Greek Medical ScienceJanuary 24, 2022
When all things were in disorder, God created all the measures and harmonies possible:
- in each thing in relation to itself, and
- in all things in relation to each other
Back then, nothing had any proportion except by accident. Nothing even was named.
All these the creator first set in order, and out of them he constructed the universe, which was a single animal comprehending in itself all other animals, mortal and immortal.
Now of the divine, he himself was the creator, but the creation of the mortal he committed to his offspring. They, imitating him, received from him the immortal principle of the soul.
Around this they proceeded to fashion a mortal body, and made it to be the vehicle of the soul, and constructed within the body a soul of another nature which was mortal, subject to terrible and irresistible affections,—first of all, pleasure, the greatest incitement to evil; then, pain, which deters from good; also rashness and fear, two foolish counsellors, anger hard to be appeased, and hope easily led astray.
These they mingled with irrational sense and with all-daring love according to necessary laws, and so framed man. Wherefore, fearing to pollute the divine any more than was absolutely unavoidable, they gave to the mortal nature a separate habitation in another part of the body, placing the neck between them to be the isthmus and boundary, which they constructed between the head and breast, to keep them apart.
In the breast, and in what is termed the thorax, they encased the mortal soul; and as the one part of this was superior and the other inferior they divided the cavity of the thorax into two parts, as the women’s and men’s apartments are divided in houses, and placed the midriff to be a wall of partition between them.
That part of the inferior soul which is endowed with courage and passion and loves contention they settled nearer the head, midway between the midriff and the neck, in order that it might be under the rule of reason and might join with it in controlling and restraining the desires when they are no longer willing of their own accord to obey the word of command issuing from the citadel.
The heart, the knot of the veins and the fountain of the blood which races through all the limbs, was set in the place of guard, that when the might of passion was roused by reason making proclamation of any wrong assailing them from without or being perpetrated by the desires within, quickly the whole power of feeling in the body, perceiving these commands and threats, might obey and follow through every turn and alley, and thus allow the principle of the best to have the command in all of them.
But the gods, foreknowing that the palpitation of the heart in the expectation of danger and the swelling and excitement of passion was caused by fire, formed and implanted as a supporter to the heart the lung, which was, in the first place, soft and bloodless, and also had within hollows like the pores of a sponge, in order that by receiving the breath and the drink, it might give coolness and the power of respiration and alleviate the heat.
They cut the air-channels leading to the lung, and placed the lung about the heart as a soft spring, that, when passion was rife within, the heart, beating against a yielding body, might be cooled and suffer less, and might thus become more ready to join with passion in the service of reason.
The part of the soul which desires meats and drinks and the other things of which it has need by reason of the bodily nature, they placed between the midriff and the boundary of the navel, contriving in all this region a sort of manger for the food of the body; and there they bound it down like a wild animal which was chained up with man, and must be nourished if man was to exist.
They appointed this lower creation his place here in order that he might be always feeding at the manger, and have his dwelling as far as might be from the council-chamber, making as little noise and disturbance as possible, and permitting the best part to advise quietly for the good of the whole.
This lower principle in man would not comprehend reason.
This is why God combined with it the liver. He placed it in the house of the lower nature, contriving that it should be solid and smooth, and bright and sweet, and should also have a bitter quality, in order that the power of thought, which proceeds from the mind, might be reflected as in a mirror which receives likenesses of objects and gives back images of them to the sight.
and so might strike terror into the desires, when, making use of the bitter part of the liver, to which it is akin, it comes threatening and invading, and diffusing this bitter element swiftly through the whole liver produces colours like bile, and contracting every part makes it wrinkled and rough;
Twisting out of its right place and contorting the lobe and closing and shutting up the vessels and gates, causes pain and loathing.
The converse happens when some gentle inspiration of the understanding pictures images of an opposite character, and allays the bile and bitterness by refusing to stir or touch the nature opposed to itself, but by making use of the natural sweetness of the liver, corrects all things and makes them to be right and smooth and free, and renders the portion of the soul which resides about the liver happy and joyful, enabling it to pass the night in peace, and to practise divination in sleep, inasmuch as it has no share in mind and reason.
The authors of our being, remembering the command of their father when he bade them create the human race as good as they could, that they might correct our inferior parts and make them to attain a measure of truth, placed in the liver the seat of divination.
