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葉he blood, flesh, sinews様ike 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謡hen 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葉he 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,葉he 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,容.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;葉he latter term he applies to the vessels which conduct air from the mouth to the lungs;揺e 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葉he 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謡here 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.