DBook II ELEPHANTIASIS 167

oily. That is why eating the flesh of pigs is peculiarly liable
to induce elephantia; for that diet produces a great deal of the
kind of. blood that is readily inflamed.

In his treatise, however, Galen does not compare different
parts of the world except with regard to their diet. 'The reason
why this disease is domesticated in Egypt, whereas the Ger—
mans and Scythians suffer less, is their diet; the Scythians have
it least, because they use milk so much. But those who live
in hot climates, also have thick blood and a skin of close tex—
ture, though for a different reason, hence their blood also is
very much overheated under the outer skin and putrefies there.
But in temperate climates the blood is of more moderate tem—
perature, and the flesh transpires freely. 'The reason why wo—
men and eunuchs, who resemble women, are less subject to
this disease than men, is that their blood is chilly and watery.
Elephantia does not cause pains or convulsions like those ob—
served in French Sickness, because it has a drier basis, and what
substance there is does not settle around the nerves and muscles,
but establishes itself more in the periphery, and for this reason
it does not cause fever. But perhaps I may be asked why this
affection does not bring on delirium or dementia, seeing that it
is constituted in black bile, inflamed. We must conclude that
the reason is that in delirium and dementia the inflammation is
especially in the region of the heart and brain, whereas in ele—
phantia it is rather in the region of the outer skin; and when—
ever it happens that the blood is inflamed within the body also,
it is nevertheless not so inflamed as to cause delirium; for nature
continually drives the infected element towards the periphery.
"TThe members swell, because a great amount of substance has
eollected under the skin, and, unable to transpire, grows hot
there and extends along the members. Moreover the nourish—
ment in those localities is incompletely concocted (digested)
and therefore grows into a malignant tumor.  Pruritus developes,
because the adustion is so acute, and to this pruritus is due
the irritation of the sexual organs, a condition which black bile
in itself does much to produce naturally, for it is especially
akin to the spirits, as we learn from Aristotle.

TThis malady begins with the face, because every exhalation
ascends very easily, especially towards the face, in which many
small blood—vessels terminate; moreover the face is spongy,
and hence many other infections also attack the face, especially,