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copious and thick, it immediately proves fatal to him, for by its cold it prevails over the blood and congeals it; or, if it be less, it in the first place obtains the mastery, and stops the respiration; and then in the course of time, when it is diffused along the veins and mixed with much warm blood, it is thus overpowered, the veins receive the air, and the patient. recovers his senses. And of little children which are seized with this disease, the greater part die, provided the defluxion be copious and humid, for the veins being slender cannot admit the phlegm, owing to its thickness and abundance; but the blood is cooled and congealed, and the child. immediately dies. But if the phlegm be in small quantity, and make a defluxion into both the veins, or to those on either side, the children survive, but exhibit. notable marks of the disorder; for either the mouth is drawn aside, or an eye, the neck, or a hand, wherever a vein being filled. with phlegm loses its tone, and is attenuated, and the part of the body connected with this vein is necessarily rendered weaker and defective. But for the most it affords relief for a longer interval; for the child is no longer seized with these attacks, if once it has contracted this impress of the disease, in consequence of which the other veins are necessarily affected, and to a certain degree attenuated, so as just to admit the air, but no longer to permit the influx of phlegm. However, the parts are proportionally enfeebled whenever the veins are in an unhealthy state. When in striplings' the defluxion is small and to the right side, they recover without leaving any marks of the disease, but there is danger of its becoming habitual, and even increasing if not treated by suitable remedies. Thus, or very nearly so, is the case when it attacks children. But when it attacks persons of a more advanced age, it neither proves fatal, nor produces distortions. For their veins are hollow (large?), and filled with hot blood; and therefore the phlegm can neither prevail nor cool the blood, so as to coagulate it, but it is quickly overpowered and mixed with the blood, and thus the veins receive the air, and sensibility remains; and, owing to their strength, the aforesaid symptoms are less likely to seize them. But when this disease attacks very old people, it therefore proves fatal, or induces paraplegia, because the veins are empty, and the blood scanty, thin, and watery. When, therefore, the defluxion is copious, and the season winter, it proves fatal; for it chokes up the exhalents, and coagulates the blood if the defluxion be to both sides; but if to either, it merely induces paraplegia. For the blood being thin, cold, and scanty, cannot prevail over the phlegm, but being itself overpowered, it is coagulated, so that those parts in which the blood is corrupted, lose their strength. The defluxion takes place rather on the right side than on the left, because the
I Meaning persons about puberty, and until 25 years of age. See Aph. v., 7. * The connection between epilepsy and apoplexy is indisputable, and has been often adverted to in modern times. See Copland's Dictionary, under Epilepsy, S$ 16, 40.
veins there are more capacious and numerous than on the left side, for on the one side they spring from the liver, and on the other from the spleen. The defluxion and melting down take place most especially in the case of children in whom the head is heated either by the sun or by fire, or if the brain suddenly contract a rigor, and then the phlegm is excreted. For it is melted down by the heat and diffusion of the brain, but it is excreted by the congealing and contracting of it, and thus a defluxion takes place. And in some this is the cause of the disease, and in others, when the south wind quickly succeeds to northern breezes, it suddenly unbinds and relaxes the brain, which is contracted and weak, so that there is an inundation of phlegm, and thus the defluxion takes place. The defluxion also takes place in consequence of fear, from any hidden cause, if we are frightened at any person's calling aloud, or while crying, when one cannot quickly recover one's breath, such as often happens to children. When any of these things occur, the body immediately shivers, the person becoming speechless cannot draw his breath, but the breath (pneuma) stops, the brain is contracted, the blood stands still, and thus the excretion and defluxion of the phlegm take place. In children, these are the causes of the attack at first. But to old persons winter is most inimical. For when the head and brain have been heated at a great fire, and then the person is brought into cold and has a rigor, or when from cold he comes into warmth, and sits at the fire, he is apt to suffer in the same way, and thus he is seized in the manner described above. And there is much danger of the same thing occurring, if in spring his head be exposed to the sun, but less so in summer, as the changes are not sudden. When a person has passed the twentieth year of his life, this disease is not apt to seize him, unless it has become habitual from childhood, or at least this is rarely or never the case. For the veins are filled with blood, and the brain consistent and firm, so that it does not run down into the veins, or if it do, it does not overpower the blood, which is copious and hot. But when it has gained strength from one's childhood, and become habitual, such a person usually suffers attacks, and is seized with them in changes of the winds, especially in south winds, and it is difficult of removal. For the brain becomes more humid than natural, and is inundated with phlegm, so that the defluxions become more frequent, and the phlegm can no longer be excreted, nor the brain be dried up, but it becomes wet and humid. This you may ascertain in particular, from beasts of the flock which are seized with this disease, and more especially goats, for they are most frequently attacked with it. If you will cut open the head, you will find the brain humid, full of sweat, and having a bad smell.' And in
1It is well known that this is also the case with sheep, and that they are subject to the disease called the sturdy, which is indisputably a sort of epilepsy. Many shepherds have told me that they have perforated the skull so as to evacuate the water in the brain. The operation, however, is not often successful. The materies morbi, I believe, is a hydatid.
