Hippocrates

The ancient Greek physician Hippocrates (ca. 460-ca. 377 B.C.), the father of medicine, put a definitive stamp on the whole character of Greek medicine.

Only the barest outline of the biography of Hippocrates emerges from the ancient writings. He was born on the Aegean island of Cos, just off the Ionian coast near Halicarnassus. He is called Hippocrates Asclepiades, "descendant of (the doctor-god) Asclepios, " but whether this descent was by family or merely by his espousing the medical profession is uncertain. His teachers in medicine are said to have been his father, Heracleides, and Herodicos of Selymbria. Hippocrates certainly was known in Athens, for Plato mentions him twice, on each occasion calling him Asclepiades. It is also clear that the height of his career was during the Peloponnesian War (431-404 B.C.).

The lack of knowledge concerning Hippocrates may seem strange in view of the great volume of writings attributed to him, the Corpus Hippocraticum (Hippocratic Corpus), the first known edition of which is from the time of the emperor Hadrian (reigned A.D. 117-138). It is clear, however, that this body of writings contains material of many different kinds and includes differences in standpoint toward medicine. This disparity was recognized even in ancient times, and Alexandrian scholars differed about the authentic Hippocrates, though none rejected every work.

Any notion of the nature of Hippocrates's medical procedure must be based on pre-Alexandrian texts, that is, on texts dating more closely to Hippocrates's lifetime and reflecting an untainted direct tradition. Two excellent sources are Plato's Phaedrus (270C-D) and Meno's account of Hippocrates in his history of medicine. There is sufficient evidence in these works to establish with certainty the main outlines of Hippocratic medicine.

In antiquity, some works in the Hippocratic Corpus were recognized as having been written by persons other than Hippocrates, but acceptance and rejection depended on a number of subjective stances. More modern scholarship has used as its touchstone the genuine doctrine of Hippocrates as found in Plato and Meno. This mode of investigation, while common to all scholars, has not produced general agreement. It is well to point out that neither Plato nor Meno quotes word for word from Hippocrates's works; they seem in fact to summarize him in their own words, which of course have overtones from their own particular philosophy. So although there is a body of doctrine connected with Hippocrates, modern scholars have no inkling of his prose style, against which the Hippocratic Corpus could be tested.

Nowhere in the Hippocratic Corpus is the entire Hippocratic doctrine to be found. However, these numerous works are so multifarious that here and there parts of the doctrine come to light. It is worth noting that, since Plato and Meno discussed the work of Hippocrates, it is reasonable to assume that they had at their disposal medical books written by him. This makes the problem even more intriguing. Hippocrates's fame, though it was at such a height during his lifetime, still could not ensure the preservation of his works.

Hippocratic Corpus

The body of writing attributed to Hippocrates, the Hippocratic Corpus, is a collection of roughly 70 works that show no uniformity in teaching or in prose style. With a few exceptions the dates of these works range between 450 and 350 B.C.; they are the oldest surviving complete medical books. It would be unfair to allege deception as the motive behind attributing the entire collection to Hippocrates; nor was it the result of ignorance and carelessness, since Galen and those before him did not regard every work as genuine. A reasonable hypothesis holds that these works were gathered together to form the basis of the medical library of some school, probably at Alexandria.

An essential orientation to the Corpus is an appreciation of the audience for which the various works were intended. Some books are directed toward the physician, for example, the surgical treatises, Prognostic, Airs Waters Places, Regimen in Acute Disease, Aphorisms and Epidemics i, in which descriptions of symptoms employ sense data, though they surpass mere descriptions. There are books with complicated pharmacy mixtures, and equally complicated preparation and administration, aimed, no doubt, at the professional physician. Other books, however, are directed more at the layman, for example, Regimen in Health, Regimen ii-iv, and Affections, in which the introduction stresses the importance for the layman of understanding something of medical questions.

One must remember that in antiquity doctors wrote treatises for the educated public, who in turn discussed medical problems with their doctors. The aim of these books is not to advise on self-treatment or even first aid, and so to dispense with the need for a doctor; rather, it is to teach the layman how to judge a physician.

The Hippocratic Corpus also contains polemical works. The Sacred Disease attacks superstition, and On Ancient Medicine opposes the intrusion of speculative philosophy into medicine. The latter work also protests against "narrowing down the causes of death and disease." But there are indeed attempts to apply to medicine the speculative method of early Greek philosophy, as in Regimen i and Nutrition. Occasionally there is no carefully written treatise but a series of jottings—research material in notebook form: Humors and Epidemics i-vii.

Experimentation obviously played its role in the Hippocratic view of medicine, because the individual approach to disease as exemplified in the case histories of Epidemics i, though basic and undeveloped, is nothing more than experimentation. It is obvious, too, that first-hand experience, as opposed to theorizing, played a part, since in scattered references throughout the Corpus the botanical ingredients of remedies are described by taste and odor. There are also instances of very rudimentary laboratory-type experiments. The Sacred Disease describes dissections of animals, the results of which permitted analogies to the human body to be drawn. Further, in their attempts to describe the body, the Hippocratics made use of external observation only. In On Ancient Medicine, the internal organs are described as they can be seen or palpated externally. It is most unlikely that dissection of the human body was practiced in the 5th century.

In Epidemics i the patient's comfort is noted as a matter of concern to the physician, because he was given water when thirsty and cooled when feverish. E. A. Ackerknecht, in A Short History of Medicine, summed up: "For better or worse Hippocrates observed sick people, not diseases." This attitude is a timely antidote to those who formerly insisted on the coldly scientific approach of the Hippocratic physician, who seemed to be so callous toward his patient, particularly in the blunt descriptions of the countenance before death in certain diseases, still known as facies hippo-cratica.

The above illustrations are meant to clarify the most fundamental concerns of the Hippocratic physician. Yet a too enthusiastic and uncritical attitude has been attached to the area of medical ethics also. Ludwig Edelstein commented in his important work on the oath (The Hippocratic Oath, 1943) that the high morality and ethics of this document were not true of the 5th century B.C. but were the result of the infusion of philosophical precepts (mainly Pythagorean) of the end of the 4th century B.C. and later. As a result, the ethic of the medical craftsman was renewed to conform with the various systems of philosophy. This was furthermore not an oath taken by all physicians, if in fact it was sworn by any doctor before the end of antiquity; its fame is more modern than that.

Further Reading on Hippocrates

Several Hippocratic treatises are translated in the Loeb Classical Library, Hippocrates (4 vols., 1923-1931). The best treatment of Hippocratic problems is in Oswei Temkin and C. Lilian Temkin, eds., Ancient Medicine: Selected Papers of Ludwig Edelstein (1967). See also William A. Heidel, Hippocratic Medicine: Its Spirit and Method (1941). Background information is in G. E. Lloyd, Early Greek Science: Thales to Aristotle (1971).

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