20. Certain sophists and physicians say that it is not possible for

any one to know medicine who does not know what man is [and how he was

made and how constructed], and that whoever would cure men properly,

must learn this in the first place. But this saying rather appertains

to philosophy, as Empedocles and certain others have described what man

in his origin is, and how he first was made and constructed.[365] But

I think whatever such has been said or written by sophist or physician

concerning nature has less connection with the art of medicine than

with the art of painting. And I think that one cannot know anything

certain respecting nature from any other quarter than from medicine;

and that this knowledge is to be attained when one comprehends the

whole subject of medicine properly, but not until then; and I say

that this history shows what man is, by what causes he was made,

and other things accurately. Wherefore it appears to me necessary

to every physician to be skilled in nature, and strive to know, if

he would wish to perform his duties, what man is in relation to the

articles of food and drink, and to his other occupations, and what

are the effects of each of them to every one. And it is not enough

to know simply that cheese is a bad article of food, as disagreeing

with whoever eats of it to satiety, but what sort of disturbance it

creates, and wherefore, and with what principle in man it disagrees;

for there are many other articles of food and drink naturally bad which

affect man in a different manner. Thus, to illustrate my meaning by an

example, undiluted wine drunk in large quantity renders a man feeble;

and everybody seeing this knows that such is the power of wine, and

the cause thereof; and we know, moreover, on what parts of a man’s

body it principally exerts its action; and I wish the same certainty

to appear in other cases. For cheese (since we used it as an example)

does not prove equally injurious to all men, for there are some who can

take it to satiety without being hurt by it in the least, but, on the

contrary, it is wonderful what strength it imparts to those it agrees

with; but there are some who do not bear it well, their constitutions

are different, and they differ in this respect, that what in their body

is incompatible with cheese, is roused and put in commotion by such a

thing; and those in whose bodies such a humor happens to prevail in

greater quantity and intensity, are likely to suffer the more from it.

But if the thing had been pernicious to the whole nature of man, it

would have hurt all. Whoever knows these things will not suffer from it.

21. During convalescence from diseases, and also in protracted

diseases, many disorders occur, some spontaneously, and some from

certain things accidentally administered. I know that the common herd

of physicians, like the vulgar, if there happen to have been any

innovation made about that day, such as the bath being used, a walk

taken, or any unusual food eaten, all which were better done than

otherwise, attribute notwithstanding the cause of these disorders, to

some of these things, being ignorant of the true cause but proscribing

what may have been very proper. Now this ought not to be so; but one

should know the effects of a bath or a walk unseasonably applied; for

thus there will never be any mischief from these things, nor from any

other thing, nor from repletion, nor from such and such an article of

food. Whoever does not know what effect these things produce upon a

man, cannot know the consequences which result from them, nor how to

apply them.

22. And it appears to me that one ought also to know what diseases

arise in man from the powers, and what from the structures. What do

I mean by this? By powers, I mean intense and strong juices; and by

structures, whatever conformations there are in man. For some are

hollow, and from broad contracted into narrow; some expanded, some hard

and round, some broad and suspended,[366] some stretched, some long,

some dense, some rare and succulent,[367] some spongy and of loose

texture.[368] Now, then, which of these figures is the best calculated

to suck to itself and attract humidity from another body? Whether

what is hollow and expanded, or what is solid and round, or what is

hollow, and from broad, gradually turning narrow? I think such as from

hollow and broad are contracted into narrow: this may be ascertained

otherwise from obvious facts: thus, if you gape wide with the mouth

you cannot draw in any liquid; but by protruding, contracting, and

compressing the lips, and still more by using a tube, you can readily

draw in whatever you wish. And thus, too, the instruments which are

used for cupping are broad below and gradually become narrow, and are

so constructed in order to suck and draw in from the fleshy parts.

The nature and construction of the parts within a man are of a like

nature; the bladder, the head, the uterus in woman; these parts clearly

attract, and are always filled with a juice which is foreign to them.

Those parts which are hollow and expanded are most likely to receive

any humidity flowing into them, but cannot attract it in like manner.

Those parts which are solid and round could not attract a humidity, nor

receive it when it flows to them, for it would glide past, and find no

place of rest on them. But spongy and rare parts, such as the spleen,

the lungs, and the breasts, drink up especially the juices around them,

and become hardened and enlarged by the accession of juices. Such

things happen to these organs especially. For it is not with the spleen

as with the stomach, in which there is a liquid, which it contains and

evacuates every day; but when it (the spleen) drinks up and receives a

fluid into itself, the hollow and lax parts of it are filled, even the

small interstices; and, instead of being rare and soft, it becomes hard

and dense, and it can neither digest nor discharge its contents: these

things it suffers, owing to the nature of its structure. Those things

which engender flatulence or tormina in the body, naturally do so in

the hollow and broad parts of the body, such as the stomach and chest,

where they produce rumbling noises; for when they do not fill the

parts so as to be stationary, but have changes of place and movements,

there must necessarily be noise and apparent movements from them. But

such parts as are fleshy and soft, in these there occur torpor and

obstructions, such as happen in apoplexy. But when it (the flatus?)

encounters a broad and resisting structure, and rushes against such a

part, and this happens when it is by nature not strong so as to be able

to withstand it without suffering injury; nor soft and rare, so as to

receive or yield to it, but tender, juicy, full of blood, and dense,

like the liver, owing to its density and broadness, it resists and does

not yield. But flatus, when it obtains admission, increases and becomes

stronger, and rushes toward any resisting object; but owing to its

tenderness, and the quantity of blood which it (the liver) contains,

it cannot be without uneasiness; and for these reasons the most acute

and frequent pains occur in the region of it, along with suppurations

and chronic tumors (phymata). These symptoms also occur in the site of

the diaphragm, but much less frequently; for the diaphragm is a broad,

expanded, and resisting substance, of a nervous (tendinous?) and strong

nature, and therefore less susceptible of pain; and yet pains and

chronic abscesses do occur about it.

23. There are both within and without the body many other kinds of

structure, which differ much from one another as to sufferings both in

health and disease; such as whether the head be small or large; the

neck slender or thick, long or short; the belly long or round; the

chest and ribs broad or narrow; and many others besides, all which you

ought to be acquainted with, and their differences; so that knowing the

causes of each, you may make the more accurate observations.

24. And, as has been formerly stated, one ought to be acquainted

with the powers of juices, and what action each of them has upon

man, and their alliances towards one another. What I say is this: if

a sweet juice change to another kind, net from any admixture, but

because it has undergone a mutation within itself; what does it first

become?--bitter? salt? austere? or acid? I think acid. And hence, an

acid juice is the most improper of all things that can be administered

in cases in which a sweet juice is the most proper. Thus, if one

should succeed in his investigations of external things, he would be

the better able always to select the best; for that is best which is

farthest removed from that which is unwholesome.

ON AIRS, WATERS, AND PLACES.

THE ARGUMENT.

Dr. Coray, in his excellent edition of this treatise, divides it

into six chapters, as follows: first, the Introduction (from § 1–3)

comprehends some general observations on the importance of cultivating

a knowledge of the effects which the different seasons, the winds, the

various kinds of water, the situation of cities, the nature of soils

and the modes of life, exercise upon the health, and the necessity of

a physician’s making himself well acquainted with all these matters,

if he would wish to practise his profession successfully. The author

insists, with particular earnestness, on the utility of studying the

constitution of the year and the nature of the seasons, and refutes the

opinions of those persons, in his days, who held that a knowledge of

all these things belongs to meteorology rather than to medicine. The

second chapter (§ 3–7) treats of climate, and the diseases prevalent in

localities characterized by their exposure to particular winds. Those

winds being peculiar to Greece, their names occasion some trouble in

order to understand them correctly, and we shall give below a summary

of what the modern Greek Coray says in illustration of them. This part

of the present treatise appears to have been highly elaborated, and

contains much important information. The third chapter (§ 7–10) treats

of the various kinds of water, and their effects in different states of

the human constitution. The remarks contained here are of an eminently

practical nature, and evidently must have been the results of patient

observation and experiment, so that, even at the present day, it would

be difficult to detect our author in a single error of judgment. In

this place he has occasion to deliver his opinions on the formation of

urinary calculi, which he does at considerable length; and I may be

permitted to remark, whatever may be thought of his etiology of the

disease, it will be admitted that his theory is plausible, and the best

that could well have been framed in the state of knowledge which then

prevailed on that subject. Indeed, even at the present day, it must

be allowed that this is a dark subject; we have acquired, it is true,

many new and curious facts connected with the minute structure of these

concretions, but it can hardly be affirmed that we have been able to

evolve from them any general principles, or certain rules of practice.

