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Title: Galen: On the Natural Faculties

Author: Galen

Translator: Arthur John Brock

Release date: August 2, 2013 [eBook #43383]

Language: English, Greek, Ancient

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*** START OF THE PROJECT GUTENBERG EBOOK GALEN: ON THE NATURAL FACULTIES ***
Transcribers Note:

References to footnotes in text and footnotes following page numbers are the original footnote numbers
while superscripted references refer to the reindexed footnote numbers.
 GALEN
ON THE NATURAL FACULTIES

WITH AN ENGLISH TRANSLATION BY

ARTHUR JOHN BROCK, M.D.
EDINBURGH

LONDON : WILLIAM HEINEMANN

NEW YORK : G. P. PUTNAM’S SONS
MCMXVI
 Pg v
PREFACE
The text used is (with a few unimportant modifications) that of Kühn (Vol. II), as edited by Georg Helmreich; Teubner,
Leipzig, 1893. The numbers of the pages of Kühn’s edition are printed at the side of the Greek text, a parallel mark (||) in
the line indicating the exact point of division between Kühn’s pages.
Words in the English text which are enclosed in square brackets are supplementary or explanatory; practically all
explanations, however, are relegated to the footnotes or introduction. In the footnotes, also, attention is drawn to words
which are of particular philological interest from the point of view of modern medicine.

I have made the translation directly from the Greek; where passages of special difficulty occurred, I have been able to
compare my own version with Linacre’s Latin translation (1523) and the French rendering of Charles Daremberg (1854-
56); in this respect I am also peculiarly fortunate in having had the help of Mr. A. W. Pickard Cambridge of Balliol
Pg vi
College, Oxford, who most kindly went through the proofs and made many valuable suggestions from the point of view
of exact scholarship.

My best thanks are due to the Editors for their courtesy and for the kindly interest they have taken in the work. I have
also gratefully to acknowledge the receipt of much assistance and encouragement from Sir William Osler, Regius
Professor of Medicine at Oxford, and from Dr. J. D. Comrie, first lecturer on the History of Medicine at Edinburgh
University. Professor D’Arcy W. Thompson of University College, Dundee, and Sir W. T. Thiselton-Dyer, late director
of the Royal Botanic Gardens at Kew, have very kindly helped me to identify several animals and plants mentioned by
Galen.

I cannot conclude without expressing a word of gratitude to my former biological teachers, Professors Patrick Geddes
and J. Arthur Thomson. The experience reared on the foundation of their teaching has gone far to help me in interpreting
the great medical biologist of Greece.
I should be glad to think that the present work might help, however little, to hasten the coming reunion between the
“humanities” and modern biological science; their present separation I believe to be against the best interest of both.

A. J. B.
22nd Stationary Hospital, Aldershot.
March, 1916.
Pg vii-viii
CONTENTS

page
preface v
introduction ix
bibliography xli
synopsis of chapters xliii
book i 1
book ii 117
book iii 223
index and glossary 335
 Pg ix
INTRODUCTION
Hippocrates
If the work of Hippocrates be taken as representing the foundation upon which the edifice of historical Greek medicine
and Galen.
was reared, then the work of Galen, who lived some six hundred years later, may be looked upon as the summit or apex
of the same edifice. Galen’s merit is to have crystallised or brought to a focus all the best work of the Greek medical
schools which had preceded his own time. It is essentially in the form of Galenism that Greek medicine was transmitted
to after ages.
The Beginnings
The ancient Greeks referred the origins of medicine to a god Asklepios (called in Latin Aesculapius), thereby testifying to
of
their appreciation of the truly divine function of the healing art. The emblem of Aesculapius, familiar in Medicine
medical symbolism
in Greece.particularly
at the present day, was a staff with a serpent coiled round it, the animal typifying wisdom in general, and more
the wisdom of the medicine-man, with his semi-miraculous powers over life and death.
Pg x “Be ye therefore wise as serpents and harmless as doves.”

The temples of Aesculapius were scattered over the ancient Hellenic world. To them the sick andThe or
Asclepiea
ailing resorted in
crowds. The treatment, which was in the hands of an hereditary priesthood, combined the best of the methods carried on
Health-Temples.
at our present-day health-resorts, our hydropathics, sanatoriums, and nursing-homes. Fresh air, water-cures, massage,
gymnastics, psychotherapy, and natural methods in general were chiefly relied on.
Hippocrates
Hippocrates, the “Father of Medicine” (5th to 4th centuries, B.C.) was associated with the Asclepieum of Cos, an island
and the
off the south-west coast of Asia Minor, near Rhodes. He apparently revitalized the work of the health-temples,
Unity of the which
had before his time been showing a certain decline in vigour, coupled with a corresponding excessiveOrganism.
tendency towards
sophistry and priestcraft.

Celsus says: “Hippocrates Cous primus quidem ex omnibus memoria dignis ab studio sapientiae disciplinam hanc
separavit.” He means that Hippocrates first gave the physician an independent standing, separating him from the
cosmological speculator. Hippocrates confined the medical man to medicine. He did with medical thought what Socrates
did with thought in general—he “brought it down from heaven to earth.” His watchword was “Back to Nature!”
At the same time, while assigning the physician his post, Hippocrates would not let him regard that post as sacrosanct.
Pg set
He xi his face against any tendency to mystery-mongering, to exclusiveness, to sacerdotalism. He was, in fact, opposed
to the spirit of trade-unionism in medicine. His concern was rather with the physician’s duties than his “rights.”
At the dawn of recorded medical history Hippocrates stands for the fundamental and primary importance of seeing
clearly—that is of clinical observation. And what he observed was that the human organism, when exposed to certain
abnormal conditions—certain stresses—tends to behave in a certain way: that in other words, each “disease” tends to
run a certain definite course. To him a disease was essentially a process, one and indivisible, and thus his practical
problem was essentially one of prognosis—“what will be the natural course of this disease, if left to itself?” Here he
found himself to no small extent in opposition with the teaching of the neighbouring medical school of Cnidus, where a
more static view-point laid special emphasis upon the minutiae of diagnosis.

Observation taught Hippocrates to place unbounded faith in the recuperative powers of the living organism—in what we
sometimes call nowadays the vis medicatrix Naturae. His observation was that even with a very considerable
“abnormality” of environmental stress the organism, in the large majority of cases, manages eventually by its own inherent
powers to adjust itself to the new conditions. “Merely give Nature a chance,” said the father of medicine in effect, “and
Pg xii diseases will cure themselves.” And accordingly his treatment was mainly directed towards “giving Nature a
most
chance.”
His keen sense of the solidarity (or rather, of the constant interplay) between the organism and its environment (the
“conditions” to which it is exposed) is instanced in his book, “Airs, Waters, and Places.” As we recognise, in our popular
everyday psychology, that “it takes two to make a quarrel,” so Hippocrates recognised that in pathology, it takes two
(organism and environment) to make a disease.

As an outstanding example of his power of clinical observation we may recall the facies Hippocratica, an accurate study
of the countenance of a dying man.
His ideals for the profession are embodied in the “Hippocratic oath.”

Impressed by this view of the organism as a unity, the Hippocratic school tended in some degree Anatomy.
to overlook the
importance of its constituent parts. The balance was re-adjusted later on by the labours of the anatomical school of
Alexandria, which, under the aegis of the enlightened Ptolemies, arose in the 3rd century B.C. Two prominent exponents
of anatomy belonging to this school were Herophilus and Erasistratus, the latter of whom we shall frequently meet with in
Pg following
the xiii pages (v. p. 95 et seq.).
After the death of the Master, the Hippocratic school tended, as so often happens with the best of culturalThe Empirics.
movements, to
show signs itself of diminishing vitality: the letter began to obscure and hamper the spirit. The comparatively small element
of theory which existed in the Hippocratic physiology was made the groundwork of a somewhat over-elaborated
“system.” Against this tendency on the part of the “Dogmatic” or “Rationalist” school there arose, also at Alexandria, the
sect of the Empiricists. “It is not,” they said, “the cause but the cure of diseases that concerns us; not how we digest, but
what is digestible.”

Horace said “Graecia capta ferum victorem cepit.” Political domination, the occupation of territory Greek
by armies, does
Medicine
not necessarily mean real conquest. Horace’s statement applied to medicine as to other branches of culture.
in Rome.

The introducer of Greek medicine into Rome was Asclepiades (1st century B.C.). A man of forceful personality, and
equipped with a fully developed philosophic system of health and disease which commended itself to the Roman savants
of the day, he soon attained to the pinnacle of professional success in the Latin capital: he is indeed to all time the type of
the fashionable (and somewhat “faddy”) West-end physician. His system was a purely mechanistic one, being based
Pg xivthe atomic doctrine of Leucippus and Democritus, which had been completed by Epicurus and recently introduced
upon
to the Roman public in Lucretius’s great poem “De Rerum Natura.” The disbelief of Asclepiades in the self-maintaining
powers of the living organism are exposed and refuted at considerable length by Galen in the volume before us.
Out of the teaching of Asclepiades that physiological processes depend upon the particular way in The which the ultimate
Methodists.
indivisible molecules come together (ἐν τῇ ποίᾳ συνόδῳ τῶν πρώτων ἐκείνων σωμάτων τῶν άπαθῶν) there was
developed by his pupil, Themison of Laodicea, a system of medicine characterised by the most engaging simplicity both
of diagnosis and treatment. This so-called “Methodic” system was intended to strike a balance between the excessive
leaning to apriorism shown by the Rationalist (Hippocratic) school and the opposite tendency of the Empiricists. “A
pathological theory we must have,” said the Methodists in effect, “but let it be simple.” They held that the molecular
groups constituting the tissues were traversed by minute channels (πόροι, “pores”); all diseases belonged to one or other
of two classes; if the channels were constricted the disease was one of stasis (στέγνωσις), and if they were dilated the
disease was one of flux (ῥύσις). Flux and stasis were indicated respectively by increase and diminution of the natural
Pg xv
secretions; treatment was of opposites by opposites—of stasis by methods causing dilatation of the channels, and
conversely.

Wild as it may seem, this pathological theory of the Methodists contained an element of truth; in various guises it has
cropped up once and again at different epochs of medical history; even to-day there are pathologists who tend to
describe certain classes of disease in terms of vaso-constriction and vaso-dilatation. The vice of the Methodist teaching
was that it looked on a disease too much as something fixed and finite, an independent entity, to be considered entirely
apart from its particular setting. The Methodists illustrate for us the tyranny of names. In its defects as in its virtues this
school has analogues at the present day; we are all acquainted with the medical man to whom a name (such, let us say, as
“tuberculosis,” “gout,” or “intestinal auto-intoxication”) stands for an entity, one and indivisible, to be treated by a definite
and unvarying formula.
To such an individual the old German saying “Jedermann hat am Ende ein Bischen Tuberkulose” is simply—
incomprehensible.

All the medical schools which I have mentioned were still holding their ground in the 2nd century a.d.,Galen.
with more or less
Pg xvi
popular acceptance, when the great Galen made his entry into the world of Graeco-Roman medicine.
Claudius Galenus was born at Pergamos in Asia Minor in the year 131 a.d. His father was one Nicon, His Nature and
a well-to-do
Nurture.
architect of that city. “I had the great good fortune,” says Galen,1 “to have as a father a highly amiable, just, good, and
benevolent man. My mother, on the other hand, possessed a very bad temper; she used sometimes to bite her serving-
maids, and she was perpetually shouting at my father and quarrelling with him—worse than Xanthippe with Socrates.
When, therefore, I compared the excellence of my father’s disposition with the disgraceful passions of my mother, I
resolved to embrace and love the former qualities, and to avoid and hate the latter.”
Nicon called his son Γαληνός, which means quiet, peaceable, and although the physician eventually turned out to be a
man of elevated character, it is possible that his somewhat excessive leaning towards controversy (exemplified in the
following pages) may have resulted from the fact that he was never quite able to throw off the worst side of the maternal
inheritance.
His father, a man well schooled in mathematics and philosophy, saw to it that his son should not lack a liberal education.
Pergamos itself was an ancient centre of civilisation, containing, among other culture-institutions, a library only second in
importance to that of Alexandria itself; it also contained an Asclepieum.
Pg xvii training was essentially eclectic: he studied all the chief philosophical systems of the time—Platonic, Aristotelian,
Galen’s
Stoic, and Epicurean—and then, at the age of seventeen, entered on a course of medical studies; these he pursued under
the best teachers at his own city, and afterwards, during a period of Wanderjahre, at Smyrna, Alexandria, and other
leading medical centres.
Returning to Pergamos, he received his first professional appointment—that of surgeon to the gladiators. After four years
here he was drawn by ambition to Rome, being at that time about thirty-one years of age. At Rome the young
Pergamene attained a brilliant reputation both as a practitioner and as a public demonstrator of anatomy; among his
patients he finally numbered even the Emperor Marcus Aurelius himself.
Medical practice in Rome at this time was at a low ebb, and Galen took no pains to conceal his contempt for the
ignorance, charlatanism, and venality of his fellow-practitioners. Eventually, in spite of his social popularity, he raised up
such odium against himself in medical circles, that he was forced to flee the city. This he did hurriedly and secretly in the
year 168 a.d., when thirty-six years of age. He betook himself to his old home at Pergamos, where he settled down
once more to a literary life.
His respite was short, however, for within a year he was summoned back to Italy by imperial mandate. Marcus Aurelius
Pg xviii
was about to undertake an expedition against the Germans, who at that time were threatening the northern frontiers of the
Empire, and he was anxious that his consulting physician should accompany him to the front. “Patriotism” in this sense,
however, seems to have had no charms for the Pergamene, and he pleaded vigorously to be excused. Eventually, the
Emperor gave him permission to remain at home, entrusting to his care the young prince Commodus.

Thereafter we know little of Galen’s history, beyond the fact that he now entered upon a period of great literary activity.
Probably he died about the end of the century.
Galen wrote extensively, not only on anatomy, physiology, and medicine in general, but also onSubsequentlogic; his logical
History of
proclivities, as will be shown later, are well exemplified in his medical writings. A considerable number of undoubtedly
Galen’s
Works.
genuine works of his have come down to us. The full importance of his contributions to medicine does not appear to
have been recognized till some time after his death, but eventually, as already pointed out, the terms Galenism and Greek
medicine became practically synonymous.
A few words may be devoted to the subsequent history of his writings.
Byzantine which left
During and after the final break-up of the Roman Empire came times or confusion and of social reconstruction,
Medicine.
Pg xix
little opportunity for scientific thought and research. The Byzantine Empire, from the 4th century onwards, was the scene
of much internal turmoil, in which the militant activities of the now State-established Christian church played a not
inconsiderable part. The Byzantine medical scholars were at best compilers, and a typical compiler was Oribasius, body-
physician to the Emperor Julian (4th century, a.d.); his excellent Synopsis was written in order to make the huge mass of
the Galenic writings available for the ordinary practitioner.
Greek medicine spread, with general Greek culture, throughout Syria, and from thence was carried byArabian
the Nestorians, a
Medicine.
persecuted heretical sect, into Persia; here it became implanted, and hence eventually spread to the Mohammedan
world. Several of the Prophet’s successors (such as the Caliphs Harun-al-Rashid and Abdul-Rahman III) were great
patrons of Greek learning, and especially of medicine. The Arabian scholars imbibed Aristotle and Galen with avidity. A
partial assimilation, however, was the farthest stage to which they could attain; with the exception of pharmacology, the
Arabians made practically no independent additions to medicine. They were essentially systematizers and commentators.
Pg xx
“Averrois che il gran comento feo”2 may stand as the type par excellence of the Moslem sage.
Avicenna (Ebn Sina), (10th to 11th century) is the foremost name in Arabian medicine: his “Book of the Canon in
Medicine,” when translated into Latin, even overshadowed the authority of Galen himself for some four centuries. Of this
work the medical historian Max Neuburger says: “Avicenna, according to his lights, imparted to contemporary medical
science the appearance of almost mathematical accuracy, whilst the art of therapeutics, although empiricism did not
wholly lack recognition, was deduced as a logical sequence from theoretical (Galenic and Aristotelian) premises.”

