Chapter XXVIII: Book III: G (2)

The inner coat has its fibres straight, since it exists for the purpose of traction. The outer coat has its fibres transverse, for the purpose of peristalsis.[341] In fact, the movements of each of the _mobile_ organs of the body depend on the setting of the fibres. Now please test this assertion first in the muscles themselves; in these the fibres are most distinct, and their movements visible owing to their vigour. And after the muscles, pass to the _physical_ organs,[342] and you will see that they all move in correspondence with their fibres. This is why the fibres throughout the intestines are circular in both coats--they only contract peristaltically, they do not exercise traction. The stomach, again, has some of its fibres longitudinal for the purpose of traction and the others transverse for the purpose of peristalsis.[342] For just as the movements in the muscles[343] take place when each of the fibres becomes tightened and drawn towards its origin, such also is what happens in the stomach; when the transverse fibres tighten, the breadth of the cavity contained by them becomes less; and when the longitudinal fibres contract and draw in upon themselves, the length must necessarily be curtailed. This curtailment of length, indeed, is well seen in the act of swallowing: the larynx is seen to rise upwards to exactly the same degree that the gullet is drawn downwards; while, after the process of swallowing has been completed and the gullet is released from tension, the larynx can be clearly seen to sink down again. This is because the inner coat of the stomach, which has the longitudinal fibres and which also lines the gullet and the mouth, extends to the interior of the larynx, and it is thus impossible for it to be drawn down by the stomach without the larynx being involved in the traction.

Further, it will be found acknowledged in Erasistratus's own writings that the circular fibres (by which the stomach as well as other parts performs its contractions) do not curtail its length, but contract and lessen its breadth. For he says that the stomach contracts peristaltically round the food during the whole period of digestion. But if it contracts, without in any way being diminished in length, this is because downward traction of the gullet is not a property of the movement of circular peristalsis. For what alone happens, as Erasistratus himself said, is that when the upper parts contract the lower ones dilate.[344] And everyone knows that this can be plainly seen happening even in a dead man, if water be poured down his throat; this symptom[345] results from the passage of matter through a narrow channel; it would be extraordinary it the channel did not dilate when a mass was passing through it.[346] Obviously then the dilatation of the lower parts along with the contraction of the upper is common both to dead bodies, when anything whatsoever is passing through them, and to living ones, whether they contract peristaltically round their contents or attract them.[347]

Curtailment of length, on the other hand, is peculiar to organs which possess longitudinal fibres for the purpose of attraction. But the gullet was shown to be pulled down; for otherwise it would not have drawn upon the larynx. It is therefore clear that the stomach attracts food by the gullet.

Further, in _vomiting_, the mere passive conveyance of rejected matter up to the mouth will certainly itself suffice to keep open those parts of the oesophagus which are distended by the returned food; as it occupies each part in front [above], it first dilates this, and of course leaves the part behind [below] contracted. Thus, in this respect at least, the condition of the gullet is precisely similar to what it is in the act of swallowing.[348] But there being no _traction_, the whole length remains equal in such cases.

And for this reason it is easier to swallow than to vomit, for deglutition results from _both_ coats of the stomach being brought into action, the inner one exerting a pull and the outer one helping by peristalsis and propulsion, whereas emesis occurs from the outer coat alone functioning, without there being any kind of pull towards the mouth. For, although the swallowing of food is ordinarily preceded by a feeling of desire on the part of the stomach, there is in the case of vomiting no corresponding desire from the mouth-parts for the experience; the two are opposite dispositions of the stomach itself; it yearns after and tends towards what is advantageous and proper to it, it loathes and rids itself of what is foreign. Thus the actual process of swallowing occurs very quickly in those who have a good appetite for such foods as are proper to the stomach; this organ obviously draws them in and down before they are masticated; whereas in the case of those who are forced to take a medicinal draught or who take food as medicine, the swallowing of these articles is accomplished with distress and difficulty.

From what has been said, then, it is clear that the inner coat of the stomach (that containing longitudinal fibres) exists for the purpose of exerting a pull from mouth to stomach, and that it is only in deglutition that it is active, whereas the external coat, which contains transverse fibres, has been so constituted in order that it may contract upon its contents and propel them forward; this coat furthermore, functions in vomiting no less than in swallowing. The truth of my statement is also borne out by what happens in the case of the _channae_ and _synodonts_[349]; the stomachs of these animals are sometimes found in their mouths, as also Aristotle writes in his _History of Animals_; he also adds the cause of this: he says that it is owing to their voracity.

The facts are as follows. In all animals, when the appetite is very intense, the stomach rises up, so that some people who have a clear perception of this condition say that their stomach "creeps out" of them; in others, who are still masticating their food and have not yet worked it up properly in the mouth, the stomach obviously snatches away the food from them against their will. In those animals, therefore, which are naturally voracious, in whom the mouth cavity is of generous proportions, and the stomach situated close to it (as in the case of the synodont and channa), it is in no way surprising that, when they are sufficiently hungry and are pursuing one of the smaller animals, and are just on the point of catching it, the stomach should, under the impulse of desire, spring into the mouth. And this cannot possibly take place in any other way than by the stomach drawing the food to itself by means of the gullet, as though by a hand. In fact, just as we ourselves, in our eagerness to grasp more quickly something lying before us, sometimes stretch out our whole bodies along with our hands, so also the stomach stretches itself forward along with the gullet, which is, as it were, its hand. And thus, in these animals in whom those three factors co-exist--an excessive propensity for food, a small gullet, and ample mouth proportions--in these, any slight tendency to movement forwards brings the whole stomach into the mouth.

Now the constitution of the organs might itself suffice to give a naturalist an indication of their functions. For Nature would never have purposelessly constructed the oesophagus of two coats with contrary dispositions; they must also have each been meant to have a different action. The Erasistratean school, however, are capable of anything rather than of recognizing the effects of Nature. Come, therefore, let us demonstrate to them by animal dissection as well that each of the two coats does exercise the activity which I have stated. Take an animal, then; lay bare the structures surrounding the gullet, without severing any of the nerves,[350] arteries, or veins which are there situated; next divide with vertical incisions, from the lower jaw to the thorax, the outer coat of the oesophagus (that containing transverse fibres); then give the animal food and you will see that it still swallows although the peristaltic function has been abolished. If, again, in another animal, you cut through both coats[351] with transverse incisions, you will observe that this animal also swallows although the inner coat is no longer functioning. From this it is clear that the animal can also swallow by either of the two coats, although not so well as by both. For the following also, in addition to other points, may be distinctly observed in the dissection which I have described--that during deglutition the gullet becomes slightly filled with air which is swallowed along with the food, and that, when the outer coat is contracting, this air is easily forced with the food into the stomach, but that, when there only exists an inner coat, the air impedes the conveyance of food, by distending this coat and hindering its action.

