he employs in his "Physics"
elements similar to those of Asclepiades, yet allows that iron is
attracted by the lodestone, and chaff by amber. He even tries to
give the cause of the phenomenon. His view is that the atoms which
flow from the stone are related in shape to those flowing from the
iron, and so they become easily interlocked with one another; thus
it is that, after colliding with each of the two compact masses (the
stone and the iron) they then rebound into the middle and so become
entangled with each other, and draw the iron after them. So far, then,
as his hypotheses regarding causation go, he is perfectly
unconvincing; nevertheless, he does grant that there is an attraction.
Further, he says that it is on similar principles that there occur
in the bodies of animals the dispersal of nutriment and the
discharge of waste matters, as also the actions of cathartic drugs.
  Asclepiades, however, who viewed with suspicion the incredible
character of the cause mentioned, and who saw no other credible
cause on the basis of his supposed elements, shamelessly had
recourse to the statement that nothing is in any way attracted by
anything else. Now, if he was dissatisfied with what Epicurus said,
and had nothing better to say himself, he ought to have refrained from
making hypotheses, and should have said that Nature is a
constructive artist and that the substance of things is always tending
towards unity and also towards alteration because its own parts act
upon and are acted upon by one another. For, if he had assumed this,
it would not have been difficult to allow that this constructive
Nature has powers which attract appropriate and expel alien matter.
For in no other way could she be constructive, preservative of the
animal, and eliminative of its diseases, unless it be allowed that she
conserves what is appropriate and discharges what is foreign.
  But in this matter, too, Asclepiades realized the logical sequence
of the principles he had assumed; he showed no scruples, however, in
opposing plain fact; he joins issue in this matter also, not merely
with all physicians, but with everyone else, and maintains that
there is no such thing as a crisis, or critical day, and that Nature
does absolutely nothing for the preservation of the animal. For his
constant aim is to follow out logical consequences and to upset
obvious fact, in this respect being opposed to Epicurus; for the
latter always stated the observed fact, although he gives an
ineffective explanation of it. For, that these small corpuscles
belonging to the lodestone rebound, and become entangled with other
similar particles of the iron, and that then, by means of this
entanglement (which cannot be seen anywhere) such a heavy substance as
iron is attracted- I fail to understand how anybody could believe
this. Even if we admit this, the same principle will not explain the
fact that, when the iron has another piece brought in contact with it,
this becomes attached to it.
  For what are we to say? That, forsooth, some of the particles that
flow from the lodestone collide with the iron and then rebound back,
and that it is by these that the iron becomes suspended? that others
penetrate into it, and rapidly pass through it by way of its empty
channels? that these then collide with the second piece of iron and
are not able to penetrate it although they penetrated the first piece?
and that they then course back to the first piece, and produce
entanglements like the former ones?
  The hypothesis here becomes clearly refuted by its absurdity. As a
matter of fact, I have seen five writing-stylets of iron attached to
one another in a line, only the first one being in contact with the
lodestone, and the power being transmitted through it to the others.
Moreover, it cannot be said that if you bring a second stylet into
contact with the lower end of the first, it becomes held, attached,
and suspended, whereas, if you apply it to any other part of the
side it does not become attached. For the power of the lodestone is
distributed in all directions; it merely needs to be in contact with
the first stylet at any point; from this stylet again the power flows,
as quick as a thought, all through the second, and from that again
to the third. Now, if you imagine a small lodestone hanging in a
house, and in contact with it all round a large number of pieces of
iron, from them again others, from these others, and so on,- all these
pieces of iron must surely become filled with the corpuscles which
emanate from the stone; therefore, this first little stone is likely
to become dissipated by disintegrating into these emanations. Further,
even if there be no iron in contact with it, it still disperses into
the air, particularly if this be also warm.
  "Yes," says Epicurus, "but these corpuscles must be looked on as
exceedingly small, so that some of them are a ten-thousandth part of
the size of the very smallest particles carried in the air." Then do
you venture to say that so great a weight of iron can be suspended
by such small bodies? If each of them is a ten-thousandth part as
large as the dust particles which are borne in the atmosphere, how big
must we suppose the hook-like extremities by which they interlock with
each other to be? For of course this is quite the smallest portion
of the whole particle.
  Then, again, when a small body becomes entangled with another
small body, or when a body in motion becomes entangled with another
also in motion, they do not rebound at once. For, further, there
will of course be others which break in upon them from above, from
below, from front and rear, from right and left, and which shake and
agitate them and never let them rest. Moreover, we must perforce
suppose that each of these small bodies has a large number of these
hook-like extremities. For by one it attaches itself to its
neighbours, by another- the topmost one- to the lodestone, and by
the bottom one to the iron. For if it were attached to the stone above
and not interlocked with the iron below, this would be of no use.
Thus, the upper part of the superior extremity must hang from the
lodestone, and the iron must be attached to the lower end of the
inferior extremity; and, since they interlock with each other by their
sides as well, they must, of course, have hooks there too. Keep in
mind also, above everything, what small bodies these are which possess
all these different kinds of outgrowths. Still more, remember how,
in order that the second piece of iron may become attached to the
first, the third to the second, and to that the fourth, these absurd
little particles must both penetrate the passages in the first piece
of iron and at the same time rebound from the piece coming next in the
series, although this second piece is naturally in every way similar
to the first.
  Such an hypothesis, once again, is certainly not lacking in
audacity; in fact, to tell the truth, it is far more shameless than
the previous ones; according to it, when five similar pieces of iron
are arranged in a line, the particles of the lodestone which easily
traverse the first piece of iron rebound from the second, and do not
pass readily through it in the same way. Indeed, it is nonsense,
whichever alternative is adopted. For, if they do rebound, how then do
they pass through into the third piece? And if they do not rebound,
how does the second piece become suspended to the first? For
Epicurus himself looked on the rebound as the active agent in
attraction.
  But, as I have said, one is driven to talk nonsense whenever one
gets into discussion with such men. Having, therefore, given a concise
and summary statement of the matter, I wish to be done with it. For if
one diligently familiarizes oneself with the writings of
Asclepiades, one will see clearly their logical dependence on his
first principles, but also their disagreement with observed facts.
Thus, Epicurus, in his desire to adhere to the facts, cuts an
awkward figure by aspiring to show that these agree with his
principles, whereas Asclepiades safeguards the sequence of principles,
but pays no attention to the obvious fact. Whoever, therefore,
wishes to expose the absurdity of their hypotheses, must, if the
argument be in answer to Asclepiades, keep in mind his disagreement
with observed fact; or if in answer to Epicurus, his discordance
with his principles. Almost all the other sects depending on similar
principles are now entirely extinct, while these alone maintain a
respectable existence still. Yet the tenets of Asclepiades have been
unanswerably confuted by Menodotus the Empiricist, who draws his
attention to their opposition to phenomena and to each other; and,
again, those of Epicurus have been confuted by Asclepiades, who
adhered always to logical sequence, about which Epicurus evidently
cares little.
  Now people of the present day do not begin by getting a clear
comprehension of these sects, as well as of the better ones,
thereafter devoting a long time to judging and testing the true and
false in each of them; despite their ignorance, they style themselves,
some "physicians" and others "philosophers." No wonder, then, that
they honour the false equally with the true. For everyone becomes like
the first teacher that he comes across, without waiting to learn
anything from anybody else. And there are some of them, who, even if
they meet with more than one teacher, are yet so unintelligent and
slow-witted that even by the time they have reached old age they are
still incapable of understanding the steps of an argument.... In the
old days such people used to be set to menial tasks.... What will be
the end of it God knows!
  Now, we usually refrain from arguing with people whose principles
are wrong from the outset. Still, having been compelled by the natural
course of events to enter into some kind of a discussion with them, we
must add this further to what was said- that it is not only
cathartic drugs which naturally attract their special qualities, but
also those which remove thorns and the points of arrows such as
sometimes become deeply embedded in the flesh. Those drugs also
which draw out animal poisons or poisons applied to arrows all show
the same faculty as does the lodestone. Thus, I myself have seen a
thorn which was embedded in a young man's foot fail to come out when
we exerted forcible traction with our fingers, and yet come away
painlessly and rapidly on the application of a medicament. Yet even to
this some people will object, asserting that when the inflammation
is dispersed from the part the thorn comes away of itself, without
being pulled out by anything. But these people seem, in the first
place, to be unaware that there are certain drugs for drawing out
inflammation and different ones for drawing out embedded substances;
and surely if it was on the cessation of an inflammation that the
abnormal matters were expelled, then all drugs which disperse
inflammations ought ipso facto; to possess the power of extracting
these substances as well.
  And secondly, these people seem to be unaware of a still more
surprising fact, namely, that not merely do certain medicaments draw
out thorns and others poisons, but that of the latter there are some
which attract the poison of the viper, others that of the sting-ray,
and others that of some other animal; we can, in fact, plainly observe
these poisons deposited on the medicaments. Here, then, we must praise
Epicurus for the respect he shows towards obvious facts, but find
fault with his views as to causation. For how can it be otherwise than
extremely foolish to suppose that a thorn which we failed to remove by
digital traction could be drawn out by these minute particles?
  Have we now, therefore, convinced ourselves that everything which
exists possesses a faculty by which it attracts its proper quality,
and that some things do this more, and some less?
  Or shall we also furnish our argument with the illustration afforded
by corn? For those who refuse to admit that anything is attracted by
anything else, will, I imagine, be here proved more ignorant regarding
Nature than the very peasants. When, for my own part, I first
learned of what happens, I was surprised, and felt anxious to see it
with my own eyes. Afterwards, when experience also had confirmed its
truth, I sought long among the various sects for an explanation,
and, with the exception of that which gave the first place to
attraction, I could find none which even approached plausibility,
all the others being ridiculous and obviously quite untenable.
  What happens, then, is the following. When our peasants are bringing
corn from the country into the city in wagons, and wish to filch
some away without being detected, they fill earthen jars with water
and stand them among the corn; the corn then draws the moisture into
itself through the jar and acquires additional bulk and weight, but
the fact is never detected by the onlookers unless someone who knew
about the trick before makes a more careful inspection. Yet, if you
care to set down the same vessel in the very hot sun, you will find
the daily loss to be very little indeed. Thus corn has a greater power
than extreme solar heat of drawing to itself the moisture in its
neighbourhood. Thus the theory that the water is carried towards the
rarefied part of the air surrounding us (particularly when that is
distinctly warm) is utter nonsense; for although it is much more
rarefied there than it is amongst the corn, yet it does not take up
a tenth part of the moisture which the corn does.
  15. Since, then, we have talked sufficient nonsense- not
willingly, but because we were forced, as the proverb says, "to behave
madly among madmen"- let us return again to the subject of urinary
secretion. Here let us forget the absurdities of Asclepiades, and,
in company with those who are persuaded that the urine does pass
through the kidneys, let us consider what is the character of this
function. For, most assuredly, either the urine is conveyed by its own
motion to the kidneys, considering this the better course (as do we
when we go off to market!), or, if this be impossible, then some other
reason for its conveyance must be found. What, then, is this? If we
are not going to grant the kidneys a faculty for attracting this
particular quality, as Hippocrates held, we shall discover no other
reason. For, surely everyone sees that either the kidneys must attract
the urine, or the veins must propel it- if, that is, it does not
move of itself. But if the veins did exert a propulsive action when
they contract, they would squeeze out into the kidneys not merely
the urine, but along with it the whole of the blood which they
contain. And if this is impossible, as we shall show, the remaining
explanation is that the kidneys do exert traction.
  And how is propulsion by the veins impossible? The situation of
the kidneys is against it. They do not occupy a position beneath the
hollow vein [vena cava] as does the sieve-like [ethmoid] passage in
the nose and palate in relation to the surplus matter from the
brain; they are situated on both sides of it. Besides, if the
kidneys are like sieves, and readily let the thinner serous
[whey-like] portion through, and keep out the thicker portion, then
the whole of the blood contained in the vena cava must go to them,
just as the whole of the wine is thrown into the filters. Further, the
example of milk being made into cheese will show clearly what I
mean. For this, too, although it is all thrown into the wicker
strainers, does not all percolate through; such part of it as is too
fine in proportion to the width of the meshes passes downwards, and
this is called whey [serum]; the remaining thick portion which is
destined to become cheese cannot get down, since the pores of the
strainers will not admit it. Thus it is that, if the blood-serum has
similarly to percolate through the kidneys, the whole of the blood
must come to them, and not merely one part of it.
  What, then, is the appearance as found on dissection?
  One division of the vena cava is carried upwards to the heart, and
the other mounts upon the spine and extends along its whole length
as far as the legs; thus one division does not even come near the
kidneys, while the other approaches them but is certainly not inserted
into them. Now, if the blood were destined to be purified by them as
if they were sieves, the whole of it would have to fall into them, the
thin part being and the thick part retained above. But, as a matter of
fact, this is not so. For the kidneys lie on either side of the vena
cava. They therefore do not act like sieves, filtering fluid sent to
them by the vena cava, and themselves contributing no force. They
obviously exert traction; for this is the only remaining alternative.
  How, then, do they exert this traction? If, as Epicurus thinks,
all attraction takes place by virtue of the rebounds and entanglements
of atoms, it would be certainly better to maintain that the kidneys
have no attractive action at all; for his theory, when examined, would
be found as it stands to be much more ridiculous even than the
theory of the lodestone, mentioned a little while ago. Attraction
occurs in the way that Hippocrates laid down; this will be stated more
clearly as the discussion proceeds; for the present our task is not to
demonstrate this, but to point out that no other cause of the
secretion of urine can be given except that of attraction by the
kidneys, and that this attraction does not take place in the way
imagined by people who do not allow Nature a faculty of her own.
  For if it be granted that there is any attractive faculty at all
in those things which are governed by Nature, a person who attempted
to say anything else about the absorption of nutriment would be
considered a fool.
  16. Now, while Erasistratus for some reason replied at great
length to certain other foolish doctrines, he entirely passed over the
view held by Hippocrates, not even thinking it worth while to
mention it, as he did in his work "On Deglutition"; in that work, as
may be seen, he did go so far as at least to make mention of the
word attraction, writing somewhat as follows:
  "Now, the stomach does not appear to exercise any attraction." But
when he is dealing with anadosis he does not mention the Hippocratic
view even to the extent of a single syllable. Yet we should have
been satisfied if he had even merely written this: "Hippocrates lies
in saying 'The flesh* attracts both from the stomach and from
without,' for it cannot attract either from the stomach or from
without." Or if he had thought it worth while to state that
Hippocrates was wrong in criticizing the weakness of the neck of the
uterus, "seeing that the orifice of the uterus has no power of
attracting semen," or if he [Erasistratus] had thought proper to write
any other similar opinion, then we in our turn would have defended
ourselves in the following terms:

  *i.e. the tissues.