Having arrived at such a condition in the hands of the Mohammedans, Galenism was now destined to Introduction
pass once more to
of
the West. From the 11th century onwards Latin translations of this “Arabian” Medicine (being Greek medicine
Arabian in oriental
Medicine
trappings) began to make their way into Europe; here they helped to undermine the authority of the one medical
to the West. school
of native growth which the West produced during the Middle Ages—namely the School of Salerno. Arabo-
Scholastic
Period.
Blending with the Scholastic philosophy at the universities of Naples and Montpellier, the teachings of Aristotle and Galen
Pg xxi
now assumed a position of supreme authority: from their word, in matters scientific and medical, there was no appeal. In
reference to this period the Pergamene was referred to in later times as the “Medical Pope of the Middle Ages.”
It was of course the logical side of Galenism which chiefly commended it to the mediaeval Schoolmen, as to the
essentially speculative Moslems.
The
The year 1453, when Constantinople fell into the hands of the Turks, is often taken as marking the commencement of the
Renascence.
Renascence. Among the many factors which tended to stimulate and awaken men’s minds during these spacious times
was the rediscovery of the Greek classics, which were brought to Europe by, among others, the scholars who fled from
Byzantium. The Arabo-Scholastic versions of Aristotle and Galen were now confronted by their Greek originals. A
passion for Greek learning was aroused. The freshness and truth of these old writings helped to awaken men to a
renewed sense of their own dignity and worth, and to brace them in their own struggle for self-expression.

Prominent in this “Humanist” movement was the English physician, Thomas Linacre (c. 1460-1524) who, having gained
in Italy an extraordinary zeal for the New Learning, devoted the rest of his life, after returning to England, to the
promotion of the litterae humaniores, and especially to making Galen accessible to readers of Latin. Thus the “De
Pg xxii
Naturalibus Facultatibus” appeared in London in 1523, and was preceded and followed by several other translations,
all marked by minute accuracy and elegant Latinity.
Two new parties now arose in the medical world—the so-called “Greeks” and the more conservative “Arabists.”
But the swing of the pendulum did not cease with the creation of the liberal “Greek” party; the dazzlingParacelsus.
vision of freedom
was to drive some to a yet more anarchical position. Paracelsus, who flourished in the first half of the 16th century, may
be taken as typifying this extremist tendency. His one cry was, “Let us away with all authority whatsoever, and get back
to Nature!” At his first lecture as professor at the medical school of Basle he symbolically burned the works of Galen and
of his chief Arabian exponent, Avicenna.
But the final collapse of authority in medicine could not be brought about by mere negativism. It was Thethe constructive
Renascence
work of the Renascence anatomists, particularly those of the Italian school, which finally brought Galenism to the ground.
Anatomists.

Vesalius (1514-64), the modern “Father of Anatomy,” for dissecting human bodies, was fiercely assailed by the hosts of
orthodoxy, including that stout Galenist, his old teacher Jacques Dubois (Jacobus Sylvius). Vesalius held on his way,
Pg xxiii proving, inter alia, that Galen had been wrong in saying that the interventricular septum of the heart was
however,
permeable (cf. present volume, p. 321).

Michael Servetus (1509-53) suggested that the blood, in order to get from the right to the left side of the heart, might
have to pass through the lungs. For his heterodox opinions he was burned at the stake.
Another 16th-century anatomist, Andrea Cesalpino, is considered by the Italians to have been a discoverer of the
circulation of the blood before Harvey; he certainly had a more or less clear idea of the circulation, but, as in the case of
the “organic evolutionists before Darwin,” he failed to prove his point by conclusive demonstration.
William Harvey, the great Englishman who founded modern experimental physiology and was the first William
to establish not
Harvey
only the fact of the circulation but also the physical laws governing it, is commonly reckoned the (1578-1657).
Father of Modern
Medicine. He owed his interest in the movements of the blood to Fabricio of Acquapendente, his tutor at Padua, who
drew his attention to the valves in the veins, thus suggesting the idea of a circular as opposed to a to-and-fro motion.
Harvey’s great generalisation, based upon a long series of experiments in vivo, was considered to have given the coup
de grâce to the Galenic physiology, and hence threw temporary discredit upon the whole system of medicine associated
therewith.
Pg xxiv medicine, based upon a painstaking research into the details of physiological function, had begun.
Modern
While we cannot sufficiently commend the results of the long modern period of research-work to which Back to
the labours of
Galen!
the Renascence anatomists from Vesalius to Harvey form a fitting prelude, we yet by no means allow that Galen’s general
medical outlook was so entirely invalidated as many imagine by the conclusive demonstration of his anatomical errors. It
is time for us now to turn to Galen again after three hundred years of virtual neglect: it may be that he will help us to see
something fundamentally important for medical practice which is beyond the power even of our microscopes and X-rays
to reveal. While the value of his work undoubtedly lies mainly in its enabling us to envisage one of the greatest of the early
steps attained by man in medical knowledge, it also has a very definite intrinsic value of its own.
No attempt can be made here to determine how much of Galen’s work is, in the true sense of the word, Galen’s original, and
Debt to his
how much is drawn from the labours of his predecessors. In any case, there is no doubt that he was Precursors.
much more than a
mere compiler and systematizer of other men’s work: he was great enough to be able not merely to collect, to digest, and
to assimilate all the best of the work done before his time, but, adding to this the outcome of his own observations,
Pg xxv
experiments, and reflections, to present the whole in an articulated “system” showing that perfect balance of parts which
is the essential criterion of a work of art. Constantly, however, in his writings we shall come across traces of the influence
of, among others, Plato, Aristotle, and writers of the Stoic school.
Influence
Although Galen is an eclectic in the best sense of influence of the term, there is one name to which he pays of special
a very
Hippocrates
tribute—that of his illustrious forerunner Hippocrates. Him on quite a number of occasions he actuallyoncalls “divine” (cf.
Galen.
p. 293).

“Hippocrates,” he says, “was the first known to us of all who have been both physicians and philosophers, in that he was
the first to recognise what nature does.” Here is struck the keynote of the teaching of both Hippocrates and Galen;
this is shown in the volume before us, which deals with “the natural faculties”—that is with the faculties of this same
“Nature” or vital principle referred to in the quotation.
If Galen be looked on as a crystallisation of Greek medicine, then this book may be looked on as “The a crystallisation of
Natural
Galen. Within its comparatively short compass we meet with instances illustrating perhaps most of the Faculties.”
sides of this many-
sided writer. The “Natural Faculties” therefore forms an excellent prelude to the study of his larger and more specialised
Pg xxvi
works.
What, now, is this “Nature” or biological principle upon which Galen, like Hippocrates, bases the whole Galen’s
of his medical
“Physiology.”
teaching, and which, we may add, is constantly overlooked—if indeed ever properly apprehended—by many
physiologists of the present day? By using this term Galen meant simply that, when we deal with a living thing, we are
dealing primarily with a unity, which, quâ living, is not further divisible; all its parts can only be understood and dealt with
as being in relation to this principle of unity. Galen was thus led to criticise with considerable severity many of the
medical and surgical specialists of his time, who acted on the assumption (implicit if not explicit) that the whole was
merely the sum of its parts, and that if, in an ailing organism, these parts were treated each in and for itself, the health of
the whole organism could in this way be eventually restored.
Galen expressed this idea of the unity of the organism by saying that it was governed by a Physis or Nature (ἡ φύσις
ἥπερ διοικεῖ τὸ ζῷον), with whose “faculties” or powers it was the province of φυσιολογία (physiology, Nature-lore)
to deal. It was because Hippocrates had a clear sense of this principle that Galen called him master. “Greatest,” say the
Moslems, “is Allah, and Mohammed is his prophet.” “Greatest,” said Galen, “is the Physis, and Hippocrates is its
prophet.” Never did Mohammed more zealously maintain the unity of the Godhead than Hippocrates and Galen the unity
ofPgthe
xxvii
organism.
But we shall not have read far before we discover that the term Physiology, as used by Galen, stands Galen’s
not merely for
Physics.
what we understand by it nowadays, but also for a large part of Physics as well. This is one of the chief sources of
confusion in his writings. Having grasped, for example, the uniqueness of the process of specific selection (ὁλκὴ τοῦ
οἰκείου), by which the tissues nourish themselves, he proceeds to apply this principle in explanation of entirely different
classes of phenomena; thus he mixes it up with the physical phenomenon of the attraction of the lodestone for iron, of dry
grain for moisture, etc. It is noteworthy, however, in these latter instances, that he does not venture to follow out his
comparison to its logical conclusion; he certainly stops short of hinting that the lodestone (like a living organ or tissue)
assimilates the metal which it has attracted!
Setting aside, however, these occasional half-hearted attempts to apply his principle of a φύσις in regions where it has no
natural standing, we shall find that in the field of biology Galen moves with an assurance bred of first-hand experience.

Against his attempt to “biologize” physics may be set the converse attempt of the mechanical Atomist Theschool. Thus in
Mechanical
Asclepiades he found a doughty defender of the view that physiology was “merely” physics. Galen’s ire being roused, he
Physicists.
Pg xxviii
is not content with driving the enemy out of the biological camp, but must needs attempt also to dislodge him from that of
physics, in which he has every right to be.
The Anatomists.
In defence of the universal validity of his principle, Galen also tends to excessive disparagement of morphological factors;
witness his objection to the view of the anatomist Erasistratus that the calibre of vessels played a part in determining the
secretion of fluids (p. 123), that digestion was caused by the mechanical action of the stomach walls (p. 243), and
dropsy by induration of the liver (p. 171).

While combating the atomic explanation of physical processes, Galen of course realised that there were Characteristics
many of these
of the
which could only be explained according to what we should now call “mechanical laws.” For example, non-living things
Living
Organism.
could be subjected to φορά (passive motion), they answered to the laws of gravity (ταῖς τῶν ὑλῶν οἰακιζόμενα
ῥοπαῖς, p. 126). Furthermore, Galen did not fail to see that living things also were not entirely exempted from the
operation of these laws; they too may be at least partly subject to gravity (loc. cit.); a hollow organ exerts, by virtue of
its cavity, an attraction similar to that of dilating bellows, as well as, by virtue of the living tissue of its walls, a specifically
“vital” or selective kind of attraction (p. 325).
Pg a
As xxix
type of characteristically vital action we may take nutrition, in which occurs a phenomenon which Galen calls
active motion (δραστικὴ κίνησις) or, more technically, alteration (ἀλλοίωσις). This active type of motion cannot be
adequately stated in terms of the passive movements (groupings and re-groupings) of its constituent parts according to
certain empirical “laws.” Alteration involves self-movement, a self-determination of the organism or organic part. Galen
does not attempt to explain this fundamental characteristic of alteration any further; he contents himself with referring his
opponents to Aristotle’s work on the “Complete Alteration of Substance” (p. 9).
The most important characteristic of the Physis or Nature is its τέχνη—its artistic creativeness. In other words, the living
organism is a creative artist. This feature may be observed typically in its primary functions of growth and nutrition;
these are dependent on the characteristic faculties or powers, by virtue of which each part draws to itself what is proper
or appropriate to it (το οἰκεῖον) and rejects what is foreign (το ἀλλότριον), thereafter appropriating or assimilating the
attracted material; this assimilation is an example of the alteration (or qualitative change) already alluded to; thus the
food eaten is “altered” into the various tissues of the body, each of these having been provided by “Nature” with its own
specific faculties of attraction and repulsion.
Pg xxx
Any The potentiality;
of the operations of the living part may be looked on in three ways, either (a) as a δύναμις, faculty, Three (b)
Categories.
3
as an ἐνέργεια, which is this δύναμις in operation; or (c) as an ἔργον, the product or effect of the ἐνέργεια.
Pg xxxi
Like his master Hippocrates, Galen attached fundamental importance to clinical observation—to the Galen’s
evidence of the
Method.
senses as the indispensable groundwork of all medical knowledge. He had also, however, a forte for rapid generalisation
Pg xxxii
from observations, and his logical proclivities disposed him particularly to deductive reasoning. Examples of an almost
Euclidean method of argument may be found in the Natural Faculties (e.g. Book III. chap. i.). While this method
undoubtedly gave him much help in his search for truth, it also not unfrequently led him astray. This is evidenced by his
attempt, already noted, to apply the biological principle of the φύσις in physics. Characteristic examples of attempts to
force facts to fit premises will be found in Book II. chap. ix., where our author demonstrates that yellow bile is “virtually”
dry, and also, by a process of exclusion, assigns to the spleen the function of clearing away black bile. Strangest of all is
his attempt to prove that the same principle of specific attraction by which the ultimate tissues nourish themselves (and the
lodestone attracts iron!) accounts for the reception of food into the stomach, of urine into the kidneys, of bile into the
gall-bladder, and of semen into the uterus.
These instances are given, however, without prejudice to the system of generalisation and deduction which, in Galen’s
hands, often proved exceedingly fruitful. He is said to have tried “to unite professional and scientific medicine with a
philosophic link.” He objected, however, to such extreme attempts at simplification of medical science as that of the
Methodists, to whom diseases were isolated entities, without any relationships in time or space (v. p. xv. supra).
HePg xxxiii
based much of his pathological reasoning upon the “humoral theory” of Hippocrates, according to which certain
diseases were caused by one or more of the four humours (blood, phlegm, black and yellow bile) being in excess—that
is, by various dyscrasiae. Our modern conception of “hormone” action shows certain resemblances with this theory.
Besides observation and reasoning, Galen took his stand on experiment; he was one of the first of experimental
physiologists, as is illustrated in the present book by his researches into the function of the kidneys (p. 59 et seq.). He
also conducted a long series of experiments into the physiology of the spinal cord, to determine what parts controlled
movement and what sensibility.
As a practitioner he modelled his work largely on the broad and simple lines laid down by Hippocrates. He had also at
his disposal all the acquisitions of biological science dating from the time of Aristotle five hundred years earlier, and
reinforced by the discoveries in anatomy made by the Alexandrian school. To these he added a large series of researches
of his own.
Galen never confined himself to what one might call the academic or strictly orthodox sources of information; he roamed
the world over for answers to his queries. For example, we find him on his journeys between Pergamos and Rome twice
visiting the island of Lemnos in order to procure some of the terra sigillata, a kind of earth which had a reputation for
Pg xxxivthe bites of serpents and other wounds. At other times he visited the copper-mines of Cyprus in search for
healing
copper, and Palestine for the resin called Balm of Gilead.
By inclination and training Galen was the reverse of a “party-man.” In the Natural Faculties (p. 55) he speaks of the
bane of sectarian partizanship, “harder to heal than any itch.” He pours scorn upon the ignorant “Erasistrateans” and
“Asclepiadeans,” who attempted to hide their own incompetence under the shield of some great man’s name (cf. p.
141).
Of the two chief objects of his censure in the Natural Faculties, Galen deals perhaps less rigorously with Erasistratus
than with Asclepiades. Erasistratus did at least recognize the existence of a vital principle in the organism, albeit, with his
eye on the structures which the scalpel displayed he tended frequently to forget it. The researches of the anatomical
school of Alexandria had been naturally of the greatest service to surgery, but in medicine they sometimes had a tendency
to check progress by diverting attention from the whole to the part.

Another novel conception frequently occurring in Galen’s writings is that of the Pneuma (i.e. the breath, The spiritus). This
Pneuma
word is used in two senses, as meaning (1) the inspired air, which was drawn into the left side of theor heart Spirit. and thence
Pg xxxv all over the body by the arteries; this has not a few analogies with oxygen, particularly as its action in the tissues is
carried
attended with the appearance of the so-called “innate heat.” (2) A vital principle, conceived as being made up of matter
in the most subtle imaginable state (i.e. air). This vital principle became resolved into three kinds: (a) πνεῦμα φυσικόν or
spiritus naturalis, carried by the veins, and presiding over the subconscious vegetative life; this “natural spirit” is
therefore practically equivalent to the φῦσις or “nature” itself. (b) The πνεῦμα ζωτικόν or spiritus vitalis; here
particularly is a source of error, since the air already alluded to as being carried by the arteries tends to be confused with
this principle of “individuality” or relative autonomy in the circulatory (including, perhaps, the vasomotor) system. (c) The
πνεῦμα ψυχικόν or spiritus animalis (anima = ψυχή), carried by longitudinal canals in the nerves; this corresponds to
the ψυχή.
This view of a “vital principle” as necessarily consisting of matter in a finely divided, fluid, or “etheric” state is not
unknown even in our day. Belief in the fundamental importance of the Pneuma formed the basis of the teaching of another
vitalist school in ancient Greece, that of the Pneumatists.
It is unnecessary to detail here the various ways in which Galen’s physiological views differ from those Galen and Moderns,
of the
the Circulation
as most of these are noticed in footnotes to the text of the present translation. His ignorance of theofcirculation
the of the
Pg xxxvi Blood.
blood does not lessen the force of his general physiological conclusions to the extent that might be anticipated. In his
opinion, the great bulk of the blood travelled with a to-and-fro motion in the veins, while a little of it, mixed with inspired
air, moved in the same way along the arteries; whereas we now know that all the blood goes outward by the arteries and
returns by the veins; in either case blood is carried to the tissues by blood-vessels, and Galen’s ideas of tissue-nutrition
were wonderfully sound. The ingenious method by which (in ignorance of the pulmonary circulation) he makes blood
pass from the right to the left ventricle, may be read in the present work (p. 321). As will be seen, he was conversant
with the “anastomoses” between the ultimate branches of arteries and veins, although he imagined that they were not
used under “normal” conditions.
Galen’s
Galen was not only a man of great intellectual gifts, but one also of strong moral fibre. In his short treatise “That the best
Character.
Physician is also a Philosopher” he outlines his professional ideals. It is necessary for the efficient healer to be versed in
the three branches of “philosophy,” viz.: (a) logic, the science of how to think; (b) physics, the science of what is—i.e.
of “Nature” in the widest sense; (c) ethics, the science of what to do. The amount of toil which he who wishes to be a
physician must undergo—firstly, in mastering the work of his predecessors and afterwards in studying disease at first
Pg xxxvii
hand—makes it absolutely necessary that he should possess perfect self-control, that he should scorn money and the
weak pleasures of the senses, and should live laborious days.
Readers of the following pages will notice that Galen uses what we should call distinctly immoderate language towards
those who ventured to differ from the views of his master Hippocrates (which were also his own). The employment of
such language was one of the few weaknesses of his age which he did not transcend. Possibly also his mother’s choleric
temper may have predisposed him to it.

