Owing to the lapse of centuries, very
little is known with certainty of the life of Hippocrates,
who was called with affectionate veneration by his
successors “the divine old man,” and who
has been justly known to posterity as “the Father
of Medicine.”
He was probably born about 470 B.C.,
and, according to all accounts, appears to have reached
the advanced age of ninety years or more. He
must, therefore, have lived during a period of Greek
history which was characterized by great intellectual
activity; for he had, as his contemporaries, Pericles
the famous statesman; the poets AEschylus, Sophocles,
Euripides, Aristophanes, and Pindar; the philosopher
Socrates, with his disciples Xenophon and Plato; the
historians Herodotus and Thucydides; and Phidias the
unrivalled sculptor.
In the island of Cos, where he was
born, stood one of the most celebrated of the temples
of AEsculapius, and in this temple because
he was descended from the Asclepiadae Hippocrates
inherited from his forefathers an important position.
Among the Asclepiads the habit of physical observation,
and even manual training in dissection, were imparted
traditionally from father to son from the earliest
years, thus serving as a preparation for medical practice
when there were no written treatises to study.
Although Hippocrates at first studied
medicine under his father, he had afterwards for his
teachers Gorgias and Democritus, both of classic fame,
and Herodicus, who is known as the first person who
applied gymnastic exercises to the cure of diseases.
The Asclepions, or temples of health,
were erected in various parts of Greece as receptacles
for invalids, who were in the habit of resorting to
them to seek the assistance of the god. These
temples were mostly situated in the neighbourhood
of medicinal springs, and each devotee at his entrance
was made to undergo a regular course of bathing and
purification. Probably his diet was also carefully
attended to, and at the same time his imagination
was worked upon by music and religious ceremonies.
On his departure, the restored patient usually showed
his gratitude by presenting to the temple votive tablets
setting forth the circumstances of his peculiar case.
The value of these to men about to enter on medical
studies can be readily understood; and it was to such
treasures of recorded observations collected
during several generations that Hippocrates
had access from the commencement of his career.
Owing to the peculiar constitution
of the Asclepions, medical and priestly pursuits had,
before the time of Hippocrates, become combined; and,
consequently, although rational means were to a certain
extent applied to the cure of diseases, the more common
practice was to resort chiefly to superstitious modes
of working upon the imagination. It is not surprising,
therefore, to find that every sickness, especially
epidemics and plagues, were attributed to the anger
of some offended god, and that penance and supplications
often took the place of personal and domestic cleanliness,
fresh air, and light.
It was Hippocrates who emancipated
medicine from the thraldom of superstition, and in
this way wrested the practice of his art from the
monopoly of the priests. In his treatise on “The
Sacred Disease” (possibly epilepsy), he discusses
the controverted question whether or not this disease
was an infliction from the gods; and he decidedly
maintains that there is no such a thing as a sacred
disease, for all diseases arise from natural causes,
and no one can be ascribed to the gods more than another.
He points out that it is simply because this disease
is unlike other diseases that men have come to regard
its cause as divine, and yet it is not really more
wonderful than the paroxysms of fevers and many other
diseases not thought sacred. He exposes the cunning
of the impostors who pretend to cure men by purifications
and spells; “who give themselves out as being
excessively religious, and as knowing more than other
people;” and he argues that “whoever is
able, by purifications and conjurings, to drive away
such an affection, will be able, by other practices,
to excite it, and, according to this view, its divine
nature is entirely done away with.” “Neither,
truly,” he continues, “do I count it a
worthy opinion to hold that the body of a man is polluted
by the divinity, the most impure by the most holy;
for, were it defiled, or did it suffer from any other
thing, it would be like to be purified and sanctified
rather than polluted by the divinity.” As
an additional argument against the cause being divine,
he adduces the fact that this disease is hereditary,
like other diseases, and that it attacks persons of
a peculiar temperament, namely, the phlegmatic, but
not the bilious; and “yet if it were really more
divine than the others,” he justly adds, “it
ought to befall all alike.”