  "My good sir, do not run us down in this rhetorical fashion
without some proof; state some definite objection to our view, in
order that either you may convince us by a brilliant refutation of the
ancient doctrine, or that, on the other hand, we may convert you
from your ignorance." Yet why do I say "rhetorical"? For we too are
not to suppose that when certain rhetoricians pour ridicule upon
that which they are quite incapable of refuting, without any attempt
at argument, their words are really thereby constituted rhetoric.
For rhetoric proceeds by persuasive reasoning; words without reasoning
are buffoonery rather than rhetoric. Therefore, the reply of
Erasistratus in his treatise "On Deglutition" was neither rhetoric nor
logic. For what is it that he says? "Now, the stomach does not
appear to exercise any traction." Let us testify against him in
return, and set our argument beside his in the same form. Now, there
appears to be no peristalsis of the gullet. "And how does this
appear?" one of his adherents may perchance ask. "For is it not
indicative of peristalsis that always when the upper parts of the
gullet contract the lower parts dilate?" Again, then, we say, "And
in what way does the attraction of the stomach not appear? For is it
not indicative of attraction that always when the lower parts of the
gullet dilate the upper parts contract?" Now, if he would but be
sensible and recognize that this phenomenon is not more indicative
of the one than of the other view, but that it applies equally to
both, we should then show him without further delay the proper way
to the discovery of truth.
  We will, however, speak about the stomach again. And the dispersal
of nutriment [anadosis] need not make us have recourse to the theory
regarding the natural tendency of a vacuum to become refilled, when
once we have granted the attractive faculty of the kidneys. Now,
although Erasistratus knew that this faculty most certainly existed,
he neither mentioned it nor denied it, nor did he make any statement
as to his views on the secretion of urine.
  Why did he give notice at the very beginning of his "General
Principles" that he was going to speak about natural activities-
firstly what they are, how they take place, and in what situations-
and then, in the case of urinary secretion, declared that this took
place through the kidneys, but left out its method of occurrence? It
must, then, have been for no purpose that he told us how digestion
occurs, or spends time upon the secretion of biliary superfluities;
for in these cases also it would have been sufficient to have named
the parts through which the function takes place, and to have
omitted the method. On the contrary, in these cases he was able to
tell us not merely through what organs, but also in what way it
occurs- as he also did, I think, in the case of anadosis; for he was
not satisfied with saying that this took place through the veins,
but he also considered fully the method, which he held to be from
the tendency of a vacuum to become refilled. Concerning the
secretion of urine, however, he writes that this occurs through the
kidneys, but does not add in what way it occurs. I do not think he
could say that this was from the tendency of matter to fill a
vacuum, for, if this were so, nobody would have ever died of retention
of urine, since no more can flow into a vacuum than has run out.
For, if no other factor comes into operation save only this tendency
by which a vacuum becomes refilled, no more could ever flow in than
had been evacuated. Nor, could he suggest any other plausible cause,
such, for example, as the of nutriment by the stomach which occurs
in the process of anadosis; this had been entirely disproved in the
case of blood in the vena cava; it is excluded, not merely owing to
the long distance, but also from the fact that the overlying heart, at
each diastole, robs the vena cava by violence of a considerable
quantity of blood.
  In relation to the lower part of the vena cava there would still
remain, solitary and abandoned, the specious theory concerning the
filling of a vacuum. This, however, is deprived of plausibility by the
fact that people die of retention of urine, and also, no less, by
the situation of the kidneys. For, if the whole of the blood were
carried to the kidneys, one might properly maintain that it all
undergoes purification there. But, as a matter of fact, the whole of
it does not go to them, but only so much as can be contained in the
veins going to the kidneys; this portion only, therefore, will be
purified. Further, the thin serous part of this will pass through
the kidneys as if through a sieve, while the thick sanguineous portion
remaining in the veins will obstruct the blood flowing in from behind;
this will first, therefore, have to run back to the vena cava, and
so to empty the veins going to the kidneys; these veins will no longer
be able to conduct a second quantity of unpurified blood to the
kidneys- occupied as they are by the blood which had preceded, there
is no passage left. What power have we, then, which will draw back the
purified blood from the kidneys? And what power,in the next place,
will bid this blood retire to the lower part of the vena cava, and
will enjoin on another quantity coming from above not to proceed
downwards before turning off into the kidneys?
  Now Erasistratus realized that all these ideas were open to many
objections, and he could only find one idea which held good in all
respects- namely, that of attraction. Since, therefore, he did not
wish either to get into difficulties or to mention the view of
Hippocrates, he deemed it better to say nothing at all as to the
manner in which secretion occurs.
  But even if he kept silence, I am not going to do so. For I know
that if one passes over the Hippocratic view and makes some other
pronouncement about the function of the kidneys, one cannot fall to
make oneself utterly ridiculous. It was for this reason that
Erasistratus kept silence and Asclepiades lied; they are like slaves
who have had plenty to say in the early part of their career, and have
managed by excessive rascality to escape many and frequent
accusations, but who, later, when caught in the act of thieving,
cannot find any excuse; the more modest one then keeps silence, as
though thunderstruck, whilst the more shameless continues to hide
the missing article beneath his arm and denies on oath that he has
ever seen it. For it was in this way also that Asclepiades, when all
subtle excuses had failed him and there was no longer any room for
nonsense about "conveyance towards the rarefied part [of the air],"
and when it was impossible without incurring the greatest derision
to say that this superfluity [i.e. the urine] is generated by the
kidneys as is bile by the canals in the liver- he, then, I say,
clearly lied when he swore that the urine does not reach the
kidneys, and maintained that it passes, in the form of vapour,
straight from the region of the vena cava, to collect in the bladder.
  Like slaves, then, caught in the act of stealing, these two are
quite bewildered, and while the one says nothing, the other indulges
in shameless lying.
  17. Now such of the younger men as have dignified themselves with
the names of these two authorities by taking the appellations
"Erasistrateans" or "Asclepiadeans" are like the Davi and Getae- the
slaves introduced by the excellent Menander into his comedies. As
these slaves held that they had done nothing fine unless they had
cheated their master three times, so also the men I am discussing have
taken their time over the construction of impudent sophisms, the one
party striving to prevent the lies of Asclepiades from ever being
refuted, and the other saying stupidly what Erasistratus had the sense
to keep silence about.
  But enough about the Asclepiadeans. The Erasistrateans, in
attempting to say how the kidneys let the urine through, will do
anything or suffer anything or try any shift in order to find some
plausible explanation which does not demand the principle of
attraction.
  Now those near the times of Erasistratus maintain that the parts
above the kidneys receive pure blood, whilst the watery residue, being
heavy, tends to run downwards; that this, after percolating through
the kidneys themselves, is thus rendered serviceable, and is sent,
as blood, to all the parts below the kidneys.
  For a certain period at least this view also found favour and
flourished, and was held to be true; after a time, however, it
became suspect to the Erasistrateans themselves, and at last they
abandoned it. For apparently the following two points were assumed,
neither of which is conceded by anyone, nor is even capable of being
proved. The first is the heaviness of the serous fluid, which was said
to be produced in the vena cava, and which did not exist,
apparently, at the beginning, when this fluid was being carried up
from the stomach to the liver. Why, then, did it not at once run
downwards when it was in these situations? And if the watery fluid
is so heavy, what plausibility can anyone find in the statement that
it assists in the process of anadosis?
  In the second place there is this absurdity, that even if it be
agreed that all the watery fluid does fall downwards, and only when it
is in the vena cava, still it is difficult, or, rather, impossible, to
say through what means it is going to fall into the kidneys, seeing
that these are not situated below, but on either side of the vena
cava, and that the vena cava is not inserted into them, but merely
sends a branch into each of them, as it also does into all the other
parts.
  What doctrine, then, took the place of this one when it was
condemned? One which to me seems far more foolish than the first,
although it also flourished at one time. For they say, that if oil
be mixed with water and poured upon the ground, each will take a
different route, the one flowing this way and the other that, and
that, therefore, it is not surprising that the watery fluid runs
into the kidneys, while the blood falls downwards along the vena cava.
Now this doctrine also stands already condemned. For why, of the
countless veins which spring from the vena cava, should blood flow
into all the others, and the serous fluid be diverted to those going
to the kidneys? They have not answered the question which was asked;
they merely state what happens and imagine they have thereby
assigned the reason.
  Once again, then (the third cup to the Saviour!),* let us now
speak of the worst doctrine of all, lately invented by Lycus of
Macedonia, but which is popular owing to its novelty. This Lycus,
then, maintains, as though uttering an oracle from the inner
sanctuary, that urine is residual matter from the nutrition of the
kidneys! Now, the amount of urine passed every day shows clearly
that it is the whole of the fluid drunk which becomes urine, except
for that which comes away with the dejections or passes off as sweat
or insensible perspiration. This is most easily recognized in winter
in those who are doing no work but are carousing, especially if the
wine be thin and diffusible; these people rapidly pass almost the same
quantity as they drink. And that even Erasistratus was aware of this
is known to those who have read the first book of his "General
Principles." Thus Lycus is speaking neither good Erasistratism, nor
good Asclepiadism, far less good Hippocratism. He is, therefore, as
the saying is, like a white crow, which cannot mix with the genuine
crows owing to its colour, nor with the pigeons owing to its size. For
all this, however, he is not to be disregarded; he may, perhaps, be
stating some wonderful truth, unknown to any of his predecessors.

  *In a toast, the third cup was drunk to Zeus Soter (the Saviour).

  Now it is agreed that all parts which are undergoing nutrition
produce a certain amount of residue, but it is neither agreed nor is
it likely, that the kidneys alone, small bodies as they are, could
hold four whole congii,* and sometimes even more, of residual
matter. For this surplus must necessarily be greater in quantity in
each of the larger viscera; thus, for example, that of the lung, if it
corresponds in amount to the size of the viscus, will obviously be
many times more than that in the kidneys, and thus the whole of the
thorax will become filled, and the animal will be at once
suffocated. But if it be said that the residual matter is equal in
amount in each of the other parts, where are the bladders, one may
ask, through which it is excreted? For, if the kidneys produce in
drinkers three and sometimes four congii of superfluous matter, that
of each of the other viscera will be much more, and thus an enormous
barrel will be needed to contain the waste products of them all. Yet
one often urinates practically the same quantity as one has drunk,
which would show that the whole of what one drinks goes to the
kidneys.

  *About twelve quarts.

  Thus the author of this third piece of trickery would appear to have
achieved nothing, but to have been at once detected, and there still
remains the original difficulty which was insoluble by Erasistratus
and by all others except Hippocrates. I dwell purposely on this topic,
knowing well that nobody else has anything to say about the function
of the kidneys, but that either we must prove more foolish than the
very butchers if we do not agree that the urine passes through the
kidneys; or, if one acknowledges this, that then one cannot possibly
give any other reason for the secretion than the principle of
attraction.
  Now, if the movement of urine does not depend on the tendency of a
vacuum to become refilled, it is clear that neither does that of the
blood nor that of the bile; or if that of these latter does so, then
so also does that of the former. For they must all be accomplished
in one and the same way, even according to Erasistratus himself.
  This matter, however, will be discussed more fully in the book
following this.
  BOOK TWO

  1. In the previous book we demonstrated that not only
Erasistratus, but also all others who would say anything to the
purpose about urinary secretion, must acknowledge that the kidneys
possess some faculty which attracts to them this particular quality
existing in the urine. Besides this we drew attention to the fact that
the urine is not carried through the kidneys into the bladder by one
method, the blood into parts of the animal by another, and the
yellow bile separated out on yet another principle. For when once
there has been demonstrated in any one organ, the drawing, or
so-called epispastic faculty, there is then no difficulty in
transferring it to the rest. Certainly Nature did not give a power
such as this to the kidneys without giving it also to the vessels
which abstract the biliary fluid,* nor did she give it to the latter
without also it to each of the other parts. And, assuredly, if this is
true, we must marvel that Erasistratus should make statements
concerning the delivery of nutriment from the food-canal which are
so false as to be detected even by Asclepiades. Now, Erasistratus
considers it absolutely certain that, if anything flows from the
veins, one of two things must happen: either a completely empty
space will result, or the contiguous quantum of fluid will run in
and take the place of that which has been evacuated. Asclepiades,
however, holds that not one of two, but one of three things must be
said to result in the emptied vessels: either there will be an
entirely empty space, or the contiguous portion will flow in, or the
vessel will contract. For whereas, in the case of reeds and tubes it
is true to say that, if these be submerged in water, and are emptied
of the air which they contain in their lumens, then either a
completely empty space will be left, or the contiguous portion will
move onwards; in the case of veins this no longer holds, since their
coats can collapse and so fall in upon the interior cavity. It may
be seen, then, how false this hypothesis- by Zeus, I cannot call it
a demonstration!- of Erasistratus is.

  *The radicles of the hepatic ducts in the liver were supposed to
be the active agents in extracting bile from the blood.

  And, from another point of view, even if it were true, it is
superfluous, if the stomach has the power of compressing the veins, as
he himself supposed, and the veins again of contracting upon their
contents and propelling them forwards. For, apart from other
considerations, no plethora would ever take place in the body, if
delivery of nutriment resulted merely from the tendency of a vacuum to
become refilled. Now, if the compression of the stomach becomes weaker
the further it goes, and cannot reach to an indefinite distance, and
if, therefore, there is need of some other mechanism to explain why
the blood is conveyed in all directions, then the principle of the
refilling of a vacuum may be looked on as a necessary addition;
there will not, however, be a plethora in any of the parts coming
after the liver, or, if there be, it will be in the region of the
heart and lungs; for the heart alone of the parts which come after the
liver draws the nutriment into its right ventricle, thereafter sending
it through the arterioid vein* to the lungs (for Erasistratus
himself will have it that, owing to the membranous excrescences, no
other parts save the lungs receive nourishment from the heart). If,
however, in order to explain how plethora comes about, we suppose
the force of compression by the stomach to persist indefinitely, we
have no further need of the principle of the refilling of a vacuum,
especially if we assume contraction of the veins in addition- as is,
again, agreeable to Erasistratus himself.

  *What we now call the pulmonary artery.

  2. Let me draw his attention, then, once again, even if he does
not wish it, to the kidneys, and let me state that these confute in
the very clearest manner such people as object to the principle of
attraction. Nobody has ever said anything plausible, nor, as we
previously showed, has anyone been able to discover, by any means, any
other cause for the secretion of urine; we necessarily appear mad if
we maintain that the urine passes into the kidneys in the form of
vapour, and we certainly cut a poor figure when we talk about the
tendency of a vacuum to become refilled; this idea is foolish in the
case of blood, and impossible, nay, perfectly nonsensical, in the case
of the urine.
  This, then, is one blunder made by those who dissociate themselves
from the principle of attraction. Another is that which they make
about the secretion of yellow bile. For in this case, too, it is not a
fact that when the blood runs past the mouths [stomata] of the
bile-ducts there will be a thorough separation out [secretion] of
biliary waste-matter. "Well," say they, "let us suppose that it is not
secreted but carried with the blood all over the body." But, you
sapient folk, Erasistratus himself supposed that Nature took thought
for the animals' future, and was workmanlike in her method; and at the
same time he maintained that the biliary fluid was useless in every
way for the animals. Now these two things are incompatible. For how
could Nature be still looked on as exercising forethought for the
animal when she allowed a noxious humour such as this to be carried
off and distributed with the blood?...
  This, however, is a small matter. I shall again point out here the
greatest and most obvious error. For if the yellow bile adjusts itself
to the narrower vessels and stomata, and the blood to the wider
ones, for no other reason than that blood is thicker and bile thinner,
and that the stomata of the veins are wider and those of the
bile-ducts narrower, then it is clear that this watery and serous
superfluity,* too, will run out into the bile-ducts quicker than
does the bile, exactly in proportion as it is thinner than the bile!
How is it, then, that it does not run out? "Because," it may be
said, "urine is thicker than bile!" This was what one of our
Erasistrateans ventured to say, herein clearly disregarding the
evidence of his senses, although he had trusted these in the case of
the bile and blood. For, if it be that we are to look on bile as
thinner than blood because it runs more, then, since the serous
residue* passes through fine linen or lint or a or a sieve more easily
even than does bile, by these tokens bile must also be thicker than
the watery fluid. For here, again, there is no argument which will
demonstrate that bile is thinner than the serous superfluities.

  *Urine, or, more exactly, blood-serum.

  But when a man shamelessly goes on using circumlocutions, and
never acknowledges when he has had a fall, he is like the amateur
wrestlers, who, when they have been overthrown by the experts and
are lying on their backs on the ground, so far from recognizing
their fall, actually seize their victorious adversaries by the necks
and prevent them from getting away, thus supposing themselves to be
the winners!
  3. Thus, every hypothesis of channels as an explanation of natural
functioning is perfect nonsense. For, if there were not an inborn
faculty given by Nature to each one of the organs at the very
beginning, then animals could not continue to live even for a few
days, far less for the number of years which they actually do. For let
us suppose they were under no guardianship, lacking in creative
ingenuity and forethought; let us suppose they were steered only by
material forces, and not by any special faculties (the one
attracting what is proper to it, another rejecting what is foreign,
and yet another causing alteration and adhesion of the matter destined
to nourish it); if we suppose this, I am sure it would be ridiculous
for us to discuss natural, or, still more, psychical, activities-
or, in fact, life as a whole.
  For there is not a single animal which could live or endure for
the shortest time if, possessing within itself so many different
parts, it did not employ faculties which were attractive of what is
appropriate, eliminative of what is foreign, and alterative of what is
destined for nutrition. On the other hand, if we have these faculties,
we no longer need channels, little or big, resting on an unproven
hypothesis, for explaining the secretion of urine and bile, and the
conception of some favourable situation (in which point alone
Erasistratus shows some common sense, since he does regard all the
parts of the body as having been well and truly placed and shaped by
Nature).
  But let us suppose he remained true to his own statement that Nature
is "artistic"- this Nature which, at the beginning, well and truly
shaped and disposed all the parts of the animal, and, after carrying
out this function (for she left nothing undone), brought it forward to
the light of day, endowed with certain faculties necessary for its
very existence, and, thereafter, gradually increased it until it
reached its due size. If he argued consistently on this principle, I
fail to see how he can continue to refer natural functions to the
smallness or largeness of canals, or to any other similarly absurd
hypothesis. For this Nature which shapes and gradually adds to the
parts is most certainly extended throughout their whole substance. Yes
indeed, she shapes and nourishes and increases them through and
through, not on the outside only. For Praxiteles and Phidias and all
the other statuaries used merely to decorate their material on the
outside, in so far as they were able to touch it; but its inner
parts they left unembellished, unwrought, unaffected by art or
forethought, since they were unable to penetrate therein and to
reach and handle all portions of the material. It is not so,
however, with Nature. Every part of a bone she makes bone, every
part of the flesh she makes flesh, and so with fat and all the rest;
there is no part which she has not touched, elaborated, and
embellished. Phidias, on the other hand, could not turn wax into ivory
and gold, nor yet gold into wax: for each of these remains as it was
at the commencement, and becomes a perfect statue simply by being
clothed externally in a form and artificial shape. But Nature does not
preserve the original character of any kind of matter; if she did
so, then all parts of the animal would be blood- that blood, namely,
which flows to the semen from the impregnated female and which is,
so to speak, like the statuary's wax, a single uniform matter,
subjected to the artificer. From this blood there arises no part of
the animal which is as red and moist [as blood is], for bone,
artery, vein, nerve, cartilage, fat, gland, membrane, and marrow are
not blood, though they arise from it.
  I would then ask Erasistratus himself to inform me what the
altering, coagulating, and shaping agent is. He would doubtless say,
"Either Nature or the semen," meaning the same thing in both cases,
but explaining it by different devices. For that which was
previously semen, when it begins to procreate and to shape the animal,
becomes, so to say, a special nature. For in the same way that Phidias
possessed the faculties of his art even before touching his
material, and then activated these in connection with this material
(for every faculty remains inoperative in the absence of its proper
material), so it is with the semen: its faculties it possessed from
the beginning,* while its activities it does not receive from its
material, but it manifests them in connection therewith.

  *Galen attributed to the semen what we should to the fertilized
ovum.

