By these veins we draw in much breath, since they are the spiracles of our bodies inhaling air to themselves and distributing it to the rest of the body, and to the smaller veins, and they and afterwards exhale it. For the breath cannot be stationary, but it passes upward and downward, for if stopped and intercepted, the part where it is stopped becomes powerless. In proof of this, when, in sitting or lying, the small veins are compressed, so that the breath from the larger vein does not pass into them, the part is immediately seized with numbness; and it is so likewise with regard to the other veins.
This malady, then, affects phlegmatic people, but not bilious. It begins to be formed while the foetus is still in utero. For the brain, like the other organs, is depurated and grows before birth. If, then, in this purgation it be properly and moderately depurated, and neither more nor less than what is proper be secreted from it, the head is thus in the most healthy condition. If the secretion (melting)the from the brain be greater than natural, the person, when he grows up, will have his head diseased, and full of noises, and will neither be able to endure the sun nor cold. Or, if the melting take place from any one part, either from the eye or ear, or if a vein has become slender, that part will be deranged in proportion to the melting. Or, should depuration not take place, but congestion accumulate in the brain, it necessarily becomes phlegmatic. And such children as have an eruption of ulcers on the head, on the ears, and along the rest of the body, with copious discharges of saliva and mucus,-these, in after life, enjoy best health; for in this way the phlegm which ought to have been purged off in the womb, is discharged and cleared away, and persons so purged, for the most part, are not subject to attacks of this disease. But such as have had their skin free from eruptions, and have had no discharge of saliva or mucus, nor have undergone the proper purgation in the womb, these persons run the risk of being seized with this disease.
But should the defluxion make its way to the heart, the person is seized with palpitation and asthma, the chest becomes diseased, and some also have curvature of the spine. For when a defluxion of cold phlegm takes place on the lungs and heart, the blood is chilled, and the veins, being violently chilled, palpitate in the lungs and heart, and the heart palpitates, so that from this necessity asthma and orthopnoea supervene. For it does not receive the spirits as much breath as he needs until the defluxion of phlegm be mastered, and being heated is distributed to the veins, then it ceases from its palpitation and difficulty of breathing, and this takes place as soon as it obtains an abundant supply; and this will be more slowly, provided the defluxion be more abundant, or if it be less, more quickly. And if the defluxions be more condensed, the epileptic attacks will be more frequent, but otherwise if it be rarer. Such are the symptoms when the defluxion is upon the lungs and heart; but if it be upon the bowels, the person is attacked with diarrhoea.
And if, being shut out from all these outlets, its defluxion be determined to the veins I have formerly mentioned, the patient loses his speech, and chokes, and foam issues by the mouth, the teeth are fixed, the hands are contracted, the eyes distorted, he becomes insensible, and in some cases the bowels are evacuated. And these symptoms occur sometimes on the left side, sometimes on the right, and sometimes in both. The cause of everyone of these symptoms I will now explain. The man becomes speechless when the phlegm, suddenly descending into the veins, shuts out the air, and does not admit it either to the brain or to the vena cava, or to the ventricles, but interrupts the inspiration. For when a person draws in air by the mouth and nostrils, the breath goes first to the brain, then the greater part of it to the internal cavity, and part to the lungs, and part to the veins, and from them it is distributed to the other parts of the body along the veins; and whatever passes to the stomach cools, and does nothing more; and so also with regard to the lungs. But the air which enters the veins is of use (to the body) by entering the brain and its ventricles, and thus it imparts sensibility and motion to all the members, so that when the veins are excluded from the air by the phlegm and do not receive it, the man loses his speech and intellect, and the hands become powerless, and are contracted, the blood stopping and not being diffused, as it was wont;and the eyes are distorted owing to the veins being excluded from the air; and they palpitate; and froth from the lungs issues by the mouth. For when the breath does not find entrance to him, he foams and sputters like a dying person. And the bowels are evacuated in consequence of the violent suffocation; and the suffocation is produced when the liver and stomach ascend to the diaphragm, and the mouth of the stomach is shut up; this takes place when the breath does not enter by the mouth, as it is wont. The patient kicks with his feet when the air is shut up in the lungs and cannot find an outlet, owing to the phlegm; and rushing by the blood upward and downward, it occasions convulsions and pain, and therefore he kicks with his feet. All these symptoms he endures when the cold phlegm passes into the warm blood, for it congeals and stops the blood. And if the deflexion be copious and thick, it immediately proves fatal to him, for by its cold it prevails over the blood and congeals it; or, if it be less, it in the first place obtains the mastery, and stops the respiration; and then in the course of time, when it is diffused along the veins and mixed with much warm blood, it is thus overpowered, the veins receive the air, and the patient recovers his senses.