The fact, too, that his vivisection experiments (e.g. pp. 59, 273) were carried out apparently without any kind of
anaesthetisation being even thought of is abhorrent to the feelings of to-day, but must be excused also on the ground that
callousness towards animals was then customary, men having probably never thought much about the subject.
Galen is a master of language, using a highly polished variety of Attic prose with a precision whichGalen’s
can be only very
Greek Style.
imperfectly reproduced in another tongue. Every word he uses has an exact and definite meaning attached to it.
Translation is particularly difficult when a word stands for a physiological conception which is not now held; instances are
the words anadosis, prosthesis, and prosphysis, indicating certain steps in the process by which nutriment is conveyed
from the alimentary canal to the tissues.
Pg xxxviiiwill be surprised to find how many words are used by Galen which they would have thought had been expressly
Readers
coined to fit modern conceptions; thus our author employs not merely such terms as physiology, phthisis, atrophy,
anastomosis, but also haematopoietic, anaesthesia, and even aseptic! It is only fair, however, to remark that these
terms, particularly the last, were not used by Galen in quite their modern significance.
To resume, then: What contribution can Galen bring to the art of healing at the present day? It was not,Summary.
surely, for nothing
that the great Pergamene gave laws to the medical world for over a thousand years!

Let us draw attention once more to:

(1) The high ideal which he set before the profession.
(2) His insistence on immediate contact with nature as the primary condition for arriving at an understanding of disease;
on the need for due consideration of previous authorities; on the need also for reflection—for employment of the mind’s
eye (ἡ λογικὴ θεωρία) as an aid to the physical eye.
(3) His essentially broad outlook, which often helped him in the comprehension of a phenomenon through his knowledge
of an analogous phenomenon in another field of nature.
Pg His
(4) xxxix keen appreciation of the unity of the organism, and of the inter-dependence of its parts; his realisation that the
vital phenomena (physiological and pathological) in a living organism can only be understood when considered in relation
to the environment of that organism or part. This is the foundation for the war that Galen waged à outrance on the
Methodists, to whom diseases were things without relation to anything. This dispute is, unfortunately, not touched upon in
the present volume. What Galen combated was the tendency, familiar enough in our own day, to reduce medicine to the
science of finding a label for each patient, and then treating not the patient, but the label. (This tendency, we may remark
in parenthesis, is one which is obviously well suited for the standardising purposes of a State medical service, and is
therefore one which all who have the weal of the profession at heart must most jealously watch in the difficult days that lie
ahead.)
(5) His realisation of the inappropriateness and inadequacy of physical formulae in explaining physiological activities.
Galen’s disputes with Asclepiades over τὰ πρῶτα ἐκεῖνα σώματα τὰ ἀπαθῆ, over the ἄναρμα στοιχεῖα καὶ ληρώδεις
ὄγκοι, is but another aspect of his quarrel with the Methodists regarding their pathological “units,” whose primary
Pg xl
characteristic was just this same ἀπάθεια (impassiveness to environment, “unimpressionability”). We have of course our
Physiatric or Iatromechanical school at the present day, to whom such processes as absorption from the alimentary
canal, the respiratory interchange of gases, and the action of the renal epithelium are susceptible of a purely physical
explanation.4
(6) His quarrel with the Anatomists, which was in essence the same as that with the Atomists, and which arose from his
clear realisation that that primary and indispensable desideratum, a view of the whole, could never be obtained by a mere
summation of partial views; hence, also, his sense of the dangers which would beset the medical art if it were allowed to
fall into the hands of a mere crowd of competing specialists without any organising head to guide them.
On the1 Affections of the Mind, p. 41 (Kühn’s ed.).

“Averrhoës
2 who made the great Commentary” (Dante). It was Averrhoës (Ebn Roshd) who, in the 12th
century, introduced Aristotle to the Mohammedan world, and the “Commentary” referred to was on
Aristotle.
What 3appear to me to be certain resemblances between the Galenical and the modern vitalistic views of
Henri Bergson may perhaps be alluded to here. Galen’s vital principle, ἡ τεχνικὴ φύσις (“creative growth”),
presents analogies with l’Evolution créatrice: both manifest their activity in producing qualitative change
(ἀλλοίωσις, changement): in both, the creative change cannot be analysed into a series of static states,
but is one and continuous. In Galen, however, it comes to an end with the development of the individual,
whereas in Bergson it continues indefinitely as the evolution of life. The three aspects of organic life may
be tabulated thus:—

δύναμις ἐνέργεια ἔργον

Work to be done. Work being done. Work done, finished.
Future aspect. Present aspect. Past aspect.
Function. Structure.
The élan vital. A “thing.”
A changing which cannot be
understood as a sum of static parts; a
constant becoming, never stopping
—at least till the ἔργον is reached.
Bergson’s “ teleological” aspect. Bergson’s “ philosophical” aspect. Bergson’s “ outlook of physical
science.”

Galen recognized “creativeness” (τέχνη) in the development of the individual and its parts (ontogeny) and
in the maintenance of these, but he failed to appreciate the creative evolution of species (phylogeny),
which is, of course, part of the same process. To the teleologist the possibilities (δυνάμεις) of the Physis
are limited, to Bergson they are unlimited. Galen and Bergson agree in attaching most practical importance
to the middle category—that of Function.

While it must be conceded that Galen, following Aristotle, had never seriously questioned the fixity of
species, the following quotation from his work On Habits (chap. ii.) will show that he must have at least
had occasional glimmerings of our modern point of view on the matter. Referring to assimilation, he says:
“Just as everything we eat or drink becomes altered in quality, so of course also does the altering factor
itself become altered.... A clear proof of the assimilation of things which are being nourished to that which
is nourishing them is the change which occurs in plants and seeds; this often goes so far that what is
highly noxious in one soil becomes, when transplanted into another soil, not merely harmless, but actually
useful. This has been largely put to the test by those who compose memoirs on farming and on plants, as
also by zoological authors who have written on the changes which occur according to the countries in
which animals live. Since, therefore, not only is the nourishment altered by the creature nourished, but the
latter itself also undergoes some slight alteration, this slight alteration must necessarily become
considerable in the course of time, and thus properties resulting from prolonged habit must come to be on
a par with natural properties.”

Galen fails to see the possibility that the “natural” properties themselves originated in this way, as
activities which gradually became habitual—that is to say, that the effects of nurture may become a
“second nature,” and so eventually nature itself.
The whole passage, however, may be commended to modern biologists—particularly, might one say, to
those bacteriologists who have not yet realised how extraordinarily relative is the term “specificity” when
applied to the subject-matter of their science.

In terms
4 of filtration, diffusion, and osmosis.
 Pg xli-xlii
BIBLIOGRAPHY

Codices

Bibliothèque Nationale. Paris. No. 2267.

Library of St. Mark. Venice. No. 275.

Translations

Arabic translations by Honain in the Escurial Library, and in the Library at Leyden. Hebrew translation in the Library at Bonn.
Latin translations in the Library of Gonville and Caius College (MSS.), No. 947; also by Linacre in editions published,
London, 1523; Paris, 1528; Leyden, 1540, 1548, and 1550; also by C.G. Kühn, Leipzig, 1821.

Commentaries and Appreciations

Nic. de Anglia in Bib. Nat. Paris (MSS.), No. 7015; J. Rochon, ibidem, No. 7025; J. Segarra, 1528; J. Sylvius, 1550, 1560; L.
Joubert, 1599; M. Sebitz, 1644, 1645; J.B. Pacuvius, 1554; J.C.G. Ackermann, 1821, in the introduction to Kühn’s
translation, p. lxxx; Ilberg in articles on “Die Schriftstellerei des Klaudios Galenos,” in Rhein. Mus., Nos. 44, 47, 51, and
52 (years 1889, 1892, 1896 and 1897); I. von Mueller in Quæstiones Criticae de Galeni libris, Erlangen, 1871;
Steinschneider in Virchow’s Archiv, No. cxxiv. for 1891; Wenrich in De auctorum graecorum versionibus et commentariis
syriacis, arabicis, armiacis, persisque, Leipzig, 1842.
 Pg xliii
SYNOPSIS OF CHAPTERS

BOOK I

Chapter I

Distinction between the effects of (a) the organism’s psyche or soul (b) its physis or nature. The author proposes to confine
himself to a consideration of the latter—the vegetative—aspect of life.

Chapter II

Definition of terms. Different kinds of motion. Alteration or qualitative change. Refutation of the Sophists’ objection that such
change is only apparent, not real. The four fundamental qualities of Hippocrates (later Aristotle). Distinction between
faculty, activity (function), and effect (work or product).

Chapter III

It is by virtue of the four qualities that each part functions. Some authorities subordinate the dry and the moist principles to the
hot and the cold. Aristotle inconsistent here.

Chapter IV

We must suppose that there are faculties corresponding in number to the visible effects (or products) with which we are
familiar.

Chapter V

Genesis, growth, and nutrition. Genesis (embryogeny) sub-divided into histogenesis and organogenesis. Growth is a
tridimensional expansion of the solid parts formed during genesis. Nutrition.

Pg xliv
Chapter VI

The process of genesis (embryogeny) from insemination onwards. Each of the simple, elementary, homogeneous parts (tissues)
is produced by a special blend of the four primary alterative faculties (such secondary alterative faculties being ostopoietic,
neuropoietic, etc.). A special function and use also corresponds to each of these special tissues. The bringing of these
tissues together into organs and the disposal of these organs is performed by another faculty called diaplastic, moulding,
or formative.

Chapter VII

We now pass from genesis to growth. Growth essentially a post-natal process; it involves two factors, expansion and nutrition,
explained by analogy of a familiar child’s game.

Chapter VIII

Nutrition.

Chapter IX
These three primary faculties (genesis, growth, nutrition) have various others subservient to them.

Chapter X

Nutrition not a simple process. (1) Need of subsidiary organs for the various stages of alteration, e.g., of bread into blood, of
that into bone, etc. (2) Need also of organs for excreting the non-utilizable portions of the food, e.g., much vegetable
matter is superfluous. (3) Need of organs of a third kind, for distributing the pabulum through the body.

Chapter XI

Nutrition analysed into the stages of application (prosthesis), adhesion (prosphysis), and assimilation. The stages illustrated by
certain pathological conditions. Different shades of meaning of the term nutriment.

Pg xlv
Chapter XII

The two chief medico-philosophical schools—Atomist and Vitalist. Hippocrates an adherent of the latter school—his doctrine of
an original principle or “nature” in every living thing (doctrine of the unity of the organism).

Chapter XIII

Failure of Asclepiades to understand the functions of kidneys and ureters. His hypothesis of vaporization of imbibed fluids is
here refuted. A demonstration of urinary secretion in the living animal; the forethought and artistic skill of Nature
vindicated. Refutation also of Asclepiades’s disbelief in the special selective action of purgative drugs.

Chapter XIV

While Asclepiades denies in toto the obvious fact of specific attraction, Epicurus grants the fact, although his attempt to explain
it by the atomic hypothesis breaks down. Refutation of the Epicurean theory of magnetic attraction. Instances of specific
attraction of thorns and animal poisons by medicaments, of moisture by corn, etc.

Chapter XV

It now being granted that the urine is secreted by the kidneys, the rationale of this secretion is enquired into. The kidneys are
not mechanical filters, but are by virtue of their nature possessed of a specific faculty of attraction.

Chapter XVI

Erasistratus, again, by his favourite principle of horror vacui could never explain the secretion of urine by the kidneys. While,
however, he acknowledged that the kidneys do secrete urine, he makes no attempt to explain this; he ignores, but does not
attempt to refute, the Hippocratic doctrine of specific attraction. “Servile” position taken up by Asclepiades and
Erasistratus in regard to this function of urinary secretion.

Pg xlvi
Chapter XVII

Three other attempts (by adherents of the Erasistratean school and by Lycus of Macedonia) to explain how the kidneys come to
separate out urine from the blood. All these ignore the obvious principle of attraction.

BOOK II

Chapter I
In order to explain dispersal of food from alimentary canal viâ the veins (anadosis) there is no need to invoke with Erasistratus,
the horror vacui, since here again the principle of specific attraction is operative; moreover, blood is also driven forward by
the compressing action of the stomach and the contractions of the veins. Possibility, however, of Erasistratus’s factor
playing a certain minor rôle.

Chapter II

The Erasistratean idea that bile becomes separated out from the blood in the liver because, being the thinner fluid, it alone can
enter the narrow stomata of the bile-ducts, while the thicker blood can only enter the wider mouths of the hepatic venules.

Chapter III

The morphological factors suggested by Erasistratus are quite inadequate to explain biological happenings. Erasistratus
inconsistent with his own statements. The immanence of the physis or nature; her shaping is not merely external like that
of a statuary, but involves the entire substance. In genesis (embryogeny) the semen is the active, and the menstrual blood
the passive, principle. Attractive, alterative, and formative faculties of the semen. Embryogeny is naturally followed by
growth; these two functions distinguished.

Pg xlvii
Chapter IV

Unjustified claim by Erasistrateans that their founder had associations with the Peripatetic (Aristotelian) school. The
characteristic physiological tenets of that school (which were all anticipated by Hippocrates) in no way agree with those of
Erasistratus, save that both recognize the purposefulness of Nature; in practice, however, Erasistratus assumed numerous
exceptions to this principle. Difficulty of understanding why he rejected the biological principle of attraction in favour of
anatomical factors.

Chapter V

A further difficulty raised by Erasistratus’s statement regarding secretion of bile in the liver.

Chapter VI

The same holds with nutrition. Even if we grant that veins may obtain their nutrient blood by virtue of the horror vacui (chap.
i.), how could this explain the nutrition of nerves? Erasistratus’s hypothesis of minute elemental nerves and vessels within
the ordinary visible nerves simply throws the difficulty further back. And is Erasistratus’s minute “simple” nerve
susceptible of further analysis, as the Atomists would assume? If so, this is opposed to the conception of a constructive
and artistic Nature which Erasistratus himself shares with Hippocrates and the writer. And if his minute nerve is really
elementary and not further divisible, then it cannot, according to his own showing, contain a cavity; therefore the horror
vacui does not apply to it. And how could this principle apply to the restoration to its original bulk of a part which had
become thin through disease, where more matter must become attached than runs away? A quotation from Erasistratus
shows that he did acknowledge an “attraction,” although not exactly in the Hippocratic sense.

Pg xlviii
Chapter VII

In the last resort, the ultimate living elements (Erasistratus’s simple vessels) must draw in their food by virtue of an inherent
attractive faculty like that which the lodestone exerts on iron. Thus the process of anadosis, from beginning to end, can be
explained without assuming a horror vacui.

Chapter VIII

Erasistratus’s disregard for the humours. In respect to excessive formation of bile, however, prevention is better than cure:
accordingly we must consider its pathology. Does blood pre-exist in the food, or does it come into existence in the body?
 Erasistratus’s purely anatomical explanation of dropsy. He entirely avoids the question of the four qualities (e.g. the
importance of innate heat) in the generation of the humours, etc. Yet the problem of blood-production is no less important
than that of gastric digestion. Proof that bile does not pre-exist in the food. The four fundamental qualities of Hippocrates
and Aristotle. How the humours are formed from food taken into the veins: when heat is in proportionate amount, blood
results; when in excess, bile; when deficient, phlegm. Various conditions determining cold or warm temperaments. The
four primary diseases result each from excess of one of the four qualities. Erasistratus unwillingly acknowledges this when
he ascribes the indigestion occurring in fever to impaired function of the stomach. For what causes this functio laesa?
Proof that it is the fever (excess of innate heat).