But Erasistratus said nothing about this, nor did he point out that the oblique situation of the gullet clearly confutes the teaching of those who hold that it is simply by virtue of the impulse from above that food which is swallowed reaches the stomach. The only correct thing he said was that many of the long-necked animals bend down to swallow. Hence, clearly, the observed fact does not show how we swallow but how we do not swallow. For from this observation it is clear that swallowing is not due merely to the impulse from above; it is yet, however, not clear whether it results from the food being attracted by the stomach, or conducted by the gullet. For our part, however, having enumerated all the different considerations--those based on the constitution of the organs, as well as those based on the other symptoms which, as just mentioned, occur both before and after the gullet has been exposed--we have thus sufficiently proved that the inner coat exists for the purpose of attraction and the outer for the purpose of propulsion.

Now the original task we set before ourselves was to demonstrate that the _retentive_ faculty exists in every one of the organs, just as in the previous book we proved the existence of the _attractive_, and, over and above this, the _alterative_ faculty. Thus, in the natural course of our argument, we have demonstrated these four faculties existing in the stomach--the attractive faculty in connection with swallowing, the retentive with digestion, the expulsive with vomiting and with the descent of digested food into the small intestine--and digestion itself we have shown to be a process of _alteration_.

VIII

Epi men oun tês pepseôs, ei kai talla panta parelipe, to
goun hoti diapherei tês ektos hepsêseôs hê en tois zôois
pepsis, epeirathê deiknynai, peri de tês kataposeôs oud'
achri tosoutou. ti gar phêsin?

"Holkê men oun tês koilias oudemia phainetai einai."

Kai mên dyo chitônas hê gastêr echei pantôs heneka tou
gegonotas kai diêkousin houtoi mechri tou stomatos, ho
men endon, hoios esti kata tên gastera, toioutos
diamenôn, ho d' heteros epi to sarkôdesteron en tô
stomachô trepomenos. hoti men oun enantias allêlais tas
epibolas tôn inôn echousin hoi chitônes houtoi, to
phainomenon auto martyrei. tinos d' heneka toioutoi
gegonasin, Erasistratos men oud' epecheirêsen eipein,
hêmeis d' eroumen.

Ho men endon eutheias echei tas inas, holkês gar heneka
ge||gonen; ho d' exôthen enkarsias hyper tou kata kyklon 169
peristellesthai; hekastô gar tôn kinoumenôn organôn en
tois sômasi kata tas tôn inôn theseis hai kinêseis
eisin. ep' autôn de prôton tôn myôn, ei boulei,
basanison ton logon, eph' hôn kai hai ines enargestatai
kai hai kinêseis autôn horôntai dia sphodrotêta. meta de
tous mys epi ta physika tôn organôn ithi kai pant' opsei
kata tas inas kinoumena kai dia touth' hekastô men tôn
enterôn strongylai kath' hekateron tôn chitônôn hai ines
eisi; peristellontai gar monon, helkousi d' ouden. hê
gastêr de tôn inôn tas men eutheias echei charin holkês,
tas d' enkarsias heneka peristolês; hôsper gar en tois
mysin hekastês tôn inôn teinomenês te kai pros tên
archên helkomenês hai kinêseis gignontai, kata ton auton
logon kan tê gastri; tôn men oun enkarsiôn inôn
teinomenôn elatton anankê gignesthai to euros tês
periechomenês hyp' autôn koilotêtos, tôn d' eutheiôn
helkomenôn te kai eis heautas synagomenôn ouk endechetai
mê ou synaireisthai to mêkos. alla mên || enargôs ge 170
phainetai katapinontôn synairoumenon kai tosouton ho
larynx anatrechôn, hoson ho stomachos kataspatai, kai
hotan ge symplêrôtheisês tês en tô katapinein energeias
aphethê tês taseôs ho stomachos, enargôs palin phainetai
katapheromenos ho larynx; ho gar endon chitôn tês
gastros ho tas eutheias inas echôn ho kai ton stomachon
hypaleiphôn kai to stoma tois entos meresin epekteinetai
tou laryngos, hôst' ouk endechetai kataspômenon auton
hypo tês koilias mê ou synepispasthai kai ton larynga.

Hoti d' hai periphereis ines, hais peristelletai ta t'
alla moria kai hê gastêr, ou synairousi to mêkos, alla
systellousi kai stenousi tên eurytêta, kai par' autou
labein estin homologoumenon Erasistratou;
peristellesthai gar phêsi tois sitiois tên gastera kata
ton tês pepseôs hapanta chronon. all' ei peristelletai
men, ouden de tou mêkous aphaireitai tês koilias, ouk
esti tês peristaltikês kinêseôs idion to kataspan katô
ton stomachon. hoper gar autos ho Erasistratos eipe,
touto monon auto symbêsetai to tôn anô systel||lomenôn 171
diastellesthai ta katô. touto d' hoti, kan eis nekrou
ton stomachon hydatos encheês, phainetai gignomenon,
oudeis agnoei. tais gar tôn hylôn dia stenou sômatos
hodoiporiais akolouthon esti to symptôma; thaumaston
gar, ei dierchomenou tinos auton onkou mê diastalêsetai.
oukoun to men tôn anô systellomenôn diastellesthai ta
katô koinon esti kai tois nekrois sômasi, di' hôn
hopôsoun ti diexerchetai, kai tois zôsin, eite
peristelloito tois dierchomenois eith' helkoito.

To de tês tou mêkous synaireseôs idion tôn tas eutheias
inas echontôn organôn, hin' epispasôntai ti. alla mên
edeichthê kataspômenos ho stomachos, ou gar an heilke
ton larynga; dêlon oun, hôs hê gastêr helkei ta sitia
dia tou stomachou.

