Seeing how plainly the passages just quoted from non-medical Writers point to these swellings being a consequence of paederastia, it is surprising that not one of the Ancient physicians, spite of _Juvenal’s_ _medico ridente_ (the doctor grinning the while), ever so far as we know, alleges this form of licentiousness as cause of affections of the sort. On the other hand we cannot help remarking that the frequency of these swellings in the time of _Martial_ and _Juvenal_ can hardly be explained as arising solely from the general prevalence of paederastia. More probably, then as now, the _Genius epidemicus_ (Epidemic influences) bore no unimportant share in bringing about the result, just as was the case (see later) with _Mentagra_ (Eruption of the chin). However not merely primary affections of the posteriors were the punishment of the _Cinaedus_, but also secondary ones of the _mouth_ and _throat_. First and foremost was hoarseness of the voice, to which _Martial_[277] alludes, when he makes the champion of the baths the _cinaedus_ Charinus speak _raucidulo ore_ (with a weak, hoarse voice). This we find, following Reiske’s[278] indication, more explicitly dealt with in _Dio Chrysostom_[279]:— “But this is surely worth mentioning, and it is a thing no one can deny. I mean the noteworthy fact that a disease has attacked so many in this city,—one which I used to hear of as prevailing much more frequently with others than amongst you. What is it I mean? Even though I could explain myself no more clearly, yet you might easily guess the answer. Do not think I am speaking of secrets, of hidden doings, when the astounding fact itself speaks plainly enough. For there are many in this city that are asleep, even while they walk and stand and speak; though they may appear to most observers to be awake, yet it is not really so. “Now they give, in my opinion, the clearest proof that they are asleep,—they snore (ῥέγχουσιν). I cannot, by heaven, express myself more clearly with decency. True only a few of the sleepers are suffering from the complaint I mean, and of the others it affects only the drunken, the overfed and such as have lain ill. But I maintain this vicious practice (ἔργον) shames the city and brands it publicly. The grossest ignominy is brought down upon their native city by these sleepers by day, and they ought, I say, to have been expelled your borders, as has been their fate everywhere else. For it is not now and then, nor here and there, they are met with; but at all times and in all places in the city occasion may be found to threaten, scorn or deride them. For the rest the practice has actually penetrated now to boys still young, and adults that yet would fain be reputable, suffer themselves to be led away into regarding the matter as a trifle, and if they refrain from the decisive step, yet it was their wish to take it.