‘Concerning disease, practice two things – to help, or at least to do no harm.’
Hippocrates, Epidemics 1.11
Considered by Seneca to be the ‘father of medicine’, Hippocrates was regarded by many ancient thinkers as the greatest physician of his time. Born on the Greek island of Kos sometime in the middle of the fifth century BCE , he gained near legendary reputation as the author of the Hippocratic Corpus, containing the Hippocratic Oath, a highly influential collection of medical writings which shaped the course of western medicine for over two thousand years.
The Hippocratic Corpus
The collection of texts known today as the Hippocratic Corpus takes the form of around sixty separate ‘books’, the styles of which differ widely throughout the anthology. While some texts seem almost to be lecture notes, detailing a single author’s teachings on a particular topic, others appear more like casebooks in which a doctor records a patient’s changing condition or the recognised symptoms of a known disease. Some are slim documents, only a paragraph in length, whilst others run to several volumes.
Collected together in Alexandria during the third century BCE, the Corpus quickly became the standard reference for medical students throughout the western world with many of its teachings used well into the 19th century.
Although it is impossible to know whether the Corpus really represents the work of a single author, scholars in the Ancient and Early Modern worlds certainly believed it did and the influence Hippocratic medicine has had upon the practice and development of medical science is unparalleled.
Medicine in Ancient Greece
‘Now all our diseases arise either from things inside the body, bile and phlegm, or from things outside it: from exertions and wounds, and from heat that makes it too hot, and cold that makes it too cold.’
Hippocrates, Diseases 1.2
Throughout human history, people have fallen ill and have tried to find both reasons for and ways of alleviating their symptoms. In many early societies, sickness and disease were blamed on the meddling of evil spirits or the wrath of the gods to whom sufferers then made desperate supplications in the hope of eliciting a divine cure.
In contrast to this, the Hippocratic Corpus is unique amongst ancient works for presenting a comprehensive philosophy of medicine centred on a belief that health and disease have physical, rather than divine or supernatural causes.
In Greek society, doctors were considered craftsmen, trained in thetechnê, the art or skill of healing the body. Hippocrates believed it was the duty of the doctor to use this skill to ‘speak the past, diagnose the present [and] predict the future’ (Epidemics 1), a feat achieved by paying careful attention to the smallest changes in those within their care. Observable differences were ascribed to imbalances between the four basic fluids, or humours within the body: yellow bile, black bile, blood and phlegm. Health could be described as the state in which the humours were in equilibrium and the Hippocratic doctor would often let blood or prescribe emetics in order to balance the humours and achieve this effect.
Hippocrates considered good health the natural state of Man. Moreover that health was a state entirely physical in origin and therefore wholly within a knowledgeable physician’s power to effect. He believed diseases had set life-cycles that could be predicted using a doctrine of critical days (see Aphorisms) and that climate, activity and diet could all affect a person’s humoural makeup and therefore health. In one of the most famous and contentious books in the Hippocratic Corpus, On the Sacred Disease, he also argues strongly against putting one’s faith in religious incantations and the quasi-magical rituals of charlatans and quacks.
The Hippocratic Oath
Possibly the most famous part of the Corpus, and certainly one of the most historically influential is the Oath, a pledge designed to be sworn by new doctors in order to govern their conduct. In it, the doctor swears to the healing gods Apollo, Asclepius, Hygieia and Panacea that he will preserve the life of his patients, proscribe medicines and treatments to the best of his knowledge but never poison those within his care nor intentionally set out to harm.
Since the ancient world had no regulation governing the use of the title ‘doctor’; any individual could claim the knowledge required to heal a sickness or wound. The Hippocratic Oath may therefore represent an attempt to form a guild-like association of medical professionals who could be recognised both by their patients and each other in what must have been a crowded and highly competitive medical marketplace.
We do not know whether the Hippocratic Oath was ever widely sworn in antiquity but the spirit contained within its lines is one familiar to us all today as the guiding ethos underlying the responsible use of medicine: a pledge to protect and extend life commonly referred to ‘Hippocratic’.
Liam A. Faulkner
See also Democracy in Athens