Complete Works (269 page)

In this connection we should pursue along these lines an inquiry into
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the causes of the phenomena associated with medical cupping, and of swallowing, as well as of the motion of all projectiles that are dispatched into the air and along the ground. We should also investigate all sounds, whether fast or slow—sounds that appear to us as high pitched or low. Sometimes, when the motion they produce in us as they move towards us lacks conformity, these sounds are inharmonious; at other times, when the motion does have conformity, the sounds are harmonious. [What happens in the latter case is this.] The slower sounds catch up with the motions [b] of the earlier and quicker sounds as these are already dying away and have come to a point of conformity with the motions produced by the slower sounds that travel later. In catching up with them, the slower sounds do not upset them, even though they introduce another motion. On the contrary, they graft onto the quicker movement, now dying away, the beginning of a slower one that conforms to it, and so they produce a single effect, a mixture of high and low. Hence the pleasure they bring to fools and the delight they afford—by their expression of divine harmony in mortal movement—to the wise.

[c] And what is more, every kind of water current, even the descent of a thunderbolt as well as that marvellous “attraction” exercised by amber and by the lodestone, in all these cases there is no such thing as a force of attraction. As any careful investigator will discover, there is no void; these things push themselves around into each other; all things move by exchanging places, each to its own place, whether in the process of combination or of dissolution. He will discover that these “works of wizardry” are due to the interactive relationships among these phenomena.

[d] The phenomenon of respiration, which provided the occasion for this account, is a case in point. The above are the principles and causes to which it owes its existence, as we have said before. The fire cuts up the food [in our bellies] and as it follows the breath it oscillates inside us. As the oscillation goes on, the fire pumps the cut-up bits of food from the belly and packs them into the veins. This is the mechanism by which the streams of nourishment continue to flow throughout the bodies of all living things. The bits of food, freshly cut up and derived from things like [e] themselves—from fruits or from vegetables which the god had caused to grow for this very purpose, to serve us as food—come to have a variety of colors as a result of being mixed together, but a reddish color pervading them predominates, a character that is the product of the cutting and staining action of fire upon moisture. This is why the color of the liquid that flows in our bodies looks the way we’ve described; this liquid we call
blood,
which feeds our flesh and indeed our whole bodies. From this source
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the various parts of our bodies are watered and so replenish the supports of the depleted areas. Now both processes, the replenishment and the depletion, follow the manner of the movement of anything within the universe at large: everything moves toward that which is of its own kind. In this case, our external environment continually wastes us away and distributes our bulk by dispatching each [elemental] kind toward its own sort. The ingredients in our blood, then, having been chopped up inside us and encompassed by the individual living thing as by the frame of the [b] universe, of necessity imitate the universe’s motion. And so, as each of the fragmented parts inside moves toward its own kind, it replenishes once again the area just then depleted. In every case, whenever there is more leaving a body than flowing in [to replenish it], it diminishes; whenever less, the body grows. So while a living thing’s constitution is still young, and its elemental triangles are “fresh from the slips,” as it were, the triangles are firmly locked together, even though the frame of its entire mass is pliable, seeing that it has just lately been formed from marrow [c] and nourished with milk. Now when the triangles that constitute the young living thing’s food and drink enter its body from the outside and are enveloped within it, the body’s own new triangles cut and prevail over these others, which are older and weaker than they are. The living thing is thus nourished by an abundance of like parts, and so made to grow big. But when the roots of the triangles are slackened as a result of numerous conflicts they have waged against numerous adversaries over a long period of time, they are no longer able to cut up the entering food-triangles into [d] conformity with themselves. They are themselves handily destroyed by the invaders from outside. Every living thing, then, goes into decline when it loses this battle, and it suffers what we call “old age.” Eventually the interlocking bonds of the triangles around the marrow can no longer hold on, and come apart under stress, and when this happens they let the bonds of the soul go. The soul is then released in a natural way, and finds it pleasant to take its flight. All that is unnatural, we recall, is painful while [e] all that occurs naturally is pleasant. This is true of death as well: a death that is due to disease or injury is painful and forced, while a death that comes naturally, when the aging process has run its course, is of all deaths the least distressing—a pleasant, not a painful death.

