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Now when each process takes place in this order, health commonly results; when in the opposite order, disease. For when the flesh becomes decomposed and sends back the wasting substance into the veins, then an over-supply of blood of diverse kinds, mingling with air in the veins, having variegated colours and bitter properties, as well as acid and saline qualities, contains all sorts of bile and serum and phlegm. For all things go the wrong way, and having become corrupted, first they taint the blood itself, and then ceasing to give nourishment the body they are carried along the veins in all directions, no longer preserving the order of their natural courses, but at war with themselves, because they receive no good from one another, and are hostile to the abiding constitution of the body, which they corrupt and dissolve. The oldest part of the flesh which is corrupted, being hard to decompose, from long burning grows black, and from being everywhere corroded becomes bitter, and is injurious to every part of the body which is still uncorrupted.
Sometimes, when the bitter element is refined away, the black part assumes an acidity which takes the place of the bitterness; at other times the bitterness being tinged with blood has a redder colour; and this, when mixed with black, takes the hue of grass; and again, an auburn colour mingles with the bitter matter when new flesh is decomposed by the fire which surrounds the internal flame-to all which symptoms some physician perhaps, or rather some philosopher, who had the power of seeing in many dissimilar things one nature deserving of a name, has assigned the common name of bile. But the other kinds of bile are variously distinguished by their colours. As for serum, that sort which is the watery part of blood is innocent, but that which is a secretion of black and acid bile is malignant when mingled by the power of heat with any salt substance, and is then called acid phlegm.
Again, the substance which is formed by the liquefaction of new and tender flesh when air is present, if inflated and encased in liquid so as to form bubbles, which separately are invisible owing to their small size, but when collected are of a bulk which is visible, and have a white colour arising out of the generation of foam-all this decomposition of tender flesh when inter-mingled with air is termed by us white phlegm. And the whey or sediment of newly-formed phlegm is sweat and tears, and includes the various daily discharges by which the body is purified. Now all these become causes of disease when the blood is not replenished in a natural manner by food and drink but gains bulk from opposite sources in violation of the laws of nature.
When the several parts of the flesh are separated by disease, if the foundation remains, the power of the disorder is only half as great, and there is still a prospect of an easy recovery; but when that which binds the flesh to the bones is diseased, and no longer being separated from the muscles and sinews, ceases to give nourishment to the bone and to unite flesh and bone, and from being oily and smooth and glutinous becomes rough and salt and dry, owing to bad regimen, then all the substance thus corrupted crumbles away under the flesh and the sinews, and separates from the bone, and the fleshy parts fall away from their foundation and leave the sinews bare and full of brine, and the flesh again gets into the circulation of the blood and makes the previously-mentioned disorders still greater. And if these bodily affections be severe, still worse are the prior disorders; as when the bone itself, by reason of the density of the flesh, does not obtain sufficient air, but becomes mouldy and hot and gangrened and receives no nutriment, and the natural process is inverted, and the bone crumbling passes into the food, and the food into the flesh, and the flesh again falling into the blood makes all maladies that may occur more virulent than those already mentioned. But the worst case of all is when the marrow is diseased, either from excess or defect; and this is the cause of the very greatest and most fatal disorders, in which the whole course of the body is reversed.
There is a third class of diseases which may be conceived of as arising in three ways; for they are produced sometimes by wind, and sometimes by phlegm, and sometimes by bile. When the lung, which is the dispenser of the air to the body, is obstructed by rheums and its passages are not free, some of them not acting, while through others too much air enters, then the parts which are unrefreshed by air corrode, while in other parts the excess of air forcing its way through the veins distorts them and decomposing the body is enclosed in the midst of it and occupies the midriff thus numberless painful diseases are produced, accompanied by copious sweats. And oftentimes when the flesh is dissolved in the body, wind, generated within and unable to escape, is the source of quite as much pain as the air coming in from without; but the greatest pain is felt when the wind gets about the sinews and the veins of the shoulders, and swells them up, so twists back the great tendons and the sinews which are connected with them. These disorders are called tetanus and opisthotonus, by reason of the tension which accompanies them. The cure of them is difficult; relief is in most cases given by fever supervening.