  And, of course, if it were to be overwhelmed with a great quantity
of blood, it would perish, while if it were to be entirely deprived of
blood it would remain inoperative and would not turn into a nature.
Therefore, in order that it may not perish, but may become a nature in
place of semen, there must be an afflux to it of a little blood- or,
rather, one should not say a little, but a quantity commensurate
with that of the semen. What is it then that measures the quantity
of this afflux? What prevents more from coming? What ensures against a
deficiency? What is this third overseer of animal generation that we
are to look for, which will furnish the semen with a due amount of
blood? What would Erasistratus have said if he had been alive, and had
been asked this question? Obviously, the semen itself. This, in
fact, is the artificer analogous with Phidias, whilst the blood
corresponds to the statuary's wax.
  Now, it is not for the wax to discover for itself how much of it
is required; that is the business of Phidias. Accordingly the
artificer will draw to itself as much blood as it needs. Here,
however, we must pay attention and take care not unwittingly to credit
the semen with reason and intelligence; if we were to do this, we
would be making neither semen nor a nature, but an actual living
animal. And if we retain these two principles- that of proportionate
attraction and that of the non-participation of intelligence- we shall
ascribe to the semen a faculty for attracting blood similar to that
possessed by the lodestone for iron. Here, then, again, in the case of
the semen, as in so many previous instances, we have been compelled to
acknowledge some kind of attractive faculty.
  And what is the semen? Clearly the active principle of the animal,
the material principle being the menstrual blood. Next, seeing that
the active principle employs this faculty primarily, therefore, in
order that any one of the things fashioned by it may come into
existence, it [the principle] must necessarily be possessed of its own
faculty. How, then, was Erasistratus unaware of it, if the primary
function of the semen be to draw to itself a due proportion of
blood? Now, this fluid would be in due proportion if it were so thin
and vaporous, that, as soon as it was drawn like dew into every part
of the semen, it would everywhere cease to display its own
particular character; for so the semen will easily dominate and
quickly assimilate it- in fact, will use it as food. It will then, I
imagine, draw to itself a second and a third quantum, and thus by
feeding it acquires for itself considerable bulk and quantity. In
fact, the alterative faculty has now been discovered as well, although
about this also has not written a word. And, thirdly the shaping
faculty will become evident, by virtue of which the semen firstly
surrounds itself with a thin membrane like a kind of superficial
condensation; this is what was described by Hippocrates in the
sixth-day birth, which, according to his statement, fell from the
singing-girl and resembled the pellicle of an egg. And following
this all the other stages will occur, such as are described by him
in his work "On the Child's Nature."
  But if each of the parts formed were to remain as small as when it
first came into existence, of what use would that be? They have, then,
to grow. Now, how will they grow? By becoming extended in all
directions and at the same time receiving nourishment. And if you will
recall what I previously said about the bladder which the children
blew up and rubbed, you will also understand my meaning better as
expressed in what I am now about to say.
  Imagine the heart to be, at the beginning, so small as to differ
in no respect from a millet-seed, or, if you will, a bean; and
consider how otherwise it is to become large than by being extended in
all directions and acquiring nourishment throughout its whole
substance, in the way that, as I showed a short while ago, the semen
is nourished. But even this was unknown to Erasistratus- the man who
sings the artistic skill of Nature! He imagines that animals grow like
webs, ropes, sacks, or baskets, each of which has, woven on to its end
or margin, other material similar to that of which it was originally
composed.
  But this, most sapient sir, is not growth, but genesis! For a bag,
sack, garment, house, ship, or the like is said to be still coming
into existence [undergoing genesis] so long as the appropriate form
for the sake of which it is being constructed by the artificer is
still incomplete. Then, when does it grow? Only when the basket, being
complete, with a bottom, a mouth, and a belly, as it were, as well
as the intermediate parts, now becomes larger in all these respects.
"And how can this happen?" someone will ask. Only by our basket
suddenly becoming an animal or a plant; for growth belongs to living
things alone. Possibly you imagine that a house grows when it is being
built, or a basket when being plated, or a garment when being woven?
It is not so, however. Growth belongs to that which has already been
completed in respect to its form, whereas the process by which that
which is still becoming attains its form is termed not growth but
genesis. That which is, grows, while that which is not, becomes.
  4. This also was unknown to Erasistratus, whom nothing escaped, if
his followers speak in any way truly in maintaining that he was
familiar with the Peripatetic philosophers. Now, in so far as he
acclaims Nature as being an artist in construction, even I recognize
the Peripatetic teachings, but in other respects he does not come near
them. For if anyone will make himself acquainted with the writings
of Aristotle and Theophrastus, these will appear to him to consist
of commentaries on the Nature-lore [physiology] of Hippocrates-
according to which the principles of heat, cold, dryness and
moisture act upon and are acted upon by one another, the hot principle
being the most active, and the cold coming next to it in power; all
this was stated in the first place by Hippocrates and secondly by
Aristotle. Further, it is at once the Hippocratic and the Aristotelian
teaching that the parts which receive that nourishment throughout
their whole substance, and that, similarly, processes of mingling
and alteration involve the entire substance. Moreover, that
digestion is a species of alteration- a transmutation of the nutriment
into the proper quality of the thing receiving it; that
blood-production also is an alteration, and nutrition as well; that
growth results from extension in all directions, combined with
nutrition; that alteration is effected mainly by the warm principle,
and that therefore digestion, nutrition, and the generation of the
various humours, as well as the qualities of the surplus substances,
result from the innate heat; all these and many other points besides
in regard to the aforesaid faculties, the origin of diseases, and
the discovery of remedies, were correctly stated first by
Hippocrates of all writers whom we know, and were in the second
place correctly expounded by Aristotle. Now, if all these views meet
with the approval of the Peripatetics, as they undoubtedly do, and
if none of them satisfy Erasistratus, what can the Erasistrateans
possibly mean by claiming that their leader was associated with
these philosophers? The fact is, they revere him as a god, and think
that everything he says is true. If this be so, then we must suppose
the Peripatetics to have strayed very far from truth, since they
approve of none of the ideas of Erasistratus. And, indeed, the
disciples of the latter produce his connection with the Peripatetics
in order to furnish his Nature-lore with a respectable pedigree.
  Now, let us reverse our argument and put it in a different way
from that which we have just employed. For if the Peripatetics were
correct in their teaching about Nature, there could be nothing more
absurd than the contentions of Erasistratus. And, I will leave it to
the Erasistrateans themselves to decide; they must either advance
the one proposition or the other. According to the former one the
Peripatetics had no accurate acquaintance with Nature, and according
to the second, Erasistratus. It is my task, then, to point out the
opposition between the two doctrines, and theirs to make the
choice....
  But they certainly will not abandon their reverence for
Erasistratus. Very well, then; let them stop talking about the
Peripatetic philosophers. For among the numerous physiological
teachings regarding the genesis and destruction of animals, their
health, their diseases, and the methods of treating these, there
will be found one only which is common to Erasistratus and the
Peripatetics- namely, the view that Nature does everything for some
purpose, and nothing in vain.
  But even as regards this doctrine their agreement is only verbal; in
practice Erasistratus makes havoc of it a thousand times over. For,
according to him, the spleen was made for no purpose, as also the
omentum; similarly, too, the arteries which are inserted into kidneys-
although these are practically the largest of all those that spring
from the great artery [aorta]! And to judge by the Erasistratean
argument, there must be countless other useless structures; for, if he
knows nothing at all about these structures, he has little more
anatomical knowledge than a butcher, while, if he is acquainted with
them and yet does not state their use, he clearly imagines that they
were made for no purpose, like the spleen. Why, however, should I
discuss these structures fully, belonging as they do to the treatise
"On the Use of Parts," which I am personally about to complete?
  Let us, then, sum up again this same argument, and, having said a
few words more in answer to the Erasistrateans, proceed to our next
topic. The fact is, these people seem to me to have read none of
Aristotle's writings, but to have heard from others how great an
authority he was on "Nature," and that those of the Porch follow in
the steps of his Nature-lore; apparently they then discovered a single
one of the current ideas which is common to Aristotle and
Erasistratus, and made up some story of a connection between
Erasistratus and these people. That Erasistratus, however, has no
share in the Nature-lore of Aristotle is shown by an enumeration of
the aforesaid doctrines, which emanated first from Hippocrates,
secondly from Aristotle, thirdly from the Stoics (with a single
modification, namely, that for them the qualities are bodies).
Perhaps, however, they will maintain that it was in the matter of
logic that Erasistratus associated himself with the Peripatetic
philosophers? Here they show ignorance of the fact that these
philosophers never brought forward false or inconclusive arguments,
while the Erasistratean books are full of them.
  So perhaps somebody may already be asking, in some surprise, what
possessed Erasistratus that he turned so completely from the doctrines
of Hippocrates, and why it is that he takes away the attractive
faculty from the biliary passages in the liver- for we have
sufficiently discussed the kidneys- alleging [as the cause of
bile-secretion] a favourable situation, the narrowness of vessels, and
a common space into which the veins from the gateway [of the liver]
conduct the unpurified blood, and from which, in the first place,
the [biliary] passages take over the bile, and secondly, the
[branches] of the vena cava take over the purified blood. For it would
not only have done him no harm to have mentioned the idea of
attraction, but he would thereby have been able to get rid of
countless other disputed questions.
  5. At the actual moment, however, the Erasistrateans are engaged
in a considerable battle, not only with others but also amongst
themselves, and so they cannot explain the passage from the first book
of the "General Principles," in which Erasistratus says, "Since
there are two kinds of vessels opening at the same place, the one kind
extending to the gall-bladder and the other to the vena cava, the
result is that, of the nutriment carried up from the alimentary canal,
that part which fits both kinds of stomata is received into both kinds
of vessels, some being carried into the gall-bladder, and the rest
passing over into the vena cava." For it is difficult to say what we
are to understand by the words "opening at the same place" which are
written at the beginning of this passage. Either they mean there is
a junction between the termination of the vein which is on the concave
surface of the liver and two other vascular terminations (that of
the vessel on the convex surface of the liver and that of the
bile-duct), or, if not, then we must suppose that there is, as it
were, a common space for all three vessels, which becomes filled
from the lower vein,* and empties itself both into the bile-duct and
into the branches of the vena cava. Now, there are many difficulties
in both of these explanations, but if I were to state them all, I
should find myself inadvertently writing an exposition of the teaching
of Erasistratus, instead of carrying out my original undertaking.
There is, however, one difficulty common to both these explanations,
namely, that the whole of the blood does not become purified. For it
ought to fall into the bile-duct as into a kind of sieve, instead of
going (running, in fact, rapidly) past it, into the larger stoma, by
virtue of the impulse of anadosis.

  *The portal vein.

  Are these, then, the only inevitable difficulties in which the
argument of Erasistratus becomes involved through his disinclination
to make any use of the attractive faculty, or is it that the
difficulty is greatest here, and also so obvious that even a child
could not avoid seeing it?
  6. And if one looks carefully into the matter one will find that
even Erasistratus' reasoning on the subject of nutrition, which he
takes up in the second book of his "General Principles," fails to
escape this same difficulty. For, having conceded one premise to the
principle that matter tends to fill a vacuum, as we previously showed,
he was only able to draw a conclusion in the case of the veins and
their contained blood. That is to say, when blood is running away
through the stomata of the veins, and is being dispersed, then,
since an absolutely empty space cannot result, and the veins cannot
collapse (for this was what he overlooked), it was therefore shown
to be necessary that the that the adjoining quantum of fluid should
flow in and fill the place of the fluid evacuated. It is in this way
that we may suppose the veins to be nourished; they get the benefit of
the blood which they contain. But how about the nerves? For they do
not also contain blood. One might obviously say that they draw their
supply from the veins. But Erasistratus will not have it so. What
further contrivance, then, does he suppose? He says that a nerve has
within itself veins and arteries, like a rope woven by Nature out of
three different strands. By means of this hypothesis he imagined
that his theory would escape from the idea of attraction. For if the
nerve contain within itself a blood-vessel it will no longer need
the adventitious flow of other blood from the real vein lying
adjacent; this fictitious vessel, perceptible only in theory, will
suffice it for nourishment.
  But this, again, is succeeded by another similar difficulty. For
this small vessel will nourish itself, but it will not be able to
nourish this adjacent simple nerve or artery, unless these possess
some innate proclivity for attracting nutriment. For how could the
nerve, being simple, attract its nourishment, as do the composite
veins, by virtue of the tendency of a vacuum to become refilled?
For, although according to Erasistratus, it contains within itself a
cavity of sorts, this is not occupied with blood, but with psychic
pneuma, and we are required to imagine the nutriment introduced, not
into this cavity, but into the vessel containing it, whether it
needs merely to be nourished, or to grow as well. How, then, are we to
imagine it introduced? For this simple vessel [i.e. nerve] is so
small- as are also the other two- that if you prick it at any part
with the finest needle you will tear the whole three of them at
once. Thus there could never be in it a perceptible space entirely
empty. And an emptied space which merely existed in theory could not
compel the adjacent fluid to come and fill it.
  At this point, again, I should like Erasistratus himself to answer
regarding this small elementary nerve, whether it is actually one
and definitely continuous, or whether it consists of many small
bodies, such as those assumed by Epicurus, Leucippus, and
Democritus. For I see that the Erasistrateans are at variance on
this subject. Some of them consider it one and continuous, for
otherwise, as they say, he would not have called it simple; and some
venture to resolve it into yet other elementary bodies. But if it be
one and continuous, then what is evacuated from it in the so-called
insensible transpiration of the physicians will leave no empty space
in it; otherwise it would not be one body but many, separated by empty
spaces. But if it consists of many bodies, then we have "escaped by
the back door," as the saying is, to Asclepiades, seeing that we
have postulated certain inharmonious elements. Once again, then, we
must call Nature "inartistic"; for this necessarily follows the
assumption of such elements.
  For this reason some of the Erasistrateans seem to me to have done
very foolishly in reducing the simple vessels to elements such as
these. Yet it makes no difference to me, since the theory of both
parties regarding nutrition will be shown to be absurd. For in these
minute simple vessels constituting the large perceptible nerves, it is
impossible, according to the theory of those who would keep the former
continuous, that any "refilling of a vacuum" should take place,
since no vacuum can occur in a continuum even if anything does run
away; for the parts left come together (as is seen in the case of
water) and again become one, taking up the whole space of that which
previously separated them. Nor will any "refilling" occur if we accept
the argument of the other Erasistrateans, since none of their elements
need it. For this principle only holds of things which are
perceptible, and not of those which exist merely in theory; this
Erasistratus expressly acknowledges, for he states that it is not a
vacuum such as this, interspersed in small portions among the
corpuscles, that his various treatises deal with, but a vacuum which
is clear, perceptible, complete in itself, large in size, evident,
or however else one cares to term it (for, what Erasistratus himself
says is, that "there cannot be a perceptible space which is entirely
empty"; while I, for my part, being abundantly equipped with terms
which are equally elucidatory, at least in relation to the present
topic of discussion, have added them as well).
  Thus it seems to me better that we also should help the
Erasistrateans with some contribution, since we are on the subject,
and should advise those who reduce the vessel called primary and
simple by Erasistratus into other elementary bodies to give up their
opinion; for not only do they gain nothing by it, but they are also at
variance with Erasistratus in this matter. That they gain nothing by
it has been clearly demonstrated; for this hypothesis could not escape
the difficulty regarding nutrition. And it also seems perfectly
evident to me that this hypothesis is not in consonance with the
view of Erasistratus, when it declares that what he calls simple and
primary is composite, and when it destroys the principle of Nature's
artistic skill. For, if we do not grant a certain unity of substance
to these simple structures as well, and if we arrive eventually at
inharmonious and indivisible elements, we shall most assuredly deprive
Nature of her artistic skill, as do all the physicians and
philosophers who start from this hypothesis. For, according to such
a hypothesis, Nature does not precede, but is secondary to the parts
of the animal. Now, it is not the province of what comes
secondarily, but of what pre-exists, to shape and to construct. Thus
we must necessarily suppose that the faculties of Nature, by which she
shapes the animal, and makes it grow and receive nourishment, are
present from the seed onwards; whereas none of these inharmonious
and non-partite corpuscles contains within itself any formative,
incremental, nutritive, or, in a word, any artistic power; it is, by
hypothesis, unimpressionable and untransformable, whereas, as we
have previously shown, none of the processes mentioned takes place
without transformation, alteration, and complete intermixture. And,
owing to this necessity, those who belong to these sects are unable to
follow out the consequences of their supposed elements, and they are
all therefore forced to declare Nature devoid of art. It is not from
us, however, that the Erasistrateans should have learnt this, but from
those very philosophers who lay most stress on a preliminary
investigation into the elements of all existing things.
  Now, one can hardly be right in supposing that Erasistratus could
reach such a pitch of foolishness as to be recognizing the logical
consequences of this theory, and that, while assuming Nature to be
artistically creative, he would at the same time break up substance
into insensible, inharmonious, and untransformable elements. If,
however, he will grant that there occurs in the elements a process
of alteration and transformation, and that there exists in them
unity and continuity, then that simple vessel of his (as he himself
names it) will turn out to be single and uncompounded. And the
simple vein will receive nourishment from itself, and the nerve and
artery from the vein. How, and in what way? For, when we were at
this point before, we drew attention to the disagreement among the
Erasistrateans, and we showed that the nutrition of these simple
vessels was impraticable according to the teachings of both parties,
although we did not hesitate to adjudicate in their quarrel and to
do Erasistratus the honour of placing him in the better sect.
  Let our argument, then, be transferred again to the doctrine which
assumes this elementary nerve to be a single, simple, and entirely
unified structure, and let us consider how it is to be nourished;
for what is discovered here will at once be found to be common also to
the school of Hippocrates.
  It seems to me that our enquiry can be most rigorously pursued in
subjects who are suffering from illness and have become very
emaciated, since in these people all parts of the body are obviously
atrophied and thin, and in need of additional substance and
feeding-up; for the same reason the ordinary perceptible nerve,
regarding which we originally began this discussion, has become
thin, and requires nourishment. Now, this contains within itself
various parts, namely, a great many of these primary, invisible,
minute nerves, a few simple arteries, and similarly also veins.
Thus, all its elementary nerves have themselves also obviously
become emaciated; for, if they had not, neither would the nerve as a
whole; and of course, in such a case, the whole nerve cannot require
nourishment without each of these requiring it too. Now, if on the one
hand they stand in need of feeding-up, and if on the other the
principle of the refilling of a vacuum can give them no help- both
by reason of the difficulties previously mentioned and the actual
thinness, as I shall show- we must then seek another cause for
nutrition.
  How is it, then, that the tendency of a vacuum to become refilled is
unable to afford nourishment to one in such a condition? Because its
rule is that only so much of the contiguous matter should succeed as
has flowed away. Now this is sufficient for nourishment in the case of
those who are in good condition, for, in them, what is presented
must be equal to what has flowed away. But in the case of those who
are very emaciated and who need a great restoration of nutrition,
unless what was presented were many times greater than what has been
emptied out, they would never be able to regain their original
habit. It is clear, therefore, that these parts will have to exert a
greater amount of attraction, in so far as their requirements are
greater. And I fail to understand how Erasistratus does not perceive
that here again he is putting the cart before the horse. Because, in
the case of the sick, there must be a large amount of presentation
in order to feed them up, he argues that the factor of "refilling"
must play an equally large part. And how could much presentation
take place if it were not preceded by an abundant delivery of
nutriment? And if he calls the conveyance of food through the veins
delivery, and its assumption by each of these simple and visible
nerves and arteries not delivery but distribution, as some people have
thought fit to name it, and then ascribes conveyance through the veins
to the principle of vacuum refilling alone, let him explain to us
the assumption of food by the hypothetical elements. For it has been
shown that at least in relation to these there is no question of the
refilling of a vacuum being in operation, and especially where the
parts are very attenuated. It is worth while listening to what
Erasistratus says about these cases in the second book of his "General
Principles": "In the ultimate simple [vessels], which are thin and
narrow, presentation takes place from the adjacent vessels, the
nutriment being attracted through the sides of the vessels and
deposited in the empty spaces left by the matter which has been
carried away." Now, in this statement firstly I admit and accept the
words "through the sides." For, if the simple nerve were actually to
take in the food through its mouth, it could not distribute it through
its whole substance; for the mouth is dedicated to the psychic pneuma.
It can, however, take it in through its sides from the adjacent simple
vein. Secondly, I also accept in Erasistratus' statement the
expression which precedes "through the sides." What does this say?
"The nutriment being attracted through the sides of the vessels."
Now I, too, agree that it is attracted, but it has been previously
shown that this is not through the tendency of evacuated matter to
be replaced.
  7. Let us, then, consider together how it is attracted. How else
than in the way that iron is attracted by the lodestone, the latter
having a faculty attractive of this particular quality [existing in
iron]? But if the beginning of anadosis depends on the squeezing
action of the stomach, and the whole movement thereafter on the
peristalsis and propulsive action of the veins, as well as on the
traction exerted by each of the parts which are undergoing
nourishment, then we can abandon the principle of replacement of
evacuated matter, as not being suitable for a man who assumes Nature
to be a skilled artist; thus we shall also have avoided the
contradiction of Asclepiades though we cannot refute it: for the
disjunctive argument used for the purposes of demonstration is, in
reality, disjunctive not of two but of three alternatives; now, if
we treat the disjunction as a disjunction of two alternatives, one
of the two propositions assumed in constructing our proof must be
false; and if as a disjunctive of three alternatives, no conclusion
will be arrived at.
  8. Now Erasistratus ought not to have been ignorant of this if he
had ever had anything to do with the Peripatetics- even in a dream.
Nor, similarly, should he have been unacquainted with the genesis of
the humours, about which, not having even anything moderately
plausible to say, he thinks to deceive us by the excuse that the
consideration of such matters is not the least useful. Then, in
Heaven's name, is it useful to know how food is digested in the
stomach, but unnecessary to know how bile comes into existence in
the veins? Are we to pay attention merely to the evacuation of this
humour, and not to its genesis? As though it were not far better to
prevent its excessive development from the beginning than to give
ourselves all the trouble of expelling it! And it is a strange thing
to be entirely unaware as to whether its genesis is to be looked on as
taking place in the body, or whether it comes from without and is
contained in the food. For, if it was right to raise this problem, why
should we not make investigations concerning the blood as well-
whether it takes its origin in the body, or is distributed through the
food as is maintained by those who postulate homoeomeries? Assuredly
it would be much more useful to investigate what kinds of food are
suited, and what kinds unsuited, to the process of blood-production
rather than to enquire into what articles of diet are easily
mastered by the activity of the stomach, and what resist and contend
with it. For the choice of the latter bears reference merely to
digestion, while that of the former is of importance in regard to
the generation of useful blood. For it is not equally important
whether the aliment be imperfectly chylified in the stomach or whether
it fail to be turned into useful blood. Why is Erasistratus not
ashamed to distinguish all the various kinds of digestive failure
and all the occasions which give rise to them, whilst in reference
to the errors of blood-production he does not utter a single word-
nay, not a syllable? Now, there is certainly to be found in the
veins both thick and thin blood; in some people it is redder, in
others yellower, in some blacker, in others more of the nature of
phlegm. And one who realizes that it may smell offensively not in
one way only, but in a great many different respects (which cannot
be put into words, although perfectly appreciable to the senses),
would, I imagine, condemn in no measured terms the carelessness of
Erasistratus in omitting a consideration so essential to the
practice of our art.
  Thus it is clear what errors in regard to the subject of dropsies
logically follow this carelessness. For, does it not show the most
extreme carelessness to suppose that the blood is prevented from going
forward into the liver owing to the narrowness of the passages, and
that dropsy can never occur in any other way? For, to imagine that
dropsy is never caused by the spleen or any other part, but always
by induration of the liver,* is the standpoint of a man whose
intelligence is perfectly torpid and who is quite out of touch with
things that happen every day. For, not merely once or twice, but
frequently, we have observed dropsy produced by chronic haemorrhoids
which have been suppressed, or which, through immoderate bleeding,
have given the patient a severe chill; similarly, in women, the
complete disappearance of the monthly discharge, or an undue
evacuation such as is caused by violent bleeding from the womb,
often provoke dropsy; and in some of them the so-called female flux
ends in this disorder. I leave out of account the dropsy which
begins in the flanks or in any other susceptible part; this clearly
confutes Erasistratus' assumption, although not so obviously as does
that kind of dropsy which is brought about by an excessive chilling of
the whole constitution; this, which is the primary reason for the
occurrence of dropsy, results from a failure of blood-production, very
much like the diarrhoea which follows imperfect digestion of food;
certainly in this kind of dropsy neither the liver nor any other
viscus becomes indurated.

