Now, it seems to me that Erasistratus is unaware16 of this fact also, that the actual disease is that condition of the body which, not accidentally, but primarily and of itself, impairs17 the normal function. How, then, is he going to diagnose or cure diseases if he is entirely18 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 apparently19 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 vomit20 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 terminology21, 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 temperaments22, 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 defective23 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 “artistic24” 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 persistently25 in the veins mingled26 with the blood? Yet Hippocrates says, “Dysentery is a fatal condition if it proceeds from black bile”; while that proceeding27 from yellow bile is by no means deadly, and most people recover from it; this proves how much more pernicious and acrid28 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 stultified29 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 cleanse30 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 mighty31 Erasistratus affected32 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 ulcers33 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 diagnosis34 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 doctrines35. 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 secondly36, from obvious bodily phenomena37, 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 pointed38 this out by help of as few as possible of the proofs given by ancient writers, I shall now proceed to what remains39 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 demonstration40 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 fermenting41 and undergoing alteration42 through the agency of its contained heat. Imagine next two residual43 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 yolk44 of an egg, both in colour and density45; and again, even the black bile itself becomes much more malignant46 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 corrosive47 or acetose, because it also becomes sharp like vinegar and corrodes48 the animal’s body — as also the earth, if it be poured out upon it — and it produces a kind of fermentation and seething49, accompanied by bubbles — an abnormal putrefaction50 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 bowel51 and which also frequently rises to the top [of the stomach-contents]; and they call black bile that part which, through a kind of combustion52 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 innate53 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 vessels54; now, this is thin, moist, and fluid, not like what it is when, having been roasted to an excessive degree, it becomes yellow, fiery55, and thick, like the yolk of eggs; for this latter is already abnormal, while the previously56 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 faculty57 is unnatural58; it has assumed an acridity59 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 conversion60 into one another. And they differ in that those first mentioned are unmixed and unique, while the latter forms are diluted61 with various kinds of serum62. And all the serums63 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 treatises64 as may deal with the use of parts. And the blood also needs, not least, the yellow humour, which has as yet not reached the extreme stage of combustion; in the treatises mentioned it will be pointed out what purpose is subserved by this.
Now Nature has made no organ for clearing away phlegm, this being cold and moist, and, as it were, half-digested nutriment; such a substance, therefore, does not need to be evacuated66, but remains in the body and undergoes alteration there. And perhaps one cannot properly give the name of phlegm to the surplus-substance which runs down from the brain, but one should call it mucus [blenna] or coryza — as, in fact, it is actually termed; in any case it will be pointed out, in the treatise65 “On the Use of Parts,” how Nature has provided for the evacuation of this substance. Further, the device provided by Nature which ensures that the phlegm which forms in the stomach and intestines67 may be evacuated in the most rapid and effective way possible — this also will be described in that commentary. As to that portion of the phlegm which is carried in the veins, seeing that this is of service to the animal, it requires no evacuation. Here too, then, we must pay attention and recognise that, just as in the case of each of the two kinds of bile, there is one part which is useful to the animal and in accordance with its nature, while the other part is useless and contrary to nature, so also is it with the phlegm; such of it as is sweet is useful to the animal and according to nature, while, as to such of it as has become bitter or salt, that part which is bitter is completely undigested, while that part which is salt has undergone putrefaction. And the term “complete indigestion” refers of course to the second digestion68 — that which takes place in the veins; it is not a failure of the first digestion — that in the alimentary canal — for it would not have become a humour at the outset if it had escaped this digestion also.
It seems to me that I have made enough reference to what has been said regarding the genesis and destruction of humours by Hippocrates, Plato, Aristotle, Praxagoras, and Diocles, and many others among the Ancients; I did not deem it right to transport the whole of their final pronouncements into this treatise. I have said only so much regarding each of the humours as will stir up the reader, unless he be absolutely inept69, to make himself familiar with the writings of the Ancients, and will help him to gain more easy access to them. In another treatise I have written on the humours according to Praxagoras, to Praxagoras, son of authority Nicarchus; although this authority makes as many as ten humours, not including the blood (the blood itself being an eleventh), this is not a departure from the teaching of Hippocrates; for Praxagoras divides into species and varieties the humours which Hippocrates first mentioned, with the demonstration proper to each.
Those, then, are to be praised who explain the points which have been duly mentioned, as also those who add what has been left out; for it is not possible for the same man to make both a beginning and an end. Those, on the other hand, deserve censure70 who are so impatient that they will not wait to learn any of the things which have been duly mentioned, as do also those who are so ambitious that, in their lust71 after novel doctrines, they are always attempting some fraudulent sophistry72, either purposely neglecting certain subjects, as Erasistratus does in the case of the humours, or unscrupulously attacking other people, as does this same writer, as well as many of the more recent authorities.
But let this discussion come to an end here, and I shall add in the third book all that remains.