He who would understand what he remembers to have been said, whether in a dream or when he was awake, by the prophetic and inspired nature, or would determine by reason the meaning of the apparitions which he has seen, and what indications they afford to this man or that, of past, present or future good and evil, must first recover his wits.
But, while he continues demented, he cannot judge of the visions which he sees or the words which he utters; the ancient saying is very true, that ‘only a man who has his wits can act or judge about himself and his own affairs.’ And for this reason it is customary to appoint interpreters to be judges of the true inspiration.
Some persons call them prophets; they are quite unaware that they are only the expositors of dark sayings and visions, and are not to be called prophets at all, but only interpreters of prophecy.
Such is the nature of the liver, which is placed as we have described in order that it may give prophetic intimations. During the life of each individual these intimations are plainer, but after his death the liver becomes blind, and delivers oracles too obscure to be intelligible. The neighbouring organ (the spleen) is situated on the left-hand side, and is constructed with a view of keeping the liver bright and pure,—like a napkin, always ready prepared and at hand to clean the mirror.
When any impurities arise in the region of the liver by reason of disorders of the body, the loose nature of the spleen, which is composed of a hollow and bloodless tissue, receives them all and clears them away, and when filled with the unclean matter, swells and festers, but, again, when the body is purged, settles down into the same place as before, and is humbled.
Concerning the soul, as to which part is mortal and which divine, and how and why they are separated, and where located, if God acknowledges that we have spoken the truth, then, and then only, can we be confident; still, we may venture to assert that what has been said by us is probable, and will be rendered more probable by investigation. Let us assume thus much.
The creation of the rest of the body follows next in order, and this we may investigate in a similar manner. And it appears to be very meet that the body should be framed on the following principles:—
The authors of our race were aware that we should be intemperate in eating and drinking, and take a good deal more than was necessary or proper, by reason of gluttony. In order then that disease might not quickly destroy us, and lest our mortal race should perish without fulfilling its end—intending to provide against this, the gods made what is called the lower belly, to be a receptacle for the superfluous meat and drink, and formed the convolution of the bowels, so that the food might be prevented from passing quickly through and compelling the body to require more food, thus producing insatiable gluttony, and making the whole race an enemy to philosophy and music, and rebellious against the divinest element within us.
The bones and flesh, and other similar parts of us, were made as follows.
The first principle of all of them was the generation of the marrow. For the bonds of life which unite the soul with the body are made fast there, and they are the root and foundation of the human race.
The marrow itself is created out of other materials= God took such of the primary triangles as were straight and smooth, and were adapted by their perfection to produce fire and water, and air and earth—these, he separated from their kinds, and mingling them in due proportions with one another, made the marrow out of them to be a universal seed of the whole race of mankind; and in this seed he then planted and enclosed the souls, and in the original distribution gave to the marrow as many and various forms as the different kinds of souls were hereafter to receive.
That which, like a field, was to receive the divine seed, he made round every way, and called that portion of the marrow, brain, intending that, when an animal was perfected, the vessel containing this substance should be the head; but that which was intended to contain the remaining and mortal part of the soul he distributed into figures at once round and elongated, and he called them all by the name ‘marrow’; and to these, as to anchors, fastening the bonds of the whole soul, he proceeded to fashion around them the entire framework of our body, constructing for the marrow, first of all a complete covering of bone.
Bone was composed by him in the following manner. Having sifted pure and smooth earth he kneaded it and wetted it with marrow, and after that he put it into fire and then into water, and once more into fire and again into water—in this way by frequent transfers from one to the other he made it insoluble by either. Out of this he fashioned, as in a lathe, a globe made of bone, which he placed around the brain, and in this he left a narrow opening; and around the marrow of the neck and back he formed vertebrae which he placed under one another like pivots, beginning at the head and extending through the whole of the trunk.
Thus wishing to preserve the entire seed, he enclosed it in a stone-like casing, inserting joints, and using in the formation of them the power of the other or diverse as an intermediate nature, that they might have motion and flexure. Then again, considering that the bone would be too brittle and inflexible, and when heated and again cooled would soon mortify and destroy the seed within—having this in view, he contrived the sinews and the flesh, that so binding all the members together by the sinews, which admitted of being stretched and relaxed about the vertebrae, he might thus make the body capable of flexion and extension, while the flesh would serve as a protection against the summer heat and against the winter cold, and also against falls, softly and easily yielding to external bodies, like articles made of felt; and containing in itself a warm moisture which in summer exudes and makes the surface damp, would impart a natural coolness to the whole body; and again in winter by the help of this internal warmth would form a very tolerable defence against the frost which surrounds it and attacks it from without. He who modelled us, considering these things, mixed earth with fire and water and blended them; and making a ferment of acid and salt, he mingled it with them and formed soft and succulent flesh.
