Hippocrates

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Hippocrates of Kos
A conventionalized image in a Roman "portrait" bust (19th-century engraving)
Bornc. 460 BC
Diedc. 370 BC
(aged approximately 90)
Larissa, Ancient Greece
OccupationPhysician
EraClassical Greece

Hippocrates of Kos (/hɪˈpɒkrətz/; Greek: Ἱπποκράτης ὁ Κῷος, translit. Hippokrátēs ho Kôios; c. 460 – c. 370 BC), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of medicine. He is traditionally referred to as the "Father of Medicine" in recognition of his lasting contributions to the field, such as the use of prognosis and clinical observation, the systematic categorization of diseases, or the formulation of humoral theory. The Hippocratic school of medicine revolutionized ancient Greek medicine, establishing it as a discipline distinct from other fields with which it had traditionally been associated (theurgy and philosophy), thus establishing medicine as a profession.[1][2]

However, the achievements of the writers of the

clinical medicine, summing up the medical knowledge of previous schools, and prescribing practices for physicians through the Hippocratic Corpus and other works.[1][3]

Biography

Artaxerxes, who was asking for his services. Painted by Girodet, 1792.[4]

Historians agree that Hippocrates was born around the year 460 BC on the Greek island of Kos; other biographical information, however, is likely to be untrue.[5]

Soranus of Ephesus, a 2nd-century Greek physician,[6] was Hippocrates' first biographer and is the source of most personal information about him. Later biographies are in the Suda of the 10th century AD, and in the works of John Tzetzes, which date from the 12th century AD.[1][7] Hippocrates is mentioned in passing in the writings of two contemporaries: in Plato's dialogues Protagoras and Phaedrus,[8] and in Aristotle's Politics, all of which date from the 4th century BC.[9]

Soranus wrote that Hippocrates' father was

Hippocrates (Hippocrates III and IV).[10][11]

Soranus said that Hippocrates learned medicine from his father and grandfather (

Asclepiad";[12][13] while in Phaedrus, Plato suggests that "Hippocrates the Asclepiad" thought that a complete knowledge of the nature of the body was necessary for medicine.[14] Hippocrates taught and practiced medicine throughout his life, traveling at least as far as Thessaly, Thrace, and the Sea of Marmara. Several different accounts of his death exist. He died, probably in Larissa, at the age of 83, 85 or 90, though some say he lived to be well over 100.[11]

Hippocratic theory

It is thus with regard to the disease called Sacred: it appears to me to be nowise more divine nor more sacred than other diseases, but has a natural cause from the originates like other affections. Men regard its nature and cause as divine from ignorance and wonder....

— Hippocrates, On the Sacred Disease

Hippocrates is credited as the first person to believe that diseases were caused naturally, not because of superstition and gods.

environmental factors, diet, and living habits. There is not a single mention of a mystical illness in the entirety of the Hippocratic Corpus. However, Hippocrates did hold many convictions that were based on incorrect anatomy and physiology, such as Humorism.[16][17][18]

Ancient Greek schools of medicine were split into the Knidian and Koan on how to deal with disease. The Knidian school of medicine focused on diagnosis. Medicine at the time of Hippocrates knew almost nothing of human anatomy and physiology because of the Greek taboo forbidding the dissection of humans. The Knidian school consequently failed to distinguish when one disease caused many possible series of symptoms.[19] The Hippocratic school or Koan school achieved greater success by applying general diagnoses and passive treatments. Its focus was on patient care and prognosis, not diagnosis. It could effectively treat diseases and allowed for a great development in clinical practice.[20][21]

Hippocratic medicine and its philosophy are far removed from modern medicine, in which the physician focuses on specific diagnosis and specialized treatment, both of which were espoused by the Knidian school. This shift in medical thought since Hippocrates' day has generated serious criticism of their denunciations; for example, the French doctor M. S. Houdart called the Hippocratic treatment a "meditation upon death".[22]

