The Bladder

I was therefore compelled to show them in a live animal, the urine running out through the ureters into the bladder to check their nonsensical talk.

The demonstration is as follows.

Divide the peritoneum in front of the ureters.

Then secure these with ligatures, and next, having bandaged up the animal, let him go (for he will not continue to urinate).

After this one loosens the external bandages and shows the bladder empty and the ureters quite full and distended—in fact almost on the point of rupturing; on removing the ligature from them, one then plainly sees the bladder becoming filled with urine.

When this has been made quite clear, then, before the animal urinates, one has to tie a ligature round his penis and then to squeeze the bladder all over; still nothing goes back through the ureters to the kidneys.

Here, then, it becomes obvious that not only in a dead animal, but in one which is still living, the ureters are prevented from receiving back the urine from the bladder.

Loosen the ligature from the animal’s penis which allows him to urinate.

Then again ligatures one of the ureters and leaves the other to discharge into the bladder.

Allowing, then, some time to elapse, one now demonstrates that the ureter which was ligatured is obviously full and distended on the side next to the kidneys, while the other one—that from which the ligature had been taken—is itself flaccid, but has filled the bladder with urine.

Then, again, one must divide the full ureter, and demonstrate how the urine spurts out of it, like blood in the operation of venesection; and after this one cuts through the other also, and both being thus divided, one bandages up the animal externally.

Then when enough time seems to have elapsed, one takes off the bandages; the bladder will now be found empty, and the whole region between the intestines and the peritoneum full of urine, as if the animal were suffering from dropsy.

If anyone will but test this for himself on an animal, I think he will strongly condemn the rashness of Asclepiades, and if he also learns the reason why nothing regurgitates from the bladder into the ureters, I think he will be persuaded by this also of the forethought and art shown by Nature in relation to animals.93

Now Hippocrates, who was the first known to us of all those who have been both physicians and philosophers inasmuch as he was the first to recognize what Nature effects, expresses his admiration of her, and is constantly singing her praises and calling her “just.” Alone, he says, she suffices for the animal in every respect, performing of her own accord and without any teaching all that is required.

Being such, she has, as he supposes, certain faculties, one attractive of what is appropriate, and another eliminative of what is foreign, and she nourishes the animal, makes it grow, and expels its diseases by crisis.

Therefore he says that there is in our bodies a concordance in the movements of air and fluid, and that everything is in sympathy.

According to Asclepiades, however, nothing is naturally in sympathy with anything else, all substance being divided and broken up into inharmonious elements and absurd “molecules.” Necessarily, then, besides making countless other statements in opposition to plain fact, he was ignorant of Nature’s faculties, both that attracting what is appropriate, and that expelling what is foreign.

Thus he invented some wretched nonsense to explain blood-production and anadosis,96 and, being utterly unable to find anything to say regarding the clearing-out97 of superfluities, he did not hesitate to join issue with obvious facts, and, in this matter of urinary secretion, to deprive both the kidneys and the ureters of their activity, by assuming that there were certain invisible channels opening into the bladder. It was, of course, a grand and impressive thing to do, to mistrust the obvious, and to pin one’s faith in things which could not be seen!

Also, in the matter of the yellow bile, he makes an even grander and more spirited venture; for he says this is actually generated in the bile-ducts, not merely separated out.

How comes it, then, that in cases of jaundice two things happen at the same time—that the dejections contain absolutely no bile, and that the whole body becomes full of it? He is forced here again to talk nonsense, just as he did in regard to the urine. He also talks no less nonsense about the black bile and the spleen, not understanding what was said by Hippocrates; and he attempts in stupid—I might say insane—language, to contradict what he knows nothing about.

He neither was able to cure a kidney ailment, nor jaundice, nor a disease of black bile.

nor would he agree with the view held not merely by Hippocrates but by all men regarding drugs—that some of them purge away yellow bile, and others black, some again phlegm, and others the thin and watery superfluity98; he held that all the substances evacuated99 were produced by the drugs themselves, just as yellow bile is produced by the biliary passages!

It matters nothing, according to this extraordinary man, whether we give a hydragogue or a cholagogue in a case of dropsy, for these all equally purge99 and dissolve the body, and produce a solution having such and such an appearance, which did not exist as such before!100

Must we not, therefore, suppose he was either mad, or entirely unacquainted with practical medicine? For who does not know that if a drug for attracting phlegm be given in a case of jaundice it will not even evacuate four cyathi101 of phlegm? Similarly also if one of the hydragogues be given. A cholagogue, on the other hand, clears away a great quantity of bile, and the skin of patients so treated at once becomes clear. I myself have, in many cases, after treating the liver condition, then removed the disease by means of a single purgation; whereas, if one had employed a drug for removing phlegm one would have done no good.

Hippocrates is not the only one who knows this to be so.

Those who take experience alone as their starting-point102 know otherwise; they, as well as all physicians who are engaged in the practice of medicine, are of this opinion. Asclepiades, however is an exception; he would hold it a betrayal of his assumed “elements”103 to confess the truth about such matters.

For if a single drug were to be discovered which attracted such and such a humour only, there would obviously be danger of the opinion gaining ground that there is in every body104 a faculty which attracts its own particular quality.

He therefore says that safflower,105 the Cnidian berry,106 and Hippophaes,107 do not draw phlegm from the body, but actually make it. Moreover, he holds that the flower and scales of bronze, and burnt bronze itself, and germander,108 and wild mastich109 dissolve the body into water, and that dropsical patients derive benefit from these substances, not because they are purged by them, but because they are rid of substances which actually help to increase the disease; for, if the medicine does not evacuate110 the dropsical fluid contained in the body, but generates it, it aggravates the condition further. Moreover, scammony, according to the Asclepiadean argument, not only fails to evacuate110 the bile from the bodies of jaundiced subjects, but actually turns the useful blood into bile, and dissolves the body; in fact it does all manner of evil and increases the disease.

And yet this drug may be clearly seen to do good to numbers of people! “Yes,” says he, “they derive benefit certainly, but merely in proportion to the evacuation.” … But if you give these cases a drug which draws off phlegm they will not be benefited.

This is so obvious that even those who make experience alone their starting-point111 are aware of it; and these people make it a cardinal point of their teaching to trust to no arguments, but only to what can be clearly seen. In this, then, they show good sense; whereas Asclepiades goes far astray in bidding us distrust our senses where obvious facts plainly overturn his hypotheses. Much better would it have been for him not to assail obvious facts, but rather to devote himself entirely to these.

Is it, then, these facts only which are plainly irreconcilable with the views of Asclepiades? Is not also the fact that in summer yellow bile is evacuated in greater quantity by the same drugs, and in winter phlegm, and that in a young man more bile is evacuated, and in an old man more phlegm?

Each drug attracts something which already exists, and does not generate something previously non-existent.

Thus if you give in the summer season a drug which attracts phlegm to a young man of a lean and warm habit, who has lived neither idly nor too luxuriously, you will with great difficulty evacuate a very small quantity of this humour, and you will do the man the utmost harm. On the other hand, if you give him a cholagogue, you will produce an abundant evacuation and not injure him at all.

Do we still, then, disbelieve that each drug attracts that humour which is proper to it?112

Possibly the adherents of Asclepiades will assent to this—or rather, they will—not possibly, but certainly—declare that they disbelieve it, lest they should betray their darling prejudices.