Kai hê kata ton emeton de tôn emoumenôn achri tou
stomatos phora pantôs men pou kai autê ta men hypo tôn
anapheromenôn diateinomena merê tou stomachou diestôta
kektêtai, tôn prosô d' ho ti an hekastot' epilambanêtai,
tout' archomenon diastelletai, to d' || opisthen 172
kataleipei dêlonoti systellomenon, hôsth' homoian einai
pantê tên diathesin tou stomachou kata ge touto tê tôn
katapinontôn; alla tês holkês mê parousês to mêkos holon
ison en tois toioutois symptômasi diaphylattetai.

Dia touto de kai katapinein rhaon estin ê emein, hoti
katapinetai men amphoin tês gastros tôn chitônôn
energountôn, tou men entos helkontos, tou d' ektos
peristellomenou te kai synepôthountos, emeitai de
thaterou monou tou exôthen energountos, oudenos
helkontos eis to stoma. ou gar dê hôsper hê tês gastros
orexis proêgeito tou katapinein ta sitia, ton auton
tropon kan tois emetois epithymei ti tôn kata to stoma
moriôn tou gignomenou pathêmatos, all' amphô tês gastros
autês eisin enantiai diatheseis, oregomenês men kai
prosiemenês ta chrêsima te kai oikeia, dyscherainousês
de kai apotribomenês ta allotria. dio kai to katapinein
auto tois men hikanôs oregomenois tôn oikeiôn edesmatôn
tê gastri tachista gignetai, saphôs helkousês auta kai
kataspôsês prin ê masêthênai, tois d' êtoi pharmakon ti
kat' anan||kên pinousin ê sition en chôra pharmakou 173
prospheromenois aniara kai mogis hê kataposis autôn
epiteleitai.

Dêlos oun estin ek tôn eirêmenôn ho men endon chitôn tês
gastros ho tas eutheias echôn inas tês ek tou stomatos
eis autên holkês heneka gegonôs kai dia tout' en tais
kataposesi monais energôn, ho d' exôthen ho tas
enkarsias echôn heneka men tou peristellesthai tois
enyparchousi kai proôthein auta toioutos apotelestheis,
energôn d' ouden hêtton en tois emetois ê tais
kataposesin. enargestata de martyrei tô legomenô kai to
kata tas channas te kai tous synodontas gignomenon;
heurisketai gar eniote toutôn hê gastêr en tô stomati
kathaper kai ho Aristotelês en tais peri zôôn egrapsen
historiais kai prostithêsi ge tên aitian hypo laimargias
autois touto symbainein phaskôn.

Echei gar hôde; kata tas sphodroteras orexeis anô
prostrechei pasi tois zôois hê gastêr, hôste tines tou
pathous aisthêsin enargê schontes exerpein hautois phasi
tên koilian, eniôn de masômenôn eti kai mêpô || kalôs en 174
tô stomati ta sitia katergasamenôn exarpazei phanerôs
akontôn. eph' hôn oun zôôn physei laimargôn hyparchontôn
hê t' eurychôria tou stomatos esti dapsilês hê te tês
gastros thesis engys, hôs epi synodontos te kai channês,
ouden thaumaston, hotan hikanôs peinasanta diôkê ti tôn
mikroterôn zôôn, eit' êdê plêsion ê tou syllabein,
anatrechein epeigousês tês epithymias eis to stoma tên
gastera. genesthai d' allôs amêchanon touto mê ouch
hôsper dia cheiros tou stomachou tês gastros epispômenês
eis heautên ta sitia. kathaper gar kai hêmeis hypo
prothymias eniote tê cheiri synepekteinomen holous hêmas
autous heneka tou thatton epidraxasthai tou prokeimenou
sômatos, houtô kai hê gastêr hoion cheiri tô stomachô
synepekteinetai. kai dia tout' eph' hôn zôôn hama ta
tria tauti synepesen, ephesis te sphodra tês trophês ho
te stomachos mikros hê t' eurychôria tou stomatos
dapsilês, epi toutôn oligê rhopê tês epektaseôs eis to
stoma tên koilian holên anapherei.

Êrkei men oun isôs andri physikô par' autês monês tês
kataskeuês tôn orga||nôn tên endeixin tês energeias 175
lambanein. ou gar dê matên g' an hê physis ek dyoin
chitônôn enantiôs allêlois echontôn apeirgasato ton
oisophagon, ei mê kai diaphorôs hekateros autôn energein
emellen. all' epei panta mallon ê ta tês physeôs erga
diagignôskein hoi peri ton Erasistraton eisin hikanoi,
phere kak tês tôn zôôn anatomês epideixômen autois, hôs
hekateros tôn chitônôn energei tên eirêmenên energeian.
ei dê ti labôn zôon, eita gymnôsas autou ta perikeimena
tô stomachô sômata chôris tou diatemein tina tôn neurôn
ê tôn artêriôn ê tôn phlebôn tôn autothi tetagmenôn
ethelois apo tês genyos heôs tou thôrakos eutheiais
tomais dielein ton exô chitôna ton tas enkarsias inas
echonta kapeita tô zôô trophên prosenenkois, opsei
katapinon auto kaitoi tês peristaltikês energeias
apolôluias. ei d' au palin eph' heterou zôou diatemois
amphoterous tous chitônas tomais enkarsiais, theasê kai
touto katapinon ouket' energountos tou entos. hô dêlon,
hoti kai dia thaterou men autôn katapinein hoion t'
estin, || alla cheiron ê di' amphoterôn. pros gar au 176
tois allois kai tout' esti theasasthai saphôs epi tês
eirêmenês anatomês, hôs en tô katapinein hypopimplatai
pneumatos ho stomachos tou synkatapinomenou tois
sitiois, ho peristellomenou men tou exôthen chitônos
ôtheitai rhadiôs eis tên gastera syn tois edesmasi,
monou de tou endon hyparchontos empodôn histatai tê
phora tôn sitiôn diateinon t' auton kai tên energeian
empodizon.