If, then, heat plays so important a part in abnormal functioning, so must it also in normal (i.e. causes of eucrasia involved
in those of dyscrasia, of physiology in those of pathology). A like argument explains the genesis of the humours. Addition
of warmth to things already warm makes them bitter; thus honey turns to bile in people who are already warm; where
warmth deficient, as in old people, it turns to useful blood. This is a proof that bile does not pre-exist, as such, in the food.

Pg xlix
Chapter IX

The functions of organs also depend on the way in which the four qualities are mixed—e.g. the contracting function of the
stomach. Treatment only possible when we know the causes of errors of function. The Erasistrateans practically
Empiricists in this respect. On an appreciation of the meaning of a dyscrasia follows naturally the Hippocratic principle of
treating opposites by opposites (e.g. cooling the over-heated stomach, warming it when chilled, etc.). Useless in treatment
to know merely the function of each organ; we must know the bodily condition which upsets this function. Blood is warm
and moist. Yellow bile is warm and (virtually, though not apparently) dry. Phlegm is cold and moist. The fourth possible
combination (cold and dry) is represented by black bile. For the clearing out of this humour from the blood, Nature has
provided the spleen—an organ which, according to Erasistratus, fulfils no purpose. Proof of the importance of the spleen
is the jaundice, toxaemia, etc., occurring when it is diseased. Erasistratus’s failure to mention the views of leading
authorities on this organ shows the hopelessness of his position. The Hippocratic view has now been demonstrated
deductively and inductively. The classical view as to the generation of the humours. Normal and pathological forms of
yellow and black bile. Part played by the innate heat in their production. Other kinds of bile are merely transition-stages
between these extreme types. Abnormal forms removed by liver and spleen respectively. Phlegm, however, does not need a
special excretory organ, as it can undergo entire metabolism in the body.

Need for studying the works of the Ancients carefully, in order to reach a proper understanding of this subject.

Pg l BOOK III

Chapter I

A recapitulation of certain points previously demonstrated. Every part of the animal has an attractive and an alterative
(assimilative) faculty; it attracts the nutrient juice which is proper to it. Assimilation is preceded by adhesion (prosphysis)
and that again, by application (prosthesis). Application the goal of attraction. It would not, however, be followed by
adhesion and assimilation if each part did not also possess a faculty for retaining in position the nutriment which has been
applied. A priori necessity for this retentive faculty.

Chapter II

The same faculty to be proved a posteriori. Its corresponding function (i.e. the activation of this faculty or potentiality) well
seen in the large hollow organs, notably the uterus and stomach.

Chapter III
Exercise of the retentive faculty particularly well seen in the uterus. Its object is to allow the embryo to attain full development;
this being completed, a new faculty—the expulsive—hitherto quiescent, comes into play. Characteristic signs and
symptoms of pregnancy. Tight grip of uterus on growing embryo, and accurate closure of os uteri during operation of the
retentive faculty. Dilatation of os and expulsive activities of uterus at full term, or when foetus dies. Prolapse from undue
exercise of this faculty. Rôle of the midwife. Accessory muscles in parturition.

Chapter IV

Same two faculties seen in stomach. Gurglings or borborygmi show that this organ is weak and is not gripping its contents
Pgtightly
li enough. Undue delay of food in a weak stomach proved not to be due to narrowness of pylorus: length of stay
depends on whether digestion (another instance of the characteristically vital process of alteration) has taken place or not.
Erasistratus wrong in attributing digestion merely to the mechanical action of the stomach walls. When digestion
completed, then pylorus opens and allows contents to pass downwards, just as os uteri when development of embyro
completed.

Chapter V

If attraction and elimination always proceeded pari passu, the content of these hollow organs (including gall-bladder and urinary
bladder) would never vary in amount. A retentive faculty, therefore, also logically needed. Its existence demonstrated.
Expulsion determined by qualitative and quantitative changes of contents. “Diarrhoea” of stomach. Vomiting.

Chapter VI

Every organic part has an appetite and aversion for the qualities which are appropriate and foreign to it respectively. Attraction
necessarily leads to a certain benefit received. This again necessitates retention.

Chapter VII

Interaction between two bodies; the stronger masters the weaker; a deleterious drug masters the forces of the body, whereas
food is mastered by them; this mastery is an alteration, and the amount of alteration varies with the different organs; thus
a partial alteration is effected in mouth by saliva, but much greater in stomach, where not only gastric juice, but also bile,
pneuma, innate heat (i.e. oxidation?), and other powerful factors are brought to bear on it; need of considerable alteration
Pg in
lii stomach as a transition-stage between food and blood; appearance of faeces in intestine another proof of great alteration
effected in stomach. Asclepiades’s denial of real qualitative change in stomach rebutted. Erasistratus’s denial that digestion
in any way resembles a boiling process comes from his taking words too literally.

Chapter VIII

Erasistratus denies that the stomach exerts any pull in the act of swallowing. That he is wrong, however, is proved by the
anatomical structure of the stomach—its inner coat with longitudinal fibres obviously acts as a vis a fronte (attraction),
whilst its outer coat exercises through the contraction of its circular fibres a vis a tergo (propulsion); the latter also comes
into play in vomiting. The stomach uses the oesophagus as a kind of hand, to draw in its food with. The functions of the
two coats proved also by vivisection. Swallowing cannot be attributed merely to the force of gravity.

Chapter IX

These four faculties which subserve nutrition are thus apparent in many different parts of the body.

Chapter X

Need for elaborating the statements of the ancient physicians. Superiority of Ancients to Moderns. This state of affairs can only
be rectified by a really efficient education of youth. The chief requisites of such an education.
 Chapter XI

For the sake of the few who realty wish truth, the argument will be continued. A third kind of fibre—the oblique—subserves
retention; the way in which this fibre is disposed in different coats.

Pg liii
Chapter XII

The factor which brings the expulsive faculty into action is essentially a condition of the organ or its contents which is the
reverse of that which determined attraction. Analogy between abortion and normal parturition. Whatever produces
discomfort must be expelled. That discomfort also determines expulsion of contents from gall-bladder is not so evident as
in the case of stomach, uterus, urinary bladder, etc., but can be logically demonstrated.

Chapter XIII

Expulsion takes place through the same channel as attraction (e.g., in stomach, gall-bladder, uterus). Similarly the delivery
(anadosis) of nutriment to the liver from the food-canal viâ the mesenteric veins may have its direction reversed.
Continuous give-and-take between different parts of the body; superior strength of certain parts is natural, of others
acquired. When liver contains abundant food and stomach depleted, latter may draw on former; this occurs when animal
can get nothing to eat, and so prevents starvation. Similarly, when one part becomes over-distended, it tends to deposit its
excess in some weaker part near it; this passes it on to some still weaker part, which cannot get rid of it; hence deposits of
various kinds. Further instances of reversal of the normal direction of anadosis from the food canal through the veins.
Such reversal of functions would in any case be expected a priori. In the vomiting of intestinal obstruction, matter may be
carried backwards all the way from the intestine to the mouth; not surprising, therefore, that, under certain circumstances,
food-material might be driven right back from the skin-surface to the alimentary canal (e.g. in excessive chilling of
surface); not much needed to determine this reversal of direction. Action of purgative drugs upon terminals of veins; one
part draws from another until whole body participates; similarly in intestinal obstruction, each part passes on the irritating
substance to its weaker neighbour. Reversal of direction of flow occurs not merely on occasion but also constantly (as in
Pg liv
arteries, lungs, heart, etc.). The various stages of normal nutrition described. Why the stomach sometimes draws back the
nutriment it had passed on to portal veins and liver. A similar ebb and flow in relation to the spleen. Comparison of the parts
of the body to a lot of animals at a feast. The valves of the heart are a provision of Nature to prevent this otherwise
inevitable regurgitation, though even they are not quite efficient.

Chapter XIV

The superficial arteries, when they dilate, draw in air from the atmosphere, and the deeper ones a fine, vaporous blood from the
veins and heart. Lighter matter such as air will always be drawn in preference to heavier; this is why the arteries in the
food-canal draw in practically none of the nutrient matter contained in it.

Chapter XV

The two kinds of attraction—the mechanical attraction of dilating bellows and the “physical” (vital) attraction by living tissue of
nutrient matter which is specifically allied or appropriate to it. The former kind—that resulting from horror vacui—acts
primarily on light matter, whereas vital attraction has no essential concern with such mechanical factors. A hollow organ
exercises, by virtue of its cavity, the former kind of attraction, and by virtue of the living tissue of its walls, the second
kind. Application of this to question of contents of arteries; anastomoses of arteries and veins. Foramina in
interventricular septum of heart, allowing some blood to pass from right to left ventricle. Large size of aorta probably due
to fact that it not merely carries the pneuma received from the lungs, but also some of the blood which percolates through
septum from right ventricle. Thus arteries carry not merely pneuma, but also some light vaporous blood, which certain
Pg parts
lv need more than the ordinary thick blood of the veins. The organic parts must have their blood-supply sufficiently
near to allow them to absorb it; comparison with an irrigation system in a garden. Details of the process of nutrition in the
ultimate specific tissues; some are nourished from the blood directly; in others a series of intermediate stages must precede
complete assimilation; for example, marrow is an intermediate stage between blood and bone.
From the generalisations arrived at in the present work we can deduce the explanation of all kinds of particular phenomena;
an instance is given, showing the co-operation of various factors previously discussed.
 Pg 1-3
GALEN Greek text

ON THE NATURAL FACULTIES5

BOOK I

I
Since feeling and voluntary motion are peculiar to animals, whilst growth and nutrition are common to plants as well, we
may look on the former as effects6 of the soul7 and the latter as effects of the nature.8 And if there be anyone who
allows a share in soul to plants as well, and separates the two kinds of soul, naming the kind in question vegetative, and
the other sensory, this person is not saying anything else, although his language is somewhat unusual. We, however, for
our part, are convinced that the chief merit of language is clearness, and we know that nothing detracts so much from this
as do unfamiliar terms; accordingly we employ those terms which the bulk of people are accustomed to use, and we say
that animals are governed at once by their soul and by their nature, and plants by their nature alone, and that growth and
nutrition are the effects of nature, not of soul.
Pg 5
II Greek text

Thus we shall enquire, in the course of this treatise, from what faculties these effects themselves, as well as any other
effects of nature which there may be, take their origin.

First, however, we must distinguish and explain clearly the various terms which we are going to use in this treatise, and to
what things we apply them; and this will prove to be not merely an explanation of terms but at the same time a
demonstration of the effects of nature.
When, therefore, such and such a body undergoes no change from its existing state, we say that it is at rest; but, if it
departs from this in any respect we then say that in this respect it undergoes motion.9 Accordingly, when it departs in
various ways from its pre-existing state, it will be said to undergo various kinds of motion. Thus, if that which is white
becomes black, or what is black becomes white, it undergoes motion in respect to colour; or if what was previously
sweet now becomes bitter, or, conversely, from being bitter now becomes sweet, it will be said to undergo motion in
respect to flavour; to both of these instances, as well as to those previously mentioned, we shall apply the term
qualitative motion. And further, it is not only things which are altered in regard to colour and flavour which, we say,
undergo motion; when a warm thing becomes cold, and a cold warm, here, too we speak of its undergoing Pg 7 motion;
Greek text
similarly also when anything moist becomes dry, or dry moist. Now, the common term which we apply to all these cases
is alteration.
This is one kind of motion. But there is another kind which occurs in bodies which change their position, or as we say,
pass from one place to another; the name of this is transference.10

These two kinds of motion, then, are simple and primary, while compounded from them we have growth and decay,11
as when a small thing becomes bigger, or a big thing smaller, each retaining at the same time its particular form. And two
other kinds of motion are genesis and destruction,12 genesis being a coming into existence,13 and destruction being the
opposite.

Now, common to all kinds of motion is change from the pre-existing state, while common to all conditions of rest is
retention of the pre-existing state. The Sophists, however, while allowing that bread in turning into blood becomes
changed as regards sight, taste, and touch, will not agree that this change occurs in reality. Thus some of them hold that
all such phenomena are tricks and illusions of our senses; the senses, they say, are affected now in one way, now in
another, whereas the underlying substance does not admit of any of these changes to which the names are given. Others
(such as Anaxagoras)14 will have it that the qualities do exist in it, but that they are unchangeable andPgimmutable
9 from
Greek text
eternity to eternity, and that these apparent alterations are brought about by separation and combination.
Now, if I were to go out of my way to confute these people, my subsidiary task would be greater than my main one.
Thus, if they do not know all that has been written, “On Complete Alteration of Substance”15 by Aristotle, and after him
by Chrysippus,16 I must beg of them to make themselves familiar with these men’s writings. If, however, they know
these, and yet willingly prefer the worse views to the better, they will doubtless consider my arguments foolish also. I
have shown elsewhere that these opinions were shared by Hippocrates, who lived much earlier than Aristotle. In fact, of
all those known to us who have been both physicians and philosophers Hippocrates was the first who took in hand to
demonstrate that there are, in all, four mutually interacting qualities, and that to the operation of these is due the genesis
and destruction of all things that come into and pass out of being. Nay, more; Hippocrates was also the first to recognise
that all these qualities undergo an intimate mingling with one another; and at least the beginnings of the proofs to which
Aristotle later set his hand are to be found first in the writings of Hippocrates.
As to whether we are to suppose that the substances as well as their qualities undergo this intimate mingling, as Zeno of
Citium afterwards declared, I do not think it necessary to go further into this question in the present treatise;17 for
immediate purposes we only need to recognize the complete alteration of substance. In this way, nobody Pg 11will suppose
Greek text
that bread represents a kind of meeting-place18 for bone, flesh, nerve, and all the other parts, and that each of these
subsequently becomes separated in the body and goes to join its own kind;19 before any separation takes place, the
whole of the bread obviously becomes blood; (at any rate, if a man takes no other food for a prolonged period, he will
have blood enclosed in his veins all the same).20 And clearly this disproves the view of those who consider the
elements21 unchangeable, as also, for that matter, does the oil which is entirely used up in the flame of the lamp, or the
faggots which, in a somewhat longer time, turn into fire.
I said, however, that I was not going to enter into an argument with these people, and it was only because the example
was drawn from the subject-matter of medicine, and because I need it for the present treatise, that I have mentioned it.
We shall then, as I said, renounce our controversy with them, since those who wish may get a good grasp of the views of
the ancients from our own personal investigations into these matters.
The discussion which follows we shall devote entirely, as we originally proposed, to an enquiry into the number and
character of the faculties of Nature, and what is the effect which each naturally produces. Now, of course, Pg 13I mean by an
22 23 Greek text
effect that which has already come into existence and has been completed by the activity of these faculties—for
example, blood, flesh, or nerve. And activity is the name I give to the active change or motion, and the cause of this I
call a faculty. Thus, when food turns into blood, the motion of the food is passive, and that of the vein active. Similarly,
when the limbs have their position altered, it is the muscle which produces, and the bones which undergo the motion. In
these cases I call the motion of the vein and of the muscle an activity, and that of the food and the bones a symptom or
affection,24 since the first group undergoes alteration and the second group is merely transported. One might,
therefore, also speak of the activity as an effect of Nature25—for example, digestion, absorption,26 blood-production;
one could not, however, in every case call the effect an activity; thus flesh is an effect of Nature, but it is, of course, not
an activity. It is, therefore, clear that one of these terms is used in two senses, but not the other.

III
It appears to me, then, that the vein, as well as each of the other parts, functions in such and such a way according to the
manner in which the four qualities 27 are mixed. There are, however, a considerable number of not undistinguished
Pg 15 men
Greek text
—philosophers and physicians—who refer action to the Warm and the Cold, and who subordinate to these, as passive,
the Dry and the Moist; Aristotle, in fact, was the first who attempted to bring back the causes of the various special
activities to these principles, and he was followed later by the Stoic school. These latter, of course, could logically make
active principles of the Warm and Cold, since they refer the change of the elements themselves into one another to
certain diffusions and condensations.28 This does not hold of Aristotle, however; seeing that he employed the four
qualities to explain the genesis of the elements, he ought properly to have also referred the causes of all the special
activities to these. How is it that he uses the four qualities in his book “On Genesis and Destruction,” whilst in his
“Meteorology,” his “Problems,” and many other works he uses the two only? Of course, if anyone were to maintain that
in the case of animals and plants the Warm and Cold are more active, the Dry and Moist less so, he might perhaps have
even Hippocrates on his side; but if he were to say that this happens in all cases, he would, I imagine, lack support, not
merely from Hippocrates, but even from Aristotle himself—if, at least, Aristotle chose to remember what he himself
taught us in his work “On Genesis and Destruction,” not as a matter of simple statement, but with an accompanying
demonstration. I have, however, also investigated these questions, in so far as they are of value to a physician, in my
work “On Temperaments.”
Pg 17
IV Greek text

The so-called blood-making29 faculty in the veins, then, as well as all the other faculties, fall within the category of
relative concepts; primarily because the faculty is the cause of the activity, but also, accidentally, because it is the cause of
the effect. But if the cause is relative to something—for it is the cause of what results from it, and of nothing else—it is
obvious that the faculty also falls into the category of the relative; and so long as we are ignorant of the true essence of
the cause which is operating, we call it a faculty. Thus we say that there exists in the veins a blood-making faculty, as
also a digestive30 faculty in the stomach, a pulsatile31 faculty in the heart, and in each of the other parts a special faculty
corresponding to the function or activity of that part. If, therefore, we are to investigate methodically the number and
kinds of faculties, we must begin with the effects; for each of these effects comes from a certain activity, and each of
these again is preceded by a cause.

