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Airs Waters Places (1-5)

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Whoever wishes to pursue properly the science of medicine must proceed thus. First he ought to consider what effects each season of the year can produce; for the seasons are not at all alike, but differ widely both in themselves and at their changes. The next point is the hot winds and the cold, especially those that are universal, but also those that are peculiar to each particular region. He must also consider the properties of the waters; for as these differ in taste and in weight, so the property of each is far different from that of any other. Therefore, on arrival at a town with which he is unfamiliar, a physician should examine its position with respect to the winds and to the risings of the sun. For a northern, a southern, an eastern, and a western aspect has each its own individual property. He must consider with the greatest care both these things and how the natives are off for water, whether they use marshy, soft waters, or such as are hard and come from rocky heights, or brackish and harsh. The soil too, whether bare and dry or wooded and watered, hollow and hot or high and cold. The mode of life also of the inhabitants that is pleasing to them, whether they

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are heavy drinkers, taking lunch,[*] and inactive, or athletic, industrious, eating much and drinking little.

Using this evidence he must examine the several problems that arise. For if a physician know these things well, by preference all of them, but at any rate most, he will not, on arrival at a town with which he is unfamiliar, be ignorant of the local diseases, or of the nature of those that commonly prevail; so that he will not be at a loss in the treatment of diseases, or make blunders, as is likely to be the case if he have not this knowledge before he consider his several problems. As time and the year passes he will be able to tell what epidemic diseases will attack the city either in summer or in winter, as well as those peculiar to the individual which are likely to occur through change in mode of life. For knowing the changes of the seasons, and the risings and settings of the stars, with the circumstances of each of these phenomena, he will know beforehand the nature of the year that is coming. Through these considerations and by learning the times beforehand, he will have full knowledge of each particular case, will succeed best in securing health, and will achieve the greatest triumphs in the practice of his art. If it be thought that all this belongs to meteorology, he will find out, on second thoughts, that the contribution of astronomy to medicine is not a very small one but a very great one indeed. For with the seasons mens diseases, like their digestive organs, suffer change.

I will now set forth clearly how each of the foregoing questions ought to be investigated, and

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the tests to be applied. A city that lies exposed to the hot windsthese are those between the winter rising of the sun and its winter settingwhen subject to these and sheltered from the north winds, the waters here are plentiful and brackish, and must be near the surface,[*] hot in summer and cold in winter. The heads of the inhabitants are moist and full of phlegm, and their digestive organs are frequently deranged from the phlegm that runs down into them from the head. Most of them have a rather flabby physique, and they are poor eaters and poor drinkers. For men with weak heads will be poor drinkers, as the after-effects are more distressing to them. The endemic diseases are these. In the first place, the women are unhealthy and subject to excessive fluxes. Then many are barren through disease and not by nature, while abortions are frequent. Children are liable to convulsions and asthma, and to what they think causes the disease of childhood, and to be a sacred disease.[*] Men suffer from dysentery, diarrhoea, ague, chronic fevers in winter, many attacks[*] of eczema, and from hemorrhoids. Cases of pleurisy, pneumonia, ardent fever, and of diseases considered acute, rarely occur. These diseases cannot prevail where the bowels are loose. Inflammations of the eyes occur with running, but are not
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serious; they are of short duration, unless a general epidemic take place after a violent change. When they are more than fifty years old, they are paralyzed by catarrhs supervening from the brain, when the sun suddenly strikes their head or they are chilled. These are their endemic diseases, but besides, they are liable to any epidemic disease that prevails through the change of the seasons.

But the following is the condition of cities with the opposite situation, facing the cold winds that blow from between the summer setting and the summer rising of the sun, being habitually exposed to these winds, but sheltered from the hot winds and from the south. First, the waters of the region are generally hard and cold. The natives must be sinewy and spare, and in most cases their digestive organs are costive and hard in their lower parts, but more relaxed in the upper. They must be bilious rather than phlegmatic. Their heads are healthy and hard, but they have in most cases a tendency to internal lacerations. Their endemic diseases are as follow. Pleurisies are common, likewise those diseases which are accounted acute. It must be so, since their digestive organs are hard, and the slightest cause inevitably produces in many patients abscesses, the result of a stiff body and hard digestive organs. For their dryness, combined with the coldness of the water, makes them liable to internal lacerations. Such

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constitutions necessarily make men eat much and drink little; for one cannot be both a great eater and a great drinker. Inflammations of the eyes occur at last; they are hard and violent, and rapidly cause rupture of the eyes. Men under thirty suffer from violent bleedings at the nose in summer. Instances of the disease called sacred are rare but violent. These men are more likely to be long-lived than are others. Their sores become neither phlegmatic[*] nor malignant, but their characters incline to fierceness, not to mildness. For men these diseases are endemic, besides there are epidemic diseases which may prevail through the change of the seasons. As to the women, firstly many become barren through the waters being hard, indigestible and cold. Their menstrual discharges are not healthy, but are scanty and bad. Then childbirth is difficult, although abortion is rare. After bearing children they cannot rear them, for their milk is dried up through the hardness and indigestibility of the waters, while cases of phthisis are frequent after parturition, for the violence of it causes ruptures and strains. Children suffer from dropsies in the testicles while they are little, which disappear as they grow older. In such a city puberty is late.

The effects of hot winds and of cold winds on these cities are such as I have described; the following are the effects of winds on cities lying

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exposed to those between the summer and winter risings of the sun, and to those opposite to these. Those that lie towards the risings of the sun are likely to be healthier than those facing the north and those exposed to the hot winds, even though they be but a furlong apart. In the first place, the heat and the cold are more moderate. Then the waters that face the risings of the sun must be clear, sweet-smelling, soft and delightful, in such a city. For the sun, shining down upon them when it rises, purifies them. The persons of the inhabitants are of better complexion and more blooming than elsewhere, unless some disease prevents this. They are clear-voiced, and with better temper and intelligence than those who are exposed to the north, just as all things growing there are better. A city so situated is just like spring, because the heat and the cold are tempered; the diseases, while resembling those which we said occur in cities facing the hot winds, are both fewer and less severe. The women there very readily conceive and have easy deliveries.

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opposite 2 w 4135
situation 1 w 4144
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Their 2 w 4602
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Inflammations 2 w 5046
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Men 2 w 5124
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