§1## ΓΑΛΗΝΟΥ ΠΕΡΙ ΤΗΣ ΤΩΝ ΚΑΘΑΙΡΟΝΤΩΝ ΦΑΡΜΑΚΩΝ ΔΥΝΑΜΕΩΣ.
Κατὰ τὴν αὐτὴν αἰτίαν ἐοίκασιν οἱ παλαιότατοι τῶν ἰατρῶν τὰς πονηρὰς δόξας ἀνελέγκτους ἐᾶσαι, καθ’ ἣν καὶ τῶν νομοθετῶν οἱ ἀρχαιότατοι τὰ μέγιστα τῶν ἁμαρτημάτων ἀτιμώρητα.
GALEN ON THE POWER OF PURGATIVE DRUGS. For the very same reason, the most ancient of physicians seem to have left harmful opinions unrefuted, just as the most ancient of legislators left the greatest of crimes unpunished.
μετριωτέρας γὰρ οὔσης κατ’ ἐκεῖνον τὸν χρόνον τῆς κακίας καὶ μήτε ἀδικεῖν ἐπιχειρούντων τὰ μέγιστα μήτε ἀναισχυντεῖν ὑπομενόντων τὰ φανερώτατα, πῶς ἄν τις ἢ κόλασιν ὥριζε τοῖς μηδ’ ὅλως γεγενημένοις, ἢ ἔλεγχον ἐπῆγεν οἷς οὐδεὶς ὅλως εἶπεν;
For since wickedness was more moderate at that time, and people neither attempted to commit the greatest injustices nor deigned to behave with the most obvious shamelessness, who would have prescribed a punishment for things that had not happened at all, or brought a refutation against things that no one had ever said?
ἐπειδὴ δ’ ἐν τῷ χρόνῳ τῆς κακίας αὐξανομένης οὔτε ἀτόλμητον οὐδὲν ἔτι τοῖς ἀνθρώποις οὔτε ἄῤῥητον ἦν, οἱ μὲν νομοθέται πολλοὺς τρόπους καινοὺς ἐξευρίσκουσι τῶν ἐπὶ τοῖς ἀδικοῦσι τιμωριῶν.
But when, as time passed and wickedness increased, nothing was any longer left undared by humans, nor anything left unsaid, the legislators discovered many new ways of punishing wrongdoers, while those who honor the truth discovered manifold forms of refutations against the sophists.
οἱ δ’ ἀλήθειαν τιμῶντες ἐλέγχων ἰδέας πολυτρόπους ἐπὶ τοῖς σοφισταῖς, ὅπερ νῦν ἐοίκαμεν καὶ ἡμεῖς ἂν δράσειν, ἐξελέγχοντες τοὺς ἀναιροῦντας μὲν τῶν καθαιρόντων φαρμάκων τὴν ἑλκτικὴν δύναμιν ὧν ἐκκενοῦσι χυμῶν, μεταβλητικὴν δέ τινα φάσκοντας ἔχειν ἁπάντων ὁμοτίμως τῶν πλησιαζόντων αὐτοῖς.
This is what we too seem likely to do now, by refuting those who deny the attractive power of purgative drugs for the humors they evacuate, while claiming that they possess a certain power to alter all humors that come near them equally.
λέλεκται δ’ οὐδὲν Ἱπποκράτει πρὸς τὴν τοιαύτην δόξαν.
But nothing has been said by Hippocrates against such an opinion.
οὔπω γὰρ οὔτ’ Ἀσκληπιάδης ἦν κατ’ αὐτὸν, ὁ προφανῶς ἀναισχυντήσας τε καὶ ὥσπερ ἔπαθλόν τινα κατὰ τῆς ἀληθείας ἀποδυσάμενος, οὔτ’ Ἐρασίστρατος, ὁ μετ’ αἰδοῦς μέν τινος, ὅλον δ’ ἀνατρέψας τὸ κεφάλαιον αὐτὸ, ὃ περὶ τῶν καθαιρόντων φαρμάκων φανερῶς ὑπάρχει.
For in his time there was not yet Asclepiades, who openly behaved shamelessly and, stripping off his clothes as if for a prize-fight, took up arms against the truth, nor Erasistratus, who, though with a certain modesty, nevertheless overturned the very core of what is obvious concerning purgative drugs.
τὴν γάρ τοι δραστικωτάτην τε καὶ οἰκειοτάτην τῆς φύσεως δύναμιν τὴν ἑλκτικὴν οὐκ οἶδεν Ἐρασίστρατος οὐδαμόθεν τῶν ἑαυτοῦ συγγραμμάτων, ἀλλὰ τῇ πρὸς τὸ κενούμενον ἀκολουθίᾳ μᾶλλον ἀντ’ αὐτῆς χρῆται.