  *Cirrhosis of the liver.

  The learned Erasistratus, however, overlooks- nay, despises- what
neither Hippocrates, Diocles, Praxagoras, nor indeed any of the best
philosophers, whether Plato, Aristotle, or Theophrastus; he passes
by whole functions as though it were but a trifling and casual
department of medicine which he was neglecting, without deigning to
argue whether or not these authorities are right in saying that the
bodily parts of all animals are governed by the Warm, the Cold, the
Dry and the Moist, the one pair being active the other passive, and
that among these the Warm has most power in connection with all
functions, but especially with the genesis of the humours. Now, one
cannot be blamed for not agreeing with all these great men, nor for
imagining that one knows more than they; but not to consider such
distinguished teaching worthy either of contradiction or even
mention shows an extraordinary arrogance.
  Now, Erasistratus is thoroughly small-minded and petty to the last
degree in all his disputations- when, for instance, in his treatise
"On Digestion," he argues jealously with those who consider that
this is a process of putrefaction of the food; and, in his work "On
Anadosis," with those who think that the anadosis of blood through the
veins results from the contiguity of the arteries; also, in his work
"On Respiration," with those who maintain that the air is forced along
by contraction. Nay, he did not even hesitate to contradict those
who maintain that the urine passes into the bladder in a vaporous
state, as also those who say that imbibed fluids are carried into
the lung. Thus he delights to choose always the most valueless
doctrines, and to spend his time more and more in contradicting these;
whereas on the subject of the origin of blood (which is in no way less
important than the chylification of food in the stomach) he did not
deign to dispute with any of the ancients, nor did he himself
venture to bring forward any other opinion, despite the fact that at
the beginning of his treatise on "General Principles" he undertook
to say how all the various natural functions take place, and through
what parts of the animal! Now, is it possible that, when the faculty
which naturally digests food is weak, the animal's digestion fails,
whereas the faculty which turns the digested food into blood cannot
suffer any kind of impairment? Are we to suppose this latter faculty
alone to be as tough as steel and unaffected by circumstances? Or is
it that weakness of this faculty will result in something else than
dropsy? The fact, therefore, that Erasistratus, in regard to other
matters, did not hesitate to attack even the most trivial views,
whilst in this he neither dared to contradict his predecessors nor
to advance any new view of his own, proves plainly that he
recognized the fallacy of his own way of thinking.
  For what could a man possibly say about blood who had no use for
innate heat? What could he say about yellow or black bile, or
phlegm? Well, of course, he might say that the bile could come
directly from without, mingled with the food! Thus Erasistratus
practically says so in the following words: "It is of no value in
practical medicine to find out whether fluid of this kind* arises from
the elaboration of food in the stomach-region, or whether it reaches
the body because it is mixed with the food taken in from outside." But
my very good Sir, you most certainly maintain also that this humour
has to be evacuated from the animal, and that it causes great pain
if it be not evacuated. How, then, if you suppose that no good comes
from the bile, do you venture to say that an investigation into its
origin is of no value in medicine?

  *Bile.

  Well, let us suppose that it is contained in the food, and not
specifically secreted in the liver (for you hold these two things
possible). In this case, it will certainly make a considerable
difference whether the ingested food contains a minimum or a maximum
of bile; for the one kind is harmless, whereas that containing a large
quantity of bile, owing to the fact that it cannot be properly
purified in the liver, will result in the various affections-
particularly jaundice- which Erasistratus himself states to occur
where there is much bile. Surely, then, it is most essential for the
physician to know in the first place, that the bile is contained in
the food itself from outside, and, secondly, that for example, beet
contains a great deal of bile, and bread very little, while olive
oil contains most, and wine least of all, and all the other articles
of diet different quantities. Would it not be absurd for any one to
choose voluntarily those articles which contain more bile, rather than
those containing less?
  What, however, if the bile is not contained in the food, but comes
into existence in the animal's body? Will it not also be useful to
know what state of the body is followed by a greater, and what by a
smaller occurrence of bile? For obviously it is in our power to
alter and transmute morbid states of the body- in fact, to give them a
turn for the better. But if we did not know in what respect they
were morbid or in what way they diverged from the normal, how should
we be able to ameliorate them?
  Therefore it is not useless in treatment, as Erasistratus says, to
know the actual truth about the genesis of bile. Certainly it is not
impossible, or even difficult to discover that the reason why honey
produces yellow bile is not that it contains a large quantity of
this within itself, but because it [the honey] undergoes change,
becoming altered and transmuted into bile. For it would be bitter to
the taste if it contained bile from the outset, and it would produce
an equal quantity of bile in every person who took it. The facts,
however, are not so. For in those who are in the prime of life,
especially if they are warm by nature and are leading a life of
toil, the honey changes entirely into yellow bile. Old people,
however, it suits well enough, inasmuch as the alteration which it
undergoes is not into bile, but into blood. Erasistratus, however,
in addition to knowing nothing about this, shows no intelligence
even in the division of his argument; he says that it is of no
practical importance to investigate whether the bile is contained in
the food from the beginning or comes into existence as a result of
gastric digestion. He ought surely to have added something about its
genesis in liver and veins, seeing that the old physicians and
philosophers declare that it along with the blood is generated in
these organs. But it is inevitable that people who, from the very
outset, go astray, and wander from the right road, should talk such
nonsense, and should, over and above this, neglect to search for the
factors of most practical importance in medicine.
  Having come to this poi in the argument, I should like to ask
those who declare that Erasistratus was very familiar with the
Peripatetics, whether they know what Aristotle stated and demonstrated
with regard to our bodies being compounded out of the Warm, the
Cold, the Dry and the Moist, and how he says that among these the Warm
is the most active, and that those animals which are by nature warmest
have abundance of blood, whilst those that are colder are entirely
lacking in blood, and consequently in winter lie idle and
motionless, lurking in holes like corpses. Further, the question of
the colour of the blood has been dealt with not only by Aristotle
but also by Plato. Now I, for my part, as I have already said, did not
set before myself the task of stating what has been so well
demonstrated by the Ancients, since I cannot surpass these men
either in my views or in my method of giving them expression.
Doctrines, however, which they either stated without demonstration, as
being self-evident (since they never suspected that there could be
sophists so degraded as to contemn the truth in these matters), or
else which they actually omitted to mention at all- these I propose to
discover and prove.
  Now in reference to the genesis of the humours, I do not know that
any one could add anything wiser than what has been said by
Hippocrates, Aristotle, Praxagoras, Philotimus and many other among
the Ancients. These men demonstrated that when the nutriment becomes
altered in the veins by the innate heat, blood is produced when it
is in moderation, and the other humours when it is not in proper
proportion. And all the observed facts agree with this argument. Thus,
those articles of food, which are by nature warmer are more productive
of bile, while those which are colder produce more phlegm. Similarly
of the periods of life, those which are naturally warmer tend more
to bile, and the colder more to phlegm. Of occupations also,
localities and seasons, and, above all, of natures themselves, the
colder are more phlegmatic, and the warmer more bilious. Also cold
diseases result from and warmer ones from yellow bile. There is not
a single thing to be found which does not bear witness to the truth of
this account. How could it be otherwise? For, seeing that every part
functions in its own special way because of the manner in which the
four qualities are compounded, it is absolutely necessary that the
function [activity] should be either completely destroyed, or, at
least hampered, by any damage to the qualities, and that thus the
animal should fall ill, either as a whole, or in certain of its parts.
  Also the diseases which are primary and most generic are four in
number, and differ from each other in warmth, cold, dryness and
moisture. Now, Erasistratus himself confesses this, albeit
unintentionally; for when he says that the digestion of food becomes
worse in fever, not because the innate heat has ceased to be in due
proportion, as people previously supposed, but because the stomach,
with its activity impaired, cannot contract and triturate as before-
then, I say, one may justly ask him what it is that has impaired the
activity of the stomach.
  Thus, for example, when a bubo develops following an accidental
wound gastric digestion does not become impaired until the patient has
become fevered; neither the bubo nor the sore of itself impedes in any
way or damages the activity of the stomach. But if fever occurs, the
digestion at once deteriorates, and we are also right in saying that
the activity of the stomach at once becomes impaired. We must add,
however, by what it has been impaired. For the wound was not capable
of impairing it, nor yet the bubo, for, if they had been, then they
would have caused this damage before the fever as well. If it was
not these that caused it, then it was the excess of heat (for these
two symptoms occurred besides the bubo- an alteration in the
arterial and cardiac movements and an excessive development of natural
heat). Now the alteration of these movements will not merely not
impair the function of the stomach in any way: it will actually
prove an additional help among those animals in which, according to
Erasistratus, the pneuma, which is propelled through the arteries
and into the alimentary canal, is of great service in digestion; there
is only left, then, the disproportionate heat to account for the
damage to the gastric activity. For the pneuma is driven in more
vigorously and continuously, and in greater quantity now than
before; thus in this case, the animal whose digestion is promoted by
pneuma will digest more, whereas the remaining factor- abnormal
heat- will give them indigestion. For to say, on the one hand, that
the pneuma has a certain property by virtue of which it promotes
digestion, and then to say that this property disappears in cases of
fever, is simply to admit the absurdity. For when they are again asked
what it is that has altered the pneuma, they will only be able to
reply, "the abnormal heat," and particularly if it be the pneuma in
the food canal which is in question (since this does not come in any
way near the bubo).
  Yet why do I mention those animals in which the property of the
pneuma plays an important part, when it is possible to base one's
argument upon human beings, in whom it is either of no importance at
all, or acts quite faintly and feebly? But Erasistratus himself agrees
that human beings digest badly in fevers, adding as the cause that the
activity of the stomach has been impaired. He cannot, however, advance
any other cause of this impairment than abnormal heat. But if it is
not by accident that the abnormal heat impairs this activity, but by
virtue of its own essence and power, then this abnormal heat must
belong to the primary diseases. But, indeed, if disproportion of
heat belongs to the primary diseases, it cannot but be that a
proportionate blending [eucrasia] of the qualities produces the normal
activity. For a disproportionate blend [dyscrasia] can only become a
cause of the primary diseases through derangement of the eucrasia.
That is to say, it is because the [normal] activities arise from the
eucrasia that the primary impairments of these activities
necessarily arise the from derangement.
  I think, then, it has been proved to the satisfaction of those who
are capable of seeing logical consequences, that, even according to
Erasistratus' own argument, the cause of the normal functions is
eucrasia of the Warm. Now, this being so, there is nothing further
to prevent us from saying that, in the case of each function, eucrasia
is followed by the more, and dyscrasia by the less favourable
alternative. And, therefore, if this be the case, we must suppose
blood to be the outcome of proportionate, and yellow bile of
disproportionate heat. So we naturally find yellow bile appearing in
greatest quantity in ourselves at the warm periods of life, in warm
countries, at warm seasons of the year, and when we are in a warm
condition; similarly in people of warm temperaments, and in connection
with warm occupations, modes of life, or diseases.
  And to be in doubt as to whether this humour has the genesis in
the human body or is contained in the food is what you would expect
from one who has- I will not say failed to see that, when those who
are perfectly healthy have, under the compulsion of circumstances,
to fast contrary to custom, their mouths become bitter and their urine
bile-coloured, while they suffer from gnawing pains in the stomach-
but has, as it were, just made a sudden entrance into the world, and
is not yet familiar with the phenomena which occur there. Who, in
fact, does not know that anything which is overcooked grows at first
salt and afterwards bitter? And if you will boil honey itself, far the
sweetest of all things, you can demonstrate that even this becomes
quite bitter. For what may occur as a result of boiling in the case of
other articles which are not warm by nature, exists naturally in
honey; for this reason it does not become sweeter on being boiled,
since exactly the same quantity of heat as is needed for the
production of sweetness exists from beforehand in the honey. Therefore
the external heat, which would be useful for insufficiently warm
substances, becomes in the honey a source of damage, in fact an
excess; and it is for this reason that honey, when boiled, can be
demonstrated to become bitter sooner than the others. For the same
reason it is easily transmuted into bile in those people who are
naturally warm, or in their prime, since warm when associated with
warm becomes readily changed into a disproportionate combination and
turns into bile sooner than into blood. Thus we need a cold
temperament and a cold period of life if we would have honey brought
to the nature of blood. Therefore Hippocrates not improperly advised
those who were naturally bilious not to take honey, since they were
obviously of too warm a temperament. So also, not only Hippocrates,
but all physicians say that honey is bad in bilious diseases but
good in old age; some of them having discovered this through the
indications afforded by its nature, and others simply through
experiment, for the Empiricist physicians too have made precisely
the same observation, namely, that honey is good for an old man and
not for a young one, that it is harmful for those who are naturally
bilious, and serviceable for those who are phlegmatic. In a word, in
bodies which are warm either through nature, disease, time of life,
season of the year, locality, or occupation, honey is productive of
bile, whereas in opposite circumstances it produces blood.
  But surely it is impossible that the same article of diet can
produce in certain persons bile and in others blood, if it be not that
the genesis of these humours is accomplished in the body. For if all
articles of food contained bile from the beginning and of
themselves, and did not produce it by undergoing change in the
animal body, then they would produce it similarly in all bodies; the
food which was bitter to the taste would, I take it, be productive
of bile, while that which tasted good and sweet would not generate
even the smallest quantity of bile. Moreover, not only honey but all
other sweet substances are readily converted into bile in the
aforesaid bodies which are warm for any of the reasons mentioned.
  Well, I have somehow or other been led into this discussion,- not in
accordance with my plan, but compelled by the course of the
argument. This subject has been treated at great length by Aristotle
and Praxagoras, who have correctly expounded the view of Hippocrates
and Plato.
  9. For this reason the things that we have said are not to be looked
upon as proofs but rather as indications of the dulness of those who
think differently, and who do not even recognise what is agreed on
by everyone and is a matter of daily observation. As for the
scientific proofs of all this, they are to be drawn from these
principles of which I have already spoken- namely, that bodies act
upon and are acted upon by each other in virtue of the Warm, Cold,
Moist and Dry. And if one is speaking of any activity, whether it be
exercised by vein, liver, arteries, heart, alimentary canal, or any
part, one will be inevitably compelled to acknowledge that this
activity depends upon the way in which the four qualities are blended.
Thus I should like to ask the Erasistrateans why it is that the
stomach contracts upon the food, and why the veins generate blood.
There is no use in recognizing the mere fact of contraction, without
also knowing the cause; if we know this, we shall also be able to
rectify the failures of function. "This is no concern of ours," they
say; "we do not occupy ourselves with such causes as these; they are
outside the sphere of the practitioner, and belong to that of the
scientific investigator." Are you, then, going to oppose those who
maintain that the cause of the function of every organ is a natural
eucrasia, that the dyscrasia is itself known as a disease, and that it
is certainly by this that the activity becomes impaired? Or, on the
other hand, will you be convinced by the proofs which the ancient
writers furnished? Or will you take a midway course between these two,
neither perforce accepting these arguments as true nor contradicting
them as false, but suddenly becoming sceptics- Pyrrhonists, in fact?
But if you do this you will have to shelter yourselves behind the
Empiricist teaching. For how are you going to be successful in
treatment, if you do not understand the real essence of each
disease? Why, then, did you not call yourselves Empiricists from the
beginning? Why do you confuse us by announcing that you are
investigating natural activities with a view to treatment? If the
stomach is, in a particular case, unable to exercise its peristaltic
and grinding functions, how are we going to bring it back to the
normal if we do not know the cause of its disability? What I say is
that we must cool the over-heated stomach and warm the warm the
chilled one; so also we must moisten the one which has become dried
up, and conversely; so, too, in combinations of these conditions; if
the stomach becomes at the same time warmer and drier than normally,
the first principle of treatment is at once to chill and moisten it;
and if it become colder and moister, it must be warmed and dried; so
also in other cases. But how on earth are the followers of
Erasistratus going to act, confessing as they do that they make no
sort of investigation into the cause of disease? For the fruit of
the enquiry into activities is that by knowing the causes of the
dyscrasiae one may bring them back to the normal, since it is of no
use for the purposes of treatment merely to know what the activity
of each organ is.
  Now, it seems to me that Erasistratus is unaware of this fact
also, that the actual disease is that condition of the body which, not
accidentally, but primarily and of itself, impairs the normal
function. How, then, is he going to diagnose or cure diseases if he is
entirely ignorant of what they are, and of what kind and number? As
regards the stomach, certainly, Erasistratus held that one should at
least investigate how it digests the food. But why was not
investigation also made as to the primary originative cause of this?
And, as regards the veins and the blood, he omitted even to ask the
question "how?"
  Yet neither Hippocrates nor any of the other physicians or
philosophers whom I mentioned a short while ago thought it right to
omit this; they say that when the heat which exists naturally in every
animal is well blended and moderately moist it generates blood; for
this reason they also say that the blood is a virtually warm and moist
humour, and similarly also that yellow bile is warm and dry, even
though for the most part it appears moist. (For in them the apparently
dry would seem to differ from the virtually dry.) Who does not know
that brine and sea-water preserve meat and keep it uncorrupted, whilst
all other water- the drinkable kind- readily spoils and rots it? And
who does not know that when yellow bile is contained in large quantity
in the stomach, we are troubled with an unquenchable thirst, and
that when we vomit this up, we at once become much freer from thirst
than if we had drunk very large quantities of fluid? Therefore this
humour has been very properly termed warm, and also virtually dry.
And, similarly, phlegm has been called cold and moist; for about
this also clear proofs have been given by Hippocrates and the other
Ancients.
  Prodicus also, when in his book "On the Nature of Man" he gives
the name "phlegm" to that element in the humours which has been burned
or, as it were, over-roasted, while using a different terminology,
still keeps to the fact just as the others do; this man's
innovations in nomenclature have also been amply done justice to by
Plato. Thus, the white-coloured substance which everyone else calls
phlegm, and which Prodicus calls blenna [mucus], is the well-known
cold, moist humour which collects mostly in old people and in those
who have been chilled in some way, and not even a lunatic could say
that this was anything else than cold and moist.
  If, then, there is a warm and moist humour, and another which is
warm and dry, and yet another which is moist and cold, is there none
which is virtually cold and dry? Is the fourth combination of
temperaments, which exists in all other things, non-existent in the
humours alone? No; the black bile is such a humour. This, according to
intelligent physicians and philosophers, tends to be in excess, as
regards seasons, mainly in the fall of the year, and, as regards ages,
mainly after the prime of life. And, similarly, also they say that
there are cold and dry modes of life, regions, constitutions, and
diseases. Nature, they suppose, is not defective in this single
combination; like the three other combinations, it extends everywhere.
  At this point, also, I would gladly have been able to ask
Erasistratus whether his "artistic" Nature has not constructed any
organ for clearing away a humour such as this. For whilst there are
two organs for the excretion of urine, and another of considerable
size for that of yellow bile, does the humour which is more pernicious
than these wander about persistently in the veins mingled with the
blood? Yet Hippocrates says, "Dysentery is a fatal condition if it
proceeds from black bile"; while that proceeding from yellow bile is
by no means deadly, and most people recover from it; this proves how
much more pernicious and acrid in its potentialities is black than
yellow bile. Has Erasistratus, then, not read the book, "On the Nature
of Man," any more than any of the rest of Hippocrates' writings,
that he so carelessly passes over the consideration of the humours?
Or, does the know it, and yet voluntarily neglect one of the finest
studies in medicine? Thus he ought not to have said anything about the
spleen, nor have stultified himself by holding that an artistic Nature
would have prepared so large an organ for no purpose. As a matter of
fact, not a matter of fact, not only Hippocrates and Plato- who are no
less authorities on Nature than is Erasistratus- say that this
viscus also is one of those which cleanse the blood, but there are
thousands of the ancient physicians and philosophers as well who are
in agreement with them. Now, all of these the high and mighty
Erasistratus affected to despise, and he neither contradicted them nor
even so much as mentioned their opinion. Hippocrates, indeed, says
that the spleen wastes in those people in whom the body is in good
condition, and all those physicians also who base themselves on
experience agree with this. Again, in those cases in which the
spleen is large and is increasing from internal suppuration, it
destroys the body and fills it with evil humours; this again is agreed
on, not only by Hippocrates, but also by Plato and many others,
including the Empiric physicians. And the jaundice which occurs when
the spleen is out of order is darker in colour, and the cicatrices
of ulcers are dark. For, generally speaking, when the spleen is
drawing the atrabiliary humour into itself to a less degree than is
proper, the blood is unpurified, and the whole body takes on a bad
colour. And when does it draw this in to a less degree than proper?
Obviously, when it [the spleen] is in a bad condition. Thus, just as
the kidneys, whose function it is to attract the urine, do this
badly when they are out or order, so also the spleen, which has in
itself a native power of attracting an atrabiliary quality,if it
ever happens to be weak, must necessarily exercise this attraction
badly, with the result that the blood becomes thicker and darker.
  Now all these points, affording as they do the greatest help in
the diagnosis and in the cure of disease were entirely passed over
by Erasistratus, and he pretended to despise these great men- he who
does not despise ordinary people, but always jealously attacks the
most absurd doctrines. Hence, it was clearly because he had nothing to
say against the statements made by the Ancients regarding the function
and utility of the spleen, and also because he could discover
nothing new himself, that he ended by saying nothing at all. I,
however, for my part, have demonstrated, firstly from the causes by
which everything throughout nature is governed (by the causes I mean
the Warm, Cold, Dry and Moist) and secondly, from obvious bodily
phenomena, that there must needs be a cold and dry humour. And
having in the next place drawn attention to the fact that this
humour is black bile [atrabiliary] and that the viscus which clears it
away is the spleen- having pointed this out by help of as few as
possible of the proofs given by ancient writers, I shall now proceed
to what remains of the subject in hand.
  What else, then, remains but to explain clearly what it is that
happens in the generation of the humours, according to the belief
and demonstration of the Ancients? This will be more clearly
understood from a comparison. Imagine, then, some new wine which has
been not long ago pressed from the grape, and which is fermenting
and undergoing alteration through the agency of its contained heat.
Imagine next two residual substances produced during this process of
alteration, the one tending to be light and air-like and the other
to be heavy and more of the nature of earth; of these the one, as I
understand, they call the flower and the other the lees. Now you may
correctly compare yellow bile to the first of these, and black bile to
the latter, although these humours have not the same appearance when
the animal is in normal health as that which they often show when it
is not so; for then the yellow bile becomes vitelline, being so termed
because it becomes like the yolk of an egg, both in colour and
density; and again, even the black bile itself becomes much more
malignant than when in its normal condition, but no particular name
has been given to [such a condition of] the humour, except that some
people have called it corrosive or acetose, because it also becomes
sharp like vinegar and corrodes the animal's body- as also the
earth, if it be poured out upon it- and it produces a kind of
fermentation and seething, accompanied by bubbles- an abnormal
putrefaction having become added to the natural condition of the black
humour. It seems to me also that most of the ancient physicians give
the name black humour and not black bile to the normal portion of this
humour, which is discharged from the bowel and which also frequently
rises to the top [of the stomach-contents]; and they call black bile
that part which, through a kind of combustion and putrefaction, has
had its quality changed to acid. There is no need, however, to dispute
about names, but we must realise the facts, which are as follow:-
  In the genesis of blood, everything in the nutriment which belongs
naturally to the thick and earth-like part of the food, and which does
not take on well the alteration produced by the innate heat- all
this the spleen draws into itself. On the other hand, that part of the
nutriment which is roasted, so to speak, or burnt (this will be the
warmest and sweetest part of it, like honey and fat), becomes yellow
bile, and is cleared away through the so-called biliary vessels;
now, this is thin, moist, and fluid, not like what it is when,
having been roasted to an excessive degree, it becomes yellow,
fiery, and thick, like the yolk of eggs; for this latter is already
abnormal, while the previously mentioned state is natural. Similarly
with the black humour: that which does not yet produce, as I say, this
seething and fermentation on the ground, is natural, while that
which has taken over this character and faculty is unnatural; it has
assumed an acridity owing to the combustion caused by abnormal heat,
and has practically become transformed into ashes. In somewhat the
same way burned lees differ from unburned. The former is a warm
substance, able to burn, dissolve, and destroy the flesh. The other
kind, which has not yet undergone combustion, one may find the
physicians employing for the same purposes that one uses the so-called
potter's earth and other substances which have naturally a combined
drying and chilling action.
  Now the vitelline bile also may take on the appearance of this
combusted black bile, if ever it chance to be roasted, so to say, by
fiery heat. And all the other forms of bile are produced, some the
from blending of those mentioned, others being, as it were,
transition-stages in the genesis of these or in their conversion
into one another. And they differ in that those first mentioned are
unmixed and unique, while the latter forms are diluted with various
kinds of serum. And all the serums in the humours are waste
substances, and the animal body needs to be purified from them.
There is, however, a natural use for the humours first mentioned, both
thick and thin; the blood is purified both by the spleen and by the
bladder beside the liver, and a part of each of the two humours is put
away, of such quantity and quality that, if it were carried all over
the body, it would do a certain amount of harm. For that which is
decidedly thick and earthy in nature, and has entirely escaped
alteration in the liver, is drawn by the spleen into itself; the other
part which is only moderately thick, after being elaborated [in the
liver], is carried all over the body. For the blood in many parts of
the body has need of a certain amount of thickening, as also, I take
it, of the fibres which it contains. And the use of these has been
discussed by Plato, and it will also be discussed by me in such of
my treatises as may deal with the use of parts. And the blood also
needs, not least, the yellow humour, which has as yet not reached
the extreme stage of combustion; in the treatises mentioned it will be
pointed out what purpose is subserved by this.
  Now Nature has made no organ for clearing away phlegm, this being
cold and moist, and, as it were, half-digested nutriment; such a
substance, therefore, does not need to be evacuated, but remains in
the body and undergoes alteration there. And perhaps one cannot
properly give the name of phlegm to the surplus-substance which runs
down from the brain, but one should call it mucus [blenna] or
coryza- as, in fact, it is actually termed; in any case it will be
pointed out, in the treatise "On the Use of Parts," how Nature has
provided for the evacuation of this substance. Further, the device
provided by Nature which ensures that the phlegm which forms in the
stomach and intestines may be evacuated in the most rapid and
effective way possible- this also will be described in that
commentary. As to that portion of the phlegm which is carried in the
veins, seeing that this is of service to the animal, it requires no
evacuation. Here too, then, we must pay attention and recognise
that, just as in the case of each of the two kinds of bile, there is
one part which is useful to the animal and in accordance with its
nature, while the other part is useless and contrary to nature, so
also is it with the phlegm; such of it as is sweet is useful to the
animal and according to nature, while, as to such of it as has
become bitter or salt, that part which is bitter is completely
undigested, while that part which is salt has undergone
putrefaction. And the term "complete indigestion" refers of course
to the second digestion- that which takes place in the veins; it is
not a failure of the first digestion- that in the alimentary canal-
for it would not have become a humour at the outset if it had
escaped this digestion also.
  It seems to me that I have made enough reference to what has been
said regarding the genesis and destruction of humours by
Hippocrates, Plato, Aristotle, Praxagoras, and Diocles, and many
others among the Ancients; I did not deem it right to transport the
whole of their final pronouncements into this treatise. I have said
only so much regarding each of the humours as will stir up the reader,
unless he be absolutely inept, to make himself familiar with the
writings of the Ancients, and will help him to gain more easy access
to them. In another treatise I have written on the humours according
to Praxagoras, to Praxagoras, son of authority Nicarchus; although
this authority makes as many as ten humours, not including the blood
(the blood itself being an eleventh), this is not a departure from the
teaching of Hippocrates; for Praxagoras divides into species and
varieties the humours which Hippocrates first mentioned, with the
demonstration proper to each.
  Those, then, are to be praised who explain the points which have
been duly mentioned, as also those who add what has been left out; for
it is not possible for the same man to make both a beginning and an
end. Those, on the other hand, deserve censure who are so impatient
that they will not wait to learn any of the things which have been
duly mentioned, as do also those who are so ambitious that, in their
lust after novel doctrines, they are always attempting some fraudulent
sophistry, either purposely neglecting certain subjects, as
Erasistratus does in the case of the humours, or unscrupulously
attacking other people, as does this same writer, as well as many of
the more recent authorities.
  But let this discussion come to an end here, and I shall add in
the third book all that remains.
  BOOK THREE