The white phlegm, though dangerous when detained within by reason of the air-bubbles, yet if it can communicate with the outside air, is less severe, and only discolours the body, generating leprous eruptions and similar diseases. When it is mingled with black bile and dispersed about the courses of the head, which are the divinest part of us, the attack if coming on in sleep, is not so severe; but when assailing those who are awake it is hard to be got rid of, and being an affection of a sacred part, is most justly called sacred. An acid and salt phlegm, again, is the source of all those diseases which take the form of catarrh, but they have many names because the places into which they flow are manifold. Inflammations of the body come from burnings and inflamings, and all of them originate in bile. When bile finds a means of discharge, it boils up and sends forth all sorts of tumours; but when imprisoned within, it generates many inflammatory diseases, above all when mingled with pure blood; since it then displaces the fibres which are scattered about in the blood and are designed to maintain the balance of rare and dense, in order that the blood may not be so liquefied by heat as to exude from the pores of the body, nor again become too dense and thus find a difficulty in circulating through the veins.
The fibres are so constituted as to maintain this balance; and if any one brings them all together when the blood is dead and in process of cooling, then the blood which remains becomes fluid, but if they are left alone, they soon congeal by reason of the surrounding cold. The fibres having this power over the blood, bile, which is only stale blood, and which from being flesh is dissolved again into blood, at the first influx coming in little by little, hot and liquid, is congealed by the power of the fibres; and so congealing and made to cool, it produces internal cold and shuddering. When it enters with more of a flood and overcomes the fibres by its heat, and boiling up throws them into disorder, if it have power enough to maintain its supremacy, it penetrates the marrow and burns up what may be termed the cables of the soul, and sets her free; but when there is not so much of it, and the body though wasted still holds out, the bile is itself mastered, and is either utterly banished, or is thrust through the veins into the lower or upper-belly, and is driven out of the body like an exile from a state in which there has been civil war; whence arise diarrhoeas and dysenteries, and all such disorders.
When the constitution is disordered by excess of fire, continuous heat and fever are the result; when excess of air is the cause, then the fever is quotidian; when of water, which is a more sluggish element than either fire or air, then the fever is a tertian; when of earth, which is the most sluggish of the four, and is only purged away in a four-fold period, the result is a quartan fever, which can with difficulty be shaken off. Such is the manner in which diseases of the body arise; the disorders of the soul, which depend upon the body, originate as follows. We must acknowledge disease of the mind to be a want of intelligence; and of this there are two kinds; to wit, madness and ignorance. In whatever state a man experiences either of them, that state may be called disease; and excessive pains and pleasures are justly to be regarded as the greatest diseases to which the soul is liable. For a man who is in great joy or in great pain, in his unseasonable eagerness to attain the one and to avoid the other, is not able to see or to hear anything rightly; but he is mad, and is at the time utterly incapable of any participation in reason.
He who has the seed about the spinal marrow too plentiful and overflowing, like a tree overladen with fruit, has many throes, and also obtains many pleasures in his desires and their offspring, and is for the most part of his life deranged, because his pleasures and pains are so very great; his soul is rendered foolish and disordered by his body; yet he is regarded not as one diseased, but as one who is voluntarily bad, which is a mistake. The truth is that the intemperance of love is a disease of the soul due chiefly to the moisture and fluidity which is produced in one of the elements by the loose consistency of the bones. And in general, all that which is termed the incontinence of pleasure and is deemed a reproach under the idea that the wicked voluntarily do wrong is not justly a matter for reproach. For no man is voluntarily bad; but the bad become bad by reason of an ill disposition of the body and bad education, things which are hateful to every man and happen to him against his will. And in the case of pain too in like manner the soul suffers much evil from the body.