For Erasistratus does not recognize anywhere in his writings the attractive power, which is the most active and most proper power of nature, but instead of it, he rather makes use of the principle of following upon what is being emptied.
μέρος δέ ἐστι τῆς τῶν οἰκείων ἑλκτικῆς δυνάμεως ἡ ἐν τοῖς καθαίρουσι φαρμάκοις, ὥσπερ γε καὶ καθ’ ἣν ἡ χολὴ διακρίνεται καὶ τὸ οὖρον, ἄλλα τε πολλὰ κατά τε τὴν ὑγείαν τῶν ζώων ὑπὸ τῆς φύσεως ἀποτελούμενα καὶ κατὰ τὰς ἰάσεις τῶν νοσημάτων καὶ κατὰ τὰ νοσήματα, ὑπό τε τῶν ἰατρῶν καὶ αὐτῆς τῆς φύσεως οὐχ ἥκιστα.
And the power in purgative drugs is a part of the attractive power of proper substances, just as is the power by which bile and urine are separated, and many other things accomplished by nature for the health of animals, and during the treatment of diseases, and during diseases themselves, not least by physicians and by nature itself.
ἐπεὶ τοίνυν Ἱπποκράτης οὐδὲν εἶπεν πρὸς τοὺς ἀναιροῦντας ἐκ τῶν ὄντων τὴν ὁλκὴν, ὅτι μηδὲ προστάτην οὕτως ἰταμὸν ὁ λόγος ἔσχεν, οἷοι πολλοὶ τῶν μετ’ αὐτῶν ἐγένοντο, δίκαιον ἂν εἴη περὶ τῆς ἀληθείας ἀνθ’ Ἱπποκράτους ἡμᾶς ἀγωνίσασθαι καὶ πρῶτον μὲν οἷόν τι λέγουσιν ἀναμνῆσαι τοὺς ἄνδρας, εἶθ’ ἑξῆς ὡς οὐκ ὀρθῶς λέγοντας ἐπιδεῖξαι.
Since, therefore, Hippocrates said nothing against those who deny attraction from among existing things, because the doctrine did not yet have so impudent a champion as many of those who came after him became, it would be just for us to fight on behalf of the truth in place of Hippocrates, and first to remind these men of the kind of things they say, and then in order to show that they do not speak correctly.
ὁ μὲν δὴ λόγος αὐτῶν τοιόσδε.
Now their argument is as follows.
τὸ καθαῖρον φάρμακον, οὗπερ ἂν ψαύσῃ χυμοῦ, τοῦτον εἰς τὴν ἰδίαν ἰδέαν ἀλλοιοῖ, χολὴν μὲν ξανθὴν ἐργαζόμενον, ὅπερ ὀνομάζουσι χολαγωγὸν, ὥσπερ καὶ φλέγμα, ὃ καλοῦσι φλεγμαγωγόν· ὑδατώδη δέ τινα φύσιν ἀποτελοῦν ὃ καλοῦσιν ὑδραγωγὸν, ἄλλο γε μέλαιναν χολὴν ἀποφαῖνον οὗπερ ἂν ἅψηται χυμοῦ.
The purgative drug, whatever humor it touches, alters this into its own specific form, making it yellow bile—which they call bile-attracting—just as also phlegm, which they call phlegm-attracting; and producing a certain watery substance, which they call water-attracting; and another turning whatever humor it touches into black bile.
συνελόντα δὲ φάναι, μεταβολὴ καὶ ἀλλοίωσίς ἐστι τῶν ἐν ταῖς φλεψὶ χυμῶν ἁπάντων, οὐ κένωσις ἑνὸς ἐξ αὐτῶν, ἡ προσαγορευομένη κάθαρσις, ὡς ὁ τούτων λόγος.
To speak briefly, according to their theory, the so-called purgation is a change and alteration of all the humors in the veins, not an evacuation of one of them.
ἀλλ’ εἴπερ ταῦτα βούλεσθε, λέγωμεν ἤδη πρὸς αὐτοὺς, ἄν τε χολῆς ἀγωγὸν, ἄν τε φλέγματος, ἄν τε μελαίνης, ἄν τε ὀῤῥώδους ὑγρότητος λάβῃ τὶς φάρμακον, ἅπαντας κενοῦσθαι τοὺς ἐκ τῶν φλεβῶν χυμούς.
But if this is what you wish, let us now say to them: whether one takes a drug for bile, for phlegm, for black bile, or for watery fluid, all the humors from the veins are evacuated.
