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Tile mosaic with rabbit, lizard and mushroom. 19th or 20th c. via Metropolitan Museum of Art.

Oribasius and Rufus treat men's sexual health

August 16, 2023 by Sean Coughlin in Ancient Medicine

Rufus of Ephesus was likely practicing in ancient Alexandria or in ancient Ephesus. Some of his writings are preserved by Oribasius and Aetius, and in some of those, Rufus preserves patient concerns. Here, he records his interactions with several young men who are concerned about their sexual health, and the testimony provides some examples of how Rufus thinks through diagnosis and treatment. The text is part of a larger section in book 11 of Aetius on drugs related to sexual health and well-being.

Oribasius’ Sexual Stimulants

Equal parts of pepper, parsley, filings from dried deer’s testicle, and terebinth. Combine with honey and give with wine to drink.

Another. Burn a gecko, grind, then add it to oil. Rub the oil onto the big toe of your right foot and have sexual intercourse. If you want to stop the effects, wash your toe.

Another from the same. Rub hare’s suet or lion’s lard onto your genitals. Then take three grains of pepper together with juice of tragacanth gum, and apply to your testicles, perineum, and lower back.

From the works of Rufus, an effective ointment that excites the genitals.

Take one drachma of myrrh, unburnt sulphur, and the inner part of the knēkō plant, two obols of pyrethrum, two drachmas of melanthinon, thirty grains of pepper, and twenty grains of nettle, cleaned. Chop them up and grind with one drachma of squill, melt one ounce of wax and with eight ounces of castor oil; add also three ounces of honey and use [1]. After intercourse, the areas are wiped clean with a cloth. Some also apply this ointment to their buttocks.

Rufus also adds the following: “it is easy,” he says, “to find a therapy here for those who are unable to engage in sexual activity. A youth came to me once and said that he really wanted to have sex, but when he enaged in it, he could not ejaculate and lost a great deal of breath. I took this as an indication of dryness of the spermatic vessels and the treatment showed that I was right. For by using a moist diet productive of good humours, he was able to ejaculate. Another twenty-year-old youth said that when he had sex with a woman, he was not able to ejaculate, but when he was asleep, he frequently had wet dreams. It seemed to me that the spermatic parts we not being heated during intercourse due to the excessive moisture accompanied by cooling [2], since the heat is being dissipated along the surface of the body. During sleep, on the other hand, they become hotter, because dreams are able to heat the inside parts of the body and cool the outside parts. So I recommended that this man exercise his lower parts and ride horses, drink castoreum, and adopt a diet that was wholly warm and dry.”

Ὀριβασίου ἐντατικόν.

Πεπέρεως, πετροσελίνου, ἐλαφείου αἰδοίου ῥινίσματος ξηροῦ, τερεβινθίνης ἴσα· μέλιτι ἀναλάμβανε καὶ δίδου πίνειν μετ' οἴνου.

Ἄλλο· Ἀσκαλαβώτην καύσας, λεάνας, εἶτα ἐπιβαλὼν ἔλαιον, χρίσον τοῦ δεξιοῦ ποδὸς τὸν μεγαδάκτυλον καὶ συγγίνου· εἰ δὲ βούλει παύσασθαι, ἀπόπλυνε τὸν δάκτυλον.

Ἄλλο τοῦ αὐτοῦ. Λαγωοῦ πιτύαν ἢ λέοντος στέαρ χρίε τὸ αἰδοῖον· εἶτα τρία ἅμα πεπέρεα μετὰ χυλοῦ τραγακάνθης, χρίε τοὺς διδύμους καὶ περίναιον καὶ ὀσφῦν.

Ἐκ τῶν Ῥούφου χρίσμα ἐνεργὸν, ἐντεῖνον τὸ αἰδοῖον.

Σμύρνης, θείου ἀπύρου, κνήκου τοῦ ἐντὸς ἀνὰ 𐅻 αʹ, πυρέθρου ὀβολοὺς βʹ, μελάνθιον 𐅻 βʹ, πεπέρεως κόκκοι λʹ, κνίδιοι κόκκοι κεκαθαρμένοι κʹ· κόψας καὶ λεάνας ἅμα σκίλλης 𐅻 αʹ, καὶ τήξας κηροῦ οὐγγ. αʹ μετὰ ἐλαίου κικίνου οὐγγ. ηʹ ἐπίβαλε καὶ μέλιτος οὐγγ. γʹ, καὶ χρῶ· μετὰ δὲ τὴν μίξιν ὀθονίῳ ἀκριβῶς ἐκμασσέσθωσαν οἱ τόποι· ἔνιοι δὲ καὶ τῷ χρίσματι τούτῳ τῆς ἕδρας προσάπτονται.

Προστίθησι δὲ ὁ Ῥοῦφος καὶ ταῦτα· εὔκολον δέ φησι κἀντεῦθεν θεραπείας εὑρίσκεσθαι τοῖς οὐ δυναμένοις ἀφροδισιάζειν· νεανίσκος γάρ τις ἀφικόμενος πρὸς ἡμᾶς ἔφη, καὶ πάνυ μὲν ἐφίεσθαι μιγῆναι, μισγόμενος δὲ γονὴν μὲν μὴ ἀφιέναι, πνεύματα δὲ πολλὰ ἀπολλύειν. Τούτῳ ἐτεκμαιρόμην ξηρότητα εἶναι τῶν σπερματικῶν ἀγγείων, καὶ ἔδειξεν ἡ ἴασις· ὑγρᾷ γὰρ καὶ εὐχύμῳ διαίτῃ χρησάμενος ἐξέκρινε τὴν γονήν. Ἕτερος δὲ νεανίσκος εἰκοσαέτης ἔλεγεν, εἰ μὲν μίσγοιτο γυναικὶ, μὴ δύνασθαι γονὴν ἀφιέναι, καθεύδοντι δὲ πολὺ ὑπέρχεσθαι τοῦ σπέρματος. Ἐδόκει δέ μοι διὰ πολλὴν ὑγρότητα μετὰ ψύξεως μὴ θερμαίνεσθαι τὰ σπερματικὰ μόρια, ἐν ταῖς μίξεσι χεομένης περὶ τὴν τοῦ σώματος ἐπιφάνειαν τῆς θερμασίας, ἐν τοῖς ὕπνοις δὲ θερμαίνεσθαι πλέον, καθότι δύνανται ὕπνοι τὰ μὲν ἔσωθεν θερμαίνειν, τὰ δὲ ἔξωθεν ψύχειν. Ἐκέλευσα δὲ τοῦτον γυμνάζεσθαι τὰ κάτω μέρη καὶ ἱππάζεσθαι, καστόριον δὲ πίνειν καὶ διαίτῃ πάσῃ κεχρῆσθαι θερμῇ καὶ ξηρᾷ.