  1. It has been made clear in the preceding discussion that nutrition
occurs by an alteration or assimilation of that which nourishes to
that which receives nourishment, and that there exists in every part
of the animal a faculty which in view of its activity we call, in
general terms, alterative, or, more specifically, assimilative and
nutritive. It was also shown that a sufficient supply of the matter
which the part being nourished makes into nutriment for itself is
ensured by virtue of another faculty which naturally attracts its
proper juice [humour] that juice is proper to each part which is
adapted for assimilation, and that the faculty which attracts the
juice is called, by reason of its activity, attractive or
epispastic. It has also been shown that assimilation is preceded by
adhesion, and this, again, by presentation, the latter stage being, as
one might say, the end or goal of the activity corresponding to the
attractive faculty. For the actual bringing up of nutriment from the
veins into each of the parts takes place through the activation of the
attractive faculty, whilst to have been finally brought up and
presented to the part is the actual end for which we desired such an
activity; it is attracted in order that it may be presented. After
this, considerable time is needed for the nutrition of the animal;
whilst a thing may be even rapidly attracted, on the other hand to
become adherent, altered, and entirely assimilated to the part which
is being nourished and to become a part of it, cannot take place
suddenly, but requires a considerable amount of time. But if the
nutritive juice, so presented, does not remain in the part, but
withdraws to another one, and keeps flowing away, and constantly
changing and shifting its position, neither adhesion nor complete
assimilation will take place in any of them. Here too, then, the
[animal's] nature has need of some other faculty for ensuring a
prolonged stay of the presented juice at the part, and this not a
faculty which comes in from somewhere outside but one which is
resident in the part which is to be nourished. This faculty, again, in
view of its activity our predecessors were obliged to call retentive.
  Thus our argument has clearly shown the necessity for the genesis of
such a faculty, and whoever has an appreciation of logical sequence
must be firmly persuaded from what we have said that, if it be laid
down and proved by previous demonstration that Nature is artistic
and solicitous for the animal's welfare, it necessarily follows that
she must also possess a faculty of this kind.
  2. Since, however, it is not our habit to employ this kind of
demonstration alone, but to add thereto cogent and compelling proofs
drawn from obvious facts, we will also proceed to the latter kind in
the present instance: we will demonstrate that in certain parts of the
body the retentive faculty is so obvious that its operation can be
actually recognised by the senses, whilst in other parts it is less
obvious to the senses, but is capable even here of being detected by
the argument.
  Let us begin our exposition, then, by first dealing systematically
for a while with certain definite parts of the body, in reference to
which we may accurately test and enquire what sort of thing the
retentive faculty is.
  Now, could one begin the enquiry in any better way than with the
largest and hollowest organs? Personally I do not think one could.
It is to be expected that in these, owing to their size, the
activities will show quite clearly, whereas with respect to the
small organs, even if they possess a strong faculty of this kind,
its activation will not at once be recognisable to sense.
  Now those parts of the animal which are especially hollow and
large are the stomach and the organ which is called the womb or
uterus. What prevents us, then, from taking up these first and
considering their activities, conducting the enquiry on our own
persons in regard to those activities which are obvious without
dissection, and, in the case of those which are more obscure,
dissecting animals which are near to man; not that even animals unlike
him will not show, in a general way, the faculty in question, but
because in this manner we may find out at once what is common to all
and what is peculiar to ourselves, and so may become more
resourceful in the diagnosis and treatment of disease.
  Now it is impossible to speak of both organs at once, so we shall
deal with each in turn, beginning with the one which is capable of
demonstrating the retentive faculty most plainly. For the stomach
retains the food until it has quite digested it, and the uterus
retains the embryo until it brings it to completion, but the time
taken for the completion of the embryo is many times more than that
for the digestion of food.
  3. We may expect, then, to detect the retentive faculty in the
uterus more clearly in proportion to the longer duration of its
activity as compared with that of the stomach. For, as we know, it
takes nine months in most women for the foetus to attain maturity in
the womb, this organ having its neck quite closed, and entirely
surrounding the embryo together with the chorion. Further, it is the
utility of the function which determines the closure of the os and the
stay of the foetus in the uterus. For it is not casually nor without
reason that Nature has made the uterus capable of contracting upon,
and of retaining the embryo, but in order that the latter may arrive
at a proper size. When, therefore, the object for which the uterus
brought its retentive faculty into play has been fulfilled, it then
stops this faculty and brings it back to a state of rest, and
employs instead of it another faculty hitherto quiescent- the
propulsive faculty. In this case again the quiescent and active states
are both determined by utility; when this calls, there is activity;
when it does not, there is rest.
  Here, then, once more, we must observe well the Art [artistic
tendency] of Nature- how she has not merely placed in each organ the
capabilities of useful activities, but has also fore-ordained the
times both of rest and movement. For everything connected with the
pregnancy proceeds properly, the eliminative faculty remains quiescent
as though it did not exist, but if anything goes wrong in connection
either with the chorion or any of the other membranes or with the
foetus itself, and its completion is entirely despaired of, then the
uterus no longer awaits the nine-months period, but the retentive
faculty forthwith ceases and allows the heretofore inoperative faculty
to come into action. Now it is that something is done- in fact, useful
work effected- by the eliminative or propulsive faculty (for so it,
too, has been called, receiving, like the rest,its names from the
corresponding activities).
  Further, our theory can, I think, demonstrate both together; for
seeing that they succeed each other, and that the one keeps giving
place to the other according as utility demands, it seems not
unreasonable to accept a common demonstration also for both. Thus it
is the work of the retentive faculty to make the uterus contract
upon the foetus at every point, so that, naturally enough, when the
midwives palpate it, the os is found to be closed, whilst the pregnant
women themselves, during the first days- and particularly on that on
which conception takes place- experience a sensation as if the
uterus were moving and contracting upon itself. Now, if both of
these things occur- if the os closes apart from inflammation or any
other disease, and if this is accompanied by a feeling of movement
in the uterus- then the women believe that they have received the
semen which comes from the male, and that they are retaining it.
  Now we are not inventing this for ourselves: one may say the
statement is based on prolonged experience of those who occupy
themselves with such matters. Thus Herophilus does not hesitate to
state in his writings that up to the time of labour the os uteri
will not admit so much as the tip of a probe, that it no longer
opens to the slightest degree if pregnancy has begun- that, in fact,
it dilates more widely at the times of the menstrual flow. With him
are in agreement all the others who have applied themselves to this
subject; and particularly Hippocrates, who was the first of all
physicians and philosophers to declare that the os uteri closes during
pregnancy and inflammation, albeit in pregnancy it does not depart
from its own nature, whilst in inflammation it becomes hard.
  In the case of the opposite (the eliminative) faculty, the os opens,
whilst the whole fundus approaches as near as possible to the os,
expelling the embryo as it does so; and along with the fundus the
contiguous parts- which form as it were a girdle round the whole
organ- cooperate in the work; they squeeze upon the embryo and
propel it bodily outwards. And, in many women who exercise such a
faculty immoderately, violent pains cause forcible prolapse of the
whole womb; here almost the same thing happens as frequently occurs in
wresting-bouts and struggles, when in our eagerness to overturn and
throw others we are ourselves upset along with them; for similarly
when the uterus is forcing the embryo forward it sometimes becomes
entirely prolapsed, and particularly when the ligaments connecting
it with the spine happen to be naturally lax.
  A wonderful device of Nature's also is this- that, when the foetus
is alive, the os uteri is closed with perfect accuracy, but if it
dies, the os at once opens up to the extent which is necessary for the
foetus to make its exit. The midwife, however, does not make the
parturient woman get up at once and sit down on the [obstetric] chair,
but she begins by palpating the os as it gradually dilates, and the
first thing she says is that it has dilated "enough to admit the
little finger," then that "it is bigger now," and as we make enquiries
from time to time, she answers that the size of the dilatation is
increasing. And when it is sufficient to allow of the transit of the
foetus, she then makes the patient get up from her bed and sit on
the chair, and bids her make every effort to expel the child. Now,
this additional work which the patient does of herself is no longer
the work of the uterus but of the epigastric muscles, which also
help us in defaecation and micturition.
  4. Thus the two faculties are clearly to be seen in the case of
the uterus; in the case of the stomach they appear as follows:-
Firstly in the condition of gurgling, which physicians are
persuaded, and with reason, to be a symptom of weakness of the
stomach; for sometimes when the very smallest quantity of food has
been ingested this does not occur, owing to the fact that the
stomach is contracting accurately upon the food and constricting it at
every point; sometimes when the stomach is full the gurglings yet make
themselves heard as though it were empty. For if it be in a natural
condition, employing its contractile faculty in the ordinary way,
then, even if its contents be very small, it grasps the whole of
them and does not leave any empty space. When it is weak, however,
being unable to lay hold of its contents accurately, it produces a
certain amount of vacant space, and amount of vacant space, and allows
the liquid contents to flow about in different directions in
accordance with its changes of shape, and so to produce gurglings.
  Thus those who are troubled with this symptom expect, with good
reason, that they will also be unable to digest adequately; proper
digestion cannot take place in a weak stomach. In such people also,
the mass of food may be plainly seen to remain an abnormally long time
in the stomach, as would be natural if their digestion were slow.
Indeed, the chief way in which these people will surprise one is in
the length of time that not food alone but even fluids will remain
in their stomachs. Now, the actual cause of this is not, as one
would imagine, that the lower outlet of the stomach, being fairly
narrow, will allow nothing to pass before being reduced to a fine
state of division. There are a great many people who frequently
swallow large quantities of big fruit-stones; one person who was
holding a gold ring in his mouth, inadvertently swallowed it;
another swallowed a coin, and various people have swallowed various
hard and indigestible objects; yet all these people easily passed by
the bowel what they had swallowed, without there being any
subsequent symptoms. Now surely if narrowness of the gastric outlet
were the cause of untriturated food remaining for an abnormally long
time, none of these articles I have mentioned would ever have escaped.
Furthermore, the fact that it is liquids which remain longest in these
people's stomachs is sufficient to put the idea of narrowness of the
outlet out of court. For, supposing a rapid descent were dependent
upon emulsification, then soups, milk, and barley-emulsion would at
once pass along in every case. But as a matter of fact this is not so.
For in people who are extremely asthenic it is just these fluids which
remain undigested, which accumulate and produce gurglings, and which
oppress and overload the stomach, whereas in strong persons not merely
do none of these things happen, but even a large quantity of bread
or meat passes rapidly down.
  And it is not only because the stomach is distended and loaded and
because the fluid runs from one part of it to another accompanied by
gurglings- it is not only for these reasons that one would judge
that there was an unduly long continuance of the food in it, in
those people who are so disposed, but also from the vomiting. Thus,
there are some who vomit up every particle of what they have eaten,
not after three or four hours, but actually in the middle of the
night, a lengthy period having elapsed since their meal.
  Suppose you fill any animal whatsoever with liquid food- an
experiment I have often carried out in pigs, to whom I give a sort
of mess of wheaten flour and water, there after cutting them open
after three or four hours; if you will do this yourself, you will find
the food still in the stomach. For it is not chylification which
determines the length of its stay here- since this can also be
effected outside the stomach; the determining factor is digestion
which is a different thing from chylification, as are blood-production
and nutrition. For, just as it has been shown that these two processes
depend upon a change of qualities, similarly also the digestion of
food in the stomach involves a transmutation of it into the quality
proper to that which is receiving nourishment. Then, when it is
completely digested, the lower outlet opens and the food is quickly
ejected through it, even if there should be amongst it abundance of
stones, bones, grape-pips, or other things which cannot be reduced
to chyle. And you may observe this yourself in an animal, if you
will try to hit upon the time at which the descent of food from the
stomach takes place. But even if you should fail to discover the time,
and nothing was yet passing down, and the food was still undergoing
digestion in the stomach, still even then you would find dissection
not without its uses. You will observe, as we have just said, that the
pylorus is accurately closed, and that the whole stomach is in a state
of contraction upon the food very much as the womb contracts upon
the foetus. For it is never possible to find a vacant space in the
uterus, the stomach, or in either of the two bladders- that is, either
in that called bile-receiving or in the other; whether their
contents be abundant or scanty, their cavities are seen to be
replete and full, owing to the fact that their coats contract
constantly upon the contents- so long, as least, as the animal is in a
natural condition.
  Now Erasistratus for some reason declares that it is the
contractions of the stomach which are the cause of everything- that is
to say, of the softening of the food, the removal of waste matter, and
the absorption of the food when chylified [emulsified].
  Now I have personally, on countless occasions, divided the
peritoneum of a still living animal and have always found all the
intestines contracting peristaltically upon their contents. The
condition of the stomach, however, is found less simple; as regards
the substances freshly swallowed, it had grasped these accurately both
above and below, in fact at every point, and was as devoid of movement
as though it had grown round and become united with the food. At the
same time I found the pylorus persistently closed and accurately shut,
like the os uteri on the foetus.
  In the cases, however, where digestion had been completed the
pylorus had opened, and the stomach was undergoing peristaltic
movements, similar to those of the intestines.
  5. Thus all these facts agree that the stomach, uterus, and bladders
possess certain inborn faculties which are retentive of their own
proper qualities and eliminative of those that are foreign. For it has
been already shown that the bladder by the liver draws bile into
itself, while it is also quite obvious that it eliminates this daily
into the stomach. Now, of course, if the eliminative were to succeed
the attractive faculty and there were not a retentive faculty
between the two, there would be found, on every occasion that
animals were dissected, an equal quantity of bile in the gall-bladder.
This however, we do not find. For the bladder is sometimes observed to
be very full, sometimes quite empty, while at other times you find
in it various intermediate degrees of fulness, just as is the case
with the other bladder- that which receives the urine; for even
without resorting to anatomy we may observe that the urinary bladder
continues to collect urine up to the time that it becomes
uncomfortable through the increasing quantity of urine or the
irritation caused by its acidity- the presumption thus being that
here, too, there is a retentive faculty.
  Similarly, too, the stomach, when, as often happens, it is irritated
by acidity, gets rid of the food, although still undigested, earlier
than proper; or again, when oppressed by the quantity of its contents,
or disordered from the co-existence of both conditions, it is seized
with diarrhoea. Vomiting also is an affection of the upper [part of
the] stomach analogous to diarrhoea, and it occurs when the stomach is
overloaded or is unable to stand the quality of the food or surplus
substances which it contains. Thus, when such a condition develops
in the lower parts of the stomach, while the parts about the inlet are
normal, it ends in diarrhoea, whereas if this condition is in the
upper stomach, the lower parts being normal, it ends in vomiting.
  6. This may often be clearly in those who are disinclined for
food; when obliged to eat, they have not the strength to swallow, and,
even if they force themselves to do so, they cannot retain the food,
but at vomit it up. And those especially who have a dislike to some
particular kind of food, sometimes take it under compulsion, and
then promptly bring it up; or, if they force themselves to keep it
down, they are nauseated and feel their stomach turned up, and
endeavouring to relieve itself of its discomfort.
  Thus, as was said at the beginning, all the observed facts testify
that there must exist in almost all parts of the animal a certain
inclination towards, or, so to speak, an appetite for their own
special quality, and an aversion to, or, as it were, a hatred of the
foreign quality. And it is natural that when they feel an
inclination they should attract, and that when they feel aversion they
should expel.
  From these facts, then, again, both the attractive and the
propulsive faculties have been demonstrated to exist in everything.
  But if there be an inclination or attraction, there will also be
some benefit derived; for no existing thing attracts anything else for
the mere sake of attracting, but in order to benefit by what is
acquired by the attraction. And of course it cannot benefit by it if
it cannot retain it. Herein, then, again, the retentive faculty is
shown to have its necessary origin: for the stomach obviously inclines
towards its own proper qualities and turns away from those that are
foreign to it.*

