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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.
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.
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.
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.
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.
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.
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?
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 before hand 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 [...]
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