Aetius of Amida, Medical Books XI.35, p. 581 & 126 Rouelle

[1] It is not stated explicitly when the ingredients are mixed in with the oil.

[2] The word can also mean “embarassment,” but I’m wary to read it this way.

August 16, 2023 /Sean Coughlin
Rufus of Ephesus, Oribasius, sex, Doctors
Ancient Medicine
Comment

Octopus, detail from Oceanus and Tethys mosaic, Zeugmas Mosaic Museum, Gaziantep. Image by Dosseman via Wikimedia Commons CC BY-SA 4.0.

Rufus of Ephesus on Sexual Health

July 17, 2023 by Sean Coughlin in Ancient Medicine

On Sexual Activity from the works of Rufus (of Ephesus).

Sex is indeed a natural act, while nothing natural is harmful. But intimacy becomes harmful when it is immoderate and frequent and when it is engaged in at inappropriate times. Frequent intimacy is especially harmful for those who have weakness in the nerve-like parts, such as the chest, kidneys, lower back, hip region, or legs. Here also are some indications [it is harmful]: a person's whole strength becomes weaker during intimacy, but strength is the innate heat within us, hence concoction does not happen as well for those engaging in intercourse, and they become extremely pale and do not see or hear as they should, nor do they have any other strong sensation. Indeed, such people are forgetful and trembling, their joints painful, especially in the hip area; some also develop kidney disease, others have illness in the bladder, some develop thrush-like sores around the mouth, tooth pain, or inflammation of the tonsils; many men ejaculate blood after excessive sexual activity, some due to the violent retention and tension of pneuma, some due to the interaction of the veins and arteries running from the chest to the testicles. Women however ejaculate very little blood during intercourse due to the overall moistness of their bodies, due to the fact that they do not exert themselves as much during intercourse, and due to their regular discharges below, so that even if a woman happens to ejaculate blood, the discharges are a great healing factor for her. For these reasons, the good doctors will recommend that if any of the illnesses mentioned are present or if they are anticipated due to the natural weakness of the person, that they should abstain from sexual activity.

So far, I have spoken about the harms and co-affections (lit. sympathies) of sexual activity, to the extent that as I was able to do so succinctly. Now, we must speak about its benefits. For sexual activity is not always harmful if one takes into consideration the timing, measure, and overall health of the person engaging in intimacy. The benefits of sexual activity are these: to relieve fullness, to provide the body with lightness, to stimulate growth, and to bring about a more manly appearance. And for those in a hardened (tense) state, intimacy at regular intervals is beneficial: it softens (relaxes?) the organs, widens the pores, and removes some phlegm; it breaks up coagulated thoughts and relaxes intense desires. Hence, for a melancholic, depressed, and misanthropic person, sexual intercourse can serve as the most significant and suitable remedy. It can bring to a more moderate state of mind those driven mad in other ways, halt some epileptic symptoms, and relieve those suffering from a weary head and those with pains brought about during puberty. Hippocrates said, in a word, that sexual activity, “is the best remedy for illnesses from phlegm.” Many weakened people have been restored to health from illnesses due to intimacy, with some people’s breathing becoming easier instead of more difficult, and some people's appetite becoming better instead of worse. Some have even been freed from frequent nocturnal emissions. Natures suitable for sexual activity are warmer, more moist, and more actively disposed to intimacy than others, while least suitable are dry and cold; and the nature of those in their prime is right for it, but not the nature of those in their old age.

In terms of seasons, spring is appropriate, while autumn and summer are inappropriate. Winter is not too good either because it is cooling. Moreover, a warmer and moister diet is productive for sexual activity, while a drying and cooling diet is unproductive. Diets suitable for intercourse are appropriate for those who are unable to perform during intercourse. Therefore, the diet should be moist and warm, exertion should be moderate, and food should be plentiful. Wine therefore should be tawny in color and light in body, breads should be freshly baked and pure, meats, of young goats, lambs and pigs, poultry such as hens, thrushes, partridges, geese, and duck; of fish, octopus and whichever are called soft-bodied; of vegetables, sage, erysimon, rocket and turnip that is difficult to cook and has become tender (for these are also given as drugs); of legumes, bean, chick-peas, ochroi, phasiloi, pissoi, and loboi that are full of pneuma and provide plenty of nutrition. I also encourage adding the extremely excellent grape into the current diet; for it moistens and fills the body with blood and pneuma. But someone about to engage in sexual activity must avoid doing it on a full stomach, or with indigestion, drunkenness, or a lack of food. For it is bad to have intercourse when there are residues, one should avoid fatigue from the gym and bath, and recent vomiting and diarrhea from the belly. For these can be chronic when sexual activity causes dryness. The best intercourse happens with food but not after becoming full. For it contributes to strength and the chilling that occurs become less. If someone eagerly desires sex after breakfast, they should wait until the food settles; but if after dinner, it is necessary to sleep for a while. I do not encourage intense desires, and I rather recommend one resist them, especially those for whom it is an illness and are easily harmed by intimacy.