In the fourth chapter (§ 10–12), the nature of the seasons is treated

of, and their influence on the health circumstantially stated. Some

of the observations contained in this part of the work are remarkable

for their acuteness and originality, such as the following, that, in

estimating the effects of a season on the health, we ought to take

into account the seasons which preceded it. This is well expressed by

Celsus, as follows: “neque solum interest quales dies sint sed etiam

quales præcesserint.” (Præfat.) See also Hippocrates (de Humoribus, §

8); and Coray (ad h. 1. § cix.) It will be seen in our annotations that

a considerable number of the Aphorisms are abstracted from this part of

the present treatise. In the fifth chapter (§ 12–17), the effects of

climate and the institutions of society on the inhabitants of Asia are

treated of at considerable length. Our author, in this place, evinces

a great acquaintance with human life, and a most philosophical spirit

in contemplating the subject which he is handling. Indeed few works in

any language display so much accurate observation and originality of

thought. The varieties of disposition, and of intellectual and moral

development among mankind, are set down as being derived, in a great

measure, from differences of climate and modes of government. Thus the

Asiatics are of an effeminate and slavish disposition, because they

live in a soft climate, on a rich soil, where they are little exposed

to hardships or labor, and under a despotic form of government, which

arrests the development of their mental energies.[369] This part also

contains some interesting observations on the Macrocephali and the

inhabitants of Phasis. In the sixth and last chapter (§ 17 to the

end), the peculiar traits of the European character, as connected with

climate and institutions, are described in a very interesting manner.

Here the observations on the Amazons, Sauromatæ, and Scythians are

well deserving of an attentive perusal, and more particularly the

description of the disease induced by continual riding on horseback,

the probable nature of which we shall consider presently. Here, too,

are given our author’s remarks on diseases supposed to be divine,

which, as we have stated in the Preliminary section on his life, evince

a wonderful exemption from the superstitious belief of his age, and

indicate an extraordinary depth of thought.

This is a general outline of the contents of this treatise, which

is one of the most celebrated in the whole Collection. From what we

have stated, it will at once be seen that it relates to a subject

of commanding interest, and deserves to be carefully studied, as

containing the oldest exposition which we possess of the opinions

entertained by an original and enlightened mind on many important

questions connected with Public Hygiene and Political Economy, two

sciences which, of late years, have commanded a large amount of

professional attention. Whether or not modern experience may confirm

our author’s judgment in every particular case, it surely can neither

be unprofitable nor uninteresting to ascertain what his opinions on

these subjects actually were. Let us be thankful, then, that the

destroying hand of time has spared us so valuable a relic of antiquity;

and, instead of undervaluing our ancient instructor because he shows

himself ignorant of many truths which we are now familiar with, let us

be grateful to him for the amount of information which he has supplied

to us, and for setting us an example which it must be both safe and

profitable for us to follow. Surely great praise is due to the man who

first mooted so many important questions, and stated their bearings in

distinct terms, although he did not always succeed in solving them.[370]

I may take the present opportunity of mentioning that M. Littré,

with some appearance of truth, blames Hippocrates for having rather

overrated the influence of climate and institutions, in producing

military valor, which, as he justly remarks, has been proved by

modern examples to be most intimately connected with discipline, and

a knowledge of the arts of war. But if Hippocrates was wrong on this

point, it was because he did not avail himself properly of the lights

of his own age; for he might have learned from his contemporary,

Socrates, the very doctrine which M. Littré here inculcates. “The

question being put to him,” says Xenophon, “whether valor was a thing

that could be taught, or was natural? I am of opinion, he said, that as

one body is born with greater powers than another for enduring labor,

so is one soul produced by nature stronger than another for enduring

dangers. For I see persons brought up under the same institutions and

habits differing much from one another in courage. But I think that

every nature may be improved in valour by learning and discipline.

For it is obvious that the Scythians and Thracians would not dare to

contend with the Lacedemonians with bucklers and spears; and it is

clear that, the Lacedemonians would not be willing to contend with

the Thracians with small targets and javelins, or with the Scythians

with bows and arrows.” (Memorab. iii., 9.) The same doctrine is taught

with remarkable subtlety of argument and originality of thought in the

“Protagoras” of Plato, (see § 97). If, then, Hippocrates was wrong on

this head, (which, however, may be doubted), it is clear that he is

not to be screened by the alleged ignorance of his age, and that he

might have put himself right by attending to the instructions of a

contemporary with whom he, in all probability, was familiar, and who

undoubtedly was the greatest master of human nature that ever existed.

As there are certain matters connected with this treatise which will

require a more lengthened discussion than can well suit with foot

notes, I think it advisable to treat of them in this place:--

1. With regard to the seasons of the year, as indicated try the

risings and settings of the stars. the following observations, taken in

a great measure from Clifton’s Preface will supply, in as brief a space

as possible, all the information that will be required; “As the reader

will find frequent mention of seasons, equinoxes, solstices, risings

and settings of the sun and stars (particularly Arcturus, the Dog-star,

and the Pleiades), it may not be amiss to premise, in the first place,

that a year was divided by the ancients into four parts, every one of

these was distinguished astronomically.

“Thus, for instance, the winter began at the setting of the Pleiades,

and continued to the vernal equinox.

“The spring began at the vernal equinox, and ended at the rising of the

Pleiades.

“The summer began at the rising of the Pleiades, and ended at the

rising of Arcturus.

“The autumn began at the rising of Arcturus, and ended at the setting

of the Pleiades.

“The rising and setting of the stars is always to be understood of what

astronomers call the heliacal rising or setting, i. e. when a star

rises or sets with the sun.

“The rising and setting of the sun in summer or winter (an expression

which often occurs in this treatise), implies those points of the

compass the sun rises and sets at.”[371]

[Illustration]

II. On the winds, of which frequent mention is made by our author,

Coray has treated with a degree of prolixity and earnestness for which

it is difficult to recognize the necessity. The figure given above, if

properly studied and understood, will supply the professional reader

with all the information he will require on this head.

III. One of the most singular diseases noticed in this work is the

effeminacy with which the Scythians are said to have been attacked in

consequence of spending the greater part of their time on horseback.

(See § 22.) As the subject has attracted a good deal of attention

lately, I will give a summary of the information which has been

collected respecting it. See Coray, etc., t. ii., p. 331; Littré, t.

ii., p. 5, 6; and Avert., xxxix., p. 47; t. iv., p. 9.

In the first place, then, it can scarcely admit of doubt that the

disease is the same as that which Herodotus describes in the following

passage: “Venus inflicted upon the Scythians, who pillaged her temple

at Ascalon, and on their descendants, _the feminine disease_;

at least it is to this cause that they attribute their disease; and

travellers that go to the land of Scythia see how these persons are

affected whom the Scythians called _accursed_ (ἐναρεες).”[372]

All the opinions which have been entertained respecting this affection

are referred by M. Littré to the three following categories:

I. A vice, namely (A), Pederasty, which, he says is the most ancient

opinion we have respecting it, as indicated by Longinus[373] (on the

Sublime, 25), and defended by his commentators, Toll and Pearce, and by

Casaubon and Coster.[374] (B), Onanism, the opinion to which Sprengel

inclines in his work on Hippocrates.

2. A bodily disease, to wit: (A), Hemorrhoids, as maintained by

Paul Thomas de Girac,[375] by Valkenäer, by Bayer,[376] and by the

Compilers of the ‘Universal History.’[377] (B), A true menstruation,

as appears to be maintained by Lefevre and Dacier,[378] and by others.

(C), Blenorrhagia, as Guy Patin[379] and others suppose. (D), A true

impotence, as held by Mercuriali and others.

3. A mental disease, as maintained by Sauvages,[380] Heyne,[381]

Coray,[382] and others.

M. Rosenbaum is at great pains to make out that the affection in

question was pederasty, and that the _accursed_ (ἐνάρεες) of

Herodotus were the same as the _pathici_ of the Romans. I must

say, that in my opinion Rosenbaum makes out a strong case in support

of this opinion. In particular it will be remarked, that Herodotus

says, the descendants of these Scythians were also afflicted with this

complaint. Now Celsus Aurelianus says expressly, that the affection of

the pathici was hereditary.[383] Taking everything into account, I must

say that my own opinion has always been that the disease in question

must have been some variety of _spermatorrhœa_. I need scarcely

remark that this affection induces a state, both of body and mind,

analogous to that of the pathici, as described by ancient authors.

Before leaving this subject, however, I should mention that M. Littré,

in the fourth volume of his Hippocrates (p. xi.), brings into view a

thesis by M. Graff, the object of which is to prove that the disease

of the Scythians was a true sort of impotence; and in illustration of

it, he cites a passage from the memoirs of M. Larrey, containing a

description of a species of impotence, attended with wasting of the

testicle, which attacked the French army in Egypt. But, as far as I can

see, this disease described by Larrey had nothing to do with riding on

horseback, and I cannot see any relation between it and the diseases

described by Herodotus and Hippocrates.

IV. Of all the legendary tales of antiquity, there is probably no

one which was so long and so generally credited by the best informed

historians, critics, geographers, poets, and philosophers, as the

story of the Amazons. They are noticed historically by Homer (Iliad,

iii., 186; vi., 152); Apollonius Rhodius (ii., 196); Pindar (Olymp.

xiii., 84); Herodotus (ix., 27); Lysias (Epitaph. 3); Plato (Menex.);

Isocrates (Panyg.); Ctesias (Persic.); Plutarch (Theseus); Strabo

(Geogr. ix.); Pausanias (iv., 31, 6; vii., 2, 4); Arrian (Exped.

