Hippocrates

Greek physician

• Born: c. 460 b.c.e.
• Birthplace: Island of Cos, Greece
• Died: c. 370 b.c.e.
• Place of death: Larissa, Thessaly (now in Greece)

Hippocrates is credited with separating the practice of medicine from magic and superstition, inaugurating the modern practice of scientific observation, and setting the guidelines for high standards of ethical medical practice.

Early Life

Hippocrates (hihp-AWK-ruh-teez) was born in Cos; he lived during the period spanning the end of the fifth century and the first half of the fourth century b.c.e., according to two references to him in Plato’s dialogues. Though little else can be thoroughly documented, many legends, possibly true in parts, have been offered by commentators regarding Hippocrates’ early life. According to tradition, he was one of several sons of Praxithea and Heracleides. He probably had the education suitable to one of his background, which would include nine years of physical education, reading, writing, spelling, music, singing, and poetry. After another two years at a gymnasium, where he would have had intensive training in athletics, it is conjectured that Hippocrates studied medicine under his father, a member of the priest-physician group known as Asclepiads. This training was a form of apprenticeship in a medical guild.

In addition to his training, which consisted of following a physician and observing his treatment of patients, Hippocrates is believed to have traveled to the nearby islands of the Aegean Sea, to the Greek mainland, and possibly to Egypt and Libya, to study the local medical traditions. He is thought to have met the philosopher Democritus and the rhetorician Gorgias.

His sons Thessalus and Draco carried on the family tradition of medical practice. As testimony to his fame, legend also has it that King Perdiccas of Macedonia asked Hippocrates and another physician, Euryphon, to examine him and that Hippocrates helped him to recover from his illness.

Hippocrates was equally renowned as a teacher, giving rise to the image of the “Tree of Hippocrates,” beneath which students sat and listened to him. Plato, a younger contemporary, referred to Hippocrates the Asclepiad as the very type of the teacher of medicine. Some historical accounts suggest that Hippocrates habitually covered his head with a felt cap, though the reason for this habit is only a matter of speculation. This description did, however, help twentieth century archaeologists to identify a likeness of him.

Life’s Work

That Hippocrates was a well-known Greek physician who lived in the period of golden achievements in Greek history is undisputed. The rest of his achievements remain a matter of scholarly debate, centered on the problem of Corpus Hippocraticum (fifth to third century b.c.e.; Hippocratic collection), a substantial body of writings whose authorship seems to be spread out over different historical periods.

Thus the medical views expressed in this collection are carefully referred to as the ideas of Hippocratic medicine, acknowledging the complete lack of confirmation about the identity of his actual writings. Of the approximately seventy unsigned treatises that constitute the collection, only two are definitively known to have been written by Hippocrates’ son-in-law, Polybus, because another famous ancient writer, Aristotle, quoted from them.

The normal historical tendency has been to attribute those that are written with authority and good sense and that seem to be of the approximately right time period to Hippocrates and the rest to other authors. The debate over the authorship of the Corpus Hippocraticum itself has produced an enormous body of scholarship; one tentative point of agreement is that the earliest essays are from the fifth century b.c.e. and the latest about two centuries later. To cloud the matter even further, the Hippocratic writings themselves are inconsistent, suggesting that the collection incorporates the thinking of different schools of medical practice.

The collection is historically important precisely because it had more than one purpose: to establish medicine as a practice distinct from philosophy and religion and, in furtherance of this goal, to collect information about this separate discipline in writing for the future edification of patients and physicians. Part of this effort involved debate with other schools of thought, such as the Cnidian school.

The centers of medical teaching were often in the temples of healing known as Asclepieions. The two most famous ones of the time were on Cos and Cnidus, between which there were both a traditional rivalry and a fundamental difference in approach to medical practice. The Cnidus practitioners, under the guidance of the chief physician, Euryphon, seemed to have been much concerned about the classification of diseases and continued the tradition of deductive knowledge of disease derived from the practice of ancient Greece, Babylonia, and Egypt. Hippocrates was of the Coan school, which worked more inductively, concentrating on observation and treatment of the entire patient and taking into account the mental as well as the physical state.

The first important contribution of the Hippocratic writers—to separate medicine from the shackles of religion, superstition, and philosophy—is apparent in the first text of the collection, Peri archaies ietrikes (fifth or fourth century b.c.e.; On Ancient Medicine, 1849), which is a reminder that medicine had previously been very much a matter for philosophical speculation. This essay establishes medicine as a branch of knowledge with its own rational methods and describes a practice that calls for skill and craft and art, one based on observation.

Hippocratic medicine recognized disease as a natural process and further suggested that most acute diseases are self-limited. The symptoms of fever, malaise, and other apparent sicknesses were not considered to be mysterious spiritual symptoms but merely the body’s way of fighting off the poison of infection. Epilepsy, for example, much feared as a mysterious, sacred affliction, is discussed as a medical problem. The focus of Hippocratic medicine was on regulation of diet, meaning not merely nutrition but exercise as well. The adjustment of diet to the physical state of the patient was thus viewed as the original function of medicine, and the importance of the kind of food and its preparation to treat sickness was recognized early.

The Hippocratic writers mention other ideas equally surprising in their modern relevance and influence, such as the notion that great changes, whether in temperature, periods of life, or diet, can lead to illness. Thus the collection of four books titled Peri diaites oxeon (fifth or fourth century b.c.e.; Regimen, in Acute Diseases, 1849) starts with the argument that health is affected by the totality of diet and exercise; the age, strength, and constitution of the individual; the seasonal changes; variations in wind and weather; and the location in which the patient lives. The Hippocratic idea that a local condition must be treated in conjunction with the general condition, the whole constitution (physis) and the complex relations to the environment, is also remarkably similar to the modern notion of holistic healing.

