Translated by Charles Darwin Adams
It is thus with regard to the disease called Sacred: it appears to me to be nowise more divine nor more sacred than other diseases, but has a natural cause from the originates like other affections. Men regard its nature and cause as divine from ignorance and wonder, because it is not at all like to other diseases. And this notion of its divinity is kept up by their inability to comprehend it, and the simplicity of the mode by which it is cured, for men are freed from it by purifications and incantations. But if it is reckoned divine because it is wonderful, instead of one there are many diseases which would be sacred; for, as I will show, there are others no less wonderful and prodigious, which nobody imagines to be sacred. The quotidian, tertian, and quartan fevers, seem to me no less sacred and divine in their origin than this disease, although they are not reckoned so wonderful. And I see men become mad and demented from no manifest cause, and at the same time doing many things out of place; and I have known many persons in sleep groaning and crying out, some in a state of suffocation, some jumping up and fleeing out of doors, and deprived of their reason until they awaken, and afterward becoming well and rational as before, although they be pale and weak; and this will happen not once but frequently. And there are many and various things of the like kind, which it would be tedious to state particularly.
They who first referred this malady to the gods appear to me to have been just such persons as the conjurors, purificators, mountebanks, and charlatans now are, who give themselves out for being excessively religious, and as knowing more than other people. Such persons, then, using the divinity as a pretext and screen of their own inability to of their own inability to afford any assistance, have given out that the disease is sacred, adding suitable reasons for this opinion, they have instituted a mode of treatment which is safe for themselves, namely, by applying purifications and incantations, and enforcing abstinence from baths and many articles of food which are unwholesome to men in diseases. Of sea substances, the surmullet, the blacktail, the mullet, and the eel; for these are the fishes most to be guarded against. And of fleshes, those of the goat, the stag, the sow, and the dog: for these are the kinds of flesh which are aptest to disorder the bowels. Of fowls, the cock, the turtle, and the bustard, and such others as are reckoned to be particularly strong. And of potherbs, mint, garlic, and onions; for what is acrid does not agree with a weak person. And they forbid to have a black robe, because black is expressive of death; and to sleep on a goat’s skin, or to wear it, and to put one foot upon another, or one hand upon another; for all these things are held to be hindrances to the cure. All these they enjoin with reference to its divinity, as if possessed of more knowledge, and announcing beforehand other causes so that if the person should recover, theirs would be the honor and credit; and if he should die, they would have a certain defense, as if the gods, and not they, were to blame, seeing they had administered nothing either to eat or drink as medicines, nor had overheated him with baths, so as to prove the cause of what had happened. But I am of opinion that (if this were true) none of the Libyans, who live in the interior, would be free from this disease, since they all sleep on goats’ skins, and live upon goats’ flesh; neither have they couch, robe, nor shoe that is not made of goat’s skin, for they have no other herds but goats and oxen. But if these things, when administered in food, aggravate the disease, and if it be cured by abstinence from them, godhead is not the cause at all; nor will purifications be of any avail, but it is the food which is beneficial and prejudicial, and the influence of the divinity vanishes.
Thus, they who try to cure these maladies in this way, appear to me neither to reckon them sacred nor divine. For when they are removed by such purifications, and this method of cure, what is to prevent them from being brought upon men and induced by other devices similar to these? So that the cause is no longer divine, but human. For whoever is able, by purifications conjurations, to drive away such an affection, will be able, by other practices, to excite it; and, according to this view, its divine nature is entirely done away with. By such sayings and doings, they profess to be possessed of superior knowledge, and deceive mankind by enjoining lustrations and purifications upon them, while their discourse turns upon the divinity and the godhead. And yet it would appear to me that their discourse savors not of piety, as they suppose, but rather of impiety, and as if there were no gods, and that what they hold to be holy and divine, were impious and unholy. This I will now explain.
For, if they profess to know how to bring down the moon, darken the sun, induce storms and fine weather, and rains and droughts, and make the sea and land unproductive, and so forth, whether they arrogate this power as being derived from mysteries or any other knowledge or consideration, they appear to me to practice impiety, and either to fancy that there are no gods, or, if there are, that they have no ability to ward off any of the greatest evils. How, then, are they not enemies to the gods? For if a man by magical arts and sacrifices will bring down the moon, and darken the sun, and induce storms, or fine weather, I should not believe that there was anything divine, but human, in these things, provided the power of the divine were overpowered by human knowledge and subjected to it. But perhaps it will be said, these things are not so, but, not withstanding, men being in want of the means of life, invent many and various things, and devise many contrivances for all other things, and for this disease, in every phase of the disease, assigning the cause to a god. Nor do they remember the same things once, but frequently. For, if they imitate a goat, or grind their teeth, or if their right side be convulsed, they say that the mother of the gods is the cause. But if they speak in a sharper and more intense tone, they resemble this state to a horse, and say that Poseidon (Neptune) is the cause. Or if any excrement be passed, which is often the case, owing to the violence of the disease, the appellation of Enodia ( Hecate? )is adhibited; or, if it be passed in smaller and denser masses, like bird’s, it is said to be from Apollo Nomius. But if foam be emitted by the mouth, and the patient kick with his feet, Ares (Mars) then gets the blame. But terrors which happen during the night, and fevers, and delirium, and jumpings out of bed, and frightful apparitions, and fleeing away,-all these they hold to be the plots of Hecate, and the invasions the and use purifications and incantations, and, as appears to me, make the divinity to be most wicked and most impious. For they purify those laboring under this disease, with the same sorts of blood and the other means that are used in the case of those who are stained with crimes, and of malefactors, or who have been enchanted by men, or who have done any wicked act; who ought to do the very reverse, namely, sacrifice and pray, and, bringing gifts to the temples, supplicate the gods. But now they do none of these things, but purify; and some of the purifications they conceal in the earth, and some they throw into the sea, and some they carry to the mountains where no one can touch or tread upon them. But these they ought to take to the temples and present to the god, if a god be the cause of the disease. Neither truly do I count it a worthy opinion to hold that the body of man is polluted by god, the most impure by the most holy; for were it defiled, or did it suffer from any other thing, it would be like to be purified and sanctified rather than polluted by god. For it is the divinity which purifies and sanctifies the greatest of offenses and the most wicked, and which proves our protection from them. And we mark out the boundaries of the temples and the groves of the gods, so that no one may pass them unless he be pure, and when we enter them we are sprinkled with holy water, not as being polluted, but as laying aside any other pollution which we formerly had. And thus it appears to me to hold, with regard to purifications.
But this disease seems to me to be no more divine than others; but it has its nature such as other diseases have, and a cause whence it originates, and its nature and cause are divine only just as much as all others are, and it is curable no less than the others, unless when, the from of time, it is confirmed, and has became stronger than the remedies applied. Its origin is hereditary, like that of other diseases. For if a phlegmatic person be born of a phlegmatic, and a bilious of a bilious, and a phthisical of a phthisical, and one having spleen disease, of another having disease of the spleen, what is to hinder it from happening that where the father and mother were subject to this disease, certain of their offspring should be so affected also? As the semen comes from all parts of the body, healthy particles will come from healthy parts, and unhealthy from unhealthy parts. And another great proof that it is in nothing more divine than other diseases is, that it occurs in those who are of a phlegmatic constitution, but does not attack the bilious. Yet, if it were more divine than the others, this disease ought to befall all alike, and make no distinction between the bilious and phlegmatic.
But in them, the brain is the cause of this affection, as it is of other very great diseases, and in what manner and from what cause it is formed, I will now plainly declare. The brain of man, as in all other animals, is double, and a thin membrane (meninx) divides it through the middle, and therefore the pain is not always in the same part of the head; for sometimes it is situated on either side, and sometimes the whole is affected; and veins run toward it from all parts of the body, many of which are small, but two are thick, the one from the liver, and the other from the spleen. And it is thus with regard to the one from the liver: a portion of it runs downward through the parts on the side, near the kidneys and the psoas muscles, to the inner part of the thigh, and extends to the foot. It is called vena cava. The other runs upward by the right veins and the lungs, and divides into branches for the heart and the right arm. The remaining part of it rises upward across the clavicle to the right side of the neck, and is superficial so as to be seen; near the ear it is concealed, and there it divides; its thickest, largest, and most hollow part ends in the brain; another small vein goes to the right ear, another to the right eye, and another to the nostril. Such are the distributions of the hepatic vein. And a vein from the spleen is distributed on the left side, upward and downward, like that from the liver, but more slender and feeble.
By these veins we draw in much spirit (gas?) , since they are the spiracles of our bodies inhaling air to themselves and distributing it to the rest of the body, and to the smaller veins, and they and afterwards exhale it. For the breath (pneuma) cannot be stationary, but it passes upward and downward, for if stopped and intercepted, the part where it is stopped becomes powerless. In proof of this, when, in sitting or lying, the small veins are compressed, so that the breath (pneuma) from the larger vein does not pass into them, the part is immediately seized with numbness; and it is so likewise with regard to the other veins.
This malady, then, affects phlegmatic people, but not bilious. It begins to be formed while the foetus is still in utero . For the brain, like the other organs, is depurated and grows before birth. If, then, in this purgation it be properly and moderately depurated, and neither more nor less than what is proper be secreted from it, the head is thus in the most healthy condition. If the secretion (melting) the from the brain be greater than natural, the person, when he grows up, will have his head diseased, and full of noises, and will neither be able to endure the sun nor cold. Or, if the melting take place from any one part, either from the eye or ear, or if a vein has become slender, that part will be deranged in proportion to the melting. Or, should depuration not take place, but it ( the secretion? ) accumulate in the brain, it necessarily becomes phlegmatic. And such children as have an eruption of ulcers on the head, on the ears, and along the rest of the body, with copious discharges of saliva and mucus,-these, in after life, enjoy best health; for in this way the phlegm which ought to have been purged off in the womb, is discharged and cleared away, and persons so purged, for the most part, are not subject to attacks of this disease. But such as have had their skin free from eruptions, and have had no discharge of saliva or mucus, nor have undergone the proper purgation in the womb, these persons run the risk of being seized with this disease.
But should the defluxion make its way to the heart, the person is seized with palpitation and asthma, the chest becomes diseased, and some also have curvature of the spine. For when a defluxion of cold phlegm takes place on the lungs and heart, the blood is chilled, and the veins, being violently chilled, palpitate in the lungs and heart, and the heart palpitates, so that from this necessity asthma and orthopnoea supervene. For it does not receive the spirits ( pneuma ) as much breath as he needs until the defluxion of phlegm be mastered, and being heated is distributed to the veins, then it ceases from its palpitation and difficulty of breathing, and this takes place as soon as it obtains an abundant supply; and this will be more slowly, provided the defluxion be more abundant, or if it be less, more quickly. And if the defluxions be more condensed, the epileptic attacks will be more frequent, but otherwise if it be rarer. Such are the symptoms when the defluxion is upon the lungs and heart; but if it be upon the bowels, the person is attacked with diarrhoea.
And if, being shut out from all these outlets, its defluxion be determined to the veins I have formerly mentioned, the patient loses his speech, and chokes, and foam issues by the mouth, the teeth are fixed, the hands are contracted, the eyes distorted, he becomes insensible, and in some cases the bowels are evacuated. And these symptoms occur sometimes on the left side, sometimes on the right, and sometimes in both. The cause of everyone of these symptoms I will now explain. The man becomes speechless when the phlegm, suddenly descending into the veins, shuts out the air, and does not admit it either to the brain or to the vena cava, or to the ventricles, but interrupts the inspiration. For when a person draws in air by the mouth and nostrils, the breath ( pneuma )goes first to the brain, then the greater part of it to the internal cavity, and part to the lungs, and part to the veins, and from them it is distributed to the other parts of the body along the veins; and whatever passes to the stomach cools, and does nothing more; and so also with regard to the lungs. But the air which enters the veins is of use (to the body) by entering the brain and its ventricles, and thus it imparts sensibility and motion to all the members, so that when the veins are excluded from the air by the phlegm and do not receive it, the man loses his speech and intellect, and the hands become powerless, and are contracted, the blood stopping and not being diffused, as it was wont; and the eyes are distorted owing to the veins being excluded from the air; and they palpitate; and froth from the lungs issues by the mouth. For when the breath ( pneuma ) does not find entrance to him, he foams and sputters like a dying person. And the bowels are evacuated in consequence of the violent suffocation; and the suffocation is produced when the liver and stomach ascend to the diaphragm, and the mouth of the stomach is shut up; this takes place when the breath ( pneuma ） does not enter by the mouth, as it is wont. The patient kicks with his feet when the air is shut up in the lungs and cannot find an outlet, owing to the phlegm; and rushing by the blood upward and downward, it occasions convulsions and pain, and therefore he kicks with his feet. All these symptoms he endures when the cold phlegm passes into the warm blood, for it congeals and stops the blood. And if the deflexion be copious and thick, it immediately proves fatal to him, for by its cold it prevails over the blood and congeals it; or, if it be less, it in the first place obtains the mastery, and stops the respiration; and then in the course of time, when it is diffused along the veins and mixed with much warm blood, it is thus overpowered, the veins receive the air, and the patient recovers his senses.
Of little children who are seized with this disease, the greater part die, provided the defluxion be copious and humid, for the veins being slender cannot admit the phlegm, owing to its thickness and abundance; but the blood is cooled and congealed, and the child immediately dies. But if the phlegm be in small quantity, and make a defluxion into both the veins, or to those on either side, the children survive, but exhibit notable marks of the disorder; for either the mouth is drawn aside, or an eye, the neck, or a hand, wherever a vein being filled with phlegm loses its tone, and is attenuated, and the part of the body connected with this vein is necessarily rendered weaker and defective. But for the most it affords relief for a longer interval; for the child is no longer seized with these attacks, if once it has contracted this impress of the disease, in consequence of which the other veins are necessarily affected, and to a certain degree attenuated, so as just to admit the air, but no longer to permit the influx of phlegm. However, the parts are proportionally enfeebled whenever the veins are in an unhealthy state. When in striplings the defluxion is small and to the right side, they recover without leaving any marks of the disease, but there is danger of its becoming habitual, and even increasing if not treated by suitable remedies. Thus, or very nearly so, is the case when it attacks children.
To persons of a more advanced age, it neither proves fatal, nor produces distortions. For their veins are ( large? ) and filled with hot blood; and therefore the phlegm can neither prevail nor cool the blood, so as to coagulate it, but it is quickly overpowered and mixed with the blood, and thus the veins receive the air, and sensibility remains; and, owing to their strength, the aforesaid symptoms are less likely to seize them. But when this disease attacks very old people, it therefore proves fatal, or induces paraplegia, because the veins are empty, and the blood scanty, thin, and watery. When, therefore, the defluxion is copious, and the season winter, it proves fatal; for it chokes up the exhalents, and coagulates the blood if the defluxion be to both sides; but if to either, it merely induces paraplegia. For the blood being thin, cold, and scanty, cannot prevail over the but being itself overpowered, it is coagulated, so that those parts in which the blood is corrupted, lose their strength.
The flux is to the right rather than to the left because the veins there are more capacious and numerous than on the left side, for on the one side they spring from the liver, and on the other from the spleen. The defluxion and melting down take place most especially in the case of children in whom the head is heated either by the sun or by fire, or if the brain suddenly contract a rigor, and then the phlegm is excreted. For it is melted down by the heat and diffusion of the but it is excreted by the congealing and contracting of it, and thus a defluxion takes place. And in some this is the cause of the disease, and in others, when the south wind quickly succeeds to northern breezes, it suddenly unbinds and relaxes the brain, which is contracted and weak, so that there is an inundation of phlegm, and thus the defluxion takes place. The defluxion also takes place in consequence of fear, from any hidden cause, if we are the at any person’s calling aloud, or while crying, when one cannot quickly recover one’s breath, such as often happens to children. When any of these things occur, the body immediately shivers, the person becoming speechless cannot draw his breath, but the breath ( pneuma ) stops, the brain is contracted, the blood stands still, and thus the excretion and defluxion of the phlegm take place. In children, these are the causes of the attack at first. But to old persons winter is most inimical. For when the head and brain have been heated at a great fire, and then the person is brought into cold and has a rigor, or when from cold he comes into warmth, and sits at the fire, he is apt to suffer in the same way, and thus he is seized in the manner described above. And there is much danger of the same thing occurring, if his head be exposed to the sun, but less so in summer, as the changes are not sudden. When a person has passed the twentieth year of his life, this disease is not apt to seize him, unless it has become habitual from childhood, or at least this is rarely or never the case. For the veins are filled with blood, and the brain consistent and firm, so that it does not run down into the veins, or if it do, it does not master the blood, which is copious and hot.
But when it has gained strength from one’s childhood, and become habitual, such a person usually suffers attacks, and is seized with them in changes of the winds, especially in south winds, and it is difficult of removal. For the brain becomes more humid than natural, and is inundated with phlegm, so that the defluxions become more frequent, and the phlegm can no longer be the nor the brain be dried up, but it becomes wet and humid. This you may ascertain in particular, from beasts of the flock which are seized with this disease, and more especially goats, for they are most frequently attacked with it. If you will cut open the head, you will find the brain humid, full of sweat, and having a bad smell. And in this way truly you may see that it is not a god that injures the body, but disease. And so it is with man. For when the disease has prevailed for a length of time, it is no longer curable, as the brain is corroded by the phlegm, and melted, and what is melted down becomes water, and surrounds the brain externally, and overflows it; wherefore they are more frequently and readily seized with the disease. And therefore the disease is protracted, because the influx is thin, owing to its quantity, and is immediately overpowered by the blood and heated all through.
But such persons as are habituated to the disease know beforehand when they are about to be seized and flee from men; if their own house be at hand, they run home, but if not, to a deserted place, where as few persons as possible will see them falling, and they immediately cover themselves up. This they do from shame of the affection, and not from fear of the divinity, as many suppose. And little children at first fall down wherever they may happen to be, from inexperience. But when they have been often seized, and feel its approach beforehand, they flee to their mothers, or to any other person they are acquainted with, from terror and dread of the affection, for being still infants they do not know yet what it is to be ashamed.
Therefore, they are attacked during changes of the winds, and especially south winds, then also with north winds, and afterwards also with the others. These are the strongest winds, and the most opposed to one another, both as to direction and power. For, the north wind condenses the air, and separates from it whatever is muddy and nebulous, and renders it clearer and brighter, and so in like manner also, all the winds which arise from the sea and other waters; for they extract the humidity and nebulosity from all objects, and from men themselves, and therefore it (the north wind) is the most wholesome of the winds. But the effects of the south are the very reverse. For in the first place it begins by melting and diffusing the condensed air, and therefore it does not blow strong at first, but is gentle at the commencement, because it is not able at once to overcome the and compacted air, which yet in a while it dissolves. It produces the same effects upon the land, the sea, the fountains, the wells, and on every production which contains humidity, and this, there is in all things, some more, some less. For all these feel the effects of this wind, and from clear they become cloudy, from cold, hot; from dry, moist; and whatever ear then vessels are placed upon the ground, filled with wine or any other fluid, are affected with the south wind, and undergo a change. And the a change. And the sun, and the moon, it renders blunter appearance than they naturally are. When, then, it possesses such powers over things so great and strong, and the body is made to feel and undergo changes in the changes of the winds, it necessarily follows that the brain should be disolved and overpowered with moisture, and that the veins should become more relaxed by the south winds, and that by the north the healthiest portion of the brain should become contracted, while the most morbid and humid is secreted, and overflows externally, and that catarrhs should thus take place in the changes of these winds. Thus is this disease formed and prevails from those things which enter into and go out of the body, and it is not more difficult to understand or to cure than the others, neither is it more divine than other diseases.
And men ought to know that from nothing else but ( from the brain ) come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentations. And by this, in an especial manner, we acquire wisdom and knowledge, and see and hear, and know what are foul and what are fair, what are bad and what are good, what are sweet, and what unsavory; some we discriminate by habit, and some we perceive by their utility. By this we distinguish objects of relish and disrelish, according to the seasons; and the same things do not always please us. And by the same organ we become mad and delirious, and fears and terrors assail us, some by night, and some by day, and dreams and untimely wanderings, and cares that are not suitable, and ignorance of present circumstances, desuetude, and unskilfulness. All these things we endure from the brain, when it is not healthy, but is more hot, more cold, more moist, or more dry than natural, or when it suffers any other preternatural and unusual affection. And we become mad from humidity ( of the brain ). For when it is more moist than natural, it is necessarily put into motion, and the affection being moved, neither the sight nor hearing can be at rest, and the tongue speaks in accordance with the sight and hearing.
As long as the brain is at rest, the man enjoys his reason, but the depravement of the brain arises from phlegm and bile, either of which you may recognize in this manner: Those who are mad from phlegm are quiet, and do not cry out nor make a noise; but those from bile are vociferous, malignant, and will not be quiet, but are always doing something improper. If the madness be constant, these are the causes thereof. But if terrors and fears assail, they are connected with derangement of the brain, and derangement is owing to its being heated. And it is heated by bile when it is determined to the brain along the bloodvessels running from the trunk; and fear is present until it returns again to the veins and trunk, when it ceases. He is grieved and troubled when the brain is unseasonably cooled and contracted beyond its wont. This it suffers from phlegm, and from the same affection the patient becomes oblivious. He calls out and screams at night when the brain is suddenly heated. The bilious endure this. But the phlegmatic are not heated, except when much blood goes to the brain, and creates an ebullition. Much blood passes along the aforesaid veins. But when the man happens to see a frightful dream and is in fear as if awake, then his face is in a greater glow, and the eyes are red when the patient is in fear. And the understanding meditates doing some mischief, and thus it is affected in sleep. But if, when awakened, he returns to himself, and the blood is again distributed along the veins, it ceases.
In these ways I am of the opinion that the brain exercises the greatest power in the man. This is the interpreter to us of those things which emanate from the air, when it ( the brain ) happens to be in a sound state. But the air supplies sense to it. And the eyes, the ears, the tongue and the feet, administer such things as the brain cogitates. For in as much as it is supplied with air, does it impart sense to the body. It is the brain which is the messenger to the understanding. For when the man draws the breath ( pneuma ) into himself, it passes first to the brain, and thus the air is distributed to the rest of the body, leaving in the brain its acme, and whatever has sense and understanding. For if it passed first to the body and last to the brain, then having left in the flesh and veins the judgment, when it reached the brain it would be hot, and not at all pure, but mixed with the humidity from flesh and blood, so as to be no longer pure.
Wherefore, I say, that it is the brain which interprets the understanding. But the diaphragm has obtained its name ( frenes ) from accident and usage, and not from reality or nature, for I know no power which it possesses, either as to sense or understanding, except that when the man is affected with unexpected joy or sorrow, it throbs and produces palpitations, owing to its thinness, and as having no belly to receive anything good or bad that may present themselves to it, but it is thrown into commotion by both these, from its natural weakness. It then perceives beforehand none of those things which occur in the body, but has received its name vaguely and without any proper reason, like the parts about the heart, which are called auricles, but which contribute nothing towards hearing. Some say that we think with the heart, and that this is the part which is grieved, and experiences care. But it is not so; only it contracts like the diaphragm, and still more so for the same causes. For veins from all parts of the body run to it, and it has valves, so as to as to perceive if any pain or pleasurable emotion befall the man. For when grieved the body necessarily shudders, and is contracted, and from excessive joy it is affected in like manner. Wherefore the heart and the diaphragm are particularly sensitive, they have nothing to do, however, with the operations of the understanding, but of all but of all these the brain is the cause. Since, then, the brain, as being the primary seat of sense and of the spirits, perceives whatever occurs in the body, if any change more powerful than usual take place in the air, owing to the seasons, the brain becomes changed by the state of the air. For, on this account, the brain first perceives, because, I say, all the most acute, most powerful, and most deadly diseases, and those which are most difficult to be understood by the inexperienced, fall upon the brain.
