132 Hippocratic Corpus and Diocles of Carystus
The structure of the explanation is clear: the disease is caused by a
blockage of the passages which tentacle out from a cognitive centre over the
rest of the body and which are responsible for transporting ‘consciousness-
bearing’ material, in this casepneuma. The brain is the ‘cause’ (aitios)of
the disease, and its condition can be influenced by a number of external
causal factors (prophaseis) such as age, climate, season, the right or left side
of the body, and the like.
A haematocentric approach to epilepsy can be found in the Hippocratic
writingOn Breaths. The author of this highly rhetorical treatise (probably
written at the end of the fifth centurybce) assigns a pivotal role to air
(pneuma,phusa) in the life of organisms. He takes the view that the main
cause of diseases consists in a shortage or excess of air in the body or in
the contaminated state of this air. This may either have external causes or
be due to bad digestion of food, which also contains air, in the body (for
instance because there is too much of it in the body) which causes all kinds
of harmful gases to form. Such a disturbing effect of air due to a surplus
of it is also what causes the ‘so-called sacred disease’. It is again striking
how the author incorporates the empirically perceptible phenomena of the
disease in his own explanation:
In my view, the same cause is also responsible for the disease called sacred... I
believe that none of the parts of the body that contribute to consciousness in any-
one is more important than blood. So long as this remains in a stable condition,
consciousness, too, remains stable; but when the blood undergoes change, con-
sciousness also changes. There are many things that testify that this is the case. First
of all, an affection which is common to all living beings, namely sleep, testifies to
what has just been said. When sleep comes upon the body, the blood is chilled,
for it is the nature of sleep to cause chill. When the blood is chilled, its passages
become more sluggish. This is evident; the body leans and gets heavy... the eyes
close, and consciousness is changed, and certain other thoughts remain present,
which are called dreams... So if all of the blood is brought in a state of complete
turmoil, consciousness is completely destroyed.... I state that the sacred disease
is caused in the following way. When much wind has been mixed throughout
the body with all the blood, many obstructions arise in many places in the blood
vessels. Whenever therefore much air weighs, and continues to weigh, upon the
thick, blood-filled blood vessels, the blood is prevented from passing on. So in
one place it stops, in another it passes slowly, in another more quickly. When the
progress of the blood through the body becomes irregular, all kinds of irregularities
occur. The whole body is torn in all directions; the parts of the body are shaken in
obedience to the troubling and disturbance of the blood; distortions of every kind
occur in every manner. At this time the patients are unconscious of everything –
deaf to what is spoken, blind to what is happening, and insensible to pain. So
greatly does a disturbance of the air disturb and pollute the blood. Foam rises