Digestion

The 2 faculties are clearly seen in the case of the uterus.

In the case of the stomach they appear as follows:—Firstly in the condition of gurgling, which physicians are persuaded, and with reason, to be a symptom of weakness of the stomach;

for sometimes when the very smallest quantity of food has been ingested this does not occur, owing to the fact that the stomach is contracting accurately upon the food and constricting it at every point; sometimes when the stomach is full the gurglings yet make themselves heard as though it were empty.

For if it be in a natural condition, employing its contractile faculty in the ordinary way, then, even if its contents be very small, it grasps the whole of them and does not leave any empty space. When it is weak, however, being unable to lay hold of its contents accurately, it produces a certain amount of vacant space, and allows the liquid contents to flow about in different directions in accordance with its changes of shape, and so to produce gurglings.

Thus those who are troubled with this symptom expect, with good reason, that they will also be unable to digest adequately; proper digestion cannot take place in a weak stomach. In such people also, the mass of food may be plainly seen to remain an abnormally long time in the stomach, as would be natural if their digestion were slow.

Indeed, the chief way in which these people will surprise one is in the length of time that not food alone but even fluids will remain in their stomachs. Now, the actual cause of this is not, as one would imagine, that the lower outlet of the stomach,311 being fairly narrow, will allow nothing to pass before being reduced to a fine state of division.

Many people frequently swallow large quantities of big fruit-stones.

• One person inadvertently swallowed a gold ring.
• Another swallowed a coin
• Other people have swallowed various hard and indigestible objects

Yet all these people easily passed by the bowel what they had swallowed, without there being any subsequent symptoms.

If the narrowness of the gastric outlet were the cause of untriturated food remaining for an abnormally long time, none of these articles I have mentioned would ever have escaped.

The fact that it is liquids which remain longest in these people’s stomachs is sufficient to put the idea of narrowness of the outlet out of court.

For, supposing a rapid descent were dependent upon emulsification,312 then soups, milk, and barley-emulsion313 would at once pass along in every case.

But this is not so.

For in people who are extremely asthenic it is just these fluids which remain undigested, which accumulate and produce gurglings, and which oppress and overload the stomach, whereas in strong persons not merely do none of these things happen, but even a large quantity of bread or meat passes rapidly down.

It is not only because the stomach is distended and loaded and because the fluid runs from one part of it to another accompanied by gurglings—it is not only for these reasons that one would judge that there was an unduly long continuance of the food in it, in those people who are so disposed, but also from the vomiting.

Thus, there are some who vomit up every particle of what they have eaten, not after three or four hours, but actually in the middle of the night, a lengthy period having elapsed since their meal.

If you fill any animal whatsoever with liquid food—an experiment I have carried out in pigs, to whom I give a sort of mess of wheaten flour and water, thereafter cutting them open after three or four hours;

if you will do this yourself, you will find the food still in the stomach.

It is not chylification314 which determines the length of its stay here since this can also be effected outside the stomach.

The determining factor is digestion315 which is a different thing from chylification, as are blood-production and nutrition.

These 2 processes depend on a change of qualities. This is similar to how the digestion of food in the stomach involves a transmutation of it into the quality proper to that which is receiving nourishment.317

Then, when it is completely digested, the lower outlet opens and the food is quickly ejected through it, even if there should be amongst it abundance of stones, bones, grape-pips, or other things which cannot be reduced to chyle.

But even if you should fail to discover the time, and nothing was yet passing down, and the food was still undergoing digestion in the stomach, still even then you would find dissection not without its uses. You will observe, as we have just said, that the pylorus is accurately closed, and that the whole stomach is in a state of contraction upon the food very much as the womb contacts upon the foetus.

For it is never possible to find a vacant space in the uterus, the stomach, or in either of the two bladders—that is, either in that called bile-receiving318 or in the other; whether their contents be abundant or scanty, their cavities are seen to be replete and full, owing to the fact that their coats contract constantly upon the contents—so long, at least, as the animal is in a natural condition.

Erasistratus declares that it is the contractions319 of the stomach causes ofeverything:

• the softening of the food,320
• the removal of waste matter
• the absorption of the food when chylified [emulsified].

Many times, I have personally divided the peritoneum of a living animal.

• I have always found all the intestines contracting peristaltically321 pon their contents.

The condition of the stomach, however, is less simple; as regards the substances freshly swallowed, it had grasped these accurately both above and below, in fact at every point, and was as devoid of movement as though it had grown round and become united with the food.322

At the same time I found the pylorus persistently closed and accurately shut, like the os uteri on the foetus.

In the cases, however, where digestion had been completed the pylorus had opened, and the stomach was undergoing peristaltic movements, similar to those of the intestines.

Chapter 5

These facts show that the stomach, uterus, and bladders possess certain inborn faculties which are:

• retentive of their own proper qualities
• eliminative of those that are foreign.

The bladder by the liver draws bile into itself, while it is also quite obvious that it eliminates this daily into the stomach.

If the eliminative were to succeed the attractive faculty and there were not a retentive faculty between the two, there would be found, on every occasion that animals were dissected, an equal quantity of bile in the gall-bladder. This however, we do not find.

The bladder is sometimes observed to be very full, sometimes quite empty. At other times you find in it various intermediate degrees of fulness, just as is the case with the other bladder—that which receives the urine;

for even without resorting to anatomy we may observe that the urinary bladder continues to collect urine up to the time that it becomes uncomfortable through the increasing quantity of urine or the irritation caused by its acidity—the presumption thus being that here, too, there is a retentive faculty.

When the stomach is irritated by acidity, it gets rid of the undigested food earlier than proper.

When it is oppressed by the quantity of its contents, or disordered from the co-existence of both conditions, it is seized with diarrhoea.

Vomiting also is an affection of the upper part of the stomach analogous to diarrhoea.

It occurs when the stomach is overloaded or is unable to stand the quality of the food or surplus substances which it contains.

Thus, when such a condition develops in the lower parts of the stomach, while the parts about the inlet are normal, it ends in diarrhoea, whereas if this condition is in the upper stomach, the lower parts being normal, it ends in vomiting.