The Kidneys
Table of Contents
The truth in the doctrines of Hippocrates may be gauged from:
- how his opponents deny obvious facts
- the various subjects of natural research themselves
For those people who do not believe that there exists in any part of the animal a faculty for attracting its own special quality are compelled repeatedly to deny obvious facts.
Asclepiades, the physician, did this in the case of the kidneys.
The kidneys are organs for secreting [separating out] the urine.
This was the belief of Hippocrates, Diocles, Erasistratus, Praxagoras, and all other physicians of eminence.
Every butcher is aware of this.
He observes the position of the kidneys and the duct (ureter) which runs from each kidney into the bladder.
Nephritics suffer either from:
- frequent dysuria or
- retention of urine
They feel pain in the loins and pass sandy matter in their water.
I do not think that Asclepiades ever:
- saw a stone which had been passed by one of these sufferers, or
- observed that this was preceded by a sharp pain in the region between kidneys and bladder as the stone traversed the ureter, or
- when the stone was passed, both the pain and the retention at once ceased.
Asclepiades’ theory accounts for the presence of urine in the bladder.
- He puts aside these broad, clearly visible routes
- He postulates others which are narrow and invisible
He thinks that the fluid which we drink passes into the bladder by being resolved into vapours.
- When these have been again condensed, it regains its previous form, and turns from vapour into fluid.
The bladder is just a sponge.
It is not a compact and impervious body with two very strong coats.
This is because he thinks that the vapours pass through these coats.
But of course the peritoneal coat is more impervious than the bladder, and this is why it keeps out the vapours, while the bladder admits them.
But:
- the outer coat of the bladder springs from the peritoneum and is essentially the same as it
- the inner coat, which is peculiar to the bladder, is more than twice as thick as the outer
Perhaps it is not the thickness of the coats, but the situation of the bladder which is the reason for the vapours being carried into it?
On the contrary, even if it were probable for every other reason that the vapours accumulate there, yet the situation of the bladder would be enough in itself to prevent this.
For the bladder is situated below, whereas vapours have a natural tendency to rise upwards; thus they would fill all the region of the thorax and lungs long before they came to the bladder.
But why do I mention the situation of the bladder, peritoneum, and thorax?
When the vapours have passed through the coats of the stomach and intestines, it is in the space between these and the peritoneum that they will collect and become liquefied (just as in dropsical subjects it is in this region that most of the water gathers).
Otherwise the vapours must necessarily pass straight forward through everything which in any way comes in contact with them, and will never come to a standstill.
But, if this be assumed, then they will traverse not merely the peritoneum but also the epigastrium, and will become dispersed into the surrounding air; otherwise they will certainly collect under the skin.
Even these considerations, however, our present-day Asclepiadeans attempt to answer, despite the fact that they always get soundly laughed at by all who happen to be present at their disputations on these subjects—so difficult an evil to get rid of is this sectarian partizanship, so excessively resistant to all cleansing processes, harder to heal than any itch!
The bladder, that, if one fills it with water or air and then ties up its neck and squeezes it all round, it does not let anything out at any point, but accurately retains all its contents.
If there were any large and perceptible channels coming into it from the kidneys the liquid would run out through these when the bladder was squeezed, in the same way that it entered?
And some of them who had allowed themselves to be shown the ureters coming from the kidneys and becoming implanted in the bladder, even had the audacity to say that these also existed for no purpose; and others said that they were spermatic ducts, and that this was why they were inserted into the neck of the bladder and not into its cavity.
When, therefore, we had demonstrated to them the real spermatic ducts92 entering the neck of the bladder lower down than the ureters, we supposed that, if we had not done so before, we would now at least draw them away from their false assumptions, and convert them forthwith to the opposite view.
But even this they dispute.
They said that it was not to be wondered at that the semen should remain longer in these latter ducts, these being more constricted, and that it should flow quickly down the ducts which came from the kidneys, seeing that these were well dilated.