Though many of the other practices and theories have been discarded medically, some were influential for so long that they have been incorporated into the history of Western culture. For example, among the most influential theories set forth in the Hippocratic collection is the idea that the human body is composed of four fluid substances: blood, phlegm, yellow bile, and black bile. Perfect health results from the balance of these fluids in the body. Concomitantly, an excess or deficiency or imperfect mixture results in pain, sickness, and disease. The influence of this theory is apparent in many classics of Western literature, such as the plays of William Shakespeare and Ben Jonson.

Hippocratic medicine was also conservative, seeking primarily to help the sick when it would be beneficial. Medicine was defined by three purposes: It should relieve suffering, reduce the severity of the illness, and finally, abstain from treating that which was beyond the practice of medicine. The physician’s job was to help the natural recovery process with diet and regimen, to be administered only after careful observation of the individual symptoms and the patient’s constitution. The remedies recommended were mild and adapted to the various stages of the disease; drugs were relatively rare. Most important, sudden and violent measures to interrupt the natural course of the disease were forbidden.

The Coan school believed in prognosis, in predicting, from the experience of long and careful observation, the course of the disease and furthermore in telling the patients and their friends, so that they could be mentally prepared for what might follow, even if it were death. This dictum prevented the physician from prescribing ineffective or expensive treatments simply to remain busy; it is thought that the Hippocratic physician would not even undertake the treatment of a hopeless case, though he probably did his best to make the patient as comfortable as possible.

The most important view in the Hippocratic collection—the most important because it is still unchanged over the course of two thousand years—is the clearly expressed concept of the medical profession as it is summed up in the Hippocratic oath. The doctor is defined as a good man, skilled at healing. Perhaps for this definition alone, the man who is thought to have written or inspired the Hippocratic writings has been called the father of medicine, a title that suggests the ideal of the philosopher-physician—similar to the ideal of the philosopher-king—a person with moral character as well as practical skills.

Significance

Hippocrates was a much admired physician whose contemporaries were also giants in their fields: Aeschylus, Sophocles, and Euripides in tragedy; Aristophanes in comedy; Thucydides in history; Pericles in government. Leaving aside the question of authorship of the Hippocratic writings, it is clear why the figure of Hippocrates, for whom the collection is named, is so revered: The keen observations of human behavior and health recorded in these pieces remain fruitful reading.

The Hippocratic writings include a book of more than four hundred aphorisms, pithy observations that have been absorbed, though sometimes in a mutilated form, into the English language, influencing those outside the medical field. The most famous of these, popularly remembered as “Life is short, Art long,” started as

Life is short, whereas the demands of the (medical) profession are unending, the crisis is urgent, experiment dangerous, and decision difficult. But the physician must not only do what is necessary, he must also get the patient, the attendants, and the external factors to work together to the same end.

Others reveal a common sense which has been proven over and over again: “Restricted or strict diets are dangerous; extremes must be avoided”; “People who are excessively overweight (by nature) are far more apt to die suddenly than those of average weight”; “Inebriation removes hunger (for solid foods).”

If much of the rest of the body of medical knowledge represented by Hippocrates has long since been surpassed, its spirit has not. Hippocrates and his colleagues changed the attitude toward disease, freeing medicine from magic and superstition and insisting on the importance of observation over philosophical speculation. The Hippocratic writings established medicine as a separate discipline with a scientific basis, setting down in writing the medical knowledge of the time regarding surgery, prognosis, therapeutics, principles of medical ethics, and relations between physicians and patients, thus laying the foundations and formulating the ideals of modern medicine.

Bibliography

Edelstein, Ludwig. The Hippocratic Oath: Text, Translation, and Interpretation. Baltimore: The Johns Hopkins University Press, 1943. This monograph argues that the Hippocratic oath represented the opinion of a small segment of Greek medical society, was based on Pythagorean principles, and served as a voluntary oath of conscience between teacher and student.

Goldberg, Herbert S. Hippocrates, Father of Medicine. New York: Franklin Watts, 1963. A short, simple overview of the life and work of Hippocrates, his times, and his relevance to modern health practice. Includes index.

Jones, W. H. S., trans. Hippocrates. 4 vols. 1923-1931. Reprint. New York: Putnam, 1995. Among the best English translations and critical editions of Hippocratic writings, this work is part of the Loeb Classical Library edition. Greek texts face their English counterparts.

King, Helen. Hippocrates’ Woman: Reading the Female Body in Ancient Greece. New York: Routledge, 1998. Explores early gynecology as based on ideas about women taken from myths. King argues that doctors twisted ancient Greek texts into ways of controlling women’s behavior.

Levine, Edwin Burton. Hippocrates. New York: Twayne, 1971. Levine introduces the problems of scholarship in identifying authorship of the Hippocratic writings. The discussion focuses on ideas presented in various selected essays. Includes notes, an index, and an extensive annotated bibliography.

Moon, Robert Oswald. Hippocrates and His Successors in Relation to the Philosophy of Their Time. New York: AMS Press, 1979. This work briefly categorizes the philosophies underlying the practice of ancient medicine before and after Hippocrates. Index.

Phillips, E. D. Greek Medicine. New York: St. Martin’s Press, 1973. Phillips traces practical and theoretical achievements of Greek medicine up to Galen. Includes selected references to the Hippocratic collection, an appendix on the cult of Asclepius, illustrations, an extensive bibliography, and indexes.

Temkin, Owsei. Hippocrates in a World of Pagans and Christians. Baltimore: The Johns Hopkins University Press, 1995. Examines the ways in which Hippocratic practice helped establish a relationship between medicine and monotheistic worship.