Claudius Galenus

“ 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 ”

“ 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 others 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. ”

“ 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. ”

“ His view, in fact, is that the fluid which we drink passes into the bladder by being resolved into vapours, and that, when these have again been condensed, it thus regains its previous form, and turns from vapour into fluid. He simply looks upon the bladder as a sponge or a piece of wool, and not as the perfectly compact and impervious body that it is, with two very strong coats. For if we say that the vapours pass through these coats, why should they not pass through the peritoneum and the diaphragm, thus filling the whole abdominal cavity and thorax with water? ”

“ 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? ”

“ Now the extent of exactitude and truth in the doctrines of Hippocrates may be gauged, not merely from the way in which his opponents are at variance with obvious facts, but also from the various subjects of natural research themselves—the functions of animals, and the rest. For those people who do not believe that there exists in any part of the animal a faculty for attracting its own special quality are compelled repeatedly to deny obvious facts. ”

“ 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. ”

“ 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. ”

“ All people, therefore, who can appreciate the logical sequence of an hypothesis hold that, according to the second teaching, there does not exist any substance or faculty peculiar either to Nature or to Soul, but that these result from the way in which the primary corpuscles, which are unaffected by change, come together. According to the first-mentioned teaching, on the other hand, Nature is not posterior to the corpuscles, but is a long way prior to them and older that they; and therefore in their view it is Nature which puts together the bodies both of plants and animals ”

“ 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. ”

“ When, however, the animal has attained its complete size, then, during the whole period following its birth and until the acme is reached, the faculty of growth is predominant, while the alterative and nutritive faculties are accessory—in fact, act as its handmaids. What, then, is the property of this faculty of growth? To extend in every direction that which has already come into existence—that is to say, the solid parts of the body, the arteries, veins, nerves, bones, cartilages, membranes, ligaments, and the various coats which we have just called elementary, homogeneous, and simple. ”

“ 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. ”

“ 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. ”

“ But, if the children were able to bring nourishment to this thin part, then they would make the bladder big in the smae way that Nature does. As it is, however, they cannot do what Nature does, for to imitate this is beyond the power not only of children, but of any one soever; it is a property of Nature alone. It will now, therefore, be clear to you that nutrition is a necessity for growing things. For if such bodies were distended, but not at the same time nourished, they would take on a false appearance of growth, not a true growth. ”

“ 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 dycrasiae 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. ”

“ 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. ”

“ 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. ”

“ If we are not going to grant the kidneys a faculty for attracting this particular quality, as Hippocrates held, we shall discover no other reason. For, surely everyone sees that either the kidneys must attract the urine, or the veins must propel it—if, that is, it does not move of itself. But if the veins did exert a propulsive action when they contract, they would squeeze out into the kidneys not merely the urine, but along with it the whole of the blood which they contain. ”

“ 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. ”

“ Who, in fact, does not know that anything which is overcooked grows at first salty and afterwards bitter? And if you will boil honey itself, far the sweetest of things, you can demonstrate that even this becomes quite bitter. For what may occur as a result of boiling in the case of other articles which are not warm by nature, exists naturally in honey; for this reason it does not become sweeter on being boiled, since exactly the same quantity of heat as is needed for the production of sweetness exists from beforehand in the honey. ”

“ 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. ”

“ Some of these people have even expressly declared that the soul possesses no reasoning faculty, but that we are led like cattle by the impression of our senses, and are unable to refuse or dissent from anything. In their view, obviously, courage, wisdom, temperance, and self-control are all mere nonsense, we do not love either each other or our offspring, nor do the gods care anything for us. ”

“ 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. ”

“ Thus it is quite easy for blood to become flesh; for, if Nature thicken it to such an extent that it acquires a certain consistency and ceases to be fluid, it thus becomes original newly-formed flesh; but in order that blood may turn into bone, much time is needed and much elaboration and transformation of the blood. Further, it is quite clear that bread, and, more particularly lettuce, beet, and the like, require a great deal of alteration, in order to become blood. This, then, is one reason why there are so many organs concerned in the alteration of food. ”

“ 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. ”

“ 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. ”

“ Is not also the fact that in summer yellow bile is evacuated in greater quantity by the same drugs, and in winter phlegm, and that in a young man more bile is evacuated, and in an old man more phlegm? Obviously each drug attracts something which already exists, and does not generate something previously non-existent. Thus if you give in the summer season a drug which attracts phlegm to a young man of a lean and warm habit, who has lived neither idly nor too luxuriously, you will with great difficulty evacuate a very small quantity of this humour, and you will do the man the utmost harm. ”

“ 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 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. ”

“ We, however, for our part, are convinced that the chief merit of language is clearness, and we know that nothing detracts so much from this as do unfamiliar terms; accordingly we employ those terms which the bulk of people are accustomed to use, and we say that animals are governed at once by their soul and by their nature, and plants by their nature alone, and that growth and nutrition are the effects of nature, not of soul. ”