And the disease called the Sacred arises from causes as the others, namely, those things which enter and quit the body, such as cold, the sun, and the winds, which are ever changing and are never at rest. And these things are divine, so that there is no necessity for making a distinction, and holding this disease to be more divine than the others, but all are divine, and all human. And each has its own peculiar nature and power, and none is of an ambiguous nature, or irremediable. And the most of them are curable by the same means as those by which any other thing is food to one, and injurious to another. Thus, then, the physician should under-stand and distinguish the season of each, so that at one time he may attend to the nourishment and increase, and at another to abstraction and diminution. And in this disease as in all others, he must strive not to feed the disease, but endeavor to wear it out by administering whatever is most opposed to each disease, and not that which favors and is allied to it. For by that which is allied to it, it gains vigor and increase, but it wears out and disappears under the use of that which is opposed to it. But whoever is acquainted with such a change in men, and can render a man humid and dry, hot and cold by regimen, could also cure this disease, if he recognizes the proper season for administering his remedies, without minding purifications, spells, and all other illiberal practices of a like kind.
OR, NUTRIMENT
Translated by W. H. S. Jones
I. NUTRIMENT and form of nutriment, one and many. One, inasmuch as its kind is one ; form varies with moistness or dryness. These foods too have their forms and quantities ; they are for certain things, and for a certain number of things.
II. It increases, strengthens, clothes with flesh, makes like, makes unlike, what is in the several parts, according to the nature of each part and its original power.
III. It makes into the likeness of a power, when the nutriment that comes in has the mastery, and when that is mastered which was there to begin with.
IV. It also loses its qualities ; sometimes the earlier nutriment, when in time it has been liberated or added, sometimes the later, when in time it has been liberated or added.
V. Both are weakened in time and after a time by the nutriment from without which has continuously entered in, and for a long time firmly has interwoven itself with all the limbs.
VI. And it sends forth shoots of its own proper form. It changes the old form and descends ; it nourishes as it is digested. Sometimes it alters the earlier form, and completely obscures the former ones.
VII. Power of nutriment reaches to bone and to all the parts of bone, to sinew, to vein, to artery, to muscle, to membrane, to flesh, fat, blood, phlegm, marrow, brain, spinal marrow, the intestines and all their parts ; it reaches also to heat, breath, and moisture.
VIII. Nutriment is that which is nourishing ; nutriment is that which is fit to nourish ; nutriment is that which is about to nourish.
IX. The beginning of all things is one and the end of all things is one, and the end and beginning are the same.
X. And all the particular details in nourishment are managed well or ill ; well if as aforesaid, ill if ordered in the opposite way to these.
XI. Juices varied in colours and in powers, to harm or to help, or neither to harm nor to help, varied in amount, excess or defect, in combination of some but not of others.
XII. And to the warming of all it harms or helps, to the cooling it harms or helps, to the power it harms or helps.
XIII. Of power varied natures.
XIV. Humours corrupting whole, part, from without, from within, spontaneous, not spontaneous ; spontaneous for us, not spontaneous for the cause. Of the cause, part is clear, part is obscure, part is within our power and part is not.
XV. Nature is sufficient in all for all.
XVI. To deal with nature from without : plaster, anointing, salve, uncovering of whole or part, covering of whole or part, warming or cooling similarly, astriction, ulceration, biting, grease ; from within : some of the aforesaid, and in addition an obscure cause in part or whole, in some cases but not in all.
XVII. Secretions in accordance with nature, by the bowels, urine, sweat, sputum, mucus, womb, through hemorrhoid, wart, leprosy, tumour, carcinoma, from nostrils, lungs, bowels, seat, penis, in accordance with nature or contrary to nature. The peculiar differences in these things depend on differences in the individual, on times and on methods. All these things are one nature and not one. All these things are many natures and one nature.
XVIII. Purging upward or downward, neither upward nor downward.
XIX. In nutriment purging excellent, in nutriment purging bad ; bad or excellent according to circumstances.
XX. Ulceration, burn-scab, blood, pus, lymph, leprosy, scurf, dandruff, scurvy, white leprosy, freckles, sometimes harm and sometimes help, and sometimes neither harm nor help.
XXI. Nutriment not nutriment if it have not its power. Not nutriment nutriment if it can nourish. Nutriment in name, not in deed ; nutriment in deed, not in name.
XXII. It travels from within to hair, nails, and to the extreme surface ; from without nutriment travels from the extreme surface to the innermost parts.
XXIII. Conflux one, conspiration one, all things in sympathy ; all the parts as forming a whole, and severally the parts in each part, with reference to the work.
XXIV. The great beginning travels to the extreme part ; from the extreme part there is travelling to the great beginning. One nature to be and not to be.
XXV. Differences of diseases depend on nutriment, on breath, on heat, on blood, on phlegm, on bile, on humours, on flesh, on fat, on vein, on artery, on sinew, muscle, membrane, bone, brain, spinal marrow, mouth, tongue, oesophagus, stomach, bowels, midriff, peritoneum, liver, spleen, kidneys, bladder, womb, skin. All these things both as a whole and severally. Their greatness great and not great.
XXVI. Signs : tickling, ache, rupture, mind, sweat, sediment in urine, rest, tossing, condition of the eyes, imaginations, jaundice, hiccoughs, epilepsy, blood entire, sleep, from both these and all other things in accordance with nature, and everything else of a similar nature that tends to harm or help. Pains of the whole or of a part, indications of severity : of the one, greater severity, of the other, less, and from both come signs of greater severity, and from both come signs of less.
XXVII. Sweet, not sweet ; sweet in power, like water, sweet to the taste, like honey. Signs of either are sores, eyes and tastings, which can also distinguish degrees. Sweet to sight, in colours and in combinations generally, sweet to a greater or less degree.
XXVIII. Porousness of a body for transpiration healthy for those from whom more is taken ; denseness of body for transpiration unhealthy for those from whom less is taken. Those who transpire freely are weaker, healthier, and recover easily ; those who transpire hardly are stronger before they are sick, but on falling sick they make difficult recovery. These for both whole and part.
XXIX. The lungs draw a nourishment which is the opposite of that of the body, all other parts draw the same.
XXX. Beginning of nutriment of breath, nostrils, mouth, throat, lungs, and the transpiratory system generally. Beginning of nutriment, both wet and dry, mouth, oesophagus, stomach. The more ancient nutriment, through the epigastrium, where the navel is.
XXXI. Root of veins, liver ; root of arteries, heart. Out of these travel to all parts blood and breath, and heat passes through them.
XXXII. Power one, and not one, by which all these things and those of a different sort are managed ; one for the life of whole and part, not one for the sensation of whole and part.
XXXIII. Milk nutriment, for those to whom milk is a natural nutriment, but for others it is not. For some wine is nutriment, for others not. So with meats and the other many forms of nutriment, the differences being due to place and habit.
XXXIV. Nourishment is sometimes into growth and being, sometimes into being only, as is the case with old men ; sometimes in addition it is into strength. The condition of the athlete is not natural. A healthy state is superior in all.
XXXV. It is a great thing successfully to adapt quantity to power.
XXXVI. Milk and blood are what is left over from nutriment.
XXXVII. Periods generally harmonise for the embryo and its nutriment ; and again nutriment tends upwards to milk and the nourishment of the baby.
XXXVIII. Inanimates get life, animates get life, the parts of animates get life.
XXXIX. The natures of all are untaught.
XL. Blood of another is useful, one’s own blood is useful ; blood of another is harmful, one’s own blood is harmful ; one’s own humours are harmful, humours of another are harmful ; humours of another are beneficial, one’s own humours are beneficial ; the harmonious is unharmonious, the unharmonious is harmonious ; another’s milk is good, one’s own milk is bad ; another’s milk is harmful, one’s own milk is useful.
XLI. Food for the young partly digested, for the old completely changed, for adults unchanged.
XLII. For formation, thirty-five days ; for movement, seventy days ; for completion, two hundred and ten days. Others, for form, forty-five days ; for motion, ninety days ; for delivery, two hundred and seventy days. Others, fifty for form ; for the first leap, one hundred ; for completion, three hundred days. For distinction of limbs, forty ; for shifting, eighty ; for detachment, two hundred and forty days. It is not and is. There are found therein both more and less, in respect of both the whole and the parts, but the more is not much more, and the less not much less.
XLIII. Nutriment of bones after breaking ; for the nostril, twice five ; for jaw, collar-bone and ribs, twice this ; for the fore-arm, thrice ; for the leg and upper-arm, four times ; for the thigh, five times ; there may be, however, in these a little more or less.
XLIV. Blood is liquid and blood is solid. Liquid blood is good, liquid blood is bad. Solid blood is good, solid blood is bad. All things are good or bad relatively.
XLV. The way up, down.
XLVI. Power of nutriment superior to mass ; mass of nutriment superior to power ; both in moist things and in dry.
XLVII. It takes away and adds not the same thing ; it takes away from one, and adds to another, the same thing.
XLVIII. Pulsations of veins and breathing of the lungs according to age, harmonious and unharmonious, signs of disease and of health, and of health more than of disease, and of disease more than of health. For breath too is nutriment.
XLIX. Liquid nutriment more easily changed than solid ; solid nutriment more easily changed than liquid. That which is hardly altered is hard of digestion, and that which is easily added is easy of digestion.
L. And for such as need a quick reinforcement, a liquid remedy is best for recovery of power ; for such as need a quicker, a remedy through smell ; for those who need a slower reinforcement, solid nutriment.
LI. Muscles being more solid waste less easily than other parts, save bone and sinew. Parts that have been exercised resist change, being according to their kind stronger than they otherwise would have been, and therefore less liable to waste.
LII. Pus comes from flesh ; pus-like lymph comes from blood and moisture generally. Pus is nutriment for a sore ; lymph is nutriment for vein and artery.
LIII. Marrow nutriment of bone, and through this a callus forms.
LIV. Power gives to all things increase, nourishment and birth.
LV. Moisture the vehicle of nutriment.
Translated by W. H. S. Jones
I. TIME is that wherein there is opportunity, and opportunity is that wherein there is no great time. Healing is a matter of time, but it is sometimes also a matter of opportunity. However, knowing this, one must attend in medical practice not primarily to plausible theories, but to experience combined with reason. For a theory is a composite memory of things apprehended with sense-perception. For the sense-perception, coming first in experience and conveying to the intellect the things subjected to it, is clearly imaged, and the intellect, receiving these things many times, noting the occasion, the time and the manner, stores them up in itself and remembers. Now I approve of theorising also if it lays its foundation in incident, and deduces its conclusions in accordance with phenomena. For if theorising lays its foundation in clear fact, it is found to exist in the domain of intellect, which itself receives from other sources each of its impressions. So we must conceive of our nature as being stirred and instructed under compulsion by the great variety of things ; and the intellect, as I have said, taking over from nature the impressions, leads us afterwards into truth. But if it begins, not from a clear impression, but from a plausible fiction, it often induces a grievous and troublesome condition. All who so act are lost in a blind alley. Now no harm would be done if bad practitioners received their due wages. But as it is their innocent patients suffer, for whom the violence of their disorder did not appear sufficient without the addition of their physician’s inexperience. I must now pass on to another subject.
II. But conclusions which are merely verbal cannot bear fruit, only those do which are based on demonstrated fact. For affirmation and talk are deceptive and treacherous. Wherefore one must hold fast to facts in generalisations also, and occupy oneself with facts persistently, if one is to acquire that ready and infallible habit which we call “ the art of medicine.” For so to do will bestow a very great advantage upon sick folk and medical practitioners. Do not hesitate to inquire of laymen, if thereby there seems likely to result any improvement in treatment. For so I think the whole art has been set forth, by observing some part of the final end in each of many particulars, and then combining all into a single whole. So one must pay attention to generalities in incidents, with help and quietness rather than with professions and the excuses that accompany ill-success.
III. Early determination of the patient’s treatment — since only what has actually been administered will benefit ; emphatic assertion is of no use — is beneficial but complicated. For it is through many turns and changes that all diseases settle into some sort of permanence.
IV. This piece of advice also will need our consideration, as it contributes somewhat to the whole. For should you begin by discussing fees, you will suggest to the patient either that you will go away and leave him if no agreement be reached, or that you will neglect him and not prescribe any immediate treatment. So one must not be anxious about fixing a fee. For I consider such a worry to be harmful to a troubled patient, particularly if the disease be acute. For the quickness of the disease, offering no opportunity for turning back, spurs on the good physician not to seek his profit but rather to lay hold on reputation. Therefore it is better to reproach a patient you have saved than to extort money from those who are at death’s door.
V. And yet some patients ask for what is out of the way and doubtful, through prejudice, deserving indeed to be disregarded, but not to be punished. Wherefore you must reasonably oppose them, as they are embarked upon a stormy sea of change.
For, in heaven’s name, who that is a brotherly physician practises with such hardness of heart as not at the beginning to conduct a preliminary examination of every illness and prescribe what will help towards a cure, to heal the patient and not to overlook the reward, to say nothing of the desire that makes a man ready to learn?
VI. I urge you not to be too unkind, but to consider carefully your patient’s superabundance or means. Sometimes give your services for nothing, calling to mind a previous benefaction or present satisfaction. And if there be an opportunity of serving one who is a stranger in financial straits, give full assistance to all such. For where there is love of man, there is also love of the art. For some patients, though conscious that their condition is perilous, recover their health simply through their contentment with the goodness of the physician. And it is well to superintend the sick to make them well, to care for the healthy to keep them well, but also to care for one’s own self, so as to observe what is seemly.
VII. Now those who are buried in deep ignorance of the art cannot appreciate what has been said. In fact such men will be shown up as ignorant of medicine, suddenly exalted yet needing good luck. For should wealthy men gain some remission of their trouble, these quacks win reputation through a double good fortune, and if a relapse occurs they stand upon their dignity, having neglected the irreproachable methods of the art, wherewith a good physician, a “ brother of the art “ as he is called, would be at his best. But he who accomplishes his cures easily without making a mistake would transgress none of these methods through want of power ; for he is not distrusted on the ground of wickedness. For quacks do not attempt treatment when they see an alarming condition, and avoid calling in other physicians, because they wickedly hate help. And the patients in their pain drift on a sea of twofold wretchedness for not having intrusted themselves to the end to the fuller treatment that is given by the art. For a remission of a disease affords a sick man much relief. Wherefore wanting a healthy condition they do not wish always to submit to the same treatment, therein being in accord with a physician’s versatility. For the patients are in need through heavy expenditure, worshipping incompetence and showing no gratitude when they meet it ; when they have the power to be well off, they exhaust themselves about fees, really wishing to be well for the sake of managing their investments or farms, yet without a thought in these matters to receive anything.
VIII. So much for such recommendations. For remission and aggravation of a disease require respectively less or more medical assistance. A physician does not violate etiquette even if, being in difficulties on occasion over a patient and in the dark through inexperience, he should urge the calling in of others, in order to learn by consultation the truth about the case, and in order that there may be fellow-workers to afford abundant help. For when a diseased condition is stubborn and the evil grows, in the perplexity of the moment most things go wrong. So on such occasions one must be bold. For never will I lay it down that the art has been condemned in this matter. Physicians who meet in consultation must never quarrel, or jeer at one another. For I will assert upon oath, a physician’s reasoning should never be jealous of another. To be so will be a sign of weakness. Those who act thus lightly are rather those connected with the business of the market-place. Yet it is no mistaken idea to call in a consultant. For in all abundance there is lack.
IX. With all these things it will appear strong evidence for the reality of the art if a physician, while skilfully treating the patient, does not refrain from exhortations not to worry in mind in the eagerness to reach the hour of recovery. For we physicians take the lead in what is necessary for health. And if he be under orders the patient will not go far astray. For left to themselves patients sink through their painful condition, give up the struggle and depart this life. But he who has taken the sick man in hand, if he display the discoveries of the art, preserving nature, not trying to alter it, will sweep away the present depression or the distrust of the moment. For the healthy condition of a human being is a nature that has naturally attained a movement, not alien but perfectly adapted, having produced it by means of breath, warmth and coction of humours, in every way, by complete regimen and by everything combined, unless there be some congenital or early deficiency. Should there be such a thing in a patient who is wasting, try to assimilate to the fundamental nature. For the wasting, even of long standing, is unnatural.
X. You must also avoid adopting, in order to gain a patient, luxurious headgear and elaborate perfume. For excess of strangeness will win you ill-repute, but a little will be considered in good taste, just as pain in one part is a trifle, while in every part it is serious. Yet I do not forbid your trying to please, for it is not unworthy of a physician’s dignity.
XI. Bear in mind the employment of instruments and the pointing out of significant symptoms, and so forth.
XII. And if for the sake of a crowded audience you do wish to hold a lecture, your ambition is no laudable one, and at least avoid all citations from the poets, for to quote them argues feeble industry. For I forbid in medical practice an industry not pertinent to the art, and laboriously far-fetched, and which therefore has in itself alone an attractive grace. For you will achieve the empty toil of a drone and a drone’s spoils.
XIII. A condition too is desirable free from the late-learner’s faults. For his state accomplishes nothing that is immediate, and its remembrance of what is not before the eyes is but tolerable. So there arises a quarrelsome inefficiency, with headstrong outrage, that has no thought for what is seemly, while definitions, professions, oaths, great as far as the gods invoked are concerned, come from the physician in charge of the disease, bewildered laymen being lost in admiration of flowery language spoken in continuous reading and instruction, crowding together even before they are troubled by a disease. Wherever I may be in charge of a case, with no confidence should I call in such men to help as consultants. For in them comprehension of seemly learning is far to seek. Seeing then that they cannot but be unintelligent, I urge that experience is useful, the learning of opinions coming far after. For who is desirous and ambitious of learning truly subtle diversities of opinion, to the neglect of calm and practised skill? Wherefore I advise you to listen to their words but to oppose their acts.
XIV. When regimen has been restricted you must not suppress for long a long-standing desire of the patient. In a chronic disease indulgence too helps to set a man on his feet again, if one pay the necessary attention to one who is blind. As great fear is to be guarded against, so is excessive joy. A sudden disturbance of the air is also to be guarded against. The prime of life has everything lovely, the decline has the opposite. Incoherence of speech comes from an affection, or from the ears, or from the speaker’s talking of something fresh before he has uttered what was in his mind before, or from his thinking of fresh things before he has expressed what was in his thoughts before. Now this is a thing that happens without any “visible affection” socalled, mostly to those who are in love with their art. The power of youth, when the matter is trifling, is sometimes supremely great. Irregularity in a disease signifies that it will be a long one. A crisis is the riddance of a disease. A slight cause turns into a cure unless the affection be in a vital part. Because fellow-feeling at grief causes distress, some are distressed through the fellow-feeling of another. Loud talking is painful. Overwork calls for gentle dissuasion. A wooded district benefits.
Translated by W. H. S. Jones
I. THE colour of the humours, where there is no ebb of them, is like that of flowers. They must be drawn along the suitable parts whither they tend, except those whose coction comes in due time. Coction tends outwards or inwards, or in any other necessary direction. Caution. Lack of experience. Difficulty of learning by experience. Falling out of hair. Emptiness of bowels, for the lower, repletion, for the upper, nourishment. Tendency upwards; tendency downwards. Spontaneous movements upwards, downwards; beneficial, harmful. Congenital constitution, country, habit, age, season, constitution of the disease, excess, defect, the deficient and the amount of the deficiency, or the contrary. Remedies. Deflection. Deviation, to head, to the sides, along the route to which the chief tendencies are. Or revulsion, downwards when there is an upwards tendency, upwards when there is a downwards tendency. Drying up. Cases in which the upper parts, or the lower, are washed out; cases for soothing remedies. Do not shut up extravasated humours inside, but dry up the evacuations. Disturbance; flooding out, washing through, for those who will have an abscession to the seat, whereby is withdrawn poison, or sore, or solidified humour, or growth, or flatulence, or food, or creature, or inflammation, or any other affection.
I. Observe these things: symptoms which cease of themselves, or for example the blisters that rise upon burns, what are harmful or beneficial and in what cases, positions, movement, rising, subsidence, sleep, waking, to be quick when something must be done or prevented. Instruction about vomit, evacuation below, sputum, mucus, coughing, belching, hiccoughing, flatulence, urine, sneezing, tears, itching, pluckings, touchings, thirst, hunger, repletion, sleep, pain, absence of pain, body, mind, learning, memory, voice, silence.
III. In affections of the womb, purgations; evacuations from above, with colic, that are greasy, uncompounded, foamy, hot, biting, verdigris-coloured, varied, with shreds, lees or blood, without air, unconcocted, concocted, desiccated, the nature of the liquid part, looking at the comfort or discomfort of the patient before danger comes, and also what ought not to be stopped. Coction, descent of the humours below, rising of the humours above, fluxes from the womb, the wax in the ears. Orgasm, opening, emptying, warming, chilling, within or without, in some cases but not in others. When that which causes the colic is below the navel the colic is slow and mild, and vice versa.
IV. The evacuations, whither they tend; without foam, with coction, without coction, cold, fetid, dry, moist. In fevers not ardent, thirst that was not present before, brought about neither by heat nor by any other cause, urine, wetness of the nostrils. Prostration, dryness or fulness of the body; rapid respiration; hypochondrium; extremities; eyes sickly; change of complexion; pulsations; chills; palpitations: hardness of the skin, muscles, joints, voice, mind; voluntary posture; hair; nails; power, or the want of power, to bear easily what is necessary. These are signs: — smell of the skin, mouth, ear, stools, flatulence, urine, sores, sweat, sputum, nose; saltness of skin, sputum, nose, tears, or of the humours generally. In every way similar the things that benefit, the things that harm. The dreams the patient sees, what he does in sleep; if his hearing be sharp, if he be interested in information. In estimating signs take the majority that are more important and more prominent — those that denote recovery are more seasonable than the others. If the patients perceive everything with every sense and bear easily, for example, smells, conversation, clothes, postures and so on. Symptoms which benefit even when they manifest themselves spontaneously (and sometimes these too bring about a crisis), such as flatulence and urine, of the right kind, of the right amount, and at the right time. What is contrary avert; combat it. Parts near and common to affected places suffer lesions first and most.
V. In examining the constitution of a disease look to the excretions in the initial stages, the nature of the urine, the state of collapse, change of colour, diminution of respiration and the other symptoms besides. The abnormal conditions that must be known: passage of urine, menstruation, sputum, nasal discharge, eyes, sweat, discharge from tumours, from wounds, from eruptions, what is spontaneous and what artificial; for all critical symptoms follow a norm, as do those that help, those that harm and those that kill. They must be known, that the bad may be shunned and averted, and that the good may be invited, encouraged and welcomed. Similarly with other symptoms, of the skin, extremities, hypochondria, joints, mouth, eye, postures, sleep, such as denote a crisis, and when symptoms of this kind must be provoked. Moreover, abscessions of a helpful character must be encouraged by foods, drinks, smells, sights, sounds, ideas, evacuations, warmth, cooling, moist things, dry things, moistening, drying, anointings, ointments, plasters, salves, powders, dressings, applications [postures, massage, leaving alone, exertion, rest, sleep, keeping awake], breaths from above, from below, common, particular, artificial — not, however, when paroxysms are present or imminent, nor when the feet are chilled, but when the disease is declining.
VI. At the periodic paroxysms do not give nourishment; do not force it on the patient, but diminish the quantity before the crisis. Do not disturb a patient either during a crisis or just after one, either by purgings or by other irritants; do not try experiments either, but leave the patient alone. [Critical signs of an improvement ought not to be expected to appear at once.] Purge or otherwise disturb concocted, not crude, humours, and avoid the onset of a disease, unless there be orgasm, a thing which rarely occurs then. Evacuate the humours that have to be evacuated in the direction in which they mostly tend, and by the convenient passages. Judge of evacuations, not by bulk, but by conformity to what is proper, and by the way in which the patient supports them. When occasion calls for it, reduce the patient, if need be, to a fainting condition, until the object in view be attained. If then there be need of anything further, shift your ground; dry up the humours, moisten them, treat by revulsion, if, that is, the strength of the patient permits. Take as your tests the following symptoms: the dry will be hot, and the moist cold; purgatives will produce the opposite effect. This is what usually happens. On odd days evacuations should be upwards if the periods and the constitution of the paroxysms be odd. On even days they are generally downwards, for so they are beneficial even when spontaneous, if the periods cause the paroxysms on the even days. But when the circumstances are not such, evacuations should be upwards on even days, downwards on odd days.