As for the sinews, he made them of a mixture of bone and unfermented flesh, attempered so as to be in a mean, and gave them a yellow colour; wherefore the sinews have a firmer and more glutinous nature than flesh, but a softer and moister nature than the bones.
With these God covered the bones and marrow, binding them together by sinews, and then enshrouded them all in an upper covering of flesh. The more living and sensitive of the bones he enclosed in the thinnest film of flesh, and those which had the least life within them in the thickest and most solid flesh.
So again on the joints of the bones, where reason indicated that no more was required, he placed only a thin covering of flesh, that it might not interfere with the flexion of our bodies and make them unwieldy because difficult to move; and also that it might not, by being crowded and pressed and matted together, destroy sensation by reason of its hardness, and impair the memory and dull the edge of intelligence. Wherefore also the thighs and the shanks and the hips, and the bones of the arms and the forearms, and other parts which have no joints, and the inner bones, which on account of the rarity of the soul in the marrow are destitute of reason—all these are abundantly provided with flesh; but such as have mind in them are in general less fleshy, except where the creator has made some part solely of flesh in order to give sensation,—as, for example, the tongue. But commonly this is not the case. For the nature which comes into being and grows up in us by a law of necessity, does not admit of the combination of solid bone and much flesh with acute perceptions.
More than any other part the framework of the head would have had them, if they could have co-existed, and the human race, having a strong and fleshy and sinewy head, would have had a life twice or many times as long as it now has, and also more healthy and free from pain.
But our creators, considering whether they should make a longer-lived race which was worse, or a shorter-lived race which was better, came to the conclusion that every one ought to prefer a shorter span of life, which was better, to a longer one, which was worse; and therefore they covered the head with thin bone, but not with flesh and sinews, since it had no joints; and thus the head was added, having more wisdom and sensation than the rest of the body, but also being in every man far weaker.
For these reasons and after this manner God placed the sinews at the extremity of the head, in a circle round the neck, and glued them together by the principle of likeness and fastened the extremities of the jawbones to them below the face, and the other sinews he dispersed throughout the body, fastening limb to limb. The framers of us framed the mouth, as now arranged, having teeth and tongue and lips, with a view to the necessary and the good contriving the way in for necessary purposes, the way out for the best purposes; for that is necessary which enters in and gives food to the body; but the river of speech, which flows out of a man and ministers to the intelligence, is the fairest and noblest of all streams. Still the head could neither be left a bare frame of bones, on account of the extremes of heat and cold in the different seasons, nor yet be allowed to be wholly covered, and so become dull and senseless by reason of an overgrowth of flesh. The fleshy nature was not therefore wholly dried up, but a large sort of peel was parted off and remained over, which is now called the skin.
This met and grew by the help of the cerebral moisture, and became the circular envelopment of the head. And the moisture, rising up under the sutures, watered and closed in the skin upon the crown, forming a sort of knot. The diversity of the sutures was caused by the power of the courses of the soul and of the food, and the more these struggled against one another the more numerous they became, and fewer if the struggle were less violent. This skin the divine power pierced all round with fire, and out of the punctures which were thus made the moisture issued forth, and the liquid and heat which was pure came away, and a mixed part which was composed of the same material as the skin, and had a fineness equal to the punctures, was borne up by its own impulse and extended far outside the head, but being too slow to escape, was thrust back by the external air, and rolled up underneath the skin, where it took root.
Thus the hair sprang up in the skin, being akin to it because it is like threads of leather, but rendered harder and closer through the pressure of the cold, by which each hair, while in process of separation from the skin, is compressed and cooled. Wherefore the creator formed the head hairy, making use of the causes which I have mentioned, and reflecting also that instead of flesh the brain needed the hair to be a light covering or guard, which would give shade in summer and shelter in winter, and at the same time would not impede our quickness of perception.