How diseases originate is, I take it, obvious to all. Given that there are
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four kinds of stuff out of which the body has been constructed—earth, fire, water and air—it may happen that some of these unnaturally increase themselves at the expense of the others. Or they may switch regions, each leaving its own and moving into another’s region. Or again, since there is in fact more than one variety of fire and the other stuffs, it may happen that a given bodily part accommodates a particular variety that is not appropriate for it. When these things happen, they bring on conflicts and diseases. For when any of these unnatural occurrences and changes take [b] place, bodily parts that used to be cold become hot, or those that are dry go on to become moist, and so with light and heavy, too. They undergo all sorts of changes in all sorts of ways. Indeed, it is our view that only when that which arrives at or leaves a particular bodily part is the same as that part, consistent, uniform and in proper proportion with it, will the body be allowed to remain stable, sound and healthy. On the other hand, anything that causes offense by passing beyond these bounds as it arrives or departs will bring on a multiplicity of altered states, and an infinity of diseases and degenerations.

Furthermore, since there is a class of secondary structures to be found [c] in nature, anyone who intends to understand diseases will have a second set of subjects to study. Since marrow and bone, flesh and sinew are composed of the elemental stuffs—from which blood also has been formed, though in a different way—most of the diseases are brought on in the manner just described. But the most serious and grievous diseases are contracted when the process of generation that led to the formation of these structures is reversed. When this happens, they degenerate. It is natural for flesh and sinews to be formed from blood, the sinew from the [d] fiber (which is of its own kind) and the flesh from the part of the blood that congeals when the sinew is separated from it. And the sticky and oily stuff that in its turn emerges from the sinew and the flesh both glues the flesh to the bone and feeds the marrow-encompassing bone itself, so causing it to grow. And because the bone is so dense, the part of this stuff that filters through, consisting as it does of the purest, smoothest and oiliest [e] kind of triangles, forms droplets inside the bone and waters the marrow. And when this is the way it actually happens in each case, health will generally result.

Disease, however, will result if things happen the other way around. For when flesh that is wasting away passes its waste back into the veins, the veins will contain not only air but also an excess of blood of great variety. This blood will have a multitude of colors and bitter aspects, and even acidic and salty qualities, and will contain bile and serum and phlegm of every sort. These are all back-products and agents of destruction. To
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begin with, they corrupt the blood itself, and then also they do not supply the body any further with nourishment. They move everywhere throughout the veins, no longer keeping to the order of natural circulation. They are hostile to one another, since none receives any advantage from any other, and they wage a destructive and devastating war against the constituents of the body that have stayed intact and kept to their posts.

Now as the oldest part of the flesh wastes away, it resists assimilation. It turns black as a result of being subjected to a prolonged process of [b] burning, and because it is thoroughly eaten up it is bitter, and so it launches a severe attack against any part of the body that has not yet been destroyed. Sometimes the bitterness is largely refined away, and then the black color acquires an acidic quality that replaces the bitter. At other times, though, the bitterness is steeped in blood, and then it comes to have more of a reddish color, and when the black is mixed with this, it becomes a grass-like green. Further, when the flesh that is disintegrated by the fire of the inflammation is fairly young, the color that is mixed with the bitterness is a yellowish orange. Now the name “bile,” common to all these varieties, was given to them either by doctors, possibly, or else by someone who [c] had the ability to look at a plurality of unlike things and see in them a single kind that deserves to be called by a single name. As for everything that can be called a variety of bile, each has its own distinctive definition, depending on its color. In the case of serum, some of it, the watery part of the blood, is benign while that which is a part of the black, acid bile is malignant when heat causes it to be mixed with a salty quality. This kind of thing is called acid phlegm. Furthermore, when the stuff that comes from the disintegration of young, tender flesh is exposed to air and blown [d] up with wind and enveloped in moisture, bubbles form as a result, each one too small to be seen though collectively amounting to a visible mass. These bubbles look white, as foam begins to form. All this disintegration of tender flesh reacting with air is what we call white phlegm. Newly formed phlegm, furthermore, has a watery part which consists of perspiration and tears, as well as any other impurities that are discharged every [e] day. So whenever the blood, instead of being replenished in the natural way by nutrients from food and drink, derives its volume from opposite sources, contrary to nature’s way, all these things, it turns out, serve as instruments of disease.