Περὶ ἀφροδισίων ἐκ τῶν Ῥούφου. Φυσικὸν μὲν ἔργον ἡ συνουσία ἐστίν, οὐδὲν δὲ τῶν φυσικῶν βλαβερόν· παρὰ δὲ τὴν ἄμετρόν τε καὶ συνεχῆ χρῆσιν καὶ κατὰ καιρὸν τὸν οὐ προσήκοντα παραλαμβανομένη βλαβερὰ γίγνεται, πολλῷ δὲ μᾶλλον βλαβερὰ ἡ συνεχὴς χρῆσις γίγνεται τοῖς τὸ νευρῶδες ἀσθενὲς ἔχουσιν ἢ θώρακα ἢ νεφροὺς ἢ ὀσφὺν ἢ ἰσχιάδα ἢ πόδας. ἔστω δέ σοι τεκμήρια καὶ τάδε· σύμπασα γὰρ ἡ ἰσχὺς τοῦ ἀνθρώπου ἀσθενεστέρα γίγνεται ἐν τῇ χρήσει· ἡ δὲ ἰσχύς ἐστι τὸ ἐν ἡμῖν ἔμφυτον θερμόν· ὅθεν αἱ πέψεις οὐκ ἀγαθαὶ τῷ μισγομένῳ καὶ ἔξωχροι γίγνονται καὶ οὔτε δεόντως ὁρῶσιν οὔτε ἀκούουσιν, ὡς χρή, οὐδὲ ἄλλην τινὰ αἴσθησιν ἐρρωμένην κέκτηνται καὶ μὲν δὴ καὶ ἐπιλήσμονες οἱ τοιοῦτοι καὶ τρομώδεις εἰσὶ καὶ τὰ ἄρθρα ὀδυνηροί, μάλιστα τὰ τῶν ἰσχίων, καὶ οἱ μὲν νεφριτικοὶ γίγνονται, οἱ δὲ καὶ κατὰ κύστιν νόσημα ἔχουσιν, τοῖς δὲ καὶ στόματα ἀφθώδη γίγνεται καὶ ὀδόντων πόνοι καὶ γαργαρεώνων φλεγμοναί· πολλοὶ δὲ ἄνδρες ἐπὶ τοῖς πολλοῖς ἀφροδισίοις καὶ αἷμα ἔπτυσαν, τὸ μέν τι τῇ βιαίῳ κατοχῇ τε καὶ ἐντάσει τοῦ πνεύματος, τὸ δέ τι τῇ κοινωνίᾳ τῶν ἀπὸ τοῦ θώρακος ἐπὶ τοὺς ὄρχεις φερομένων φλεβῶν καὶ ἀρτηριῶν. γυνὴ δὲ ἥκιστα ἐπὶ ταῖς μίξεσι πτύει αἷμα τῇ τε ἄλλῃ τοῦ σώματος ὑγρότητι καὶ τῷ ἧσσον πονεῖσθαι ἐν τῇ μίξει, καὶ διὰ τὰς εἰωθυίας κάτω καθάρσεις, ὥστε κἂν τύχῃ γυναῖκα πτύσαι αἷμα, μέγα ἴαμα αἱ καθάρσεις αὐτῇ γίγνονται. διὰ ταῦτα μὲν δὴ τὰ εἰρημένα παρακελεύονται τῶν ἰατρῶν οἱ ἀγαθοί, ἤν τε πάρεστι τι τῶν εἰρημένων νοσημάτων, ἤν τε προσδόκιμον ᾖ διὰ τὴν φυσικὴν ἀσθένειαν τοῦ ἀνθρώπου, ἀπέχεσθαι τῶν ἀφροδισίων.

ἄχρι μὲν δὴ τούτων τὰς βλάβας καὶ τὰς συμπαθείας, ἐφ' ὅσον δυνατὸν ἦν ἡμῖν διὰ βραχέων εἰπεῖν, εἰρήκαμεν· ῥητέον δὲ νῦν καὶ τὰς ὠφελείας· οὐ γὰρ παντάπασι κάκιστα τὰ ἀφροδίσιά ἐστιν, ἐὰν καὶ τὸν καιρὸν τῆς χρήσεως καὶ τὸ μέτρον καὶ τὴν ὑγιεινὴν κατάστασιν τοῦ χρωμένου σκοπεῖν ἐθέλοις. ὠφέλειαι δὲ αἱ ἐκ τῶν ἀφροδισίων εἰσὶν αἵδε· πλησμονήν τε κενῶσαι καὶ ἐλαφρὸν παρασχεῖν τὸ σῶμα καὶ εἰς αὔξησιν προτρέψαι καὶ ἀνδρωδέστερον ἀποφῆναι. καὶ τῇ δὲ σκληρᾷ ἕξει ἐκ διαλειμμάτων πλειόνων ἡ χρῆσις ὠφέλιμος· μαλάσσει γὰρ τὰ ὄργανα καὶ ἀνευρύνει τοὺς πόρους καί τι τοῦ φλέγματος ἐκκαθαίρει, καὶ συνεστηκότα δὲ λογισμὸν διαλύει καὶ ὀργὰς μεγίστας ἐπανίησι. διὸ καὶ τῷ μελαγχολικῷ καὶ κατηφεῖ καὶ μισανθρώπῳ ὄντι ὥς τι μέγιστον ἴαμα ἐπιτηδειότατον μίσγεσθαι. καθίστησι δ' εἰς τὸ σωφρονέστερον καὶ τοὺς κατ' ἄλλον τρόπον ἐκμανέντας καί τινας ἐπιλήπτους ἔπαυσε καὶ βαρυνομένους τὴν κεφαλὴν καὶ ἀλγοῦντας μεταβολῇ τοῦ ἡβάσκειν. Ἱπποκράτης δὲ ἑνὶ λόγῳ “τοῖς ἀπὸ φλέγματος νοσήμασιν εἶναι κράτιστα” ἀφροδίσια ἔφη. πολλοὶ δὲ καὶ ἐκ νόσων ἄτροφοι ἀνεκομίσθησαν ἐπὶ τῇ χρήσει· οἱ δὲ καὶ εὐπνούστεροι ἀντὶ δυσπνουστέρων ἐγένοντο, καὶ εὐσιτότεροι ἀντὶ ἀποσίτων· οἱ δὲ καὶ ὀνειρωγμῶν συνεχῶν ἀπηλλάγησαν. φύσεις δὲ πρὸς ἀφροδίσια ἐπιτήδειοι αἱ θερμότεραι καὶ ὑγρότεραι καὶ πλέον τῶν ἄλλων εἰς τὴν χρῆσιν εὔφοροι, ἥκιστα δὲ αἱ ξηραὶ καὶ ψυχραὶ καὶ ἡ μὲν τῶν ἀκμαζόντων εὔθετος, ἡ δὲ τῶν γερόντων οὐδαμῶς.

