A. CORNELIUS CELSUSOFMEDICINE.BOOK IV.CHAP. I.OF THE INTERNAL PARTS OF THE HUMAN BODY.
A. CORNELIUS CELSUS
OF
MEDICINE.
Thus far we have spoken of those kinds of distempers, which so affect the whole body, that no certain seats can be assigned to them: I shall now treat of those which belong to particular parts. Now the diseases of all the internal parts, and their method of cure will be more easily understood, when I shall have first given a short description of the parts they afflict.
The head then and what is contained in the mouth are bounded not only by the tongue and palate, but by the external parts, which lie exposed to view. On the right and left side about the throat are large veins, which are calledsphagitides[ BW ]; and arteries, namedcarotides[ BX ], running upwards, which reach beyond the ears. And in the neck itself are placed small glands, which sometimes swell, and are painful. Then two passages begin: one of which is called the aspera arteria, or wind-pipe; the other the gullet. The wind-pipe is more external, and goes to the lungs; the gullet more internal, and leads to the stomach. The former receives the breath, the latter the food. Their courses being different, where they meet there is something like a smalltongue(1)in the wind-pipe at the entrance of the fauces: when we breathe this stands erect;when we take meat or drink, it shuts the wind-pipe. Now the wind-pipe being hard and cartilaginous, is prominent in the throat; and elsewhere falls back. It is composed of certain circles formed like the vertebræ in the spine, yet so, that it is rough on the external part, on the internal smooth like the gullet; and thus descending to the præcordia it is connected with the lungs: these are of a spongy nature, and therefore capacious of air; and behind being joined to the spine, they are divided into two lobes like an ox’s hoof. With these the heart is connected, being muscular, situated in the thorax under the left breast: and it has what we may call two ventricles. But under the heart and lungs is the transverse septum, consisting of a strong membrane equally nervous, which divides the abdomen from the præcordia, many vessels also being dispersed over it: it separates from the superior parts not only the intestines, but the liver and spleen too. These bowels are next to it, but placed below it, the one on the right side, and the other on the left. The liver having its origin under the præcordia from the very septum itself, on the inside is concave, and the outside gibbous. This projecting rests gently upon the stomach, and is divided into four lobes. On the lower part, the gall-bladder adheres to it. But in the left side the spleen is not connected with the septum, but to an intestine; it is of a soft and loose texture, of a moderate length and thickness; and this proceeding a little beyond the region of the ribs into the abdomen, is chiefly covered by them. And these indeed are joined. But the kidneys are divided: which adhere to the loins below the lastribs(2), and the sides next these are round, on the other they turn inward; they are both stocked with vessels, and covered over withcoats(3). These then are the situations of the bowels. But the gullet, which is the beginning of the intestines, arises nervous from the seventh vertebra of the spine, and about the præcordia is united with the stomach. The stomach, which is the receptacle of food, consists of two coats, and is placed betwixt the spleen and liver, each of these going a little over it. There are also some fine membranes, by which these three are connected together, and are joined to the transverse septum above-mentioned. After that the lower part of the stomach turning a little to the rightside grows narrower, till it meet the first intestine. This juncture the Greeks callpylorus[ BY ]; because like a gate it emits into the lower parts, what we are to discharge by excrement. There begins the intestine jejunum, not much folded: this name is given to it, because it never retains what it has received; but immediately transmits it into the lower parts. Next to this, is the smaller intestine, very much folded into sinuses: each of whose rings are by small membranes connected with the more internal, which being turned toward the right side, and ending at the right hip, yet fill more the superior parts. Then this intestine is joined with another thicker, and running across; which beginning on the right side, towards the left is open and long; to the right is not so; and therefore it is called cæcum. But that, which is open, is of large compass and sinuous, and less nervous than the former intestines, on both sides rolled different ways, but occupying more of the left and lower parts, it touches the liver and stomach: then it is joined with some small membranes, that come from the right kidney; and there turning to the right, it is directed downward, where it discharges the excrements: and therefore at that place it takes the name of the intestinum rectum. All these parts are covered by the omentum, which on the lower part is smooth and contracted, and on the upper softer. Fat also grows to it, which like the brain and marrow is insensible. From each kidney proceeds a tube of a white colour to the bladder; the Greeks call themureteres[ BZ ], because by them they believe the urine to be distilled into the bladder. The bladder in its sinus is nervous and double; in the neck full and fleshy, and joined by veins to the intestine and to that bone, which is under the pubes: itself is loose, and more at liberty. It is differently placed in men and in women: for in men it is close to the intestine rectum, rather inclined to the left side: in women it is situated above their genital parts, and as it hangs, is sustained by the womb. Then in men the passage of the urine is extended longer and narrower from its neck to the penis: in women it is shorter, and wider, and shows itself above the neck of the womb. Now the womb in virgins is very small: in women, when not pregnant, not much larger, than to be held in the hand. It begins with a straight and small neck, which is called thevagina[ CA ], in a line with the middle of the belly, then is turned a little to the right hip; then mounting above the intestine rectum, its sides are connected to the ilia of the woman. The ilia are situated betwixt the hips and pubes in the lower belly. From which and the pubes the abdomen reaches upwards to the præcordia; on the external side the skin appears; on the inside it is lined by a thin membrane, which is joined to the omentum, and is called by the Greeksperitonæum[ CB ].