All' oute toutôn ouden Erasistratos eipen outh' hôs hê
skolia thesis tou stomachou diaballei saphôs to dogma
tôn nomizontôn hypo tês anôthen bolês monês podêgoumena
mechri tês gastros ienai ta katapinomena. monon d' hoti
polla tôn makrotrachêlôn zôôn epikekyphota katapinei,
kalôs eipen. hô dêlon, hoti to phainomenon ou to pôs
katapinomen apodeiknysin, alla to pôs ou katapinomen;
hoti gar mê dia monês tês anôthen bolês, ek toutou
dêlon; ou mên eith' helkousês tês koilias eite
paragontos auta tou stomachou, dêlon êdê pô. all' hêmeis
ge || pantas tous logismous eipontes tous t' ek tês 177
kataskeuês tôn organôn hormômenous kai tous apo tôn
allôn symptômatôn tôn te pro tou gymnôthênai ton
stomachon kai gymnôthentos, hôs oligô prosthen elegomen,
hikanôs enedeixametha tou men helkein heneka ton entos
chitôna, tou d' apôthein ton ektos gegonenai.

Prouthemetha men oun apodeixai tên kathektikên dynamin
en hekastô tôn organôn ousan, hôsper en tô prosthen logô
tên helktikên te kai proseti tên alloiôtikên. hypo de
tês akolouthias tou logou tas tettaras apedeixamen
hyparchousas tê gastri, tên helktikên men en tô
katapinein, tên kathektikên d' en tô pettein, tên
apôstikên d' en tois emetois kai tais tôn pepemmenôn
sitiôn eis to lepton enteron hypochôrêsesin, autên de
tên pepsin alloiôsin hyparchein.

IX

Concerning the spleen, also, we shall therefore have no further doubts[352] as to whether it attracts what is proper to it, rejects what is foreign, and has a natural power of altering and retaining all that it attracts; nor shall we be in any doubt as to the liver, veins, arteries, heart, or any other organ. For these four faculties have been shown to be necessary for every part which is to be nourished; this is why we have called these faculties the _handmaids of nutrition_. For just as human faeces are most pleasing to dogs, so the residual matters from the liver are, some of them, proper to the spleen,[353] others to the gall-bladder, and others to the kidneys.

IX

Oukoun et' aporêsomen oude peri tou splênos, ei helkei
men to oikeion, apokrinei de to allotrion, alloioun de
kai katechein, hoson an epispasêtai, pephyken, oude peri
hêpatos ê phlebos ê artêrias ê kardias ê tôn || allôn 178
tinos; anankaiai gar edeichthêsan hai tettares hautai
dynameis hapanti moriô tô mellonti threpsesthai kai dia
tout' autas hypêretidas einai threpseôs ephamen; hôs gar
to tôn anthrôpôn apopatêma tois kysin hêdiston, houtô
kai ta tou hêpatos perittômata to men tô splêni, to de
tê cholêdochô kystei, to de tois nephrois oikeion.

X

I should not have cared to say anything further as to the origin of these [surplus substances] after Hippocrates, Plato, Aristotle, Diocles, Praxagoras, and Philotimus, nor indeed should I even have said anything about the _faculties_, if any of our predecessors had worked out this subject thoroughly.

While, however, the statements which the Ancients made on these points were correct, they yet omitted to defend their arguments with logical proofs; of course they never suspected that there could be sophists so shameless as to try to contradict obvious facts. More recent physicians, again, have been partly conquered by the sophistries of these fellows and have given credence to them; whilst others who attempted to argue with them appear to me to lack to a great extent the power of the Ancients. For this reason I have attempted to put together my arguments in the way in which it seems to me the Ancients, had any of them been still alive, would have done, in opposition to those who would overturn the finest doctrines of our art.

I am not, however, unaware that I shall achieve either nothing at all or else very little. For I find that a great many things which have been conclusively demonstrated by the Ancients are unintelligible to the bulk of the Moderns owing to their ignorance--nay, that, by reason of their laziness, they will not even make an attempt to comprehend them; and even if any of them have understood them, they have not given them impartial examination.

The fact is that he whose purpose is to know anything better than the multitude do must far surpass all others both as regards his nature and his early training. And when he reaches early adolescence he must become possessed with an ardent love for truth, like one inspired; neither day nor night may he cease to urge and strain himself in order to learn thoroughly all that has been said by the most illustrious of the Ancients. And when he has learnt this, then for a prolonged period he must test and prove it, observing what part of it is in agreement, and what in disagreement with obvious fact; thus he will choose this and turn away from that. To such an one my hope has been that my treatise would prove of the very greatest assistance.... Still, such people may be expected to be quite few in number, while, as for the others, this book will be as superfluous to them as a tale told to an ass.

X

Kai legein eti peri tês toutôn geneseôs ouk an etheloimi
meth' Hippokratên kai Platôna kai Aristotelên kai
Dioklea kai Praxagoran kai Philotimon; oude gar oude
peri tôn dynameôn eipon an, ei tis tôn emprosthen
akribôs exeirgasato ton hyper autôn logon.

Epei d' hoi men palaioi kalôs hyper autôn apophênamenoi
parelipon agônisasthai tô logô, mêd' hyponoêsantes
esesthai tinas eis tosouton anaischyntous sophistas, hôs
antilegein epicheirêsai tois enargesin, hoi neôteroi de
to men ti nikêthentes hypo tôn sophismatôn epeisthêsan
autois, to de ti kai antilegein epicheirêsantes apodein
moi poly tês tôn palaiôn edoxan dynameôs, || dia touth', 179
hôs an ekeinôn autôn, eiper et' ên tis, agônisasthai moi
dokei pros tous anatrepontas tês technês ta kallista,
kai autos houtôs epeirathên syntheinai tous logous.

Hoti d' ê ouden ê pantapasin anysô ti smikron, ouk
agnoô; pampolla gar heuriskô teleôs men apodedeigmena
tois palaiois, oute de syneta tois pollois tôn nyn di'
amathian all' oud' epicheiroumena gignôskesthai dia
rhathymian, out', ei kai gnôstheiê tini, dikaiôs
exetazomena.

Chrê gar ton mellonta gnôsesthai ti tôn pollôn ameinon
euthys men kai tê physei kai tê prôtê didaskalia poly
tôn allôn dienenkein; epeidan de genêtai meirakion,
alêtheias tina schein erôtikên manian, hôsper
enthousiônta kai mêth' hêmeras mête nyktos dialeipein
speudonta te kai syntetamenon ekmathein, hosa tois
endoxotatois eirêtai tôn palaiôn; epeidan d' ekmathê,
krinein auta kai basanizein chronô pampollô kai skopein,
posa men homologei tois enargôs phainomenois, posa de
diapheretai, || kai houtô ta men haireisthai, ta d' 180
apostrephesthai. tô men dê toioutô pany sphodra
chrêsimous êlpika tous hêmeterous esesthai logous; eien
d' an oligoi pantapasin houtoi; tois d' allois houtô
genêsetai to gramma peritton, hôs ei kai mython onô tis
legoi.