ὥρα δὲ τὸ μὲν ἔαρ ἐπιτήδειον. ἄθετον δὲ τὸ φθινόπωρον καὶ τὸ θέρος. ἀλλ' οὐδὲ ὁ χειμών ἐστιν ἀγαθὸς τῷ ψύχειν. καὶ δὴ καὶ δίαιτα ἡ θερμοτέρα καὶ ὑγροτέρα εἰς λαγνείαν εὔφορος, δύσφορος δὲ ἡ ξηραίνουσα καὶ ψύχουσα. αἱ γὰρ δίαιται πρὸς μίξεις τῷ ἀδυνάτῳ μίσγεσθαι ἐπιτήδειοι. χρὴ τοίνυν τὴν μὲν δίαιταν ὑγρὰν καὶ θερμὴν ὑπάρχειν· εἴη δ' ἂν πόνων μὲν μετριότης καὶ σίτου εὐωχία. οἶνος μὲν οὖν ἔστω κιρρὸς τῇ χροιᾷ, λεπτὸς δὲ τῇ συστάσει, ἄρτοι καθαροὶ ἰπνῖται πρόσφατοι, κρέα ἐρίφων καὶ ἀρνῶν καὶ χοίρων, πτηνὰ ἀλεκτορίδες ἀτταγῆνες πέρδικες χῆνες νῆσσαι· ἰχθύων δὲ οἱ πολύποδες καὶ ὅσα μαλακόσαρκα λέγεται· λαχάνων δὲ ὅρμινον ἐρύσιμον εὔζωμον γογγυλὶς δύσεφθος καὶ τακερὰ γενομένη (ταῦτα γὰρ καὶ ὡς φάρμακα δίδοται), ὀσπρίων δὲ κύαμοι ἐρέβινθοι ὦχροι φάσιλοι πισσοὶ λοβοὶ πνεύματός τε ἐμπιπλῶντες καὶ ἀφθονίαν τροφῆς παρασκευάζοντες. μεγάλως δὲ ἐπαινῶ καὶ τὴν καλλίστην σταφυλὴν εἰς τὴν νῦν δίαιταν· ὑγραίνει γὰρ καὶ αἵματος καὶ πνεύματος ἐμπίπλησι τὸ σῶμα. τὸν δὲ μέλλοντα ἀφροδισίοις χρῆσθαι πλησμονὰς προσφάτους φυλάττεσθαι χρὴ καὶ ἀπεψίας καὶ μέθας καὶ ἐνδείας. κακὸν γὰρ ἐπὶ περιττώμασι μίσγεσθαι καὶ ἀπὸ γυμνασίων καὶ λουτρῶν καὶ κόπους δὲ φυλακτέον καὶ ἐμέτους γεγενημένους καὶ διαρροίας γαστρὸς προσφάτους. τὰς γὰρ χρονίους ἐστὶν ὅτε ξηραίνει τὰ ἀφροδίσια. κάλλιστον δὲ τὸν μισγόμενον ἐπὶ σίτοις μίσγεσθαι μὴ ἐμπλησθέντα· καὶ γὰρ πρὸς ἰσχὺν συμφέρει καὶ αἱ γιγνόμεναι ψύξεις ἧσσον γίγνονται καὶ εἰ μὲν ἐπὶ τῷ ἀρίστῳ τις προθυμηθείη, ἀναπαύσασθαι χρὴ μέχρι καταστῇ τὸ σιτίον, εἰ δὲ ἐπὶ τῷ δείπνῳ ὑπνοῦν ἀνάγκη πρὸς ὀλίγον. καὶ τὰς σφοδρὰς δὲ ἐπιθυμίας οὐκ ἐπαινῶ ἀλλὰ κελεύω δὴ πλέον ἀντέχειν καὶ μᾶλλον οἷς νόσημά ἐστι ῥᾷον ἐκ τῆς χρήσεως βλαπτόμενον.

Rufus of Ephesus, quoted in Aetius of Amida, Medical Books, 3.8, 265,13–268,12 Olivieri

Also in Daremberg’s Oeuvres de Rufus d'Ephèse, pp. 318–325

July 17, 2023 /Sean Coughlin
Rufus of Ephesus, Hippocrates, sex, pneuma, pharmacology, diet
Ancient Medicine
Comment
Scene from the Casa di Lupanare piccolo in Pompeii, fresco, first century CE. Image via wikimedia commons.

Scene from the Casa di Lupanare piccolo in Pompeii, fresco, first century CE. Image via wikimedia commons.

“Implausible explanations of things that don’t happen”: Galen on Sabinus on first times

Humboldt-Universität zu Berlin
May 21, 2021 by Sean Coughlin in Ancient Medicine

Galen talks about ancient readings, his critics, the difference between conversational and written commentary, and why he sometimes feels he has to write as much as he does.

He’s arguing against a reading of Hippocrates by Sabinus. Now Sabinus is a Hippocratic commentator, roughly contemporary with Galen, maybe a generation or two before. Galen sometimes refers to him directly, sometimes he refers to his circle. It’s not clear whether there’s anything to this. Galen thinks Sabinus’ commentaries, along with those of Rufus of Ephesus and Numisianus, are worth reading—high praise from Galen—, but here he takes issue with his comments on an aphorism about sex and gassy bellies. I’m not sure I’ve totally understood what Galen is saying about why Sabinus thinks the passage is about people just starting to have sex, but Galen thinks this is wrong. It’s not impossible that Hippocrates wrote what Sabinus thinks, however, and so Galen needs to defend his reading in another way, namely by appealing to experience. What Sabinus attributes to Hippocrates never happens, at least according to Galen, and since it doesn’t happen, it’s not something Hippocrates is likely to have said.

Thanks to David and Peter for help with the translation.

Here’s the aphorism as recorded in Wenkebach’s text (it’s different from Littré and Smith, which I also inlcude):

“For some, the belly becomes gassy when they have sex, like Damnagoras; for others, a noise in them, like Arcesilaus.”

Οἷσιν, ὅταν ἀφροδισιάζωσι, φυσᾶται ἡ γαστὴρ ὡς Δαμναγόρᾳ, οἷσι δ' ἐν τούτοισι ψόφος <ὡς> Ἀρκεσιλάῳ.

Epidemics 6.3.12 (136,11–13 Wenkebach-Pfaff)

6.3.5 (3.5 V 294,7–8 Littré) οἷσιν, ὅταν ἀφροδισιάζωσι, φυσᾶται ἡ γαστὴρ, ὡς Δαμναγόρᾳ· οἷσι δ' ἐν τούτῳ ψόφος, Ἀρκεσιλάῳ δὲ καὶ ᾤδεεν. Τὸ φυσῶδες ξυναίτιον τοῖσι πιτυρώδεσι, καὶ γάρ εἰσι φυσώδεες.