Again, speaking of a disease common
among the Scythians, Hippocrates remarks that the
people attributed it to a god, but that “to me
it appears that such affections are just as much divine
as all others are, and that no one disease is either
more divine or more human than another, but that all
are alike divine, for that each has its own nature,
and that no one arises without a natural cause.”
From this it will be seen that Hippocrates
regarded all phenomena as at once divine and scientifically
determinable. In this respect it is interesting
to compare him with one of his most illustrious contemporaries,
namely, with Socrates, who distributed phenomena into
two classes: one wherein the connection of antecedent
and consequent was invariable and ascertainable by
human study, and wherein therefore future results
were accessible to a well-instructed foresight; the
other, which the gods had reserved for themselves and
their unconditional agency, wherein there was no invariable
or ascertainable sequence, and where the result could
only be foreknown by some omen or prophecy, or other
special inspired communication from themselves.
Each of these classes was essentially distinct, and
required to be looked at and dealt with in a manner
radically incompatible with the other. Physics
and astronomy, in the opinion of Socrates, belonged
to the divine class of phenomena in which human research
was insane, fruitless, and impious.
Hippocrates divided the causes of
diseases into two classes: the one comprehending
the influence of seasons, climates, water, situation,
and the like; the other consisting of such causes
as the amount and kind of food and exercise in which
each individual indulges. He considered that
while heat and cold, moisture and dryness, succeeded
one another throughout the year, the human body underwent
certain analogous changes which influenced the diseases
of the period. With regard to the second class
of causes producing diseases, he attributed many disorders
to a vicious system of diet, for excessive and defective
diet he considered to be equally injurious.
In his medical doctrines Hippocrates
starts with the axiom that the body is composed of
the four elements air, earth, fire, and
water. From these the four fluids or humours
(namely, blood, phlegm, yellow bile, and black bile)
are formed. Health is the result of a right condition
and proper proportion of these humours, disease being
due to changes in their quality or distribution.
Thus inflammation is regarded as the passing of blood
into parts not previously containing it. In the
course of a disorder proceeding favourably, these
humours undergo spontaneous changes in quality.
This process is spoken of as coction, and is
the sign of returning health, as preparing the way
for the expulsion of the morbid matters a
state described as the crisis. These crises
have a tendency to occur at certain periods, which
are hence called critical days. As the
critical days answer to the periods of the process
of coction, they are to be watched with anxiety,
and the actual condition of the patient at these times
is to be compared with the state which it was expected
he ought to show. From these observations the
physician may predict the course which the remainder
of the disease will probably take, and derive suggestions
as to the practice to be followed in order to assist
Nature in her operations.
Hippocrates thus appears to have studied
“the natural history of diseases.”
As stated above, his practice was to watch the manner
in which the humours were undergoing their fermenting
coction, the phenomena displayed in the critical
days, and the aspect and nature of the critical discharges not
to attempt to check the process going on, but simply
to assist the natural operation. His principles
and practice were based on the theory of the existence
of a restoring essence (or {physis}) penetrating through
all creation; the agent which is constantly striving
to preserve all things in their natural state, and
to restore them when they are preternaturally deranged.
In the management of this vis medicatrix naturae
the art of the physician consisted. Attention,
therefore, to regimen and diet was the principal remedy
Hippocrates employed; nevertheless he did not hesitate,
when he considered that occasion required, to administer
such a powerful drug as hellebore in large doses.
The writings which are extant under the name of Hippocrates
cannot all be ascribed to him. Many were doubtless written by his family,
his descendants, or his pupils. Others are productions of the Alexandrian
school, some of these being considered by critics as wilful forgeries, the high
prices paid by the Ptolemies for books of reputation probably having acted as
inducements to such fraud. The following works have generally been
admitted as genuine:
1. On Airs, Waters,
and Places.
2. On Ancient Medicine.
3. On the Prognostics.
4. On the Treatment
in Acute Diseases.
5. On Epidemics.
6. On Wounds of
the Head.
7. On the Articulations.
8. On Fractures.
9. On the Instruments
of Reduction.
