Galen: On the Natural Faculties

by Galen

Further, in vomiting, the mere passive conveyance of rejected matter up to the mouth will certainly itself suffice to keep open those parts of the oesophagus which are distended by the returned food; as it occupies each part in front [above], it first dilates this, and of course leaves the part behind [below] contracted. Thus, in this respect at least, the condition of the gullet is precisely similar to what it is in the act of swallowing.[348] But there being no traction, the whole length remains equal in such cases.

And for this reason it is easier to swallow than to vomit, for deglutition results from both coats of the stomach being brought into action, the inner one exerting a pull and the outer one helping by peristalsis and propulsion, whereas emesis occurs from the outer coat alone functioning, without there being any kind of pull towards the mouth. For, although the swallowing of food is ordinarily preceded by a feeling of desire on the part of the stomach, there is in the case of vomiting no corresponding desire from the mouth-parts for the experience; the two are opposite dispositions of the stomach itself; it yearns after and tends towards what is advantageous and proper to it, it loathes and rids itself of what is foreign. Thus the actual process of swallowing occurs very quickly in those who have a good appetite for such foods as are proper to the stomach; this organ obviously draws them in and down before they are masticated; whereas in the case of those who are forced to take a medicinal draught or who take food as medicine, the swallowing of these articles is accomplished with distress and difficulty.

From what has been said, then, it is clear that the inner coat of the stomach (that containing longitudinal fibres) exists for the purpose of exerting a pull from mouth to stomach, and that it is only in deglutition that it is active, whereas the external coat, which contains transverse fibres, has been so constituted in order that it may contract upon its contents and propel them forward; this coat furthermore, functions in vomiting no less than in swallowing. The truth of my statement is also borne out by what happens in the case of the channae and synodonts[349]; the stomachs of these animals are sometimes found in their mouths, as also Aristotle writes in his History of Animals; he also adds the cause of this: he says that it is owing to their voracity.

The facts are as follows. In all animals, when the appetite is very intense, the stomach rises up, so that some people who have a clear perception of this condition say that their stomach “creeps out” of them; in others, who are still masticating their food and have not yet worked it up properly in the mouth, the stomach obviously snatches away the food from them against their will. In those animals, therefore, which are naturally voracious, in whom the mouth cavity is of generous proportions, and the stomach situated close to it (as in the case of the synodont and channa), it is in no way surprising that, when they are sufficiently hungry and are pursuing one of the smaller animals, and are just on the point of catching it, the stomach should, under the impulse of desire, spring into the mouth. And this cannot possibly take place in any other way than by the stomach drawing the food to itself by means of the gullet, as though by a hand. In fact, just as we ourselves, in our eagerness to grasp more quickly something lying before us, sometimes stretch out our whole bodies along with our hands, so also the stomach stretches itself forward along with the gullet, which is, as it were, its hand. And thus, in these animals in whom those three factors co-exist—an excessive propensity for food, a small gullet, and ample mouth proportions—in these, any slight tendency to movement forwards brings the whole stomach into the mouth.

Now the constitution of the organs might itself suffice to give a naturalist an indication of their functions. For Nature would never have purposelessly constructed the oesophagus of two coats with contrary dispositions; they must also have each been meant to have a different action. The Erasistratean school, however, are capable of anything rather than of recognizing the effects of Nature. Come, therefore, let us demonstrate to them by animal dissection as well that each of the two coats does exercise the activity which I have stated. Take an animal, then; lay bare the structures surrounding the gullet, without severing any of the nerves,[350] arteries, or veins which are there situated; next divide with vertical incisions, from the lower jaw to the thorax, the outer coat of the oesophagus (that containing transverse fibres); then give the animal food and you will see that it still swallows although the peristaltic function has been abolished. If, again, in another animal, you cut through both coats[351] with transverse incisions, you will observe that this animal also swallows although the inner coat is no longer functioning. From this it is clear that the animal can also swallow by either of the two coats, although not so well as by both. For the following also, in addition to other points, may be distinctly observed in the dissection which I have described—that during deglutition the gullet becomes slightly filled with air which is swallowed along with the food, and that, when the outer coat is contracting, this air is easily forced with the food into the stomach, but that, when there only exists an inner coat, the air impedes the conveyance of food, by distending this coat and hindering its action.

But Erasistratus said nothing about this, nor did he point out that the oblique situation of the gullet clearly confutes the teaching of those who hold that it is simply by virtue of the impulse from above that food which is swallowed reaches the stomach. The only correct thing he said was that many of the long-necked animals bend down to swallow. Hence, clearly, the observed fact does not show how we swallow but how we do not swallow. For from this observation it is clear that swallowing is not due merely to the impulse from above; it is yet, however, not clear whether it results from the food being attracted by the stomach, or conducted by the gullet. For our part, however, having enumerated all the different considerations—those based on the constitution of the organs, as well as those based on the other symptoms which, as just mentioned, occur both before and after the gullet has been exposed—we have thus sufficiently proved that the inner coat exists for the purpose of attraction and the outer for the purpose of propulsion.

Now the original task we set before ourselves was to demonstrate that the retentive faculty exists in every one of the organs, just as in the previous book we proved the existence of the attractive, and, over and above this, the alterative faculty. Thus, in the natural course of our argument, we have demonstrated these four faculties existing in the stomach—the attractive faculty in connection with swallowing, the retentive with digestion, the expulsive with vomiting and with the descent of digested food into the small intestine—and digestion itself we have shown to be a process of alteration.

[IX]

Concerning the spleen, also, we shall therefore have no further doubts[352] as to whether it attracts what is proper to it, rejects what is foreign, and has a natural power of altering and retaining all that it attracts; nor shall we be in any doubt as to the liver, veins, arteries, heart, or any other organ. For these four faculties have been shown to be necessary for every part which is to be nourished; this is why we have called these faculties the handmaids of nutrition. For just as human faeces are most pleasing to dogs, so the residual matters from the liver are, some of them, proper to the spleen,[353] others to the gall-bladder, and others to the kidneys.