From the combination of sinew, skin, and bone, in the structure of the finger, there arises a triple compound, which, when dried up, takes the form of one hard skin partaking of all three natures, and was fabricated by these second causes, but designed by mind which is the principal cause with an eye to the future. For our creators well knew that women and other animals would some day be framed out of men, and they further knew that many animals would require the use of nails for many purposes; wherefore they fashioned in men at their first creation the rudiments of nails. For this purpose and for these reasons they caused skin, hair, and nails to grow at the extremities of the limbs.
And now that all the parts and members of the mortal animal had come together, since its life of necessity consisted of fire and breath, and it therefore wasted away by dissolution and depletion, the gods contrived the following remedy= They mingled a nature akin to that of man with other forms and perceptions, and thus created another kind of animal. These are the trees and plants and seeds which have been improved by cultivation and are now domesticated among us; anciently there were only the wild kinds, which are older than the cultivated. For everything that partakes of life may be truly called a living being, and the animal of which we are now speaking partakes of the third kind of soul, which is said to be seated between the midriff and the navel, having no part in opinion or reason or mind, but only in feelings of pleasure and pain and the desires which accompany them. For this nature is always in a passive state, revolving in and about itself, repelling the motion from without and using its own, and accordingly is not endowed by nature with the power of observing or reflecting on its own concerns. Wherefore it lives and does not differ from a living being, but is fixed and rooted in the same spot, having no power of self-motion.
Now after the superior powers had created all these natures to be food for us who are of the inferior nature, they cut various channels through the body as through a garden, that it might be watered as from a running stream. In the first place, they cut two hidden channels or veins down the back where the skin and the flesh join, which answered severally to the right and left side of the body. These they let down along the backbone, so as to have the marrow of generation between them, where it was most likely to flourish, and in order that the stream coming down from above might flow freely to the other parts, and equalize the irrigation.
In the next place, they divided the veins about the head, and interlacing them, they sent them in opposite directions; those coming from the right side they sent to the left of the body, and those from the left they diverted towards the right, so that they and the skin might together form a bond which should fasten the head to the body, since the crown of the head was not encircled by sinews; and also in order that the sensations from both sides might be distributed over the whole body. And next, they ordered the water-courses of the body in a manner which I will describe, and which will be more easily understood if we begin by admitting that all things which have lesser parts retain the greater, but the greater cannot retain the lesser. Now of all natures fire has the smallest parts, and therefore penetrates through earth and water and air and their compounds, nor can anything hold it. And a similar principle applies to the human belly; for when meats and drinks enter it, it holds them, but it cannot hold air and fire, because the particles of which they consist are smaller than its own structure.
These elements, therefore, God employed for the sake of distributing moisture from the belly into the veins, weaving together a network of fire and air like a weel, having at the entrance two lesser weels; further he constructed one of these with two openings, and from the lesser weels he extended cords reaching all round to the extremities of the network.
All the interior of the net he made of fire, but the lesser weels and their cavity, of air. The network he took and spread over the newly-formed animal in the following manner:—He let the lesser weels pass into the mouth; there were two of them, and one he let down by the air-pipes into the lungs, the other by the side of the air-pipes into the belly. The former he divided into two branches, both of which he made to meet at the channels of the nose, so that when the way through the mouth did not act, the streams of the mouth as well were replenished through the nose. With the other cavity (i.e. of the greater weel) he enveloped the hollow parts of the body, and at one time he made all this to flow into the lesser weels, quite gently, for they are composed of air, and at another time he caused the lesser weels to flow back again; and the net he made to find a way in and out through the pores of the body, and the rays of fire which are bound fast within followed the passage of the air either way, never at any time ceasing so long as the mortal being holds together. This process, as we affirm, the name-giver named inspiration and expiration. And all this movement, active as well as passive, takes place in order that the body, being watered and cooled, may receive nourishment and life; for when the respiration is going in and out, and the fire, which is fast bound within, follows it, and ever and anon moving to and fro, enters through the belly and reaches the meat and drink, it dissolves them, and dividing them into small portions and guiding them through the passages where it goes, pumps them as from a fountain into the channels of the veins, and makes the stream of the veins flow through the body as through a conduit.