For where the acid and briny phlegm and other bitter and bilious humours wander about in the body, and find no exit or escape, but are pent up within and mingle their own vapours with the motions of the soul, and are blended, with them, they produce all sorts of diseases, more or fewer, and in every degree of intensity; and being carried to the three places of the soul, whichever they may severally assail, they create infinite varieties of ill-temper and melancholy, of rashness and cowardice, and also of forgetfulness and stupidity. Further, when to this evil constitution of body evil forms of government are added and evil discourses are uttered in private as well as in public, and no sort of instruction is given in youth to cure these evils, then all of us who are bad become bad from two causes which are entirely beyond our control.
In such cases the planters are to blame rather than the plants, the educators rather than the educated. But however that may be, we should endeavour as far as we can by education, and studies, and learning, to avoid vice and attain virtue; this, however, is part of another subject. There is a corresponding enquiry concerning the mode of treatment by which the mind and the body are to be preserved, about which it is meet and right that I should say a word in turn; for it is more our duty to speak of the good than of the evil. Everything that is good is fair, and the animal fair is not without proportion, and the animal which is to be fair must have due proportion. Now we perceive lesser symmetries or proportions and reason about them, but of the highest and greatest we take no heed; for there is no proportion or disproportion more productive of health and disease, and virtue and vice, than that between soul and body.
This however we do not perceive, nor do we reflect that when a weak or small frame is the vehicle of a great and mighty soul, or conversely, when a little soul is encased in a large body, then the whole animal is not fair, for it lacks the most important of all symmetries; but the due proportion of mind and body is the fairest and loveliest of all sights to him who has the seeing eye. Just as a body which has a leg too long, or which is unsymmetrical in some other respect, is an unpleasant sight, and also, when doing its share of work, is much distressed and makes convulsive efforts, and often stumbles through awkwardness, and is the cause of infinite evil to its own self-in like manner we should conceive of the double nature which we call the living being; and when in this compound there is an impassioned soul more powerful than the body, that soul, I say, convulses and fills with disorders the whole inner nature of man; and when eager in the pursuit of some sort of learning or study, causes wasting; or again, when teaching or disputing in private or in public, and strifes and controversies arise, inflames and dissolves the composite frame of man and introduces rheums; and the nature of this phenomenon is not understood by most professors of medicine, who ascribe it to the opposite of the real cause.
And once more, when body large and too strong for the soul is united to a small and weak intelligence, then inasmuch as there are two desires natural to man,-one of food for the sake of the body, and one of wisdom for the sake of the diviner part of us-then, I say, the motions of the stronger, getting the better and increasing their own power, but making the soul dull, and stupid, and forgetful, engender ignorance, which is the greatest of diseases. There is one protection against both kinds of disproportion:-that we should not move the body without the soul or the soul without the body, and thus they will be on their guard against each other, and be healthy and well balanced. And therefore the mathematician or any one else whose thoughts are much absorbed in some intellectual pursuit, must allow his body also to have due exercise, and practise gymnastic; and he who is careful to fashion the body, should in turn impart to the soul its proper motions, and should cultivate music and all philosophy, if he would deserve to be called truly fair and truly good.
And the separate parts should be treated in the same manner, in imitation of the pattern of the universe; for as the body is heated and also cooled within by the elements which enter into it, and is again dried up and moistened by external things, and experiences these and the like affections from both kinds of motions, the result is that the body if given up to motion when in a state of quiescence is overmastered and perishes; but if any one, in imitation of that which we call the foster-mother and nurse of the universe, will not allow the body ever to be inactive, but is always producing motions and agitations through its whole extent, which form the natural defence against other motions both internal and external, and by moderate exercise reduces to order according to their affinities the particles and affections which are wandering about the body, as we have already said when speaking of the universe, he will not allow enemy placed by the side of enemy to stir up wars and disorders in the body, but he will place friend by the side of friend, so as to create health.
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