XI

For the sake, then, of those who are aiming at truth, we must complete this treatise by adding what is still wanting in it. Now, in people who are very hungry, the stomach obviously attracts or draws down the food before it has been thoroughly softened in the mouth, whilst in those who have no appetite or who are being forced to eat, the stomach is displeased and rejects the food.[354] And in a similar way each of the other organs possesses both faculties--that of attracting what is proper to it, and that of rejecting what is foreign. Thus, even if there be any organ which consists of only one coat (such as the two bladders,[355] the uterus, and the veins), it yet possesses both kinds of fibres, the longitudinal and the transverse.

But further, there are fibres of a third kind--the _oblique_--which are much fewer in number than the two kinds already spoken of. In the organs consisting of two coats this kind of fibre is found in the one coat only, mixed with the longitudinal fibres; but in the organs composed of one coat it is found along with the other two kinds. Now, these are of the greatest help to the action of the faculty which we have named _retentive_. For during this period the part needs to be tightly contracted and stretched over its contents at every point--the stomach during the whole period of digestion,[356] and the uterus during that of gestation.

Thus too, the coat of a vein, being single, consists of various kinds of fibres; whilst the outer coat of an artery consists of circular fibres, and its inner coat mostly of longitudinal fibres, but with a few oblique ones also amongst them. Veins thus resemble the uterus or the bladder as regards the arrangement of their fibres, even though they are deficient in thickness; similarly arteries resemble the stomach. Alone of all organs the intestines consist of two coats of which both have their fibres transverse.[357] Now the proof that it was _for the best_ that all the organs should be naturally such as they are (that, for instance, the intestines should be composed of two coats) belongs to the subject of the _use of parts_[358]; thus we must not now desire to hear about matters of this kind nor why the anatomists are at variance regarding the number of coats in each organ. For these questions have been sufficiently discussed in the treatise "On Disagreement in Anatomy." And the problem as to why each organ has such and such a character will be discussed in the treatise "On the Use of Parts."

XI

Symperanteon oun hêmin ton logon heneka tôn tês
alêtheias ephiemenôn hosa leipei kat' auton eti
prostheisin. hôs gar hê gastêr helkei men enargôs kai
kataspa ta sitia tois sphodra peinôdesi, prin akribôs en
tô stomati leiôthênai, dyscherainei de kai apôtheitai
tois apositois te kai pros anankên esthiousin, houtô kai
tôn allôn organôn hekaston amphoteras echei tas
dynameis, tên te tôn oikeiôn helktikên kai tên tôn
allotriôn apokritikên. kai dia touto, kan ex henos ê
chitônos organon ti synestôs, hôsper kai hai kysteis
amphoterai kai hai mêtrai kai hai phlebes, amphotera tôn
inôn echei ta genê, tôn eutheiôn te kai tôn enkarsiôn.

Kai men ge kai triton ti || genos inôn esti <tôn> loxôn, 181
elatton poly tô plêthei tôn proeirêmenôn dyo genôn.
heurisketai d' en men tois ek dyoin chitônôn
synestêkosin organois en thaterô monô tais eutheiais
isin anamemigmenon, en de tois ex henos hama tois allois
dyo genesi. synepilambanousi d' hautai megiston tê tês
kathektikês onomastheisês dynameôs energeia; deitai gar
en toutô tô chronô pantachothen esphinchthai kai
peritetasthai tois enyparchousi to morion, hê men gastêr
en tô tês pepseôs, hai mêtrai d' en tô tês kyêseôs
chronô panti.

Taut' ara kai ho tês phlebos chitôn heis ôn ek polyeidôn
inôn egeneto kai tôn tês artêrias ho men exôthen ek tôn
strongylôn, ho d' esôthen ek men tôn eutheiôn pleistôn,
oligôn de tinôn syn autais kai tôn loxôn, hôste tas men
phlebas tais mêtrais kai tais kystesin eoikenai kata ge
tên tôn inôn synthesin, ei kai tô pachei leipontai, tas
d' artêrias tê gastri. mona de pantôn organôn ek dyoin
th' hama kai amphoterôn enkarsias echontôn tas inas
egeneto ta entera. to d' hoti beltion ên || tôn t' allôn 182
hekastô toioutô tên physin hyparchein, hoionper kai nyn
esti, tois t' enterois ek dyoin homoiôn chitônôn
synkeisthai, tês peri chreias moriôn pragmateias estin.
oukoun nyn chrê pothein akouein peri tôn toioutôn,
hôsper oude dia ti peri tou plêthous tôn chitônôn
hekastou tôn organôn diapephônêtai tois anatomikois
andrasin. hyper men gar toutôn autarkôs en tois peri tês
anatomikês diaphônias eirêtai; peri de tou dioti
toiouton hekaston egeneto tôn organôn, en tois peri
chreias moriôn eirêsetai.

XII

It is not, however, our business to discuss either of these questions here, but to consider duly the _natural faculties_, which, to the number of four, exist in each organ. Returning then, to this point, let us recall what has already been said, and set a crown to the whole subject by adding what is still wanting. For when every part of the animal has been shewn to draw into itself the juice which is proper to it (this being practically _the first of the natural faculties_), the next point to realise is that the part does not get rid either of this attracted nutriment as a whole, or even of any superfluous portion of it, until either the organ itself, or the major part of its contents also have their condition reversed. Thus, when the stomach is sufficiently filled with the food and has absorbed and stored away the most useful part of it in its own coats, it then rejects the rest like an alien burden. The same happens to the bladders, when the matter attracted into them begins to give trouble either because it distends them through its quantity or irritates them by its quality.