καὶ μὴν ταύτῃ μόνον ἄρα διαλλάττει τὸ καθῆραί τινα τοιούτῳ φαρμάκῳ, τοῦ τέμνοντα φλέβα κενῶσαι τὸ αἷμα, καθόσον ἐν μὲν ταῖς φλεβοτομίαις οἷόν περ ἔμπροσθεν ἐνυπάρχει ἐκκρίνεται, κατὰ δὲ τὰς καθάρσεις ἐξαλλαττόμενόν ἐστιν οὐ τῇ χρόᾳ μόνον, ἀλλὰ καὶ τῇ συστάσει.
And indeed, purging someone with such a drug differs only in this respect from evacuating blood by cutting a vein: in phlebotomies, that which was previously present is excreted just as it was, whereas in purgations, it is changed not only in color but also in consistency.
τὸ μὲν γὰρ τῶν ὑδατωδῶν ἀγωγὸν ὑγρὰ καὶ λεπτὰ πάντα ποιεῖται τὰ κατὰ τὰς φλέβας, εἰ καὶ τύχοι πρότερον ὄντα παχύτατα τὸ δὲ τῆς μελαίνης ἔμπαλιν ἅπαντα παχέα καὶ στάσιμα, κᾂν εἰ πρόσθεν ἦν ὑγρότατα.
For the attracter of watery fluids makes all things in the veins liquid and thin, even if they happened to be very thick before, while the attracter of black bile, conversely, makes everything thick and stagnant, even if they were very liquid before.
καὶ τοίνυν καὶ ἡ ἔκλεξις ἡμῖν τοῦ φλεβοτομῆσαί τε καὶ καθῆραι κατ’ ἄλλους μέν τινας ἔσται σκοποὺς, κατ’ αὐτὴν δὲ τὴν ἰδέαν τῶν κενουμένων οὐκ ἔσται.
Consequently, our choice between phlebotomy and purgation will be based on certain other indications, and will not be based on the nature itself of the evacuated substances.
τίνες δ’ ἄλλοι σκοποί;
And what are these other indications?
πολλοὶ μὲν ἑτοιμότεροι πρὸς φλεβοτομίαν εἰσὶ τῶν ἄλλων, ἔνιοι δὲ πρὸς κάθαρσιν, ὥσπερ γε καὶ ἄλλοι θᾶττον ὁτιοῦν πάθειεν ἢ φλεβοτομοῖεν.
Many are more ready for phlebotomy than for the other treatments, and some for purgation, just as others would rather suffer anything than undergo phlebotomy.
ἔνιοι δὲ ἀποκοπῆναι μᾶλλον ὑπομένουσι μόριόν τι τοῦ σώματος ἢ καταπιεῖν φάρμακον.
And some submit rather to having a part of the body cut off than to swallowing a drug.
καὶ μὲν δὴ καὶ τινὲς μὲν ἀνατρέπονται τὸν στόμαχον ὑπὸ τῶν καθαιρόντων φαρμάκων, ἕτεροι δὲ ἀλύπως λαμβάνουσιν.
And indeed, some have their stomach upset by purgative drugs, while others take them without distress.
ἀπὸ τῶν τοιούτων οὖν σκοπῶν ἐνίους μὲν τῶν ἀνθρώπων φλεβοτομήσομεν, ἐνίοις δὲ τὸ καθαῖρον φάρμακον δώσομεν, οὐκ ἀφ’ ὧν ἐνόμιζον οἱ Ἀσκληπιάδαι, φλεβοτομίαν μὲν ὁμοτίμως ἐκκενοῦν ἅπαντας τοὺς ἐν ταῖς φλεψὶ νομίζοντες χυμοὺς, τὴν κάθαρσιν δ’ οὐχ ὁμοτίμως, ἀλλ’ ἕνα μέν τινα καὶ μόνον ἐκεῖνον, οὗπερ ἂν ἀγωγὸν εἶναι λέγεται.
Based on such indications, therefore, we shall perform phlebotomy on some men, and to others we shall give the purgative drug, not on the grounds of what the Asclepiadeans believed—who thought that phlebotomy evacuates all humors in the veins equally, but purgation not equally, but only one specific humor, namely that which the drug is said to attract.
διὸ καὶ καθαίρεσθαι φασὶ τὸ αἷμα ὑπὸ τῶν τοιούτων φαρμάκων, οὐ κενοῦσθαι καθάπερ ἐν ταῖς φλεβοτομίαις.
For this reason, they say that blood is purified by such drugs, not evacuated as in phlebotomies.
ταῦτα ὑμῶν ἕπεται ταῖς ὑποθέσεσιν ἑκόντων τε καὶ ἀκόντων.
These things follow from your hypotheses, whether you like it or not.