(а) — A purge is necessary on an odd day. If paroxysms occur on odd days, purge upwards. If paroxysms occur on even days, purge downwards.
(b) — A purge is necessary on an even day. If paroxysms occur on even days, purge downwards. If paroxysms occur on odd days, purge upwards.
Such constitutions are rare, and the crises are rather uncertain. Prolonged illnesses must be similarly treated — for example, those which last thirteen or fourteen days; purge on the thirteenth day downwards, on the fourteenth upwards (to do so is beneficial for the crisis), and similarly with diseases of twenty days, except when purging should be downwards. Purging must be copious, and not near the crisis but some time before it. Rarely in acute diseases must evacuation be copious.
II. Generally, in cases of fever with prostration, abscessions are most likely to occur at the joints and by the jaw, in each case near to the part where the pains are, more often, in fact generally, to an upper part. If the disease be sluggish and incline to the lower parts, the abscessions too collect in a lower part. Hot feet especially signify a lower abscession, cold feet an upper abscession. When patients, on rising after an illness, suffer immediately pains in arms or feet, abscessions form in these parts. Moreover, if a part suffer pain before the illness, it is in it that the humours settle, as was the case with those who in Perinthus suffered from cough and angina. For coughs, like fevers, cause abscessions. These results are the same, whether they come from humours or from wasting of body and soul.
VI. Know in what seasons the humours break out, what diseases they cause in each, and what symptoms they cause in each disease. As to the body generally, know to what disease the physical constitution most inclines. For example, a swollen spleen produces a certain effect, to which the constitution contributes something. It is much the same with an evil complexion, or the body is parched, and so on. Be practised in these things.
IX. Among psychical symptoms are intemperance in drink and food, in sleep, and in wakefulness, the endurance of toil either for the sake of certain passions (for example, love of dice) or for the sake of one’s craft or through necessity, and the regularity or irregularity of such endurance. States of mind before and after changes. Of moral characteristics: diligence of mind, whether in inquiry or practice or sight or speech; similarly, for example, griefs, passionate outbursts, strong desires. Accidents grieving the mind, either through vision or through hearing. How the body behaves: when a mill grinds the teeth are set on edge; the legs shake when one walks beside a precipice; the hands shake when one lifts a load that one should not lift; the sudden sight of a snake causes pallor. Fears, shame, pain, pleasure, passion and so forth: to each of these the appropriate member of the body responds by its action. Instances are sweats, palpitation of the heart and so forth.
X. Of remedies that may help or harm those applied externally include anointing, affusions, inunction, cataplasms, bandages of wool and the like; the internal parts of the body react to these remedies just as the external parts react to remedies applied internally. Moreover, a bed made out of unwashed fleeces, and the sight or smell of the cumin called “ royal.” Things that purge the head are disturbing, conversation, voice and so forth. Breasts, seed, womb are symptomatic at the various ages; in chokings and in coughs, fluxes to the testicles.
XI. As the soil is to trees, so is the stomach to animals. It nourishes, it warms, it cools; as it empties it cools, as it fills it warms. As a soil that is manured warms in winter, so the stomach grows warm. Trees have a slight, dry bark, but inside they are of dry texture, healthy, free from rot, durable; so among animals are tortoises and the like. In their ages animals are like the seasons and the year. They do not wear out, but improve with moderate use. As a water-pot, when new, lets the liquid pass through it, but holds it as time goes on, so the stomach lets nourishment pass, and like a vessel retains a sediment.
XII. The fashions of diseases. Some are congenital and may be learned by inquiry, as also may those that are due to the district, for most people are permanent residents there, so that those who know are numerous. Some are the result of the physical constitution, others of regimen, of the constitution of the disease, of the seasons. Countries badly situated with respect to the seasons engender diseases analogous to the season. E.g. when it produces irregular heat or cold on the same day, diseases in the country are autumnal, and similarly in the case of the other seasons. Some spring from the smells of mud or marshes, others from waters, stone, for example, and diseases of the spleen: of this kind are waters because of winds good or bad.
XIII. What the character of a season’s diseases and constitutions will be you must foretell from the following signs. If the seasons proceed normally and regularly, they produce diseases that come easily to a crisis. The diseases that are peculiar to the seasons are clear as to their fashions. According to the alterations in a season, the diseases such as arise in this season will be either like or unlike their usual nature. If the season proceeds normally, similar or somewhat similar to the normal will he the diseases, as, for example, autumnal jaundice; for cold spells succeed to hot spells and heat to cold. If the summer prove bilious, and if the increased bile be left behind, there will also be diseases of the spleen. So when spring too has had a bilious constitution, there occur cases of jaundice in spring also. For this motion is very closely akin to the season when it has this nature. When summer turns out like to spring, sweats occur in fevers; these are mild, not acute, and do not parch the tongue. When the spring turns out wintry, with after-winter storms, the diseases too are wintry, with coughs, pneumonia or angina. So in autumn, should there be sudden and unseasonable wintry weather, symptoms are not continuously autumnal, because they began in their wrong season, but irregularities occur. So seasons, like diseases, can fail to show crisis or to remain true to type, should they break out suddenly, or be determined too soon, or be left behind. For seasons, too, suffer from relapses, and so cause diseases. Accordingly, account must also be taken of the condition of a body when the seasons come upon it.
XIV. South winds cause deafness, dimness of vision, headaches, heaviness, and are relaxing. When such winds prevail, their characteristics extend to sufferers from diseases. Sores are soft, especially in the mouth, the privy parts, and similar places. A north wind causes coughs, sore throats, constipation, difficult micturition accompanied by shivering, pains in the side and chest; such are the diseases that one must be prone to expect when this wind prevails. Should its predominance be greater still, the fevers which follow drought and rain are determined by the conditions that preceded this predominance, by the physical condition produced by the previous season, and by the particular humour that prevails in the body. Droughts accompany both south winds and north winds. Winds cause differences — and this too is important — in all other respects also. For humours vary in strength according to season and district; summer, for instance, produces bile; spring, blood, and so on in each case.
VII. It is changes that are chiefly responsible for diseases, especially the greatest changes, the violent alterations both in the seasons and in other things. But seasons which come on gradually are the safest, as are gradual changes of regimen and temperature, and gradual changes from one period of life to another.
VIII. The constitutions of men are well or ill adapted to the seasons, some to summer, some to winter; others again to districts, to periods of life, to modes of living, to the various constitutions of diseases. Periods of life too are well or ill adapted to districts, seasons, modes of living and constitutions of diseases. So with the seasons vary modes of living, foods and drinks. In winter no work is done and foods are ripe and simple — an important point; in autumn work is done, exposure to the sun is beneficial, drinks are frequent and foods varied, with wine and fruits.
XIV. As it is possible to infer diseases from the seasons, so occasionally it is possible from diseases to forecast rains, winds and droughts; for example, north winds and south winds. For he who has noticed symptoms carefully and accurately has evidence on which to work; certain skin diseases, for instance, and pains at the joints are irritating when rain threatens, to quote one example out of many.
XV. Rains occur every other day, or every day, or at other intervals; some are continuous. Winds sometimes last for many days, and are opposed to one another; others are shorter; some, like rains, are periodic. These have resemblances to the seasonal constitutions, though less marked. If the year, having had a certain character to a marked degree, has given this character to the constitution, the diseases too have this character to a marked degree and are more severe; in this way have arisen very serious diseases, very widespread and lasting a very long period of time. After the first rains, when rain is coming after a long drought, it is possible to predict dropsies; and when the other slight signs appear at a period of calm, or at a change, one must infer what diseases are typical of the various rains or winds, and must listen to anyone who knows the nature of the spring or summer that will follow a winter of such and such a character.
XIX. Complexions vary with the seasons; they are not the same in north winds as in south winds; individuals differ, and the same individual varies in complexion as he grows older. Judge of complexions by their permanent characteristics, realising that ages resemble seasons in colour as in character.
XX. Sufferers from hemorrhoids are attacked neither by pleurisy, nor by pneumonia, nor by spreading ulcer, nor by boils, nor by swellings, nor perhaps by skin-eruptions and skin-diseases. However, unseasonably cured, many have been quickly caught by such diseases, and, moreover, in a fatal manner. All other abscessions, too, such as fistula, are cures of other diseases. So symptoms that relieve complaints if they come after their development, prevent the development if they come before. Suspected places cause relief, by acting as receptacles owing to pain, weight, or any other cause. In other cases there is the sympathetic action. The issue, through the flow, ceases to be one of blood, but the patients spit up matter connected with the humour. In some such cases seasonable blood-letting is possible, but in other cases blood-letting, as sometimes in the former cases, is not suitable but only a hindrance. Blood-spitting may be caused by the season, by pleurisy, or by bile. When swellings by the ear do not suppurate at a crisis, a relapse occurs when the swelling softens; when the relapse follows the normal course of relapses, the swelling rises again and remains, following the same periods as occur when fevers relapse. In such cases expect an abscession to the joints. Thick, white urine, as in the case of the slave of Antigenes, sometimes is passed on the fourth day in prostrating fevers, and saves the patient from the abscession, and this is especially so if in addition there is a copious flow of blood from the nostrils. The patient whose right bowel was painful became easier when arthritis supervened, but when this symptom was cured the pains became worse.
Translated by W. H. S. Jones
LXXXVI. He who has learnt aright about the signs that come in sleep will find that they have an important influence upon all things. For when the body is awake the soul is its servant, and is never her own mistress, but divides her attention among many things, assigning a part of it to each faculty of the body — to hearing, to sight, to touch, to walking, and to acts of the whole body; but the mind never enjoys independence. But when the body is at rest, the soul, being set in motion and awake, administers her own household, and of herself performs all the acts of the body. For the body when asleep has no perception; but the soul when awake has cognizance of all things — sees what is visible, hears what is audible, walks, touches, feels pain, ponders. In a word, all the functions of body and of soul are performed by the soul during sleep. Whoever, therefore, knows how to interpret these acts aright knows a great part of wisdom.
LXXXVII. Now such dreams as are divine, and foretell to cities or to private persons things evil or things good, have interpreters in those who possess the art of dealing with such things. But all the physical symptoms foretold by the soul, excess, of surfeit or of depletion, of things natural, or change to unaccustomed things, these also the diviners interpret, sometimes with, sometimes without success. But in neither case do they know the cause, either of their success or of their failure. They recommend precautions to be taken to prevent harm, yet they give no instruction how to take precautions, but only recommend prayers to the gods. Prayer indeed is good, but while calling on the gods a man should himself lend a hand.
LXXXVIII. This is the truth of the matter. Such dreams as repeat in the night a man’s actions or thoughts in the day-time, representing them as REGIMEN, IV. LXXXVIII. occurring naturally, just as they were done or planned during the day in a normal act — these are good for a man. They signify health, because the soul abides by the purposes of the day, and is overpowered neither by surfeit nor by depletion nor by any attack from without. But when dreams are contrary to the acts of the day, and there occurs about them some struggle or triumph, a disturbance in the body is indicated, a violent struggle meaning a violent mischief, a feeble struggle a less serious mischief. As to whether the act should be averted or not I do not decide, but I do advise treatment of the body. For a disturbance of the soul has been caused by a secretion arising from some surfeit that has occurred. Now if the contrast be violent, it is beneficial to take an emetic, to increase gradually a light diet for five days, to take in the early morning long, sharp walks, increasing them gradually, and to adapt exercises, when in training, so as to match the gradual increase of food. If the contrast be milder, omit the emetic, reduce food by a third, resuming this by a gentle, gradual increase spread over five days. Insist on vigorous walks, use voice-exercises, and the disturbance will cease.
LXXXIX. To see the sun, moon, heavens and stars clear and bright, each in the proper order, is good, as it indicates physical health in all its signs, but this condition must be maintained by adhering to the regimen followed at the time. But if there be a contrast between the dream and reality, it indicates a physical illness, a violent contrast a violent illness, a slighter contrast a lighter illness. The stars are in the outer sphere, the sun in the middle sphere, the moon in the sphere next the hollow. When any one of the heavenly bodies appears to be disfigured, to disappear, or to be arrested in its revolution, if it be through mist or cloud, the malign influence is comparatively weak; if through rain also or hail, the influence is more powerful. In any case it is indicated that a moist and phlegm-like secretion, arising in the body, has fallen to the outer circuit. It is beneficial for this man to make his runs long, wearing his cloak the while, to increase them gradually, that he may perspire as freely as possible, and after exercise to take long walks; luncheon should be left out. Reduce food by one-third, and take five days in gradually resuming the normal quantity. Should the trouble appear to be of the more potent kind, use also the vapour-bath; for, as the mischief lies in the outer circuit, it is expedient to make the purgation through the skin. The foods employed are to be dry, acrid, astringent and unmixed; the exercises such as are the most drying. But if it be the moon that shows these signs at all, it is beneficial to effect the revulsion inwards, and to administer an emetic after foods that are acrid, salt and soft. There should be sharp circular runs, walks, voice-exercises, omission of luncheon, the same reduction and gradual increase of food. The revulsion must be directed inwards because the harm showed itself at the hollow parts of the body. But if it be the sun that manifests the phenomena, the malady is more potent, and harder to eliminate. It is necessary to effect the revulsions in both directions, to employ running on the double track and on the round track, walks and all other exercises, the same reduction and gradual increase of food. After an emetic should come another gradual increase spread over five days. But if in a clear sky the heavenly bodies are crushed, seeming to be weak and overpowered by the dryness of the revolution, it indicates a danger of falling into a disease. What is necessary is to reduce food, to employ the moistest regimen, baths and increased rest, and sleep, until there is a recovery. If the hostile influence appear to be fiery and hot, a secretion of bile is indicated. Now if the force win, a disease is indicated. If the vanquished be also annihilated, there is a danger that the disease will have a fatal issue. But if the force seem to be put to flight, and to flee quickly, pursued by the stars, there is a danger that the patient will become delirious, unless he be treated. In all these cases it is most beneficial to be purged with hellebore before submitting to regimen. The next best course is to adopt a watery regimen, and to abstain from wine unless it be white, thin, soft and diluted. There should be abstinence from things that are hot, acrid, drying and salt. Let there be plenty of natural exercises and long runs with the cloak worn. Let there be no massage, no ordinary wrestling, and no wrestling on dust. Long sleeps on a soft bed; rest except after the natural exercises; let there be a walk after dinner. It is a good thing too to take a vapour-bath. After the vapour-bath an emetic is to be drunk. Until thirty days are gone the appetite should not be fully satisfied, and when the time has come for this full satisfaction, let an emetic be taken three times a month after a meal of sweet, watery and light foods. Whenever the heavenly bodies wander about, some in one way and others in another, it indicates a disturbance of the soul arising from anxiety. Rest is beneficial in such a case. The soul should be turned to the contemplation of comic things, if possible, if not, to such other things as will bring most pleasure when looked at, for two or three days, and recovery will take place. Otherwise there is a risk of falling ill. Whenever a heavenly body appears to fall away from its orbit, should it be pure and bright, and the motion towards the east, it is a sign of health. For whenever a pure substance in the body is secreted from the circuit in the natural motion from west to east, it is right and proper. In fact secretions into the belly and substances disgorged into the flesh all fall away from the circuit. But whenever a heavenly body seems to be dark and dull, and to move towards the west, or into the sea, or into the earth, or upwards, disease is indicated. When the motion is upwards, it means fluxes of the head; when into the sea, diseases of the bowels; when into the earth, most usually tumours growing in the flesh. In such eases it is beneficial to reduce food by one-third and to take an emetic, to be followed by a gradual increase of food for five days, the normal diet being resumed in another five. Another emetic should be followed by the same gradual increase. Whenever a heavenly body seems to settle on you, if it be pure and moist, it indicates health, because what descends from the ether on to the person is pure, and the soul too sees it in its true character as it entered the body. But should the heavenly body be dark, impure and not transparent, it indicates disease caused neither by surfeit nor by depletion, but by the entrance of something from without. It is beneficial in this case to take sharp runs on the round track, that there may be as little melting of the body as possible, and that by breathing as rapidly as possible the patient may secrete the foreign body. After these runs let there be sharp walks. Diet to be soft and light for four days. Whatsoever a man seems to receive pure from a pure god is good for health; for it indicates that the matter is pure that enters the body. But whatever he seems to see that is the opposite thereof is not good; for it indicates that something diseased has entered the body. Accordingly the treatment in this case should be the same as the former. Should it seem to rain with a gentle shower from a clear sky, with neither a violent downpour nor a terrible storm, it is a good sign; for it indicates that the breath has come from the air in just measure and pure. If the reverse occur, violent rain, storm and tempest, and the water be foul, it indicates disease from the breath that comes from without. In this case also the same regimen must be employed, and diet must be very strictly limited. So with this knowledge about the heavenly bodies, precautions must be taken, with change of regimen and prayers to the gods; in the case of good signs, to the Sun, to Heavenly Zeus, to Zeus, Protector of Home, to Athena, Protectress of Home, to Hermes and to Apollo; in the case of adverse signs, to the Averters of evil, to Earth and to the Heroes, that all dangers may be averted.
XC. The following too are signs that foretell health. To see and hear clearly the things on the earth, to walk surely, to run surely, quickly and without fear, to see the earth level and well tilled, trees that are luxuriant, covered with fruit and cultivated, rivers flowing naturally, with water that is pure, and neither higher nor lower than it should be, and springs and wells that are similar. All these indicate health for the dreamer, and that the body with all its circuits, diet and secretions are proper and normal. But if anything be seen that is the reverse of these things, it indicates some harm in the body. If sight or hearing be impaired, it indicates disease in the region of the head. In addition to the preceding regimen the dreamer should take longer walks in the early morning and after dinner. If it be the legs that are injured, the revulsion should be made with emetics, and in addition to the preceding regimen there should be more wrestling. For the earth to be rough indicates that the flesh is impure. So the walks after exercises must be made longer. Fruitless trees signify corruption of the human seed. Now if the trees are shedding their leaves, the harm is caused by moist, cold influences; if leaves abound without any fruit, by hot, dry influences. In the former case regimen must be directed towards warming and drying; in the latter towards cooling and moistening. When rivers are abnormal they indicate a circulation of the blood; high water excess of blood, low water defect of blood. Regimen should be made to increase the latter and lessen the former. Impure streams indicate disturbance of the bowels. The impurities are removed by running on the round track and by walks, which stir them up by accelerated respiration. Springs and cisterns indicate some trouble of the bladder; it should be thoroughly purged by diuretics. A troubled sea indicates disease of the belly; it should be thoroughly purged by light, soft aperients. Trembling of the earth or of a house indicates illness when the dreamer is in health, and a change from disease to health when he is sick. So it is beneficial to change the regimen of a healthy dreamer. Let him first take an emetic, that he may resume nourishment again little by little, for it is the present nourishment that is troubling all the body. A sick dreamer benefits by continuing the same regimen, for the body is already changing from its present condition. To see the earth flooded by water or sea signifies a disease, as there is much moisture in the body. What is necessary is to take emetics, to avoid luncheon, to exercise and to adopt a dry diet. Then there should be a gradual increase of food, little by little, and little to begin with. It is not good either to see the earth black or scorched, but there is a danger of catching a violent, or even a fatal disease, for it indicates excess of dryness in the flesh. What is necessary is to give up exercises and such food as is dry and acrid and diuretic. Regimen should consist of barley-water well boiled, light and scanty meals, copious white wine well diluted, and numerous baths. No bath should be taken on an empty stomach, the bed should be soft and rest abundant. Chill and the sun should be avoided. Pray to Earth, Hermes and the Heroes. If the dreamer thinks that he is diving in a lake, in the sea, or in a river, it is not a good sign, for it indicates excess of moisture. In this case also benefit comes from a drying regimen and increased exercises. But for a fever patient these dreams are a good sign, for the heat is being suppressed by the moisture.
XCI. The sight of something connected with the person that is normal, and for which the physique is neither too large nor too small, is a good sign for the health. To be wearing white clothes, and the most beautiful shoes, is also a good sign. But anything too large or too small for the limbs is not good. What is necessary is in the latter case to increase by regimen, in the former to diminish. Black objects indicate a worse and more dangerous disease; what is necessary is to soften and to moisten. New objects indicate a change.
XCII. To see the dead clean and in white cloaks is a good sign, and to receive something clean from them indicates both health of body and the healthiness of the things that enter it. For from the dead come nourishment, growth and seed, and for these to enter the body clean indicates health. But if, on the contrary, one should see them naked, or clothed in black, or not clean, or taking something, or bringing something out of the house, the sign is unfavourable, as it indicates disease, the things entering the body being harmful. What is necessary is to purge them away by runs on the round track and by walks, and after an emetic gradually to increase a soft and light diet.
XCIII. Monstrous bodies that are seen in sleep and frighten a man indicate a surfeit of unaccustomed food, a secretion, a bilious flux and a dangerous disease. What is necessary is an emetic, followed idiomatic, though the sense is not materially altered: “neither too large nor too small for the physique.” by a gradual increase, for five days, of the lightest food possible, neither abundant nor acrid, neither dry nor hot, with such exercises as are most natural, excepting walks after dinner. The dreamer should take hot baths and rest, and avoid the sun and cold. Whenever in his sleep a man thinks he is eating or drinking his usual food or drink, it indicates a want of nourishment and depression of the soul. Meats if they be very strong show a very great excess; if they be weaker, a less excess. For just as eating is good, so eating in a dream is a good sign. So it is beneficial to reduce the quantity of food, for an excess of nourishment is indicated. The meaning is the same when bread is eaten, prepared with cheese and honey. To drink clean water in dreams is no sign of harm, but it is to drink any other kind. Whenever a man thinks that he beholds familiar objects, it indicates a desire of the soul. Whenever he runs away in fear, it indicates that the blood is arrested by dryness. It is in this case beneficial to cool and moisten the body. Fighting, or to be pierced or bound by another, indicates that there has occurred in the body a secretion opposed to the circuit. It is beneficial to take an emetic, to reduce the flesh, to walk, to eat light foods, and after the emetic to increase food gradually for four days. Wanderings and difficult ascents have the same meaning. Crossing rivers, enemy men-at-arms and strange monsters indicate disease or raving. It is beneficial to take small meals of light, soft food, and emetics, and gently to increase food for five days, with plenty of natural exercise except after dinner; but hot baths, rest, cold and sun are to be avoided. Using these means in the way I have described a man will live a healthy life: in fact I have discovered regimen, with the gods’ help, as far as it is possible for mere man to discover it.
Translated by W. H. S. Jones
I. SOME there are who have made an art of vilifying the arts, though they consider, not that they are accomplishing the object I mention, but that they are making a display of their own knowledge. In my opinion, however, to discover that was unknown before, when the discovery of it is better than a state of ignorance, is the ambition and task of intelligence, and so is to bring to completion what was already accomplished in part. On the other hand, to be eager to bring shame through the art of abuse upon the discoveries of others, improving nothing, but disparaging before those who do not know the discoveries of those who do, seems to me to be not the ambition and work of intelligence, but the sign of a nasty nature, or of want of art. Indeed it becomes only those who are without art to act in this manner, with the ambition, though not the power, to indulge their malevolence by disparaging what is right in their neighbours’ works and by eavilling at what is amiss. Now as for the attacks of this kind that are made on the other arts, let them be repelled by those who care to do so and can, and with regard to those points about which they care; the present discussion will oppose those who thus invade the art of medicine, and it is emboldened by the nature of those it blames, well equipped through the art it defends, and powerful through the wisdom in which it has been educated.
