On The Natural Faculties
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.
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 by which it was yielded up to the liver during absorption of nutriment. 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* 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.
*The mesenteric 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. Thus the stronger draws and the weaker is evacuated.
Now, one part is weaker or stronger than another either absolutely, by nature, and in all cases, or else it becomes so in such and such a particular instance. Thus, by nature and in all men alike, the heart is stronger than the liver at attracting what is serviceable to it and rejecting what is not so; similarly the liver is stronger than the intestines and stomach, and the arteries than the veins. In each of us personally, however, liver has stronger drawing power at one time, and the stomach at another. For when there is much nutriment contained in the alimentary canal and the appetite and craving of the liver is violent, then the viscus exerts far the strongest traction. Again, when the liver is full and distended and the stomach empty and in need, then the force of the traction shifts to the latter.
Suppose we had some food in our hands and were snatching it from one another; if we were equally in want, the stronger would be likely to prevail, but if he had satisfied his appetite, and was holding what was over carelessly, or was anxious to share it with somebody, and if the weaker was excessively desirous of it, there would be nothing to prevent the latter from getting it all. In a similar manner the stomach easily attracts nutriment from the liver when it [the stomach] has a sufficiently strong craving for it, and the appetite of the viscus is satisfied. And sometimes the surplusage of nutriment in the liver is a reason why the animal is not hungry; for when the stomach has better and more available food it requires nothing from extraneous sources, but if ever it is in need and is at a loss how to supply the need, it becomes filled with waste-matters; these are certain biliary, phlegmatic [mucous] and serous fluids, and are the only substances that the liver yields in response to the traction of the stomach, on the occasions when the latter too is in want of nutriment.
Now, just as the parts draw food from each other, so also they sometimes deposit their excess substances in each other, and just as the stronger prevailed when the two were exercising traction, so it is also when they are depositing; this is the cause of the so-called fluxions, for every part has a definite inborn tension, by virtue of which it expels its superfluities, and, therefore, when one of these parts,- owing, of course, to some special condition- becomes weaker, there will necessarily be a confluence into it of the superfluities from all the other parts. The strongest part deposits its surplus matter in all the parts near it; these again in other parts which are weaker; these next into yet others; and this goes on for a long time, until the superfluity, being driven from one part into another, comes to rest in one of the weakest of all; it cannot flow from this into another part, because none of the stronger ones will receive it, while the affected part is unable to drive it away.
When, however, we come to deal again with the origin and cure of disease, it will be possible to find there also abundant proofs of all that we have correctly indicated in this book. For the present, however, let us resume again the task that lay before us, i.e. to show that there is nothing surprising in nutriment coming from the liver to the intestines and stomach by way of the very veins through which it had previously been yielded up from these organs into the liver. And in many people who have suddenly and completely given up active exercise, or who have had a limb cut off, there occurs at certain periods an evacuation of blood by way of the intestines- as Hippocrates has also pointed out somewhere. This causes no further trouble but sharply purges the whole body and evacuates the plethoras; the passage of the superfluities is effected, of course, through the same veins by which absorption took place.
Frequently also in disease Nature purges the animal through these same veins- although in this case the discharge is not sanguineous, but corresponds to the humour which is at fault. Thus in cholera the entire body is evacuated by way of the veins leading to the intestines and stomach.