There are two causes of cardiaca, an internal, and an external. The following are the external causes: excess of heat that comes suddenly, or excess of cold, or excessive weakness of nature, such as excess of sweat; a bath made of rotten wood244 as Galen says, and everything that causes nature to collapse suddenly; coitus superfluus, accidents of the soul, and everything that disperses the heat suddenly from the heart, and drives unnatural heat in suddenly to it. Poison, on being taken, has the same effect, and the bite of a poisonous reptile,245 and everything that weakens the heart and its force; worms, and excess of food and drink; pestilential air, and bad time of plague, intercourse with a woman suffering from lepra, and too much meditation.246