6.3.5 (236,18–21 Smith) ἔστιν οἷσιν ὅταν ἀφροδισιάζωσι φυσᾶται ἡ γαστὴρ, ὡς Δαμναγόρᾳ, οἷσι δ' ἐν τούτῳ ψόφος. Ἀρκεσιλάῳ δὲ καὶ ᾤδει. τὸ φυσῶδες ξυναίτιον τοῖσι πτερυγώδεσι, καὶ γάρ εἰσι φυσώδεις.

And here is Galen’s commentary:

‘Different people write the passage in different ways, and some add to it the phrase “when they begin”, leaving out the “for some” at the beginning and composing the sentence like this: “when they begin to have sex, the belly becomes gassy”. They want it to say that those who are beginning to have sex, i.e., those who are first trying out this activity, suffer what was indicated in the passage that follows. Now, no ancient book or commentator knows this reading. Nevertheless, Sabinus’ circle says his [i.e. Hippocrates’] account is about those beginning to have sex, even though Hippocrates mentioned one man by name, Damnagoras. This is something he usually does when he goes through something that happens only to a few people. And without anything written about these things by Hippocrates, one should have learned about the phenomenon from experience. For it is not the case that those who are beginning to have sex suffer intestines filled with gas or have a noise contained in them; it is rather that, in rare cases, some of those past their prime and who have the affection called flatulent, hypochondriac and melancholic, more often suffer from intestines filled with gas when they have sex. These same people also have a constant desire for sex.

“Well then, I have said it before many times already: whether I neglect the readings which others have offered in this passage, or whether I talk about them all, there are many people who will find fault with either of them, since they judge the appropriate length of the discussion by their own desires, not the nature of the subject matter. And of course even if I should talk about some things that have been said or written down, and leave out others, even then some of them will blame me because I should have left out some of the things that I discussed since they are clearly frivolous, while I should have discussed some of the things I left out since they are not inferior to what I did discuss. For in our day-to-day intercourse, once we have found out from those present what kind of explanation they want to hear from us, we try to adapt it [sc. the explanation] to their wishes. In a book, however, this is not possible to do. That is why in the majority of passages I generally chose not to mention variants from the ancient reading or interpretations that are altogether unusual. In some cases, however, either when the transmitted text is not altogether implausible *** The readers should keep the commentaries in mind, to mention them in each passage they are burdensome *** [the text is problematic].

‘Sabinus’ circle, then, said that those who attempt sex for the first time suffer what was described in the passage, and assuming this is true, they try to explain the cause of it; but contrary to them, some took [ἐποιήσαντο] this reading of the passage: “it is the case for some that when they have sex, the belly becomes gassy.” Those in Sabinus’ circle say, not without reason, that this happens to those who are beginning to have sex. First, <they say> big and strange changes are happening to the body (for they write like this), and because of these strange changes, epilepsy and nephritis and other chronic conditions affect them. And then <they say> that Democritus said, “man springs from man in sexual intercourse” [DK 32B]. And so for this reason, they say, there is a great deal of irritation since they are unaccustomed to semen and they are affected by the acridity; and in fact the account is common, so they say, to both women and men, and they say the cause in the case of women is clear. For the intestines lie under the womb, while the bladder lies on top of it. It is likely, then, that it holds back the excretion from both when it is stretched and engorged; and so, since the gas is continually stopped up inside, she suffers a build-up of pneuma, and since the urine is stopped, the area around the belly becomes swollen. This, then, is what Sabinus’ circle says, giving implausible explanations of things that do not happen. For these things do not happen to young people when they begin having sex, but to those called melancholic and flatulent, who experience these kinds of things after they are past their prime. For generally being filled with gas occurs because of weakness of the natural heat; when this is strong, none of these things happens.

‘In the Problemata, Aristotle also inquires into the cause on account of which melancholics are sexually excited, and he says they have a lot of gassy pneuma that collects in their hypochondrion, which is why these kinds of affection are called pneumatic and hypochondriac, and both Diocles and Pleistonicus and many other doctors say this is how they are called. It would not be a bad idea to mention a passage from what was written by Aristotle, which goes like this: “Why are melancholics sexually excited? Is it because they are full of pneuma? For semen is an outlet for pneuma. Thus, for this reason when there is much of it, necessarily one often desires to be purged, for then they are relieved” [Problemata 4.30, 880a30-33]. Thus, also for this reason, Rufus chose to write “fear” instead of “noise”, so that Hippocrates’ discussion would be about melancholics, for whom fear is particularly specific. For while their fears are different, there is always some one thing for each of them when they are moderately depressed, otherwise there are two or more, or very many, for some of them even everything. Thus, according to Rufus, the passage will be as follows: “for some, when they have sex, the belly becomes gassy, as for Damnagoras, while for some there is fear in them”; but according to the ancient commentators, it is as it has been written at the start, for I always add their reading, even if it seems to be in error according to the first copyists. For as I have said many times already, once we have said how it was discovered to have been written, we should right away offer some interpretation in addition indicating this very thing. The interpretation of Sabinus’ circle has been discussed.

‘Kapito however wrote it in this way: “It is the case for some, when they have sex, the belly becomes gassy, as for Damnagoras, while for some there is a noise in them.” Dioscorides in this way: “while for some, when they have sex, the belly becomes gassy, as for Damnagoras, for some there is a noise in them.” For he left out the letter delta. Actually, none of the interpreters agree with one another on the interpretation of the word “noise”, some saying it means intestinal rumbling, some belching, some passing gas downwards, some whichever of these is simplest, whatever movement in the intestines is perceptible to hearing, for there are some other motions and “sounds” in the intestines beyond intestinal rumbling, some like echoes, some like hissing or some such manner of noise.

‘“For Arcesilaus, it also used to become swollen.” “For Arcesilaus”, he says, not only did “the belly used to be gassy”, but also “swollen”, i.e., he had an oedema. I have said already many times that he calls all masses that are contrary to nature “oedema”, whether they are inflammatory, erysipelic, or like a hardened swelling; the moderns, however, call only the spongy mass an “oedema”. But just what kind of mass he said Arcesilaus developed is no small inquiry. He seems to me to have meant what is specifically termed such by the moderns. It is implausible that he developed an erysipelas or inflammation or hardened swelling or some other such thing around the time of sexual activities or a little later, and again in addition to not establishing it much. This whole problem has been left out by the commentators. Nevertheless, Hippocrates mentions this Arcesliaus in another place in the book, where he says: “at the onset of this, it is the case that some pass gass, like Arcesilaus.” And so it is clear that for such people the belly is full of gas and that it is caused to be emitted by the tension that arises during sex. Dioscorides wrote the passage in this way: “But for Arcesilaus bad gassiness swelled up” instead of “the gassiness smelled bad”, wanting it to be written in this way, while everyone else begins the second passage with “the gassiness”, as it is written next.’