II. Now it seems to me that generally speaking there is no art which does not exist; in fact it is absurd to regard as non-existent one of the things that exist. Since what substance could there be of non-existents, and who could behold them and declare that they exist? For if really it be possible to see the non-existent, as it is to see the existent, I do not know how a man could regard as nonexistent what he can both see with his eyes and with his mind think that it exists. Nay, it cannot be so; but the existent is always seen and known, and the non-existent is neither seen nor known. Now reality is known when the arts have been already revealed, and there is no art which is not seen as the result of some real essence. I for my part think that the names also of the arts have been given them because of their real essences; for it is absurd — nay impossible — to hold that real essences spring from names. For names are conventions, but real essences are not conventions but the offspring of nature.
III. As to this subject in general, if it is not sufficiently understood from what I have said, other treatises will give clearer instruction. I will now turn to medicine, the subject of the present treatise, and set forth the exposition of it. First I will define what I conceive medicine to be. In general terms, it is to do away with the sufferings of the sick, to lessen the violence of their diseases, and to refuse to treat those who are overmastered by their diseases, realizing that in such cases medicine is powerless. That medicine fulfils these conditions, and is able constantly to fulfil them, will be the subject of my treatise from this point. In the exposition of the art I shall at the same time refute the arguments of those who think to shame it, and I shall do so just in those points where severally they believe they achieve some success.
IV. The beginning of my discourse is a point which will be conceded by all. It is conceded that of those treated by medicine some are healed. But because not all are healed the art is blamed, and those who malign it, because there are some who succumb to diseases, assert that those who escape do so through luck and not through the art. Now I, too, do not rob luck of any of its prerogatives, but I am nevertheless of opinion that when diseases are badly treated ill-luck generally follows, and good luck when they are treated well. Again, how is it possible for patients to attribute their recoveries to anything else except the art, seeing that it was by using it and serving it that they recovered? For in that they committed themselves to the art they showed their unwillingness to behold nothing but the reality of luck, so that while freed from dependence upon luck they are not freed from dependence upon the art. For in that they committed themselves with confidence to the art, they thereby acknowledged also its reality, and when its work was accomplished they recognized its power.
V. Now my opponent will object that in the past many, even without calling in a physician, have been cured of their sickness, and I agree that he is right. But I hold that it is possible to profit by the art of medicine even without calling in a physician, not indeed so as to know what is correct medical treatment and what is incorrect, but so as by chance to employ in self-treatment the same means as would have been employed had a physician actually been called in. And it is surely strong proof of the existence of the art, that it both exists and is powerful, if it is obvious that even those who do not believe in it recover through it. For even those who, without calling in a physician, recovered from a sickness must perforce know that their recovery was due to doing something or to not doing something; it was caused in fact by fasting or by abundant diet, by excess of drink or by abstinence therefrom, by bathing or by refraining therefrom, by violent exercise or by rest, by sleep or by keeping awake, or by using a combination of all these things. And they must perforce have learnt, by having been benefited, what it was that benefited them, just as when they were harmed they must have learnt, by having been harmed, what it was that harmed them.
For it is not everybody who is capable of discerning things distinguished by benefit and things distinguished by harm. If therefore the patient will know how to praise or to blame what composed the regimen under which he recovered, all these things belong to the art of medicine. Again, mistakes, no less than benefits, witness to the existence of the art; for what benefited did so because correctly administered, and what harmed did so because incorrectly administered. Now where correctness and incorrectness each have a defined limit, surely there must be an art. For absence of art I take to be absence of correctness and of incorrectness; but where both are present art cannot be absent.
VI. Moreover, if the medical art and medical men brought about a cure only by means of medicines, purgative or astringent, my argument would be weak. As it is, the physicians of greatest repute obviously cure by regimen and by other substances, which nobody — not only a physician but also an unlearned layman, if he heard of them — would say do not belong to the art. Seeing then that there is nothing that cannot be put to use by good physicians and by the art of medicine itself, but in most things that grow or are made are present the essential substances of cures and of drugs, no patient who recovers without a physician can logically attribute the recovery to spontaneity. Indeed, under a close examination spontaneity disappears; for everything that occurs will be found to do so through something, and this “through something” shows that spontaneity is a mere name, and has no reality. Medicine, however, because it acts “through something,” and because its results may be forecasted, has reality, as is manifest now and will be manifest for ever.
VI. Such then might be the answer to those who attribute recovery to chance and deny the existence of the art. As to those who would demolish the art by fatal cases of sickness, I wonder what adequate reason induces them to hold innocent the ill-luck of the victims, and to put all the blame upon the intelligence of those who practised the art of medicine. It amounts to this: while physicians may give wrong instructions, patients can never disobey orders. And yet it is much more likely that the sick cannot follow out the orders than that the physicians give wrong instructions. The physician sets about his task with healthy mind and healthy body, having considered the case and past cases of like characteristics to the present, so as to say how they were treated and cured. The patient knows neither what he is suffering from, nor the cause thereof; neither what will be the outcome of his present state, nor the usual results of like conditions. In this state he receives orders, suffering in the present and fearful of the future; full of the disease, and empty of food; wishful of treatment rather to enjoy immediate alleviation of his sickness than to recover his health; not in love with death, but powerless to endure. Which is the more likely: that men in this condition obey, instead of varying, the physician’s orders, or that the physician, in the condition that my account has explained above, gives improper orders? Surely it is much more likely that the physician gives proper orders, which the patient not unnaturally is unable to follow; and not following them he meets with death, the cause of which illogical reasoners attribute to the innocent, allowing the guilty to go free.
VIII. Some too there are who blame medicine because of those who refuse to undertake desperate cases, and say that while physicians undertake cases which would cure themselves, they do not touch those where great help is necessary; whereas, if the art existed, it ought to cure all alike. Now if those who make such statements charged physicians with neglecting them, the makers of the statements, on the ground that they are delirious, they would bring a more plausible charge than the one they do bring. For if a man demand from an art a power over what does not belong to the art, or from nature a power over what does not belong to nature, his ignorance is more allied to madness than to lack of knowledge. For in cases where we may have the mastery through the means afforded by a natural constitution or by an art, there we may be craftsmen, but nowhere else. Whenever therefore a man suffers from an ill which is too strong for the means at the disposal of medicine, he surely must not even expect that it can be overcome by medicine. For example, of the caustics employed in medicine fire is the most powerful, though there are many others less powerful than it. Now affections that are too strong for the less powerful caustics plainly are not for this reason incurable; but those which are too strong for the most powerful plainly are incurable. For when fire operates, surely affections not overcome thereby show that they need another art, and not that wherein fire is the means. I apply the same argument to the other agents employed in medicine; when any one of them plays the physician false, the blame should be laid on the power of the affection, and not on the art. Now those who blame physicians who do not undertake desperate cases, urge them to take in hand unsuitable patients just as much as suitable ones. When they urge this, while they are admired by physicians in name, they are a laughing-stock of really scientific physicians. Those experienced in this craft have no need either of such foolish blame or of such foolish praise; they need praise only from those who have considered where the operations of craftsmen reach their end and are complete, and likewise where they fall short; and have considered moreover which of the failures should be attributed to the craftsmen, and which to the objects on which they practise their craft.
IX. The scope of the other arts shall be discussed at another time and in another discourse; the scope of medicine, the nature of things medical and how they are to be judged, my discourse has or will set forth. Men with an adequate knowledge of this art realize that some, but only a few, diseases have their seat where they can be seen; others, and they are many, have a seat where they cannot be perceived. Those that can be perceived produce eruptions on the skin, or manifest themselves by colour or swelling; for they allow us to perceive by sight or touch their hardness, moistness, heat or cold, and what are the conditions which, by their presence or absence in each case, cause the diseases to be of the nature they are. Of all such diseases in all cases the cures should be infallible, not because they are easy, but because they have been discovered. However, they have not been discovered for those who have desire only, but for those of them who have power; this power belongs to those whose education has been adequate, and whose natural ability is not wretched.
X. Now such being its nature the art must be a match for the open diseases; it ought however not to be helpless before diseases that are more hidden. These are those which are determined to the bones or to the cavities. The body has of these not one but several. There are two that take in food and discharge it, with several others besides these, known to men who are interested in these things; all limbs, in fact, have cavities that are surrounded by the flesh that is called muscle. Everything in fact not a continuous growth, whether it be skin or flesh that covers it, is hollow, and in health is filled with air, in disease with juice.
Such flesh then the arms have, and so have the thighs and the legs. Moreover, in the fleshless parts also there are cavities like those we have shown to be in the fleshy parts. For the trunk, as it is called, in which the liver is covered, the sphere of the head, in which is the brain, the back, by which are the lungs — all these are themselves hollow, being full of interstices, which do not at all fail to be vessels to contain many things, some of which do harm to the possessor and some do good. Moreover, in addition to these there are many veins, and sinews that are not near the surface of the flesh but stretched along the bones, binding the joints to a certain point, and the joints themselves, at which the movable bones meet and turn round. Of these none is not porous; all have cells about them, which are made known by juice, which, when the cells are opened, comes out in great quantity, causing many pains.
XI. Without doubt no man who sees only with his eyes can know anything of what has been here described. It is for this reason that I have called them obscure, even as they have been judged to be by the art. Their obscurity, however, does not mean that they are our masters, but as far as is possible they have been mastered, a possibility limited only by the capacity of the sick to be examined and of researchers to conduct research. More pains, in fact, and quite as much time, are required to know them as if they were seen with the eyes; for what escapes the eyesight is mastered by the eye of the mind, and the sufferings of patients due to their not being quickly observed are the fault, not of the medical attendants, but of the nature of the patient and of the disease. The attendant in fact, as he could neither see the trouble with his eyes nor learn it with his ears, tried to track it by reasoning. Indeed, even the attempted reports of their illnesses made to their attendants by sufferers from obscure diseases are the result of opinion, rather than of knowledge. If indeed they understood their diseases they would never have fallen into them, for the same intelligence is required to know the causes of diseases as to understand how to treat them with all the treatment that prevents illnesses from growing worse. Now when not even the reports afford perfectly reliable information, the attendant must look out for fresh light. For the delay thus caused not the art is to blame, but the constitution of human bodies. For it is only when the art sees its way that it thinks it right to give treatment, considering how it may give it, not by daring but by judgment, not by violence but by gentleness. As to our human constitution, if it admits of being seen, it will also admit of being healed. But if, while the sight is being won, the body is mastered by slowness in calling in the attendant or by the rapidity of the disease, the patient will pass away. For if disease and treatment start together, the disease will not win the race, but it will if it start with an advantage, which advantage is due to the density of our bodies, in which diseases lurk unseen, and to the careless neglect of patients. This advantage is not to be wondered at, as it is only when diseases have established themselves, not while they are doing so, that patients are ready to submit to treatment.
XI. Now the power of the art, when it raises a patient suffering from an obscure disease, is more surprising than its failure when it attempts to treat incurables.... So in the ease of no other craft that has been discovered are such extravagant demands made; those that depend on fire are inoperative when fire is not present, but operative when one has been lighted. And the arts that are worked in materials easy to shape aright, using in some eases wood, in others leather, in others — these form the great majority — paint, bronze, iron and similar substances — the articles wrought, I say, through these arts and with these substances are easily shaped aright, and yet are wrought not so much with a view to speed as to correctness. Nor are they wrought in a casual manner, but functioning ceases if any instrument be lacking. Yet in these arts too slowness is contrary to their interests; but in spite of this it is preferred.
XII. Now medicine, being prevented, in cases of empyema, and of diseased liver, kidneys, and the cavities generally, from seeing with the sight with which all men see everything most perfectly, has nevertheless discovered other means to help it. There is clearness or roughness of the voice, rapidity or slowness of respiration, and for the customary discharges the ways through which they severally pass, sometimes smell, sometimes colour, sometimes thinness or thickness furnishing medicine with the means of inferring, what condition these symptoms indicate, what symptoms mean that a part is already affected and what that a part may hereafter be affected. When this information is not afforded, and nature herself will yield nothing of her own accord, medicine has found means of compulsion, whereby nature is constrained, without being harmed, to give up her secrets; when these are given up she makes clear, to those who know about the art, what course ought to be pursued. The art, for example, forces nature to disperse phlegm by acrid foods and drinks, so that it may form a conclusion by vision concerning those things which before were invisible. Again, when respiration is symptomatic, by uphill roads and by running it compels nature to reveal symptoms. It brings on sweats by the means already stated, and forms the conclusions that are formed through fire when it makes hot water give out steam. There are also certain excretions through the bladder which indicate the disease better than those which come out through the flesh. So medicine has also discovered drinks and foods of such a kind that, becoming wanner than the natural heat, melt the matters 1 spoke of, and make them flow away, which they never would have done without this treatment. Now as the relation between excretions and the information they give is variable, and depends upon a variety of conditions, it is accordingly not surprising that disbelief in this information is prolonged, but treatment is curtailed, for extraneous factors must be used in interpreting the information before it can be utilized by medical intelligence.
XIII. Now that medicine has plentiful reasoning in itself to justify its treatment, and that it would rightly refuse to undertake obstinate cases, or undertaking them would do so without making a mistake, is shown both by the present essay and by the expositions of those versed in the art, expositions set forth in acts, not by attention to words, under the conviction that the multitude find it more natural to believe what they have seen than what they have heard.
Translated by W. H. S. Jones
I. THERE are some arts which to those that possess them are painful, but to those that use them are helpful, a common good to laymen, but to those that practise them grievous. Of such arts there is one which the Greeks call medicine. For the medical man sees terrible sights, touches unpleasant things, and the misfortunes of others bring a harvest of sorrows that are peculiarly his; but the sick by means of the art rid themselves of the worst of evils, disease, suffering, pain and death. For medicine proves for all these evils a manifest cure. And of this art the weak points are difficult to apprehend, while the strong points are more easy; the weak points laymen cannot know, but only those skilled in medicine, as they are matters of the understanding and not of the body. For whenever surgical treatment is called for, training by habituation is necessary, for habit proves the best teacher of the hands; but to judge of the most obscure and difficult diseases is more a matter of opinion than of art, and therein there is the greatest possible difference between experience and inexperience. Now of these obscure matters one is the cause of diseases, what the beginning and source is whence come affections of the body. For knowledge of the cause of a disease will enable one to administer to the body what things are advantageous. Indeed this sort of medicine is quite natural. For example, hunger is a disease, as everything is called a disease which makes a man suffer. What then is the remedy for hunger? That which makes hunger to cease. This is eating; so that by eating must hunger be cured. Again, drink stays thirst; and again repletion is cured by depletion, depletion by repletion, fatigue by rest. To sum up in a single sentence, opposites are cures for opposites. Medicine in fact is substraction and addition, substraction of what is in excess, addition of what is wanting. He who performs these acts best is the best physician; he who is farthest removed therefrom is also farthest removed from the art. These remarks I have made incidentally in passing to the discourse that is to come.
II. Now of all diseases the fashion is the same, but the seat varies. So while diseases are thought to be entirely unlike one another, owing to the difference in their seat, in reality all have one essence and cause. What this cause is I shall try to declare in the discourse that follows.
III. Now bodies, of men and of animals generally, are nourished by three kinds of nourishment, and the names thereof are solid food, drink, and wind. Wind in bodies is called breath, outside bodies it is called air. It is the most powerful of all and in all, and it is worth while examining its power. A breeze is a flowing and a current of air. When therefore much air flows violently, trees are torn up by the roots through the force of the wind, the sea swells into waves, and vessels of vast bulk are tossed about. Such then is the power that it has in these things, but it is invisible to sight, though visible to reason. For what can take place without it? In what is it not present? What does it not accompany? For everything between earth and heaven is full of wind. Wind is the cause of both winter and summer, becoming in winter thick and cold, and in summer gentle and calm. Nay, the progress of sun, moon, and stars is because of wind; for wind is food for fire, and without air fire could not live. Wherefore, too, air being thin causes the life of the sun to be eternal. Nay, it is clear that the sea, too, partakes of wind, for swimming creatures would not be able to live did they not partake of wind. Now how could they partake except by inhaling the air of the water? In fact the earth too is a base for air, and air is a vehicle of the earth, and there is nothing that is empty of air.
IV. How air, then, is strong in the case of wholes has been said; and for mortals too this is the cause of life, and the cause of disease in the sick. So great is the need of wind for all bodies that while a man can be deprived of everything else, both food and drink, for two, three, or more days, and live, yet if the wind passages into the body be cut off he will die in a brief part of a day, showing that the greatest need for a body is wind. Moreover, all other activities of a man are intermittent, for life is full of changes; but breathing is continuous for all mortal creatures, inspiration and expiration being alternate.
V. Now I have said that all animals participate largely in air. So after this I must say that it is likely that maladies occur from this source and from no other. On the subject as a whole I have said sufficient; after this I will by the same reasoning proceed to facts and show that diseases are all the offspring of air.
VI. I will begin in the first place with the most common disease, fever, for this disease is associated with all other diseases. To proceed on these lines, there are two kinds of fevers; one is epidemic, called pestilence, the other is sporadic, attacking those who follow a bad regimen. Both of these fevers, however, are caused by air. Now epidemic fever has this characteristic because all men inhale the same wind; when a similar wind has mingled with all bodies in a similar way, the fevers too prove similar. But perhaps someone will say, “Why then do such diseases attack, not all animals, but only one species of them?” I would reply that it is because one body differs from another, one air from another, one nature from another and one nutriment from another. For all species of animals do not find the same things either well or ill-adapted to themselves, but some things are beneficial to some things and other things to others, and the same is true of things harmful. So whenever the air has been infected with such pollutions as are hostile to the human race, then men fall sick, but when the air has become ill-adapted to some other species of animals, then these fall sick.
VII. Of epidemic diseases I have already spoken, as well as of the victims and of the cause thereof; I must now go on to describe the fever caused by bad regimen. By bad regimen I mean, firstly, the giving of more food, moist or dry, to the body than the body can bear, without counteracting the bulky food by exercise; and, secondly, the taking of foods that are varied and dissimilar. For dissimilar foods disagree, and some are digested quickly and some more slowly. Now along with much food much wind too must enter, for everything that is eaten or drunk is accompanied into the body by wind, either in greater quantity or in less. This is shown by the following fact. After food and drink most people suffer from belching, because the enclosed air rushes upwards when it has broken the bubbles in which it is concealed. When therefore the body is filled full of food, it becomes full of wind too, if the foods remain a long time; and they do remain a long time because owing to their bulk they cannot pass on. The lower belly being thus obstructed, the breaths spread through all the body, and striking the parts of the body that are most full of blood they chill them. These parts being chilled, where are the roots and springs of the blood, a shiver passes through all the body, for when all the blood has been chilled all the body shivers.
VIII. Now this is the reason why shivering occurs before fevers. The character, however, of the rigor depends upon the volume and coldness of the breaths that burst out; from copious and colder breaths come more violent rigor, from less copious and less cold, less violent rigor. The tremors of the body in shivers are caused as follows. The blood, through fear of the shivers that are present, runs together and dashes throughout the body to the warmest parts of it. As the blood leaps from the extremities of the body to the viscera, the sick man shakes. The reason is that some parts of the body become over-full, but others depleted, of blood. Now the depleted parts cannot be still, but shake, because of their being chilled; for the heat has left them. But the over-filled parts tremble because of the quantity of blood; having become great it cannot keep still. Gapes precede fevers because much air gathers together, and, passing upwards in a mass, unbolts the mouth and forces it open, as through it there is an easy passage. For just as copious steam rises from pots when the water boils, even so, as the body grows hot, the air rushes through the mouth compressed and violently carried along. The joints too relax before fevers, because the sinews stretch when they grow warm. But when the greater part of the blood has been massed together, the air that cooled the blood becomes warm again, being overcome by the heat; and when it has become fiery and waterless, it imparts its heat to the whole body. Herein it is aided by the blood, which melts as it grows warm, and wind arises out of it; as the wind strikes the channels of the body, sweat is formed. For the wind when it condenses flows as water, and going through the channels passes on to the surface, just as steam rising from boiling water, should it meet a solid object that it must strike, thickens and condenses, and drops fall away from the lids on which the steam strikes. Headache with fever arises in the following manner. The blood passages in the head become narrowed. The veins in fact are filled with air, and when full and inflated cause the headache; for the hot blood, forcibly forced through the narrow passages, cannot traverse them quickly because of the many hindrances and barriers in the way. This too is the reason why pulsations occur about the temples.
IX. This then is the way fevers are caused, and the pains and illnesses that accompany fever. As to other maladies, ileus and tormina for example, it is obvious, I think, to everybody that they are settlements of breaths, for the medical treatment for such disorders is to draw off some of the wind. For when it strikes against places that are not usually attacked by it, it pierces the flesh like an arrow forcing its way. Sometimes it strikes against the hypochondria, sometimes against the flanks, sometimes against both. It is for this reason that attendants try to soothe the pain by applying hot fomentations to the skin. For by the heat of the fomentation the wind is rarefied and passes through the body, thus affording some relief of the pains.
X. Perhaps it may be objected : “How then do breaths cause fluxes, and in what way is wind the cause of chest hemorrhages?” I think I can show that these too are caused by this agent. When the veins about the head are loaded with air, at first the head becomes heavy through the breaths that press against it. Then the blood is compressed, the passages being unable, on account of their narrowness, to pour it through. The thinnest part of the blood is pressed out through the veins, and when a great accumulation of this liquid has been formed, it moves through other channels. Any part of the body it reaches in a mass becomes the seat of a disease. If it go to the eyes, the pain is there; if it be to the ears, the disease is there. If it go to the chest, it is called sore throat; for phlegm, mixed with acrid humours, produces sores wherever it strikes an unusual spot, and the throat, being soft, is roughened when a flux strikes it. For the wind that is breathed in through the throat passes into the chest, and comes out again through this passage. So when the ascending wind meets the descending flux, a cough comes on, and the phlegm is thrown upwards. This being so the throat becomes sore, rough and hot, and being hot draws the moisture from the head, which passes on to the throat the moisture it receives from the rest of the body.
When therefore the flux has grown used to flowing by this route, and the passages have become channelled, it now spreads even to the chest. Being acrid the phlegm ulcerates the flesh when it strikes it, and bursts open the veins. The extravasated blood rots in course of time and becomes pus, as it can neither ascend nor get away downwards. For a fluid thing cannot easily ascend upwards, and the diaphragm is a barrier to its descent. Why ever then is it that the flux bursts upwards, either spontaneously or through pains? Well, there is a spontaneous flux whenever the air spontaneously enters the veins and makes the channels narrow for the passage of the blood; for on such occasions the blood is compressed because of its volume, and bursts open the passages wherever the pressure is greatest. Whenever excessive pains cause hemorrhage, in these cases also it is wind with which the pains have filled the veins, seeing that any part in pain must retain the wind. Other cases are like those that I have already described.
XI. Lacerations in all cases occur for the following reason. Whenever flesh is violently severed from flesh, and wind slips into the gap, the pain is thereby produced.
XII. If the breaths by passing through the flesh dilate the passages of the body, and these breaths are followed by moisture, the way for which is prepared by the air, then, when the body has become sodden, the flesh melts away and swellings descend to the legs. A disease of this kind is called dropsy. The strongest evidence that breaths cause the disease is the following. Patients already at death’s door in some cases are pumped dry of the water. Now the water appears to come copiously from the cavity at first, becoming less plentiful after a time. Now it is plain that at first the water is full of air, and the air makes it of great bulk. But as the wind goes away the water is left by itself, and so it appears to be less, though the quantity is really equal. These patients furnish another proof, in that when the cavity has been completely emptied, not even three days elapse before they are full again. What then filled them except air? What else could fill them up so quickly? Not drink; for surely so much does not enter the body. Not flesh either; as there does not remain flesh to be dissolved. In fact only bones, sinews and skin are left, from none of which could come any increase of water.
XIII. The cause of dropsy then has been set forth; apoplexy, too, is caused by breaths. For when they pass through the flesh and puff it up, the parts of the body affected lose the power of feeling. So if copious breaths rush through the whole body, the whole patient is affected with apoplexy. If the breaths reach only a part, only that part is affected. If the breaths go away, the disease comes to an end; if they remain, the disease too remains.