And this also happens in the case of the uterus; for it is either because it can no longer bear to be stretched that it strives to relieve itself of its annoyance, or else because it is irritated by the quality of the fluids poured out into it. Now both of these conditions sometimes occur with actual violence, and then _miscarriage_ takes place. But for the most part they happen in a normal way, this being then called not miscarriage but _delivery_ or _parturition_. Now abortifacient drugs or certain other conditions which destroy the embryo or rupture certain of its membranes are followed by abortion, and similarly also when the uterus is in pain from being in a bad state of tension; and, as has been well said by Hippocrates, excessive movement on the part of the embryo itself brings on labour. Now _pain_ is common to all these conditions, and of this there are three possible causes--either excessive bulk, or weight, or irritation; bulk when the uterus can no longer support the stretching, weight when the contents surpass its strength, and irritation when the fluids which had previously been pent up in the membranes, flow out, on the rapture of these, into the uterus itself, or else when the whole foetus perishes, putrefies, and is resolved into pernicious ichors, and so irritates and bites the coat of the uterus.

In all organs, then, both their natural effects and their disorders and maladies plainly take place on analogous lines,[359] some so clearly and manifestly as to need no demonstration, and others less plainly, although not entirely unrecognizable to those who are willing to pay attention.

Thus, to take the case of the stomach: the irritation is evident here because this organ possesses most sensibility, and among its other affections those producing nausea and the so-called heartburn clearly demonstrate the eliminative faculty which expels foreign matter. So also in the case of the uterus and the urinary bladder; this latter also may be plainly observed to receive and accumulate fluid until it is so stretched by the amount of this as to be incapable of enduring the pain; or it may be the quality of the urine which irritates it; for every superfluous substance which lingers in the body must obviously putrefy, some in a shorter, and some in a longer time, and thus it becomes pungent, acrid, and burdensome to the organ which contains it. This does not apply, however, in the case of the bladder alongside the liver, whence it is clear that it possesses fewer nerves than do the other organs. Here too, however, at least the physiologist[360] must discover an analogy. For since it was shown that the gall-bladder attracts its own special juice, so as to be often found full, and that it discharges it soon after, this desire to discharge must be either due to the fact that it is burdened by the quantity or that the bile has changed in quality to pungent and acrid. For while food does not change its original quality so fast that it is already ordure as soon as it falls into the small intestine, on the other hand the bile even more readily than the urine becomes altered in quality as soon as ever it leaves the veins, and rapidly undergoes change and putrefaction. Now, if there be clear evidence in relation to the uterus, stomach, and intestines, as well as to the urinary bladder, that there is either some distention, irritation, or burden inciting each of these organs to elimination, there is no difficulty in imagining this in the case of the gall-bladder also, as well as in the other organs,--to which obviously the arteries and veins also belong.

XII

Nyni d' oudeteron toutôn prokeitai legein, alla tas
physikas dynameis monas apodeiknyein en hekastô tôn
organôn tettaras hyparchousas. epi tout' oun palin
epanelthontes anamnêsômen te tôn emprosthen eirêmenôn
epithômen te kephalên êdê tô logô panti to leipon eti
prosthentes. epeidê gar hekaston tôn en tô zôô moriôn
helkein eis heauto ton oikeion chymon apodedeiktai kai
prôtê schedon hautê tôn physikôn esti dynameôn, ephexês
|| ekeinô gnôsteon, hôs ou proteron apotribetai tên 183
helchtheisan <trophên> êtoi sympasan ê kai ti perittôma autês,
prin an eis enantian metapesê diathesin ê auto to
organon ê kai tôn periechomenôn en autô ta pleista. hê
men oun gastêr, epeidan men hikanôs emplêsthê tôn sitiôn
kai to chrêstotaton autôn eis tous heautês chitônas
enapothêtai bdallousa, tênikaut' êdê to loipon
apotribetai kathaper achthos allotrion; hai kysteis d',
epeidan hekaston tôn helchthentôn ê tô plêthei diateinon
ê tê poiotêti daknon aniaron genêtai.

Tô d' autô tropô kai hai mêtrai; êtoi gar, epeidan
mêketi pherôsi diateinomenai, to lypoun apothesthai
speudousin ê tê poiotêti daknomenai tôn ekchythentôn eis
autas hygrôn. hekateron de tôn eirêmenôn gignetai men
kai biaiôs estin hote kai amblôskousi tênikauta,
gignetai d' hôs ta polla kai prosêkontôs, hoper ouk
amblôskein all' apokyïskein te kai tiktein onomazetai.
tois men oun amblôthridiois pharmakois ê tisin allois
pathêmasi diaphthei||rousi to embryon ê tinas tôn 184
hymenôn autou rhêgnyousin hai amblôseis hepontai, houtô
de kapeidan aniathôsi poth' hai mêtrai kakôs echousai tê
diatasei, tais de tôn embryôn autôn kinêsesi tais
sphodrotatais hoi tokoi, kathaper kai touth' Hippokratei
kalôs eirêtai. koinon d' hapasôn tôn diatheseôn hê ania
kai tautês aition tritton ê onkos perittos ê ti baros ê
dêxis; onkos men, epeidan mêketi pherôsi diateinomenai,
baros d', epeidan hyper tên rhômên autôn ê to
periechomenon, dêxis d', epeidan êtoi ta proteron en
tois hymesin hygra stegomena rhagentôn autôn eis autas
ekchythê tas mêtras ê kai sympan apophtharen to kyêma
sêpomenon te kai dialyomenon eis mochthêrous ichôras
houtôs erethizê te kai daknê ton chitôna tôn hysterôn.

Analogon oun en hapasi tois organois hekasta tôn t'
ergôn autôn tôn physikôn kai mentoi tôn pathêmatôn te
kai nosêmatôn phainetai gignomena, ta men enargôs kai
saphôs houtôs, hôs apodeixeôs deisthai mêden, ta d'
hêtton men enargôs, ou mên agnôsta ge pantapasi tois || 185
ethelousi prosechein ton noun.