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1
drawn
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| v.拖，拉，拔出；adj.憔悴的，紧张的 | |
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virtue
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| n.德行，美德；贞操；优点；功效，效力 | |
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vein
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| n.血管，静脉；叶脉，纹理；情绪；vt.使成脉络 | |
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4
arteries
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| n.动脉( artery的名词复数 )；干线，要道 | |
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5
alimentary
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| adj.饮食的，营养的 | |
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6
inevitably
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| adv.不可避免地；必然发生地 | |
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veins
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| n.纹理；矿脉( vein的名词复数 )；静脉；叶脉；纹理 | |
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8
mere
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| adj.纯粹的；仅仅，只不过 | |
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contraction
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| n.缩略词，缩写式，害病 | |
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10
rectify
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| v.订正，矫正，改正 | |
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practitioner
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| n.实践者，从事者；(医生或律师等)开业者 | |
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12
investigator
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| n.研究者，调查者，审查者 | |
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13
impaired
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| adj.受损的；出毛病的；有（身体或智力）缺陷的v.损害，削弱( impair的过去式和过去分词 ) | |
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14
followers
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| 追随者( follower的名词复数 )； 用户； 契据的附面； 从动件 | |
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investigation
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| n.调查，调查研究 | |
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16
unaware
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| a.不知道的，未意识到的 | |
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17
impairs
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| v.损害，削弱( impair的第三人称单数 ) | |
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18
entirely
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| ad.全部地，完整地；完全地，彻底地 | |
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apparently
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| adv.显然地；表面上，似乎 | |
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20
vomit
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| v.呕吐，作呕；n.呕吐物，吐出物 | |
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terminology
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| n.术语；专有名词 | |
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22
temperaments
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| 性格( temperament的名词复数 )； （人或动物的）气质； 易冲动； （性情）暴躁 | |
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23
defective
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| adj.有毛病的，有问题的，有瑕疵的 | |
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artistic
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| adj.艺术(家)的，美术(家)的；善于艺术创作的 | |
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persistently
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| ad.坚持地；固执地 | |
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mingled
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| 混合，混入( mingle的过去式和过去分词 )； 混进，与…交往[联系] | |
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proceeding
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| n.行动，进行，(pl.)会议录，学报 | |
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acrid
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| adj.辛辣的，尖刻的，刻薄的 | |
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stultified
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| v.使成为徒劳，使变得无用( stultify的过去式和过去分词 ) | |
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cleanse
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| vt.使清洁，使纯洁，清洗 | |
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mighty
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| adj.强有力的；巨大的 | |
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affected
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| adj.不自然的，假装的 | |
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ulcers
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| n.溃疡( ulcer的名词复数 )；腐烂物；道德败坏；腐败 | |
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diagnosis
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| n.诊断，诊断结果，调查分析，判断 | |
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doctrines
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| n.教条( doctrine的名词复数 )；教义；学说；（政府政策的）正式声明 | |
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secondly
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| adv.第二，其次 | |
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phenomena
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| n.现象 | |
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pointed
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| adj.尖的，直截了当的 | |
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remains
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| n.剩余物，残留物；遗体，遗迹 | |
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demonstration
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| n.表明，示范，论证，示威 | |
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41
fermenting
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| v.（使）发酵( ferment的现在分词 )；（使）激动；骚动；骚扰 | |
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alteration
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| n.变更，改变；蚀变 | |
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residual
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| adj.复播复映追加时间；存留下来的，剩余的 | |
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yolk
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| n.蛋黄，卵黄 | |
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density
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| n.密集，密度，浓度 | |
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malignant
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| adj.恶性的，致命的；恶意的，恶毒的 | |
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corrosive
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| adj.腐蚀性的；有害的；恶毒的 | |
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48
corrodes
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| v.使腐蚀，侵蚀( corrode的第三人称单数 ) | |
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49
seething
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| 沸腾的，火热的 | |
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50
putrefaction
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| n.腐坏，腐败 | |
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51
bowel
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| n.肠(尤指人肠)；内部，深处 | |
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52
combustion
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| n.燃烧；氧化；骚动 | |
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53
innate
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| adj.天生的，固有的，天赋的 | |
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54
vessels
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| n.血管( vessel的名词复数 )；船；容器；（具有特殊品质或接受特殊品质的）人 | |
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55
fiery
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| adj.燃烧着的，火红的；暴躁的；激烈的 | |
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56
previously
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| adv.以前，先前（地） | |
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57
faculty
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| n.才能；学院，系；(学院或系的)全体教学人员 | |
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unnatural
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| adj.不自然的；反常的 | |
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59
acridity
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| n.辛辣，狠毒；苛性；极苦 | |
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60
conversion
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| n.转化，转换，转变 | |
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61
diluted
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| 无力的，冲淡的 | |
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62
serum
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| n.浆液，血清，乳浆 | |
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serums
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| n.（动物体内的）浆液( serum的名词复数 )；血清；（一剂）免疫血清 | |
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treatises
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| n.专题著作，专题论文，专著( treatise的名词复数 ) | |
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treatise
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| n.专著；(专题)论文 | |
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66
evacuated
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| 撤退者的 | |
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67
intestines
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| n.肠( intestine的名词复数 ) | |
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68
digestion
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| n.消化，吸收 | |
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69
inept
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| adj.不恰当的，荒谬的，拙劣的 | |
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70
censure
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| v./n.责备；非难；责难 | |
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71
lust
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| n.性(淫)欲；渴(欲)望；vi.对…有强烈的欲望 | |
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sophistry
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| n.诡辩 | |
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