Καὶ ταύτην τὴν ῥῆσιν ἄλλος ἄλλως γράφει καί τινες προστιθέασιν αὐτῇ τὸ “ὅταν ἄρχωνται”, τὸ κατὰ τὴν ἀρχὴν εἰρημένον «οἷσιν» ἀφαιροῦντες καὶ ποιοῦντες τὴν λέξιν τοιαύτην· “ὅταν ἄρχωνται «ἀφροδισιάζειν, φυσᾶται ἡ γαστήρ»”, βουλόμενοι τοὺς ἀρχομένους ἀφροδισίων, τουτέστι τοὺς πρῶτον ἐπιχειροῦντας τῷ ἔργῳ τούτῳ, πάσχειν τὰ διὰ τῆς ῥήσεως ἐφεξῆς δηλούμενα. καίτοι τὴν γραφὴν ταύτην οὔτε βιβλίον | τι παλαιὸν οὔτ' ἐξηγητὴς οἶδεν. ἀλλ' ὅμως οἱ περὶ τὸν Σαβῖνον ἐπὶ τῶν ἀρχομένων ἀφροδισιάζειν τὸν λόγον αὐτῷ εἶναί φασι, καίτοι μνημονεύσαντος αὐτονομαστὶ τοῦ Ἱπποκράτους ἑνὸς ἀνθρώπου, τοῦ Δαμναγόρου. τοῦτο δ' εἴωθε ποιεῖν, ὅταν ὀλίγοις τισὶ γινόμενον πρᾶγμα διέρχηται. καὶ χωρὶς δὲ τοῦ γεγράφθαι τι περὶ τούτων Ἱπποκράτει τὸ φαινόμενον ἐχρῆν ἐκ τῆς πείρας μαθεῖν. οὐ γὰρ συμβαίνει τοῖς ἀρχομένοις ἀφροδισίων «ἐμφυσᾶσθαι» τὴν κοιλίαν ἢ «ψόφον» ἴσχειν ἐν αὐτῇ, ἀλλὰ μᾶλλον ἐνίοις ἐν τῷ σπανίῳ τῶν παρακμαζόντων τε καὶ τὸ καλούμενον πάθημα φυσῶδές τε καὶ ὑποχονδριακὸν καὶ μελαγχολικὸν ἐχόντων «ἐμφυσᾶσθαι» συμβαίνει μᾶλλον «τὴν γαστέρα», ὅταν «ἀφροδισίοις» χρήσωνται. τοῖς δ' αὐτοῖς τού<τοις> ὑπάρχει καὶ τὸ συνεχῶς ὀρέγεσθαι μίξεως.

ὅπερ οὖν πολλάκις ἤδη πρόσθεν εἶπον, ἐάν τε παραλείπω τὰς γραφὰς ἃς ἐποιήσαντο κατὰ τήνδε τὴν ῥῆσιν, ἐάν τ' εἴπω πάσας, ἑκατέρῳ μέμψονται πολλοὶ ταῖς ἑαυτῶν ἐπιθυμίαις κρίνοντες τὸ σύμμετρον ἐν τοῖς λόγοις, οὐ τῇ τῶν πραγμάτων φύσει. καὶ μέντοι κἄν | τινα μὲν εἴπω τῶν εἰρημένων τε καὶ γεγραμμένων, τινὰ <δὲ> παραλείπω, καὶ οὕτως ἔσονταί τινες οἱ μεμψάμενοί τινα μὲν τῶν εἰρημένων ὡς ἐχρῆν παραλελεῖφθαι καὶ ταῦτα ληρώδη γε ὄντα, τινὰ δὲ τῶν παραλελειμμένων ὡς ἐχρῆν εἰρῆσθαι μὴ χείρω τῶν εἰρημένων ὄντα. κατὰ μὲν γὰρ τὰς ὁσημέραι γινομένας συνουσίας ὁποίαν τινὰ βούλονται τὴν ἐξήγησιν ἀκούειν οἱ παρόντες, αὐτῶν ἐκείνων πυθόμενοι ἁρμόττεσθαι πειρῶνται ταῖς βουλήσεσιν αὐτῶν. ἐν βιβλίῳ δ' οὐκ ἔστι πρᾶξαι τοῦτο. διόπερ εἱλόμην ἐν μὲν ταῖς πλείσταις τῶν ῥήσεων ἢ μηδ' ὅλως μνημονεύειν τῶν ὑπαλλαττόντων τὴν ἀρχαίαν γραφὴν ἢ παντάπασιν ἀλλοκότως ἐξηγησαμένων. ἐπί τινων δ' ἤτοι τὰ μὴ παντάπασιν ἀπιθάνως εἰρημένα *** μεμνῆσθαι χρὴ τοὺς ἀναγινώσκοντας τὰ ὑπομνήματα καθ' ἑκάστην <γὰρ> τὴν ῥῆσιν ἀναμιμνῄσκειν αὐτῶν ἐπαχθές.

