Galen: On the Natural Faculties

by Galen

It is not, however, our business to discuss either of these questions here, but to consider duly the natural faculties, which, to the number of four, exist in each organ. Returning then, to this point, let us recall what has already been said, and set a crown to the whole subject by adding what is still wanting. For when every part of the animal has been shewn to draw into itself the juice which is proper to it (this being practically the first of the natural faculties), the next point to realise is that the part does not get rid either of this attracted nutriment as a whole, or even of any superfluous portion of it, until either the organ itself, or the major part of its contents also have their condition reversed. Thus, when the stomach is sufficiently filled with the food and has absorbed and stored away the most useful part of it in its own coats, it then rejects the rest like an alien burden. The same happens to the bladders, when the matter attracted into them begins to give trouble either because it distends them through its quantity or irritates them by its quality.

And this also happens in the case of the uterus; for it is either because it can no longer bear to be stretched that it strives to relieve itself of its annoyance, or else because it is irritated by the quality of the fluids poured out into it. Now both of these conditions sometimes occur with actual violence, and then miscarriage takes place. But for the most part they happen in a normal way, this being then called not miscarriage but delivery or parturition. Now abortifacient drugs or certain other conditions which destroy the embryo or rupture certain of its membranes are followed by abortion, and similarly also when the uterus is in pain from being in a bad state of tension; and, as has been well said by Hippocrates, excessive movement on the part of the embryo itself brings on labour. Now pain is common to all these conditions, and of this there are three possible causes—either excessive bulk, or weight, or irritation; bulk when the uterus can no longer support the stretching, weight when the contents surpass its strength, and irritation when the fluids which had previously been pent up in the membranes, flow out, on the rapture of these, into the uterus itself, or else when the whole foetus perishes, putrefies, and is resolved into pernicious ichors, and so irritates and bites the coat of the uterus.

In all organs, then, both their natural effects and their disorders and maladies plainly take place on analogous lines,[359] some so clearly and manifestly as to need no demonstration, and others less plainly, although not entirely unrecognizable to those who are willing to pay attention.

Thus, to take the case of the stomach: the irritation is evident here because this organ possesses most sensibility, and among its other affections those producing nausea and the so-called heartburn clearly demonstrate the eliminative faculty which expels foreign matter. So also in the case of the uterus and the urinary bladder; this latter also may be plainly observed to receive and accumulate fluid until it is so stretched by the amount of this as to be incapable of enduring the pain; or it may be the quality of the urine which irritates it; for every superfluous substance which lingers in the body must obviously putrefy, some in a shorter, and some in a longer time, and thus it becomes pungent, acrid, and burdensome to the organ which contains it. This does not apply, however, in the case of the bladder alongside the liver, whence it is clear that it possesses fewer nerves than do the other organs. Here too, however, at least the physiologist[360] must discover an analogy. For since it was shown that the gall-bladder attracts its own special juice, so as to be often found full, and that it discharges it soon after, this desire to discharge must be either due to the fact that it is burdened by the quantity or that the bile has changed in quality to pungent and acrid. For while food does not change its original quality so fast that it is already ordure as soon as it falls into the small intestine, on the other hand the bile even more readily than the urine becomes altered in quality as soon as ever it leaves the veins, and rapidly undergoes change and putrefaction. Now, if there be clear evidence in relation to the uterus, stomach, and intestines, as well as to the urinary bladder, that there is either some distention, irritation, or burden inciting each of these organs to elimination, there is no difficulty in imagining this in the case of the gall-bladder also, as well as in the other organs,—to which obviously the arteries and veins also belong.

[XIII]

Nor is there any further difficulty in ascertaining that it is through the same channel that both attraction and discharge take place at different times. For obviously the inlet to the stomach does not merely conduct food and drink into this organ, but in the condition of nausea it performs the opposite service. Further, the neck of the bladder which is beside the liver, albeit single, both fills and empties the bladder. Similarly the canal of the uterus affords an entrance to the semen and an exit to the foetus.

But in this latter case, again, whilst the eliminative faculty is evident, the attractive faculty is not so obvious to most people. It is, however, the cervix which Hippocrates blames for inertia of the uterus when he says:—“Its orifice has no power of attracting semen.”[361]

Erasistratus, however, and Asclepiades reached such heights of wisdom that they deprived not merely the stomach and the womb of this faculty but also the bladder by the liver, and the kidneys as well. I have, however, pointed out in the first book that it is impossible to assign any other cause for the secretion of urine or bile.[362]

Now, when we find that the uterus, the stomach and the bladder by the liver carry out attraction and expulsion through one and the same duct, we need no longer feel surprised that Nature should also frequently discharge waste-substances into the stomach through the veins. Still less need we be astonished if a certain amount of the food should, during long fasts, be drawn back from the liver into the stomach through the same veins[363] by which it was yielded up to the liver during absorption of nutriment.[364] To disbelieve such things would of course be like refusing to believe that purgative drugs draw their appropriate humours from all over the body by the same stomata through which absorption previously takes place, and to look for separate stomata for absorption and purgation respectively. As a matter of fact one and the same stoma subserves two distinct faculties, and these exercise their pull at different times in opposite directions—first it subserves the pull of the liver and, during catharsis, that of the drug. What is there surprising, then, in the fact that the veins situated between the liver and the region of the stomach[365] fulfil a double service or purpose? Thus, when there is abundance of nutriment contained in the food-canal, it is carried up to the liver by the veins mentioned; and when the canal is empty and in need of nutriment, this is again attracted from the liver by the same veins.

For everything appears to attract from and to go shares with everything else, and, as the most divine Hippocrates has said, there would seem to be a consensus in the movements of fluids and vapours.[366] Thus the stronger draws and the weaker is evacuated.