Alexand.); Quintus Curtius (vi., 4). Now it is singular that in all

this list of authorities, which, it will be remarked, comprehends

the _élite_ of ancient scholars, no one, with the exception of

Strabo, ventures to express the slightest doubt respecting the actual

existence of the Amazons. Some of them, indeed, admit that the race

had become extinct in their time; but they all seem satisfied that

the Amazons had truly existed in a bygone age, and consequently they

acknowledge them as real historical personages. See, in particular,

Arrian, who, although compelled by his respect for truth to acknowledge

that they did not exist in the days of Alexander the Great, still does

not hesitate to declare that it appeared incredible that this race of

women, celebrated as they were by the most eminent authors, should

never have existed at all. Yet, notwithstanding the mass of evidence

in support of their actual existence, I suppose few scholars nowadays

will hesitate to agree with Heyne (Apollodor. ii., 5, 9), and with

Grote (Hist. of Greece, i., 2), in setting down the whole story as mere

myth. But, considering how generally it had been believed, we need not

wonder that Hippocrates in this treatise should appear to entertain no

doubt of their actual existence. The reader will remark that he makes

the locality of the Amazons to be in Europe, among the Sarmatians,

on the north side of the Euxine. It is generally taken for granted,

however, in the ancient myths, that their place of residence was on

the banks of the Thermodon, in Cappadocia, and they are described as

having afterwards crossed to the opposite side of the Euxine, when

expelled from this locality. But, in fact, they are remarkable so

much for nothing as their ubiquity, being sometimes located in Asia,

sometimes in Africa, and at other times in Athens. I may remark,

before concluding, that Mr. Payne Knight (Symbolical Language, etc.,

Classical Journal, 23), and Creuzer (Symbolik. etc.), give a symbolical

interpretation to the story of the Amazons; but this mode of explaining

the myths of antiquity is altogether fanciful and unsatisfactory. It

seems safer and more judicious to deal with them as Mr. Grote has

done,[384] that is to say, to receive them as tales in which the

ancients believed, without having any rational foundation for their

faith. That there may have been a certain basis of truth in the story

of the Amazons need not be denied; but in this, as in all the ancient

myths, it is a hopeless task to attempt to separate truth from fiction.

ON AIRS, WATERS, AND PLACES.

1. Whoever wishes to investigate medicine properly, should proceed

thus: in the first place to consider the seasons of the year, and what

effects each of them produces (for they are not at all alike, but

differ much from themselves in regard to their changes).[385] Then

the winds, the hot and the cold, especially such as are common to all

countries, and then such as are peculiar to each locality. We must

also consider the qualities of the waters, for as they differ from

one another in taste and weight, so also do they differ much in their

qualities. In the same manner, when one comes into a city to which he

is a stranger, he ought to consider its situation, how it lies as to

the winds and the rising of the sun; for its influence is not the same

whether it lies to the north or the south, to the rising or to the

setting sun. These things one ought to consider most attentively, and

concerning the waters which the inhabitants use, whether they be marshy

and soft, or hard, and running from elevated and rocky situations, and

then if saltish and unfit for cooking; and the ground, whether it be

naked and deficient in water, or wooded and well watered, and whether

it lies in a hollow, confined situation, or is elevated and cold; and

the mode in which the inhabitants live, and what are their pursuits,

whether they are fond of drinking and eating to excess, and given to

indolence, or are fond of exercise and labor, and not given to excess

in eating and drinking.[386]

2. From these things he must proceed to investigate everything else.

For if one knows all these things well, or at least the greater

part of them, he cannot miss knowing, when he comes into a strange

city, either the diseases peculiar to the place, or the particular

nature of common diseases, so that he will not be in doubt as to the

treatment of the diseases, or commit mistakes, as is likely to be the

case provided one had not previously considered these matters. And

in particular, as the season and the year advances, he can tell what

epidemic diseases will attack the city, either in summer or in winter,

and what each individual will be in danger of experiencing from the

change of regimen. For knowing the changes of the seasons, the risings

and settings of the stars, how each of them takes place, he will be

able to know beforehand what sort of a year is going to ensue. Having

made these investigations, and knowing beforehand the seasons, such a

one must be acquainted with each particular, and must succeed in the

preservation of health, and be by no means unsuccessful in the practice

of his art. And if it shall be thought that these things belong rather

to meteorology,[387] it will be admitted, on second thoughts, that

astronomy contributes not a little, but a very great deal, indeed, to

medicine. For with the seasons the digestive organs of men undergo a

change.

3. But how each of the afore-mentioned things should be investigated

and explained, I will now declare in a clear manner. A city that is

exposed to hot winds (these are between the wintry rising, and the

wintry setting of the sun), and to which these are peculiar, but which

is sheltered from the north winds; in such a city the waters will be

plenteous and saltish, and as they run from an elevated source, they

are necessarily hot in summer, and cold in winter;[388] the heads of

the inhabitants are of a humid and pituitous constitution, and their

bellies subject to frequent disorders, owing to the phlegm running down

from the head; the forms of their bodies, for the most part, are rather

flabby; they do not eat nor drink much; drinking wine in particular,

and more especially if carried to intoxication, is oppressive to them;

and the following diseases are peculiar to the district: in the first

place, the women are sickly and subject to excessive menstruation; then

many are unfruitful from disease, and not from nature, and they have

frequent miscarriages; infants are subject to attacks of convulsions

and asthma, which they consider to be connected with infancy,[389]

and hold to be a sacred disease (epilepsy). The men are subject to

attacks of dysentery, diarrhœa, hepialus,[390] chronic fevers in

winter, of epinyctis,[391] frequently, and of hemorrhoids about the

anus. Pleurisies, peripneumonies, ardent fevers, and whatever diseases

are reckoned acute, do not often occur, for such diseases are not apt

to prevail where the bowels are loose. Ophthalmies occur of a humid

character, but not of a serious nature, and of short duration, unless

they attack epidemically from the change of the seasons. And when they

pass their fiftieth year, defluxions supervening from the brain, render

them paralytic when exposed suddenly to strokes of the sun,[392] or

to cold. These diseases are endemic to them, and, moreover, if any

epidemic disease connected with the change of the seasons, prevail,

they are also liable to it.

4. But the following is the condition of cities which have the

opposite exposure, namely, to cold winds, between the summer settings

and the summer risings of the sun, and to which these winds are

peculiar, and which are sheltered from the south and the hot breezes.

In the first place the waters are, for the most part, hard and cold.

The men must necessarily be well braced and slender, and they must have

the discharges downwards of the alimentary canal hard, and of difficult

evacuation, while those upwards are more fluid, and rather bilious

than pituitous. Their heads are sound and hard, and they are liable to

burstings (of vessels?) for the most part. The diseases which prevail

epidemically with them, are pleurisies, and those which are called

acute diseases. This must be the case when the bowels are bound; and

from any causes, many become affected with suppurations in the lungs,

the cause of which is the tension of the body, and hardness of the

bowels; for their dryness and the coldness of the water dispose them

to ruptures (of vessels?). Such constitutions must be given to excess

of eating, but not of drinking; for it is not possible to be gourmands

and drunkards at the same time. Ophthalmies, too, at length supervene;

these being of a hard and violent nature, and soon ending in rupture

of the eyes; persons under thirty years of age are liable to severe

bleedings at the nose in summer; attacks of epilepsy are rare but

severe. Such people are likely to be rather long-lived; their ulcers

are not attended with serous discharges, nor of a malignant character;

in disposition they are rather ferocious than gentle. The diseases I

have mentioned are peculiar to the men, and besides they are liable to

any common complaint which may be prevailing from the changes of the

seasons. But the women, in the first place, are of a hard constitution,

from the waters being hard, indigestible, and cold; and their menstrual

discharges are not regular, but in small quantity, and painful. Then

they have difficult parturition, but are not very subject to abortions.

And when they do bring forth children, they are unable to nurse them;

for the hardness and indigestible nature of the water puts away their

milk. Phthisis frequently supervenes after childbirth, for the efforts

of it frequently bring on ruptures and strains.[393] Children while

still little are subject to dropsies in the testicle, which disappear

as they grow older; in such a town they are late in attaining manhood.

It is, as I have now stated, with regard to hot and cold winds and

cities thus exposed.

5. Cities that are exposed to winds between the summer and the winter

risings of the sun, and those the opposite to them, have the following

characters:--Those which lie to the rising of the sun are all likely

to be more healthy than such as are turned to the North, or those

exposed to the hot winds, even if there should not be a furlong

between them.[394] In the first place, both the heat and cold are more

moderate. Then such waters as flow to the rising sun, must necessarily

be clear, fragrant, soft, and delightful to drink, in such a city. For

the sun in rising and shining upon them purifies them, by dispelling

the vapors which generally prevail in the morning. The persons of

the inhabitants are, for the most part, well colored and blooming,

unless some disease counteract. The inhabitants have clear voices,

and in temper and intellect are superior to those, which are exposed

to the north, and all the productions of the country in like manner

are better. A city so situated resembles the spring as to moderation

between heat and cold, and the diseases are few in number, and of a

feeble kind, and bear a resemblance to the diseases which prevail in

regions exposed to hot winds. The women there are very prolific, and

have easy deliveries. Thus it is with regard to them.