VIII. To the same cause I attribute also the disease called sacred. I will try to persuade my hearers by the same arguments as persuaded myself. Now I hold that no constituent of the body in anyone contributes more to intelligence than does blood. So long as the blood remains in its normal condition, intelligence too remains normal; but when the blood alters, the intelligence also changes. There are many testimonies that this is the case. In the first place sleep, which is common to all the animals, witnesses to the truth of my words. When sleep comes upon the body the blood is chilled, as it is of the nature of sleep to cause chill. When the blood is chilled its passages become more sluggish. This is evident; the body grows heavy and sinks (all heavy things naturally fall downwards); the eyes close; the intelligence alters, and certain other fancies linger, which are called dreams. Again, in cases of drunkenness, when the blood has increased in quantity, the soul and the thoughts in the soul change; the ills of the present are forgotten, but there is confidence that the future will be happy.
I could mention many other examples of an alteration in the blood producing an alteration of the intelligence. So if all the blood experience a thorough disturbance, the intelligence is thoroughly destroyed. For learnings and recognitions are matters of habit. So whenever we depart from our wonted habit our intelligence perishes. I hold that the sacred disease is caused in the following way. When much wind has combined throughout the body with all the blood, many barriers arise in many places in the veins. Whenever therefore much air weighs, and continues to weigh, upon the thick, blood-filled veins, the blood is prevented from passing on. So in one place it stops, in another it passes sluggishly, in another more quickly. The progress of the blood through the body proving irregular, all kinds of irregularities occur. The whole body is torn in all directions; the parts of the body are shaken in obedience to the troubling and disturbance of the blood; distortions of every kind occur in every manner. At this time the patients are unconscious of everything — deaf tu what is spoken, blind to what is happening, and insensible to pain. So greatly does a disturbance of the air disturb and pollute the blood. Foam naturally rises through the mouth. For the air, passing through the veins, itself rises and brings up with it the thinnest part of the blood. The moisture, mixing with the air, becomes white, for the air being pure is seen through thin membranes. For this reason the foam appears completely white. When then will the victims of this disease rid themselves of their disorder and the storm that attends it? When the body exercised by its exertions has warmed the blood, and the blood thoroughly warmed has warmed the breaths, and these thoroughly warmed are dispersed, breaking up the congestion of the blood, some going out along with the respiration, others with the phlegm. The disease finally ends when the foam has frothed itself away, the blood has re-established itself, and calm has arisen in the body.
IX. So breaths are seen to be the most active agents during all diseases; all other things are but secondary and subordinate causes. This then as the cause of diseases I have now expounded. I promised to declare the cause of diseases, and I have set forth how wind is lord, not only in things as wholes, but also in the bodies of animals. I have led my discourse on to familiar maladies in which the hypothesis has shown itself correct. If indeed I were to speak of all maladies, my discourse, while being longer, would not be in the least more true or more convincing.
Translated by W. H. S. Jones
I. NOT without reason are those who present as useful for many things wisdom, that is, wisdom applied to life. Most kinds of wisdom, indeed, have manifestly come into being as superfluities; I mean those which confer no advantage upon the objects that they discuss. Parts thereof may be tolerated up to tins point, that where idleness is not neither is there evil. Idleness and lack of occupation tend — nay are dragged — towards evil. Alertness, however, and exercise of the intellect, bring with them something that helps to make life beautiful. I leave out of account mere talk that leads to no useful purpose. More gracious is wisdom that even with some other object has been fashioned into an art, provided that it be an art directed towards decorum and good repute.
II. Any wisdom, in fact, wherein works some scientific method, is honourable if it be not tainted with base love of gain and unseemliness. If they be so tainted, such kinds of wisdom become popular only through impudence. Young men fall in with the devotees thereof; when they are grown up they sweat with shame at the sight of them; when they are old, in their spleen they pass laws to banish these devotees from their cities. These are the very men who go around cities, and gather a crowd about them, deceiving it with cheap vulgarity. You should mark them by their dress, and by the rest of their attire; for even if magnificently adorned, they should much more be shunned and hated by those who behold them.
III. The opposite kind of wisdom one should conceive of thus. No studied preparation, and no over-elaboration. Dress decorous and simple, not over-elaborated, but aiming rather at good repute, and adapted for contemplation, introspection and walking. The several characteristics are: to be serious, artless, sharp in encounters, ready to reply, stubborn in opposition, with those who are of like mind quick-witted and affable, good-tempered towards all, silent in face of disturbances, in the face of silence ready to reason and endure, prepared for an opportunity and quick to take it, knowing how to use food and temperate, patient in waiting for an opportunity, setting out in effectual language everything that has been shown forth, graceful in speech, gracious in disposition, strong in the reputation that these qualities bring, turning to the truth when a thing has been shown to be true.
III. The dominant factor in all the qualities I have mentioned is nature. In fact, if they have natural ability, those engaged in the arts have already made progress in all the qualities mentioned. For in the art, as in wisdom, use is not a thing that can be taught. Before any teaching has taken place nature has rushed down in a flood to make the beginning; it is afterwards that wisdom comes to know the things that are done by nature herself. In fact many, worsted in both words, have in no way used for demonstration both the actual things together. Accordingly, whenever one of them examines in regard to truth something that is being set out in speech, nature will in no way come to their aid. These are found at any rate to have walked in a path similar to that followed by the others. Wherefore being stripped they clothe themselves with the whole of badness and disgrace. For reasoning that comes as the result of work that has been taught is a good thing; for everything that has been done artistically has been performed as the result of reasoning. But when a thing is not done, but only expressed artistically, it indicates method divorced from art. For to hold opinions, without putting them into action, is a sign of want of education and of want of art. For mere opining brings, in medicine most particularly, blame upon those who hold opinions and ruin upon those who make use of them. In fact, if they persuade themselves by word, and opine that they know the work that is the result of education, they SHOW themselves up like gold proved by fire to be dross. And yet such a forecast is something inexorable. Where understanding is on a par with action, knowledge at once makes plain the end. In some cases time has put the art on the right track, or has made clear the means of approach to those who have chanced upon the like route.
IV. Wherefore resume each of the points mentioned, and transplant wisdom into medicine and medicine into wisdom. For a physician who is a lover of wisdom is the equal of a god. Between wisdom and medicine there is no gulf fixed; in fact medicine possesses all the qualities that make for wisdom. It has disinterestedness, shamefastness, modesty, reserve, sound opinion, judgment, quiet, pugnacity, purity, sententious speech, knowledge of the things good and necessary for life, selling of that which cleanses, freedom from superstition, pre-excellence divine. What they have, they have in opposition to intemperance, vulgarity, greed, concupiscence, robbery, shamelessness. This is knowledge of one’s income, use of what conduces to friendship, the way and manner to be adopted towards one’s children and money. Now with medicine a kind of wisdom is an associate, seeing that the physician has both these things and indeed most things.
VI. In fact it is especially knowledge of the gods that by medicine is woven into the stuff of the mind. For in affections generally, and especially in accidents, medicine is found mostly to be held in honour by the gods. Physicians have given place to the gods. For in medicine that which is powerful is not in excess. In fact, though physicians take many things in hand, many diseases are also overcome for them spontaneously. All that medicine has now mastered it will supply thence. The gods are the real physicians, though people do not think so. But the truth of this statement is shown by the phenomena of disease, which are co-extensive with the whole of medicine, changing in form or in quality, sometimes being cured by surgery, sometimes being relieved, either through treatment or through regimen. The information I have given on these matters must serve as a summary.
VII. As all I have said is true, the physician must have at his command a certain ready wit, as dourness is repulsive both to the healthy and to the sick. He must also keep a most careful watch over himself, and neither expose much of his person nor gossip to laymen, but say only what is absolutely necessary. For he realizes that gossip may cause criticism of his treatment. He will do none at all of these things in a way that savours of fuss or of show. Let all these things be thought out, so that they may be ready beforehand for use as required. Otherwise there must always be lack when need arises.
VIII. You must practise these things in medicine with all reserve, in the matter of palpation, anointing, washing, to ensure elegance in moving the hands, in the matter of lint, compresses, bandages, ventilation, purges, for wounds and eye-troubles, and with regard to the various kinds of these things, in order that you may have ready beforehand instruments, appliances, knives and so forth. For lack in these matters means helplessness and harm. See that you have a second physician’s case, of simpler make, that you can carry in your hands when on a journey. The most convenient is one methodically arranged, for the physician cannot possibly go through everything.
IX. Keep well in your memory drugs and their properties, both simple and compound, seeing that after all it is in the mind that are also the cures of diseases; remember their modes, and their number and variety in the several cases. This in medicine is beginning, middle and end.
X. You must have prepared in advance emollients classified according to their various uses, and get ready powerful draughts prepared according to formula after their various kinds. You must make ready beforehand purgative medicines also, taken from suitable localities, prepared in the proper manner, after their various kinds and sizes, some preserved so as to last a long time, others fresh to be used at the time, and similarly with the rest.
VII. When you enter a sick man’s room, having made these arrangements, that you may not be at a loss, and having everything in order for what is to be done, know what you must do before going in.
For many cases need, not reasoning, but practical help. So you must from your experience forecast what the issue will be. To do so adds to one’s reputation, and the learning thereof is easy.
VIII. On entering bear in mind your manner of sitting, reserve, arrangement of dress, decisive utterance, brevity of speech, composure, bedside manners, care, replies to objections, calm self-control to meet the troubles that occur, rebuke of disturbance, readiness to do what has to be done. In addition to these things be careful of your first preparation. Failing this, make no further mistake in the matters wherefrom instructions are given for readiness XIII. Make frequent visits; be especially careful in your examinations, counteracting the things wherein you have been deceived at the changes. Thus you will know the case more easily, and at the same time you will also be more at your ease. For instability is characteristic of the humours, and so they may also be easily altered by nature and by chance. For failure to observe the proper season for help gives the disease a start and kills the patient, as there was nothing to relieve him.
For when many things together produce a result there is difficulty. Sequences of single phenomena are more manageable, and are more easily learnt by experience.
XIV. Keep a watch also on the faults of the patients, which often make them lie about the taking of things prescribed. For through not taking disagreeable drinks, purgative or other, they sometimes die. What they have done never results in a confession, but the blame is thrown upon the physician.
XV. The bed also must be considered. The season and the kind of illness will make a difference. Some patients are put into breezy spots, others into covered places or underground. Consider also noises and smells, especially the smell of wine. This is distinctly bad, and you must shun it or change it.
XVI. Perform all this calmly and adroitly, concealing most things from the patient while you are attending to him. Give necessary orders with cheerfulness and serenity, turning his attention away from what is being done to him; sometimes reprove sharply and emphatically, and sometimes comfort with solicitude and attention, revealing nothing of the patient’s future or present condition. For many patients through this cause have taken a turn for the worse, 1 mean by the declaration I have mentioned of what is present, or by a forecast of what is to come.
XI. Let one of your pupils be left in charge, to carry out instructions without unpleasantness, and to administer the treatment. Choose out those who have been already admitted into the mysteries of the art, so as to add anything necessary, and to give treatment with safety. He is there also to prevent those things escaping notice that happen in the intervals between visits. Never put a layman in charge of anything, otherwise if a mischance occur the blame will fall on you. Let there never be any doubt about the points which will secure the success of your plan, and no blame will attach to you, but achievement will bring you pride. So say beforehand all this at the time the things are done, to those whose business it is to have fuller knowledge of the parts about which I have spoken, wrap himself round always with the other, watch it and keep it, perform it and pass it on. For things that are glorious are closely guarded among all men. And those who have made their way through them are held in honour by parents and children; and if any of them do not know many things, they are brought to understanding by the facts of actual experience.
Translated by W. H. S. Jones
THE dignity of a physician requires that he should look healthy, and as plump as nature intended him to be; for the common crowd consider those -who are not of this excellent bodily condition to be unable to take care of others. Then he must be clean in person, well dressed, and anointed with sweet-smelling unguents that are not in any way suspicious. This, in fact, is pleasing to patients. The prudent man must also be careful of certain moral considerations — not only to be silent, but also of a great regularity of life, since thereby his reputation will be greatly enhanced; he must be a gentleman in character, and being this he must be grave and kind to all. For an over-forward obtrusiveness is despised, even though it may be very useful. Let him look to the liberty of action that is his; for when the same things are rarely presented to the same persons there is content. In appearance, let him be of a serious but not harsh countenance; for harshness is taken to mean arrogance and unkindness, while a man of uncontrolled laughter and excessive gaiety is considered vulgar, and vulgarity especially must be avoided. In every social relation he will be fair, for fairness must be of great service. The intimacy also between physician and patient is close. Patients in fact put themselves into the hands of their physician, and at every moment he meets women, maidens and possessions very precious indeed. So towards all these self-control must be used. Such then should the physician be, both in body and in soul.
Translated by W. H. S. Jones
I. CHILDREN who are naturally well-nourished do not suck milk in proportion to their fleshiness.
II. Children with voracious appetites, and who suck much milk do not put on flesh in proportion.
III. Of sucking children those that pass much urine are the least subject to vomiting.
IV. Children that pass copious stools and have good digestion are the more healthy; those that pass stools scantily, and with voracious appetites are not nourished in proportion, are unhealthy.
V. Those that vomit copiously milky matters suffer from constipation.
VI. Those who while teething have their bowels moved often are less subject to convulsions than those who have them moved seldom.
VII. Those who while teething are attacked by acute fever seldom suffer from convulsions.
VIII. Those who while teething are lethargic while remaining well-nourished run a risk of being seized with convulsions.
IX. Those who teethe in winter, other things being equal, come off better.
X. Not all children die that are seized with convulsions while teething; many recover.
XI. Teething is protracted when complicated with a cough, and emaciation in such cases is excessive while the teeth are coming through.
XII. Children who have a troublesome time while teething, if they are suitably attended to, bear up more easily against teething.
XIII. Those that pass more urine than faeces are proportionately better nourished.
XIV. Those who do not pass urine in proportion, but from babyhood discharge undigested food frequently, are unhealthy.
XV. Children who sleep well, and are well- nourished, may take a great deal of food, even though it is placed before them insufficiently prepared for digestion.
XVI. Those that eat solid food while being suckled bear weaning more easily.
XVII. Those that often pass stools of undigested food mixed with blood, the great majority of them when feverish are drowsy.
XVIII. Ulcers on the tonsils that come without fever are less dangerous.
XIX. Babies that are attacked by a cough while being suckled usually have an enlarged uvula.
XX. When corroding sores form quickly on the tonsils, the fevers and coughs remaining, there is a danger of ulcerations occurring again.
XXI. Ulcerations that recur on the tonsils are dangerous.
XXII. When children have considerable ulceration of the tonsils, if they can drink, it is a sign that they may recover, the more so if they could not drink before.
XXIII. In cases of ulcerated tonsils, to vomit bilious matters, or to evacuate them by stools, is attended with danger.
XXIV. In cases of ulcerated tonsils, the formation of a membrane like a spider’s web is not a good sign.
XXV. In cases of ulcerated tonsils, after the first periods it is useful for phlegm to flow from the mouth, which before did not do so; nevertheless it must be brought up. If the symptoms begin to disappear, is altogether a welcome sign. If the phlegm does not flow in this way, you must be careful.
XVIII. When there is a discharge on the tonsils, in most cases dry coughs are resolved by evacuation through the bowels; with children most cases are resolved by the vomiting of concocted matters.
XIX. Ulcerations on the tonsils, that remain for a long time without increasing, are not attended with danger before five or six days.
XX. Children at the breast that take much milk are generally drowsy.
XXI. Children at the breast that are ill nourished also pick up strength with difficulty.
XXII. Ulcerated tonsils that occur in summer are worse than those that occur at other seasons, for they spread more rapidly.
XXIII. Ulcers on the tonsils that spread over the uvula alter the voice of those who recover.
XXXII Ulcers that spread about the throat are more serious and acute, as they generally bring on difficulty of breathing.
Thessaly, near Larissa — Hippocrates taught and practiced medicine throughout his life, travelling to Thessaly in his final years.
In this section of the eBook, readers can view the original Greek texts of Hippocrates’ works. You may wish to Bookmark this page for future reference.
CONTENTS
ON ANCIENT MEDICINE - Περὶ ἀρχαίας ἰητρικῆς
EPIDEMICS I AND III - Ἐπιδημιών
ON REGIMEN IN ACUTE DISEASES - Περὶ διαίτης ὀξέων
ON AIRS, WATERS, AND PLACES - Περὶ ἀέρων, ὑδάτων, τόπων
ON THE ARTICULATIONS - Περὶ ἄρθρων
ON THE INSTRUMENTS OF REDUCTION - Μοχλικός
ON INJURIES OF THE HEAD - Περὶ τῶν ἐν κεφαλῇ τρωμάτων
THE HIPPOCRATIC OATH - Ιπποκράτειος Όρκος
THE PHYSICIAN’S ESTABLISHMENT - Κατ’ ἰητρεῖον
ON ANCIENT MEDICINE - Περὶ ἀρχαίας ἰητρικῆς
1. Ὁπόσοι μὲν ἐπεχείρησαν περὶ ἰητρικῆς λέγειν ἢ γράφειν, ὑπόθεσιν αὐτοὶ αὐτοῖς ὑποθέμενοι τῷ λόγῳ, θερμὸν ἢ ψυχρὸν ἢ ὑγρὸν ἢ ξηρὸν ἢ ἄλλο τι ὃ ἂν θέλωσιν, ἐς βραχὺ ἄγοντες τὴν ἀρχὴν τῆς αἰτίης τοῖσι ἀνθρώποισι νούσων τε καὶ θανάτου, καὶ πᾶσι τὴν αὐτήν, ἓν ἢ δύο ὑποθέμενοι, ἐν πολλοῖσι μὲν καὶ οἷσι λέγουσι καταφανέες εἰσὶ ἁμαρτάνοντες, μάλιστα δὲ ἄξιον μέμψασθαι, ὅτι ἀμφὶ τέχνης ἐούσης, ᾗ χρέονταί τε πάντες ἐπὶ τοῖσι μεγίστοισι καὶ τιμῶσι μάλιστα τοὺς ἀγαθοὺς χειροτέχνας καὶ δημιουργούς. εἰσὶν δὲ δημιουργοὶ οἱ μὲν φαῦλοι, οἱ δὲ πολλὸν διαφέροντες: ὅπερ, εἰ μὴ ἦν ἰητρικὴ ὅλως, μηδ᾽ ἐν αὐτῇ ἔσκεπτο μηδ᾽ εὕρητο μηδέν, οὐκ ἂν ἦν, ἀλλὰ πάντες ὁμοίως αὐτῆς ἄπειροί τε καὶ ἀνεπιστήμονες ἦσαν, τύχῃ δ᾽ ἂν πάντα τὰ τῶν καμνόντων διοικεῖτο. νῦν δ᾽ οὐχ οὕτως ἔχει, ἀλλ᾽ ὥσπερ καὶ τῶν ἄλλων τεχνέων πασέων οἱ δημιουργοὶ πολλὸν ἀλλήλων διαφέρουσιν κατὰ χεῖρα καὶ κατὰ γνώμην, οὕτω δὲ καὶ ἐπὶ ἰητρικῆς. διὸ οὐκ ἠξίουν αὐτὴν ἔγωγε κενῆς ὑποθέσιος δεῖσθαι ὥσπερ τὰ ἀφανέα τε καὶ ἀπορεόμενα, περὶ ὧν ἀνάγκη, ἤν τις ἐπιχειρῇ τι λέγειν, ὑποθέσει χρῆσθαι, οἷον περὶ τῶν μετεώρων ἢ τῶν ὑπὸ γῆν: ἃ εἴ τις λέγοι καὶ γινώσκοι ὡς ἔχει, οὔτ᾽ ἂν αὐτῷ τῷ λέγοντι οὔτε τοῖς ἀκούουσι δῆλα ἂν εἴη, εἴτε ἀληθέα ἐστὶν εἴτε μή. οὐ γὰρ ἔστι πρὸς ὅ τι χρὴ ἀνενέγκαντα εἰδέναι τὸ σαφές.
2. Ἰητρικῇ δὲ πάλαι πάντα ὑπάρχει, καὶ ἀρχὴ καὶ ὁδὸς εὑρημένη, καθ᾽ ἣν τὰ εὑρημένα πολλά τε καὶ καλῶς ἔχοντα εὕρηται ἐν πολλῷ χρόνῳ, καὶ τὰ λοιπὰ εὑρεθήσεται, ἤν τις ἱκανός τε ἐὼν καὶ τὰ εὑρημένα εἰδὼς ἐκ τούτων ὁρμώμενος ζητῇ. ὅστις δὲ ταῦτα ἀποβαλὼν καὶ ἀποδοκιμάσας πάντα, ἑτέρῃ ὁδῷ καὶ ἑτέρῳ σχήματι ἐπιχειρεῖ ζητεῖν, καί φησί τι ἐξευρηκέναι, ἐξηπάτηται καὶ ἐξαπατᾶται: ἀδύνατον γάρ: δι᾽ ἃς δὲ ἀνάγκας ἀδύνατον, ἐγὼ πειρήσομαι ἐπιδεῖξαι, λέγων καὶ ἐπιδεικνύων τὴν τέχνην ὅ τι ἐστίν. ἐκ δὲ τούτου καταφανὲς ἔσται ἀδύνατα ἐόντα ἄλλως πως τούτων εὑρίσκεσθαι. μάλιστα δέ μοι δοκεῖ περὶ ταύτης δεῖν λέγοντα τῆς τέχνης γνωστὰ λέγειν τοῖσι δημότῃσι. οὐ γὰρ περὶ ἄλλων τινῶν οὔτε ζητεῖν οὔτε λέγειν προσήκει ἢ περὶ τῶν παθημάτων ὧν αὐτοὶ οὗτοι νοσεουσί τε καὶ πονέουσι. αὐτοὺς μὲν οὖν τὰ σφέων αὐτῶν παθήματα καταμαθεῖν, ὡς γίνεται καὶ παύεται καὶ δι᾽ οἵας προφάσιας αὔξεταί τε καὶ φθίνει, δημότας ἐόντας οὐ ῥηίδιον: ὑπ᾽ ἄλλου δὲ εὑρημένα καὶ λεγόμενα, εὐπετές. οὐδὲν γὰρ ἕτερον ἢ ἀναμιμνήσκεται ἕκαστος ἀκούων τῶν αὐτῷ συμβαινόντων. εἰ δέ τις τῆς τῶν ἰδιωτέων γνώμης ἀποτεύξεται καὶ μὴ διαθήσει τοὺς ἀκούοντας οὕτως, τοῦ ἐόντος ἀποτεύξεται. καὶ διὰ ταῦτα οὖν ταῦτα οὐδὲν δεῖ ὑποθέσιος.