V
The effects of Nature, then, while the animal is still being formed in the womb, are all the different parts of its body; and
after it has been born, an effect in which all parts share is the progress of each to its full size, and thereafter its
maintenance of itself as long as possible.
The activities corresponding to the three effects mentioned are necessarily three—one to each—namely,Pg 19 Genesis,
Greek text
Growth, and Nutrition. Genesis, however, is not a simple activity of Nature, but is compounded of alteration and of
shaping.32 That is to say, in order that bone, nerve, veins, and all other [tissues] may come into existence, the
underlying substance from which the animal springs must be altered; and in order that the substance so altered may
acquire its appropriate shape and position, its cavities, outgrowths, attachments, and so forth, it has to undergo a
shaping or formative process.33 One would be justified in calling this substance which undergoes alteration the
material of the animal, just as wood is the material of a ship, and wax of an image.
Growth is an increase and expansion in length, breadth, and thickness of the solid parts of the animal (those which have
been subjected to the moulding or shaping process). Nutrition is an addition to these, without expansion.

VI
Let us speak then, in the first place, of Genesis, which, as we have said, results from alteration together with shaping.
The seed having been cast into the womb or into the earth (for there is no difference),34 then, after a certain definite
period, a great number of parts become constituted in the substance which is being generated; these differ as regards
moisture, dryness, coldness and warmth,35 and in all the other qualities which naturally derive therefrom.
Pg 21 36
These
Greek text
derivative qualities, you are acquainted with, if you have given any sort of scientific consideration to the question of
genesis and destruction. For, first and foremost after the qualities mentioned come the other so-called tangible
distinctions, and after them those which appeal to taste, smell, and sight. Now, tangible distinctions are hardness and
softness, viscosity, friability, lightness, heaviness, density, rarity, smoothness, roughness, thickness and thinness; all of
these have been duly mentioned by Aristotle.37 And of course you know those which appeal to taste, smell, and sight.
Therefore, if you wish to know which alterative faculties are primary and elementary, they are moisture, dryness,
coldness, and warmth, and if you wish to know which ones arise from the combination of these, they will be found to be
in each animal of a number corresponding to its sensible elements. The name sensible elements is given to all the
homogeneous38 parts of the body, and these are to be detected not by any system, but by personal observation of
dissections.39
Now Nature constructs bone, cartilage, nerve, membrane, ligament, vein, and so forth, at the first stage of the animal’s
genesis,40 employing at this task a faculty which is, in general terms, generative and alterative, and, in more detail,
warming, chilling, drying, or moistening; or such as spring from the blending of these, for example, the Pg 23
bone-producing,
Greek text
nerve-producing, and cartilage-producing faculties41 (since for the sake of clearness these names must be used as well).
Now the peculiar42 flesh of the liver is of this kind as well, also that of the spleen, that of the kidneys, that of the lungs,
and that of the heart; so also the proper substance of the brain, stomach, gullet, intestines, and uterus is a sensible
element, of similar parts all through, simple, and uncompounded. That is to say, if you remove from each of the organs
mentioned its arteries, veins, and nerves,43 the substance remaining in each organ is, from the point of view of the senses,
simple and elementary. As regards those organs consisting of two dissimilar coats,44 of which each is simple, of these
organs the coats are the elements—for example, the coats of the stomach, oesophagus, intestines, and arteries; each of
these two coats has an alterative faculty peculiar to it, which has engendered it from the menstrual blood of the mother.
Thus the special alterative faculties in each animal are of the same number as the elementary parts45; and further, the
activities must necessarily correspond each to one of the special parts, just as each part has its special use—for
example, those ducts which extend from the kidneys into the bladder, and which are called ureters; for these are not
arteries, since they do not pulsate nor do they consist of two coats; and they are not veins, since they Pg neither
25 contain
Greek text
blood, nor do their coats in any way resemble those of veins; from nerves they differ still more than from the structures
mentioned.
“What, then, are they?” someone asks—as though every part must necessarily be either an artery, a vein, a nerve, or a
complex of these,46 and as though the truth were not what I am now stating, namely, that every one of the various organs
has its own particular substance. For in fact the two bladders—that which receives the urine, and that which receives the
yellow bile—not only differ from all other organs, but also from one another. Further, the ducts which spring out like
kinds of conduits from the gall-bladder and which pass into the liver have no resemblance either to arteries, veins or
nerves. But these parts have been treated at a greater length in my work “On the Anatomy of Hippocrates,” as well as
elsewhere.
As for the actual substance of the coats of the stomach, intestine, and uterus, each of these has been rendered what it is
by a special alterative faculty of Nature; while the bringing of these together,47 the combination therewith of the structures
which are inserted into them, the outgrowth into the intestine,48 the shape of the inner cavities, and the like, have all been
determined by a faculty which we call the shaping or formative faculty49; this faculty we also state to be artistic—nay,
the best and highest art—doing everything for some purpose, so that there is nothing ineffective orPgsuperfluous,
27 or
Greek text
capable of being better disposed. This, however, I shall demonstrate in my work “On the Use of Parts.”

VII
Passing now to the faculty of Growth50 let us first mention that this, too, is present in the foetus in utero as is also the
nutritive faculty, but that at that stage these two faculties are, as it were, handmaids to those already mentioned,51 and
do not possess in themselves supreme authority. When, however, the animal52 has attained its complete size, then, during
the whole period following its birth and until the acme is reached, the faculty of growth is predominant, while the
alterative and nutritive faculties are accessory—in fact, act as its handmaids. What, then, is the property of this faculty of
growth? To extend in every direction that which has already come into existence—that is to say, the solid parts of the
body, the arteries, veins, nerves, bones, cartilages, membranes, ligaments, and the various coats which we have just
called elementary, homogeneous, and simple. And I shall state in what way they gain this extension in every direction, first
giving an illustration for the sake of clearness.
Children take the bladders of pigs, fill them with air, and then rub them on ashes near the fire, so as to warm, but not to
injure them. This is a common game in the district of Ionia, and among not a few other nations. As they Pg 29
rub, they sing
Greek text
songs, to a certain measure, time, and rhythm, and all their words are an exhortation to the bladder to increase in size.
When it appears to them fairly well distended, they again blow air into it and expand it further; then they rub it again. This
they do several times, until the bladder seems to them to have become large enough. Now, clearly, in these doings of the
children, the more the interior cavity of the bladder increases in size, the thinner, necessarily, does its substance become.
But, if the children were able to bring nourishment to this thin part, then they would make the bladder big in the same way
that Nature does. As it is, however, they cannot do what Nature does, for to imitate this is beyond the power not only of
children, but of any one soever; it is a property of Nature alone.
It will now, therefore, be clear to you that nutrition is a necessity for growing things. For if such bodies were distended,
but not at the same time nourished, they would take on a false appearance of growth, not a true growth. And further, to
be distended in all directions belongs only to bodies whose growth is directed by Nature; for those which are distended
by us undergo this distension in one direction but grow less in the others; it is impossible to find a body which will remain
entire and not be torn through whilst we stretch it in the three dimensions. Thus Nature alone has the power to expand a
body in all directions so that it remains unruptured and preserves completely its previous form.

Such then is growth, and it cannot occur without the nutriment which flows to the part and is worked upPginto
31 it.
Greek text

VIII
We have, then, it seems, arrived at the subject of Nutrition, which is the third and remaining consideration which we
proposed at the outset. For, when the matter which flows to each part of the body in the form of nutriment is being
worked up into it, this activity is nutrition, and its cause is the nutritive faculty. Of course, the kind of activity here
involved is also an alteration, but not an alteration like that occurring at the stage of genesis.53 For in the latter case
something comes into existence which did not exist previously, while in nutrition the inflowing material becomes
assimilated to that which has already come into existence. Therefore, the former kind of alteration has with reason been
termed genesis, and the latter, assimilation.

IX
Now, since the three faculties of Nature have been exhaustively dealt with, and the animal would appear not to need any
others (being possessed of the means for growing, for attaining completion, and for maintaining itself as long a time as
possible), this treatise might seem to be already complete, and to constitute an exposition of all the faculties of Nature. If,
however, one considers that it has not yet touched upon any of the parts of the animal (I mean the stomach, Pg 33 intestines,
liver, and the like), and that it has not dealt with the faculties resident in these, it will seem as though Greek text
merely a kind of
introduction had been given to the practical parts of our teaching. For the whole matter is as follows: Genesis, growth,
and nutrition are the first, and, so to say, the principal effects of Nature; similarly also the faculties which produce these
effects—the first faculties—are three in number, and are the most dominating of all. But as has already been shown, these
need the service both of each other, and of yet different faculties. Now, these which the faculties of generation and
growth require have been stated. I shall now say what ones the nutritive faculty requires.

X
For I believe that I shall prove that the organs which have to do with the disposal54 of the nutriment, as also their
faculties, exist for the sake of this nutritive faculty. For since the action of this faculty55 is assimilation, and it is
impossible for anything to be assimilated by, and to change into anything else unless they already possess a certain
community and affinity in their qualities,56 therefore, in the first place, any animal cannot naturally derive nourishment
from any kind of food, and secondly, even in the case of those from which it can do so, it cannot do this at once.
Therefore, by reason of this law,57 every animal needs several organs for altering the nutriment. ForPg in 35
order that the
Greek text
yellow may become red, and the red yellow, one simple process of alteration is required, but in order that the white may
become black, and the black white, all the intermediate stages are needed.58 So also, a thing which is very soft cannot all
at once become very hard, nor vice versa; nor, similarly can anything which has a very bad smell suddenly become quite
fragrant, nor again, can the converse happen.
How, then, could blood ever turn into bone, without having first become, as far as possible, thickened and white? And
how could bread turn into blood without having gradually parted with its whiteness and gradually acquired redness? Thus
it is quite easy for blood to become flesh; for, if Nature thicken it to such an extent that it acquires a certain consistency
and ceases to be fluid, it thus becomes original newly-formed flesh; but in order that blood may turn into bone, much time
is needed and much elaboration and transformation of the blood. Further, it is quite clear that bread, and, more
particularly lettuce, beet, and the like, require a great deal of alteration in order to become blood.
This, then, is one reason why there are so many organs concerned in the alteration of food. A second reason is the nature
of the superfluities.59 For, as we are unable to draw any nourishment from grass, although this is possible for cattle,
similarly we can derive nourishment from radishes, albeit not to the same extent as from meat; for almostPgthe 37 whole of the
60 Greek text
latter is mastered by our natures ; it is transformed and altered and constituted useful blood; but, in the radish, what is
appropriate61 and able of being altered (and that only with difficulty, and with much labour) is the very smallest part;
almost the whole of it is surplus matter, and passes through the digestive organs, only a very little being taken up into the
veins as blood—nor is this itself entirely utilisable blood. Nature, therefore had need of a second process of separation
for the superfluities in the veins. Moreover, these superfluities need, on the one hand, certain fresh routes to conduct them
to the outlets, so that they may not spoil the useful substances, and they also need certain reservoirs, as it were, in which
they are collected till they reach a sufficient quantity, and are then discharged.
Thus, then, you have discovered bodily parts of a second kind, consecrated in this case to the [removal of the]
superfluities of the food. There is, however, also a third kind, for carrying the pabulum in every direction; these are like a
number of roads intersecting the whole body.
Thus there is one entrance—that through the mouth—for all the various articles of food. What receives nourishment,
however, is not one single part, but a great many parts, and these widely separated; do not be surprised, therefore, at the
abundance of organs which Nature has created for the purpose of nutrition. For those of them whichPghave 39 to do with
Greek text
alteration prepare the nutriment suitable for each part; others separate out the superfluities; some pass these along, others
store them up, others excrete them; some, again, are paths for the transit62 in all directions of the utilisable juices. So, if
you wish to gain a thorough acquaintance with all the faculties of Nature,63 you will have to consider each one of these
organs.
Now in giving an account of these we must begin with those effects of Nature, together with their corresponding parts
and faculties, which are closely connected with the purpose to be achieved.64

XI
Let us once more, then, recall the actual purpose for which Nature has constructed all these parts. Its name, as
previously stated, is nutrition, and the definition corresponding to the name is: an assimilation of that which nourishes
to that which receives nourishments.65 And in order that this may come about, we must assume a preliminary process
of adhesion,66 and for that, again, one of presentation.67 For whenever the juice which is destined to nourish any of the
parts of the animal is emitted from the vessels, it is in the first place dispersed all through this part, next it is presented,
and next it adheres, and becomes completely assimilated.
The so-called white [leprosy] shows the difference between assimilation and adhesion, in the same wayPgthat 41 the kind of
Greek text
dropsy which some people call anasarca clearly distinguishes presentation from adhesion. For, of course, the genesis of
such a dropsy does not come about as do some of the conditions of atrophy and wasting,68 from an insufficient supply of
moisture; the flesh is obviously moist enough,—in fact it is thoroughly saturated,—and each of the solid parts of the body
is in a similar condition. While, however, the nutriment conveyed to the part does undergo presentation, it is still too
watery, and is not properly transformed into a juice,69 nor has it acquired that viscous and agglutinative quality which
results from the operation of innate heat;70 therefore, adhesion cannot come about, since, owing to this abundance of
thin, crude liquid, the pabulum runs off and easily slips away from the solid parts of the body. In white [leprosy], again,
there is adhesion of the nutriment but no real assimilation. From this it is clear that what I have just said is correct, namely,
that in that part which is to be nourished there must first occur presentation, next adhesion, and finally assimilation proper.
Strictly speaking, then, nutriment is that which is actually nourishing, while the quasi-nutriment which is not yet
nourishing (e.g. matter which is undergoing adhesion or presentation) is not, strictly speaking, nutriment, but is so called
Pg 43
only by an equivocation. Also, that which is still contained in the veins, and still more, that which is in the stomach, from
Greek text
the fact that it is destined to nourish if properly elaborated, has been called “nutriment.” Similarly we call the various
kinds of food “nutriment,” not because they are already nourishing the animal, nor because they exist in the same state as
the material which actually is nourishing it, but because they are able and destined to nourish it if they be properly
elaborated.
This was also what Hippocrates said, viz., “Nutriment is what is engaged in nourishing, as also is quasi-nutriment, and
what is destined to be nutriment.” For to that which is already being assimilated he gave the name of nutriment; to the
similar material which is being presented or becoming adherent, the name of quasi-nutriment; and to everything else—
that is, contained in the stomach and veins—the name of destined nutriment.

XII
It is quite clear, therefore, that nutrition must necessarily be a process of assimilation of that which is nourishing to that
which is being nourished. Some, however, say that this assimilation does not occur in reality, but is merely apparent; these
are the people who think that Nature is not artistic, that she does not show forethought for the animal’s welfare, and that
she has absolutely no native powers whereby she alters some substances, attracts others, and discharges others.
Now, speaking generally, there have arisen the following two sects in medicine and philosophy amongPgthose45 who have
Greek text
made any definite pronouncement regarding Nature. I speak, of course, of such of them as know what they are talking
about, and who realize the logical sequence of their hypotheses, and stand by them; as for those who cannot understand
even this, but who simply talk any nonsense that comes to their tongues, and who do not remain definitely attached either
to one sect or the other—such people are not even worth mentioning.
What, then, are these sects, and what are the logical consequences of their hypotheses?71 The one class supposes that all
substance which is subject to genesis and destruction is at once continuous72 and susceptible of alteration. The other
school assumes substance to be unchangeable, unalterable, and sub-divided into fine particles, which are separated from
one another by empty spaces.