this way truly you may see that it is not god that injures the body, but disease. And so it is with man. For when the disease has prevailed for a length of time, it is no longer curable, as the brain is corroded by the phlegm, and melted, and what is melted down becomes water, and surrounds the brain externally, and overflows it; wherefore they are more frequently and readily seized with the disease. And therefore the disease is protracted, because the influx is thin, owing to its quantity, and is immediately overpowered by the blood and heated all through. But such persons as are habituated to the disease, know beforehand when they are about to be seized and flee from men; if their own house be at hand, they run home, but if not, to a deserted place, where as few persons as possible will see them falling, and they immediately cover themselves up. This they do from shame of the affection, and not from fear of the divinity, as many suppose. And little children at first fall down wherever they may happen to be, from inexperience. But when they have been often seized, and feel its approach beforehand, they flee to their mothers, or to any other person they are acquainted with, from terror and dread of the affection, for being still infants they do not know yet what it is to be ashamed. And for these reasons, I say, they are attacked during changes of the winds, and especially south winds, then also with north winds, and afterwards also with the others. These are the strongest winds, and the most opposed to one another, both as to direction and power. For, the north wind condenses the air, and separates from it whatever is muddy and nebulous, and renders it clearer and brighter, and so in like manner also, all the winds which arise from the sea and other waters; for they extract the humidity and nebulosity from all objects, and from men themselves, and therefore it (the north wind) is the most wholesome of the winds. But the effects of the south are the very reverse.' For in the first place it begins by melting and diffusing the condensed air, and therefore it does not blow strong at first, but is gentle at the commencement, because it is not able at once to overcome the dense and compacted air, which yet in a while it dissolves. It produces the same effects upon the land, the sea, the rivers, the fountains, the wells, and on every production which contains humidity, and this, there is in all things, some more, some less. For all these feel the effects of this wind, and from clear they become cloudy, from cold, hot; from dry, moist; and whatever earthen vessels are placed upon the ground, filled with wine or any other fluid, are affected with the south wind, and undergo a change. And the sun, the moon, and the stars it renders blunter in appearance than they natu
The classical scholar will here recollect the character of the auster given by Horace:
"frustra per autumnum nocentem Corporibus mutuemus austrum.”
This wind, I suppose, there can be no doubt, was the sirocco.