If you want to learn about the health of a population, look at the air they breathe, the water they drink, and the places where they live.[23][24]

— Hippocrates, 5th century BC

Analogies have been drawn between Thucydides' historical method and the Hippocratic method, in particular the notion of "human nature" as a way of explaining foreseeable repetitions for future usefulness, for other times or for other cases.[25]

Crisis

Asklepieion on Kos

An important concept in Hippocratic medicine was that of a crisis, a point in the progression of disease at which either the illness would begin to triumph and the patient would succumb to death, or the opposite would occur and natural processes would make the patient recover. After a crisis, a relapse might follow, and then another deciding crisis. According to this doctrine, crises tend to occur on critical days, which were supposed to be a fixed time after the contraction of a disease. If a crisis occurred on a day far from a critical day, a relapse might be expected. Galen believed that this idea originated with Hippocrates, though it is possible that it predated him.[26]

Illustration of a Hippocratic bench, date unknown

Hippocratic medicine was humble and passive. The therapeutic approach was based on "the healing power of nature" ("

four humours and heal itself (physis).[27] Hippocratic therapy focused on simply easing this natural process. To this end, Hippocrates believed "rest and immobilization [were] of capital importance".[28] In general, the Hippocratic medicine was very kind to the patient; treatment was gentle, and emphasized keeping the patient clean and sterile. For example, only clean water or wine were ever used on wounds, though "dry" treatment was preferable. Soothing balms were sometimes employed.[29]

Hippocrates was reluctant to administer drugs and engage in specialized treatment that might prove to be wrongly chosen; generalized therapy followed a generalized diagnosis.[29][30] Some of the generalized treatments he prescribed are fasting and the consumption of a mix of honey and vinegar. Hippocrates once said that "to eat when you are sick, is to feed your sickness". However, potent drugs were used on certain occasions.[31] This passive approach was very successful in treating relatively simple ailments such as broken bones, which required traction to stretch the skeletal system and relieve pressure on the injured area. The Hippocratic bench and other devices were used to this end.[32]

In Hippocrates' time it was thought that fever was a disease in and of itself.[33] Hippocrates treated patients with fever by starving them out,[34] believing that 'starving' the fever was a way to neutralize the disease.[35] He may therefore have been the originator of the idea "Feed a cold, starve a fever".[36]

One of the strengths of Hippocratic medicine was its emphasis on prognosis. At Hippocrates' time, medicinal therapy was quite immature, and often the best thing that physicians could do was to evaluate an illness and predict its likely progression based upon data collected in detailed case histories.[18][37]

Professionalism

A number of ancient Greek surgical tools. On the left is a trephine; on the right, a set of scalpels. Hippocratic medicine made good use of these tools.[38]

Hippocratic medicine was notable for its strict professionalism, discipline, and rigorous practice.

fingernails to a precise length.[41]

The Hippocratic School gave importance to the clinical doctrines of observation and documentation. These doctrines dictate that physicians record their findings and their medicinal methods in a very clear and objective manner, so that these records may be passed down and employed by other physicians.[11] Hippocrates made careful, regular note of many symptoms including complexion, pulse, fever, pains, movement, and excretions.[37] He is said to have measured a patient's pulse when taking a case history to discover whether the patient was lying.[42] Hippocrates extended clinical observations into family history and environment.[43] "To him medicine owes the art of clinical inspection and observation."[18]

Direct contributions to medicine

Eisenmenger's syndrome
; first described by Hippocrates, clubbing is also known as "Hippocratic fingers".
A woodcut of the reduction of a dislocated shoulder with a Hippocratic device

Hippocrates and his followers were first to describe many diseases and medical conditions.

