Analysis: Requirements for a Physician

Date: c. 320 BCE

Geographic Region: Greece

Author: Hippocrates

Summary Overview

Hippocrates was a Greek physician who is considered the father of Western medicine. The Hippocratic School of Medicine that he founded established medicine as a distinct discipline, separating it from other religious and philosophical studies. In addition, the Hippocratic School is credited with the discovery that diseases are a result of natural causes, not the punishments of angry gods or curses. He encouraged healthy living to prevent disease and attention to environmental dangers that may be contributing factors. He encouraged his students to observe and record the symptoms of their patients and created a natural history of disease. Physicians of Hippocrates's time did not have an accurate understanding of human anatomy and physiology, as there was a strong taboo against dissection, so his methods focused on patient care and outward symptoms of disease. The Hippocratic School worked to professionalize the practice of medicine and taught students the importance of the doctor-patient relationship. In this selection from his teachings, Hippocrates emphasized the importance of the physician's behavior and appearance to earning the trust of his patients and his community.

Defining Moment

Ancient Greeks believed that disease was punishment from the gods and that healing was miraculous. They believed that supernatural factors were at work in the body; curses and blessings were commonly thought to have a physical effect. Sick people would often travel to sacred sites to seek forgiveness from the gods and advice from priests, and monuments thanking gods for healing were common. By the mid-fifth century BCE, informed in part by the treatment of soldiers on the battlefield, medical practitioners in Greece began to look to natural rather than spiritual causes for disease and injury. This new focus on the body encouraged new lines of inquiry: physicians began to examine environmental and lifestyle factors that seemed to contribute to disease, then recorded symptoms and analyzed treatments.

Leading this movement were Hippocrates and his followers. The Hippocratic School produced a library of medical texts, around sixty of which survive and are known as the Hippocratic Corpus. Though these works vary in age and authorship, they are associated with the core teachings of the Hippocrates himself, and provide a detailed view of the Greek medical profession in its earliest years. Hippocratic students paid for their training and entered into a very close relationship with their teachers, binding themselves to a common ethical code by taking the Hippocratic Oath. They were expected to be disciplined, honest, and professional—key factors in the establishment of the physician as a community leader.

In addition to believing that diseases had a natural cause, Hippocrates and his followers believed in the necessity of observing and recording the progression and symptoms of disease and, so, provided the first detailed descriptions of physiological changes associated with major diseases (cloudy eyes, changes in skin color, etc.). They identified stages of disease, noting symptoms critical to each stage and grouping diseases in categories, such as acute or chronic. Because the physical cause of disease was not fully understood (Hippocratic students believed in the theory of humors, involving the balance of various elements in the body), they focused instead on patient care and prognosis, believing that an understanding of how a disease was likely to progress was critical to its treatment. This led to a strict operating code for physicians.

Hippocrates also believed that factors such as diet, temperature, cleanliness, and air quality contributed to the cause and treatment of disease. Efforts to control these factors gave the patient agency in the recovery process for the first time. A healthy body was less susceptible to illness and would be more likely to recover quickly. The role of diet was emphasized, but misunderstood, as Hippocratic texts urged food deprivation while ill. This and many other conclusions drawn by Hippocrates and his followers proved to be erroneous, even dangerous, but the pursuit of natural causes of disease represented a great leap forward in the study of medicine and the treatment of patients.

Author Biography

Hippocrates was born around 460 BCE on the Greek island of Kos, but little is known of his early life. A later biographer wrote that he was the son of a physician, and his earliest students were his own children. According to some sources, Hippocrates learned medicine from his father and grandfather and studied philosophy and other subjects with well-known teachers on the island, as well as a physician from Thrace. He travelled widely and may have spent time in Athens before returning to Kos to practice medicine. The school of medical thought that formed around him became well known throughout the Greek world. It continued after his death, and many of the works attributed to him were productions of his later followers. He is believed to have lived into his eighties and died in the Greek city of Larissa.

Document Analysis

Hippocrates's description of an ideal physician should be seen in the context of a teacher who was pioneering a new profession. Though there had been physicians before him, they were often also religious figures, or those thought to have spiritual powers of guidance. Hippocratic physicians do not look for spiritual or supernatural causes for disease and, therefore, lack the traditional authority of religious figures. In addition, Hippocratic medicine teaches the primary importance of the patient in the study of illness. Patients are to be treated as participants in their cure and carefully observed. In order to gain access to information about his patients, the physician needs to be trusted completely by them, their families, and the community at large. This is the primary theme of this selection. Hippocrates instructs physicians to set a good example; be professional in appearance and demeanor; and, above all, be trustworthy.

The opening of this treatise is an admonition to set a good example. A healthy doctor is his own best advertisement, since others will assume he is not a good doctor if he cannot take care of himself. (In ancient Greece, doctors, and all of Hippocrates's students, would have been men.) Weight and complexion are specifically identified as important and should be kept at the “correct natural standard.” A healthy body is only part of the outward presence of an ideal physician, however. He also needed to dress well and smell good, wearing “totally unsuspicious perfume,” which would be pleasant for patients, who presumably would have the doctor very close to them.

In addition to physical attributes, Hippocrates emphasized the importance of demeanor. The physician should be quiet, but above all, self-controlled in all of his life, exuding an air of authority. Such controlled behavior is advised as the best way to establish a strong reputation. The gentlemanly character that the physician promotes should not be aggressive because “people dislike forwardness and interference,” and technical ability must be practiced to ensure patients' desires can be met. Physicians should cultivate a mild manner, reflected in their facial expressions and mannerisms. Excessive grimness is seen as too harsh, while being too cheerful is also discouraged as inappropriate, so a neutral professionalism is preferred.

Hippocrates ends his instructions with a warning to physicians not to abuse the trust that is placed in them by their patients. They will frequently interact with women and girls and should not be tempted into sexual impropriety. They may be called to houses with valuable possessions, and vulnerable patients need to be able to trust that they will not be robbed or abused in any way. The idea of self-control, both physical and psychological, is paramount—physicians must be trustworthy, healthy, and steady leaders in their communities.

Bibliography and Additional Reading

Hippocrates. Delphi Complete Works of Hippocrates. East Sussex, UK: Delphi Classics, 2015. Kindle file.

Jouanna, Jacques. Greek Medicine from Hippocrates to Galen: Selected Papers. Boston: Brill, 2012. Print.

Pinault, Jody Rubin. Hippocratic Lives and Legends. New York: Brill, 1992. Print.