3. Τὴν γὰρ ἀρχὴν οὔτ᾽ ἂν εὑρέθη ἡ τέχνη ἡ ἰητρικὴ οὔτ᾽ ἂν ἐζητήθη — οὐδὲν γὰρ αὐτῆς ἔδει-εἰ τοῖσι κάμνουσι τῶν ἀνθρώπων τὰ αὐτὰ διαιτωμένοισί τε καὶ προσφερομένοισι, ἅπερ οἱ ὑγιαίνοντες ἐσθίουσί τε καὶ πίνουσι καὶ τἄλλα διαιτέονται, συνέφερεν, καὶ μὴ ἦν ἕτερα τούτων βελτίω. νῦν δὲ αὐτὴ ἡ ἀνάγκη ἰητρικὴν ἐποίησεν ζητηθῆναί τε καὶ εὑρεθῆναι ἀνθρώποισι, ὅτι τοῖσι κάμνουσι ταὐτὰ προσφερομένοισι, ἅπερ οἱ ὑγιαίνοντες, οὐ συνέφερεν, ὡς οὐδὲ νῦν συμφέρει. ἔτι δὲ ἄνωθεν ἔγωγε ἀξιῶ οὐδ᾽ ἂν τὴν τῶν ὑγιαινόντων δίαιτάν τε καὶ τροφήν, ᾗ νῦν χρέονται, εὑρεθῆναι, εἰ ἐξήρκει τῷ ἀνθρώπῳ ταὐτὰ ἐσθίοντι καὶ πίνοντι βοΐ τε καὶ ἵππῳ καὶ πᾶσιν ἐκτὸς ἀνθρώπου, οἷον τὰ ἐκ τῆς γῆς φυόμενα, καρπούς τε καὶ ὕληνν καὶ χόρτον. ἀπὸ τούτων γὰρ καὶ τρέφονται καὶ αὔξονται καὶ ἄπονοι διάγουσιν οὐδὲν προσδεόμενοι ἄλλης διαίτης. καί τοι τήν γε ἀρχὴν ἔγωγε δοκέω καὶ τὸν ἄνθρωπον τοιαύτῃ τροφῇ κεχρῆσθαι. τὰ δὲ νῦν διαιτήματα εὑρημένα καὶ τετεχνημένα ἐν πολλῷ χρόνῳ γεγενῆσθαί μοι δοκεῖ. ὡς γὰρ ἔπασχον πολλά τε καὶ δεινὰ ὑπὸ ἰσχυρῆς τε καὶ θηριώδεος διαίτης ὠμά τε καὶ ἄκρητα καὶ μεγάλας δυνάμιας ἔχοντα ἐσφερόμενοι. οἷά περ ἂν καὶ νῦν ὑπ᾽ αὐτῶν πάσχοιεν πόνοισί τε ἰσχυροῖσι καὶ νούσοις περιπίπτοντες καὶ διὰ τάχεος θανάτοισι. ἧσσον μὲν οὖν ταῦτα τότε εἰκὸς ἦν πάσχειν διὰ τὴν συνήθειαν, ἰσχυρῶς δὲ καὶ τότε. καὶ τοὺς μὲν πλείστους τε καὶ ἀσθενεστέρην φύσιν ἔχοντας ἀπόλλυσθαι εἰκός, τοὺς δὲ τούτων ὑπερέχοντας πλείω χρόνον ἀντέχειν: ὥσπερ καὶ νῦν ἀπὸ τῶν ἰσχυρῶν βρωμάτων οἱ μὲν ῥηϊδίως ἀπαλλάσσονται, οἱ δὲ μετὰ πολλῶν πόνων τε καὶ κακῶν. διὰ δὴ ταύτην τὴν αἰτίην καὶ οὗτοί μοι δοκέουσι ζητῆσαι τροφὴν ἁρμόζουσαν τῇ φύσει καὶ εὑρεῖν ταύτην, ᾗ νῦν χρεώμεθα. ἐκ μὲν οὖν τῶν πυρῶν βρέξαντές σφας καὶ πτίσαντες καὶ καταλέσαντές τε καὶ διασήσαντες καὶ φορύξαντες καὶ ὀπτήσαντες ἀπετέλεσαν ἄρτον, ἐκ δὲ τῶν κριθέων μᾶζαν: ἄλλα τε πολλὰ περὶ ταῦτα πρηγματευσάμενοι ἥψησάν τε καὶ ὤπτησαν καὶ ἔμιξαν, καὶ ἐκέρασαν τὰ ἰσχυρά τε καὶ ἄκρητα τοῖς ἀσθενεστέροις, πλάσσοντες πάντα πρὸς τὴν τοῦ ἀνθρώπου φύσιν τε καὶ δύναμιν, ἡγεύμενοι, ὅσα μὲν ἂν ἰσχυρότερα ᾖ ἢ δυνήσεται κρατεῖν ἡ φύσις, ἢν ἐμφέρηται, ἀπὸ τούτων δ᾽ αὐτῶν πόνους τε καὶ νούσους καὶ θανάτους ἔσεσθαι, ὁπόσων δ᾽ ἂν δύνηται ἐπικρατεῖν, ἀπὸ τούτων τροφήν τε καὶ αὔξησιν καὶ ὑγιείην. τῷ δὲ εὑρήματι τούτῳ καὶ ζητήματι τί ἄν τις ὄνομα δικαιότερον ἢ προσῆκον μᾶλλον θείη ἢ ἰητρικήν; ὅτι γε εὕρηται ἐπὶ τῇ τοῦ ἀνθρώπου ὑγιείῃ τε καὶ σωτηρίῃ καὶ τροφῇ, ἄλλαγμα ἐκείνης τῆς διαίτης, ἐξ ἧς οἱ πόνοι καὶ νοῦσοι καὶ θάνατοι ἐγίνοντο.
4. Εἰ δὲ μὴ τέχνη αὕτη νομίζεται εἶναι, οὐκ ἀπεοικός: ἧς γὰρ μηδείς ἐστιν ἰδιώτης, ἀλλὰ πάντες ἐπιστήμονες διὰ τὴν χρῆσίν τε καὶ ἀνάγκην, οὐ προσήκει ταύτης οὐδένα τεχνίτην καλεῖσθαι: ἐπεὶ τό γε εὕρημα μέγα τε καὶ πολλῆς σκέψιος τε καὶ τέχνης. ἔτι γοῦν καὶ νῦν οἱ τῶν γυμνασίων τε καὶ ἀσκησίων ἐπιμελόμενοι αἰεί τι προσεξευρίσκουσιν κατὰ τὴν αὐτὴν ὁδὸν ζητέοντες ὅ τι ἐσθίων τε καὶ πίνων ἐπικρατήσει τε αὐτοῦ μάλιστα καὶ ἰσχυρότερος αὐτὸς ἑωυτοῦ ἔσται.
5. Σκεψώμεθα δὲ καὶ τὴν ὁμολογεομένως ἰητρικήν, τὴν ἀμφὶ τοὺς κάμνοντας εὑρημένην, ἣ καὶ ὄνομα καὶ τεχνίτας ἔχει, ἦρά τι καὶ αὐτὴ τῶν αὐτῶν ἐθέλει, καὶ πόθεν ποτὲ ἦρκται. ἐμοὶ μὲν γάρ, ὅπερ ἐν ἀρχῇ εἶπον, οὐδ᾽ ἂν ζητῆσαι ἰητρικὴν δοκεῖ οὐδείς, εἰ ταὐτὰ διαιτήματα τοῖσί τε κάμνουσι καὶ τοῖσι ὑγιαίνουσιν ἥρμοζεν. ἔτι γοῦν καὶ νῦν ὅσοι ἰητρικῇ μὴ χρέονται, οἵ τε βάρβαροι καὶ τῶν Ἑλλήνων ἔνιοι, τὸν αὐτὸν τρόπον, ὅνπερ οἱ ὑγιαίνοντες, διαιτέονται πρὸς ἡδονήν, καὶ οὔτ᾽ ἂν ἀπόσχοιντο οὐδενὸς ὧν ἐπιθυμέουσιν οὔθ᾽ ὑποστείλαιντο ἄν. οἱ δὲ ζητήσαντες καὶ εὑρόντες ἰητρικὴν τὴν αὐτὴν ἐκείνοισι διάνοιαν ἔχοντες, περὶ ὧν μοι ὁ πρότερος λόγος εἴρηται, πρῶτον μέν, οἶμαι, ὑφεῖλον τοῦ πλήθεος τῶν σιτίων αὐτῶν τούτων, καὶ ἀντὶ πλειόνων ὀλίγιστα ἐποίησαν. ἐπεὶ δὲ αὐτοῖσι τοῦτο ἔστι μὲν ὅτε πρός τινας τῶν καμνόντων ἤρκεσε καὶ φανερὸν ἐγένετο ὠφελῆσαν, οὐ μέντοι πᾶσί γε, ἀλλ᾽ ἦσάν τινες οὕτως ἔχοντες, ὡς μὴ ὀλίγων σιτίων δύνασθαι ἐπικρατεῖν, ἀσθενεστέρου δὲ δή τινος οἱ τοιοίδε ἐδόκεον δεῖσθαι, εὗρον τὰ ῥυφήματα μίξαντες ὀλίγα τῶν ἰσχυρῶν πολλῷ τῷ ὕδατι καὶ ἀφαιρεόμενοι τὸ ἰσχυρὸν τῇ κρήσει τε καὶ ἑψήσει. ὅσοι δὲ μηδὲ τῶν ῥυφημάτων ἐδύναντο ἐπικρατεῖν, ἀφεῖλον καὶ ταῦτα, καὶ ἀφίκοντο ἐς πόματα, καὶ ταῦτα τῇσι τε κρήσεσι καὶ τῷ πλήθει διαφυλάσσοντες ὡς μετρίως ἔχοι, μήτε πλείω τῶν δεόντων μήτε ἀκρη τέστερα προσφερόμενοι μηδὲ ἐνδεέστερα.
6. Εὖ δὲ χρὴ τοῦτο εἰδέναι, ὅτι τισὶ τὰ ῥυφήματα ἐν τῇσι νούσοισιν οὐ συμφέρει, ἀλλ᾽ ἄντικρυς, ὅταν ταῦτα προσαίρωνται, παροξύνονταί σφισι οἵ τε πυρετοὶ καὶ τὰ ἀλγήματα: καὶ δῆλον τὸ προσενεχθὲν τῇ μὲν νούσῳ τροφή τε καὶ αὔξησις γενόμενον, τῷ δὲ σώματι φθίσις τε καὶ ἀρρωστίη. ὅσοι δὲ ἂν τῶν ἀνθρώπων ἐν ταύτῃ τῇ διαθέσει ἐόντες προσενέγκωνται ξηρὸν σιτίον ἢ μᾶζαν ἢ ἄρτον, καὶ ἢν πάνυ σμικρόν, δεκαπλασίως ἂν μᾶλλον καὶ ἐπιφανέστερον κακωθεῖεν ἢ ῥυφέοντες, δι᾽ οὐδὲν ἄλλο ἢ διὰ τὴν ἰσχὺν τοῦ βρώματος πρὸς τὴν διάθεσιν: καὶ ὅτῳ ῥυφεῖν μὲν συμφέρει, ἐσθίειν δ᾽ οὔ, εἰ πλείω φάγοι, πολὺ ἂν μᾶλλον κακωθείη, ἢ εἰ ὀλίγα: καὶ εἰ ὀλίγα δέ, πονήσειεν ἄν. πάντα δὴ τὰ αἴτια τοῦ πόνου ἐς τὸ αὐτὸ ἀνάγεται, τὰ ἰσχυρότατα μάλιστά τε καὶ ἐπιφανέστατα λυμαίνεσθαι τὸν ἄνθρωπον καὶ τὸν ὑγιᾶ ἐόντα καὶ τὸν κάμνοντα.
7. Τί οὖν φαίνεται ἑτεροῖον διανοηθεὶς ὁ καλεύμενος ἰητρὸς καὶ ὁμολογεομένως χειροτέχνης, ὃς ἐξεῦρε τὴν ἀμφὶ τοὺς κάμνοντας δίαιτάν τε καὶ τροφήν, ἢ ἐκεῖνος ὁ ἀπ᾽ ἀρχῆς τοῖσι πᾶσιν ἀνθρώποισιν τροφήν, ᾗ νῦν χρώμεθα, ἐξ ἐκείνης τῆς ἀγρίης τε καὶ θηριώδεος διαίτης εὑρών τε καὶ παρασκευασάμενος; ἐμοὶ μὲν γὰρ φαίνεται ὁ αὐτὸς λόγος καὶ ἓν καὶ ὅμοιον τὸ εὕρημα. ὁ μέν, ὅσων μὴ ἐδύνατο ἡ φύσις ἡ ἀνθρωπίνη ὑγιαίνουσα ἐπικρατεῖν ἐμπιπτόντων διὰ τὴν θηριότητά τε καὶ τὴν ἀκρησίην, ὁ δέ, ὅσων ἡ διάθεσις, ἐν οἵῃ ἂν ἑκάστοτε ἕκαστος τύχῃ διακείμενος, μὴ δύνηται ἐπικρατεῖν, ταῦτα ἐζήτησεν ἀφελεῖν. τί δὴ τοῦτο ἐκείνου διαφέρει ἀλλ᾽ ἢ πλέον τό γε εἶδος, καὶ ὅτι ποικιλώτερον καὶ πλείονος πρηγματίης, ἀρχὴ δὲ ἐκείνη ἡ πρότερον γενομένη;
8. Εἰ δέ τις σκέπτοιτο τὴν τῶν καμνόντων δίαιταν πρὸς τὴν τῶν ὑγιαινόντων, εὕροι ἂν τὴν τῶν θηρίων τε καὶ τῶν ἄλλων ζῴων οὐ βλαβερωτέρην πρὸς τὴν τῶν ὑγιαινόντων. ἀνὴρ γὰρ κάμνων νοσήματι μήτε τῶν χαλεπῶν τε καὶ ἀπόρων μήτε αὖ τῶν παντάπασιν εὐηθέων, ἀλλ᾽ ὅ τι αὐτῷ ἐξαμαρτάνοντι μέλλει ἐπίδηλον ἔσεσθαι, εἰ ἐθέλοι καταφαγεῖν ἄρτον καὶ κρέας ἢ ἄλλο τι ὧν οἱ ὑγιαίνοντες ἐσθίοντες ὠφελέονται, μὴ πολλόν, ἀλλὰ πολλῷ ἔλασσον ἢ ὑγιαίνων ἂν ἐδύνατο, ἄλλος τε τῶν ὑγιαινόντων φύσιν ἔχων μήτε παντάπασιν ἀσθενέα μήτε αὖ ἰσχυρὴν φάγοι τι ὧν βοῦς ἢ ἵππος φαγὼν ἂν ὠφελοῖτό τε καὶ ἰσχύοι, ὀρόβους ἢ κριθὰς ἢ ἄλλο τι τῶν τοιούτων, μὴ πολύ, ἀλλὰ πολλῷ μεῖον ἢ δύναιτο, οὐκ ἂν ἧσσον ὁ ὑγιαίνων τοῦτο ποιήσας πονήσειέ τε καὶ κινδυνεύσειε κείνου τοῦ νοσέοντος, ὃς τὸν ἄρτον ἢ τὴν μᾶζαν ἀκαίρως προσηνέγκατο. ταῦτα δὴ πάντα τεκμήρια, ὅτι αὕτη ἡ τέχνη πᾶσα ἡ ἰητρικὴ τῇ αὐτῇ ὁδῷ ζητεομένη εὑρίσκοιτο ἄν.
9. Καὶ εἰ μὲν ἦν ἁπλοῦν, ὥσπερ ὑφήγητο, ὅσα μὲν ἦν ἰσχυρότερα, ἔβλαπτεν, ὅσα δ᾽ ἦν ἀσθενέστερα, ὠφέλει τε καὶ ἔτρεφεν καὶ τὸν κάμνοντα καὶ τὸν ὑγιαίνοντα, εὐπετὲς ἂν ἦν τὸ πρῆγμα: πολλὸν γὰρ τοῦ ἀσφαλέος ἂν ἔδει περιλαμβάνοντας ἄγειν ἐπὶ τὸ ἀσθενέστερον. νῦν δὲ οὐκ ἔλασσον ἁμάρτημα, οὐδὲ ἧσσον λυμαίνεται τὸν ἄνθρωπον, ἢν ἐλάσσονα καὶ ἐνδεέστερα τῶν ἱκανῶν προσφέρηται. τὸ γὰρ τοῦ λιμοῦ μένος δύνα ται ἰσχυρῶς ἐν τῇ φύσει τοῦ ἀνθρώπου καὶ γυιῶσαι καὶ ἀσθενέα ποιῆσαι καὶ ἀποκτεῖναι. πολλὰ δὲ καὶ ἄλλα κακὰ ἑτεροῖα τῶν ἀπὸ πληρώσιος, οὐχ ἧσσον δὲ δεινά, καὶ ἀπὸ κενώσιος. διότι πολλὸν ποικιλώτερά τε καὶ διὰ πλείονος ἀκριβείης ἐστί. δεῖ γὰρ μέτρου τινὸς στοχάσασθαι. μέτρον δὲ οὔτε ἀριθμὸν οὔτε σταθμὸν ἄλλον, πρὸς ὃ ἀναφέρων εἴσῃ τὸ ἀκριβές, οὐκ ἂν εὕροις ἀλλ᾽ ἢ τοῦ σώματος τὴν αἴσθησιν. διὸ ἔργον οὕτω καταμαθεῖν ἀκριβέως, ὥστε σμικρὰ ἁμαρτάνειν ἔνθα ἢ ἔνθα. κἂν ἐγὼ τοῦτον τὸν ἰητρὸν ἰσχυρῶς ἐπαινέοιμι τὸν σμικρὰ ἁμαρτάνοντα. τὸ δὲ ἀτρεκὲς ὀλιγάκις ἔστι κατιδεῖν. ἐπεὶ οἱ πολλοί γε τῶν ἰητρῶν τὰ αὐτά μοι δοκέουσιν τοῖσι κακοῖσι κυβερνήτῃσι πάσχειν. καὶ γὰρ ἐκεῖνοι ὅταν ἐν γαλήνῃ κυβερνῶντες ἁμαρτάνωσιν, οὐ καταφανέες εἰσίν: ὅταν δὲ αὐτοὺς κατάσχῃ χειμών τε μέγας καὶ ἄνεμος ἐξώστης, φανερῶς πᾶσιν ἤδη ἀνθρώποις δι᾽ ἀγνωσίην καὶ ἁμαρτίην δῆλοί εἰσιν ἀπολέσαντες τὴν ναῦν. οὕτω δὴ καὶ οἱ κακοί τε καὶ οἱ πλεῖστοι ἰητροί, ὅταν μὲν θεραπεύωσιν ἀνθρώπους μηδὲν δεινὸν ἔχοντας, ἐς οὓς ἄν τις τὰ μέγιστα ἐξαμαρτάνων οὐδὲν δεινὸν ἐργάσαιτο-πολλὰ δὲ τοιαῦτα νοσήματα καὶ πολλόν τι πλείω τῶν δεινῶν ἀνθρώποις συμβαίνει — ἐν μὲν τοῖσι τοιούτοις ἁμαρτάνοντες οὐ καταφανέες εἰσὶν τοῖσιν ἰδιώτῃσιν: ὅταν δ᾽ ἐντύχωσιν μεγάλῳ τε καὶ ἰσχυρῷ καὶ ἐπισφαλεῖ νοσήματι, τότε σφέων τά τε ἁμαρτήματα καὶ ἡ ἀτεχνίη πᾶσι καταφανής: οὐ γὰρ ἐς μακρὸν αὐτῶν ἑκατέρου αἱ τιμωρίαι, ἀλλὰ διὰ τάχεος πάρεισιν.
10. Ὅτι δ᾽ οὐδὲν ἐλάσσους ἀπὸ κενώσιος ἀκαίρου κακοπάθειαι γίνονται τῷ ἀνθρώπῳ ἢ ἀπὸ πληρώσιος, καταμανθάνειν καλῶς ἔχει ἐπαναφέροντας ἐπὶ τοὺς ὑγιαίνοντας. ἔστι γὰρ οἷσιν αὐτῶν συμφέρει μονοσιτεῖν, καὶ τοῦτο διὰ τὸ συμφέρον οὕτως αὐτοὶ ἐτάξαντο, ἄλλοισι δὲ ἀριστῆν διὰ τὴν αὐτὴν ἀνάγκην: οὕτω γὰρ αὐτοῖσι συμφέρει. καὶ μὴν τοῦτ᾽ εἰσὶ οἳ δι᾽ ἡδονὴν ἢ δι᾽ ἄλλην τινὰ συγκυρίην ἐπετήδευσαν ὁπότερον αὐτῶν. τοῖς μὲν γὰρ πλείστοισι τῶν ἀνθρώπων οὐδὲν διαφέρει, ὁπότερον ἂν ἐπιτηδεύσωσιν, εἴτε μονοσιτεῖν εἴτε ἀριστῆν, τούτῳ τῷ ἔθει χρῆσθαι. εἰσὶ δέ τινες οἳ οὐκ ἂν δύναιντο ἔξω τοῦ συμφέροντος ποιέοντες ῥηϊδίως ἀπαλλάσσειν, ἀλλὰ συμβαίνει αὐτῶν ἑκατέροισι παρ᾽ ἡμέρην μιαν καὶ ταύτην οὐχ ὅλην μεταβάλλουσιν ὑπερφυὴς κακοπάθεια. οἱ μὲν γὰρ ἢν ἀριστήσωσιν μὴ συμφέροντος αὐτοῖσι, εὐθέως βαρέες καὶ νωθροὶ καὶ τὸ σῶμα καὶ τὴν γνώμην χάσμης τε καὶ νυσταγμοῦ καὶ δίψης πλήρεες: ἢν δὲ καὶ ἐπιδειπνήσωσι, καὶ φῦσα καὶ στρόφος καὶ ἡ κοιλίη καταρρήγνυται. καὶ πολλοῖσιν ἀρχὴ νούσου αὕτη μεγάλης ἐγένετο, καὶ ἢν τὰ σιτία, ἃ μεμαθήκεσαν ἅπαξ ἀναλίσκειν, ταῦτα δὶς προσενέγκωνται καὶ μηδὲν πλείω. τοῦτο δέ, ἢν ἀριστῆν μεμαθηκώς τις — καὶ οὕτως αὐτῷ συμφέρον ἦν — μὴ ἀριστήσῃ, ὅταν τάχιστα παρέλθῃ ἡ ὥρη, εὐθὺς ἀδυναμίη δεινή, τρόμος, ἀψυχίη: ἐπὶ τούτοις ὀφθαλμοὶ κοῖλοι, οὖρον χλωρότερον καὶ θερμότερον, στόμα πικρόν, καὶ τὰ σπλάγχνα δοκεῖ οἱ κρέμασθαι, σκοτοδινίη, δυσθυμίη, δυσεργείη. ταῦτα δὲ πάντα, καὶ ὅταν δειπνεῖν ἐπιχειρήσῃ, ἀηδέστερος μὲν ὁ σῖτος, ἀναλίσκειν δὲ οὐ δύναται ὅσα ἀριστιζόμενος πρότερον ἐδείπνει. ταῦτα δὲ αὐτὰ μετὰ στρόφον καὶ ψόφου καταβαίνοντα συγκαίει τὴν κοιλίην, δυσκοιτέουσί τε καὶ ἐνυπνιάζουσι τεταραγμένα τε καὶ θορυβώδεα. πολλοῖσι δὲ καὶ τούτων αὕτη ἀρχὴ νούσου ἐγένετο.
11. Σκέψασθαι δὲ χρή, διὰ τίνα αἰτίην αὐτοῖσιν ταῦτα συνέβη. τῷ μέν, οἶμαι, μεμαθηκότι μονοσιτεῖν, ὅτι οὐκ ἀνέμεινεν τὸν χρόνον τὸν ἱκανόν, μέχρι αὐτοῦ ἡ κοιλίη τῶν τῇ προτεραίῃ προσενηνεγμένων σιτίων ἀπολαύσῃ τελέως καὶ ἐπικρατήσῃ καὶ λαπαχθῇ τε καὶ ἡσυχάσῃ, ἀλλ᾽ ἐπὶ ζέουσάν τε καὶ ἐζυμωμένην καινὰ ἐπεσηνέγκατο. αἱ δὲ τοιαῦται κοιλίαι πολλῷ τε βραδύτερον πέσσουσι καὶ πλείονος δέονται ἀναπαύσιός τε καὶ ἡσυχίης. ὁ δὲ μεμαθηκὼς ἀριστίζεσθαι, διότι, ἐπειδὴ τάχιστα ἐδεήθη τὸ σῶμα τροφῆς καὶ τὰ πρότερα κατανάλωτο καὶ οὐκ εἶχεν οὐδεμίαν ἀπόλαυσιν, οὐκ εὐθέως αὐτῷ προσεγένετο καινὴ τροφή, φθίνει δὴ καὶ συντήκεται ὑπὸ λιμοῦ. πάντα γάρ, ἃ λέγω πάσχειν τὸν τοιοῦτον ἄνθρωπον, λιμῷ ἀνατίθημι. φημὶ δὲ καὶ τοὺς ἄλλους ἀνθρώπους ἅπαντας, οἵτινες ἂν ὑγιαίνοντες ἄσιτοι δύο ἡμέρας ἢ τρεῖς γένωνται, ταῦτα πείσεσθαι, οἷάπερ ἐπὶ τῶν ἀναρίστων γενομένων εἴρηκα.