Falstaff's death in Act II, Scene iii. of Henry V.[46][47]

Hippocrates began to categorize illnesses as

chest surgeon and his findings and techniques, while crude, such as the use of lead pipes to drain chest wall abscess, are still valid.[49]

The Hippocratic school of medicine described well the ailments of the human

speculum, a common medical device, are discussed in the Hippocratic Corpus.[51] This constitutes the earliest recorded reference to endoscopy.[54][55] Hippocrates often used lifestyle modifications such as diet and exercise to treat diseases such as diabetes, what is today called lifestyle medicine
.

Two popular but likely misquoted attributions to Hippocrates are "Let food be your medicine, and medicine be your food" and "Walking is man's best medicine".[56] Both appear to be misquotations, and their exact origins remain unknown.[57][58]

In 2017, researchers claimed that, while conducting restorations on the

South Sinai, they found a manuscript which contains a medical recipe of Hippocrates. The manuscript also contains three recipes with pictures of herbs that were created by an anonymous scribe.[59]

Hippocratic Corpus

Byzantine manuscript of the Oath in the form of a cross

The Hippocratic Corpus (Latin: Corpus Hippocraticum) is a collection of around seventy early medical works collected in

Ionic Greek. The question of whether Hippocrates himself was the author of any of the treatises in the corpus has not been conclusively answered,[61] but modern debate revolves around only a few of the treatises seen as potentially authored by him. Because of the variety of subjects, writing styles and apparent date of construction, the Hippocratic Corpus could not have been written by one person (Ermerins numbers the authors at nineteen).[31] The corpus came to be known by his name because of his fame, possibly all medical works were classified under 'Hippocrates' by a librarian in Alexandria.[12][40][62] The volumes were probably produced by his students and followers.[63]

The Hippocratic Corpus contains textbooks, lectures, research, notes and philosophical essays on various subjects in medicine, in no particular order.[61][64] These works were written for different audiences, both specialists and laymen, and were sometimes written from opposing viewpoints; significant contradictions can be found between works in the Corpus.[65] Among the treatises of the Corpus are The Hippocratic Oath; The Book of Prognostics; On Regimen in Acute Diseases; Aphorisms; On Airs, Waters and Places; Instruments of Reduction; On The Sacred Disease; etc.[31]

Hippocratic Oath

The Hippocratic Oath, a seminal document on the ethics of medical practice, was attributed to Hippocrates in antiquity although new information shows it may have been written after his death. This is probably the most famous document of the Hippocratic Corpus. Recently, the authenticity of the document's author has come under scrutiny. While the Oath is rarely used in its original form today, it serves as a foundation for other, similar oaths and laws that define good medical practice and morals.[66] Such derivatives are regularly taken by modern medical graduates about to enter medical practice.[12][67][68]

Legacy

Mural painting showing Galen and Hippocrates. 12th century; Anagni, Italy

Although Hippocrates neither founded the school of medicine named after him, nor wrote most of the treatises attributed to him, he is traditionally regarded as the "Father of Medicine".

Fielding Garrison.[71]

After Hippocrates, another significant physician was

European Renaissance, Hippocratic methods were revived in western Europe and even further expanded in the 19th century. Notable among those who employed Hippocrates' rigorous clinical techniques were Thomas Sydenham, William Heberden, Jean-Martin Charcot and William Osler. Henri Huchard, a French physician, said that these revivals make up "the whole history of internal medicine."[75]

Image

Engraving: bust of Hippocrates by Paulus Pontius after Peter Paul Rubens, 1638

According to Aristotle's testimony, Hippocrates was known as "The Great Hippocrates".[76] Concerning his disposition, Hippocrates was first portrayed as a "kind, dignified, old country doctor" and later as "stern and forbidding".[12] He is certainly considered wise, of very great intellect and especially as very practical. Francis Adams describes him as "strictly the physician of experience and common sense."[19]

His image as the wise, old doctor is reinforced by busts of him, which wear large beards on a wrinkled face. Many physicians of the time wore their hair in the style of

