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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.
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.
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 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 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.
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 [...]
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