Epi men oun tês gastros hai te dêxeis enargeis, dioti
pleistês aisthêseôs metechei, ta t' alla pathêmata ta te
nautian empoiounta kai hoi kaloumenoi kardiôgmoi saphôs
endeiknyntai tên apokritikên te kai apôstikên tôn
allotriôn dynamin, houtô de kapi tôn hysterôn te kai tês
kysteôs tês to ouron hypodechomenês; enargôs gar oun kai
hautê phainetai mechri tosoutou to hygron hypodechomenê
te kai athroizousa, achris an êtoi pros tou plêthous
autou diateinomenê mêketi pherê tên anian ê pros tês
poiotêtos daknomenê; chronizon gar hekaston tôn
perittômatôn en tô sômati sêpetai dêlonoti, to men
elattoni, to de pleioni chronô, kai houtô daknôdes te
kai drimy kai aniaron tois periechousi gignetai. ou mên
epi ge tês epi tô hêpati kysteôs homoiôs echei; hô
dêlon, hoti neurôn hêkista metechei. chrê de kantautha
ton ge physikon andra to analogon exeuriskein. ei gar
helkein te ton oikeion apedeichthê chymon, hôs
phainesthai pollakis mestên, apokri||nein te ton auton 186
touton ouk eis makran, anankaion estin autên ê dia to
plêthos barynomenên ê tês poiotêtos metaballousês epi to
daknôdes te kai drimy tês apokriseôs ephiesthai. ou gar
dê ta men sitia tên archaian hypallattei poiotêta
tacheôs houtôs, hôst', epeidan empesê tois leptois
enterois, euthys einai kopron, hê cholê d' ou poly
mallon ê to ouron, epeidan hapax ekpesê tôn phlebôn,
exallattei tên poiotêta, tachista metaballonta kai
sêpomena. kai mên eiper epi te tôn kata tas hysteras kai
tên koilian kai ta entera kai proseti tên to ouron
hypodechomenên kystin enargôs phainetai diatasis tis ê
dêxis ê achthos epegeiron hekaston tôn organôn eis
apokrisin, ouden chalepon kapi tês cholêdochou kysteôs
tauto tout' ennoein epi te tôn allôn hapantôn organôn,
ex hôn dêlonoti kai hai artêriai kai hai phlebes eisin.

XIII

Nor is there any further difficulty in ascertaining that it is through the same channel that both attraction and discharge take place at different times. For obviously the inlet to the stomach does not merely conduct food and drink into this organ, but in the condition of nausea it performs the opposite service. Further, the neck of the bladder which is beside the liver, albeit single, both fills and empties the bladder. Similarly the canal of the uterus affords an entrance to the semen and an exit to the foetus.

But in this latter case, again, whilst the eliminative faculty is evident, the attractive faculty is not so obvious to most people. It is, however, the cervix which Hippocrates blames for inertia of the uterus when he says:--"Its orifice has no power of attracting semen."[361]

Erasistratus, however, and Asclepiades reached such heights of wisdom that they deprived not merely the stomach and the womb of this faculty but also the bladder by the liver, and the kidneys as well. I have, however, pointed out in the first book that it is impossible to assign any other cause for the secretion of urine or bile.[362]

Now, when we find that the uterus, the stomach and the bladder by the liver carry out attraction and expulsion through one and the same duct, we need no longer feel surprised that Nature should also frequently discharge waste-substances into the stomach through the veins. Still less need we be astonished if a certain amount of the food should, during long fasts, be drawn back from the liver into the stomach through the same veins[363] by which it was yielded up to the liver during absorption of nutriment.[364] To disbelieve such things would of course be like refusing to believe that purgative drugs draw their appropriate humours from all over the body by the same stomata through which absorption previously takes place, and to look for separate stomata for absorption and purgation respectively. As a matter of fact one and the same stoma subserves two distinct faculties, and these exercise their pull at different times in opposite directions--first it subserves the pull of the liver and, during catharsis, that of the drug. What is there surprising, then, in the fact that the veins situated between the liver and the region of the stomach[365] fulfil a double service or purpose? Thus, when there is abundance of nutriment contained in the food-canal, it is carried up to the liver by the veins mentioned; and when the canal is empty and in need of nutriment, this is again attracted from the liver by the same veins.

For everything appears to attract from and to go shares with everything else, and, as the most divine Hippocrates has said, there would seem to be a consensus in the movements of fluids and vapours.[366] Thus the stronger draws and the weaker is evacuated.

Now, one part is weaker or stronger than another either absolutely, by nature, and in all cases, or else it becomes so in such and such a particular instance. Thus, by nature and in all men alike, the heart is stronger than the liver at attracting what is serviceable to it and rejecting what is not so; similarly the liver is stronger than the intestines and stomach, and the arteries than the veins. In each of us personally, however, the liver has stronger drawing power at one time, and the stomach at another. For when there is much nutriment contained in the alimentary canal and the appetite and craving of the liver is violent, then the viscus[367] exerts far the strongest traction. Again, when the liver is full and distended and the stomach empty and in need, then the force of the traction shifts to the latter.

Suppose we had some food in our hands and were snatching it from one another; if we were equally in want, the stronger would be likely to prevail, but if he had satisfied his appetite, and was holding what was over carelessly, or was anxious to share it with somebody, and if the weaker was excessively desirous of it, there would be nothing to prevent the latter from getting it all. In a similar manner the stomach easily attracts nutriment from the liver when it [the stomach] has a sufficiently strong craving for it, and the appetite of the viscus is satisfied. And sometimes the surplusage of nutriment in the liver is a reason why the animal is not hungry; for when the stomach has better and more available food it requires nothing from extraneous sources, but if ever it is in need and is at a loss how to supply the need, it becomes filled with waste-matters; these are certain biliary, phlegmatic [mucous] and serous fluids, and are the only substances that the liver yields in response to the traction of the stomach, on the occasions when the latter too is in want of nutriment.

Now, just as the parts draw food from each other, so also they sometimes deposit their excess substances in each other, and just as the stronger prevailed when the two were exercising traction, so it is also when they are depositing; this is the cause of the so-called fluxions,[368] for every part has a definite inborn tension, by virtue of which it expels its superfluities, and, therefore, when one of these parts,--owing, of course, to some special condition--becomes weaker, there will necessarily be a confluence into it of the superfluities from all the other parts. The strongest part deposits its surplus matter in all the parts near it; these again in other parts which are weaker; these next into yet others; and this goes on for a long time, until the superfluity, being driven from one part into another, comes to rest in one of the weakest of all; it cannot flow from this into another part, because none of the stronger ones will receive it, while the affected part is unable to drive it away. When, however, we come to deal again with the origin and cure of disease, it will be possible to find there also abundant proofs of all that we have correctly indicated in this book. For the present, however, let us resume again the task that lay before us, _i.e._ to show that there is nothing surprising in nutriment coming from the liver to the intestines and stomach by way of the very veins through which it had previously been yielded up from these organs into the liver. And in many people who have suddenly and completely given up active exercise, or who have had a limb cut off, there occurs at certain periods an evacuation of blood by way of the intestines--as Hippocrates has also pointed out somewhere. This causes no further trouble but sharply purges the whole body and evacuates the plethoras; the passage of the superfluities is effected, of course, through the same veins by which absorption took place.

