Part I
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I. He who is accustomed to hear speakers discuss the nature of man beyond its relations to medicine will not find the present account of any interest. For I do not say at all that a man is air, or fire, or water, or earth, or anything else that is not an obvious constituent of a man; such accounts I leave to those that care to give them. Those, however, who give them have not in my opinion correct knowledge. For while adopting the same idea they do not give the same account. Though they add the same appendix to their idea—saying that “what is” is a unity, and that this is both unity and the all—yet they are not agreed as to its name. One of them asserts that this one and the all is air, another calls it fire, another, water, and another, earth; while each appends to his own account evidence and proofs that amount to nothing. The fact that, while adopting the same idea, they do not give the same account, shows that their knowledge too is at fault... .
II. Now about these men I have said enough, and I will turn to physicians. Some of them say that a man is blood, others that he is bile, a few that he is phlegm. Physicians, like the metaphysicians, all add the same appendix. For they say that a man is a unity, giving it the name that severally they wish to give it; this changes its form and its power, being constrained by the hot and the cold, and becomes sweet, bitter, white, black and so on. But in my opinion these views also are incorrect. Most physicians then maintain views like these, if not identical with them; but I hold that if man were a unity he would never feel pain, as there would be nothing from which a unity could suffer pain. And even if he were to suffer, the cure too would have to be one. But as a matter of fact cures are many. For in the body are many constituents, which, by heating, by cooling, by drying or by wetting one another contrary to nature, engender diseases; so that both the forms of diseases are many and the healing of them is manifold. But I require of him who asserts that man is blood and nothing else, to point out a man when he does not change his form or assume every quality, and to point out a time, a season of the year or a season of human life, in which obviously blood is the only constituent of man. For it is only natural that there should be one season in which blood-in-itself appears as the sole constituent. My remarks apply also to him who says that man is only phlegm, and to him who says that man is bile. I for my part will prove that what I declare to be the constituents of a man are, according to both convention and nature, always alike the same; it makes no difference whether the man be young or old, or whether the season be cold or hot. I will also bring evidence, and set forth the necessary causes why each constituent grows or decreases in the body.
III... .Therefore, since such is the nature both of all other things and of man, man of necessity is not one, but each of the components contributing to generation has in the body the power it contributed. Again, each component must return to its own nature when the body of a man dies, moist to moist, dry to dry, hot to hot and cold to cold. Such too is the nature of animals, and of all other things. All things are born in a like way, and all things die in a like way. For the nature of them is composed of all those things I have mentioned above, and each thing, according to what, has been said, ends in that from which it was composed. So that too is whither it departs.
IV. The body of man has in itself blood, phlegm, yellow bile and black bile; these make up the nature of his body, and through these he feels pain or enjoys health. Now he enjoys the most perfect health when these elements are duly proportioned to one another in respect of compounding, power and bulk, and when they are perfectly mingled. Pain is felt when one of these elements is in defect or excess, or is isolated in the body without being compounded with all the others. For when an element is isolated and stands by itself, not only must the place which it left become diseased, but the place where it stands in a flood must, because of the excess, cause pain and distress. In fact when more of an element flows out of the body than is necessary to get rid of superfluity, the emptying causes pain. If, on the other hand, it be to an inward part that there takes place the emptying, the shifting and the separation from other elements, the man certainly must, according to what has been said, suffer from a double pain, one in the place left, and another in the place flooded.
V. Now I promised to show that what are according to me the constituents of man remain always the same, according to both convention and nature. These constituents are, I hold, blood, phlegm, yellow bile and black bile. First I assert that the names of these according to convention are separated, and that none of them has the same name as the others; furthermore, that according to nature their essential forms are separated, phlegm being quite unlike blood, blood being quite unlike bile, bile being quite unlike phlegm. How could they be like one another, when their colours appear not alike to the sight nor does their touch seem alike to the hand? For they are not equally warm, nor cold, nor dry, nor moist. Since then they are so different from one another in essential form and in power, they cannot be one, if fire and water are not one. From the following evidence you may know that these elements are not all one, but that each of them has its own power and its own nature. If you were to give a man a medicine which withdraws phlegm, he will vomit you phlegm; if you give him one which withdraws bile, he will vomit you bile. Similarly too black bile is purged away if you give a medicine which withdraws black bile. And if you wound a man’s body so as to cause a wound, blood will flow from him. And you will find all these things happen on any day and on any night, both in winter and in summer, so long as the man can draw breath in and then breathe it out again, or until he is deprived of one of the elements congenital with him. Congenital with him (how should they not be so?) are the elements already mentioned. First, so long as a man lives he manifestly has all these elements always in him; then he is born out of a human being having all these elements, and is nursed in a human being having them all, I mean those elements I have mentioned with proofs.