6. But such cities as lie to the west, and which are sheltered from

winds blowing from the east, and which the hot winds and the cold winds

of the north scarcely touch, must necessarily be in a very unhealthy

situation: in the first place the waters are not clear, the cause of

which is, because the mist prevails commonly in the morning, and it is

mixed up with the water and destroys its clearness, for the sun does

not shine upon the water until he be considerably raised above the

horizon. And in summer, cold breezes from the east blow and dews fall;

and in the latter part of the day the setting sun particularly scorches

the inhabitants, and therefore they are pale and enfeebled, and are

partly subject to all the aforesaid diseases, but no one is peculiar to

them. Their voices are rough and hoarse owing to the state of the air,

which in such a situation is generally impure and unwholesome, for they

have not the northern winds to purify it; and these winds they have

are of a very humid character, such being the nature of the evening

breezes. Such a situation of a city bears a great resemblance to autumn

as regards the changes of the day, inasmuch as the difference between

morning and evening is great. So it is with regard to the winds that

are conducive to health, or the contrary.

7. And I wish to give an account of the other kinds of waters,

namely, of such as are wholesome and such as are unwholesome, and

what bad and what good effects may be derived from water; for water

contributes much towards health.[395] Such waters then as are marshy,

stagnant, and belong to lakes, are necessarily hot in summer, thick,

and have a strong smell, since they have no current; but being

constantly supplied by rain-water, and the sun heating them, they

necessarily want their proper color, are unwholesome and form bile; in

winter, they become congealed, cold, and muddy with the snow and ice,

so that they are most apt to engender phlegm, and bring on hoarseness;

those who drink them have large and obstructed spleens, their bellies

are hard, emaciated, and hot; and their shoulders, collar-bones, and

faces are emaciated; for their flesh is melted down and taken up by the

spleen, and hence they are slender; such persons then are voracious and

thirsty; their bellies are very dry both above and below, so that they

require the strongest medicines.[396] This disease is habitual to them

both in summer and in winter, and in addition they are very subject

to dropsies of a most fatal character; and in summer dysenteries.

diarrhœas, and protracted quartan fevers frequently seize them, and

these diseases when prolonged dispose such constitutions to dropsies,

and thus prove fatal. These are the diseases which attack them in

summer; but in winter younger persons are liable to pneumonia, and

maniacal affections; and older persons to ardent fevers, from hardness

of the belly. Women are subject to œdema and leucophlegmasiæ;[397]

when pregand then during nursing they become wasted and sickly, and

the lochial discharge after parturition does not proceed properly

with the women. The children are particularly subject to hernia, and

adults to varices and ulcers on their legs, so that persons with

such constitutions cannot be long-lived, but before the usual period

they fall into a state of premature old age. And further, the women

appear to be with child, and when the time of parturition arrives,

the fulness of the belly disappears, and this happens from dropsy of

the uterus.[398] Such waters then I reckon bad for every purpose.

The next to them in badness are those which have their fountains in

rocks, so that they must necessarily be hard, or come from a soil

which produces thermal waters, such as those having iron, copper,

silver, gold, sulphur, alum, bitumen, or nitre (soda) in them: for

all these are formed by the force of heat.[399] Good waters cannot

proceed from such a soil, but those that are hard and of a heating

nature, difficult to pass by urine, and of difficult evacuation by

the bowels. The best are those which flow from elevated grounds, and

hills of earth; these are sweet, clear, and can bear a little wine;

they are hot in summer and cold in winter, for such necessarily must be

the waters from deep wells. But those are most to be commended which

run to the rising of the sun, and especially to the summer sun; for

such are necessarily more clear, fragrant, and light. But all such as

are saltish, crude, and hard, are not good for drink. But there are

certain constitutions and diseases with which such waters agree when

drunk, as I will explain presently. Their characters are as follows:

the best are such as have their fountains to the east; the next, those

between the summer risings and settings of the sun, and especially

those to the risings; and third, those between the summer and winter

settings; but the worst are those to the south, and the parts between

the winter rising and setting, and those to the south are very bad, but

those to the north are better. They are to be used as follows: whoever

is in good health and strength need not mind, but may always drink

whatever is at hand. But whoever wishes to drink the most suitable for

any disease, may accomplish his purpose by attending to the following

directions: To persons whose bellies are hard and easily burnt up, the

sweetest, the lightest, and the most limpid waters will be proper; but

those persons whose bellies are soft, loose, and pituitous, should

choose the hardest, those kinds that are most crude, and the saltest,

for thus will they be most readily dried up; for such waters as are

adapted for boiling, and are of a very solvent nature, naturally loosen

readily and melt down the bowels; but such as are intractable, hard,

and by no means proper for boiling, these rather bind and dry up the

bowels. People have deceived themselves with regard to salt waters,

from inexperience, for they think these waters purgative, whereas they

are the very reverse; for such waters are crude, and ill adapted for

boiling, so that the belly is more likely to be bound up than loosened

by them.[400] And thus it is with regard to the waters of springs.

8. I will now tell how it is with respect to rain-water, and

water from snow. Rain waters, then, are the lightest, the sweetest,

the thinnest, and the clearest; for originally the sun raises and

attracts the thinnest and lightest part of the water, as is obvious

from the nature of salts; for the saltish part is left behind owing

to its thickness and weight, and forms salts; but the sun attracts

the thinnest part, owing to its lightness, and he abstracts this not

only from the lakes, but also from the sea, and from all things which

contain humidity, and there is humidity in everything; and from man

himself the sun draws off the thinnest and lightest part of the juices.

As a strong proof of this, when a man walks in the sun, or sits down

having a garment on, whatever parts of the body the sun shines upon do

not sweat, for the sun carries off whatever sweat makes its appearance;

but those parts which are covered by the garment, or anything else,

sweat, for the particles of sweat are drawn and forced out by the

sun, and are preserved by the cover so as not to be dissipated by the

sun; but when the person comes into the shade the whole body equally

perspires, because the sun no longer shines upon it.[401] Wherefore,

of all kinds of water, these spoil the soonest; and rain water has

a bad smell, because its particles are collected and mixed together

from most objects, so as to spoil the soonest. And in addition to

this, when attracted and raised up, being carried about and mixed

with the air, whatever part of it is turbid and darkish is separated

and removed from the other, and becomes cloud and mist, but the most

attenuated and lightest part is left, and becomes sweet, being heated

and concocted by the sun, for all other things when concocted become

sweet. While dissipated then and not in a state of consistence it is

carried aloft. But when collected and condensed by contrary winds, it

falls down wherever it happens to be most condensed. For this is likely

to happen when the clouds being carried along and moving with a wind

which does not allow them to rest, suddenly encounters another wind and

other clouds from the opposite direction: there it is first condensed,

and what is behind is carried up to the spot, and thus it thickens,

blackens, and is conglomerated, and by its weight it falls down and

becomes rain. Such, to all appearance, are the best of waters, but they

require to be boiled and strained;[402] for otherwise they have a bad

smell, and occasion hoarseness and thickness of the voice to those who

drink them.[403] Those from snow and ice are all bad, for when once

congealed, they never again recover their former nature; for whatever

is clear, light, and sweet in them, is separated and disappears; but

the most turbid and weightiest part is left behind.[404] You may

ascertain this in the following manner: If in winter you will pour

water by measure into a vessel and expose it to the open air until

it is all frozen, and then on the following day bring it into a warm

situation where the ice will thaw, if you will measure the water

again when dissolved you will find it much less in quantity. This is

a proof that the lightest and thinnest part is dissipated and dried

up by the congelation, and not the heaviest and thickest, for that is

impossible:[405] wherefore I hold that waters from snow and ice, and

those allied to them, are the worst of any for all purposes whatever.

Such are the characters of rain-water, and those from ice and snow.

9.[406] Men become affected with the stone, and are seized with

diseases of the kidneys, strangury, sciatica, and become ruptured,

when they drink all sorts of waters, and those from great rivers into

which other rivulets run, or from a lake into which many streams of

all sorts flow, and such as are brought from a considerable distance.