All people, therefore, who can appreciate the logical sequence of an hypothesis hold that, according to the second
teaching, there does not exist any substance or faculty peculiar either to Nature or to Soul,73 but that these result from
the way in which the primary corpuscles,74 which are unaffected by change, come together. According to the first-
mentioned teaching, on the other hand, Nature is not posterior to the corpuscles, but is a long way prior to them and
older than they; and therefore in their view it is Nature which puts together the bodies both of plants and animals; and this
she does by virtue of certain faculties which she possesses—these being, on the one hand, attractive and assimilative of
what is appropriate, and, on the other, expulsive of what is foreign. Further, she skilfully moulds everything Pg 47 during the
Greek text
stage of genesis; and she also provides for the creatures after birth, employing here other faculties again, namely, one of
affection and forethought for offspring, and one of sociability and friendship for kindred. According to the other school,
none of these things exist in the natures75 [of living things], nor is there in the soul any original innate idea, whether of
agreement or difference, of separation or synthesis, of justice or injustice, of the beautiful or ugly; all such things, they say,
arise in us from sensation and through sensation, and animals are steered by certain images and memories.
Some of these people have even expressly declared that the soul possesses no reasoning faculty, but that we are led like
cattle by the impression of our senses, and are unable to refuse or dissent from anything. In their view, obviously,
courage, wisdom, temperance, and self-control are all mere nonsense, we do not love either each other or our offspring,
nor do the gods care anything for us. This school also despises dreams, birds, omens, and the whole of astrology,
subjects with which we have dealt at greater length in another work,76 in which we discuss the views of Asclepiades the
physician.77 Those who wish to do so may familiarize themselves with these arguments, and they may also consider at
this point which of the two roads lying before us is the better one to take. Hippocrates took the first-mentioned.
Pg 49
According to this teaching, substance is one and is subject to alteration; there is a consensus in the movements of air
78 Greek text
and fluid throughout the whole body; Nature acts throughout in an artistic and equitable manner, having certain
faculties, by virtue of which each part of the body draws to itself the juice which is proper to it, and, having done so,
attaches it to every portion of itself, and completely assimilates it; while such part of the juice as has not been mastered,79
and is not capable of undergoing complete alteration and being assimilated to the part which is being nourished, is got rid
of by yet another (an expulsive) faculty.

XIII
Now the extent of exactitude and truth in the doctrines of Hippocrates may be gauged, not merely from the way in which
his opponents are at variance with obvious facts, but also from the various subjects of natural research themselves—the
functions of animals, and the rest. For those people who do not believe that there exists in any part of the animal a faculty
for attracting its own special quality80 are compelled repeatedly to deny obvious facts.81 For instance, Asclepiades, the
physician,82 did this in the case of the kidneys. That these are organs for secreting [separating out] the urine, was the
belief not only of Hippocrates, Diocles, Erasistratus, Praxagoras,83 and all other physicians of eminence, Pg 51
but practically
every butcher is aware of this, from the fact that he daily observes both the position of the kidneys andGreek text
the duct (termed
the ureter) which runs from each kidney into the bladder, and from this arrangement he infers their characteristic use and
faculty. But, even leaving the butchers aside, all people who suffer either from frequent dysuria or from retention of urine
call themselves “nephritics,”84 when they feel pain in the loins and pass sandy matter in their water.
I do not suppose that Asclepiades ever saw a stone which had been passed by one of these sufferers, or observed that
this was preceded by a sharp pain in the region between kidneys and bladder as the stone traversed the ureter, or that,
when the stone was passed, both the pain and the retention at once ceased. It is worth while, then, learning how his
theory accounts for the presence of urine in the bladder, and one is forced to marvel at the ingenuity of a man who puts
aside these broad, clearly visible routes,85 and postulates others which are narrow, invisible—indeed, entirely
imperceptible. His view, in fact, is that the fluid which we drink passes into the bladder by being resolved into vapours,
and that, when these have been again condensed, it thus regains its previous form, and turns from vapour into fluid. He
simply looks upon the bladder as a sponge or a piece of wool, and not as the perfectly compact and impervious body
Pg 53they not pass
that it is, with two very strong coats. For if we say that the vapours pass through these coats, why should
86 Greek text
through the peritoneum and the diaphragm, thus filling the whole abdominal cavity and thorax with water? “But,” says
he, “of course the peritoneal coat is more impervious than the bladder, and this is why it keeps out the vapours, while the
bladder admits them.” Yet if he had ever practised anatomy, he might have known that the outer coat of the bladder
springs from the peritoneum and is essentially the same as it, and that the inner coat, which is peculiar to the bladder, is
more than twice as thick as the former.
Perhaps, however, it is not the thickness or thinness of the coats, but the situation of the bladder, which is the reason for
the vapours being carried into it? On the contrary, even if it were probable for every other reason that the vapours
accumulate there, yet the situation of the bladder would be enough in itself to prevent this. For the bladder is situated
below, whereas vapours have a natural tendency to rise upwards; thus they would fill all the region of the thorax and
lungs long before they came to the bladder.
But why do I mention the situation of the bladder, peritoneum, and thorax? For surely, when the vapours have passed
through the coats of the stomach and intestines, it is in the space between these and the peritoneum87 that they will collect
and become liquefied (just as in dropsical subjects it is in this region that most of the water gathers).88 Otherwise the
vapours must necessarily pass straight forward through everything which in any way comes in contact with Pg 55
them, and will
Greek text
never come to a standstill. But, if this be assumed, then they will traverse not merely the peritoneum but also the
epigastrium, and will become dispersed into the surrounding air; otherwise they will certainly collect under the skin.
Even these considerations, however, our present-day Asclepiadeans attempt to answer, despite the fact that they always
get soundly laughed at by all who happen to be present at their disputations on these subjects—so difficult an evil to get
rid of is this sectarian partizanship, so excessively resistant to all cleansing processes, harder to heal than any itch!

Thus, one of our Sophists who is a thoroughly hardened disputer and as skilful a master of language as there ever was,
once got into a discussion with me on this subject; so far from being put out of countenance by any of the above-
mentioned considerations, he even expressed his surprise that I should try to overturn obvious facts by ridiculous
arguments! “For,” said he, “one may clearly observe any day in the case of any bladder, that, if one fills it with water or
air and then ties up its neck and squeezes it all round, it does not let anything out at any point, but accurately retains all its
contents. And surely,” said he, “if there were any large and perceptible channels coming into it from the kidneys the liquid
would run out through these when the bladder was squeezed, in the same way that it entered?”89 Having abruptly made
these and similar remarks in precise and clear tones, he concluded by jumping up and departing—leaving Pg me
57 as though I
Greek text
were quite incapable of finding any plausible answer!
The fact is that those who are enslaved to their sects are not merely devoid of all sound knowledge, but they will not
even stop to learn! Instead of listening, as they ought, to the reason why liquid can enter the bladder through the ureters,
but is unable to go back again the same way,—instead of admiring Nature’s artistic skill90—they refuse to learn; they
even go so far as to scoff, and maintain that the kidneys, as well as many other things, have been made by Nature for no
purpose!91 And some of them who had allowed themselves to be shown the ureters coming from the kidneys and
becoming implanted in the bladder, even had the audacity to say that these also existed for no purpose; and others said
that they were spermatic ducts, and that this was why they were inserted into the neck of the bladder and not into its
cavity. When, therefore, we had demonstrated to them the real spermatic ducts92 entering the neck of the bladder lower
down than the ureters, we supposed that, if we had not done so before, we would now at least draw them away from
their false assumptions, and convert them forthwith to the opposite view. But even this they presumed to dispute, and
said that it was not to be wondered at that the semen should remain longer in these latter ducts, these being more
constricted, and that it should flow quickly down the ducts which came from the kidneys, seeing thatPgthese 59 were well
Greek text
dilated. We were, therefore, further compelled to show them in a still living animal, the urine plainly running out through
the ureters into the bladder; even thus we hardly hoped to check their nonsensical talk.
Now the method of demonstration is as follows. One has to divide the peritoneum in front of the ureters, then secure
these with ligatures, and next, having bandaged up the animal, let him go (for he will not continue to urinate). After this
one loosens the external bandages and shows the bladder empty and the ureters quite full and distended—in fact almost
on the point of rupturing; on removing the ligature from them, one then plainly sees the bladder becoming filled with urine.
When this has been made quite clear, then, before the animal urinates, one has to tie a ligature round his penis and then to
squeeze the bladder all over; still nothing goes back through the ureters to the kidneys. Here, then, it becomes obvious
that not only in a dead animal, but in one which is still living, the ureters are prevented from receiving back the urine from
the bladder. These observations having been made, one now loosens the ligature from the animal’s penis and allows him
to urinate, then again ligatures one of the ureters and leaves the other to discharge into the bladder. Allowing, then, some
time to elapse, one now demonstrates that the ureter which was ligatured is obviously full and distended on the side next
to the kidneys, while the other one—that from which the ligature had been taken—is itself flaccid, but has filled the
bladder with urine. Then, again, one must divide the full ureter, and demonstrate how the urine spurts out Pgof
61it, like blood
Greek text
in the operation of venesection; and after this one cuts through the other also, and both being thus divided, one bandages
up the animal externally. Then when enough time seems to have elapsed, one takes off the bandages; the bladder will
now be found empty, and the whole region between the intestines and the peritoneum full of urine, as if the animal were
suffering from dropsy. Now, if anyone will but test this for himself on an animal, I think he will strongly condemn the
rashness of Asclepiades, and if he also learns the reason why nothing regurgitates from the bladder into the ureters, I
think he will be persuaded by this also of the forethought and art shown by Nature in relation to animals.93
Now Hippocrates, who was the first known to us of all those who have been both physicians and philosophers inasmuch
as he was the first to recognize what Nature effects, expresses his admiration of her, and is constantly singing her praises
and calling her “just.” Alone, he says, she suffices for the animal in every respect, performing of her own accord and
without any teaching all that is required. Being such, she has, as he supposes, certain faculties, one attractive of what is
appropriate,94 and another eliminative of what is foreign, and she nourishes the animal, makes it grow, and expels its
diseases by crisis.95 Therefore he says that there is in our bodies a concordance in the movements of air and fluid, and
that everything is in sympathy. According to Asclepiades, however, nothing is naturally in sympathy withPganything
63 else, all
Greek text
substance being divided and broken up into inharmonious elements and absurd “molecules.” Necessarily, then, besides
making countless other statements in opposition to plain fact, he was ignorant of Nature’s faculties, both that attracting
what is appropriate, and that expelling what is foreign. Thus he invented some wretched nonsense to explain blood-
production and anadosis,96 and, being utterly unable to find anything to say regarding the clearing-out97 of superfluities,
he did not hesitate to join issue with obvious facts, and, in this matter of urinary secretion, to deprive both the kidneys
and the ureters of their activity, by assuming that there were certain invisible channels opening into the bladder. It was, of
course, a grand and impressive thing to do, to mistrust the obvious, and to pin one’s faith in things which could not be
seen!
Also, in the matter of the yellow bile, he makes an even grander and more spirited venture; for he says this is actually
generated in the bile-ducts, not merely separated out.
How comes it, then, that in cases of jaundice two things happen at the same time—that the dejections contain absolutely
no bile, and that the whole body becomes full of it? He is forced here again to talk nonsense, just as he did in regard to
the urine. He also talks no less nonsense about the black bile and the spleen, not understanding what was said by
Hippocrates; and he attempts in stupid—I might say insane—language, to contradict what he knows nothing about.
And what profit did he derive from these opinions from the point of view of treatment? He neither was Pg 65
able to cure a
kidney ailment, nor jaundice, nor a disease of black bile, nor would he agree with the view heldGreek nottext
merely by
Hippocrates but by all men regarding drugs—that some of them purge away yellow bile, and others black, some again
phlegm, and others the thin and watery superfluity98; he held that all the substances evacuated99 were produced by the
drugs themselves, just as yellow bile is produced by the biliary passages! It matters nothing, according to this
extraordinary man, whether we give a hydragogue or a cholagogue in a case of dropsy, for these all equally purge99 and
dissolve the body, and produce a solution having such and such an appearance, which did not exist as such before!100
Must we not, therefore, suppose he was either mad, or entirely unacquainted with practical medicine? For who does not
know that if a drug for attracting phlegm be given in a case of jaundice it will not even evacuate four cyathi101 of
phlegm? Similarly also if one of the hydragogues be given. A cholagogue, on the other hand, clears away a great quantity
of bile, and the skin of patients so treated at once becomes clear. I myself have, in many cases, after treating the liver
condition, then removed the disease by means of a single purgation; whereas, if one had employed a drug for removing
phlegm one would have done no good.
Nor is Hippocrates the only one who knows this to be so, whilst those who take experience alone Pg as67their starting-
102 Greek text
point know otherwise; they, as well as all physicians who are engaged in the practice of medicine, are of this opinion.
Asclepiades, however is an exception; he would hold it a betrayal of his assumed “elements”103 to confess the truth
about such matters. For if a single drug were to be discovered which attracted such and such a humour only, there would
obviously be danger of the opinion gaining ground that there is in every body104 a faculty which attracts its own particular
quality. He therefore says that safflower,105 the Cnidian berry,106 and Hippophaes,107 do not draw phlegm from the
body, but actually make it. Moreover, he holds that the flower and scales of bronze, and burnt bronze itself, and
germander,108 and wild mastich109 dissolve the body into water, and that dropsical patients derive benefit from these
substances, not because they are purged by them, but because they are rid of substances which actually help to increase
the disease; for, if the medicine does not evacuate110 the dropsical fluid contained in the body, but generates it, it
aggravates the condition further. Moreover, scammony, according to the Asclepiadean argument, not only fails to
evacuate110 the bile from the bodies of jaundiced subjects, but actually turns the useful blood into bile, and dissolves the
body; in fact it does all manner of evil and increases the disease.
And yet this drug may be clearly seen to do good to numbers of people! “Yes,” says he, “they derivePgbenefit69 certainly,
Greek text
but merely in proportion to the evacuation.” ... But if you give these cases a drug which draws off phlegm they will not be
benefited. This is so obvious that even those who make experience alone their starting-point111 are aware of it; and these
people make it a cardinal point of their teaching to trust to no arguments, but only to what can be clearly seen. In this,
then, they show good sense; whereas Asclepiades goes far astray in bidding us distrust our senses where obvious facts
plainly overturn his hypotheses. Much better would it have been for him not to assail obvious facts, but rather to devote
himself entirely to these.
Is it, then, these facts only which are plainly irreconcilable with the views of Asclepiades? Is not also the fact that in
summer yellow bile is evacuated in greater quantity by the same drugs, and in winter phlegm, and that in a young man
more bile is evacuated, and in an old man more phlegm? Obviously each drug attracts something which already exists,
and does not generate something previously non-existent. Thus if you give in the summer season a drug which attracts
phlegm to a young man of a lean and warm habit, who has lived neither idly nor too luxuriously, you will with great
difficulty evacuate a very small quantity of this humour, and you will do the man the utmost harm. On the other hand, if
you give him a cholagogue, you will produce an abundant evacuation and not injure him at all.
Do we still, then, disbelieve that each drug attracts that humour which is proper to it?112 PossiblyPg the71adherents of
Greek text
Asclepiades will assent to this—or rather, they will—not possibly, but certainly—declare that they disbelieve it, lest they
should betray their darling prejudices.

XIV
Let us pass on, then, again to another piece of nonsense; for the sophists do not allow one to engage in enquiries that are
of any worth, albeit there are many such; they compel one to spend one’s time in dissipating the fallacious arguments
which they bring forward.
What, then, is this piece of nonsense? It has to do with the famous and far-renowned stone which draws iron [the
lodestone]. It might be thought that this would draw113 their minds to a belief that there are in all bodies certain faculties
by which they attract their own proper qualities.

Now Epicurus, despite the fact that he employs in his Physics114 elements similar to those of Asclepiades,115 yet allows
that iron is attracted by the lodestone,116 and chaff by amber. He even tries to give the cause of the phenomenon. His
view is that the atoms which flow from the stone are related in shape to those flowing from the iron, and so they become
easily interlocked with one another; thus it is that, after colliding with each of the two compact masses (the stone and the
iron) they then rebound into the middle and so become entangled with each other, and draw the iron after Pg 73them. So far,
117 Greek text
then, as his hypotheses regarding causation go, he is perfectly unconvincing; nevertheless, he does grant that there is
an attraction. Further, he says that it is on similar principles that there occur in the bodies of animals the dispersal of
nutriment118 and the discharge of waste matters, as also the actions of cathartic drugs.
Asclepiades, however, who viewed with suspicion the incredible character of the cause mentioned, and who saw no
other credible cause on the basis of his supposed elements, shamelessly had recourse to the statement that nothing is in
any way attracted by anything else. Now, if he was dissatisfied with what Epicurus said, and had nothing better to say
himself, he ought to have refrained from making hypotheses, and should have said that Nature is a constructive artist and
that the substance of things is always tending towards unity and also towards alteration because its own parts act upon
and are acted upon by one another.119 For, if he had assumed this, it would not have been difficult to allow that this
constructive nature has powers which attract appropriate and expel alien matter. For in no other way could she be
constructive, preservative of the animal, and eliminative of its diseases,120 unless it be allowed that she conserves what is
appropriate and discharges what is foreign.