10. The Aphorisms.
11. The Oath.
The works “On Fractures,”
“On the Articulations,” “On Injuries
to the Head,” and “On the Instruments
of Reduction,” deal with anatomical or surgical
matters, and exhibit a remarkable knowledge of osteology
and anatomy generally. It has sometimes been
doubted if Hippocrates could ever have had opportunities
of gaining this knowledge from dissections of
the human body, for it has been thought that the feeling
of the age was diametrically opposed to such a practice,
and that Hippocrates would not have dared to violate
this feeling. The language used, however, in
some passages in the work “On the Articulations,”
seems to put the matter beyond doubt. Thus he
says in one place, “But if one will strip the
point of the shoulder of the fleshy parts, and where
the muscle extends, and also lay bare the tendon that
goes from the armpit and clavicle to the breast,”
etc. And again, further on in the same treatise,
“It is evident, then, that such a case could
not be reduced either by succussion or by any other
method, unless one were to cut open the patient, and
then, having introduced the hand into one of the great
cavities, were to push outwards from within, which
one might do in the dead body, but not at all in the
living.”
His descriptions of the vertebrae,
with all their processes and ligaments, as well as
his account of the general characters of the internal
viscera, would not have been as free from error as
they are if he had derived all his knowledge from
the dissection of the inferior animals. Moreover,
it is indisputable that, within less than a hundred
years from the death of Hippocrates, the human body
was openly dissected in the schools of Alexandria nay,
further, that even the vivisection of condemned criminals
was not uncommon. It would be unreasonable to
suppose that such a practice as the former sprang up
suddenly under the Ptolemies, and it seems, therefore,
highly probable that it was known and tolerated in
the time of Hippocrates. It is not surprising,
when we remember the rude appliances and methods which
then obtained, that in his knowledge of minute anatomy
Hippocrates should compare unfavourably with anatomists
of the present day. Of histology, and such other
subjects as could not be brought within his direct
personal observation, the knowledge of Hippocrates
was necessarily defective. Thus he wrote of the
tissues without distinguishing them; confusing arteries,
veins, and nerves, and speaking of muscles vaguely
as “flesh.” But with matters within
the reach of the Ancient Physician’s own careful
observation, the case is very different. This
is well shown in his wonderful chapter on the club-foot,
in which he not only states correctly the true nature
of the malformation, but gives some very sensible
directions for rectifying the deformity in early life.
When human strength was not sufficient
to restore a displaced limb, he skilfully availed
himself of all the mechanical powers which were then
known. He does not appear to have been acquainted
with the use of pulleys for the purpose, but the axles
which he describes as being attached to the bench
which bears his name (Scamnum Hippocratis) must
have been quite capable of exercising the force required.
The work called “The Aphorisms,”
which was probably written in the old age of Hippocrates,
consists of more than four hundred short pithy sentences,
setting forth the principles of medicine, physiology,
and natural philosophy. A large number of these
sentences are evidently taken from the author’s
other works, especially those “On Air,”
etc., On Prognostics, and On the Articulations. They embody the
result of a vast amount of observation and reflection, and the majority of them
have been confirmed by the experience of two thousand years. A proof of
the high esteem in which they have always been held is furnished by the fact
that they have been translated into all the languages of the civilized world;
among others, into Hebrew, Arabic, Latin, English, Dutch, Italian, German, and
French. The following are a few examples of these aphorisms:
“Spontaneous lassitude
indicates disease.”
“Old people on the whole
have fewer complaints than the young; but
those chronic diseases which
do befall them generally never leave
them.”
“Persons who have sudden
and violent attacks of fainting without any
obvious cause die suddenly.”
“Of the constitutions
of the year, the dry upon the whole are more
healthy than the rainy, and
attended with less mortality.”
“Phthisis most commonly
occurs between the ages of eighteen and
thirty-five years.”
“If one give to a person
in fever the same food which is given to a
person in good health, what
is strength to the one is disease to the
other.”
“Such food as is most
grateful, though not so wholesome, is to be
preferred to that which is
better, but distasteful.”
“Life is short and the art long;
the opportunity fleeting; experience fallacious
and judgment difficult. The physician must not
only do his duty himself, but must also make the
patient, the attendants and the externals, co-operate.”