Let us once more consider the phenomena of respiration, and enquire into the causes which have made it what it is. They are as follows:—Seeing that there is no such thing as a vacuum into which any of those things which are moved can enter, and the breath is carried from us into the external air, the next point is, as will be clear to every one, that it does not go into a vacant space, but pushes its neighbour out of its place, and that which is thrust out in turn drives out its neighbour; and in this way everything of necessity at last comes round to that place from whence the breath came forth, and enters in there, and following the breath, fills up the vacant space; and this goes on like the rotation of a wheel, because there can be no such thing as a vacuum. Wherefore also the breast and the lungs, when they emit the breath, are replenished by the air which surrounds the body and which enters in through the pores of the flesh and is driven round in a circle; and again, the air which is sent away and passes out through the body forces the breath inwards through the passage of the mouth and the nostrils.
In the interior of every animal the hottest part is that which is around the blood and veins; it is in a manner an internal fountain of fire, which we compare to the network of a creel, being woven all of fire and extended through the centre of the body, while the outer parts are composed of air.
Heat naturally proceeds outward to its own place and to its kindred element. There are two exits for the heat, the one out through the body, and the other through the mouth and nostrils.
When it moves towards the one, it drives round the air at the other, and that which is driven round falls into the fire and becomes warm, and that which goes forth is cooled. But when the heat changes its place, and the particles at the other exit grow warmer, the hotter air inclining in that direction and carried towards its native element, fire, pushes round the air at the other; and this being affected in the same way and communicating the same impulse, a circular motion swaying to and fro is produced by the double process, which we call inspiration and expiration.
The phenomena of medical cupping-glasses and of the swallowing of drink and of the projection of bodies, whether discharged in the air or bowled along the ground, are to be investigated on a similar principle. Swift and slow sounds, which appear to be high and low, and are sometimes discordant on account of their inequality, and then again harmonical on account of the equality of the motion which they excite in us.
When the motions of the antecedent swifter sounds begin to pause and the two are equalized, the slower sounds overtake the swifter and then propel them. When they overtake them they do not intrude a new and discordant motion, but introduce the beginnings of a slower, which answers to the swifter as it dies away, thus producing a single mixed expression out of high and low, whence arises a pleasure which even the unwise feel, and which to the wise becomes a higher sort of delight, being an imitation of divine harmony in mortal motions. Moreover, as to the flowing of water, the fall of the thunderbolt, and the marvels that are observed about the attraction of amber and the Heraclean stones,—in none of these cases is there any attraction; but he who investigates rightly, will find that such wonderful phenomena are attributable to the combination of certain conditions—the non-existence of a vacuum, the fact that objects push one another round, and that they change places, passing severally into their proper positions as they are divided or combined.
Such as we have seen, is the nature and such are the causes of respiration,—the subject in which this discussion originated. For the fire cuts the food and following the breath surges up within, fire and breath rising together and filling the veins by drawing up out of the belly and pouring into them the cut portions of the food; and so the streams of food are kept flowing through the whole body in all animals.
Fresh cuttings from kindred substances, whether the fruits of the earth or herb of the field, which God planted to be our daily food, acquire all sorts of colours by their inter-mixture; but red is the most pervading of them, being created by the cutting action of fire and by the impression which it makes on a moist substance; and hence the liquid which circulates in the body has a colour such as we have described. The liquid itself we call blood, which nourishes the flesh and the whole body, whence all parts are watered and empty places filled.
Now the process of repletion and evacuation is effected after the manner of the universal motion by which all kindred substances are drawn towards one another. For the external elements which surround us are always causing us to consume away, and distributing and sending off like to like; the particles of blood, too, which are divided and contained within the frame of the animal as in a sort of heaven, are compelled to imitate the motion of the universe. Each, therefore, of the divided parts within us, being carried to its kindred nature, replenishes the void. When more is taken away than flows in, then we decay, and when less, we grow and increase.
The frame of the entire creature when young has the triangles of each kind new, and may be compared to the keel of a vessel which is just off the stocks; they are locked firmly together and yet the whole mass is soft and delicate, being freshly formed of marrow and nurtured on milk.
Now when the triangles out of which meats and drinks are composed come in from without, and are comprehended in the body, being older and weaker than the triangles already there, the frame of the body gets the better of them and its newer triangles cut them up, and so the animal grows great, being nourished by a multitude of similar particles. But when the roots of the triangles are loosened by having undergone many conflicts with many things in the course of time, they are no longer able to cut or assimilate the food which enters, but are themselves easily divided by the bodies which come in from without. In this way every animal is overcome and decays, and this affection is called old age.