ὅπερ οὖν ἔλεγον οἱ μὲν περὶ τὸν Σαβῖνον ὡς τοῖς πρῴην τῶν ἀφροδισίων πειρωμένοις συμβαίνει τὰ κατὰ τὴν ῥῆσιν εἰρημένα πάσχειν, ὡς ἀληθὲς ὑποθέμενοι πειρῶνται λέγειν τὴν αἰτίαν αὐτοῦ. τινὲς δ' | ἔμπαλιν τοῖσδε τὴν γραφὴν τῆς λέξεως ἐποιήσαντο τοιάνδε· “εἰσὶν «οἷσιν, ὅταν ἀφροδισιάζωσι, φυσᾶται ἡ γαστήρ».” οἱ μὲν περὶ τὸν Σαβῖνον οὐκ ἀλόγως φασὶ τοῖς ἀφροδισιάζειν ἀρχομένοις τοῦτο συμβαίνειν· πρῶτον μὲν ὅτι μέγας ὁ ξενισμὸς γίνεται περὶ τὸ σῶμα (γράφουσι γὰρ οὕτως αὐτοί), δι' ὃν ξενισμόν φασιν ἐπιληψίαν τε καὶ νεφρίτιδας αὐτοῖς ἕτερά τε χρόνια γίνεσθαι· ἔπειτα δὲ καὶ ὅτι <Δημόκριτος> εἶπεν “ἄνθρωπον ἐξ ἀνθρώπου ἐν ταῖς συνουσίαις ἐκθόρνυσθαι”. καὶ μέντοι καὶ διότι φασὶ πολὺν ὀδαξησμὸν διὰ τὴν ἀήθειαν τοῦ θοροῦ καὶ τὴν δριμύτητα πάσχουσι, καὶ κοινοῦ γε, ὡς λέγουσιν, ὄντος τοῦ λόγου θηλειῶν τε καὶ ἀρρένων, ἐπὶ θηλειῶν φασι σαφῆ τὴν αἰτίαν εἶναι· τῇ γὰρ ὑστέρᾳ τὸ μὲν ἔντερον ὑπεστόρεσται , ἡ κύστις δ' ἐπίκειται· εἰκὸς οὖν ἐντεινομένην αὐτὴν καὶ σφριγῶσαν ἐπέχειν τὴν ἀμφοτέρων ἀπόκρισιν· ἐναπολαμβανομένης οὖν τῆς φύσης συνεχῶς ἐμπνευματοῦσθαι καὶ τοῦ οὔρου δὲ κατεχομένου τὸ ἐπιγάστριον οἰδεῖν. ταῦτα μὲν οὖν οἱ περὶ τὸν Σαβῖνον λέγουσιν, ἀπιθάνους αἰτίας ἀποδιδόντες τῶν μὴ γινομένων. οὐ γὰρ συμβαίνει ταῦτα τοῖς ἀρχομένοις ἀφροδισίων μειρακίοις, ἀλλὰ τοῖς μελαγχολικοῖς καὶ φυσώδεσιν ὀνομαζομένοις, οἳ καὶ μετὰ τὴν παρακμαστικὴν ἡλικίαν τὰ τοιαῦτα πάσχουσιν. ὅλως γὰρ τὸ φύσης ἐμπίπλασθαι δι' ἀσθένειαν γίνεται τῆς ἐμφύτου θερμάσιας. ἐρρωμένης γὰρ ταύτης τῶν τοιούτων οὐδὲν συμβαίνει.

Ἀριστοτέλης δ' ἐν τοῖς Προβλήμασι καὶ τὴν αἰτίαν ζητεῖ, δι' ἣν ἀφροδισιαστικοὺς συμβαίνει γίνεσθαι τοὺς μελαγχολικούς, ἀθροίζεσθαί τε πνεῦμά φησιν αὐτοῖς ἐν ὑποχονδρίοις φυσῶδες οὐκ ὀλίγον, διὸ πνευματώδη τε καὶ ὑποχονδριακὰ προσαγορεύεσθαι τὰ τοιαῦτα πάθη, καὶ <Διοκλῆς> δὲ καὶ <Πλειστόνικος> ἕτεροί τε πολλοὶ τῶν ἰατρῶν οὕτως ὀνομάζεσθαί φασιν αὐτά. οὐ χεῖρον δὲ καὶ λέξιν τινὰ τῶν τῷ Ἀριστοτέλει γεγραμμένων εἰπεῖν ἔχουσαν ὧδε· “διὰ τί οἱ μελαγχολικοί <εἰσιν> ἀφροδισιαστικοί; ἢ ὅτι πνευματώδεις. τὸ γὰρ σπέρμα πνεύματος ἔξοδός ἐστι. διότι οὖν πολὺ τὸ τοιοῦτον, ἀνάγκη πολλάκις ἐπιθυμεῖν καθαίρεσθαι, κουφίζονται γάρ.” διὰ τοῦτ' οὖν καὶ Ῥοῦφος [ἔλεγεν] ἀντὶ τοῦ «ψόφος» εἵλετο γρά|φειν “φόβος”, ἵνα ὁ λόγος ᾖ τῷ Ἱπποκράτει περὶ τῶν μελαγχολικῶν, οἷς ἐστιν ἰδιαίτατος ὁ φόβος· ἄλλῳ μὲν γὰρ ἄλλο φοβερόν, ἓν γοῦν τι πάντως καθ' ἕκαστον αὐτῶν, ὅταν γε τὰ μέτρια δυσθυμῶσιν, εἰ δὲ μή, καὶ δύο καὶ πλείω καὶ πάνυ πολλὰ καί τισιν αὐτῶν ἅπαντα. γενήσεται <δ'> οὖν κατὰ μὲν τὸν <Ῥοῦφον> ἡ λέξις οὕτως ἔχουσα· «οἷσιν, ὅταν ἀφροδισιάζωσι, φυσᾶται ἡ γαστήρ, ὡς Δαμναγόρᾳ, οἷσι δ' ἐν τούτοις ὁ φόβος»· κατὰ δὲ τοὺς παλαιοὺς ἐξηγητάς, ὡς ἐν ἀρχῇ γέγραπται, τὴν γὰρ ἐκείνων γραφὴν ἀεὶ προστίθημι, κἂν ἡμαρτῆσθαι δοκῇ κατὰ τοὺς πρώτους ἀντιγραψαμένους. ἄμεινον γάρ, ὡς εἶπον ἤδη πολλάκις, ὅπως εὑρέθη γεγραμμένον εἰπόντας, οὕτως ἤδη προσεπινοεῖν αὐτούς τι δηλοῦντας αὐτὸ τοῦτο. λέλεκται δὲ καὶ ἡ <τῶν> περὶ τὸν Σαβῖνον ἐξήγησις [τε].