12. Τὰς δὲ τοιαύτας φύσιας ἔγωγέ φημι τὰς ταχέως τε καὶ ἰσχυρῶς τῶν ἁμαρτημάτων ἀπολαυούσας ἀσθενεστέρας εἶναι τῶν ἑτέρων. ἐγγύτατα δὲ τοῦ ἀσθενέοντός ἐστιν ὁ ἀσθενής, ἔτι δὲ ἀσθενέστερος ὁ ἀσθενέων, καὶ μᾶλλον αὐτῷ προσήκει ὅ τι ἂν τοῦ καιροῦ ἀποτυγχάνῃ πονεῖν. χαλεπὸν δὲ τοιαύτης ἀκριβείης ἐούσης περὶ τὴν τέχνην τυγχάνειν αἰεὶ τοῦ ἀτρεκεστάτου. πολλὰ δὲ εἴδεα κατ᾽ ἰητρικὴν ἐς τοσαύτην ἀκρίβειαν ἥκει, περὶ ὧν εἰρήσεται. οὔ φημι δὲ δεῖν διὰ τοῦτο τὴν τέχνην ὡς οὐκ ἐοῦσαν οὐδὲ καλῶς ζητεομένην τὴν ἀρχαίην ἀποβάλλεσθαι, εἰ μὴ ἔχει περὶ πάντα ἀκρίβειαν, ἀλλὰ πολὺ μᾶλλον διὰ τὸ ἐγγὺς οἶμαι τοῦ ἀτρεκεστάτου δύνασθαι ἥκειν λογισμῷ ἐκ πολλῆς ἀγνωσίης θαυμάζειν τὰ ἐξευρημένα, ὡς καλῶς καὶ ὀρθῶς ἐξεύρηται καὶ οὐκ ἀπὸ τύχης.
13. Ἐπὶ δὲ τῶν τὸν καινὸν τρόπον τὴν τέχνην ζητεύντων ἐξ ὑποθέσιος τὸν λόγον ἐπανελθεῖν βούλομαι. εἰ γάρ τί ἐστιν θερμὸν ἢ ψυχρὸν ἢ ξηρὸν ἢ ὑγρὸν τὸ λυμαινόμενον τὸν ἄνθρωπον, καὶ δεῖ τὸν ὀρθῶς ἰητρεύοντα βοηθεῖν τῷ μὲν θερμῷ ἐπὶ τὸ ψυχρόν, τῷ δὲ ψυχρῷ ἐπὶ τὸ θερμόν, τῷ δὲ ξηρῷ ἐπὶ τὸ ὑγρόν, τῷ δὲ ὑγρῷ ἐπὶ τὸ ξηρόν. ἔστω μοι ἄνθρωπος μὴ τῶν ἰσχυρῶν φύσει, ἀλλὰ τῶν ἀσθενεστέρων: οὗτος δὲ πυροὺς ἐσθιέτω, οὓς ἂν ἀπὸ τῆς ἅλω ἀνέλῃ, ὠμοὺς καὶ ἀργούς, καὶ κρέα ὠμὰ καὶ πινέτω ὕδωρ. ταύτῃ χρεώμενος τῇ διαίτῃ εὖ οἶδ᾽ ὅτι πείσεται πολλὰ καὶ δεινά: καὶ γὰρ πόνους πονήσει καὶ τὸ σῶμα ἀσθενὲς ἔσται καὶ ἡ κοιλίη φθαρήσεται καὶ ζῆν πολὺν χρόνον οὐ δυνήσεται. τί δὴ χρὴ βοήθημα παρεσκευάσθαι ὧδ᾽ ἔχοντι; θερμὸν ἢ ψυχρὸν ἢ ξηρὸν ἢ ὑγρόν; δῆλον γὰρ ὅτι τούτων τι. εἰ γὰρ τὸ λυμαινόμενόν ἐστιν τούτων τὸ ἕτερον, τῷ ὑπεναντίῳ προσήκει λῦσαι, ὡς ὁ ἐκείνων λόγος ἔχει. τὸ μὲν γὰρ βεβαιότατόν τε καὶ προφανέστατον φάρμακον ἀφελόντα τὰ διαιτήματα, οἷς ἐχρῆτο, ἀντὶ μὲν τῶν πυρῶν ἄρτον διδόναι, ἀντὶ δὲ τῶν ὠμῶν κρεῶν ἑφθά, πιεῖν τε ἐπὶ τούτοισιν οἴνου. ταῦτα μεταβαλόντα οὐχ οἷόν τε μὴ οὐχ ὑγιᾶ γενέσθαι, ἤν γε μὴ παντάπασιν ᾖ διεφθαρμένος ὑπὸ χρόνου τε καὶ τῆς διαίτης. τί δὴ φήσομεν; πότερον αὐτῷ ἀπὸ ψυχροῦ κακοπαθέοντι θερμὰ ταῦτα προσενέγκαντες ὠφέλησαν ἢ τἀναντία; οἶμαι γὰρ ἔγωγε πολλὴν ἀπορίην τῷ ἐρωτηθέντι παρασχεῖν. ὁ γὰρ τὸν ἄρτον παρασκευάζων τῶν πυρῶν τὸ θερμὸν ἢ τὸ ψυχρὸν ἢ τὸ ξηρὸν ἢ τὸ ὑγρὸν ἀφείλατο; ὃ γὰρ καὶ πυρὶ καὶ ὕδατι δέδοται καὶ ἄλλοις πολλοῖσι ἤργασται, ὧν ἕκαστον ἰδίην δύναμιν καὶ φύσιν ἔχει, τὰ μὲν τῶν ὑπαρχόντων ἀποβέβληκε, ἄλλοισι δὲ κέκρηταί τε καὶ μέμικται.
14. Οἶδα μὲν γὰρ καὶ τάδε δήπου, ὅτι διαφέρει ἐς τὸ σῶμα τοῦ ἀνθρώπου καθαρὸς ἄρτος ἢ συγκομιστός, ἢ ἀπτίστων πυρῶν ἢ ἐπτισμένων, ἢ πολλῷ ὕδατι πεφυρημένος ἢ ὀλίγῳ, ἢ ἰσχυρῶς πεφυρημένος ἢ ἀφύρητος, ἢ ἔξοπτος ἢ ἔνωμος, ἄλλα τε πρὸς τούτοισι μυρία. ὡς δ᾽ αὔτως καὶ περὶ μάζης. καὶ αἱ δυνάμιες μεγάλαι τε ἑκάστου καὶ οὐδὲν ἡ ἑτέρη τῇ ἑτέρῃ ἐοικυῖα. ὅστις δὲ ταῦτα οὐκ ἐπέσκεπται ἢ σκεπτόμενος οὐκ οἶδεν, πῶς ἄν τι οὗτος δύναιτο τῶν κατ᾽ ἄνθρωπον παθημάτων εἰδέναι; ὑπὸ γὰρ ἑνὸς ἑκάστου τούτων πάσχει τε καὶ ἑτεροιοῦται ὁ ἄνθρωπος ἢ τοῖον ἢ τοῖον. καὶ διὰ τούτων πᾶς ὁ βίος καὶ ὑγιαίνοντι καὶ ἐκ νούσου ἀνατρεφομένῳ καὶ κάμνοντι. οὐκ ἂν οὖν ἕτερα τούτων χρησιμώτερα οὐδὲ ἀναγκαιότερα εἴη εἰδέναι δήπου, ὡς δὲ καλῶς καὶ λογισμῷ προσήκοντι ζητήσαντες πρὸς τὴν τοῦ ἀνθρώπου φύσιν εὗρον αὐτὰ οἱ πρῶτοι εὑρόντες καὶ ᾠήθησαν ἀξίην τὴν τέχνην θεῷ προσθεῖναι, ὥσπερ καὶ νομίζεται. οὐ γὰρ τὸ ξηρὸν οὐδὲ τὸ ὑγρὸν οὐδὲ τὸ θερμὸν οὐδὲ τὸ ψυχρὸν οὐδὲ ἄλλο τούτων ἡγησάμενοι οὐδὲν οὔτε λυμαίνεσθαι οὔτε προσδεῖσθαι οὐδενὸς τούτων τὸν ἄνθρωπον, ἀλλὰ τὸ ἰσχυρὸν ἑκάστου καὶ τὸ κρέσσον τῆς φύσιος τῆς ἀνθρωπείης, οὗ μὴ ἠδύνατο κρατεῖν, τοῦτο βλά πτειν ἡγήσαντο καὶ τοῦτο ἐζήτησαν ἀφαιρεῖν. ἰσχυρότατον δ᾽ ἐστὶ τοῦ μὲν γλυκέος τὸ γλυκύτατον, τοῦ δὲ πικροῦ τὸ πικρότατον, τοῦ δὲ ὀξέος τὸ ὀξύτατον, ἑκάστου δὲ πάντων τῶν ἐνεόντων ἡ ἀκμή. ταῦτα γὰρ ἑώρων καὶ ἐν τῷ ἀνθρώπῳ ἐνεόντα καὶ λυμαινόμενα τὸν ἄνθρωπον. ἔνι γὰρ ἐν ἀνθρώπῳ καὶ ἁλμυρὸν καὶ πικρὸν καὶ γλυκὺ καὶ ὀξὺ καὶ στρυφνὸν καὶ πλαδαρὸν καὶ ἄλλα μυρία παντοίας δυνάμιας ἔχοντα πλῆθός τε καὶ ἰσχύν. ταῦτα μὲν μεμιγμένα καὶ κεκρημένα ἀλλήλοισιν οὔτε φανερά ἐστιν οὔτε λυπεῖ τὸν ἄνθρωπον. ὅταν δέ τι τούτων ἀποκριθῇ καὶ αὐτὸ ἐφ᾽ ἑωυτοῦ γένηται, τότε καὶ φανερόν ἐστι καὶ λυπεῖ τὸν ἄνθρωπον: τοῦτο δέ, τῶν βρωμάτων ὅσα ἡμῖν ἀνεπιτήδειά ἐστιν καὶ λυμαίνεται τὸν ἄνθρωπον ἐμπεσόντα, τούτων ἓν ἕκαστον ἢ πικρόν ἐστιν ἢ ἁλμυρὸν ἢ ὀξὺ ἢ ἄλλο τι ἄκρητόν τε καὶ ἰσχυρόν, καὶ διὰ τοῦτο ταρασσόμεθα ὑπ᾽ αὐτῶν, ὥσπερ καὶ ὑπὸ τῶν ἐν τῷ σώματι ἀποκρινομένων. πάντα δὲ ὅσα ἄνθρωπος ἐσθίει ἢ πίνει, τὰ τοιαῦτα βρώματα ἥκιστα τοιούτου χυμοῦ ἀκρήτου τε καὶ διαφέροντος δῆλά ἐστιν μετέχοντα, οἷον ἄρτος τε καὶ μᾶζα καὶ τὰ ἑπόμενα τούτοις, οἷς εἴθισται ὁ ἄνθρωπος πλείστοισί τε καὶ αἰεὶ χρῆσθαι, ἔξω τῶν πρὸς ἡδονήν τε καὶ κόρον ἠρτυμένων τε καὶ ἐσκευασμένων. καὶ ἀπὸ τούτων πλείστων ἐσιόντων ἐς τὸν ἄνθρωπον τάραχος καὶ ἀπόκρισις τῶν ἀμφὶ τὸ σῶμα δυναμίων ἥκιστα γίνεται, ἰσχὺς δὲ καὶ αὔξησις καὶ τροφὴ μάλιστα δι᾽ οὐδὲν ἕτερον γίνεται ἢ ὅτι εὖ τε κέκρηται καὶ οὐδὲν ἔχει οὔτε ἄκρητον οὔτε ἰσχυρόν, ἀλλ᾽ ὅλον ἕν τε γέγονε καὶ ἁπλοῦν.
15. Ἀπορέω δ᾽ ἔγωγε, οἱ τὸν λόγον ἐκεῖνον λέγοντες καὶ ἄγοντες ἐκ ταύτης τῆς ὁδοῦ ἐπὶ ὑπόθεσιν τὴν τέχνην τίνα ποτὲ τρόπον θεραπεύουσι τοὺς ἀνθρώπους, ὥσπερ ὑποτίθενται. οὐ γάρ ἐστιν αὐτοῖς, οἶμαι, ἐξευρημένον αὐτό τι ἐφ᾽ ἑωυτοῦ θερμὸν ἢ ψυχρὸν ἢ ξηρὸν ἢ ὑγρὸν μηδενὶ ἄλλῳ εἴδει κοινωνέον. ἀλλ᾽ οἴομαι ἔγωγε ταὐτὰ βρώματα καὶ πόματα αὐτοῖσι ὑπάρχειν, οἷσι πάντες χρεώμεθα. προστιθέασι δὲ τῷ μὲν εἶναι θερμῷ, τῷ δὲ ψυχρῷ, τῷ δὲ ξηρῷ, τῷ δὲ ὑγρῷ, ἐπεὶ ἐκεῖνό γε ἄπορον προστάξαι τῷ κάμνοντι θερμόν τι προσενέγκασθαι. εὐθὺ γὰρ ἐρωτήσει: τί; ὥστε ληρεῖν ἀνάγκη ἢ ἐς τούτων τι τῶν γινωσκομένων καταφεύγειν. εἰ δὲ δὴ τυγχάνει τι θερμὸν ἐὸν στρυφνόν, ἄλλο δὲ θερμὸν ἐὸν πλαδαρόν, ἄλλο δὲ θερμὸν ἄραδον ἔχον — ἔστι γὰρ καὶ ἄλλα πολλὰ θερμὰ καὶ ἄλλας δυνάμιας ἔχοντα ἑωυτοῖς ὑπεναντίας — ἦ διοίσει τι αὐτῶν προσενεγκεῖν τὸ θερμὸν καὶ στρυφνὸν ἢ τὸ θερμὸν καὶ πλαδαρὸν ἢ ἅμα τὸ ψυχρὸν καὶ στρυφνόν — ἔστι γὰρ καὶ τοιοῦτο — ἢ τὸ ψυχρόν τε καὶ πλαδαρόν: ὥσπερ γὰρ ἐγὼ οἶδα, πᾶν τοὐναντίον ἀφ᾽ ἑκατέρου αὐτῶν ἀποβαίνει, οὐ μοῦνον ἐν ἀνθρώπῳ, ἀλλὰ καὶ ἐν σκύτει καὶ ἐν ξύλῳ καὶ ἐν ἄλλοις πολλοῖς, ἅ ἐστιν ἀνθρώπου ἀναισθητότερα. οὐ γὰρ τὸ θερμόν ἐστιν τὸ τὴν μεγάλην δύναμιν ἔχον, ἀλλὰ τὸ στρυφνὸν καὶ τὸ πλαδαρὸν καὶ τἄλλα ὅσα μοι εἴρηται καὶ ἐν τῷ ἀνθρώπῳ καὶ ἔξω τοῦ ἀνθρώπου, καὶ ἐσθιόμενα καὶ πινόμενα καὶ ἔξωθεν ἐπιχριό μενά τε καὶ προσπλασσόμενα.
16. Ψυχρότητα δ᾽ ἐγὼ καὶ θερμότητα πασέων ἥκιστα τῶν δυναμίων νομίζω δυναστεύειν ἐν τῷ σώματι διὰ τάσδε τὰς αἰτίας: ὃν μὲν ἂν δήπου χρόνον μεμιγμένα αὐτὰ ἑωυτοῖς ἅμα τὸ θερμόν τε καὶ ψυχρὸν ἐνῇ, οὐ λυπεῖ. κρῆσις γὰρ καὶ μετριότης τῷ μὲν θερμῷ γίνεται ἀπὸ τοῦ ψυχροῦ, τῷ δὲ ψυχρῷ ἀπὸ τοῦ θερμοῦ. ὅταν δ᾽ ἀποκριθῇ χωρὶς ἑκάτερον, τότε λυπεῖ. ἐν δὲ δὴ τούτῳ τῷ καιρῷ, ὅταν τὸ ψυχρὸν ἐπιγένηται καί τι λυπήσῃ τὸν ἄνθρωπον, διὰ τάχεος πρῶτον δι᾽ αὐτὸ τοῦτο πάρεστιν τὸ θερμὸν αὐτόθεν ἐκ τοῦ ἀνθρώπου, οὐδεμιῆς βοηθείης οὐδὲ παρασκευῆς δεόμενον. καὶ ταῦτα καὶ ἐν ὑγιαίνουσι τοῖς ἀνθρώποις ἀπεργάζεται καὶ ἐν κάμνουσι. τοῦτο μέν, εἴ τις θέλει ὑγιαίνων χειμῶνος διαψῦξαι τὸ σῶμα ἢ λουσάμενος ψυχρῷ ἢ ἄλλῳ τῳ τρόπῳ, ὅσῳ ἂν ἐπὶ πλεῖον αὐτὸ ποιήσῃ, καὶ ἤν γε μὴ παντάπασιν παγῇ τὸ σῶμα, ὅταν εἵματα λάβῃ καὶ ἔλθῃ ἐς τὴν σκέπην, ἔτι μᾶλλον καὶ ἐπὶ πλεῖον θερμαίνεται τὸ σῶμα: τοῦτο δέ, εἰ ἐθέλοι ἐκθερμανθῆναι ἰσχυρῶς ἢ λουτρῷ θερμῷ ἢ πυρὶ πολλῷ, ἐκ δὲ τούτου τὸ αὐτὸ εἷμα ἔχων ἐν τῷ αὐτῷ χωρίῳ τὴν διατριβὴν ποιεῖσθαι ὥσπερ διεψυγμένος, πολὺ φαίνεται καὶ ψυχρότερος καὶ ἄλλως φρικαλεώτερος: ἢ εἰ ῥιπιζόμενός τις ὑπὸ πνίγεος καὶ παρασκευαζόμενος αὐτὸς ἑωυτῷ ψῦχος ἐκ τοιούτου ἂν τρόπου διαπαύσαιτο τοῦτο ποιέων, δεκαπλάσιον ἔσται τὸ καῦμα καὶ πνῖγος ἢ τῷ μηδὲν τοιοῦτο ποιέοντι. Τόδε δὴ καὶ πολὺ μέζον: ὅσοι ἂν διὰ χιόνος ἢ ἄλλου ψύχεος βαδίσαντες ῥιγώσωσι διαφερόντως πόδας ἢ χεῖρας ἢ κεφαλήν, οἷα πάσχουσιν ἐς τὴν νύκτα, ὅταν περισταλεωσί τε καὶ ἐν ἀλέῃ γένωνται ὑπὸ καύματος καὶ κνησμοῦ. καὶ ἔστιν οἷσι φλύκταιναι ἀνίστανται ὥσπερ τοῖς ἀπὸ πυρὸς κατακεκαυμένοις. καὶ οὐ πρότερον τοῦτο πάσχουσιν, πρὶν θερμανθέωσιν. οὕτως ἑτοίμως ἑκάτερον αὐτῶν ἐπὶ θάτερον παραγίνεται. μυρία δ᾽ ἂν καὶ ἄλλα ἔχοιμι εἰπεῖν. τὰ δὲ κατὰ τοὺς νοσέοντας, οὐχὶ ὅσοις ἂν ῥῖγος γένηται, τούτοις ὀξύτατος ὁ πυρετὸς ἐκλάμπει; καὶ οὐχὶ ὅπως ἰσχυρός, ἀλλὰ καὶ παυόμενος δι᾽ ὀλίγου, καὶ ἄλλως τὰ πολλὰ ἀσινὴς καὶ ὅσον ἂν χρόνον παρῇ διάθερμος; καὶ διεξιὼν διὰ παντὸς τελευτᾷ ἐς τοὺς πόδας μάλιστα, οὗπερ τὸ ῥῖγος καὶ ἡ ψῦξις νεηνικωτάτη καὶ ἐπὶ πλεῖον ἐνεχρόνισεν: πάλιν τε ὅταν ἱδρώσῃ τε καὶ ἀπαλλαγῇ ὁ πυρετός, πολὺ μᾶλλον διέψυξε ἢ εἰ μὴ ἔλαβε τὴν ἀρχήν. ᾧ οὖν διὰ τάχεος οὕτω παραγίνεται τὸ ἐναντιώτατόν τε καὶ ἀφαιρεόμενον τὴν δύναμιν ἀπὸ τωὐτομάτου, τί ἂν ἀπὸ τούτου μέγα ἢ δεινὸν γένοιτο; ἢ τί δεῖ πολλῆς ἐπὶ τούτῳ βοηθείης;
17. Εἴποι ἄν τις: ἀλλ᾽ οἱ πυρεταίνοντες τοῖσι καύσοισί τε καὶ περιπνευμονίῃσι καὶ ἄλλοισι ἰσχυροῖσι νοσήμασι οὐ ταχέως ἐκ τῆς θέρμης ἀπαλλάσσονται, οὐδὲ πάρεστιν ἐνταῦθα ἔτι τὸ θερμὸν ἢ τὸ ψυχρόν. ἐγὼ δέ μοι τοῦτο μέγιστον τεκμήριον ἡγεῦμαι εἶναι, ὅτι οὐ διὰ τὸ θερμὸν ἁπλῶς πυρεταίνουσιν οἱ ἄνθρωποι, οὐδὲ τοῦτο εἴη τὸ αἴτιον τῆς κακώσιος μοῦνον, ἀλλ᾽ ἔστι καὶ πικρὸν καὶ θερμὸν τὸ αὐτό, καὶ ὀξὺ καὶ θερμόν, καὶ ἁλμυρὸν καὶ θερμόν, καὶ ἄλλα μυρία, καὶ πάλιν γε ψυχρὸν μετὰ δυναμίων ἑτέρων. τὰ μὲν οὖν λυμαινόμενα ταῦτ᾽ ἐστί: συμπάρεστι δὲ καὶ τὸ θερμόν, ῥώμης μὲν ἔχον ὅσον τὸ ἡγεύμενον καὶ παροξυνόμενον καὶ αὐξόμενον ἅμα ἐκείνῳ, 55 δύναμιν δὲ οὐδεμίαν πλείω τῆς προσηκούσης.
18. Δῆλα δὲ ταῦτα ὅτι ὧδε ἔχει ἐπὶ τῶνδε τῶν σημείων: πρῶτον μὲν ἐπὶ τὰ φανερώτερα, ὧν πάντες ἔμπειροι πολλάκις ἐσμέν τε καὶ ἐσόμεθα. τοῦτο μὲν γάρ, ὅσοισι ἂν ἡμέων κόρυζα ἐγγένηται καὶ ῥεῦμα κινηθῇ διὰ τῶν ῥινῶν, τοῦτο ὡς τὸ πολὺ δριμύτερον τοῦ πρότερον γινομένου τε καὶ ἰόντος ἐκ τῶν ῥινῶν καθ᾽ ἑκάστην ἡμέρην καὶ οἰδεῖν μὲν ποιεῖ τὴν ῥῖνα καὶ συγκαίει θερμήν τε καὶ διάπυρον ἐσχάτως, ἢν δὴ τὴν χεῖρα προς φέρῃς: κἢν πλείω χρόνον παρῇ, καὶ ἐξελκοῦται τὸ χωρίον ἄσαρκόν τε καὶ σκληρὸν ἐόν. παύεται δέ πως τὸ καῦμα ἐκ τῆς ῥινός, οὐχ ὅταν τὸ ῥεῦμα γίνηται καὶ ἡ φλεγμονὴ ᾖ, ἀλλ᾽ ἐπειδὰν παχύτερόν τε καὶ ἧσσον δριμὺ ῥέῃ, πέπον καὶ μεμιγμένον μᾶλλον τοῦ πρότερον γινομένου, τότε δὲ ἤδη καὶ τὸ καῦμα πέπαυται. ἀλλ᾽ οἷσι δὲ ὑπὸ ψύχεος φανερῶς αὐτοῦ μούνου γίνεται μηδενὸς ἄλλου συμπαραγενομένου, πᾶσι δὲ ἡ αὐτὴ ἀπαλλαγή, ἐκ μὲν τῆς ψύξιος διαθερμανθῆναι, ἐκ δὲ τοῦ καύματος διαψυχθῆναι, καὶ ταῦτα ταχέως παραγίνεται καὶ πέψιος οὐδεμιῆς προσδεῖται. τὰ δ᾽ ἄλλα πάντα, ὅσα διὰ χυμῶν δριμύτητας καὶ ἀκρησίας, φημὶ ἔγωγε γίνεσθαι τὸν αὐτὸν τρόπον καὶ ἀποκαθίστασθαι πεφθέντα καὶ κρηθέντα.