At last, when the bonds by which the triangles of the marrow are united no longer hold, and are parted by the strain of existence, they in turn loosen the bonds of the soul, and she, obtaining a natural release, flies away with joy. For that which takes place according to nature is pleasant, but that which is contrary to nature is painful.
Thus death, if caused by disease or produced by wounds, is painful and violent; but that sort of death which comes with old age and fulfils the debt of nature is the easiest of deaths, and is accompanied with pleasure rather than with pain.
Now every one can see whence diseases arise. There are four natures out of which the body is compacted, earth and fire and water and air, and the unnatural excess or defect of these, or the change of any of them from its own natural place into another, or—since there are more kinds than one of fire and of the other elements—the assumption by any of these of a wrong kind, or any similar irregularity, produces disorders and diseases; for when any of them is produced or changed in a manner contrary to nature, the parts which were previously cool grow warm, and those which were dry become moist, and the light become heavy, and the heavy light; all sorts of changes occur.
For, as we affirm, a thing can only remain the same with itself, whole and sound, when the same is added to it, or subtracted from it, in the same respect and in the same manner and in due proportion; and whatever comes or goes away in violation of these laws causes all manner of changes and infinite diseases and corruptions. Now there is a second class of structures which are also natural, and this affords a second opportunity of observing diseases to him who would understand them.
For whereas marrow and bone and flesh and sinews are composed of the four elements, and the blood, though after another manner, is likewise formed out of them, most diseases originate in the way which I have described; but the worst of all owe their severity to the fact that the generation of these substances proceeds in a wrong order; they are then destroyed. For the natural order is that the flesh and sinews should be made of blood, the sinews out of the fibres to which they are akin, and the flesh out of the clots which are formed when the fibres are separated.
The glutinous and rich matter which comes away from the sinews and the flesh, not only glues the flesh to the bones, but nourishes and imparts growth to the bone which surrounds the marrow; and by reason of the solidity of the bones, that which filters through consists of the purest and smoothest and oiliest sort of triangles, dropping like dew from the bones and watering the marrow. Now when each process takes place in this order, health commonly results; when in the opposite order, disease.
When the flesh becomes decomposed and sends back the wasting substance into the veins, then an over-supply of blood of diverse kinds, mingling with air in the veins, having variegated colours and bitter properties, as well as acid and saline qualities, contains all sorts of bile and serum and phlegm. For all things go the wrong way, and having become corrupted, first they taint the blood itself, and then ceasing to give nourishment to the body they are carried along the veins in all directions, no longer preserving the order of their natural courses, but at war with themselves, because they receive no good from one another, and are hostile to the abiding constitution of the body, which they corrupt and dissolve.
The oldest part of the flesh which is corrupted, being hard to decompose, from long burning grows black, and from being everywhere corroded becomes bitter, and is injurious to every part of the body which is still uncorrupted. Sometimes, when the bitter element is refined away, the black part assumes an acidity which takes the place of the bitterness; at other times the bitterness being tinged with blood has a redder colour; and this, when mixed with black, takes the hue of grass; and again, an auburn colour mingles with the bitter matter when new flesh is decomposed by the fire which surrounds the internal flame;—to all which symptoms some physician perhaps, or rather some philosopher, who had the power of seeing in many dissimilar things one nature deserving of a name, has assigned the common name of bile. But the other kinds of bile are variously distinguished by their colours. As for serum, that sort which is the watery part of blood is innocent, but that which is a secretion of black and acid bile is malignant when mingled by the power of heat with any salt substance, and is then called acid phlegm.
The substance which is formed by the liquefaction of new and tender flesh when air is present, if inflated and encased in liquid so as to form bubbles, which separately are invisible owing to their small size, but when collected are of a bulk which is visible, and have a white colour arising out of the generation of foam—all this decomposition of tender flesh when intermingled with air is termed by us white phlegm. And the whey or sediment of newly-formed phlegm is sweat and tears, and includes the various daily discharges by which the body is purified. Now all these become causes of disease when the blood is not replenished in a natural manner by food and drink but gains bulk from opposite sources in violation of the laws of nature.