  *Galen confuses the nutrition of organs with that of the ultimate
living elements or cells; the stomach does not, of course, feed itself
in the way a cell does.

  But if it aims at and attracts its food and benefits by it while
retaining and contracting upon it, we may also expect that there
will be some termination to the benefit received, and that
thereafter will come the time for the exercise of the eliminative
faculty.
  7. But if the stomach both retains and benefits by its food, then it
employs it for the end for which it [the stomach] naturally exists.
And it exists to partake of that which is of a quality befitting and
proper to it. Thus it attracts all the most useful parts of the food
in a vaporous and finely divided condition, storing this up in its own
coats, and applying it to them. And when it is sufficiently full it
puts away from it, as one might something troublesome, the rest of the
food, this having itself meanwhile obtained some profit from its
association with the stomach. For it is impossible for two bodies
which are adapted for acting and being acted upon to come together
without either both acting or being acted upon, or else one acting and
the other being acted upon. For if their forces are equal they will
act and be acted upon equally, and if the one be much superior in
strength, it will exert its activity upon its passive neighbour; thus,
while producing a great and appreciable effect, it will itself be
acted upon either little or not at all. But it is herein also that the
main difference lies between nourishing food and a deleterious drug;
the latter masters the forces of the body, whereas the former is
mastered by them.
  There cannot, then, be food which is suited for the animal which
is not also correspondingly subdued by the qualities existing in the
animal. And to be subdued means to undergo alteration. Now, some parts
are stronger in power and others weaker; therefore, while all will
subdue the nutriment which is proper to the animal, they will not
all do so equally. Thus the stomach will subdue and alter its food,
but not to the same extent as will the liver, veins, arteries, and
heart.
  We must therefore observe to what extent it does alter it. The
alteration is more than that which occurs in the mouth, but less
than that in the liver and veins. For the latter alteration changes
the nutriment into the substance of blood, whereas that in the mouth
obviously changes it into a new form, but certainly does not
completely transmute it. This you may discover in the food which is
left in the intervals between the teeth, and which remains there all
night; the bread is not exactly bread, nor the meat meat, for they
have a smell similar to that of the animal's mouth, and have been
disintegrated and dissolved, and have had the qualities of the
animal's flesh impressed upon them. And you may observe the extent
of the alteration which occurs to food in the mouth if you will chew
some corn and then apply it to an unripe [undigested] boil: you will
see it rapidly transmuting- in fact entirely digesting- the boil,
though it cannot do anything of the kind if you mix it with water. And
do not let this surprise you; this phlegm [saliva] in the mouth is
also a cure for lichens*; it even rapidly destroys scorpions; while,
as regards the animals which emit venom, some it kills at once, and
others after an interval; to all of them in any case it does great
damage. Now, the masticated food is all, firstly, soaked in and
mixed up with this phlegm; and secondly, it is brought into contact
with the actual skin of the mouth; thus it undergoes more change
than the food which is wedged into the vacant spaces between the
teeth.

  *Apparently skin-diseases in which a superficial crust (resembling
the lichen on a tree-trunk) forms- e.g. psoriasis.

  But just as masticated food is more altered than the latter kind, so
is food which has been swallowed more altered than that which has been
merely masticated. Indeed, there is no comparison between these two
processes; we have only to consider what the stomach contains- phlegm,
bile, pneuma, [innate] heat, and, indeed the whole substance of the
stomach. And if one considers along with this the adjacent viscera
like a lot of burning hearths around a great cauldron- to the right
the liver, to the left the spleen, the heart above, and along with
it the diaphragm (suspended and in a state of constant movement),
and the omentum sheltering them all- you may believe what an
extraordinary alteration it is which occurs in the food taken into the
stomach.
  How could it easily become blood if it were not previously
prepared by means of a change of this kind? It has already been
shown that nothing is altered all at once from one quality to its
opposite. How then could bread, beef, beans, or any other food turn
into blood if they had not previously undergone some other alteration?
And how could the faeces be generated right away in the small
intestine? For what is there in this organ more potent in producing
alteration than the factors in the stomach? Is it the number of the
coats, or the way it is surrounded by neighbouring viscera, or the
time that the food remains in it, or some kind of innate heat which it
contains? Most assuredly the intestines have the advantage of the
stomach in none of these respects. For what possible reason, then,
will objectors have it that bread may often remain a whole night in
the stomach and still preserve its original qualities, whereas when
once it is projected into the intestines, it straightway becomes
ordure? For, if such a long period of time is incapable of altering
it, neither will the short period be sufficient, or, if the latter
is enough, surely the longer time will be much more so! Well, then,
can it be that, while the nutriment does undergo an alteration in
the stomach, this is a different kind of alteration and one which is
not dependent on the nature of the organ which alters it? Or if it
be an alteration of this latter kind, yet one perhaps which is not
proper to the body of the animal? This is still more impossible.
Digestion was shown to be nothing else than an alteration to the
quality proper to that which is receiving nourishment. Since, then,
this is what digestion means and since the nutriment has been shown to
take on in the stomach a quality appropriate to the animal which is
about to be nourished by it, it has been demonstrated adequately
that nutriment does undergo digestion in the stomach.
  And Asclepiades is absurd when he states that the quality of the
digested food never shows itself either in eructations or in the
vomited matter, or on dissection. For of course the mere fact that the
food smells of the body shows that it has undergone gastric digestion.
But this man is so foolish that, when he hears the Ancients saying
that the food is converted in the stomach into something "good," he
thinks it proper to look out not for what is good in its possible
effects, but for what is good to the taste: this is like saying that
apples (for so one has to argue with him) become more apple-like [in
flavour] in the stomach, or honey more honey-like!
  Erasistratus, however, is still more foolish and absurd, either
through not perceiving in what sense the Ancients said that
digestion is similar to the process of boiling, or because he
purposely confused himself with sophistries. It is, he says,
inconceivable that digestion, involving as it does such trifling
warmth, should be related to the boiling process. This is as if we
were to suppose that it was necessary to put the fires of Etna under
the stomach before it could manage to alter the food; or else that,
while it was capable of altering the food, it did not do this by
virtue of its innate heat, which of course was moist, so that the word
boil was used instead of bake.
  What he ought to have done, if it was facts that he wished to
dispute about, was to have tried to show, first and foremost, that the
food is not transmuted or altered in quality by the stomach at all,
and secondly, if he could not be confident of this, he ought to have
tried to show that this alteration was not of any advantage to the
animal. If, again, he were unable even to make this misrepresentation,
he ought to have attempted to confute the postulate concerning the
active principles- to show, in fact, that the functions taking place
in the various parts do not depend on the way in which the Warm, Cold,
Dry, and Moist are mixed, but on some other factor. And if he had
not the audacity to misrepresent facts even so far as this, still he
should have tried at least to show that the Warm is not the most
active of all the principles which play a part in things governed by
Nature. But if he was unable to demonstrate this any more than any
of the previous propositions, then he ought not to have made himself
ridiculous by quarrelling uselessly with a mere name- as though
Aristotle had not clearly stated in the fourth book of his
"Meteorology," as well as in many other passages, in what way
digestion can be said to be allied to boiling, and also that the
latter expression is not used in its primitive or strict sense.
  But, as has been frequently said already, the one starting-point
of all this is a thorough-going enquiry into the question of the Warm,
Cold, Dry and Moist; this Aristotle carried out in the second of his
books "On Genesis and Destruction," where he shows that all the
transmutations and alterations throughout the body take place as a
result of these principles. Erasistratus, however, advanced nothing
against these or anything else that has been said above, but
occupied himself merely with the word "boiling."
  8. Thus, as regards digestion, even though he neglected everything
else, he did at least attempt to prove his point- namely, that
digestion in animals differs from boiling carried on outside; in
regard to the question of deglutition, however, he did not go even
so far as this. What are his words?
  "The stomach does not appear to exercise any traction."
  Now the fact is that the stomach possesses two coats, which
certainly exist for some purpose; they extend as far as the mouth, the
internal one remaining throughout similar to what it is in the
stomach, and the other one tending to become of a more fleshy nature
in the gullet. Now simple observation will testify that these coats*
have their fibres inserted in contrary directions. And, although
Erasistratus did not attempt to say for what reason they are like
this, I am going to do so.

  *The mucous and the muscular coats.

  The inner coat has its fibres straight, since it exists for the
purpose of traction. The outer coat has its fibres transverse, for the
purpose of peristalsis. In fact, the movements of each of the mobile
organs of the body depend on the setting of the fibres. Now please
test this assertion first in the muscles themselves; in these the
fibres are most distinct, and their movements visible owing to their
vigour. And after the muscles, pass to the physical organs, and you
will see that they all move in correspondence with their fibres.
This is why the fibres throughout the intestines are circular in
both coats- they only contract peristaltically, they do not exercise
traction. The stomach, again, has some of its fibres longitudinal
for the purpose of traction and the others transverse for the
purpose of peristalsis. For just as the movements in the muscles
take place when each of the fibres becomes tightened and drawn towards
its origin, such also is what happens in the stomach; when the
transverse fibres tighten, the breadth of the cavity contained by them
becomes less; and when the longitudinal fibres contract and draw in
upon themselves, the length must necessarily be curtailed. This
curtailment of length, indeed, is well seen in the act of
swallowing: the larynx is seen to rise upwards to exactly the same
degree that the gullet is drawn downwards; while, after the process of
swallowing has been completed and the gullet is released from tension,
the larynx can be clearly seen to again. This is because the inner
coat of the stomach, which has the longitudinal fibres and which
also lines the gullet and the mouth, extends to the interior of the
larynx, and it is thus impossible for it to be drawn down by the
stomach without the larynx being involved in the traction.
  Further, it will be found acknowledged in Erasistratus's own
writings that the circular fibres (by which the stomach as well as
other parts performs its contractions) do not curtail its length,
but contract and lessen its breadth. For he says that the stomach
contracts peristaltically round the food during the whole period of
digestion. But if it contracts, without in any way being diminished in
length, this is because downward traction of the gullet is not a
property of the movement of circular peristalsis. For what alone
happens, as Erasistratus himself said, is that when the upper parts
contract the lower ones dilate. And everyone knows that this can be
plainly seen happening even in a dead man, if water be poured down his
throat; this symptom results from the passage of matter through a
narrow channel; it would be extraordinary if the channel did not
dilate when a mass was passing through it. Obviously then the
dilatation of the lower parts along with the contraction of the
upper is common both to dead bodies, when anything whatsoever is
passing through them, and to living ones, whether they contract
peristaltically round their contents or attract them.
  Curtailment of length, on the other hand, is peculiar to organs
which possess longitudinal fibres for the purpose of attraction. But
the gullet was shown to be pulled down; for otherwise it would not
have drawn upon the larynx. It is therefore clear that the stomach
attracts food by the gullet.
  Further, in vomiting, the mere passive conveyance of rejected matter
up to the mouth will certainly itself suffice to keep open those parts
of the oesophagus which are distended by the returned food; as it
occupies each part in front [above], it first dilates this, and of
course leaves the part behind [below] contracted. Thus, in this
respect at least, the condition of the gullet is precisely similar
to what it is in the act of swallowing. But there being no traction,
the whole length remains equal in such cases.
  And for this reason it is easier to swallow than to vomit, for
deglutition results the coats of the stomach being brought into
action, the inner one exerting a pull and the outer one helping by
peristalsis and propulsion, whereas emesis occurs from the outer
coat alone functioning, without there being any kind of pull towards
the mouth. For, although the swallowing of food is ordinarily preceded
by a feeling of desire on the part of the stomach, there is in the
case of vomiting no corresponding desire from the mouth-parts for
the experience; the two are opposite dispositions of the stomach
itself; it yearns after and tends towards what is advantageous and
proper to it, it loathes and rids itself of what is foreign. Thus
the actual process of swallowing occurs very quickly in those who have
a good appetite for such foods as are proper to the stomach; this
organ obviously draws them in and down before they are masticated;
whereas in the case of those who are forced to take a medicinal
draught or who take food as medicine, the swallowing of these articles
is accomplished with distress and difficulty.
  From what has been said, then, it is clear that the inner coat of
the stomach (that containing longitudinal fibres) exists for the
purpose of exerting a pull the from to stomach, and that it is only in
deglutition that it is active, whereas the external coat, which
contains transverse fibres, has been so constituted in order that it
may contract upon its contents and propel them forward; this coat
furthermore, functions in vomiting no less than in swallowing. The
truth of my statement is also borne out by what happens in the channae
and synodonts;* the stomachs of these animals are sometimes found in
their mouths, as also Aristotle writes in his "History of Animals"; he
also adds the cause of this: he says that it is owing to their
voracity.