For it is impossible that such waters can resemble one another, but

one kind is sweet, another saltish and aluminous, and some flow from

thermal springs; and these being all mixed up together disagree, and

the strongest part always prevails; but the same kind is not always

the strongest, but sometimes one and sometimes another, according to

the winds, for the north wind imparts strength to this water, and

the south to that, and so also with regard to the others. There must

be deposits of mud and sand in the vessels from such waters, and the

aforesaid diseases must be engendered by them when drunk, but why not

to all I will now explain. When the bowels are loose and in a healthy

state,[407] and when the bladder is not hot, nor the neck of the

bladder very contracted, all such persons pass water freely, and no

concretion forms in the bladder; but those in whom the belly is hot,

the bladder must be in the same condition; and when preternaturally

heated, its neck becomes inflamed; and when these things happen, the

bladder does not expel the urine, but raises its heat excessively. And

the thinnest part of it is secreted, and the purest part is passed

off in the form of urine, but the thickest and most turbid part is

condensed and concreted, at first in small quantity, but afterwards

in greater; for being rolled about in the urine, whatever is of a

thick consistence it assimilates to itself, and thus it increases and

becomes indurated. And when such persons make water, the stone forced

down by the urine falls into the neck of the bladder and stops the

urine, and occasions intense pain; so that calculous children rub their

privy parts and tear at them, as supposing that the obstruction to

the urine is situated there. As a proof that it is as I say, persons

affected with calculus have very limpid urine, because the thickest

and foulest part remains and is concreted.[408] Thus it generally is

in cases of calculus. It forms also in children from milk, when it is

not wholesome, but very hot and bilious, for it heats the bowels and

bladder, so that the urine being also heated undergoes the same change.

And I hold that it is better to give children only the most diluted

wine, for such will least burn up and dry the veins. Calculi do not

form so readily in women, for in them the urethra is short and wide,

so that in them the urine is easily expelled; neither do they rub the

pudendum with their hands, nor handle the passage like males;[409] for

the urethra in women opens direct into the pudendum, which is not the

case with men, neither in them is the urethra so wide, and they drink

more than children do.[410] Thus, or nearly so, is it with reward to

them.

10. And respecting the seasons, one may judge whether the year will

prove sickly or healthy from the following observations:[411]--If

the appearances connected with the rising and setting stars be as

they should be; if there be rains in autumn; if the winter be mild,

neither very tepid nor unseasonably cold, and if in spring the rains be

seasonable, and so also in summer, the year is likely to prove healthy.

But if the winter be dry and northerly, and the spring showery and

southerly, the summer will necessarily be of a febrile character, and

give rise to ophthalmies and dysenteries.[412] For when suffocating

heat sets in all of a sudden, while the earth is moistened by the

vernal showers, and by the south wind, the heat is necessarily doubled

from the earth, which is thus soaked by rain and heated by a burning

sun, while, at the same time, men’s bellies are not in an orderly

state, nor the brain properly dried; for it is impossible, after such

a spring, but that the body and its flesh must be loaded with humors,

so that very acute fevers will attack all, but especially those of a

phlegmatic constitution. Dysenteries are also likely to occur to women

and those of a very humid temperament. And if at the rising of the

Dog-star rain and wintry storms supervene, and if the etesian winds

blow, there is reason to hope that these diseases will cease, and that

the autumn will be healthy; but if not, it is likely to be a fatal

season to children and women, but least of all to old men; and that

convalescents will pass into quartans, and from quartans into dropsies;

but if the winter be southerly, showery and mild, but the spring

northerly, dry, and of a wintry character, in the first place women

who happen to be with child, and whose accouchement should take place

in spring, are apt to miscarry; and such as bring forth, have feeble

and sickly children, so that they either die presently or are tender,

feeble, and sickly, if they live. Such is the case with the women.

The others are subject to dysenteries[413] and dry ophthalmies, and

some have catarrhs beginning in the head and descending to the lungs.

Men of a phlegmatic temperament are likely to have dysenteries; and

women, also, from the humidity of their nature, the phlegm descending

downwards from the brain; those who are bilious, too, have dry

ophthalmies from the heat and dryness of their flesh; the aged, too,

have catarrhs from their flabbiness and melting of the veins, so that

some of them die suddenly and some become paralytic on the right side

or the left.[414] For when, the winter being southerly and the body

hot, the blood and veins are not properly constringed; a spring that

is northerly, dry, and cold, having come on, the brain when it should

have been expanded and purged, by the coryza and hoarseness is then

constringed and contracted, so that the summer and the heat occurring

suddenly, and a change supervening, these diseases fall out. And such

cities as lie well to the sun and winds, and use good waters, feel

these changes less, but such as use marshy and pooly waters, and lie

well both as regards the winds and the sun, these all feel it more. And

if the summer be dry, those diseases soon cease, but if rainy, they

are protracted; and there is danger of any sore that there is becoming

phagedenic from any cause; and lienteries and dropsies supervene at

the conclusion of diseases; for the bowels are not readily dried up.

And if the summer be rainy and southerly, and next the autumn, the

winter must, of necessity, be sickly, and ardent fevers are likely to

attack those that are phlegmatic, and more elderly than forty years,

and pleurisies and peripneumonies[415] those that are bilious. But

if the summer is parched and northerly, but the autumn rainy and

southerly, headache and sphacelus of the brain[416] are likely to

occur; and in addition hoarseness, coryza, coughs, and in some cases,

consumption.[417] But if the season is northerly and without water,

there being no rain, neither after the Dog-star nor Arcturus; this

state agrees best with those who are naturally phlegmatic, with those

who are of a humid temperament, and with women: but it is most inimical

to the bilious; for they become much parched up, and ophthalmies of a

dry nature supervene, fevers both acute and chronic, and in some cases

melancholy;[418] for the most humid and watery part of the bile being

consumed, the thickest and most acrid portion is left, and of the blood

likewise, whence these diseases come upon them. But all these are

beneficial to the phlegmatic, for they are thereby dried up, and reach

winter not oppressed with humors, but with them dried up.

11. Whoever studies and observes these things may be able to foresee

most of the effects which will result from the changes of the seasons:

and one ought to be particularly guarded during the greatest changes

of the seasons, and neither willingly give medicines, nor apply the

cautery to the belly, nor make incisions there until ten or more days

be past. Now, the greatest and most dangerous are the two solstices,

and especially the summer, and also the two equinoxes, but especially

the autumnal.[419] One ought also to be guarded about the rising of

the stars, especially of the Dog-star, then of Arcturus, and then the

setting of the Pleiades; for diseases are especially apt to prove

critical in those days, and some prove fatal, some pass off, and all

others change to another form and another constitution. So it is with

regard to them.

12. I wish to show, respecting Asia and Europe, how, in all respects,

they differ from one another, and concerning the figure of the

inhabitants, for they are different, and do not at all resemble one

another. To treat of all would be a long story, but I will tell you how

I think it is with regard to the greatest and most marked differences.

I say, then, that Asia differs very much from Europe as to the nature

of all things, both with regard to the productions of the earth and

the inhabitants, for everything is produced much more beautiful and

large in Asia; the country is milder, and the dispositions of the

inhabitants also are more gentle and affectionate.[420] The cause of

this is the temperature of the seasons, because it lies in the middle

of the risings of the sun[421] towards the east, and removed from the

cold (and heat),[422] for nothing tends to growth and mildness so much

as when the climate has no predominant quality, but a general equality

of temperature prevails. It is not everywhere the same with regard

to Asia, but such parts of the country as lie intermediate between

the heat and the cold, are the best supplied with fruits and trees,

and have the most genial climate, and enjoy the purest waters, both

celestial and terrestrial. For neither are they much burnt up by the

heat, nor dried up by the drought and want of rain, nor do they suffer

from the cold; since they are well watered from abundant showers and

snow, and the fruits of the season,[423] as might be supposed, grow

in abundance, both such as are raised from seed that has been sown,

and such plants as the earth produces of its own accord, the fruits

of which the inhabitants make use of, training them from their wild

state and transplanting them to a suitable soil; the cattle also which

are reared there are vigorous, particularly prolific, and bring up

young of the fairest description; the inhabitants too, are well fed,

most beautiful in shape, of large stature, and differ little from one

another either as to figure or size; and the country itself, both as

regards its constitution and mildness of the seasons, may be said to

bear a close resemblance to the spring. Manly courage, endurance of

suffering, laborious enterprise, and high spirit, could not be produced

in such a state of things either among the native inhabitants or those

of a different country, for there pleasure necessarily reigns. For this

reason, also, the forms of wild beasts there are much varied.[424] Thus

it is, as I think, with the Egyptians and Libyans.

13. But concerning those on the right hand of the summer risings of

the sun as far as the Palus Mæotis[425] (for this is the boundary of

Europe and Asia), it is with them as follows: the inhabitants there

differ far more from one another than those I have treated of above,

owing to the differences of the seasons and the nature of the soil. But

with regard to the country itself, matters are the same there as among

all other men; for where the seasons undergo the greatest and most

rapid changes, there the country is the wildest and most unequal; and

you will find the greatest variety of mountains, forests, plains, and

meadows; but where the seasons do not change much there the country is

the most even; and, if one will consider it, so is it also with regard

to the inhabitants; for the nature of some is like to a country covered

with trees and well watered; of some, to a thin soil deficient in

water; of others, to fenny and marshy places; and of some again, to a

plain of bare and parched land.[426] For the seasons which modify their

natural frame of body are varied, and the greater the varieties of them

the greater also will be the differences of their shapes.