When the several parts of the flesh are separated by disease, if the foundation remains, the power of the disorder is only half as great, and there is still a prospect of an easy recovery; but when that which binds the flesh to the bones is diseased, and no longer being separated from the muscles and sinews, ceases to give nourishment to the bone and to unite flesh and bone, and from being oily and smooth and glutinous becomes rough and salt and dry, owing to bad regimen, then all the substance thus corrupted crumbles away under the flesh and the sinews, and separates from the bone, and the fleshy parts fall away from their foundation and leave the sinews bare and full of brine, and the flesh again gets into the circulation of the blood and makes the previously-mentioned disorders still greater. And if these bodily affections be severe, still worse are the prior disorders; as when the bone itself, by reason of the density of the flesh, does not obtain sufficient air, but becomes mouldy and hot and gangrened and receives no nutriment, and the natural process is inverted, and the bone crumbling passes into the food, and the food into the flesh, and the flesh again falling into the blood makes all maladies that may occur more virulent than those already mentioned. But the worst case of all is when the marrow is diseased, either from excess or defect; and this is the cause of the very greatest and most fatal disorders, in which the whole course of the body is reversed.
There is a third class of diseases which may be conceived of as arising in three ways; for they are produced sometimes by wind, and sometimes by phlegm, and sometimes by bile. When the lung, which is the dispenser of the air to the body, is obstructed by rheums and its passages are not free, some of them not acting, while through others too much air enters, then the parts which are unrefreshed by air corrode, while in other parts the excess of air forcing its way through the veins distorts them and decomposing the body is enclosed in the midst of it and occupies the midriff; thus numberless painful diseases are produced, accompanied by copious sweats. And oftentimes when the flesh is dissolved in the body, wind, generated within and unable to escape, is the source of quite as much pain as the air coming in from without; but the greatest pain is felt when the wind gets about the sinews and the veins of the shoulders, and swells them up, and so twists back the great tendons and the sinews which are connected with them.
These disorders are called tetanus and opisthotonus, by reason of the tension which accompanies them. The cure of them is difficult; relief is in most cases given by fever supervening. The white phlegm, though dangerous when detained within by reason of the air-bubbles, yet if it can communicate with the outside air, is less severe, and only discolours the body, generating leprous eruptions and similar diseases. When it is mingled with black bile and dispersed about the courses of the head, which are the divinest part of us, the attack if coming on in sleep, is not so severe; but when assailing those who are awake it is hard to be got rid of, and being an affection of a sacred part, is most justly called sacred. An acid and salt phlegm, again, is the source of all those diseases which take the form of catarrh, but they have many names because the places into which they flow are manifold.
Inflammations of the body come from burnings and inflamings, and all of them originate in bile. When bile finds a means of discharge, it boils up and sends forth all sorts of tumours; but when imprisoned within, it generates many inflammatory diseases, above all when mingled with pure blood; since it then displaces the fibres which are scattered about in the blood and are designed to maintain the balance of rare and dense, in order that the blood may not be so liquefied by heat as to exude from the pores of the body, nor again become too dense and thus find a difficulty in circulating through the veins. The fibres are so constituted as to maintain this balance; and if any one brings them all together when the blood is dead and in process of cooling, then the blood which remains becomes fluid, but if they are left alone, they soon congeal by reason of the surrounding cold. The fibres having this power over the blood, bile, which is only stale blood, and which from being flesh is dissolved again into blood, at the first influx coming in little by little, hot and liquid, is congealed by the power of the fibres; and so congealing and made to cool, it produces internal cold and shuddering.
When it enters with more of a flood and overcomes the fibres by its heat, and boiling up throws them into disorder, if it have power enough to maintain its supremacy, it penetrates the marrow and burns up what may be termed the cables of the soul, and sets her free; but when there is not so much of it, and the body though wasted still holds out, the bile is itself mastered, and is either utterly banished, or is thrust through the veins into the lower or upper belly, and is driven out of the body like an exile from a state in which there has been civil war; whence arise diarrhoeas and dysenteries, and all such disorders. When the constitution is disordered by excess of fire, continuous heat and fever are the result; when excess of air is the cause, then the fever is quotidian; when of water, which is a more sluggish element than either fire or air, then the fever is a tertian; when of earth, which is the most sluggish of the four, and is only purged away in a four-fold period, the result is a quartan fever, which can with difficulty be shaken off.