The doctor who put medicine before magic
Was Hippocrates the first modern doctor? A controversial new book argues that the ancient Greek physician established the principles of medicine as we know it as long ago as 470 BC.
“I swear by Apollo the physician,” the young, newly qualified doctor began as his parents looked proudly on. His oath included the promise that, “Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief”; and that whatever he learnt about his patients, “I will not divulge, as reckoning that all such should be kept secret.”
The oath he swore more than two millennia ago is still used, in a modified form, by doctors today. Known as the Hippocratic oath, it establishes the ethical basis on which they should work. But many other aspects of medicine are also attributed to the man who gave the oath his name.
Hippocrates was born on the Greek island of Kos at a time when illnesses were thought to result from the gods’ displeasure. The surest way of recovering, therefore, was to consult a priest and find a way of appeasing them.
Such doctors as there were devoted themselves to Asclepius, the god of healing. They believed that the body was a collection of isolated parts that should be treated individually, and the cures they administered relied entirely on what their patients told them about their symptoms.
Hippocrates turned all this on its head. Despite the mention of Apollo in the Hippocratic oath, his approach to sickness had nothing to do with the gods. He wrote of epilepsy – known as “the sacred disease” because of its dramatic symptoms – that, “Men believe that it is a divine disease only because of their ignorance and amazement.”
The doctor’s role, he argued, was to assist the healing power of nature. The body’s inherent resistance to disease could be built up by means of a careful diet, gymnastics, rest, exercise, massage and bathing in the sea.
He insisted, moreover, that the human body must be treated as a single organism or “physis”, in which the health of one part depended on all the others. And rather than just listening to what the patient said, a doctor should diagnose a disease by careful observation – noting how it progressed from one day to another and comparing one case with another, so that its outcome could be anticipated.
He devised different categories for illnesses, such as chronic and acute, and introduced terms including convalescence. He also emphasised the importance of mental health, regarding depression, delusions and panic attacks as symptoms of disease.
Since the dissection of bodies was forbidden by the Greeks, his knowledge of anatomy and surgery was limited. Nevertheless, he established surgical techniques for treating dislocated hips and jaws which were not improved upon until the 19th century.
Traditionally, Hippocrates was thought to have been born in around 470 BC. But a new book by Robin Lane Fox called The Invention of Medicine argues that he was born decades earlier, and was already writing influential works by then.
Was Hippocrates the first modern doctor?
Bring it to the bile
Some say, yes: Hippocrates was the first physician to approach ailments in a rational and systematic way, discounting the possibility of divine intervention. By devising a method of classifying diseases, he made it much easier to diagnose and treat them. He virtually invented the disciplines of aetiology and pathology, and the Hippocratic oath remains the cornerstone of medical ethics.
Others argue that scientific advances have changed medicine so much that it makes no sense to describe Hippocrates as modern. Much of his thinking was based on the theory put forward by Pythagoras that the body consisted of four fluids or 'humours' – black bile, yellow bile, phlegm and blood – which needed to be balanced. Nobody thinks like that today.
- Would life be simpler if everything that happened could be attributed to the activities of the gods?
- Would you be happy for your medical records to be kept on a database readily accessible to all doctors?
- Hippocrates put a great deal of emphasis on mental health. Paint a version of Edvard Munch’s The Scream with an Ancient Greek figure and setting.
- Look up the text of the Hippocratic oath. Write an equivalent oath which defines ethical behaviour for a profession you are interested in entering.
Some People Say...
“The greatest medicine of all is teaching people how not to need it.”Hippocrates (5th Century BC), Greek doctor
What do you think?
Q & A
- What do we know?
- It is generally agreed that not all the writings attributed to Hippocrates – a collection of over 60 works known as the Hippocratic Corpus – are actually by him. The earliest ones are thought to be at least 150 years older than the latest, so they cannot possibly all be by the same person. The ones most likely to be his include Aphorisms – a collection of witty sayings – and Airs, Waters and Places, the first major work on geography and climatology.
- What do we not know?
- One main area of debate is around when the seven books called Epidemics were written. Robin Lane Fox argues that the first two are Hippocrates’ own work and date from 470 BC, not 410 BC as was previously thought. If he is right, Hippocrates was not influenced by the rational philosophers active at the end of the 5th Century BC, but was the man responsible for their whole approach: among those he paved the way for was Thucydides, widely regarded as the first impartial and reliable historian.
- In Greek mythology he was the god of music as well as of medicine. The oracle at Delphi, the most important source of prophecy in Greece, was dedicated to him.
- Make public. It comes from the Latin word “vulgus”, meaning the common people.
- Soothing their anger. Politicians who advocated giving in to Hitler’s demands before the Second World War instead of fighting him were known as “appeasers”.
- The symptoms of epilepsy include blackouts and violent shaking. It was also known as “the falling sickness”.
- The study of the causes of a disease.
- The study of the behaviour of a disease, particularly by examining body tissues in a laboratory. Crime dramas often feature pathologists dissecting the bodies of murder victims.
- A 6th-century BC Greek philosopher and mathematician. He believed that nature was made of four elements – water, earth, wind and fire – and the body’s four humours were equivalent to these.
- A fluid secreted in the liver and gallbladder to assist digestion. It can also mean bad temper or irritability.
- The thick liquid that comes out of your throat when you have a wet cough. In Pythagoras’s terms it was a fluid that caused laziness and indifference; to be “phlegmatic” is to have those characteristics.