  *The channae is a kind of sea-perch; the synodont is supposed to
be an edible Mediterranean perch.

  The facts are as follows. In all animals, when the appetite is
very intense, the stomach rises up, so that some people who have a
clear perception of this condition say that their stomach "creeps out"
of them; in others, who are still masticating their food and have
not yet worked it up properly in the mouth, the stomach obviously
snatches away the food from them against their will. In those animals,
therefore, which are naturally voracious, in whom the mouth cavity
is of generous proportions, and the stomach situated close to it (as
in the case of the synodont and channae), it is in no way surprising
that, when they are sufficiently hungry and are pursuing one of the
smaller animals, and are just on the point of catching it, the stomach
should, under the impulse of desire, spring into the mouth. And this
cannot possibly take place in any other way than by the stomach
drawing the food to itself by means of the gullet, as though by a
hand. In fact, just as we ourselves, in our eagerness to grasp more
quickly something lying before us, sometimes stretch out our whole
bodies along with our hands, so also the stomach stretches itself
forward along with the gullet, which is, as it were, its hand. And
thus, in these animals in whom those three factors co-exist- an
excessive propensity for food, a small gullet, and ample mouth
proportions- in these, any slight tendency to movement forwards brings
the whole stomach into the mouth.
  Now the constitution of the organs might itself suffice to give a
naturalist an indication of their functions. For Nature would never
have purposelessly constructed the oesophagus of two coats with
contrary dispositions; they must also have each been meant to have a
different action. The Erasistratean school, however, are capable of
anything rather than of recognizing the effects of Nature. Come,
therefore, let us demonstrate to them by animal dissection as well
that each of the two coats does exercise the activity which I have
stated. Take an animal, then; lay bare the structures surrounding
the gullet, without severing any of the nerves, arteries, or veins
which are there situated; next divide with vertical incisions, from
the lower jaw to the thorax, the outer coat of the oesophagus (that
containing transverse fibres); then give the animal food and you
will see that it still swallows although the peristaltic function
has been abolished. If, again, in another animal, you cut through both
coats with transverse incisions, you will observe that this animal
also swallows although the inner coat is no longer functioning. From
this it is clear that the animal can also swallow by either of the two
coats, although not so well as by both. For the following also, in
addition to other points, may be distinctly observed in the dissection
which I have described- that during deglutition the gullet becomes
slightly filled with air which is swallowed along with the food, and
that, when the outer coat is contracting, this air is easily forced
with the food into the stomach, but that, when there only exists an
inner coat, the air impedes the conveyance of food, by distending this
coat and hindering its action.
  But Erasistratus said nothing about this, nor did he point out
that the oblique situation of the gullet clearly confutes the teaching
of those who hold that it is simply by virtue of the impulse from
above that food which is swallowed reaches the stomach. The only
correct thing he said was that many of the longnecked animals bend
down to swallow. Hence, clearly, the observed fact does not show how
we swallow but how we do not swallow. For from this observation it
is clear that swallowing is not due merely to the impulse from
above; it is yet, however, not clear whether it results from the
food being attracted by the stomach, or conducted by the gullet. For
our part, however, having enumerated all the different considerations-
those based on the constitution of the organs, as well as those
based on the other symptoms which, as just mentioned, occur both
before and after the gullet has been exposed- we have thus
sufficiently proved that the inner coast exists for the purpose of
attraction and the outer for the purpose of propulsion.
  Now the original task we set before ourselves was to demonstrate
that the retentive faculty exists in every one of the organs, just
as in the previous book we proved the existence of the attractive,
and, over and above this, the alterative faculty. Thus, in the natural
course of our argument, we have demonstrated these four faculties
existing in the stomach- the attractive faculty in connection with
swallowing, the retentive with digestion, the expulsive with
vomiting and with the descent of digested food into the small
intestine- and digestion itself we have shown to be a process of
alteration.
  9. Concerning the spleen, also, we shall therefore have no further
doubts as to whether it attracts what is proper to it, rejects what is
foreign, and has a natural power of altering and retaining all that it
attracts; nor shall we be in any doubt as to the liver, veins,
arteries, heart, or any other organ. For these four faculties have
been shown to be necessary for every part which is to be nourished;
this is why we have called these faculties the handmaids of nutrition.
For just as human faeces are most pleasing to dogs, so the residual
matters from the liver are, some of them, proper to the spleen, others
to the gall-bladder, and others to the kidneys.
  10. I should not have cared to say anything further as to the origin
of these [surplus substances] after Hippocrates, Plato, Aristotle,
Diocles, Praxagoras, and Philotimus, nor indeed should I even have
said anything about the faculties, if any of our predecessors had
worked out this subject thoroughly.
  While, however, the statements which the Ancients made on these
points were correct, they yet omitted to defend their arguments with
logical proofs; of course they never suspected that there could be
sophists so shameless as to try to contradict obvious facts. More
recent physicians, again, have been partly conquered by the
sophistries of these fellows and have given credence to them; whilst
others who attempted to argue with them appear to me to lack to a
great extent the power of the Ancients. For this reason I have
attempted to put together my arguments in the way in which it seems to
me the Ancients, had any of them been still alive, would have done, in
opposition to those who would overturn the finest doctrines of our
art.
  I am not, however, unaware that I shall achieve either nothing at
all or else very little. For I find that a great many things which
have been conclusively demonstrated by the Ancients are unintelligible
to the bulk of the Moderns owing to their ignorance- nay, that, by
reason of their laziness, they will not even make an attempt to
comprehend them; and even if any of them have understood them, they
have not given them impartial examination.
  The fact is that he whose purpose is to know anything better than
the multitude do must far surpass all others both as regards his
nature and his early training. And when he reaches early adolescence
he must become possessed with an ardent love for truth, like one
inspired; neither day nor night may he cease to urge and strain
himself in order to learn thoroughly all that has been said by the
most illustrious of the Ancients. And when he has learnt this, then
for a prolonged period he must test and prove it, observing what
part of it is in agreement, and what in disagreement with obvious
fact; thus he will choose this and turn away from that. To such an one
my hope has been that my treatise would prove of the very greatest
assistance.... Still, such people may be expected to be quite few in
number, while, as for the others, this book will be as superfluous
to them as a tale told to an ass.
  11. For the sake, then, of those who are aiming at truth, we must
complete this treatise by adding what is still wanting in it. Now,
in people who are very hungry, the stomach obviously attracts or draws
down the food before it has been thoroughly softened in the mouth,
whilst in those who have no appetite or who are being forced to eat,
the stomach is displeased and rejects the food. And in a similar way
of the other organs possesses both faculties- that of attracting
what is proper to it, and that of rejecting what is foreign. Thus,
even if there be any organ which consists of only one coat (such as
the two bladders, the uterus, and the veins), it yet possesses both
kinds of fibres, the longitudinal and the transverse.
  But further, there are fibres of a third kind- the oblique- which
are much fewer in number than the two kinds already spoken of. In
the organs consisting of two coats this kind of fibre is found in
the one coat only, mixed with the longitudinal fibres; but in the
organs composed of one coat it is found along with the other two
kinds. Now, these are of the greatest help to the action of the
faculty which we have named retentive. For during this period the part
needs to be tightly contracted and stretched over its contents at
every point- the stomach during the whole period of digestion, and the
uterus during that of gestation.
  Thus too, the coat of a vein, being single, consists of various
kinds of fibres; whilst the outer coat of an artery consists of
circular fibres, and its inner coat mostly of longitudinal fibres, but
with a few oblique ones also amongst them. Veins thus resemble the
uterus or the bladder as regards the arrangement of their fibres, even
though they are deficient in thickness; similarly arteries resemble
the stomach. Alone of all organs the intestines consist of two coats
of which both have their fibres transverse. Now the proof that it
was for the best that all the organs should be naturally such as
they are (that, for instance, the intestines should be composed of two
coats) belongs to the subject of the use of parts; thus we must not
now desire to hear about matters of this kind nor why the anatomists
are at variance regarding the number of coats in each organ. For these
questions have been sufficiently discussed in the treatise "On
Disagreement in Anatomy." And the problem as to why each organ has
such and such a character will be discussed in the treatise "On the
Use of Parts."
  12. It is not, however, our business to discuss either of these
questions here, but to consider duly the natural faculties, which,
to the number of four, exist in each organ. Returning then, to this
point, let us recall what has already been said, and set a crown to
the whole subject by adding what is still wanting. For when every part
of the animal has been shewn to draw into itself the juice which is
proper to it (this being practically the first of the natural
faculties), the next point to realise is that the part does not get
rid either of this attracted nutriment as a whole, or even of any
superfluous portion of it, until either the organ itself, or the major
part of its contents also have their condition reversed. Thus, when
the stomach is sufficiently filled with the food and has absorbed
and stored away the most useful part of it in its own coats, it then
rejects the rest like an alien burden. The same happens to the
bladders, when the matter attracted into them begins to give trouble
either because it distends them through its quantity or irritates them
by its quality.
  And this also happens in the case of the uterus; for it is either
because it can no longer bear to be stretched that it strives to
relieve itself of its annoyance, or else because it is irritated by
the quality of the fluids poured out into it. Now both of these
conditions sometimes occur with actual violence, and then
miscarriage takes place. But for the most part they happen in a normal
way, this being then called not miscarriage but delivery or
parturition. Now abortifacient drugs or certain other conditions which
destroy the embryo or rupture certain of its membranes are followed by
abortion, and similarly also when the uterus is in pain from being
in a bad state of tension; and, as has been well said by
Hippocrates, excessive movement on the part of the embryo itself
brings on labour. Now pain is common to all these conditions, and of
this there are three possible causes- either excessive bulk, or
weight, or irritation; bulk when the uterus can no longer support
the stretching, weight when the contents surpass its strength, and
irritation when the fluids which had previously been pent up in the
membranes, flow out, on the rupture of these, into the uterus
itself, or else when the whole foetus perishes, putrefies, and is
resolved into pernicious ichors, and so irritates and bites the coat
of the uterus.
  In all organs, then, both their natural effects and their
disorders and maladies plainly take place on analogous lines, some
so clearly and manifestly as to need no demonstration, and others less
plainly, although not entirely unrecognizable to those who are willing
to pay attention.
  Thus, to take the case of the stomach: the irritation is evident
here because this organ possesses most sensibility, and among its
other affections those producing nausea and the so-called heartburn
clearly demonstrate the eliminative faculty which expels foreign
matter. So also in the case of the uterus and the urinary bladder;
this latter also may be plainly observed to receive and accumulate
fluid until it is so stretched by the amount of this as to be
incapable of enduring the pain; or it may be the quality of the
urine which irritates it; for every superfluous substance which
lingers in the body must obviously putrefy, some in a shorter, and
some in a longer time, and thus it becomes pungent, acrid, and
burdensome to the organ which contains it. This does not apply,
however, in the case of the bladder alongside the liver, whence it
is clear that it possesses fewer nerves than do the other organs. Here
too, however, at least the physiologist must discover an analogy.
For since it was shown that the gall-bladder attracts its own
special juice, so as to be often found full, and that it discharges it
soon after, this desire to discharge must be either due to the fact
that it is burdened by the quantity or that the bile has changed in
quality to pungent and acrid. For while food does not change its
original quality so fast that it is already ordure as soon as it falls
into the small intestine, on the other hand the bile even more readily
than the urine becomes altered in quality as soon as ever it leaves
the veins, and rapidly undergoes change and putrefaction. Now, if
there be clear evidence in relation to the uterus, stomach, and
intestines, as well as to the urinary bladder, that there is either
some distention, irritation, or burden inciting each of these organs
to elimination, there is no difficulty in imagining this in the case
of the gall-bladder also, as well as in the other organs,- to which
obviously the arteries and veins also belong.
  13. Nor is there any further difficulty in ascertaining that it is
through the same channel that both attraction and discharge take place
at different times. For obviously the inlet to the stomach does not
merely conduct food and drink into this organ, but in the condition of
nausea it performs the neck of the bladder which is beside the
liver, albeit single, both fills and empties the bladder. Similarly
the canal of the uterus affords an entrance to the semen and an exit
to the foetus.
  But in this latter case, again, whilst the eliminative faculty is
evident, the attractive faculty is not so obvious to most people. It
is, however, the cervix which Hippocrates blames for inertia of the
uterus when he says:- "Its orifice has no power of attracting semen."
  Erasistratus, however, and Asclepiades reached such heights of
wisdom that they deprived not merely the stomach and the womb of
this faculty but also the bladder by the liver, and the kidneys as
well. I have, however, pointed out in the first book that it is
impossible to assign any other cause for the secretion of urine or
bile.
  Now, when we find that the uterus, the stomach and the bladder by
the liver carry out attraction and expulsion through one and the
same duct, we need no longer feel surprised that Nature should also
frequently discharge waste-substances into the stomach through the
veins. Still less need we be astonished if a certain amount of the
food should, during long fasts, be drawn back from the liver into
the stomach through the same veins by which it was yielded up to the
liver during absorption of nutriment. To disbelieve such things
would of course be like refusing to believe that purgative drugs
draw their appropriate humours from all over the body by the same
stomata through which absorption previously takes place, and to look
for separate stomata for absorption and purgation respectively. As a
matter of fact one and the same stoma subserves two distinct
faculties, and these exercise their pull at different times in
opposite directions- first it subserves the pull of the liver and,
during catharsis, that of the drug. What is there surprising, then, in
the fact that the veins situated between the liver and the region of
the stomach* fulfil a double service or purpose? Thus, when there is
abundance of nutriment contained in the food-canal, it is carried up
to the liver by the veins mentioned; and when the canal is empty and
in need of nutriment, this is again attracted from the liver by the
same veins.

  *The mesenteric veins.

