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400 BC
ON AIRS； WATERS； AND PLACES
by Hippocrates
Translated by Francis Adams
WHOEVER wishes to investigate medicine properly； should proceed
thus： in the first place to consider the seasons of the year； and what
effects each of them produces for they are not at all alike； but
differ much from themselves in regard to their changes。 Then the
winds； the hot and the cold； especially such as are common to all
countries； and then such as are peculiar to each locality。 We must
also consider the qualities of the waters； for as they differ from one
another in taste and weight； so also do they differ much in their
qualities。 In the same manner； when one comes into a city to which
he is a stranger； he ought to consider its situation； how it lies as
to the winds and the rising of the sun； for its influence is not the
same whether it lies to the north or the south； to the rising or to
the setting sun。 These things one ought to consider most
attentively； and concerning the waters which the inhabitants use；
whether they be marshy and soft； or hard； and running from elevated
and rocky situations； and then if saltish and unfit for cooking； and
the ground； whether it be naked and deficient in water； or wooded
and well watered； and whether it lies in a hollow； confined situation；
or is elevated and cold； and the mode in which the inhabitants live；
and what are their pursuits； whether they are fond of drinking and
eating to excess； and given to indolence； or are fond of exercise
and labor； and not given to excess in eating and drinking。
2。 From these things he must proceed to investigate everything else。
For if one knows all these things well； or at least the greater part
of them； he cannot miss knowing； when he comes into a strange city；
either the diseases peculiar to the place； or the particular nature of
common diseases； so that he will not be in doubt as to the treatment
of the diseases； or commit mistakes； as is likely to be the case
provided one had not previously considered these matters。 And in
particular； as the season and the year advances； he can tell what
epidemic diseases will attack the city； either in summer or in winter；
and what each individual will be in danger of experiencing from the
change of regimen。 For knowing the changes of the seasons； the risings
and settings of the stars； how each of them takes place； he will be
able to know beforehand what sort of a year is going to ensue。
Having made these investigations； and knowing beforehand the
seasons； such a one must be acquainted with each particular； and
must succeed in the preservation of health； and be by no means
unsuccessful in the practice of his art。 And if it shall be thought
that these things belong rather to meteorology； it will be admitted；
on second thoughts； that astronomy contributes not a little； but a
very great deal； indeed； to medicine。 For with the seasons the
digestive organs of men undergo a change。
3。 But how of the aforementioned things should be investigated and
explained； I will now declare in a clear manner。 A city that is
exposed to hot winds （these are between the wintry rising； and the
wintry setting of the sun）； and to which these are peculiar； but which
is sheltered from the north winds； in such a city the waters will be
plenteous and saltish； and as they run from an elevated source； they
are necessarily hot in summer； and cold in winter； the heads of the
inhabitants are of a humid and pituitous constitution； and their
bellies subject to frequent disorders； owing to the phlegm running
down from the head； the forms of their bodies； for the most part；
are rather flabby； they do not eat nor drink much； drinking wine in
particular； and more especially if carried to intoxication； is
oppressive to them； and the following diseases are peculiar to the
district： in the first place； the women are sickly and subject to
excessive menstruation； then many are unfruitful from disease； and not
from nature； and they have frequent miscarriages； infants are
subject to attacks of convulsions and asthma； which they consider to
be connected with infancy； and hold to be a sacred disease （epilepsy）。
The men are subject to attacks of dysentery； diarrhea； hepialus；
chronic fevers in winter； of epinyctis； frequently； and of hemorrhoids
about the anus。 Pleurisies； peripneumonies； ardent fevers； and
whatever diseases are reckoned acute； do not often occur； for such
diseases are not apt to prevail where the bowels are loose。
Ophthalmies occur of a humid character； but not of a serious nature；
and of short duration； unless they attack epidemically from the change
of the seasons。 And when they pass their fiftieth year； defluxions
supervening from the brain； render them paralytic when exposed
suddently to strokes of the sun； or to cold。 These diseases are
endemic to them； and； moreover； if any epidemic disease connected with
the change of the seasons； prevail； they are also liable to it。
4。 But the following is the condition of cities which have the
opposite exposure； namely； to cold winds； between the summer
settings and the summer risings of the sun； and to which these winds
are peculiar； and which are sheltered from the south and the hot
breezes。 In the first place the waters are； for the most part； hard
cold。 The men must necessarily be well braced and slender； and they
must have the discharges downwards of the alimentary canal hard； and
of difficult evacuation； while those upwards are more fluid； and
rather bilious than pituitous。 Their heads are sound and hard； and
they are liable to burstings （of vessels？） for the most part。 The
diseases which prevail epidemically with them； are pleurisies； and
those which are called acute diseases。 This must be the case when
the bowels are bound； and from any causes； many become affected with
suppurations in the lungs； the cause of which is the tension of the
body； and hardness of the bowels； for their dryness and the coldness
of the water dispose them to ruptures （of vessels？）。 Such
constitutions must be given to excess of eating； but not of
drinking； for it is not possible to be gourmands and drunkards at
the same time。 Ophthalmies； too； at length supervene； these being of a
hard and violent nature； and soon ending in rupture of the eyes；
persons under thirty years of age are liable to severe bleedings at
the nose in summer； attacks of epilepsy are rare but severe。 Such
people are likely to be rather long…lived； their ulcers are not
attended with serious discharges； nor of a malignant character； in
disposition they are rather ferocious than gentle。 The diseases I have
mentioned are peculiar to the men； and besides they are liable to
any common complaint which may be prevailing from the changes of the
seasons。 But the women； in the first place； are of a hard
constitution； from the waters being hard； indigestible； and cold；
and their menstrual discharges are not regular； but in small quantity；
and painful。 Then they have difficult parturition； but are not very
subject to abortions。 And when they do bring forth children； they
are unable to nurse them； for the hardness and indigestable nature
of the water puts away their milk。 Phthisis frequently supervenes
after childbirth； for the efforts of it frequently bring on ruptures
and strains。 Children while still little are subject to dropsies in
the testicle； which disappear as they grow older； in such a town
they are late in attaining manhood。 It is； as I have now stated；
with regard to hot and cold winds and cities thus exposed。
5。 Cities that are exposed to winds between the summer and the
winter risings of the sun； and those the opposite to them； have the
following characters：… Those which lie to the rising of the sun are
all likely to be more healthy than such as are turned to the North； or
those exposed to the hot winds； even if there should not be a
furlong between them。 In the first place； both the heat and cold are
more moderate。 Then such waters as flow to the rising sun； must
necessarily be clear； fragrant； soft； and delightful to drink； in such
a city。 For the sun in rising and shining upon them purifies them；
by dispelling the vapors which generally prevail in the morning。 The
persons of the inhabitants are； for the most part； well colored and
blooming； unless some disease counteract。 The inhabitants have clear
voices； and in temper and intellect are superior to those which are
exposed to the north； and all the productions of the country in like
manner are better。 A city so situated resembles the spring as to
moderation between heat and cold； and the diseases are few in
number； and of a feeble kind； and bear a resemblance to the diseases
which prevail in regions exposed to hot winds。 The women there are
very prolific； and have easy deliveries。 Thus it is with regard to
them。
6。 But such cities as lie to the west； and which are sheltered
from winds blowing from the east； and which the hot winds and the cold
winds of the north scarcely touch； must necessarily be in a very
unhealthy situation： in the