Misplaced Pages

Hippocrates

Article snapshot taken from Wikipedia with creative commons attribution-sharealike license. Give it a read and then ask your questions in the chat. We can research this topic together.

This is an old revision of this page, as edited by 212.135.1.185 (talk) at 10:42, 18 September 2006 (→Hippocratic theory). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Revision as of 10:42, 18 September 2006 by 212.135.1.185 (talk) (→Hippocratic theory)(diff) ← Previous revision | Latest revision (diff) | Newer revision → (diff)
For other uses of the name Hippocrates, see Hippocrates (disambiguation).
Hippocrates: a conventionalized image in a Roman "portrait" bust (19th century engraving)

Hippocrates of Kos II. (c. 460 BC–c. 370 BC) was an ancient Greek physician who lived in the Age of Pericles and is commonly regarded as one of the most outstanding figures in the history of medicine. For his lasting contributions to this field, he is often referred to as "The Father of Medicine". The Hippocratic school defined the field of medicine as separate from the other disciplines (notably theurgy and philosophy) and made a profession of practicing medicine. It summed up the medical knowledge of previous schools and defined moral codes and practices for physicians by which to work and live.

The Hippocratic Corpus, the collection of works commonly associated with Hippocrates, was the medium through which Hippocratic philosophy proffered the above and is largely responsible for his renown today; its achievements are inseparable from his individual ones. It also represented extraordinary skills of clinical observation in clear, concise, objective writing. The great detail and depth of the descriptions in these historic works are still respected, as is the Hippocratic Oath, which is sometimes taken today in modified form.

Biography

Askleipion on the Greek island of Kos

Only Hippocrates' birth date, birth place and profession are known for certain. Historians accept that he actually existed, was born near the year 460 BC on the island of Kos and that he was a famous physician and teacher of medicine. All other biographical information is shrouded by myth. Over the years, many legends arose concerning miraculous healing that Hippocrates supposedly did. It is now difficult to separate these from the fact of what actually happened. As no real biography was available for centuries after his death, those that we have today must be based on many years of oral tradition and are thus unreliable.

Soranus of Ephesus, about whom little is known, was his first biographer and is the source of most of our assumed knowledge of Hippocrates' person. Soranus stated that his father, a physician, was Heraclides, and his mother, daughter of Phenaretis, was named Praxitela. He had two sons, Thessalus and Draco, and a son-in-law, Polybus. All three were his students, but Galen says that Polybus was Hippocrates’ true successor. Galen also states that each of Hippocrates II.’s sons, Thessalus and Draco, had a son named Hippocrates.

Soranus says also that Hippocrates was taught medicine by his father and grandfather and other subjects by Democritus and Gorgias Siculus. He could have been trained at the Asklepieion of Kos, and may have been a pupil of Herodicus of Selymbia: Plato, Hippocrates' only contemporary to mention him, describes him as an Asclepiad. Other ancient biographers of his were Suidas, Tzetzes, and Aristotle.

It is fairly certain that Hippocrates traveled significantly, at least as far as Thessaly, Thrace and the Sea of Marmara. He may have died in Larissa at the age of 83 or 90, though his death date is speculated with very little certainty; some sources state that he lived to be over 100 years old.

Hippocratic theory

Cause of illness

Hippocrates is often hailed as the first physician to reject superstitious beliefs and practice medicine based only on scientific theory. While in some respects he did just this, Hippocrates also had a few pseudo-scientific convictions about the human body and the cause of illnesses.

Indeed, Greek medicine of the time knew almost nothing of human anatomy and physiology, largely because of the Greek taboo prohibiting the dissection of animals. The Knidian school, focused towards diagnosis, was dependent upon faulty assumptions about the human body; it failed to distinguish when one disease caused many possible series of symptoms. The Hippocratic school of Kos, however, was more successful because it was more general in its diagnoses and more passive in its treatment. So, the focus of Hippocratic medicine was on patient care, prognosis and not diagnostics, and could not effectively treat many diseases, yet it also allowed for a great development in clinical practice.

Scientific Hippocrates did deny the divine origin of all sickness. He hypothesized that disease was not punishment of the gods but due to environmental factors, diet and living habits. Indeed, there is not a single mention of mystical illness in the entirety of the Hippocratic Corpus.

Humorism

Main article: Humorism

Hippocrates held that illness was due to an imbalance of the four humours in the body, fluids which were naturally equal in amount. When the four humours, blood, black bile, yellow bile and phlegm were unbalanced (dyscrasia), a person became sick and would remain that way until the balance was restored.

Diagnosis

He classified illnesses as acute, chronic, endemic and epidemic. Other medical terms that he introduced were, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence."

