XVII

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 therarefied part [of the air],”156and when it was impossible 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,157to 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.

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 theDaviandGetae—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 anythingor try any shift in order to find some plausible explanation which does not demand the principle ofattraction.

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 ofanadosis?

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,158still 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 branch159into each of them, as it also does into all the other parts.

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!),160let us now speak of the worst doctrine of all, lately invented by Lycus of Macedonia,161but which is popular owing to its novelty. This Lycus, then, maintains, as though uttering an oracle from the inner sanctuary, that urine isresidual matter from the nutrition of the kidneys!162Now, 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 rapidly pass almost the 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.”163Thus 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 wholecongii,164and 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 thebladders, one may ask, through which it is excreted? For, if the kidneys produce in drinkers three and sometimes fourcongiiof 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 show that the 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 butchers165if 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,166it 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.

5That is, “On the Natural Powers,” the powers of thePhysisor 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.

6Ergon, here rendered aneffect, is literally aworkordeed; strictly speaking, it is somethingdone,completed, as distinguished fromenergeia, which is the actualdoing, theactivitywhich produces thisergon,cf.p.13, and Introduction, p.xxx.

7Gk.psyche, Lat.anima.

8Gk.physis, Lat.natura.

9Motion(kinesis) is Aristotle’s general term for what we would rather callchange. It includes various kinds of change, as well as movement proper,cf.Introduction, p.xxix.

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

11“Waxing and waning,” the latter literallyphthisis, a wasting or “decline;”cf.Scotchdivining, Dutchverdwijnen.

12Becoming and perishing: Latin,generatio et corruptio.

13“Ad substantiam productio seu ad formam processus” (Linacre).

14“Preformationist” 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.”

15“De ea alteratione quae per totam fit substantiam” (Linacre).

16The systematizer of Stoicism and successor of Zeno.

17Note 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 thequalitiesintobodiescf.p. 144,note 3.

18A rallying-ground: lit. a place where two glens meet.

19Thus according to Gomperz (Greek Thinkers), 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 ofnutrition, which combines them.”

20Therefore 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.

21By “elements” is meant all homogeneous, amorphous substances, such as metals, &c., as well as the elementarytissues.

22Work or product. Lat.opus.cf.p. 3,note 2.

23Operation, activation, or functioning. Lat.actio.cf.loc. cit.

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

25As already indicated, there is no exact English equivalent for the Greek termphysis, 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.

26In Greekanadosis. 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.Anadosisis lit. a yielding-up, a “delivery;” it may sometimes be rendered “dispersal.” “Distribution” (diadosis) is a further stage;cf.p. 163,note 4.

27cf.p.9.

28Since heat and cold tend to cause diffusion and condensation respectively.

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

30Lit.peptic.

31Lit.sphygmic.

32Genesiscorresponds to the intrauterine life, or what we may callembryogeny.Alterationhere means histogenesis or tissue-production;shapingormoulding(in Greekdiaplasis) means the ordering of these tissues into organs (organogenesis).

33cf.p. 25,note 4.

34Note 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.

35i.e.the four primary qualities;cf.chap.iii.supra.

36Various secondary or derivative differences in the tissues. Note pre-eminence of sense of touch.

37De Anima, ii.et seq.

38Lit.homoeomerous= of similar parts throughout, “the same all through.” He refers to the elementary tissues, conceived as not being susceptible of further analysis.

39That is, by the bodily eye, and not by the mind’s eye. The observer is here called anautoptesor “eye-witness.” Our medical termautopsythus means literally apersona inspectionof internal parts, ordinarily hidden.

40i.e.“alteration” is the earlier of the two stages which constitute embryogeny or “genesis.”cf.p. 18,note 1.

41The terms Galen actually uses are:ostopoietic,neuropoietic,chondropoietic.

42As we should say,parenchyma(a term used by Erasistratus).

43Those were all the elemental tissues that Aristotle, for example, had recognized; other tissues (e.g.flesh or muscle) he believed to be complexes of these.

44Ortunics.

45i.e.tissues.

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

47Lit.synthesis.

48By this is meant theduodenum, considered as an outgrowth or prolongation of the stomach towards the intestines.

49cf.p. 19,note 2.

50Lit. theauxeticorincrementalfaculty.

51i.e.to the alterative and shaping faculties (histogenetic and organogenetic).