14. I will pass over the smaller differences among the nations, but

will now treat of such as are great either from nature, or custom; and,

first, concerning the Macrocephali.[427] There is no other race of

men which have heads in the least resembling theirs. At first, usage

was the principal cause of the length of their head, but now nature

cooperates with usage. They think those the most noble who have the

longest heads. It is thus with regard to the usage: immediately after

the child is born, and while its head is still tender, they fashion

it with their hands, and constrain it to assume a lengthened shape by

applying bandages and other suitable contrivances whereby the spherical

form of the head is destroyed, and it is made to increase in length.

Thus, at first, usage operated, so that this constitution was the

result of force: but, in the course of time, it was formed naturally;

so that usage had nothing to do with it; for the semen comes from all

parts of the body, sound from the sound parts, and unhealthy from the

unhealthy parts. If, then, children with bald heads are born to parents

with bald heads; and children with blue eyes to parents who have blue

eyes; and if the children of parents having distorted eyes squint also

for the most part; and if the same may be said of other forms of the

body, what is to prevent it from happening that a child with a long

head should be produced by a parent having a long head?[428] But now

these things do not happen as they did formerly, for the custom no

longer prevails owing to their intercourse with other men. Thus it

appears to me to be with regard to them.

15. As to the inhabitants of Phasis,[429] their country is fenny,

warm, humid, and wooded; copious and severe rains occur there at all

seasons; and the life of the inhabitants is spent among the fens; for

their dwellings are constructed of wood and reeds, and are erected

amidst the waters; they seldom practise walking either to the city or

the market, but sail about, up and down, in canoes constructed out of

single trees, for there are many canals there.[430] They drink the

hot and stagnant waters, both when rendered putrid by the sun, and

when swollen with rains. The Phasis itself is the most stagnant of

all rivers, and runs the smoothest;[431] all the fruits which spring

there are unwholesome, of feeble and imperfect growth, owing to the

redundance of water, and on this account they do not ripen, for much

vapor from the waters overspreads the country. For these reasons the

Phasians have shapes different from those of all other men; for they

are large in stature, and of a very gross habit of body, so that not

a joint nor vein is visible; in color they are sallow, as if affected

with jaundice. Of all men they have the roughest voices, from their

breathing an atmosphere which is not clear, but misty and humid; they

are naturally rather languid in supporting bodily fatigue. The seasons

undergo but little change either as to heat or cold; their winds for

the most part are southerly, with the exception of one peculiar to

the country, which sometimes blows strong, is violent and hot, and

is called by them the wind _cenchron_. The north wind scarcely

reaches them, and when it does blow it is weak and gentle. Thus it is

with regard to the different nature and shape of the inhabitants of

Asia and Europe.

16. And with regard to the pusillanimity and cowardice of the

inhabitants, the principal reason why the Asiatics are more unwarlike

and of more gentle disposition than the Europeans is, the nature of the

seasons, which do not undergo any great changes either to heat or cold,

or the like; for there is neither excitement of the understanding nor

any strong change of the body by which the temper might be ruffled, and

they be roused to inconsiderate emotion and passion, rather than living

as they do always in the same state. It is changes of all kinds which

arouse the understanding of mankind, and do not allow them to get into

a torpid condition. For these reasons, it appears to me, the Asiatic

race is feeble, and further, owing to their laws; for monarchy prevails

in the greater part of Asia, and where men are not their own masters

nor independent, but are the slaves of others, it is not a matter of

consideration with them how they may acquire military discipline, but

how they may seem not to be warlike, for the dangers are not equally

shared, since they must serve as soldiers, perhaps endure fatigue,

and die for their masters, far from their children, their wives, and

other friends; and whatever noble and manly actions they may perform

lead only to the aggrandizement of their masters, whilst the fruits

which they reap are dangers and death; and, in addition to all this,

the lands of such persons must be laid waste by the enemy and want

of culture.[432] Thus, then, if any one be naturally warlike and

courageous, his disposition will be changed by the institutions. As a

strong proof of all this, such Greeks or barbarians in Asia as are not

under a despotic form of government, but are independent, and enjoy

the fruits of their own labors, are of all others the most warlike;

for these encounter dangers on their own account, bear the prizes of

their own valor, and in like manner endure the punishment of their own

cowardice. And you will find the Asiatics differing from one another,

for some are better and others more dastardly; of these differences, as

I stated before, the changes of the seasons are the cause. Thus it is

with Asia.

17. In Europe there is a Scythian race, called Sauromatæ, which

inhabits the confines of the Palus Mæotis, and is different from all

other races.[433] Their women mount on horseback, use the bow, and

throw the javelin from their horses, and fight with their enemies as

long as they are virgins; and they do not lay aside their virginity

until they kill three of their enemies, nor have any connection with

men until they perform the sacrifices according to law. Whoever takes

to herself a husband, gives up riding on horseback unless the necessity

of a general expedition obliges her. They have no right breast; for

while still of a tender age their mothers heat strongly a copper

instrument constructed for this very purpose, and apply it to the right

breast, which is burnt up, and its development being arrested, all the

strength and fullness are determined to the right shoulder and arm.

18. As the other Scythians have a peculiarity of shape, and do not

resemble any other, the same observation applies to the Egyptians, only

that the latter are oppressed by heat and the former by cold.[434]

What is called the Scythian desert is a prairie, abounding in meadows,

high-lying, and well watered; for the rivers which carry off the water

from the plains are large. There live those Scythians which are called

Nomades, because they have no houses, but live in wagons. The smallest

of these wagons have four wheels, but some have six; they are covered

in with felt, and they are constructed in the manner of houses, some

having but a single apartment, and some three; they are proof against

rain, snow, and winds. The wagons are drawn by yokes of oxen, some of

two and others of three, and all without horns, for they have no horns,

owing to the cold.[435] In these wagons the women live, but the men

are carried about on horses, and the sheep, oxen, and horses accompany

them; and they remain on any spot as long as there is provender for

their cattle, and when that fails they migrate to some other place.

They eat boiled meat, and drink the milk of mares, and also eat

_hippace_, which is cheese prepared from the milk of the mare.

Such is their mode of life and their customs.[436]

19. In respect of the seasons and figure of body, the Scythian race,

like the Egyptian, have a uniformity of resemblance, different from

all other nations; they are by no means prolific, and the wild beasts

which are indigenous there are small in size and few in number, for

the country lies under the Northern Bears, and the Rhiphæan mountains,

whence the north wind blows; the sun comes very near to them only when

in the summer solstice, and warms them but for a short period, and not

strongly; and the winds blowing from the hot regions of the earth do

not reach them, or but seldom, and with little force; but the winds

from the north always blow, congealed, as they are, by the snow, the

ice, and much water, for these never leave the mountains, which are

thereby rendered uninhabitable. A thick fog covers the plains during

the day, and amidst it they live, so that winter may be said to be

always present with them; or, if they have summer, it is only for a

few days, and the heat is not very strong. Their plains are high-lying

and naked, not crowned with mountains, but extending upwards under

the Northern Bears.[437] The wild beasts there are not large, but

such as can be sheltered under-ground; for the cold of winter and the

barrenness of the country prevent their growth, and because they have

no covert nor shelter.[438] The changes of the seasons, too, are not

great nor violent, for, in fact, they change gradually; and therefore

their figures resemble one another, as they all equally use the same

food, and the same clothing summer and winter, respiring a humid and

dense atmosphere, and drinking water from snow and ice; neither do they

make any laborious exertions, for neither body nor mind is capable of

enduring fatigue when the changes of the seasons are not great.[439]

For these reasons their shapes are gross and fleshy, with ill-marked

joints, of a humid temperament, and deficient in tone: the internal

cavities, and especially those of the intestines, are full of humors;

for the belly cannot possibly be dry in such a country, with such a

constitution and in such a climate; but owing to their fat, and the

absence of hairs from their bodies, their shapes resemble one another,

the males being all alike, and so also with the women: for the seasons

being of an uniform temperature, no corruption or deterioration takes

place in the concretion of the semen, unless from some violent cause,

or from disease.[440]

20. I will give you a strong proof of the humidity (laxity?) of their

constitutions.[441] You will find the greater part of the Scythians,

and all the Nomades, with marks of the cautery on their shoulders,

arms, wrists, breasts, hip-joints, and loins, and that for no other

reason but the humidity and flabbiness of their constitution, for they

can neither strain with their bows, nor launch the javelin from their

shoulder owing to their humidity and atony: but when they are burnt,

much of the humidity in their joints is dried up, and they become

better braced, better fed, and their joints get into a more suitable

condition.[442] They are flabby and squat at first, because, as in

Egypt, they are not swathed(?);[443] and then they pay no attention to

horsemanship, so that they may be adepts at it; and because of their

sedentary mode of life; for the males, when they cannot be carried

about on horseback, sit the most of their time in the wagon, and rarely

practise walking, because of their frequent migrations and shiftings of

situation; and as to the women, it is amazing how flabby and sluggish

they are. The Scythian race are tawny from the cold, and not from the

intense heat of the sun, for the whiteness of the skin is parched by

the cold, and becomes tawny.