Prognosis and therapy

Another important precept of Hippocratic doctrine was based on, "the healing power of nature" or in Latin, vis medicatrix naturae; the body will heal itself if not influenced otherwise. Hippocratic therapy was focused on simply easing this natural process ; often the patient was made to relax and recuperate on his own: "rest and immobilization are of capital importance". By these beliefs, Hippocrates was reluctant to administer drugs and engage in specialized treatment that could be wrong; generalized therapy followed a generalized diagnosis.

Crisis

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 triumph and the patient would move to die, or the opposite, and natural processes would make the patient recover. After a crisis, a relapse might follow, and then another deciding crisis. Crises occur on critical days, usually a fixed time after the contraction of the disease.

He also liked piesBold textItalic textLink title

Hippocratic practice

Professionalism

An ancient Greek treatment of a thigh injury. Use of a complex bandage can be seen.

For all of his advancements in medical theory, it was truly in discipline, practice, and strict professionalism that Hippocratic medicine excelled. In the Hippocratic work On the physician, it is recommended that physicians must always be well-kempt, honest, calm, understanding and serious.

The Hippocratic School is famous for its clinical doctrines. These recommend 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. He also extended clinical observations into family history and environment in accordance with his theory. "To him medicine owes the art of clinical inspection and observation" For this reason, he may termed only the "Father of Clinical Medicine".

Hippocrates made careful, regular note of many symptoms including complexion, pulse, fever, pains, movement, and excretions. He might have even measured a patient's pulse when taking a case history in order to know if the patient lied.

Methods of treatment

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.

In accordance with the focus on patient care, Hippocratic medicine was very kind to the patient, sterile and gentle whenever possible. For example, only clean water or wine was used on wounds, though "dry" treatment was preferable. Specifications for, "lighting, personnel, instruments, positioning of the patient, and techniques of bandaging and splinting" in the ancient operating room are described in detail.

One of Hippocrates' great contributions is his description of the symptomology, physical findings, surgical treatment and prognosis of thoracic empyema, i.e. suppuration of the lining of the chest cavity. Much of what he said is very useful to students of pulmonary medicine and surgery today. He was the first documented chest surgeon and his findings are still valid.

The Hippocratic Corpus

Main article: List of works in the Hippocratic Corpus

The Hippocratic Corpus (Latin: Corpus Hippocratum) is a collection of around seventy early medical works from ancient Greece strongly associated with Hippocrates and his teachings. Of the seventy-or-so volumes in the Corpus, none is proven to be of Hippocrates' hand itself, though some sources say otherwise.Instead, the works were probably produced by students and followers of his, maybe centuries after he died. But the corpus carries Hippocrates' name as it was attributed to him in antiquity and its teaching generally follow principles of his. Because of the variety of subjects, writing styles and apparent date of construction, scholars believe it could not have been written by one person and may be the remains of a library of Kos, or a collection compiled in the third century B.C. in Alexandria.

Content

The Hippocratic Corpus contains textbooks, lectures, research, notes and even philosophical essays on various subjects in medicine in no particular order. These works were also written for different audiences, both specialists and laymen. They were also sometimes written from opposing view points, and significant contradictions can be found between works in the Corpus.

There are a number of case-histories in the Hippocratic Corpus, 42 to be exact. Of these, 60% (25) ended in the patient's death. Nearly all of the diseases described in the Corpus are endemic diseases: colds, consumption, pneumonia, etc.

Style

"Life is short, art long, opportunity fleeting, experiment treacherous, judgment difficult."

Aphorisms i.1.

The concise and objective writing style of the Corpus has been remarked upon for centuries, being described by some as, "clear, precise, and simple" and, "grave and austere" by others. Adams goes one step further and calls it sometimes “obscure”. Not all of the Hippocratic corpus is of this “laconic” style, but most is. His style has been compared to that of Thucydides, who also is concise, sometimes too much.

The whole corpus is written in Ionic Greek, though the island of Kos was in a region that spoke Doric Greek. The use of Ionic instead of the native Doric dialect is analogous to the practice of Renaissance scientists, using Latin instead of the vernacular for their treatises.

Printed editions

The entire Hippocratic Corpus was first printed as a unit in 1525 in Latin edited by Fabius Calvus in Rome. The first complete Greek edition followed the next year in Venice, and the English version was published about 300 years later.

A significant edition was that of Émile Littré who spent twenty-two years (1839-1861) working diligently on the Hippocratic Corpus. This was scholarly, yet sometimes inaccurate and awkward. Another edition of note was that of Ermerins, whose notes were, "a pleasure to read", according to W. H. S. Jones.