Frequently also in disease Nature purges the animal through these same veins--although in this case the discharge is not sanguineous, but corresponds to the humour which is at fault. Thus in _cholera_ the entire body is evacuated by way of the veins leading to the intestines and stomach.

To imagine that matter of different kinds is carried in one direction only would characterise a man who was entirely ignorant of all the natural faculties, and particularly of the eliminative faculty, which is the opposite of the attractive. For opposite movements of matter, active and passive, must necessarily follow opposite faculties; that is to say, every part, after it has attracted its special nutrient juice and has retained and taken the benefit of it hastens to get rid of all the surplusage as quickly and effectively as possible, and this it does in accordance with the mechanical tendency of this surplus matter.[369]

Hence the stomach clears away by vomiting those superfluities which come to the surface of its contents,[370] whilst the sediment it clears away by diarrhoea. And when the animal becomes sick, this means that the stomach is striving to be evacuated by vomiting. And the expulsive faculty has in it so violent and forcible an element that in cases of _ileus_ [volvulus], when the lower exit is completely closed, vomiting of faeces occurs; yet such surplus matter could not be emitted from the mouth without having first traversed the whole of the small intestine, the jejunum, the pylorus, the stomach, and the oesophagus. What is there to wonder at, then, if something should also be transferred from the extreme skin-surface and so reach the intestines and stomach? This also was pointed out to us by Hippocrates, who maintained that not merely pneuma or excess-matter, but actual nutriment is brought down from the outer surface to the original place from which it was taken up. For the slightest mechanical movements[371] determine this expulsive faculty, which apparently acts through the transverse fibres, and which is very rapidly transmitted from the source of motion to the opposite extremities. It is, therefore, neither unlikely nor impossible that, when the part adjoining the skin becomes suddenly oppressed by an unwonted cold, it should at once be weakened and should find that the liquid previously deposited beside it without discomfort had now become more of a burden than a source of nutrition, and should therefore strive to put it away. Finally, seeing that the passage outwards was shut off by the condensation [of tissue], it would turn to the remaining exit and would thus forcibly expel all the waste-matter at once into the adjacent part; this would do the same to the part following it; and the process would not cease until the transference finally terminated at the inner ends of the veins.[372]

Now, movements like these come to an end fairly soon, but those resulting from internal irritants (_e.g._, in the administration of purgative drugs or in cholera) become much stronger and more lasting; they persist as long as the condition of things[373] about the mouths of the veins continues, that is, so long as these continue to attract what is adjacent. For this condition[374] causes evacuation of the contiguous part, and that again of the part next to it, and this never stops until the extreme surface is reached; thus, as each part keeps passing on matter to its neighbour, the original affection[375] very quickly arrives at the extreme termination. Now this is also the case in _ileus_; the inflamed intestine is unable to support either the weight or the acridity of the waste substances and so does its best to excrete them, in fact to drive them as far away as possible. And, being prevented from effecting an expulsion downwards when the severest part of the inflammation is there, it expels the matter into the adjoining part of the intestines situated above. Thus the tendency of the eliminative faculty is step by step upwards, until the superfluities reach the mouth.

Now this will be also spoken of at greater length in my treatise on disease. For the present, however, I think I have shewn clearly that there is a universal conveyance or transference from one thing into another, and that, as Hippocrates used to say, there exists in everything a consensus in the movement of air and fluids. And I do not think that anyone, however slow his intellect, will now be at a loss to understand any of these points,--how, for instance, the stomach or intestines get nourished, or in what manner anything makes its way inwards from the outer surface of the body. Seeing that all parts have the faculty of attracting what is suitable or well-disposed and of eliminating what is troublesome or irritating, it is not surprising that opposite movements should occur in them consecutively--as may be clearly seen in the case of the heart, in the various arteries, in the thorax, and lungs. In all these[376] the active movements of the organs and therewith the passive movements of [their contained] matters may be seen taking place almost every second in opposite directions. Now, you are not astonished when the trachea-artery[377] alternately draws air into the lungs and gives it out, and when the nostrils and the whole mouth act similarly; nor do you think it strange or paradoxical that the air is dismissed through the very channel by which it was admitted just before. Do you, then, feel a difficulty in the case of the veins which pass down from the liver into the stomach and intestines, and do you think it strange that nutriment should at once be yielded up to the liver and drawn back from it into the stomach by the same veins? You must define what you mean by this expression "at once." If you mean "at the same time" this is not what we ourselves say; for just as we take in a breath at one moment and give it out again at another, so at one time the liver draws nutriment from the stomach, and at another the stomach from the liver. But if your expression "at once" means that in one and the same animal a single organ subserves the transport of matter in opposite directions, and if it is this which disturbs you, consider inspiration and expiration. For of course these also take place through the same organs, albeit they differ in their manner of movement, and in the way in which the matter is conveyed through them.

Now the lungs, the thorax, the arteries rough and smooth, the heart, the mouth, and the nostrils reverse their movements at very short intervals and change the direction of the matters they contain. On the other hand, the veins which pass down from the liver to the intestines and stomach reverse the direction of their movements not at such short intervals, but sometimes once in many days.

The whole matter, in fact, is as follows:--Each of the organs draws into itself the nutriment alongside it, and devours all the useful fluid in it, until it is thoroughly satisfied; this nutriment, as I have already shown, it stores up in itself, afterwards making it adhere and then assimilating it--that is, it becomes nourished by it. For it has been demonstrated with sufficient clearness already[378] that there is something which necessarily precedes actual nutrition, namely _adhesion_, and that before this again comes _presentation_. Thus as in the case of the _animals_ themselves the end of eating is that the stomach should be filled, similarly in the case of each of the _parts_, the end of presentation is the filling of this part with its appropriate liquid. Since, therefore, every part has, like the stomach, a _craving_[379] to be nourished, it too envelops its nutriment and clasps it all round as the stomach does. And this [action of the stomach], as has been already said, is necessarily followed by the digestion of the food, although it is not to make it suitable for the other parts that the stomach contracts upon it; if it did so, it would no longer be a physiological organ,[380] but an animal possessing reason and intelligence, with the power of choosing the better [of two alternatives].