  For everything appears to attract from and to go shares with
everything else, and, as the most divine Hippocrates has said, there
would seem to be a consensus in the movements of fluids and vapours.
Thus the stronger draws and the weaker is evacuated.
  Now, one part is weaker or stronger than another either
absolutely, by nature, and in all cases, or else it becomes so in such
and such a particular instance. Thus, by nature and in all men
alike, the heart is stronger than the liver at attracting what is
serviceable to it and rejecting what is not so; similarly the liver is
stronger than the intestines and stomach, and the arteries than the
veins. In each of us personally, however, liver has stronger drawing
power at one time, and the stomach at another. For when there is
much nutriment contained in the alimentary canal and the appetite
and craving of the liver is violent, then the viscus exerts far the
strongest traction. Again, when the liver is full and distended and
the stomach empty and in need, then the force of the traction shifts
to the latter.
  Suppose we had some food in our hands and were snatching it from one
another; if we were equally in want, the stronger would be likely to
prevail, but if he had satisfied his appetite, and was holding what
was over carelessly, or was anxious to share it with somebody, and
if the weaker was excessively desirous of it, there would be nothing
to prevent the latter from getting it all. In a similar manner the
stomach easily attracts nutriment from the liver when it [the stomach]
has a sufficiently strong craving for it, and the appetite of the
viscus is satisfied. And sometimes the surplusage of nutriment in
the liver is a reason why the animal is not hungry; for when the
stomach has better and more available food it requires nothing from
extraneous sources, but if ever it is in need and is at a loss how
to supply the need, it becomes filled with waste-matters; these are
certain biliary, phlegmatic [mucous] and serous fluids, and are the
only substances that the liver yields in response to the traction of
the stomach, on the occasions when the latter too is in want of
nutriment.
  Now, just as the parts draw food from each other, so also they
sometimes deposit their excess substances in each other, and just as
the stronger prevailed when the two were exercising traction, so it is
also when they are depositing; this is the cause of the so-called
fluxions, for every part has a definite inborn tension, by virtue of
which it expels its superfluities, and, therefore, when one of these
parts,- owing, of course, to some special condition- becomes weaker,
there will necessarily be a confluence into it of the superfluities
from all the other parts. The strongest part deposits its surplus
matter in all the parts near it; these again in other parts which
are weaker; these next into yet others; and this goes on for a long
time, until the superfluity, being driven from one part into
another, comes to rest in one of the weakest of all; it cannot flow
from this into another part, because none of the stronger ones will
receive it, while the affected part is unable to drive it away.
  When, however, we come to deal again with the origin and cure of
disease, it will be possible to find there also abundant proofs of all
that we have correctly indicated in this book. For the present,
however, let us resume again the task that lay before us, i.e. to show
that there is nothing surprising in nutriment coming from the liver to
the intestines and stomach by way of the very veins through which it
had previously been yielded up from these organs into the liver. And
in many people who have suddenly and completely given up active
exercise, or who have had a limb cut off, there occurs at certain
periods an evacuation of blood by way of the intestines- as
Hippocrates has also pointed out somewhere. This causes no further
trouble but sharply purges the whole body and evacuates the plethoras;
the passage of the superfluities is effected, of course, through the
same veins by which absorption took place.
  Frequently also in disease Nature purges the animal through these
same veins- although in this case the discharge is not sanguineous,
but corresponds to the humour which is at fault. Thus in cholera the
entire body is evacuated by way of the veins leading to the intestines
and stomach.
  To imagine that matter of different kinds is carried in one
direction only would characterise a man who was entirely ignorant of
all the natural faculties, and particularly of the eliminative
faculty, which is the opposite of the attractive. For opposite
movements of matter, active and passive, must necessarily follow
opposite faculties; that is to say, every part, after it has attracted
its special nutrient juice and has retained and taken the benefit of
it hastens to get rid of all the surplusage as quickly and effectively
as possible, and this it does in accordance with the mechanical
tendency of this surplus matter.
  Hence the stomach clears away by vomiting those superfluities
which come to the surface of its contents, whilst the sediment it
clears away by diarrhoea. And when the animal becomes sick, this means
that the stomach is striving to be evacuated by vomiting. And the
expulsive faculty has in it so violent and forcible an element that in
cases of ileus [volvulus], when the lower exit is completely closed,
vomiting of faeces occurs; yet such surplus matter could not be
emitted from the mouth without having first traversed the whole of the
small intestine, the jejunum, the pylorus, the stomach, and the
oesophagus. What is there to wonder at, then, if something should also
be transferred from the extreme skin-surface and so reach the
intestines and stomach? This also was pointed out to us by
Hippocrates, who maintained that not merely pneuma or excess-matter,
but actual nutriment is brought down from the outer surface to the
original place from which it was taken up. For the slightest
mechanical movements determine this expulsive faculty, which
apparently acts through the transverse fibres, and which is very
rapidly transmitted from the source of motion to the opposite
extremities. It is, therefore, neither unlikely nor impossible that,
when the part adjoining the skin becomes suddenly oppressed by an
unwonted cold, it should at once be weakened and should find that
the liquid previously deposited beside it without discomfort had now
become more of a burden than a source of nutrition, and should
therefore strive to put it away. Finally, seeing that the passage
outwards was shut off by the condensation [of tissue], it would turn
to the remaining exit and would thus forcibly expel all the
waste-matter at once into the adjacent part; this would do the same to
the part following it; and the process would not cease until the
transference finally terminated at the inner of the veins.
  Now, movements like these come to an end fairly soon, but those
resulting from internal irritants (e.g., in the administration of
purgative drugs or in cholera) become much stronger and more
lasting; they persist as long as the condition of things about the
mouths of the veins continues, that is, so long as these continue to
attract what is adjacent. For this condition causes evacuation of
the contiguous part, and that again of the part next to it, and this
never stops until the extreme surface is reached; thus, as each part
keeps passing on matter to its neighbour, the original affection
very quickly arrives at the extreme termination. Now this is also
the case in ileus; the inflamed intestine is unable to support
either the weight or the acridity of the waste substances and so
does its best to excrete them, in fact to drive them as far away as
possible. And, being prevented from effecting an expulsion downwards
when the severest part of the inflammation is there, it expels the
matter into the adjoining part of the intestines situated above.
Thus the tendency of the eliminative faculty is step by step
upwards, until the superfluities reach the mouth.
  Now this will be also spoken of at greater length in my treatise
on disease. For the present, however, I think I have shown clearly
that there is a universal conveyance or transference from one thing
into another, and that, as Hippocrates used to say, there exists in
everything a consensus in the movement of air and fluids. And I do not
think that anyone, however slow his intellect, will now be at a loss
to understand any of these points,- how, for instance, the stomach
or intestines get nourished, or in what manner anything makes its
way inwards from the outer surface of the body. Seeing that all
parts have the faculty of attracting what is suitable or well-disposed
and of eliminating what is troublesome or irritating, it is not
surprising that opposite movements should occur in them consecutively-
as may be clearly seen in the case of the heart, in the various
arteries, in the thorax, and lungs. In all these the active
movements of the organs and therewith the passive movements of
[their contained] matters may be seen taking place almost every second
in opposite directions. Now, you are not astonished when the
trachea-artery alternately draws air into the lungs and gives it
out, and when the nostrils and the whole mouth act similarly; nor do
you think it strange or paradoxical that the air is dismissed
through the very channel by which it was admitted just before. Do you,
then, feel a difficulty in the case of the veins which pass down
from the liver into the stomach and intestines, and do you think it
strange that nutriment should at once be yielded up to the liver and
drawn back from it into the stomach by the same veins? You must define
what you mean by this expression "at once." If you mean "at the same
time" this is not what we ourselves say; for just as we take in a
breath at one moment and give it out again at another, so at one
time the liver draws nutriment from the stomach, and at another the
stomach from the liver. But if your expression "at once" means that in
one and the same animal a single organ subserves the transport of
matter in opposite directions, and if it is this which disturbs you,
consider inspiration and expiration. For of course these also take
place through the same organs, albeit they differ in their manner of
movement, and in the way in which the matter is conveyed through them.
  Now the lungs, the thorax, the arteries rough and smooth, the heart,
the mouth, and the nostrils reverse their movements at very short
intervals and change the direction of the matters they contain. On the
other hand, the veins which pass down the from the liver to the
intestines and stomach reverse the direction not at such short
intervals, but sometimes once in many days.
  The whole matter, in fact, is as follows:- Each of the organs
draws into itself the nutriment alongside it, and devours all the
useful fluid in it, until it is thoroughly satisfied; this
nutriment, as I have already shown, it stores up in itself, afterwards
making it adhere and then assimilating it- that is, it becomes
nourished by it. For it has been demonstrated with sufficient
clearness already that there is something which necessarily precedes
actual nutrition, namely adhesion, and that before this again comes
presentation. Thus as in the case of the animals themselves the end of
eating is that the stomach should be filled, similarly in the case
of each of the parts, the end of presentation is the filling of this
part with its appropriate liquid. Since, therefore, every part has,
like the stomach, a craving to be nourished, it too envelops its
nutriment and clasps it all round as the stomach does. And this
[action of the stomach], as has been already said, is necessarily
followed by the digestion of the food, although it is not to make it
suitable for the other parts that the stomach contracts upon it; if it
did so, it would no longer be a physiological organ, but an animal
possessing reason and intelligence, with the power of choosing the
better [of two alternatives].
  But while the stomach contracts for the reason that the whole body
possesses a power of attracting and of utilising appropriate
qualities, as has already been explained, it also happens that, in
this process, the food undergoes alteration; further, when filled
and saturated with the fluid pabulum from the food, it thereafter
looks on the food as a burden; thus it at once gets of the excess-
that is to say, drives it gets downwards- itself turning to another
task, namely that of causing adhesion. And during this time, while the
nutriment is passing along the whole length of the intestine, it is
caught up by the vessels which pass into the intestine; as we shall
shortly demonstrate, most of it is seized by the veins, but a little
also by the arteries; at this stage also it becomes presented to the
coats of the intestines.
  Now imagine the whole economy of nutrition divided into three
periods. Suppose that in the first period the nutriment remains in the
stomach and is digested and presented to the stomach until satiety
is reached, also that some of it is taken up from the stomach to the
liver.
  During the second period it passes along the intestines and
becomes presented both to them and to the liver- again until the stage
of satiety- while a small part of it is carried all over the body.
During this period, also imagine that what was presented to the
stomach in the first period becomes now adherent to it.
  During the third period the stomach has reached the stage of
receiving nourishment; it now entirely assimilates everything that had
become adherent to it: at the same time in the intestines and liver
there takes place adhesion of what had been before presented, while
dispersal [anadosis] is taking place to all parts of the body, as also
presentation. Now, if the animal takes food immediately after these
[three stages] then, during the time that the stomach is again
digesting and getting the benefit of this by presenting all the useful
part of it to its own coats, the intestines will be engaged in final
assimilation of the juices which have adhered to them, and so also
will the liver: while in the various parts of the body there will be
taking place adhesion of the portions of nutriment presented. And if
the stomach is forced to remain without food during this time, it will
draw its nutriment the from the veins in the mesentery and liver;
for it will not do so from the actual body of the liver (by body of
the liver I mean first and foremost its flesh proper, and after this
all the vessels contained in it), for it is irrational to suppose that
one part would draw away from another part the juice already contained
in it, especially when adhesion and final assimilation of that juice
were already taking place; the juice, however, that is in the cavity
of the veins will be abstracted by the part which is stronger and more
in need.
  It is in this way, therefore, that the stomach, when it is in need
of nourishment and the animal has nothing to eat, seizes it from the
veins in the liver. Also in the case of the spleen we have shown in
a former passage how it draws all material from the liver that tends
to be thick, and by working it up converts it into more useful matter.
There is nothing surprising, therefore, if, in the present instance
also, some of this should be drawn from the spleen into such organs as
communicate with it by veins, e.g. the omentum, mesentery, small
intestine, colon, and the stomach itself. Nor is it surprising that
the spleen should disgorge its surplus matters into the stomach at one
time, while at another time it should draw some of its appropriate
nutriment from the stomach.
  For, as has already been said, speaking generally, everything has
the power at different times of attracting from and of adding to
everything else. What happens is just as if you might imagine a number
of animals helping themselves at will to a plentiful common stock of
food; some will naturally be eating when others have stopped, some
will be on the point of stopping when others are beginning, some
eating together, and others in succession. Yes, by Zeus! and one
will often be plundering another, if he be in need while the other has
an abundant supply ready to hand. Thus it is in no way surprising that
matter should make its way back from the outer surface of the body
to the interior, or should be carried from the liver and spleen into
the stomach by the same vessels by which it was carried in the reverse
direction.
  In the case of the arteries this is clear enough, as also in the
case of heart, thorax, and lungs; for, since all of these dilate and
contract alternately, it must needs be that matter is subsequently
discharged back into the parts from which it was previously drawn. Now
Nature foresaw this necessity, and provided the cardiac openings of
the vessels with membranous attachments, to prevent their contents
from being carried backwards. How and in what manner this takes
place will be stated in my work "On the Use of Parts," where among
other things I show that it is impossible for the openings of the
vessels to be closed so accurately that nothing at all can run back.
Thus it is inevitable that the reflux into the venous artery (as
will also be made clear in the work mentioned) should be much
greater than through the other openings. But what it is important
for our present purpose to recognise is that every thing possessing
a large and appreciable cavity must, when it dilates, abstract
matter from all its neighbours, and, when it contracts, must squeeze
matter back into them. This should all be clear from what has
already been said in this treatise and from what Erasistratus and I
myself have demonstrated elsewhere respecting the tendency of a vacuum
to become refilled.
  14. And further, it has been shown in other treatises that all the
arteries possess a power which derives from the heart, and by virtue
of which they dilate and contract.
  Put together, therefore, the two facts- that the arteries have
this motion, and that everything, when it dilates, draws
neighbouring matter into itself- and you will find nothing strange
in the fact that those arteries which reach the skin draw in the outer
air when they dilate, while those which anastomose at any point with
the veins attract the thinnest and most vaporous part of the blood
which these contain, and as for those arteries which are near the
heart, it is on the heart itself that they exert their traction.
For, by virtue of the tendency by which a vacuum becomes refilled, the
lightest and thinnest part obeys the tendency before that which is
heavier and thicker. Now the lightest and thinnest of anything in
the body is firstly pneuma, secondly vapour, and in the third place
that part of the blood which has been accurately elaborated and
refined.
  These, then, are what the arteries draw into themselves on every
side; those arteries which reach the skin draw in the outer air
(this being near them and one of the lightest of things); as to the
other arteries, those which pass up from the heart into the neck,
and that which lies along the spine, as also such arteries as are near
these- draw mostly from the heart itself; and those which are
farther from the heart and skin necessarily draw the lightest part
of the blood out of the veins. So also the traction exercised by the
diastole of the arteries which go to the stomach and intestines
takes place at the expense of the heart itself and the numerous
veins in its neighbourhood; for these arteries cannot get anything
worth speaking of from the thick heavy nutriment contained in the
intestines and stomach, since they first become filled with lighter
elements. For if you let down a tube into a vessel full of water and
sand, and suck the air out of the tube with your mouth, the sand
cannot come up to you before the water, for in accordance with the
principle of the refilling of a vacuum the lighter matter is always
the first to succeed to the evacuation.
  15. is not to be wondered at, therefore, that only a very little
[nutrient matter] such, namely, as has been accurately elaborated-
gets from the stomach into the arteries, since these first become
filled with lighter matter. We must understand that there are two
kinds of attraction, that by which a vacuum becomes refilled and
that caused by appropriateness of quality; air is drawn into bellows
in one way, and iron by the lodestone in another. And we must also
understand that the traction which results from evacuation acts
primarily on what is light, whilst that from appropriateness of
quality acts frequently, it may be, on what is heavier (if this should
be naturally more nearly related). Therefore, in the case of the heart
and the arteries, it is in so far as they are hollow organs, capable
of diastole, that they always attract the lighter matter first, while,
in so far as they require nourishment, it is actually into their coats
(which are the real bodies of these organs) that the appropriate
matter is drawn. Of the blood, then, which is taken into their
cavities when they dilate, that part which is most proper to them
and most able to afford nourishment is attracted by their actual
coats.
  Now, apart from what has been said, the following is sufficient
proof that something is taken over from the veins into the arteries.
If you will kill an animal by cutting through a number of its large
arteries, you will find the veins becoming empty along with the
arteries: now, this could never occur if there were not anastomoses
between them. Similarly, also, in the heart itself, the thinnest
portion of the blood is drawn from the right ventricle into the
left, owing to there being perforations in the septum between them:
these can be seen for a great part [of their length]; they are like
a kind of fossae [pits] with wide mouths, and they get constantly
narrower; it is not possible, however, actually to observe their
extreme terminations, owing both to the smallness of these and to
the fact that when the animal is dead all the parts are chilled and
shrunken. Here, too, however, our argument, starting from the
principle that nothing is done by Nature in vain, discovers these
anastomoses between the ventricles of the heart; for it could not be
at random and by chance that there occurred fossae ending thus in
narrow terminations.
  And secondly [the presence of these anastomoses has been assumed]
from the fact that, of the two orifices in the right ventricle, the
one conducting blood in and the other out, the former* is much the
larger. For, the fact that the insertion of the vena cava into the
heart is larger than the vein which is inserted into the lungs
suggests that not all the blood which the vena cava gives to the heart
is driven away again from the heart to the lungs. Nor can it be said
that any of the blood is expended in the nourishment of the actual
body of the heart, since there is another vein** which breaks up in it
and which does not take its origin nor get its share of blood from the
heart itself. And even if a certain amount is so expended, still the
vein leading to the lungs is not to such a slight extent smaller
than that inserted into the heart as to make it likely that the
blood is used as nutriment for the heart: the disparity is much too
great for such an explanation. It is, therefore, clear that
something is taken over into the left ventricle.***

  *The tricuspid orifice.
  **The coronary vein.
  ***Galen's conclusion, of course, is, so far, correct, but he has
substituted an imaginary direct communication between the ventricles
for the actual and more round about pulmonary circulation of whose
existence he apparently had no idea. His views were eventually
corrected by the Renascence anatomists.

  Moreover, of the two vessels connected with it, that which brings
pneuma into it from the lungs is much smaller than the great
outgrowing artery from which the arteries all over the body originate;
this would suggest that it not merely gets pneuma from the lungs,
but that it also gets blood from the right ventricle through the
anastomoses mentioned.
  Now it belongs to the treatise "On the Use of Parts" to show that it
was best that some parts of the body should be nourished by pure,
thin, and vaporous blood, and others by thick, turbid blood, and
that in this matter also Nature has overlooked nothing. Thus it is not
desirable that these matters should be further discussed. Having
mentioned, however, that there are two kinds of attraction, certain
bodies exerting attraction along wide channels during diastole (by
virtue of the principle by which a vacuum becomes refilled) and others
exerting it by virtue of their appropriateness of quality, we must
next remark that the former bodies can attract even from a distance,
while the latter can only do so from among things which are quite
close to them; the very longest tube let down into water can easily
draw up the liquid into the mouth, but if you withdraw iron to a
distance from the lodestone or corn from the jar (an instance of
this kind has in fact been already given) no further attraction can
take place.
  This you can observe most clearly in connection with garden
conduits. For a certain amount of moisture is distributed from these
into every part lying close at hand but it cannot reach those lying
farther off: therefore one has to arrange the flow of water into all
parts of the garden by cutting a number of small channels leading from
the large one. The intervening spaces between these small channels are
made of such a size as will, presumably, best allow them [the
spaces] to satisfy their needs by drawing from the liquid which
flows to them from every side. So also is it in the bodies of animals.
Numerous conduits distributed through the various limbs bring them
pure blood, much like the garden water-supply, and, further, the
intervals between these conduits have been wonderfully arranged by
Nature from the outset so that the intervening parts should be
plentifully provided for when absorbing blood, and that they should
never be deluged by a quantity of superfluous fluid running in at
unsuitable times.
  For the way in which they obtain nourishment is somewhat as follows.
In the body* which is continuous throughout, such as Erasistratus
supposes his simple vessel to be, it is the superficial parts which
are the first to make use of the nutriment with which they are brought
into contact; then the parts coming next draw their share from these
by virtue of their contiguity; and again others from these; and this
does not stop until the quality of the nutrient substance has been
distributed among all parts of the corpuscle in question. And for such
parts as need the humour which is destined to nourish them to be
altered still further, Nature has provided a kind of storehouse,
either in the form of a central cavity or else as separate caverns, or
something analogous to caverns. Thus the flesh of the viscera and of
the muscles is nourished from the blood directly, this having
undergone merely a slight alteration; the bones, however, in order
to be nourished, very great change, and what blood is to flesh
marrow is to bone; in the case of the small bones, which do not
possess central cavities, this marrow is distributed in their caverns,
whereas in the larger bones which do contain central cavities the
marrow is all concentrated in these.

  *Or we may render it "corpuscle"; Galen practically means the cell.

  For, as was pointed out in the first book, things having a similar
substance can easily change into one another, whereas it is impossible
for those which are very different to be assimilated to one another
without intermediate stages. Such a one in respect to cartilage is the
myxoid substance which surrounds it, and in respect to ligaments,
membranes, and nerves the viscous liquid dispersed inside them; for
each of these consists of numerous fibres, which are homogeneous- in
fact, actual sensible elements; and in the intervals between these
fibres is dispersed the humour most suited for nutrition; this they
drawn from the blood in the veins, choosing the most appropriate
possible, and now they are assimilating it step by step and changing
it into their own substance.
  All these considerations, then, agree with one another, and bear
sufficient witness to the truth of what has been already demonstrated;
there is thus no need to prolong the discussion further. For, from
what has been said, anyone can readily discover in what way all the
particular [vital activities] come about. For instance, we could in
this way ascertain why it is that in the case of many people who are
partaking freely of wine, the fluid which they have drunk is rapidly
absorbed through the body and almost the whole of it is passed by
the kidneys within a very short time. For here, too, the rapidity with
which the fluid is absorbed depends on appropriateness of quality,
on the thinness of the fluid, on the width of the vessels and their
mouths, and on the efficiency of the attractive faculty. The parts
situated near the alimentary canal, by virtue of their appropriateness
of quality, draw in the imbibed food for their own purposes, then
the parts next to them in their turn snatch it away, then those next
again take it from these, until it reaches the vena cava, whence
finally the kidneys attract that part of it which is proper to them.
Thus it is in no way surprising that wine is taken up more rapidly
than water, owing to its appropriateness of quality, and, further,
that the white clear kind of wine is absorbed more rapidly owing to
its thinness, while black turbid wine is checked on the way and
retarded because of its thickness.
  These facts, also, will afford abundant proof of what has already
been said about the arteries; everywhere, in fact, such blood as is
both specifically appropriate and at the same time thin in consistency
answers more readily to their traction than does blood which is not
so; this is why the arteries which, in their diastole, absorb
vapour, pneuma, and thin blood attract either none at all or very
little of the juices contained in the stomach and intestines.

                            -THE END-