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VII. Phlegm increases in a man in winter; for phlegm, being the coldest constituent of the body, is closest akin to winter. A proof that phlegm is very cold is that if you touch phlegm, bile and blood, you will find phlegm the coldest. And yet it is the most viscid, and after black bile requires most force for its evacuation. But things that are moved by force become hotter under the stress of the force. Yet in spite of all this, phlegm shows itself the coldest element by reason of its own nature. That winter fills the body with phlegm you can learn from the following evidence. It is in winter that the sputum and nasal discharge of men is fullest of phlegm; at this season mostly swellings become white, and diseases generally phlegmatic. And in spring too phlegm still remains strong in the body, while the blood increases. For the cold relaxes, and the rains come on, while the blood accordingly increases through the showers and the hot days. For these conditions of the year are most akin to the nature of blood, spring being moist and warm. You can learn the truth from the following facts. It is chiefly in spring and summer that men are attacked by dysenteries, and by hemorrhage from the nose, and they are then hottest and red. And in summer blood is still strong, and bile rises in the body and extends until autumn. In autumn blood becomes small in quantity, as autumn is opposed to its nature, while bile prevails in the body during the summer season and during autumn. You may learn this truth from the following facts. During this season men vomit bile without an emetic, and when they take purges the discharges are most bilious. It is plain too from fevers and from the complexions of men. But in summer phlegm is at its weakest. For the season is opposed to its nature, being dry and warm. But in autumn blood becomes least in man, for autumn is dry and begins from this point to chill him. It is black bile which in autumn is greatest and strongest. When winter comes on, bile being chilled becomes small in quantity, and phlegm increases again because of the abundance of rain and the length of the nights. All these elements then are always comprised in the body of a man, but as the year goes round they become now greater and now less, each in turn and according to its nature. For just as every year participates in every element, the hot, the cold, the dry and the moist—none in fact of these elements would last for a moment without all the things that exist in this universe, but if one were to fail all would disappear, for by reason of the same necessity all things are constructed and nourished by one another—even so, if any of these congenital elements were to fail, the man could not live. In the year sometimes the winter is most powerful, sometimes the spring, sometimes the summer and sometimes the autumn. So too in man sometimes phlegm is powerful, sometimes blood, sometimes bile, first yellow, and then what is called black bile. The clearest proof is that if you will give the same man to drink the same drug four times in the year, he will vomit, you will find, the most phlegmatic matter in the winter, the moistest in the spring, the most bilious in the summer, and the blackest in the autumn.
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IX. Furthermore, one must know that diseases due to repletion are cured by evacuation, and those due to evacuation are cured by repletion; those due to exercise are cured by rest, and those due to idleness are cured by exercise. To know the whole matter, the physician must set himself against the established character of diseases, of constitutions, of seasons and of ages; he must relax what is tense and make tense what is relaxed. For in this way the diseased part would rest most, and this, in my opinion, constitutes treatment.
Translated by W. H. S. Jones
Reading and Discussion Questions
1.Hippocrates accuses both physicians and metaphysicians of being overly concerned with “unity.” What does he think that the human body consists of and how does he approach questions of health?
2.How is Hippocrates thinking about the relationship between health, the seasons, and atmospheric conditions?
1As with other texts in the Hippocratic Corpus, there is some question about the authorship of Nature of Man. In History of Animals III.3, Aristotle attributes the work to Polybus, the son-in-law of Hippocrates.