The Oath

Main article: Hippocratic Oath

The most famous work in it is the Hippocratic Oath, a landmark declaration of doctoral ethics historically taken at the beginning of a doctor's career. While the oath is rarely used in its original form, derivatives of it are taken today and it serves as a foundation for other, similar oaths and laws that define good medical practice and morals.

Legacy

The Plane Tree of Hippocrates, under which Hippocrates is said to have worked.

Hippocrates was the first great physician, and for a long time, the last. He was the most important influence on medicine for over a thousand years, and after him there was a dearth of medical advancement. According to Aristotle's testimony, he was known as "the Great Hippocrates". Medical practitioners who followed him sometimes moved backwards. For instance, "after the Hippocratic period, the practice of taking clinical case-histories died out..."

After Hippocrates, the next significant physician was Galen, a Greek who lived from 129 -200 AD. Galen perpetuated Hippocratic medicine, though controversially. In the Middle Ages, Arabs, too, adopted Hippocratic methods. After the European Renaissance, Hippocratic methods were revived in Europe and even further expanded upon in the 1800s. Others that employed Hippocrates' rigorous clinical techniques were Sydenham, Heberden, Charcot and Olser.It has been said that these revivals make up "the whole history of internal medicine".

And yet, Hippocratic medicine is far removed from modern medicine. Today, the physician focuses on specific diagnosis and specialized treatment. So Hippocratic methods have seen some serious criticism in the past two millenia. M. S. Houdart in 1836 called Hippocratic treatment a "meditation upon death." He said the purpose of the doctor was to cure the patient, not simply predict how he will die.

Image

So revered was Hippocrates at the time of his death that honey (from a beehive) on his grave was believed to have healing powers. But so revered was he, that, after him, no significant advancements were made for a long time. His teachings were taken as too great to be improved upon.

Concerning his disposition, Hippocrates was first portrayed as a, "kind, dignified, old 'country doctor'" and later as, "stern and forbidding". He is certainly considered wise and of very great intellect. He is seen as very ‘’practical’’, and Adams describes him as “strictly the physician of experience and common sense”.

His image as the wise, old doctor is reinforced by our busts of him, which all wear large beards. The image is probably close, though: the physicians of the time wore their hair in the style of Jove and Asclepius. But, the busts of Hippocrates that we have today are probably only altered versions of portraits of these deities.

He, and the beliefs that he embodied, are considered medical ideals. "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." "His figure... stands for all time as that of the ideal physician”, inspiring the medical profession since his death.

Legends

Some events that, said to have taken place are unlikely to have actually occurred. For example, Hippocrates was supposed to have aided in the healing of Athenians during the Plague of Athens by lighting great fires as "disinfectants". This account, is not corraborated by any historians.

There is a story of Hippocrates curing Perdiccas, a Macedonian king of "love sickness". While the story itself probably did not occur, Hippocrates likely attended Perdiccas' court.

Another legend, this one negative, was that Hippocrates did his traveling only after he set fire to a healing temple in Greece. Soranus, the source of this story, names the temple as the one of Knidos. Tzetzes writes, however, that it was his own Temple of Cos that was burned, that he would maintain a monopoly of medical knowledge.

One more probable legend concerns how Hippocrates rejected a formal request to visit the court of the King of Persia. The validity of this is accepted by ancient sources, denied by some modern ones and is thus under contention.

Genealogy

With this legendary figure, comes a legendary genealogy, which traces Hippocrates’ heritage directly to Asclepius. The ahnentafel of Hippocrates II. is, according to John Tzetzes’s Chiliades:

1. Hippocrates II. “The Father of Medicine”
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. Sostatus
8192. Hippolochus
16384. Podalirius
32768. Asclepius

