In proof of the opinions which we have attributed to Galen, we refer the reader to ‘An Natura Sanguinis sit in Arteriis;’ ‘Administ. Anatom.’ (vii, 15); ‘de Usu Partium,’ (vi and vii, 7, 8, 9); ‘de Placitis Hippocr. et Plat.’ (i, 5.)
See also Averrhoes (Colliget. ii, 8, ii, 9; Collect. i, 9; in Cant. Avic. i, 1); Avicenna (iii, xi, 1); Actuarius (de Spiritu Animali, i, 6; de Causis Urinarum, ii, 2); Nemesius (de Natura Hominis, 24.)
With regard to the passages collected by the ingenious M. Dutens and others, from the works of Hippocrates, Plato, Nemesius, Pollux, and Theodoret, to prove that the ancients were acquainted with the circulation of the blood, as taught by Harvey, we shall only remark, that, after having attentively considered them, we cannot but draw the conclusion, that some of these authors must have had, at least, an obscure idea of this doctrine, although, in general, these passages may be understood to refer merely to the lesser circulation and the movement of the blood from the centre to the extremities, as maintained by Galen. See Dutens (Origine des Découvertes attribuées aux Modernes, p. 157); Drelincurtius (de Lienosis Epimetris); and Littré (Introduction aux Œuvres d’Hippocrate.) The last of these writers, whose minute acquaintance with the earlier works on medicine entitles his opinion to every consideration, after a searching investigation into the state of anatomical knowledge in the days of Hippocrates and his immediate successors, comes to the conclusion, that the germ of the theory of the circulation is, beyond doubt, to be found in the Hippocratic treatises. (T. i, 223.)
SECT. LXVII.—DIAGNOSIS OF THE TEMPERAMENTS OF THE LIVER.
The marks of a hot liver are, largeness of the veins, redundance of yellow bile, and, in manhood, of black; the blood hotter than natural, and by means of it the whole body, unless the parts about the heart antagonise; and thick hairs upon the hypochondriac regions, and over the stomach. Those of a cold are, smallness of the veins, much phlegm, cold blood; the whole habit of the body colder than common, unless warmed by the heart; no hair on the hypochondriac regions, nor over the stomach. Those of a dry are, thick and scanty blood, and the veins and the habit of the whole body drier. Those of a humid are, the blood abundant and liquid, the veins softer, as also the whole body, unless the heart antagonise. The marks of a temperament at once hot and dry are, the hairs very thick on the hypochondrium, the blood at the same time thicker and more scanty, a redundance of bitter bile, and in manhood, of black, largeness and hardness of the veins, and the whole body hot and dry. The heat proceeding from the heart may indeed overcome the coldness proceeding from the liver, in like manner as the coldness may the heat; but it is not possible for the dryness to be changed to the contrary state by the humidity of the heart. It is obvious that, when the temperaments of those two prime organs combine together, the whole body is affected accordingly. The humid and hot liver, less than the hot and dry, renders the hypochondrium shaggy; but the blood is abundant, the veins large, and the whole habit humid and hot, unless the heart antagonise. But, should it be preternaturally changed as to both these qualities, persons so affected will be readily seized with putrid diseases and disorders from bad humours; and more particularly if the humidity be much increased, and the heat but little, they will be liable to cacochymies. In the humid and cold, the hypochondrium is free from hairs, but the blood is pituitous, the veins contracted, and the whole body in like manner, unless changed by the heart to the opposite state. The cold and dry renders the blood scanty, the veins of the body contracted, and the body colder; and the hypochondrium is without hair, unless the heart overcome this state.
Commentary. According to the views of the ancient physiologists, the liver is the seat of the Natural powers, being the grand organ of sanguification, and the blood being the pabulum which nourishes the whole body. That the liver performs an important part in the fabrication of the blood seems probable from all the veins of the stomach and upper portion of the intestines passing to the liver, whereby it is to be supposed, that a considerable proportion of the nutritive juices will be conveyed to it; and from this viscus being proportionally large in the fœtus when it is much required to form blood, and cannot be supposed necessary for any other purpose. The ancients taught that the liver, by its attractive power, attracts the chyle from the stomach; that, by its retentive, it retains the same until the alterative convert it into blood; and that then the expulsive separates the superfluities of the blood, namely, the bile, and conveys them to the gall-bladder. See Galen (T. ii, 285, ed. Basil), and Avicenna (iii, 4, 1.)
Aristotle held that the spleen is part of the hepatic system. (De Partibus Animal. iii, 7.) His commentator, Averrhoes, in like manner, considers the spleen as a second liver. (Collect. i, 9.) Their reasoning, on this point, appears to me exceedingly acute and conclusive.
The following extract from Actuarius contains a clear exposition of ancient opinions on the subject we are treating of: “When the food in the stomach is changed and digested, the meseraic veins, which derive their origin from the liver, by their vein called ramalis, suck the stomach and intestines; and having emulged, as it were, the purer part, (namely, the food converted into chyle,) and having drawn it as if through a strainer, they convey it to the concave part of the liver, and deliver it over to the sanguificatory power. Here, then, if nothing impede it, when it is changed into blood, whatever is subtile and acrid is received by the gall-bladder, which is placed at the convex part of the liver, and attracts the bile; but whatever the blood possesses of a terrene and melancholic humour is attracted to the spleen, by some natural faculty, whereby every part attracts whatever suits its nature. Thirdly, the serous humour remains. It is attracted by the kidneys.” (De Urinis, § 4.)