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[82a] For seeing that there are four elements of which the body is compacted,—earth, fire, water and air,—when, contrary to nature, there occurs either an excess or a deficiency of these elements, or a transference thereof from their native region to an alien region; or again, seeing that fire and the rest have each more than one variety, every time that the body admits an inappropriate variety, then these and all similar occurrences bring about internal disorders and disease. For when any one element suffers a change of condition that is contrary to nature, all its particles that formerly were being cooled [82b] become heated, and the dry presently become moist, and the light heavy, and they undergo every variety of change in every respect. For, as we maintain, it is only the addition or subtraction of the same substance from the same substance in the same order and in the same manner and in due proportion which will allow the latter to remain safe and sound in its sameness with itself. But whatsoever oversteps any of these conditions in its going out or its coming in will produce alterations of every variety and countless diseases and corruptions. [82c]

Again, in the structures which are naturally secondary1 in order of construction, there is a second class of diseases to be noted by him who has a mind to take cognizance of them. For inasmuch as marrow and bone and flesh and sinew are compacted from the elements,—and blood also is formed from the same constituents, although in a different way,— most of the other maladies come about like those previously described, but the most severe of them have dangerous results for the reason following: whenever the production of these secondary substances proceeds in the reverse direction, then they are corrupted. For in the order of nature flesh and sinews arise from blood,2 [82d] the sinew from the fibrine because of its kindred quality, and flesh from the coagulated substance which coagulates on its separation from the fibrine; and further, the substance which is derived from the sinews and flesh, being viscid and oily,3 not only glues the flesh to the substance of the bones but also feeds and increases the bone itself which encloses the marrow, while that which is formed of the purest kind of triangles, very smooth and very oily, filters through [82e] the density of the bones, and, as it oozes and drips from the bones, moistens the marrow. Now when each of these substances is produced in this order, health as a rule results; but if in the reverse order, disease. For whenever the flesh is decomposed and sends its decomposed matter back again into the veins, then, uniting with the air, the blood in the veins, which is large in volume and of every variety, is diversified by colors and bitter flavors, as well as by sharp and saline properties, and contains bile and serum and phlegm of every sort. For when all the substances become reversed and corrupted, they begin by destroying the blood itself, and then they themselves cease to supply

1 Cf. 41 D ff.

2 Cf. 74 D.

3 i.e., the synovial fluid.

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