See also

References

  1. Garrison 1966, p. 92-93 harvnb error: no target: CITEREFGarrison1966 (help)
  2. Nuland 1988, p. 5 harvnb error: no target: CITEREFNuland1988 (help)
  3. ^ Martí-Ibáñez 1961, p. 86-87 harvnb error: no target: CITEREFMartí-Ibáñez1961 (help) Cite error: The named reference "marti86" was defined multiple times with different content (see the help page).
  4. ^ Garrison 1966, p. 94 harvnb error: no target: CITEREFGarrison1966 (help)
  5. Garrison 1966, p. 96 harvnb error: no target: CITEREFGarrison1966 (help)
  6. Nuland 1988, p. 4 harvnb error: no target: CITEREFNuland1988 (help)
  7. Adams 1891, p. 19 harvnb error: no target: CITEREFAdams1891 (help)
  8. ^ Margotta 1968, p. 66 harvnb error: no target: CITEREFMargotta1968 (help)
  9. Garrison 1966, p. 92 harvnb error: no target: CITEREFGarrison1966 (help)
  10. Nuland 1988, p. 7 harvnb error: no target: CITEREFNuland1988 (help)
  11. ^ Adam 1891, p. 15 harvnb error: no target: CITEREFAdam1891 (help)
  12. Margotta 1968, p. 67 harvnb error: no target: CITEREFMargotta1968 (help)
  13. Leff & Leff 1956, p. 51 harvnb error: no target: CITEREFLeffLeff1956 (help)
  14. Jones 1868, p. 11 harvnb error: no target: CITEREFJones1868 (help)
  15. Nuland 1988, p. 8-9 harvnb error: no target: CITEREFNuland1988 (help)
  16. ^ Garrison 1966, p. 97 harvnb error: no target: CITEREFGarrison1966 (help)
  17. Martí-Ibáñez 1961, p. 90 harvnb error: no target: CITEREFMartí-Ibáñez1961 (help)
  18. Margotta 1968, p. 73 harvnb error: no target: CITEREFMargotta1968 (help)
  19. ^ Garrison 1966, p. 98 harvnb error: no target: CITEREFGarrison1966 (help)
  20. Singer & Underwood 1962, p. 35 harvnb error: no target: CITEREFSingerUnderwood1962 (help)
  21. Jones 1868, p. 46 harvnb error: no target: CITEREFJones1868 (help)
  22. ^ Margotta 1968, p. 64 harvnb error: no target: CITEREFMargotta1968 (help)
  23. Margotta 1968, p. 66 harvnb error: no target: CITEREFMargotta1968 (help)
  24. Margotta 1968, p. 68 harvnb error: no target: CITEREFMargotta1968 (help)
  25. Leff & Leff 1956, p. 45 harvnb error: no target: CITEREFLeffLeff1956 (help)
  26. Martí-Ibáñez 1961, p. 88 harvnb error: no target: CITEREFMartí-Ibáñez1961 (help)
  27. Adam 1891, p. 17 harvnb error: no target: CITEREFAdam1891 (help)
  28. Rutkow, p. 24-5 harvnb error: no target: CITEREFRutkow (help)
  29. Major 1965 harvnb error: no target: CITEREFMajor1965 (help)
  30. ^ Singer & Underwood 1962, p. 27 harvnb error: no target: CITEREFSingerUnderwood1962 (help)
  31. ^ Rutkow, p. 23 harvnb error: no target: CITEREFRutkow (help)
  32. Singer & Underwood 1962, p. 28 harvnb error: no target: CITEREFSingerUnderwood1962 (help)
  33. ^ Garrison 1966, p. 95 harvnb error: no target: CITEREFGarrison1966 (help) Cite error: The named reference "gar95" was defined multiple times with different content (see the help page).
  34. Jones 1868, p. 51 harvnb error: no target: CITEREFJones1868 (help)
  35. Garrison 1966, p. 99 harvnb error: no target: CITEREFGarrison1966 (help)
  36. Jones 1868, p. 10 harvnb error: no target: CITEREFJones1868 (help)
  37. Adam 1891, p. 18 harvnb error: no target: CITEREFAdam1891 (help)
  38. Jones 1868, p. 23 harvnb error: no target: CITEREFJones1868 (help)
  39. Jones 1868, p. 62-3 harvnb error: no target: CITEREFJones1868 (help)
  40. Jones 1868, p. 217 harvnb error: no target: CITEREFJones1868 (help)
  41. Garrison 1966, p. 100 harvnb error: no target: CITEREFGarrison1966 (help)
  42. Jones 1868, p. 38 harvnb error: no target: CITEREFJones1868 (help)
  43. Leff & Leff 1956, p. 102 harvnb error: no target: CITEREFLeffLeff1956 (help)
  44. Jones 1868, p. 12-3 harvnb error: no target: CITEREFJones1868 (help)
  45. Margotta 1968, p. 73 harvnb error: no target: CITEREFMargotta1968 (help)
  46. Garrison 1966, p. 100 harvnb error: no target: CITEREFGarrison1966 (help)
  47. Singer & Underwood 1962, p. 29 harvnb error: no target: CITEREFSingerUnderwood1962 (help)
  48. Jones 1868, p. 37 harvnb error: no target: CITEREFJones1868 (help)
  49. Adams 1891, p. 11 harvnb error: no target: CITEREFAdams1891 (help)
  50. ^ Adams 1891, p. 10 harvnb error: no target: CITEREFAdams1891 (help)
  51. Adams 1891, p. 12-3 harvnb error: no target: CITEREFAdams1891 (help)

Bibliography

External links

Categories: