SECT. LXIV.—THE MARKS OF THE TEMPERAMENTS OF THE STOMACH.
The marks of a preternatural dryness of the stomach are, that those affected with it are liable to thirst, but little drink satisfies them; and they feel heavy with much drink, as the superfluity occasions gurgling in the stomach, or floats upon it; of those of a more humid, that they are not addicted to thirst, and bear readily much liquids, and rejoice in humid food. A stomach preternaturally hot has a better digestion than appetite, particularly with regard to those things which are hard and difficult to digest; it delights in much food and drink; neither is it hurt by the moderate use of cold things. A preternaturally cold stomach has a good appetite but not a good digestion, in particular with regard to such things as are of difficult digestion, and are of a cold nature, which therefore are apt to turn acid in it. And it delights indeed in cold things, but is readily hurt by the immoderate use of them. The intemperaments proceeding from disease differ from the congenital in this, that they long for opposite things, and not always alike. If the stomach then digests properly, it is of a moderate temperament; and if it does not it is of a bad; but if its eructations are fetid, its heat is inordinate and inflammatory; but if acid, the contrary. And in those who digest properly things of difficult digestion, the heat of the stomach is inordinate, and weak in those who cannot digest those things, but digest fishes. It must also be observed, whether or not the symptom is occasioned by any humour flowing from another part; for in pituitous constitutions acid eructations are apt to occur; but in the bilious, fetid airs and other disagreeable qualities are apt to prevail. The common symptom of them all is nausea. If the depraved humours swim within the cavity of the stomach, they float on the surface, and are discharged by vomiting; but if they are contained in the substance of it within its coats, they annoy it with vain attempts to vomit.
Commentary. We shall now state briefly the opinions of the ancients with regard to the functional office of the stomach.
Actuarius says, “I am of opinion, that there are four species of concoction which are performed in different parts of the body: the first in the stomach; the second in the vena ramalis (vena portæ?), meseraic veins, and concave part of the liver; the third in the convex part of the liver and veins proceeding from it; and the fourth, consisting of fabrication or assimilation, which takes place in the extreme parts of the body.” (De Urinis.) The various modes of change or concoction which the food undergoes in the body, are minutely described by Macrobius. (Saturnal. vii.) In another place, Actuarius says, “Digestion is performed by moderate heat and moisture.” (De Spiritu Animali, p. ii, s. 1.) Alsaharavius in like manner states, that the digestive faculty depends partly on the heat, and partly on the humidity of the stomach. (Pract. tr. xvi, c. 1.) It is impossible not to see that the gastric juice is alluded to in these passages. It is particularly stated of Asclepiades, that he held digestion to be the solution of the food. See C. Aurelianus. (Morb. Acut. i, 14.) And that the ancients were aware that the stomach secretes a fluid possessed of solvent properties, is put beyond a doubt, by the following extract from the works of Haly Abbas. Speaking of the changes which the food undergoes in the mouth and stomach, he says: “Immutantur cibi in ore, retinenturque, et flegmati admiscetur quod digestum est, calorque ei datur. Quod autem flegma hoc hujusmodi sit, signum nobis est quod impetigines et sarpedones curat, quædam maturat ulcera, scorpiones necat. Hac ergo de causa et in ore cibus immutatur. Sic et stomachus ipsum immutat: ejus etenim circum amplectitur substantia, quasque habet imprimit qualitates, immutaturque ipsius naturali calore cibus: Sed et quoniam cibus ipse in eo flegmati admiscetur humido.” (Theor. iv, 3.) The whole bearing of this passage, but more especially the last clause, puts it beyond a doubt that the process of digestion was supposed to be performed, in a certain measure, by the solvent powers of a fluid secreted in the stomach. And the ingenious Alexander Aphrodisiensis, in like manner, treating of the digestion of mustard, pepper, and other acrid substances, says decidedly, that their acrimony is dissolved in the copious fluid of the stomach. (Probl. i, 30.) See also Macrobius (Saturnal. vii, 8.) He calls the fluid ventralis humor, which may be literally translated, “gastric juice.” Part of the process was, no doubt, supposed to be performed indirectly by heat; and deservedly, for even Spallanzani was compelled to admit, that the comparative temperature of animals exerts a considerable influence on their digestive powers. Hence, as was stated by Averrhoes, and as is confirmed by Cuvier, Birds, which are the warmest class of animals, likewise digest the fastest. At all events, the ancients were well aware, that digestion is not a mechanical, but a vital process, being performed by the principle of life. “Digestion,” says Averrhoes, “is performed by concoction, and the concoction is influenced by heat, not that the first mover in the operation is heat, but the nutritive soul; because the operations of heat are indeterminate, and not directed to any manifest end.” (Collig. v, 3.) In the ‘Averroeana’ or ‘Letters from Averrhoes to Metrodorus,’ (which, whether genuine or not, contain a curious and interesting exposition of the Great Commentator’s opinions on various subjects, and at all events must be of considerable antiquity,) the doctrine of a gastric menstruum is discussed with singular ability. Metrodorus states, that “he found, by the writings of the physicians and philosophers of these times, that they make the menstruum, as they call it, whereby both appetite is provoked, and food in the stomach is digested, to be a certain juice or humour in the stomach,” &c. Averrhoes denies that this menstruum acts by its acidity alone.