Καπίτων δὲ οὕτως ἔγραψεν· ἔστιν «οἷς, ὅταν ἀφροδισιάζωσι, φυσᾶται ἡ γαστήρ, ὡς Δαμναγόρᾳ, οἷσι δ' ἐν τούτοισι, ψόφος». Διοσκουρίδης δὲ οὕτως· «οἷσι μὲν, ὅταν | ἀφροδισιάζωσι, φυσᾶται ἡ γαστήρ, ὡς Δαμναγόρᾳ, οἷσιν ἐν τούτοισι ψόφος». ἀφεῖλε γὰρ οὗτος τὸ δέλτα. οὐ μὴν οὐδὲ κατὰ τὴν ἐξήγησιν τοῦ «ψόφος» ὀνόματος ὡμολόγησαν ἀλλήλοις οἱ ἐξηγηταί, τινὲς μὲν βορβορυγμὸν δηλοῦσθαι λέγοντες, ἔνιοι δ' ἐρυγήν, ἔνιοι δὲ τὰς κάτω διεξιούσας φύσας, ἔνιοι δ' ὅ τι ἂν ᾖ τούτων ἁπλῶς, ἡτισοῦν ἐν τοῖς ἐντέροις κίνησις αἰσθητὴ ταῖς ἀκοαῖς, εἰσὶ γὰρ καὶ ἄλλαι τινὲς ἔξωθεν τῶν βορβορυγμῶν ἐν τοῖς ἐντέροις κινήσεις τε καὶ «ψόφοι», τινὲς μὲν ἤχοις ἐοικότες, τινὲς δὲ συριγμοῖς ἤ τινι τοιουτοτρόπῳ ψόφῳ

Ἀρκεσιλάῳ δὲ <καὶ ᾤδεε. Ἀρκεσιλάῳ>, φησίν, οὐ μόνον «ἐφυσᾶτο ἡ γαστήρ», ἀλλὰ καὶ «ᾤδει», τουτέστιν οἴδημα εἶχεν. εἴρηκα δὲ ἤδη πολλάκις οἴδημα καλεῖν αὐτὸν ἅπαντα τὸν παρὰ φύσιν ὄγκον, εἴτε φλεγμονώδης εἴτ' ἐρυσιπελατώδης εἴτε σκιρρώδης εἴη, τῶν νεωτέρων μόνον τὸν χαῦνον ὄγκον οἴδημα καλούντων. ἀλλά γε ποῖόν τινα λέγει τὸν ὄγκον γενέσθαι τῷ Ἀρκεσιλάῳ, ζήτημά ἐστιν οὐ μικρόν. ἐμοὶ μὲν οὖν δοκεῖ τὸν ἰδίως ὑπὸ τῶν νεωτέρων ὀνομαζόμενον εἰρη|κέναι. [οὐκ] ἔστι δ' ἀπίθανον ἐρυσίπελας ἢ φλεγμονὴν ἢ σκίρρον ἤ τι τῶν τοιούτων <αὐτῷ> γενέσθαι περὶ τὸν τῶν ἀφροδισίων καιρὸν ἢ σμικρὸν ὕστερον, αὖθίς τε μετ' οὐ πολὺ καθίστασθαι τοῦτο. τοῖς δ' ἐξηγηταῖς ὅλον τοῦτο παραλέλειπται τὸ σκέμμα. τοῦ μέντοι Ἀρκεσιλάου τούτου καὶ καθ' ἕτερον τόπον τοῦ βιβλίου μέμνηται ὁ Ἱπποκράτης, ἔνθα φησίν· “ἐν τῇσι προσόδοισιν <ἔστιν> οἳ <ἀπο->ψοφοῦσιν, ὡς Ἀρκεσίλαος.” εὔδηλον οὖν ὅτι τοῖς τοιούτοις φύσης ἐστὶν ἡ γαστὴρ μεστὴ καὶ ταύτην ὑπὸ τῆς γινομένης συντονίας ἐν τοῖς ἀφροδισίοις ἐκκρίνεσθαι συμβαίνει. Διοσκουρίδης δὲ οὕτως ἔγραψε τὴν ῥῆσιν· “Ἀρκεσιλάῳ δὲ κακὸν ὤδει τὸ φυσῶδες”, ἀντὶ τοῦ “κακὸν ὤζετο τὸ φυσῶδες”, ὡδὶ γεγράφθαι βουλόμενος, οἱ δ' ἄλλοι πάντες ἀρχὴν τῆς δευτέρας ῥήσεως ἐποιήσαντο “τὸ φυσῶδες”, ὡς ἐφεξῆς γέγραπται.

Galen, Commentary on Epidemics 6.3.12, 17B.25–32 K. = 136,11–140,23 Wenkebach-Pfaff

***Wenkebach or Pfaff notes the Arabic translation in the apparatus, which they translated into German:

Ich habe bei einigen Reden erwähnt, was nicht sehr weit vom Unbefriedigenden ist, oder was gesagt wurde, wie es sich nicht gehört, aber doch unverdienterweise gelobt wurde.

“In a few discussions, I have mentioned what was not very far from being unsatisfactory, or what was said in a way that was inappropriate, but undeservedly praised.”

The first part seems to translate “ἐπί τινων δ' ἤτοι τὰ μὴ παντάπασιν ἀπιθάνως εἰρημένα […]” = “in a few discussions, <I have> mentioned what was not very far from being unsatisfactory.” The next part is anyone’s guess, but it probably continued the second disjunct ἢ and a finite verb. Then a new sentence and a question whether μεμνῆσθαι goes with χρὴ or not. μεμνῆσθαι χρὴ τοὺς ἀναγινώσκοντας τὰ ὑπομνήματα, καθ' ἑκάστην <γὰρ> τὴν ῥῆσιν ἀναμιμνῄσκειν αὐτῶν ἐπαχθές or μεμνῆσθαι. χρὴ […] ἀναμιμνῄσκειν. If we try the latter and take out Wenkebach’s “γὰρ”, we have: χρὴ <δὲ?> τοὺς ἀναγινώσκοντας τὰ ὑπομνήματα καθ' ἑκάστην τὴν ῥῆσιν ἀναμιμνῄσκειν αὐτῶν ἐπαχθές. This isn’t totally intelligible, and says something like “it is necessary that those who read commentaries in each passage remember them nuisances.” This obviously isn’t right—I have no idea what to do with ἐπαχθές and I’m not sure if καθ' ἑκάστην τὴν ῥῆσιν goes with ὑπομνήματα or ἀναμιμνῄσκειν. I would like it if the passage says what Wenkebach wants it to say (or what I think he wants it to say), something like “it is necessary for the readers to keep the commentaries in mind, for to recall them in each passage would be burdensome”, but I can’t see how this would work. “Nuisance” (ἐπαχθές) seems to modify “the commentaries” (τὰ ὑπομνήματα)—I can’t see what else it might be doing.

May 21, 2021 /Sean Coughlin
Galen, Hippocratic Commentary, Sabinus, sex, Democritus, Epidemics
Ancient Medicine
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