Fielding Garrison, an authority on medical history, stated, "He is, above all, the exemplar of that flexible, critical, well-poised attitude of mind, ever on the lookout for sources of error, which is the very essence of the scientific spirit."[75] "His figure... stands for all time as that of the ideal physician," according to A Short History of Medicine, inspiring the medical profession since his death.[77]

Legends

The Travels of Sir John Mandeville reports (incorrectly) that Hippocrates was the ruler of the islands of "Kos and Lango" [sic], and recounts a legend about Hippocrates' daughter. She was transformed into a hundred-foot long dragon by the goddess Diana, and is the "lady of the manor" of an old castle. She emerges three times a year, and will be turned back into a woman if a knight kisses her, making the knight into her consort and ruler of the islands. Various knights try, but flee when they see the hideous dragon; they die soon thereafter. This is a version of the legend of Melusine.[78]

Namesakes

Statue of Hippocrates in front of the Mayne Medical School in Brisbane

Some clinical symptoms and signs have been named after Hippocrates as he is believed to be the first person to describe them.

Hippocratic face is the change produced in the countenance by death, or long sickness, excessive evacuations, excessive hunger, and the like. Clubbing, a deformity of the fingers and fingernails, is also known as Hippocratic fingers. Hippocratic succussion is the internal splashing noise of hydropneumothorax or pyopneumothorax. Hippocratic bench (a device which uses tension to aid in setting bones) and Hippocratic cap-shaped bandage are two devices named after Hippocrates.[79] Hippocratic Corpus and Hippocratic Oath are also his namesakes. Risus sardonicus, a sustained spasming of the face muscles may also be termed the Hippocratic Smile. The most severe form of hair loss and baldness is called the Hippocratic form.[80]

In the modern age, a lunar crater has been named Hippocrates. The Hippocratic Museum, a museum on the Greek island of Kos is dedicated to him. The Hippocrates Project is a program of the New York University Medical Center to enhance education through use of technology. Project Hippocrates (an acronym of "HIgh PerfOrmance Computing for Robot-AssisTEd Surgery") is an effort of the Carnegie Mellon School of Computer Science and Shadyside Medical Center, "to develop advanced planning, simulation, and execution technologies for the next generation of computer-assisted surgical robots."[81] Both the Canadian Hippocratic Registry and American Hippocratic Registry are organizations of physicians who uphold the principles of the original Hippocratic Oath as inviolable through changing social times.

Genealogy

Hippocrates' legendary genealogy traces his paternal heritage directly to Asklepius and his maternal ancestry to

Chiliades, the ahnentafel of Hippocrates II is:[82]

Asklepius
in the middle, 2nd–3rd century

1. Hippocrates II.
2. Heraclides
4. Hippocrates I.
8. Gnosidicus
16. Nebrus
32. Sostratus III.
64. Theodorus II.
128. Sostratus, II.
256. Thedorus
512. Cleomyttades
1024. Crisamis
2048. Dardanus
4096. Sostratus
8192. Hippolochus
16384.
Podalirius
32768.