Hippocrates appears to have travelled
a great deal, and to have practised his art in many
places far distant from his native island. A
few traditions of what he did during his long life
remain, but differences of opinion exist as to the
truth of these stories.
Thus one story says that when Perdiccas,
the King of Macedonia, was supposed to be dying of
consumption, Hippocrates discovered the disorder to
be love-sickness, and speedily effected a cure.
The details of this story scarcely seem to be worthy
of credence, more especially as similar legends have
been told of entirely different persons belonging to
widely different times. There are, however, some
reasons for believing that Hippocrates visited the
Macedonian court in the exercise of his professional
duties, for he mentions in the course of his writings,
among places which he had visited, several which were
situated in Macedonia; and, further, his son Thessalus
appears to have afterwards been court physician to
Archelaus, King of Macedonia.
Another story connects the name of
Hippocrates with the Great Plague which occurred at
Athens in the time of the Peloponnesian war. It
is said that Hippocrates advised the lighting of great
fires with wood of some aromatic kind, probably some
species of pine. These, being kindled all about
the city, stayed the progress of the pestilence.
Others besides Hippocrates are, however, famous for
having successfully adopted this practice.
A third legend states that the King
of Persia, pursuing the plan (which in the two celebrated
instances of Themistocles and Pausanias had proved
successful) of attracting to his side the most distinguished
persons in Greece, wrote to Hippocrates asking him
to pay a visit to his court, and that Hippocrates
refused to go. Although the story is discarded
by many scholars, it is worthy of note that Ctesias,
a kinsman and contemporary of Hippocrates, is mentioned
by Xenophon in the “Anabasis” as being
in the service of the King of Persia. And, with
regard to the refusal of the venerable physician to
comply with the king’s request, one cannot lose
sight of the fact that such refusal was the only course
consistent with the opinions he professed of a monarchical
form of government.
After his various travels Hippocrates,
as seems to be pretty generally admitted, spent the
latter portion of his life in Thessaly, and died at
Larissa at a very advanced age.
It is difficult to speak of the skill
and painstaking perseverance of Hippocrates in terms
which shall not appear exaggerated and extravagant.
His method of cultivating medicine was in the true
spirit of the inductive philosophy. His descriptions
were all derived from careful observation of its phenomena,
and, as a result, the greater number of his deductions
have stood unscathed the test of twenty centuries.
Still more difficult is it to speak
with moderation of the candour which impelled Hippocrates
to confess errors into which in his earlier practice
he had fallen; or of that freedom from superstition
which entitled him to be spoken of as a man who knew
not how to deceive or be deceived ("qui tam
fallere quam fallì nescit"); or, lastly, of that
purity of character and true nobility of soul which are brought so distinctly to
light in the words of the oath translated below:
“I swear by Apollo the Physician
and AEsculapius, and I call Hygeia and Panacea
and all the gods and goddesses to witness, that to
the best of my power and judgment I will keep
this oath and this contract; to wit to
hold him, who taught me this Art, equally dear to
me as my parents; to share my substance with him; to
supply him if he is in need of the necessaries
of life; to regard his offspring in the same light
as my own brothers, and to teach them this Art, if
they shall desire to learn it, without fee or contract;
to impart the precepts, the oral teaching, and
all the rest of the instruction to my own sons,
and to the sons of my teacher, and to pupils who have
been bound to me by contract, and who have been sworn
according to the law of medicine.
“I will adopt that system of regimen
which, according to my ability and judgment, I
consider for the benefit of my patients, and will
protect them from everything noxious and injurious.
I will give no deadly medicine to any one, even
if asked, nor will I give any such counsel, and
similarly I will not give to a woman the means of
procuring an abortion. With purity and with
holiness I will pass my life and practise my art....
Into whatever houses I enter I will go into them
for the benefit of the sick, keeping myself aloof from
every voluntary act of injustice and corruption
and lust. Whatever in the course of my professional
practice, or outside of it, I see or hear which
ought not to be spread abroad, I will not divulge,
as reckoning that all such should be kept secret.
If I continue to observe this oath and to keep
it inviolate, may it be mine to enjoy life and
the practice of the Art respected among all men for
ever. But should I violate this oath and
forswear myself, may the reverse be my lot.”