52If the reading is correct we can only suppose that Galen meantthe embryo.

53i.e.not the pre-natal development of tissue already described.cf.chap. vi.

54Administration, lit. “economy.”

55Theactivationorfunctioningof this faculty, the facultyin actual operation.cf.p. 3,note 2.

56“Un rapport commun et une affinité” (Daremberg). “Societatem aliquam cognationemque in qualitatibus” (Linacre).cf.p. 36,note 2.

57Lit. “necessity”; morerestrictive, however, than our “law of Nature.”cf.p. 314,note 1.

58His point is that no great change, in colours or in anything else, can take place at one step.

59Not quite our “wasteproducts,” since these are considered as being partly synthetic, whereas the Greekperittomatawere simply superfluous substances which could not be used and were thrown aside.

60Note “our natures,”cf.p. 12,note 4; p. 47,note 1.

61The term οἰκεῖος, here renderedappropriate, is explained onp. 33.cf.alsofootnoteon same page. Linacre often translated itconveniens, and it may usually be renderedproper,peculiar,own special, orown particularin English. Sometimes it is almost equal toakin,cognate,related:cf.p. 319,note 2. With Galen’s οἰκεῖος and ἀλλότριος we may compare the German termseigenandfremdused by Aberhalden in connection with his theory of defensive ferments in the blood-serum.

62Transit,cf.p. 6,note 1.

63i.e.of the living organism,cf.p. 2,note 1.

64i.e.with nutrition.

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

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

67Lit.prosthesis, “apposition.” One is almost tempted to retain the termsprosthesisandprosphysisin translation, as they obviously correspond much more closely to Galen’s physiological conceptions than any English or semi-English words can.

68Lit.phthisis.cf.p. 6,note 2. Now meanstuberculosisonly.

69More literally, “chymified.” Inanasarcathe subcutaneous tissue is soft, and pits on pressure. In the “white” disease referred to here (by which is probably meantnodular leprosy) the same tissues are indurated and “brawny.” The principle of certain diseases being best explained as cases ofarrestat various stages of the metabolic path is recognized in modern pathology, although of course the instances given by Galen are too crude to stand.

70The effects ofoxidationattributed to the heat which accompanies it?cf.p. 141,note 1; p. 254,note 1.

71Here follows a contrast between the Vitalists and the Epicurean Atomists.cf.p.153et seq.

72A unity orcontinuum, anindividuum.

73Lit. to thephysisor thepsyche; that is, a denial of the autonomy of physiology and psychology.

74Lit.somata.

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

76A lost work.

77For Asclepiadesv.p. 49,note 5.

78“Le corps 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.

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

80“Attractricem convenientis qualitatis vim” (Linacre).cf.p. 36,note 2.

81Lit. “obvious phenomena.”

82Asclepiades of Bithynia, who flourished in the first half of the first centuryB.C., was an adherent of the atomistic philosophy of Democritus, and is the typical representative of the Mechanistic school in Graeco-Roman medicine; he disbelieved in any principle of individuality (“nature”) in the organism, and his methods of treatment, in accordance with his pathology, were mechano-therapeutical.cf.p. 64,note 3.

83Diocles of Carystus was the chief representative of the Dogmatic or Hippocratic school in the first half of the fourth centuryB.C.Praxagoras was his disciple, and followed him in the leadership of the school. For Erasistratus,cf.p. 95et seq.

84Sufferers from kidney-trouble.

85The ureters.

86Unless otherwise stated, “peritoneum” stands for parietal peritoneum alone.

87In the peritoneal cavity.

88Contrast, however,anasarca,p. 41.

89Regurgitation, however, is prevented by the fact that the ureter runs for nearly one inch obliquely through the bladder wall before opening into its cavity, and thus an efficientvalveis produced.

90On the τέχνη (artistic or creative skill) shown by the living organism (φύσις)v.pp.25,45,47; Introduction, p.xxix.

91Direct denial of Aristotle’s dictum that “Nature does nothing in vain.” We are reminded of the view of certain modern laboratory physicians and surgeons that thecolonis a “useless” organ,cf.Erasistratus,p. 143.

92Thevasa deferentia.

93“De l’habileté et de la prévoyance de la nature à l’égard des animaux” (Daremberg).cf.p. 56,note 1.

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