rally are. When, then, it possesses such powers over things so great and strong, and the body is made to feel and undergo changes in the changes of the winds, it necessarily follows that the brain should be dissolved and overpowered with moisture, and that the veins should become more relaxed by the south winds, and that by the north the healthiest portion of the brain should become contracted, while the most morbid and humid is secreted, and overflows externally, and that catarrhs should thus take place in the changes of these winds. Thus is this disease formed and prevails from those things which enter into and go out of the body, and it is not more difficult to understand or to cure than the others, neither is it more divine than other diseases. And men ought to know that from nothing else but thence (from the brain) come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentations. And by this, in an especial manner, we acquire wisdom and knowledge, and see and hear, and know what are foul and what are fair, what are bad and what are good, what are sweet, and what unsavory; some we discriminate by habit, and some we perceive by their utility. By this we distinguish objects of relish and disrelish, according to the seasons; and the same things do not always please us. And by the same organ we become mad and delirious, and fears and terrors assail us, some by night, and some by day, and dreams and untimely wanderings, and cares that are not suitable, and ignorance of present circumstances, desuetude, and unskilfulness. All these things we endure from the brain, when it is not healthy, but is more hot, more cold, more moist, or more dry than natural, or when it suffers any other preternatural and unusual affection. And we become. mad from humidity (of the brain). For when it is more moist than natural, it is necessarily put into motion, and the affection being moved,' neither the sight nor hearing can be at rest, and the tongue speaks in accordance with the sight and hearing. As long as the brain is at rest, the man enjoys his reason, but the depravement of the brain arises from phlegm and bile, either of which you may recognize in this manner: Those who are mad from phlegm are quiet, and do not cry out nor make a noise; but those from bile are vociferous, malignant, and will not be quiet, but are always doing something improper. If the madness be constant, these are the causes thereof. But if terrors and fears assail, they are connected with derangement of the brain, and derangement is owing to its being heated. And it is heated by bile when it is determined to the brain along the blood-vessels running from the trunk; and fear is present until
1If the text be not in fault, we must here understand by “affection” the affected part, or organ; that is to say, the abstract is put for the concrete. This is constantly done by our author's contemporary, Pindar, but one would scarcely expect so bold a trope in a prose writer.
The connection between epilepsy and mania is undoubted. See Copland's Dictionary, under Epilepsy.
it return again to the veins and trunk, when it ceases. He is grieved and troubled when the brain is unseasonably cooled and contracted beyond its wont. This it suffers from phlegm, and from the same affection the patient becomes oblivious. He calls out and screams at night when the brain is suddenly heated. The bilious endure this. But the phlegmatic are not heated, except when much blood goes to the brain, and creates an ebullition. Much blood passes along the aforesaid veins. But when the man happens to see a frightful dream and is in fear as if awake, then his face is in a greater glow, and the eyes are red when the patient is in fear. And the understanding meditates doing some mischief, and thus it is affected in sleep. But if, when awakened, he returns to himself, and the blood is again distributed along the aforesaid veins, it ceases. In these ways I am of opinion that the brain exercises the greatest power in the man. This is the interpreter to us of those things which emanate from the air, when it (the brain) happens to be in a sound state. But the air supplies sense to it. And the eyes, the ears, the tongue and the feet, administer such things as the brain cogitates. For inasmuch as it is supIt is the brain which is
plied with air, does it impart sense to the body. the messenger to the understanding. For when the man draws the breath (pneuma) into himself, it passes first to the brain, and thus the air is distributed to the rest of the body, leaving in the brain its acme, and whatever has sense and understanding. For if it passed first to the body and last to the brain, then having left in the flesh and veins the judgment,' when it reached the brain it would be hot, and not at all pure, but mixed with the humidity from the fleshy parts and the blood, so as to be no longer pure. Wherefore, I say, that it is the brain which interprets the understanding. But the diaphragm has obtained its name (ppέves) from accident and usage, and not from reality or nature, for I know no power which it possesses, either as to sense or understanding, except that when the man is affected with unexpected joy or sorrow, it throbs and produces palpitations, owing to its thinness, and as having no belly to receive anything good or bad that may present themselves to it, but it is thrown into commotion by both these, from its natural weakness. It then perceives beforehand none of those things which occur in the body, but has received its name vaguely and without any proper reason, like the parts about the heart, which are called auricles, but which contribute nothing towards hearing. Some say that we think with the heart, and that this is the part which is grieved, and experiences care. But it is
1 Alάyvwors. The term is very obscure; indeed I cannot but think the text must be corrupt. If it stand, it must be understood to mean the peculiar or discriminating power or property of the pneuma.
? This opinion was decidedly maintained by Chrysippus, but he flourished more than 200 years after our author. Who, among the more ancient philosophers in particular he alludes to, it is difficult to determine with precision. Plato, in imita