21. It is impossible that persons of such a constitution could be

prolific, for, with the man, the sexual desires are not strong, owing

to the laxity of his constitution, the softness and coldness of his

belly, from all which causes it is little likely that a man should

be given to venery; and besides, from being jaded by exercise on

horseback, the men become weak in their desires. On the part of the men

these are the causes; but on that of the women, they are embonpoint and

humidity; for the womb cannot take in the semen, nor is the menstrual

discharge such as it should be, but scanty and at too long intervals;

and the mouth of the womb is shut up by fat and does not admit the

semen; and, moreover, they themselves are indolent and fat, and their

bellies cold and soft.[444] From these causes the Scythian race is not

prolific. Their female servants furnish a strong proof of this; for

they no sooner have connection with a man than they prove with child,

owing to their active course of life and the slenderness of body.

22. And, in addition to these, there are many eunuchs among the

Scythians, who perform female work, and speak like women. Such persons

are called effeminates.[445] The inhabitants of the country attribute

the cause of their impotence to a god, and venerate and worship such

persons, every one dreading that the like might befall himself; but

to me it appears that such affections are just as much divine as all

others are, and that no one disease is either more divine or more human

than another, but that all are alike divine, for that each has its own

nature, and that no one arises without a natural cause.[446] But I will

explain how I think that the affection takes its rise. From continued

exercise on horseback they are seized with chronic defluxions in

their joints (_kedmata_[447]) owing to their legs always hanging

down below their horses; they afterwards become lame and stiff at the

hip-joint, such of them, at least, as are severely attacked with it.

They treat themselves in this way: when the disease is commencing,

they open the vein behind either ear, and when the blood flows, sleep,

from feebleness, seizes them, and afterwards they awaken, some in good

health and others not. To me it appears that the semen is altered by

this treatment, for there are veins behind the ears which, if cut,

induce impotence; now, these veins would appear to me to be cut.[448]

Such persons afterwards, when they go in to women and cannot have

connection with them, at first do not think much about it, but remain

quiet; but when, after making the attempt two, three, or more times,

they succeed no better, fancying they have committed some offence

against the god whom they blame for the affection, they put on female

attire, reproach themselves for effeminacy, play the part of women, and

perform the same work as women do. This the rich among the Scythians

endure, not the basest, but the most noble and powerful, owing to

their riding on horseback; for the poor are less affected, as they

do not ride on horses. And yet, if this disease had been more divine

than the others, it ought not to have befallen the most noble and the

richest of the Scythians alone, but all alike, or rather those who have

little, as not being able to pay honors to the gods, if, indeed, they

delight in being thus rewarded by men, and grant favors in return; for

it is likely that the rich sacrifice more to the gods, and dedicate

more votive offerings, inasmuch as they have wealth, and worship the

gods; whereas the poor, from want, do less in this way, and, moreover,

upbraid the gods for not giving them wealth, so that those who have few

possessions were more likely to bear the punishments of these offences

than the rich. But, as I formerly said, these affections are divine

just as much as others, for each springs from a natural cause, and this

disease arises among the Scythians from such a cause as I have stated.

But it attacks other men in like manner, for whenever men ride much

and very frequently on horseback, then many are affected with rheums

in the joints, sciatica, and gout, and they are inept at venery. But

these complaints befall the Scythian, and they are the most impotent of

men for the aforesaid causes, and because they always wear breeches,

and spend the most of their time on horseback,[449] so as not to touch

their privy parts with the hand, and from the cold and fatigue they

forget the sexual desire, and do not make the attempt until after

they have lost their virility.[450] Thus it is with the race of the

Scythians.

23. The other races in Europe differ from one another, both as to

stature and shape, owing to the changes of the seasons, which are very

great and frequent, and because the heat is strong, the winters severe,

and there are frequent rains, and again protracted droughts, and winds,

from which many and diversified changes are induced. These changes are

likely to have an effect upon generation in the coagulation of the

semen, as this process cannot be the same in summer as in winter, nor

in rainy as in dry weather; wherefore, I think, that the figures of

Europeans differ more than those of Asiatics; and they differ very much

from one another as to stature in the same city; for vitiations of the

semen occur in its coagulation more frequently during frequent changes

of the seasons, than where they are alike and equable. And the same may

be said of their dispositions, for the wild, and unsociable, and the

passionate occur in such a constitution; for frequent excitement of

the mind induces wildness, and extinguishes sociableness and mildness

of disposition, and therefore I think the inhabitants of Europe more

courageous than those of Asia; for a climate which is always the same

induces indolence, but a changeable climate, laborious exertions both

of body and mind; and from rest and indolence cowardice is engendered,

and from laborious exertions and pains, courage. On this account the

inhabitants of Europe are more warlike than the Asiatics, and also

owing to their institutions, because they are not governed by kings

like the latter, for where men are governed by kings there they must be

very cowardly, as I have stated before; for their souls are enslaved,

and they will not willingly, or readily undergo dangers in order to

promote the power of another; but those that are free undertake dangers

on their own account, and not for the sake of others; they court hazard

and go out to meet it, for they themselves bear off the rewards of

victory, and thus their institutions contribute not a little to their

courage.[451]

Such is the general character of Europe and Asia.[452]

24. And there are in Europe other tribes, differing from one

another in stature, shape, and courage: the differences are those I

formerly mentioned, and will now explain more clearly. Such as inhabit

a country which is mountainous, rugged, elevated, and well watered,

and where the changes of the seasons are very great, are likely to

have great variety of shapes among them, and to be naturally of an

enterprising and warlike disposition;[453] and such persons are apt

to have no little of the savage and ferocious in their nature; but

such as dwell in places which are low-lying, abounding in meadows

and ill ventilated, and who have a larger proportion of hot than of

cold winds, and who make use of warm waters--these are not likely to

be of large stature nor well proportioned, but are of a broad make,

fleshy, and have black hair; and they are rather of a dark than of a

light complexion, and are less likely to be phlegmatic than bilious;

courage and laborious enterprise are not naturally in them, but may

be engendered in them by means of their institutions. And if there

be rivers in the country which carry off the stagnant and rain water

from it, these may be wholesome and clear; but if there be no rivers,

but the inhabitants drink the waters of fountains, and such as are

stagnant and marshy, they must necessarily have prominent bellies and

enlarged spleens. But such as inhabit a high country, and one that is

level, windy, and well-watered, will be large of stature, and like to

one another; but their minds will be rather unmanly and gentle. Those

who live on thin, ill-watered, and bare soils, and not well attempered

in the changes of the seasons, in such a country they are likely to

be in their persons rather hard and well braced, rather of a blond

than a dark complexion, and in disposition and passions haughty and

self-willed. For, where the changes of the seasons are most frequent,

and where they differ most from one another, there you will find

their forms, dispositions, and nature the most varied. These are the

strongest of the natural causes of difference, and next the country in

which one lives, and the waters; for, in general, you will find the

forms and dispositions of mankind to correspond with the nature of the

country; for where the land is fertile, soft, and well-watered, and

supplied with waters from very elevated situations, so as to be hot

in summer and cold in winter, and where the seasons are fine, there

the men are fleshy, have ill-formed joints,[454] and are of a humid

temperament; they are not disposed to endure labor, and, for the most

part, are base in spirit; indolence and sluggishness are visible in

them, and to the arts they are dull, and not clever nor acute. When

the country is bare, not fenced, and rugged, blasted by the winter and

scorched by the sun, there you may see the men hardy, slender, with

well-shaped joints,[454] well-braced, and shaggy; sharp industry and

vigilance accompany such a constitution; in morals and passions they

are haughty and opinionative, inclining rather to the fierce than to

the mild; and you will find them acute and ingenious as regards the

arts, and excelling in military affairs; and likewise all the other

productions of the earth corresponding to the earth itself.[455] Thus

it is with regard to the most opposite natures and shapes; drawing

conclusions from them, you may judge of the rest without any risk of

error.

ON THE PROGNOSTICS.

THE ARGUMENT.

Of the genuineness of this work I have treated in the Preliminary

Discourse, and have also briefly touched upon its relation to two other

important treatises in the Hippocratic collection, the “Prorrhetics”

and the “Coacæ Prænotiones.” The latter subject I am now to resume,

and in doing so I mean to avail myself of the talented dissertation of

Dr. Ermerins, to which also I have already made allusion. Indeed I am

persuaded that I cannot do a more acceptable service to my profession

in Britain than by laying before them a brief exposition of the

important views brought forward in this “Dissertatio Inauguralis.”[456]

After some preliminary observations on the ancient Temples of Health,

which are mainly derived from Sprengel’s “History of Medicine”[457]

he passes on to consider the opinion stated by this author and others

before his time, that the first book of the “Prorrhetics” and the

“Coacæ Prænotiones” are the results of isolated observations made upon

the sick in the Asclepion of Cos. The probability of this opinion

being well founded he shows to be very great; and he next endeavors

to solve the question whether the first book of the “Prorrhetics”

be derived from the “Coacæ Prænotiones,” or whether the latter be

the more modern work of the two. He comes to the conclusion that the

“Prorrhetics” is the more ancient work, for the following reasons: 1st.