Asklepius

See also

Notes

  1. ^ a b c Garrison 1966, pp. 92–93
  2. ^ Nuland 1988, p. 5
  3. ^ Garrison 1966, p. 96
  4. ^ Pinault 1992, p. 79
  5. ^ Nuland 1988, p. 4
  6. ^ Britannica Concise Encyclopedia 2006
  7. ^ Nuland 1988, p. 7
  8. ^ Jones 1868, p. 28
  9. ^ Aristotle, Politics VII. 1326a.
  10. ^ Adams 1891, p. 19
  11. ^ a b c Margotta 1968, p. 66
  12. ^ a b c d e Martí-Ibáñez 1961, pp. 86–87
  13. ^ Plato 380 B.C.
  14. ^ Plato 360 B.C. 270c
  15. ^ a b Adams 1891, p. 4
  16. ^ a b Jones 1868, p. 11
  17. ^ a b Nuland 1988, pp. 8–9
  18. ^ a b c d Garrison 1966, pp. 93–94
  19. ^ a b Adams 1891, p. 15
  20. ^ Margotta 1968, p. 67
  21. ^ Leff & Leff 1956, p. 51
  22. ^ Jones 1868, pp. 12–13
  23. ^ "Environment & Health - Kids Environment Kids Health NIEHS".
  24. ^ "Environmental Health - Geological Survey Ireland".
  25. ^ "L'influence de la médecine hippocratique sur la Guerre du Péloponnèse de Thucydide". www.academia.edu. Retrieved 2019-04-18.
  26. ^ Jones 1868, pp. 46, 48, 59
  27. ^ Garrison 1966, p. 99
  28. ^ a b Margotta 1968, p. 73
  29. ^ a b Garrison 1966, p. 98
  30. ^ Singer & Underwood 1962, p. 35
  31. ^ a b c d Tuke 1911
  32. .
  33. ^ LaFrance, Adrienne (16 September 2015). "A Cultural History of the Fever". The Atlantic. Retrieved 2 March 2023.
  34. . Retrieved 2 March 2023.
  35. . Retrieved 2 March 2023.
  36. . Retrieved 2 March 2023.
  37. ^ a b c Garrison 1966, p. 97
  38. ^ Adams 1891, p. 17
  39. ^ Garrison 1966
  40. ^ a b Margotta 1968, p. 64
  41. ^ Rutkow 1993, pp. 24–25
  42. ^ Martí-Ibáñez 1961, p. 88
  43. ^ Margotta 1968, p. 68
  44. ^ Starr 2017
  45. ^ Schwartz, Richards & Goyal 2006
  46. ^ Singer & Underwood 1962, p. 40
  47. ^ Margotta 1968, p. 70
  48. ^ Martí-Ibáñez 1961, p. 90
  49. ^ a b Major 1965
  50. ^ a b c Jóhannsson 2005, p. 11
  51. ^ a b c Jani 2005, pp. 24–25
  52. ^ Jóhannsson 2005, p. 12
  53. ^ Mann 2002, pp. 1, 173
  54. ^ Shah 2002, p. 645
  55. ^ NCEPOD 2004, p. 4
  56. ^ Chishti 1988, p. 11
  57. ^ Cardenas 2013
  58. ^ King 2020, pp. 105–110
  59. ^ Gibbens 2017
  60. ^ Iniesta 2011, p. d688
  61. ^ a b Singer & Underwood 1962, p. 27
  62. ^ Smith 2002
  63. ^ Hanson 2006
  64. ^ Rutkow 1993, p. 23
  65. ^ Singer & Underwood 1962, p. 28
  66. ^ WMA
  67. ^ Jones 1868, p. 217
  68. ^ Rahman 1966, pp. 56–62
  69. ^ Jouanna 1999, p. 42: "Hippocrates was neither the Father of Medicine nor the founder of the Coan school, but he did manage to confer an exceptionally lustrous reputation upon this school through his teaching". Though antiquated, the traditional title remains in wide use among scholars: see, e.g., Jouanna 1999, pp. xi, xii, 4, 229, 348; King 2008, p. 322; Smith 1998.
  70. ^ a b Garrison 1966, p. 100
  71. ^ Garrison 1966, p. 95
  72. ^ Jones 1868, p. 35
  73. ^ West 2014, pp. L121–L128
  74. ^ Leff & Leff 1956, p. 102
  75. ^ a b Garrison 1966, p. 94
  76. ^ Jones 1868, p. 38
  77. ^ Singer & Underwood 1962, p. 29
  78. ^ Bale 2012, p. 15
  79. ^ Fishchenko & Khimich 1986
  80. ^ "The dilemma of balding solve by father of medicine Hippocrates". Healthy Hair Highlights News. 15 August 2011.
  81. ^ Project Hippocrates 1995
  82. ^ Adams 1891

References

Further reading

External links