On the Causes and Symptoms of Acute Diseases (2.3)

WELL by all means has the physician, and well have the common people succeeded in the appellation of this affection! It is, indeed, the name of a very acute malady; for what is there greater or more acute than the power of Syncope ? and what other name more appropriate for the designation of this matter? what other organ more important than the heart for life or for death? Neither is it to be doubted that syncope is a disease of the heart, or that it is an injury of the vital powers thereof—such is the rapidity and such the mode of the destruction. For the affection is the solution of the bonds of the vital power, being antagonistic to the constitution of the man; for having seized fast thereon, it does not let go its hold, but brings him to dissolution. Nor is it any great wonder; for other diseases are peculiar to, and prove fatal to, certain organs, in which they are engendered, and to which they attach themselves. Thus pestilential and very malignant buboes derive their origin from the liver, but from no other part; tetanus, in like manner, from the nerves, and epilepsy from the head. Thus, therefore, syncope is a disease of the heart and of life. But such persons as regard it to be an affection of the stomach, because by means of food and wine, and in certain cases by cold substances, the powers have been restored and the mischief expelled—these, it would seem to me, ought to hold phrenitis to be a disease of the hair and skin of the

head, since the phrenitics are relieved by the shaving and wetting thereof. But to the heart the vicinity of the stomach is most important, for from it the heart draws both what is suitable and what is unsuitable to itself. And by the lungs the heart draws spirit (pneuma) for respiration, but yet the lungs do not hold a primary place in respiration; for the powers are not in the organs, but there where is the original of life and strength: But the stomach is neither the original nor seat of life; and yet one would be injured by atony thereof: for food which proves injurious to the heart does not hurt the stomach itself, but by it the heart; since those dying in such cases have symptoms of heart-affections, namely, pulse small and feeble, bruit of the heart, with violent palpitation, vertigo, fainting, torpor, loss of tone in their limbs, sweating copious and unrestrainable, coldness of the whole body, insensibility, loss of utterance. How should the stomach endure such symptoms? For those peculiar to it are nausea, vomiting, loss of appetite, hiccup, eructation, acidity; whereas in cardiac affections the patients are more acute in their senses, so that they see and hear better than formerly; they are also in understanding more sound, and in mind more pure, not only regarding present things, but also with regard to futurity they are true prophets. These, then, are the powers, not of the stomach, but of the heart, where is the soul and the nature thereof, and to it is to be referred this affection of its powers.

But this form of disease is a solution of the natural tone from a cold cause and humidity, and therefore they are not affected with heat, either internally or externally, neither do they suffer from thirst, and their breath is cold even when the disease proceeds from strong and ardent fevers, by which syncope is usually kindled up. For when nature is strong, and of the proper temperament, it rules all and commands all, whether humour, spirit (pneuma), or solid, and, by their good order and symmetry, regulates the man in life; but if the bond

of nature—that is to say, its tone—be dissolved, then this affection is produced. The original of it is causus, which is in this form.