Because in it the names of the patients are frequently given, which

is rarely the case in the “Coacæ Prænotiones.” 2d. Because queries

and doubts are oftener found in this book than in the other, when one

takes into account the number of presages. 3d. Because the number

of observations which this book contains is much smaller than those

which the “Coacæ” embrace. 4th. This is confirmed by the circumstance

that the enunciations of the prognoses are far less extended in the

“Prorrhetics,” whence it is clearly proved that they are not derived

from so great a field of observations as those we meet with in the

other work. He then gives a most lucid view of the parallelism which

subsists between the “Prorrhetica” and the “Coacæ,” and, as the results

of his observations upon them, he draws the following most important

conclusions:

1. “By a most fortunate occurrence certain monuments of the medical

art, as cultivated by the Asclepiadæ, are preserved to us in the first

“Prorrhetics” and the “Prænotiones Coacæ” which books appear to be

fragments and excerpts from the histories of diseases and cures which

were formerly found on the votive tablets of the Coan temple.

2. This sacerdotal medicine was at first a certain medical divination,

which, as it was the offspring of pure observation, so the system of

prognostics of the Coans was altogether aloof from the theories and

systems of the philosophers, and is therefore to be reckoned most

worthy of our attention, both from the great love of observation which

we admire in it, and from the exquisite and beautiful sense of the

simple truth which it evinces.

3. We must keep in view the origin of these presages from individual

observations gradually collected, in order that we may have a knowledge

of this system of prognostic semeiology. Hence we comprehend how we

meet with so many doubtful propositions, and so many uncertain and

vague remarks, and that imperfect etiology which confounded causes with

their effects, and again, the latter with the former.

4. The readers must particularly keep before their eyes this origin,

and the antiquity of those writings, if they would pass a correct

judgment on the merits of the Asclepiadæ towards the art of medicine.

Whatever in their works we have the pleasure of possessing, all attest

the infancy of the art; many things are imperfect, and not unfrequently

do we see them, while in the pursuit of truth, groping, as it were, and

proceeding with uncertain steps, like men wandering about in darkness;

but yet the method which they applied, and to which they would seem to

have betaken themselves of their own accord, was so excellent, that

nothing could surpass it. It was the same method which Hippocrates

himself always adopted, and which, in fine, Lord Bacon, many ages

afterwards, commended as the only instrument by which truth in medicine

can be found out.

5. As this method is founded on true induction, so are its dicta to be

held the more worthy of admiration, the more they possess a universal

signification. To give an example; what assiduous observation, and

what abundance of rational experience, must have been required for

enunciating the following admirable truth, and, as it were, law of

nature: “Those things which bring alleviation with bad signs, and do

not remit with good, are troublesome and difficult.”

6. Many passages bear reference to the condition of the vital powers,

which they took into account at all times, both in making presages and

in exercising the art. For, although they had not our theories of the

vital force, they perceived its effects very well by observation; and

for this very reason, that they did not search for the art in theories,

but in observation alone, we owe so many excellent things to them,

since they did not adapt their observation to theories, but related a

trustworthy and faithful history of the operations of nature.

7. They sought after many things from a comparison of health with

disease, in which also they rightly calculated the manners and customs

of men. Thus they call that, in the first place, the best mode of

reclining, which is adopted by the patient when in good health, and

hence they estimate the other modes as being less good, or altogether

unfavorable. Nor did they only compare health with disease, but

they compared also the symptoms of diseases with one another, and

interpreted the one from the other. Thus they first depict and

pronounce a favorable opinion on the best kind of excretions, and

then they described the other abnormal kinds, and pass an unfavorable

judgment on them.

8. They particularly relate the operations of a _natura medicatrix_,

which, in a region such as Greece is, and in athletic, strong bodies,

on which they appear to have practised the art, and for the most part

in acute diseases, and the few chronic ones derived from them which

they have left described, might especially be looked for. Hence that

doctrine of crises most deserving of attention, the rudiments, indeed,

of which we only have here preserved, but a just notion of which we may

easily draw from these fragments.

9. The Asclepiadæ would appear to have accommodated and directed their

art to this natural Therapia. Hence the advice that convulsions arising

from a great hemorrhage, forcibly stopped, should be cured by the

abstraction of blood. It is to be regretted that but a few monuments

of their practice remain; but these embrace admirable imitations of

nature, and the most prudent caution in administering remedies.

10. Neither did they neglect surgery, but deliver many excellent

remarks on things pertaining to wounds, ulcers, and fractures.

11. Although it cannot be made out for certain that everything which is

preserved in these writings existed before Hippocrates, there can be no

doubt that many of them are more ancient than he. And although we may

attribute some things rather to Hippocrates himself, it is nevertheless

certain that the method of deducing the art from observation and

comparison had existed before him. Some may, perhaps, object that

these books are to be attributed to the youth of Hippocrates, and

that the others, more elaborate and perfect, had proceeded from the

same person in his old age; but this supposition we may refute by a

single argument, namely, that it would be absurd to ascribe so many

observations about so many diseases to one man.

12. From the whole Coan system of cultivating medicine, the best hopes

might justly have been expected; and from what follows it will be seen

that the result did not disappoint this expectation.”

These deductions, I must say, appear to be most legitimately

drawn; and having thus satisfactorily made out that the “Coacæ

Prænotiones” are founded on the “Prorrhetics,” Dr. Ermerins proceeds

to make an interesting comparison between the former and the book

of “Prognostics.” Here again we can only find room for the general

conclusions.

1. “We have compared together two monuments of antiquity embracing

entirely the same doctrine, so that we may hold it as put out of all

doubt that they must have derived their origin from the same school,

only the one yields to the other in antiquity, as its more expanded

mode of expression shows.

2. The more recent work is attributed to Hippocrates by all the critics

and interpreters; the most ancient authors have made mention of it, and

all the characteristic marks by which the genuine works of Hippocrates

are distinguished from the spurious, without doubt, are found in it;

for whether you look to the brevity and gravity of the language, or the

paucity of the reasonings, the correctness of the observations, or the

dialect in which they are expressed, or, in fine, its agreement with

the whole Hippocratic doctrine,--all these attest that “the divine old

man” is the author of this work.

3. From a comparison of the “Coacæ Prænotiones” with the “Prognostics,”

it is as clear as the light of day that Hippocrates composed this work

from them, in such a manner that he circumscribed many of the symptoms,

limited the enunciations, and amplified them all by his own experience

in the medical Art. Hence the Prognostics may not inaptly be called the

Commentary of Hippocrates on the “Coacæ Prænotiones.”

4. With regard to the exquisite and artificial order, in which we see

many things proposed in his book, we agree entirely with Sprengel, who

thinks that they have proceeded from a more recent describer. This is

confirmed by our comparison of both works.

5. This work exhibits the fundamental principles and originals of the

Hippocratic doctrine, and although we hardly know anything as to the

manlier in which Hippocrates composed his writings, and of the form

which he gave them, it does not seem at all out of the way to hold this

book to be the oldest of all the works which “the Father of Medicine”

has left to us.

6. Inasmuch as this work is entitled the Book of Prognostics, so

it turns on the _prescience_ πρόνοια, that is to say, the

foreknowledge of the physician, which Hippocrates recommends to

physicians for three reasons: first, for the confidence of mankind,

which it will conciliate to the physician; then because it will free

the practitioner from all blame, if he has announced beforehand the

fatal result of diseases; and further, as being a very great instrument

in effecting the cure.

7. Like the Coan priests, Hippocrates drew his Prognostics from a

comparison of disease with health. This he held to be of so great

importance, that he first delivers physiological semeiotics, and then

adds pathological.

8. In calculating and judging of signs he neglected neither age nor

sex, and, in the first place, directed his mind to the power of habit

on the human body.

9. Nor did Hippocrates stop here, but directed care to be had of the

attack of epidemics, and the condition of the season.

10. The Prognostics of Hippocrates are not of one time or place, but

extend through every age, and through the whole world; inasmuch as the

prognostic signs have been proved to be true in Libya, in Delos, and

in Scythia, and it should be well known that every year, and at every

season of the year, bad symptoms bode ill, and good symptoms good.

11. But he who would wish to know properly beforehand those who

will recover from a disease, and those who will die, and those in

whom the disease will persevere for many days, and those in whom it

will last for a few, should be able to comprehend and estimate the

doctrine of all the signs, and weigh in his mind and compare together

their strength. The Hippocratic foreknowledge rests not only on the

observation of the signs, but also on the understanding of them.

12. The Book of Prognostics exhibits observations of acute diseases,

and of chronic arising from them, in which Hippocrates has diligently

noted the times and modes of the crises.

13. Such is the authority of critical days and signs, that in those

fevers which cease without the symptoms of resolution, and not upon

critical days, a relapse is to be expected.

14. The series of critical days which Hippocrates delivers, proceeds

solely upon the observation of nature. Yet neither can any of them be

exactly numbered by entire days, since neither the year nor the months

are usually numbered by entire days.”