19. Ὅσα τε αὖἐπὶ τοὺς ὀφθαλμοὺς τρέπεται τῶν ῥευμάτων, ἰσχυρὰς καὶ παντοίας δριμύτητας ἔχοντα, ἑλκοῖ μὲν βλέφαρα, κατεσθίει δ᾽ ἐνίων γνάθους τε καὶ τὰ ὑπὸ τοῖσι ὀφθαλμοῖσι, ἐφ᾽ ὅ τι ἂν ἐπιρρυῇ, ῥήγνυσι δὲ καὶ διεσθίει τὸν ἀμφὶ τὴν ὄψιν χιτῶνα. ὀδύναι δὲ καὶ καῦμα καὶ φλογμὸς ἔσχατος κατέχει μέχρι τινός, μέχρι ἂν τὰ ῥεύματα πεφθῇ καὶ γένηται παχύτερα καὶ λήμη ἀπ᾽ αὐτῶν ᾖ. τὸ δὲ πεφθῆναι γίνεται ἐκ τοῦ μιχθῆναι καὶ κρηθῆναι ἀλλήλοισι καὶ συνεψηθῆναι. τοῦτο δέ, ὅσα ἐς τὴν φάρυγγα, ἀφ᾽ ὧν βράγχοι γίνονται καὶ συνάγχαι, ἐρυσιπέλατά τε καὶ περιπνευμονίαι, πάντα ταῦτα τὸ μὲν πρῶτον ἁλμυρά τε καὶ ὑγρὰ καὶ δριμέα ἀφίει, καὶ ἐν τοῖσι τοιούτοις ἔρρωται τὰ νοσήματα. ὅταν δὲ παχύτερα καὶ πεπαίτερα γένηται καὶ πάσης δριμύτητος ἀπηλλαγμένα, τότε ἤδη καὶ οἱ πυρετοὶ παύονται καὶ τἄλλα τὰ λυπέοντα τὸν ἄνθρωπον. δεῖ δὲ δήπου ταῦτα αἴτια ἑκάστου ἡγεῖσθαι εἶναι, ὧν παρεόντων μὲν τοιου τότροπον γίνεσθαι ἀνάγκη, μεταβαλλόντων δὲ ἐς ἄλλην κρῆσιν παύεσθαι. ὁπόσα οὖν ἀπ᾽ αὐτῆς τῆς θέρμης εἰλικρινέος ἢ ψύξιος γίνεται καὶ μὴ μετέχει ἄλλης δυνάμιος μηδεμιῆς, οὕτω παύοιτο ἄν, ὅταν μεταβάλλῃ ἐκ τοῦ θερμοῦ ἐς τὸ ψυχρὸν καὶ ἐκ τοῦ ψυχροῦ ἐς τὸ θερμόν. μεταβάλλει δὲ ὅνπερ προείρηταί μοι τρόπον. ἔτι τοίνυν τἄλλα ὅσα κακοπαθεῖ ὁ ἄνθρωπος πάντα ἀπὸ δυναμίων γίνεται. τοῦτο μὲν γάρ, ὅταν πικρότης τις ἀποχυθῇ, ἣν δὴ χολὴν ξανθὴν καλέομεν, οἷαι ἄσαι καὶ καύματα καὶ ἀδυναμίαι κατέχουσιν: ἀπαλλασσόμενοι δὲ τούτου, ἐνίοτε καὶ καθαιρόμενοι, ἢ αὐτόματοι ἢ ὑπὸ φαρμάκου, ἢν ἐν καιρῷ τι αὐτῶν γίνηται, φανερῶς καὶ τῶν πόνων καὶ τῆς θέρμης ἀπαλλάσσονται. ὅσον δ᾽ ἂν χρόνον ταῦτα μετέωρα ᾖ καὶ ἄπεπτα καὶ ἄκρητα, μηχανὴ οὐδεμία οὔτε τῶν πόνων παύεσθαι οὔτε τῶν πυρετῶν. καὶ ὅσοισι δὲ ὀξύτητες προσίστανται δριμεῖαί τε καὶ ἰώδεες, οἷαι λύσσαι καὶ δήξιες σπλάγχνων καὶ θώρηκος καὶ ἀπορίη: οὐ παύεταί τι τούτου πρότερον, πρὶν ἢ ἀποκαθαρθῇ τε καὶ καταστορεσθῇ καὶ μιχθῇ τοῖσιν ἄλλοισιν: πέσσεσθαι δὲ καὶ μεταβάλλειν καὶ λεπτύνεσθαί τε καὶ παχύνεσθαι ἐς χυμῶν εἶδος δι᾽ ἄλλων εἰδέων καὶ παντοίων-διὸ καὶ κρίσιες καὶ ἀριθμοὶ τῶν χρόνων ἐν τοῖσι τοιούτοισι μέγα δύνανται — πάντων δὴ τούτων ἥκιστα προσήκει θερμῷ ἢ ψυχρῷ πάσχειν: οὔτε γὰρ ἂν τοῦτό γε σαπείη οὔτε παχυνθείη. τί γὰρ αὐτὸ φήσωμεν εἶναι; κρήσιας αὐτῶν ἄλλην πρὸς ἄλληλα ἐχούσας δύναμιν. ἐπεὶ ἄλλῳ γε οὐδενὶ τὸ θερμὸν μιχθὲν παύσεται τῆς θέρμης ἢ τῷ ψυχρῷ οὐδέ γε τὸ ψυχρὸν ἢ τῷ θερμῷ. τὰ δὲ ἄλλα πάντα τὰ περὶ τὸν ἄνθρωπον, ὅσῳ ἂν πλείοσι μίσγηται, τοσούτῳ ἠπιώτερα καὶ βελτίω. πάντων δὲ ἄριστα διάκειται ὁ ἄνθρωπος, ὅταν πᾶνπέσσηται καὶ ἐν ἡσυχίῃ ᾖ, μηδεμίαν δύναμιν ἰδίην ἀποδεικνύμενον, περὶ οὗ ἡγεῦμαι ἐπιδεδεῖ χθαι.
20. Λέγουσι δέ τινες ἰητροὶ καὶ σοφισταί, ὡς οὐκ εἴη δυνατὸν ἰητρικὴν εἰδέναι ὅστις μὴ οἶδεν ὅ τί ἐστιν ἄνθρωπος. ἀλλὰ τοῦτο δεῖ καταμαθεῖν τὸν μέλλοντα ὀρθῶς θεραπεύσειν τοὺς ἀνθρώπους. τείνει δὲ αὐτοῖς ὁ λόγος ἐς φιλοσοφίην, καθάπερ Ἐμπεδοκλῆς ἢ ἄλλοι οἳ περὶ φύσιος γεγράφασιν ἐξ ἀρχῆς ὅ τί ἐστιν ἄνθρωπος, καὶ ὅπως ἐγένετο πρῶτον καὶ ὁπόθεν συνεπάγη. ἐγὼ δὲ τοῦτο μέν, ὅσα τινὶ εἴρηται ἢ σοφιστῇ ἢ ἰητρῷ ἢ γέγραπται περὶ φύσιος, ἧσσον νομίζω τῇ ἰητρικῇ τέχνῃ προσήκειν ἢ τῇ γραφικῇ. νομίζω δὲ περὶ φύσιος γνῶναί τι σαφὲς οὐδαμόθεν ἄλλοθεν εἶναι ἢ ἐξ ἰητρικῆς: τοῦτο δὲ οἷόν τε καταμαθεῖν, ὅταν αὐτήν τις τὴν ἰητρικὴν ὀρθῶς περιλάβῃ: μέχρι δὲ τούτου πολλοῦ μοι δοκεῖ δεῖν: λέγω δὲ ταύτην τὴν ἱστορίην εἰδέναι, ἄνθρωπος τί ἐστιν καὶ δι᾽ οἵας αἰτίας γίνεται καὶ τἄλλα ἀκριβέως. ἐπεὶ τοῦτό γέ μοι δοκεῖ ἀναγκαῖον εἶναι ἰητρῷ περὶ φύσιος εἰδέναι καὶ πάνυ σπουδάσαι ὡς εἴσεται, εἴπερ τι μέλλει τῶν δεόντων ποιήσειν, ὅ τί τέ ἐστιν ἄνθρωπος πρὸς τὰ ἐσθιόμενά τε καὶ πινόμενα καὶ ὅ τι πρὸς τὰ ἄλλα ἐπιτηδεύματα, καὶ ὅ τι ἀφ᾽ ἑκάστου ἑκάστῳ συμβήσεται, καὶ μὴ ἁπλῶς οὕτως: πονηρόν ἐστιν βρῶμα τυρός. πόνον γὰρ παρέχει τῷ πληρωθέντι αὐτοῦ, ἀλλὰ τίνα τε πόνον καὶ διὰ τί καὶ τίνι τῶν ἐν τῷ ἀνθρώπῳ ἐνεόντων ἀνεπιτήδειον. ἔστι γὰρ καὶ ἄλλα πολλὰ βρώματα καὶ πόματα πονηρά, ἃ διατίθησι τὸν ἄνθρωπον οὐ τὸν αὐτὸν τρόπον. οὕτως οὖν μοι ἔστω οἷον: οἶνος ἄκρητος πολλὸς ποθεὶς διατίθησί πως τὸν ἄνθρωπον: καὶ πάντες ἂν οἱ εἰδότες τοῦτο γνοίησαν, ὅτι αὕτη δύναμις οἴνου καὶ αὐτὸς αἴτιος: καὶ οἷσί γε τῶν ἐν τῷ ἀνθρώπῳ τοῦτο δύναται μάλιστα, οἴδαμεν. τοιαύτην δὴ βούλομαι ἀληθείην καὶ περὶ τῶν ἄλλων φανῆναι. τυρὸς γάρ, ἐπειδὴ τούτῳ σημείῳ ἐχρησάμην, οὐ πάντας ἀνθρώπους ὁμοίως λυμαίνεται, ἀλλ᾽ εἰσὶν οἵτινες αὐτοῦ πληρούμενοι οὐδ᾽ ὁτιοῦν βλάπτονται, ἀλλὰ καὶ ἰσχύν, οἷσιν ἂν συμφέρῃ, θαυμασίως παρέχεται. εἰσὶ δ᾽ οἳ χαλεπῶς ἀπαλλάσσουσι. διαφέρουσιν οὖν τούτων αἱ φύσιες. διαφέρουσιν δὲ κατὰ τοῦτο, ὅπερ ἐν τῷ σώματι ἔνεστι πολέμιον τυρῷ καὶ ὑπὸ τούτου ἐγείρεταί τε καὶ κινεῖται: οἷς ὁ τοιοῦτος χυμὸς τυγχάνει πλείων ἐνεὼν καὶ μᾶλλον ἐνδυναστεύων ἐν τῷ σώματι, τούτους μᾶλλον καὶ κακοπαθεῖν εἰκός. εἰ δὲ πάσῃ τῇ ἀνθρωπίνῃ φύσει ἦν κακόν, πάντας ἂν ἐλυμήνατο. ταῦτα δὲ εἴ τις εἰδείη, οὐκ ἂν πάσχοι τάδε.
21. Ἐν τῇσιν ἀνακομιδῇσι τῇσιν ἐκ τῶν νούσων, ἔτι δὲ καὶ ἐν τῇσι νούσοισι τῇσι μακρῇσι γίνονται πολλαὶ συνταράξιες, αἱ μὲν ἀπὸ τωὐτομάτου, αἱ δὲ καὶ ἀπὸ τῶν προσενεχθέντων τῶν τυχόντων. οἶδα δὲ τοὺς πολλοὺς ἰητρούς, ὥσπερ τοὺς ἰδιώτας, ἢν τύχωσι περὶ τὴν ἡμέρην ταύτην τι κεκαινουργηκότες, ἢ λουσάμενοι ἢ περιπατήσαντες ἢ φαγόντες τι ἑτεροῖον, ταῦτα δὲ πάντα βελτίω προσενηνεγμένα ἢ μή, οὐδὲν ἧσσον τὴν αἰτίην τούτων τινὶ ἀνατιθέντας καὶ τὸ μὲν αἴτιον ἀγνοεῦντας, τὸ δὲ συμφορώτατον, ἢν οὕτω τύχῃ, ἀφαιρέοντας. δεῖ δὲ οὔ, ἀλλ᾽ εἰδέναι, τί λουτρὸν ἀκαίρως προσγενόμενον ἐργάσεται ἢ τί κόπος. οὐδέποτε γὰρ ἡ αὐτὴ κακοπάθεια τούτων οὐδετέρου, οὐδέ γε ἀπὸ πληρώσιος οὐδ᾽ ἀπὸ βρώματος τοίου ἢ τοίου. ὅστις οὖν ταῦτα μὴ εἴσεται ὡς ἕκαστα ἔχει πρὸς τὸν ἄνθρωπον, οὔτε γινώσκειν τὰ γινόμενα ἀπ᾽ αὐτῶν δυνήσεται οὔτε χρῆσθαι ὀρθῶς.
22. Δεῖν δέ μοι δοκεῖ καὶ ταῦτα εἰδέναι, ὅσα τῷ ἀνθρώπῳ παθήματα ἀπὸ δυναμίων γίνεται καὶ ὅσα ἀπὸ σχημάτων. λέγω δέ τι τοιοῦτον, δύναμιν μὲν εἶναι τῶν χυμῶν τὰς ἀκρότητάς τε καὶ ἰσχύν, σχήματα δὲ λέγω ὅσα ἔνεστιν ἐν τῷ ἀνθρώπῳ, τὰ μὲν κοῖλά τε καὶ ἐξ εὐρέος ἐς στενὸν συνηγμένα, τὰ δὲ καὶ ἐκπεπταμένα, τὰ δὲ στερεά τε καὶ στρογγύλα, τὰ δὲ πλατέα τε καὶ ἐπικρεμάμενα, τὰ δὲ διατεταμένα, τὰ δὲ μακρά, τὰ δὲ πυκνά, τὰ δὲ μανά τε καὶ τεθηλότα, τὰ δὲ σπογγοειδέα τε καὶ ἀραιά. τοῦτο μὲν οὖν, ἑλκύσαι ἐφ᾽ ἑωυτὸ καὶ ἐπισπάσασθαι ὑγρότητα ἐκ τοῦ ἄλλου σώματος, πότερον τὰ κοῖλά τε καὶ ἐκπεπταμένα ἢ τὰ στερεά τε καὶ στρογγύλα ἢ τὰ κοῖλά τε καὶ ἐς στενὸν ἐξ εὐρέος συνηγμένα δύναιτο ἂν μάλιστα; οἶμαι μὲν τὰ τοιαῦτα, τὰ ἐς στενὸν συνηγμένα ἐκ κοίλου τε καὶ εὐρέος. καταμανθάνειν δὲ δεῖ ταῦτα ἔξωθεν ἐκ τῶν φανερῶν. τοῦτο μὲν γάρ, τῷ στόματι κεχηνὼς ὑγρὸν οὐδὲν ἀνασπάσεις: προμυλλήνας δὲ καὶ συστείλας, πιέσας τε τὰ χείλεα καὶ ἔπειτεν αὐλὸν προσθέμενος ῥηϊδίως ἀνασπάσαις ἂν ὅ τι ἐθέλοις. τοῦτο δέ, αἱ σικύαι προσβαλλόμεναι ἐξ εὐρέος ἐς στενώτερον συνηγμέναι πρὸς τοῦτο τετέχνηνται, πρὸς τὸ ἕλκειν ἐκ τῆς σαρκὸς καὶ ἐπισπᾶσθαι, ἄλλα τε πολλὰ τοιουτότροπα. τῶν δὲ ἔσω φύσει τοῦ ἀνθρώπου σχῆμα τοιοῦτον κύστις τε καὶ κεφαλή, καὶ ὑστέρη γυναιξίν: καὶ φανερῶς ταῦτα μάλιστα ἕλκει καὶ πλήρεά ἐστιν ἐπάκτου ὑγρότητος αἰεί. τὰ δὲ κοῖλα καὶ ἐκπεπταμένα ἐπεσρυεῖσαν μὲν ὑγρότητα μάλιστα δέξαιτο πάντων, ἐπισπάσαιτο δ᾽ ἂν οὐχ ὁμοίως. τὰ δέ γε στερεὰ καὶ στρογγύλα οὔτ᾽ ἂν ἐπισπάσαιτο οὔτ᾽ ἂν ἐπες ρυεῖσαν δέξαιτο: περιολισθάνοι τε γὰρ καὶ οὐκ ἔχοι ἕδρην, ἐφ᾽ ἧς μένοι. τὰ δὲ σπογγοειδέα τε καὶ ἀραιά, οἷον σπλήν τε καὶ πνεύμων καὶ μαζοί, προσκαθεζόμενα μάλιστα ἀναπίνοι καὶ σκληρυνθείη ἂν καὶ αὐξηθείη ὑγρότητος προσγενομένης ταῦτα μάλιστα. οὐ γὰρ ἂν ὥσπερ ἐν κοιλίῃ, ἐν ᾗ τὸ ὑγρόν, ἔξω τε περιέχει αὐτὴ ἡ κοιλίη, ἐξαλίζοιτ᾽ ἂν καθ᾽ ἑκάστην ἡμέρην, ἀλλ᾽ ὅταν πίῃ καὶ δέξηται αὐτὸ ἐς ἑωυτὸ τὸ ὑγρόν, τὰ κενὰ καὶ ἀραιὰ ἐπληρώθη καὶ τὰ σμικρὰ πάντῃ καὶ ἀντὶ μαλθακοῦ τε καὶ ἀραιοῦ σκληρός τε καὶ πυκνὸς ἐγένετο καὶ οὔτ᾽ ἐκπέσσει οὔτ᾽ ἀφίησι. ταῦτα δὲ πάσχει διὰ τὴν φύσιν τοῦ σχήματος. ὅσα δὲ φῦσάν τε καὶ ἀνειλήματα ἀπεργάζεται ἐν τῷ σώματι, προσήκει ἐν μὲν τοῖσι κοίλοισι καὶ εὐρυχώροισι, οἷον κοιλίῃ τε καὶ θώρηκι, ψόφον τε καὶ πάταγον ἐμποιεῖν. ὅτε γὰρ ἂν μὴ ἀποπληρώσῃ οὕτως ὥστε στῆναι, ἀλλ᾽ ἔχῃ μεταβολάς τε καὶ κινήσιας, ἀνάγκη ὑπ᾽ αὐτῶν ψόφον καὶ καταφανέας κινήσιας γίνεσθαι. ὅσα δὲ σαρκώδεά τε καὶ μαλθακά, ἐν τοῖσι τοιούτοισι νάρκη τε καὶ πληρώματα οἷα ἐν τοῖσι ἀποπληγεῖσι γίνεται. ὅταν δ᾽ ἐγκυρήσῃ πλατεῖ τε καὶ ἀντικειμένῳ, καὶ πρὸς αὐτὸ ἀντιπέσῃ, καὶ φύσει τοῦτο τύχῃ ἐὸν μήτε ἰσχυρόν, ὥστε δύνασθαι ἀνέχεσθαι τὴν βίην καὶ μηδὲν κακὸν παθεῖν, μήτε μαλθακόν τε καὶ ἀραιόν, ὥστ᾽ ἐκδέξασθαί τε καὶ ὑπεῖξαι, ἁπαλὸν δὲ καὶ τεθηλὸς καὶ ἔναιμον καὶ πυκνόν, οἷον ἧπαρ, διὰ μὲν τὴν πυκνότητα καὶ πλατύτητα ἀνθέστηκέ τε καὶ οὐχ ὑπείκει, φῦσα δ᾽ ἐπισχομένη αὔξεταί τε καὶ ἰσχυροτέρη γίνεται καὶ ὁρμᾷ μάλιστα πρὸς τὸ ἀντιπαῖον. διὰ δὲ τὴν ἁπαλότητα καὶ τὴν ἐναιμότητα οὐ δύναται ἄνευ πόνων εἶναι, καὶ διὰ ταύτας τὰς προφάσιας ὀδύναι τε ὀξύταται καὶ πυκνόταται πρὸς τοῦτο τὸ χωρίον γίνονται ἐμπυήματά τε καὶ φύματα πλεῖστα. γίνεται δὲ καὶ ὑπὸ φρένας ἰσχυρῶς, ἧσσον δὲ πολλόν. διάτασις μὲν γὰρ φρενῶν πλατείη καὶ ἀντικειμένη, φύσις δὲ νευρωδεστέρη τε καὶ ἰσχυροτέρη, διὸ ἧσσον ἐπώδυνά ἐστιν. γίνεται δὲ καὶ περὶ ταῦτα καὶ πόνοι καὶ φύματα.
23. Πολλὰ δὲ καὶ ἄλλα καὶ ἔσω καὶ ἔξω τοῦ σώματος εἴδεα σχημάτων, ἃ μεγάλα ἀλλήλων διαφέρει πρὸς τὰ παθήματα καὶ νοσέοντι καὶ ὑγιαίνοντι, οἷον κεφαλαὶ σμικραὶ ἢ μεγάλαι, τράχηλοι λεπτοὶ ἢ παχέες, μακροὶ ἢ βραχέες, κοιλίαι μακραὶ ἢ στρογγύλαι, θώρηκος καὶ πλευρέων πλατύτητες ἢ στενότητες, ἄλλα μυρία, ἃ δεῖ πάντα εἰδέναι ᾗ διαφέρει, ὅπως τὰ αἴτια ἑκάστων εἰδὼς ὀρθῶς φυλάσσηται:
24. Περὶ δὲ δυναμίων χυμῶν αὐτῶν τε ἕκαστος ὅ τι δύναται ποιεῖν τὸν ἄνθρωπον ἐσκέφθαι, ὥσπερ καὶ πρότερον εἴρηται, καὶ τὴν συγγένειαν ὡς ἔχουσι πρὸς ἀλλήλους. λέγω δὲ τὸ τοιοῦτον: εἰ γλυκὺς χυμὸς ἐὼν μεταβάλλοι ἐς ἄλλο εἶδος, μὴ ἀπὸ συγκρήσιος, ἀλλὰ αὐτὸς ἐξιστάμενος, ποῖός τις ἂν πρῶτος γένοιτο, πικρὸς ἢ ἁλμυρὸς ἢ στρυφνὸς ἢ ὀξύς; οἶμαι μέν, ὀξύς. ὁ ἄρα ὀξὺς χυμὸς ἀνεπιτήδειος προσφέρειν ἂν τῶν λοιπῶν εἴη μάλιστα, εἴπερ ὁ γλυκὺς τῶν γεπάντων ἀνεπιτηδείοτατος. οὕτως εἴ τις δύναιτο ζητέων ἔξωθεν ἐπιτυγχάνειν, καὶ δύναιτο ἂν πάντων ἐκλέγεσθαι αἰεὶ τὸ βέλτιστον. βέλτιστον δέ ἐστι αἰεὶ τὸ προσωτάτω τοῦ ἀνεπιτηδείου ἀπέχον.