But in this matter, too, Asclepiades realized the logical sequence of the principles he had assumed; he showed no
scruples, however, in opposing plain fact; he joins issue in this matter also, not merely with all physicians, but with
everyone else, and maintains that there is no such thing as a crisis, or critical day,121 and that NaturePgdoes
75 absolutely
Greek text
nothing for the preservation of the animal. For his constant aim is to follow out logical consequences and to upset obvious
fact, in this respect being opposed to Epicurus; for the latter always stated the observed fact, although he gives an
ineffective explanation of it. For, that these small corpuscles belonging to the lodestone rebound, and become entangled
with other similar particles of the iron, and that then, by means of this entanglement (which cannot be seen anywhere)
such a heavy substance as iron is attracted—I fail to understand how anybody could believe this. Even if we admit this,
the same principle will not explain the fact that, when the iron has another piece brought in contact with it, this becomes
attached to it.
For what are we to say? That, forsooth, some of the particles that flow from the lodestone collide with the iron and then
rebound back, and that it is by these that the iron becomes suspended? that others penetrate into it, and rapidly pass
through it by way of its empty channels?122 that these then collide with the second piece of iron and are not able to
penetrate it although they penetrated the first piece? and that they then course back to the first piece, and produce
entanglements like the former ones?
The hypothesis here becomes clearly refuted by its absurdity. As a matter of fact, I have seen five writing-stylets of iron
attached to one another in a line, only the first one being in contact with the lodestone, and thePgpower 77 123 being
Greek text
transmitted through it to the others. Moreover, it cannot be said that if you bring a second stylet into contact with the
lower end of the first, it becomes held, attached, and suspended, whereas, if you apply it to any other part of the side it
does not become attached. For the power of the lodestone is distributed in all directions; it merely needs to be in contact
with the first stylet at any point; from this stylet again the power flows, as quick as a thought, all through the second, and
from that again to the third. Now, if you imagine a small lodestone hanging in a house, and in contact with it all round a
large number of pieces of iron, from them again others, from these others, and so on,—all these pieces of iron must
surely become filled with the corpuscles which emanate from the stone; therefore, this first little stone is likely to become
dissipated by disintegrating into these emanations.124 Further, even if there be no iron in contact with it, it still disperses
into the air, particularly if this be also warm.
“Yes,” says Epicurus, “but these corpuscles must be looked on as exceedingly small, so that some of them are a ten-
thousandth part of the size of the very smallest particles carried in the air.” Then do you venture to say that so great a
weight of iron can be suspended by such small bodies? If each of them is a ten-thousandth part as large as the dust
particles which are borne in the atmosphere, how big must we suppose the hook-like extremities by which they interlock
with each other125 to be? For of course this is quite the smallest portion of the whole particle.
Then, again, when a small body becomes entangled with another small body, or when a body in Pg 79
motion becomes
Greek text
entangled with another also in motion, they do not rebound at once. For, further, there will of course be others which
break in upon them from above, from below, from front and rear, from right and left, and which shake and agitate them
and never let them rest. Moreover, we must perforce suppose that each of these small bodies has a large number of
these hook-like extremities. For by one it attaches itself to its neighbours, by another—the topmost one—to the
lodestone, and by the bottom one to the iron. For if it were attached to the stone above and not interlocked with the iron
below, this would be of no use.126 Thus, the upper part of the superior extremity must hang from the lodestone, and the
iron must be attached to the lower end of the inferior extremity; and, since they interlock with each other by their sides as
well, they must, of course, have hooks there too. Keep in mind also, above everything, what small bodies these are
which possess all these different kinds of outgrowths. Still more, remember how, in order that the second piece of iron
may become attached to the first, the third to the second, and to that the fourth, these absurd little particles must both
penetrate the passages in the first piece of iron and at the same time rebound from the piece coming next in the series,
although this second piece is naturally in every way similar to the first.
Such an hypothesis, once again, is certainly not lacking in audacity; in fact, to tell the truth, it is far more shameless than
the previous ones; according to it, when five similar pieces of iron are arranged in a line, the particlesPgof81the lodestone
which easily traverse the first piece of iron rebound from the second, and do not pass readily through itGreek in thetext
same way.
Indeed, it is nonsense, whichever alternative is adopted. For, if they do rebound, how then do they pass through into the
third piece? And if they do not rebound, how does the second piece become suspended to the first? For Epicurus
himself looked on the rebound as the active agent in attraction.
But, as I have said, one is driven to talk nonsense whenever one gets into discussion with such men. Having, therefore,
given a concise and summary statement of the matter, I wish to be done with it. For if one diligently familiarizes oneself
with the writings of Asclepiades, one will see clearly their logical dependence on his first principles, but also their
disagreement with observed facts. Thus, Epicurus, in his desire to adhere to the facts, cuts an awkward figure by aspiring
to show that these agree with his principles, whereas Asclepiades safeguards the sequence of principles, but pays no
attention to the obvious fact. Whoever, therefore, wishes to expose the absurdity of their hypotheses, must, if the
argument be in answer to Asclepiades, keep in mind his disagreement with observed fact; or if in answer to Epicurus, his
discordance with his principles. Almost all the other sects depending on similar principles are now entirely extinct, while
these alone maintain a respectable existence still. Yet the tenets of Asclepiades have been unanswerably confuted by
Menodotus the Empiricist, who draws his attention to their opposition to phenomena and to each other; Pg 83 again, those
and,
Greek text
of Epicurus have been confuted by Asclepiades, who adhered always to logical sequence, about which Epicurus
evidently cares little.
Now people of the present day do not begin by getting a clear comprehension of these sects, as well as of the better
ones, thereafter devoting a long time to judging and testing the true and false in each of them; despite their ignorance, they
style themselves, some “physicians” and others “philosophers.” No wonder, then, that they honour the false equally with
the true. For everyone becomes like the first teacher that he comes across, without waiting to learn anything from
anybody else. And there are some of them, who, even if they meet with more than one teacher, are yet so unintelligent
and slow-witted that even by the time they have reached old age they are still incapable of understanding the steps of an
argument.... In the old days such people used to be set to menial tasks.... What will be the end of it God knows!
Now, we usually refrain from arguing with people whose principles are wrong from the outset. Still, having been
compelled by the natural course of events to enter into some kind of a discussion with them, we must add this further to
what was said—that it is not only cathartic drugs which naturally attract their special qualities,127 but also those which
remove thorns and the points of arrows such as sometimes become deeply embedded in the flesh. Those drugs also
which draw out animal poisons or poisons applied to arrows all show the same faculty as does the lodestone. Thus, I
myself have seen a thorn which was embedded in a young man’s foot fail to come out when we exertedPgforcible 85 traction
Greek text
with our fingers, and yet come away painlessly and rapidly on the application of a medicament. Yet even to this some
people will object, asserting that when the inflammation is dispersed from the part the thorn comes away of itself, without
being pulled out by anything. But these people seem, in the first place, to be unaware that there are certain drugs for
drawing out inflammation and different ones for drawing out embedded substances; and surely if it was on the cessation
of an inflammation that the abnormal matters were expelled, then all drugs which disperse inflammations ought, ipso
facto, to possess the power of extracting these substances as well.128
And secondly, these people seem to be unaware of a still more surprising fact, namely, that not merely do certain
medicaments draw out thorns and others poisons, but that of the latter there are some which attract the poison of the
viper, others that of the sting-ray,129 and others that of some other animal; we can, in fact, plainly observe these poisons
deposited on the medicaments. Here, then, we must praise Epicurus for the respect he shows towards obvious facts, but
find fault with his views as to causation. For how can it be otherwise than extremely foolish to suppose that a thorn which
we failed to remove by digital traction could be drawn out by these minute particles?
Have we now, therefore, convinced ourselves that everything which exists130 possesses a faculty by which it attracts its
proper quality, and that some things do this more, and some less?
Or shall we also furnish our argument with the illustration afforded by corn?131 For those who refuse Pg 87to admit that
Greek text
anything is attracted by anything else, will, I imagine, be here proved more ignorant regarding Nature than the very
peasants. When, for my own part, I first learned of what happens, I was surprised, and felt anxious to see it with my own
eyes. Afterwards, when experience also had confirmed its truth, I sought long among the various sects for an explanation,
and, with the exception of that which gave the first place to attraction, I could find none which even approached
plausibility, all the others being ridiculous and obviously quite untenable.
What happens, then, is the following. When our peasants are bringing corn from the country into the city in wagons, and
wish to filch some away without being detected, they fill earthen jars with water and stand them among the corn; the corn
then draws the moisture into itself through the jar and acquires additional bulk and weight, but the fact is never detected
by the onlookers unless someone who knew about the trick before makes a more careful inspection. Yet, if you care to
set down the same vessel in the very hot sun, you will find the daily loss to be very little indeed. Thus corn has a greater
power than extreme solar heat of drawing to itself the moisture in its neighbourhood.132 Thus the theory that the water is
carried towards the rarefied part of the air surrounding us133 (particularly when that is distinctly warm) is utter nonsense;
Pg of
for although it is much more rarefied there than it is amongst the corn, yet it does not take up a tenth part 89 the moisture
Greek text
which the corn does.

XV
Since then, we have talked sufficient nonsense—not willingly, but because we were forced, as the proverb says, “to
behave madly among madmen”—let us return again to the subject of urinary secretion. Here let us forget the absurdities
of Asclepiades, and, in company with those who are persuaded that the urine does pass through the kidneys, let us
consider what is the character of this function. For, most assuredly, either the urine is conveyed by its own motion to the
kidneys, considering this the better course (as do we when we go off to market!134), or, if this be impossible, then some
other reason for its conveyance must be found. What, then, is this? If we are not going to grant the kidneys a faculty for
attracting this particular quality,135 as Hippocrates held, we shall discover no other reason. For, surely everyone sees that
either the kidneys must attract the urine, or the veins must propel it—if, that is, it does not move of itself. But if the veins
did exert a propulsive action when they contract, they would squeeze out into the kidneys not merely the urine, but along
with it the whole of the blood which they contain.136 And if this is impossible, as we shall show, the remaining explanation
is that the kidneys do exert traction.
Pg 91 a position
And how is propulsion by the veins impossible? The situation of the kidneys is against it. They do not occupy
beneath the hollow vein [vena cava] as does the sieve-like [ethmoid] passage in the nose and palate Greek text
in relation to the
137
surplus matter from the brain; they are situated on both sides of it. Besides, if the kidneys are like sieves, and readily
let the thinner serous [whey-like] portion through, and keep out the thicker portion, then the whole of the blood
contained in the vena cava must go to them, just as the whole of the wine is thrown into the filters. Further, the example
of milk being made into cheese will show clearly what I mean. For this, too, although it is all thrown into the wicker
strainers, does not all percolate through; such part of it as is too fine in proportion to the width of the meshes passes
downwards, and this is called whey [serum]; the remaining thick portion which is destined to become cheese cannot get
down, since the pores of the strainers will not admit it. Thus it is that, if the blood-serum has similarly to percolate through
the kidneys, the whole of the blood must come to them, and not merely one part of it.
What, then, is the appearance as found on dissection?
One division of the vena cava is carried upwards138 to the heart, and the other mounts upon the spine and extends along
its whole length as far as the legs; thus one division does not even come near the kidneys, while the other Pg 93 approaches
them but is certainly not inserted into them. Now, if the blood were destined to be purified by them as if Greek text
they were sieves,
the whole of it would have to fall into them, the thin part being thereafter conveyed downwards, and the thick part
retained above. But, as a matter of fact, this is not so. For the kidneys lie on either side of the vena cava. They therefore
do not act like sieves, filtering fluid sent to them by the vena cava, and themselves contributing no force. They obviously
exert traction; for this is the only remaining alternative.
How, then, do they exert this traction? If, as Epicurus thinks, all attraction takes place by virtue of the rebounds and
entanglements of atoms, it would be certainly better to maintain that the kidneys have no attractive action at all; for his
theory, when examined, would be found as it stands to be much more ridiculous even than the theory of the lodestone,
mentioned a little while ago. Attraction occurs in the way that Hippocrates laid down; this will be stated more clearly as
the discussion proceeds; for the present our task is not to demonstrate this, but to point out that no other cause of the
secretion of urine can be given except that of attraction by the kidneys,139 and that this attraction does not take place in
the way imagined by people who do not allow Nature a faculty of her own.140
For if it be granted that there is any attractive faculty at all in those things which are governed by Nature,141 a person
who attempted to say anything else about the absorption of nutriment142 would be considered a fool.
Pg 95
XVI Greek text

Now, while Erasistratus[143] for some reason replied at great length to certain other foolish doctrines, he entirely passed
over the view held by Hippocrates, not even thinking it worth while to mention it, as he did in his work “On Deglutition”;
in that work, as may be seen, he did go so far as at least to make mention of the word attraction, writing somewhat as
follows:
“Now, the stomach does not appear to exercise any attraction.”143 But when he is dealing with anadosis he does not
mention the Hippocratic view even to the extent of a single syllable. Yet we should have been satisfied if he had even
merely written this: “Hippocrates lies in saying ‘The flesh144 attracts both from the stomach and from without,’ for it
cannot attract either from the stomach or from without.” Or if he had thought it worth while to state that Hippocrates was
wrong in criticizing the weakness of the neck of the uterus, “seeing that the orifice of the uterus has no power of attracting
semen,”145 or if he [Erasistratus] had thought proper to write any other similar opinion, then we in our turn would have
defended ourselves in the following terms:
“My good sir, do not run us down in this rhetorical fashion without some proof; state some definite objection to our view,
in order that either you may convince us by a brilliant refutation of the ancient doctrine, or that, on the other hand, we
may convert you from your ignorance.” Yet why do I say “rhetorical”? For we too are not to suppose Pg that97when certain
Greek text
rhetoricians pour ridicule upon that which they are quite incapable of refuting, without any attempt at argument, their
words are really thereby constituted rhetoric. For rhetoric proceeds by persuasive reasoning; words without reasoning
are buffoonery rather than rhetoric. Therefore, the reply of Erasistratus in his treatise “On Deglutition” was neither
rhetoric nor logic. For what is it that he says? “Now, the stomach does not appear to exercise any traction.” Let us testify
against him in return, and set our argument beside his in the same form. Now, there appears to be no peristalsis146 of
the gullet. “And how does this appear?” one of his adherents may perchance ask. “For is it not indicative of peristalsis
that always when the upper parts of the gullet contract the lower parts dilate?” Again, then, we say, “And in what way
does the attraction of the stomach not appear? For is it not indicative of attraction that always when the lower parts of
the gullet dilate the upper parts contract?” Now, if he would but be sensible and recognize that this phenomenon is not
more indicative of the one than of the other view, but that it applies equally to both,147 we should then show him without
further delay the proper way to the discovery of truth.
We will, however, speak about the stomach again. And the dispersal of nutriment [anadosis] need not make us have
recourse to the theory regarding the natural tendency of a vacuum to become refilled,148 when oncePg we99have granted
Greek text
the attractive faculty of the kidneys. Now, although Erasistratus knew that this faculty most certainly existed, he neither
mentioned it nor denied it, nor did he make any statement as to his views on the secretion of urine.
Why did he give notice at the very beginning of his “General Principles” that he was going to speak about natural
activities—firstly what they are, how they take place, and in what situations—and then, in the case of urinary secretion,
declared that this took place through the kidneys, but left out its method of occurrence? It must, then, have been for no
purpose that he told us how digestion occurs, or spends time upon the secretion of biliary superfluities;149 for in these
cases also it would have been sufficient to have named the parts through which the function takes place, and to have
omitted the method. On the contrary, in these cases he was able to tell us not merely through what organs, but also in
what way it occurs—as he also did, I think, in the case of anadosis; for he was not satisfied with saying that this took
place through the veins, but he also considered fully the method, which he held to be from the tendency of a vacuum to
become refilled. Concerning the secretion of urine, however, he writes that this occurs through the kidneys, but does not
add in what way it occurs. I do not think he could say that this was from the tendency of matter to fill a vacuum,150 for, if
this were so, nobody would have ever died of retention of urine, since no more can flow into a vacuumPg 101has run out.
than
151 Greek text
For, if no other factor comes into operation save only this tendency by which a vacuum becomes refilled, no more
could ever flow in than had been evacuated. Nor could he suggest any other plausible cause, such, for example, as the
expression of nutriment by the stomach152 which occurs in the process of anadosis; this had been entirely disproved in
the case of blood in the vena cava;153 it is excluded, not merely owing to the long distance, but also from the fact that the
overlying heart, at each diastole, robs the vena cava by violence of a considerable quantity of blood.
In relation to the lower part of the vena cava154 there would still remain, solitary and abandoned, the specious theory
concerning the filling of a vacuum. This, however, is deprived of plausibility by the fact that people die of retention of
urine, and also, no less, by the situation of the kidneys. For, if the whole of the blood were carried to the kidneys, one
might properly maintain that it all undergoes purification there. But, as a matter of fact, the whole of it does not go to
them, but only so much as can be contained in the veins going to the kidneys;155 this portion only, therefore, will be
purified. Further, the thin serous part of this will pass through the kidneys as if through a sieve, while the thick
sanguineous portion remaining in the veins will obstruct the blood flowing in from behind; this will first, therefore, have to
run back to the vena cava, and so to empty the veins going to the kidneys; these veins will no longer be ablePg 103
to conduct a
Greek text
second quantity of unpurified blood to the kidneys—occupied as they are by the blood which had preceded, there is no
passage left. What power have we, then, which will draw back the purified blood from the kidneys? And what power, in
the next place, will bid this blood retire to the lower part of the vena cava, and will enjoin on another quantity coming
from above not to proceed downwards before turning off into the kidneys?
Now Erasistratus realized that all these ideas were open to many objections, and he could only find one idea which held
good in all respects—namely, that of attraction. Since, therefore, he did not wish either to get into difficulties or to
mention the view of Hippocrates, he deemed it better to say nothing at all as to the manner in which secretion occurs.
But even if he kept silence, I am not going to do so. For I know that if one passes over the Hippocratic view and makes
some other pronouncement about the function of the kidneys, one cannot fail to make oneself utterly ridiculous. It was for
this reason that Erasistratus kept silence and Asclepiades lied; they are like slaves who have had plenty to say in the early
part of their career, and have managed by excessive rascality to escape many and frequent accusations, but who, later,
when caught in the act of thieving, cannot find any excuse; the more modest one then keeps silence, as though
thunderstruck, whilst the more shameless continues to hide the missing article beneath his arm and denies on oath that he
has ever seen it. For it was in this way also that Asclepiades, when all subtle excuses had failed him and there was no
longer any room for nonsense about “conveyance towards the rarefied part [of the air],”156 and when Pg 105 impossible
it was
Greek text
without incurring the greatest derision to say that this superfluity [i.e. the urine] is generated by the kidneys as is bile by
the canals in the liver—he, then, I say, clearly lied when he swore that the urine does not reach the kidneys, and
maintained that it passes, in the form of vapour, straight from the region of the vena cava,157 to collect in the bladder.
Like slaves, then, caught in the act of stealing, these two are quite bewildered, and while the one says nothing, the other
indulges in shameless lying.

