INTRODUCTION AND ANALYSIS : Section 6
I shall not attempt to connect the
physiological speculations of Plato either with ancient
or modern medicine. What light I can throw upon
them will be derived from the comparison of them with
his general system.
There is no principle so apparent
in the physics of the Timaeus, or in ancient physics
generally, as that of continuity. The world is
conceived of as a whole, and the elements are formed
into and out of one another; the varieties of substances
and processes are hardly known or noticed. And
in a similar manner the human body is conceived of
as a whole, and the different substances of which,
to a superficial observer, it appears to be composed the
blood, flesh, sinews like the elements out
of which they are formed, are supposed to pass into
one another in regular order, while the infinite complexity
of the human frame remains unobserved. And diseases
arise from the opposite process when the
natural proportions of the four elements are disturbed,
and the secondary substances which are formed out
of them, namely, blood, flesh, sinews, are generated
in an inverse order.
Plato found heat and air within the
human frame, and the blood circulating in every part.
He assumes in language almost unintelligible to us
that a network of fire and air envelopes the greater
part of the body. This outer net contains two
lesser nets, one corresponding to the stomach, the
other to the lungs; and the entrance to the latter
is forked or divided into two passages which lead
to the nostrils and to the mouth. In the process
of respiration the external net is said to find a
way in and out of the pores of the skin: while
the interior of it and the lesser nets move alternately
into each other. The whole description is figurative,
as Plato himself implies when he speaks of a ‘fountain
of fire which we compare to the network of a creel.’
He really means by this what we should describe as
a state of heat or temperature in the interior of
the body. The ‘fountain of fire’ or
heat is also in a figure the circulation of the blood.
The passage is partly imagination, partly fact.
He has a singular theory of respiration
for which he accounts solely by the movement of the
air in and out of the body; he does not attribute
any part of the process to the action of the body itself.
The air has a double ingress and a double exit, through
the mouth or nostrils, and through the skin.
When exhaled through the mouth or nostrils, it leaves
a vacuum which is filled up by other air finding a
way in through the pores, this air being thrust out
of its place by the exhalation from the mouth and
nostrils. There is also a corresponding process
of inhalation through the mouth or nostrils, and of
exhalation through the pores. The inhalation
through the pores appears to take place nearly at the
same time as the exhalation through the mouth; and
conversely. The internal fire is in either case
the propelling cause outwards the inhaled
air, when heated by it, having a natural tendency
to move out of the body to the place of fire; while
the impossibility of a vacuum is the propelling cause
inwards.
Thus we see that this singular theory
is dependent on two principles largely employed by
Plato in explaining the operations of nature, the
impossibility of a vacuum and the attraction of like
to like. To these there has to be added a third
principle, which is the condition of the action of
the other two, the interpenetration of particles
in proportion to their density or rarity. It
is this which enables fire and air to permeate the
flesh.
Plato’s account of digestion
and the circulation of the blood is closely connected
with his theory of respiration. Digestion is supposed
to be effected by the action of the internal fire,
which in the process of respiration moves into the
stomach and minces the food. As the fire returns
to its place, it takes with it the minced food or blood;
and in this way the veins are replenished. Plato
does not enquire how the blood is separated from the
faeces.
Of the anatomy and functions of the
body he knew very little, e.g. of the uses
of the nerves in conveying motion and sensation, which
he supposed to be communicated by the bones and veins;
he was also ignorant of the distinction between veins
and arteries; the latter term he applies
to the vessels which conduct air from the mouth to
the lungs; he supposes the lung to be hollow
and bloodless; the spinal marrow he conceives to be
the seed of generation; he confuses the parts of the
body with the states of the body the network
of fire and air is spoken of as a bodily organ; he
has absolutely no idea of the phenomena of respiration,
which he attributes to a law of equalization in nature,
the air which is breathed out displacing other air
which finds a way in; he is wholly unacquainted with
the process of digestion. Except the general
divisions into the spleen, the liver, the belly, and
the lungs, and the obvious distinctions of flesh,
bones, and the limbs of the body, we find nothing
that reminds us of anatomical facts. But we find
much which is derived from his theory of the universe,
and transferred to man, as there is much also in his
theory of the universe which is suggested by man.
The microcosm of the human body is the lesser image
of the macrocosm. The courses of the same and
the other affect both; they are made of the same elements
and therefore in the same proportions. Both are
intelligent natures endued with the power of self-motion,
and the same equipoise is maintained in both.
The animal is a sort of ‘world’ to the
particles of the blood which circulate in it.
All the four elements entered into the original composition
of the human frame; the bone was formed out of smooth
earth; liquids of various kinds pass to and fro; the
network of fire and air irrigates the veins. Infancy
and childhood is the chaos or first turbid flux of
sense prior to the establishment of order; the intervals
of time which may be observed in some intermittent
fevers correspond to the density of the elements.
The spinal marrow, including the brain, is formed
out of the finest sorts of triangles, and is the connecting
link between body and mind. Health is only to
be preserved by imitating the motions of the world
in space, which is the mother and nurse of generation.
The work of digestion is carried on by the superior
sharpness of the triangles forming the substances
of the human body to those which are introduced into
it in the shape of food. The freshest and acutest
forms of triangles are those that are found in children,
but they become more obtuse with advancing years;
and when they finally wear out and fall to pieces,
old age and death supervene.
As in the Republic, Plato is still
the enemy of the purgative treatment of physicians,
which, except in extreme cases, no man of sense will
ever adopt. For, as he adds, with an insight
into the truth, ’every disease is akin to the
nature of the living being and is only irritated by
stimulants.’ He is of opinion that nature
should be left to herself, and is inclined to think
that physicians are in vain (Laws where
he says that warm baths would be more beneficial to
the limbs of the aged rustic than the prescriptions
of a not over-wise doctor). If he seems to be
extreme in his condemnation of medicine and to rely
too much on diet and exercise, he might appeal to
nearly all the best physicians of our own age in support
of his opinions, who often speak to their patients
of the worthlessness of drugs. For we ourselves
are sceptical about medicine, and very unwilling to
submit to the purgative treatment of physicians.
May we not claim for Plato an anticipation of modern
ideas as about some questions of astronomy and physics,
so also about medicine? As in the Charmides
he tells us that the body cannot be cured without the
soul, so in the Timaeus he strongly asserts the sympathy
of soul and body; any defect of either is the occasion
of the greatest discord and disproportion in the other.
Here too may be a presentiment that in the medicine
of the future the interdependence of mind and body
will be more fully recognized, and that the influence
of the one over the other may be exerted in a manner
which is not now thought possible.