Now when a certain part of the flesh is decomposed by disease, as long as the foundations of the flesh remain intact, the effect of the calamity is only half of what it would otherwise be, for there is still a chance of an easy recovery. But when the stuff that binds the flesh to the bones becomes
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diseased and no longer nourishes the bone or binds the flesh to the bone because it is now separated from flesh and bone as well as from sinews,
⁴³
it turns from being slick and smooth and oily to being rough and briny, shriveled up in consequence of its bad regimen. When this occurs, all the stuff that this happens to crumbles away back into the flesh and the sinew, and separates from the bone. The flesh, which collapses with it away from its roots, leaves the sinews bare and full of brine. And the flesh itself [b] succumbs back into the bloodstream, where it works to aggravate the previously mentioned diseases.

Severe as these bodily processes are, those disorders that affect the more basic tissues are even more serious. When the density of the flesh prevents the bone from getting enough ventilation, the bone gets moldy, which causes it to get too hot. Gangrene sets in and the bone cannot take in its nourishment. It then crumbles and, by a reverse process, is dissolved into [c] that nourishment which, in its turn, enters the flesh, and as the flesh lands in the blood it causes all of the previously mentioned diseases to become more virulent still. But the most extreme case of all is when the marrow becomes diseased, either as a result of some deficiency or some excess. This produces the most serious, the most critically fatal diseases, in which all the bodily processes are made to flow backwards.

Further, there is a third class of diseases, which we should think of as [d] arising in three ways. (a) One way is from air, (b) another from phlegm and (c) the third from bile. (a) When the lungs, the dispensers of air to the body, are obstructed by humors, they do not permit a clear passage. At some places the air cannot get in, while at others more than the appropriate amount gets in. In the former case, there will be parts of the body that don’t get any breath and so begin to decay, while in the latter case the air forces its way through the veins and twists them together like strands. It makes its way into the central region of the body, the region that contains the midriff, where it is shut in, thereby causing the body to waste away. [e] These factors produce countless painful diseases, often accompanied by profuse perspiration. And often, when flesh disintegrates inside the body, air is produced there, but is unable to get out. This air then causes just as much excruciating pain as the air that comes in from outside. The pain is most severe when the air settles around the sinews and the veins there and causes them to swell, thereby stretching backwards the “back stays” (the great sinews of the shoulder and arm) and the sinews attached to them. It is from this phenomenon of stretching, of course, that the diseases called
tetanus
(“tension”) and
opisthotonus
(“backward stretching”) have received their names. These diseases are difficult to cure. In fact, the onset
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of a fever affords the best prospects for relief from such ailments.

(b) Now as for the white phlegm, as long as it is trapped in the body, it is troublesome because of the air in its bubbles. But if it finds a vent to the outside of the body, it is gentler, even though it does deck the body with white, leprous spots and engenders the corresponding diseases. If it is mixed with black bile and the mixture is sprayed against the divine circuits in the head, thereby throwing them into confusion, the effect is [b] fairly mild if it comes during sleep, but should it come upon someone while awake, it is much harder to shake off. Seeing that it is a disease of the sacred part of our constitution, it is entirely just that it should be called the “sacred” disease (i.e., epilepsy).