XVII
Now such of the younger men as have dignified themselves with the names of these two authorities by taking the
appellations “Erasistrateans” or “Asclepiadeans” are like the Davi and Getae—the slaves introduced by the excellent
Menander into his comedies. As these slaves held that they had done nothing fine unless they had cheated their master
three times, so also the men I am discussing have taken their time over the construction of impudent sophisms, the one
party striving to prevent the lies of Asclepiades from ever being refuted, and the other saying stupidly what Erasistratus
had the sense to keep silence about.
But enough about the Asclepiadeans. The Erasistrateans, in attempting to say how the kidneys let the urine through, will
do anything or suffer anything or try any shift in order to find some plausible explanation which doesPgnot
107demand the
Greek text
principle of attraction.
Now those near the times of Erasistratus maintain that the parts above the kidneys receive pure blood, whilst the watery
residue, being heavy, tends to run downwards; that this, after percolating through the kidneys themselves, is thus
rendered serviceable, and is sent, as blood, to all the parts below the kidneys.

For a certain period at least this view also found favour and flourished, and was held to be true; after a time, however, it
became suspect to the Erasistrateans themselves, and at last they abandoned it. For apparently the following two points
were assumed, neither of which is conceded by anyone, nor is even capable of being proved. The first is the heaviness of
the serous fluid, which was said to be produced in the vena cava, and which did not exist, apparently, at the beginning,
when this fluid was being carried up from the stomach to the liver. Why, then, did it not at once run downwards when it
was in these situations? And if the watery fluid is so heavy, what plausibility can anyone find in the statement that it assists
in the process of anadosis?
In the second place there is this absurdity, that even if it be agreed that all the watery fluid does fall downwards, and only
when it is in the vena cava,158 still it is difficult, or, rather, impossible, to say through what means it is going to fall into the
kidneys, seeing that these are not situated below, but on either side of the vena cava, and that the vena cava is not
inserted into them, but merely sends a branch159 into each of them, as it also does into all the other parts.Pg 109
Greek text
What doctrine, then, took the place of this one when it was condemned? One which to me seems far more foolish than
the first, although it also flourished at one time. For they say, that if oil be mixed with water and poured upon the ground,
each will take a different route, the one flowing this way and the other that, and that, therefore, it is not surprising that the
watery fluid runs into the kidneys, while the blood falls downwards along the vena cava. Now this doctrine also stands
already condemned. For why, of the countless veins which spring from the vena cava, should blood flow into all the
others, and the serous fluid be diverted to those going to the kidneys? They have not answered the question which was
asked; they merely state what happens and imagine they have thereby assigned the reason.
Once again, then (the third cup to the Saviour!),160 let us now speak of the worst doctrine of all, lately invented by Lycus
of Macedonia,161 but which is popular owing to its novelty. This Lycus, then, maintains, as though uttering an oracle from
the inner sanctuary, that urine is residual matter from the nutrition of the kidneys!162 Now, the amount of urine passed
every day shows clearly that it is the whole of the fluid drunk which becomes urine, except for that which comes away
with the dejections or passes off as sweat or insensible perspiration. This is most easily recognized in winter in those who
are doing no work but are carousing, especially if the wine be thin and diffusible; these people rapidlyPgpass
111 almost the
Greek text
same quantity as they drink. And that even Erasistratus was aware of this is known to those who have read the first book
of his “General Principles.”163 Thus Lycus is speaking neither good Erasistratism, nor good Asclepiadism, far less good
Hippocratism. He is, therefore, as the saying is, like a white crow, which cannot mix with the genuine crows owing to its
colour, nor with the pigeons owing to its size. For all this, however, he is not to be disregarded; he may, perhaps, be
stating some wonderful truth, unknown to any of his predecessors.
Now it is agreed that all parts which are undergoing nutrition produce a certain amount of residue, but it is neither agreed
nor is it likely, that the kidneys alone, small bodies as they are, could hold four whole congii,164 and sometimes even
more, of residual matter. For this surplus must necessarily be greater in quantity in each of the larger viscera; thus, for
example, that of the lung, if it corresponds in amount to the size of the viscus, will obviously be many times more than that
in the kidneys, and thus the whole of the thorax will become filled, and the animal will be at once suffocated. But if it be
said that the residual matter is equal in amount in each of the other parts, where are the bladders, one may ask, through
which it is excreted? For, if the kidneys produce in drinkers three and sometimes four congii of superfluous matter, that
of each of the other viscera will be much more, and thus an enormous barrel will be needed to contain the waste
products of them all. Yet one often urinates practically the same quantity as one has drunk, which would Pg 113-115
show that the
Greek text
whole of what one drinks goes to the kidneys.
Thus the author of this third piece of trickery would appear to have achieved nothing, but to have been at once detected,
and there still remains the original difficulty which was insoluble by Erasistratus and by all others except Hippocrates. I
dwell purposely on this topic, knowing well that nobody else has anything to say about the function of the kidneys, but
that either we must prove more foolish than the very butchers165 if we do not agree that the urine passes through the
kidneys; or, if one acknowledges this, that then one cannot possibly give any other reason for the secretion than the
principle of attraction.
Now, if the movement of urine does not depend on the tendency of a vacuum to become refilled,166 it is clear that neither
does that of the blood nor that of the bile; or if that of these latter does so, then so also does that of the former. For they
must all be accomplished in one and the same way, even according to Erasistratus himself.
This matter, however, will be discussed more fully in the book following this.
That is,
5 “On the Natural Powers,” the powers of the Physis or Nature. By that Galen practically means
what we would call the physiological or biological powers, the characteristic faculties of the living
organism; his Physis is the subconscious vital principle of the animal or plant. Like Aristotle, however, he
also ascribes quasi-vital properties to inanimate things, cf. Introduction, p. xxvii.

Ergon,6 here rendered an effect, is literally a work or deed; strictly speaking, it is something done,
completed, as distinguished from energeia, which is the actual doing, the activity which produces this
ergon, cf. p. 13, and Introduction, p. xxx.
Gk. psyche,
7 Lat. anima.

Gk. physis,
8 Lat. natura.
Motion9 (kinesis) is Aristotle’s general term for what we would rather call change. It includes various kinds
of change, as well as movement proper, cf. Introduction, p. xxix.

“Conveyance,”
10 “transport,” “transit”; purely mechanical or passive motion, as distinguished from
alteration (qualitative change).

“Waxing
11 and waning,” the latter literally phthisis, a wasting or “decline;” cf. Scotch divining, Dutch
verdwijnen.
Becoming
12 and perishing: Latin, generatio et corruptio.
“Ad substantiam
13 productio seu ad formam processus” (Linacre).
“Preformationist”
14 doctrine of Anaxagoras. To him the apparent alteration in qualities took place when a
number of minute pre-existing bodies, all bearing the same quality, came together in sufficient numbers to
impress that quality on the senses. The factor which united the minute quality-bearers was Nous. “In the
beginning,” says Anaxagoras, “all things existed together—then came Nous and brought them into
order.”

“De ea
15 alteratione quae per totam fit substantiam” (Linacre).
The systematizer
16 of Stoicism and successor of Zeno.

Note 17
characteristic impatience with metaphysics. To Galen, as to Hippocrates and Aristotle, it sufficed to
look on the qualitative differences apprehended by the senses as fundamental. Zeno of Citium was the
founder of the Stoic school; on the further analysis by this school of the qualities into bodies cf. p. 144,
note 3.
A rallying-ground:
18 lit. a place where two glens meet.

Thus19according to Gomperz (Greek Think ers), the hypothesis of Anaxagoras was that “the bread ...
already contained the countless forms of matter as such which the human body displays. Their
minuteness of size would withdraw them from our perception. For the defect or ‘weakness’ of the senses is
the narrowness of their receptive area. These elusive particles are rendered visible and tangible by the
process of nutrition, which combines them.”

Therefore
20 the blood must have come from the bread. The food from the alimentary canal was supposed by
Galen to be converted into blood in and by the portal veins, cf. p. 17.
By “elements”
21 is meant all homogeneous, amorphous substances, such as metals, &c., as well as the
elementary tissues.

Work22
or product. Lat. opus. cf. p. 3, note 2.
Operation,
23 activation, or functioning. Lat. actio. cf. loc. cit.

i.e. a 24
concomitant (secondary) or passive affection. Galen is contrasting active and passive “motion.” cf.
p. 6, note 1.

As already
25 indicated, there is no exact English equivalent for the Greek term physis, which is a principle
immanent in the animal itself, whereas our term “Nature” suggests something more transcendent; we are
forced often, however, to employ it in default of a better word. cf. p. 2, note 1.
In Greek
26 anadosis. This process includes two stages: (1) transmission of food from alimentary canal to
liver (rather more than our “absorption”); (2) further transmission from liver to tissues. Anadosis is lit. a
yielding-up, a “delivery;” it may sometimes be rendered “dispersal.” “Distribution” (diadosis) is a further
stage; cf. p. 163, note 4.

cf. p. 27
9.
Since28
heat and cold tend to cause diffusion and condensation respectively.

Lit. haematopoietic.
29 cf. p. 11, note 3.

Lit. peptic.
30
Lit. sphygmic.
31
Genesis
32 corresponds to the intrauterine life, or what we may call embryogeny. Alteration here means
histogenesis or tissue-production; shaping or moulding (in Greek diaplasis) means the ordering of these
tissues into organs (organogenesis).
cf. p. 33
25, note 4.

Note 34
inadequate analogy of semen with fertilised seeds of plants (i.e. of gamete with zygote). Strictly
speaking, of course, semen corresponds to pollen. cf. p. 130, note 2.
i.e. the
35 four primary qualities; cf. chap. iii. supra.
Various
36 secondary or derivative differences in the tissues. Note pre-eminence of sense of touch.
De Anima,
37 ii. et seq.
Lit. homoeomerous
38 = of similar parts throughout, “the same all through.” He refers to the elementary
tissues, conceived as not being susceptible of further analysis.
That 39
is, by the bodily eye, and not by the mind’s eye. The observer is here called an autoptes or “eye-
witness.” Our medical term autopsy thus means literally a persona inspection of internal parts, ordinarily
hidden.

i.e. “alteration”
40 is the earlier of the two stages which constitute embryogeny or “genesis.” cf. p. 18, note 1.
The terms
41 Galen actually uses are: ostopoietic, neuropoietic, chondropoietic.
As we
42should say, parenchyma (a term used by Erasistratus).
Those
43were all the elemental tissues that Aristotle, for example, had recognized; other tissues (e.g. flesh or
muscle) he believed to be complexes of these.

Or tunics.
44
i.e. tissues.
45
As, for
46 example, Aristotle had held; cf. p. 23, note 3. Galen added many new tissues to those described by
Aristotle.

Lit. synthesis.
47
By this
48 is meant the duodenum, considered as an outgrowth or prolongation of the stomach towards the
intestines.

cf. p. 49
19, note 2.

Lit. the
50 auxetic or incremental faculty.
i.e. to51the alterative and shaping faculties (histogenetic and organogenetic).

If the52
reading is correct we can only suppose that Galen meant the embryo.
i.e. not
53 the pre-natal development of tissue already described. cf. chap. vi.
Administration,
54 lit. “economy.”

The activation
55 or functioning of this faculty, the faculty in actual operation. cf. p. 3, note 2.
“Un rapport
56 commun et une affinité” (Daremberg). “Societatem aliquam cognationemque in qualitatibus”
(Linacre). cf. p. 36, note 2.

Lit. “necessity”;
57 more restrictive, however, than our “law of Nature.” cf. p. 314, note 1.
His point
58 is that no great change, in colours or in anything else, can take place at one step.
Not quite
59 our “waste products,” since these are considered as being partly synthetic, whereas the Greek
perittomata were simply superfluous substances which could not be used and were thrown aside.
Note 60
“our natures,” cf. p. 12, note 4; p. 47, note 1.

The term
61 οἰκεῖος, here rendered appropriate, is explained on p. 33. cf. also footnote on same page. Linacre
often translated it conveniens, and it may usually be rendered proper, peculiar, own special, or own
particular in English. Sometimes it is almost equal to ak in, cognate, related: cf. p. 319, note 2. With
Galen’s οἰκεῖος and ἀλλότριος we may compare the German terms eigen and fremd used by Aberhalden in
connection with his theory of defensive ferments in the blood-serum.

Transit,
62 cf. p. 6, note 1.
i.e. of63the living organism, cf. p. 2, note 1.

i.e. with
64 nutrition.
We might
65 perhaps say, more shortly, “assimilation of food to feeder,” or, “of food to fed”; Linacre renders,
“nutrimenti cum nutrito assimilatio.”

Lit. prosphysis,
66 i.e. attachment, implantation.

Lit. prosthesis,
67 “apposition.” One is almost tempted to retain the terms prosthesis and prosphysis in
translation, as they obviously correspond much more closely to Galen’s physiological conceptions than
any English or semi-English words can.
Lit. phthisis.
68 cf. p. 6, note 2. Now means tuberculosis only.

More69literally, “chymified.” In anasarca the subcutaneous tissue is soft, and pits on pressure. In the
“white” disease referred to here (by which is probably meant nodular leprosy) the same tissues are
indurated and “brawny.” The principle of certain diseases being best explained as cases of arrest at
various stages of the metabolic path is recognized in modern pathology, although of course the instances
given by Galen are too crude to stand.
The effects
70 of oxidation attributed to the heat which accompanies it? cf. p. 141, note 1; p. 254, note 1.

Here 71
follows a contrast between the Vitalists and the Epicurean Atomists. cf. p. 153 et seq.
A unity
72 or continuum, an individuum.
Lit. to73the physis or the psyche; that is, a denial of the autonomy of physiology and psychology.

Lit. somata.
74
For “natures”
75 in the plural, involving the idea of a separate nature immanent in each individual, cf. p. 36,
note 1.

A lost76work.
For Asclepiades
77 v. p. 49, note 5.

“Le corps
78 tout entier a unité de souffle (perspiration et expiration) et unité de flux (courants, circulation
des liquides)” (Daremberg). “Conspirabile et confluxile corpus esse” (Linacre). Apparently Galen refers to
the pneuma and the various humours. cf. p. 293, note 2.

i.e. “appropriated”;
79 very nearly “assimilated.”

80