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HIPPOCRATES

Volume 11 · 1,933 words · 1860 Edition

the "Father of Medicine," was born in the Island of Cos, B.C. 460. By his father Heraclides, he was descended from Asclepius, and by his mother Phæarete, from Hercules. After the preliminary instruction received from his father, he proceeded to Athens to prosecute medicine under Herodicus. He studied philosophy under Geórgias, and some add Democritus of Abdera. He travelled in Thessaly, Macedonia, and Scythia, latterly settling down in the first of these places. Here he died at Larissa about B.C. 357, at the age of about 100.

A parallel has been drawn between Homer, the father of verse, and Hippocrates, the father of medicine. Each remounts to great antiquity, and each is first in order of excellence. Yet so little is known about either, that the history of each has become clogged with numerous accretions of mere fable; while, passing to the opposite extreme, some have doubted whether the men themselves ever existed at all. Some of the stories circulated about Hippocrates may be mentioned. He is represented as having the charge of a library at Cos or Cnidus. Having used the works of others much too freely in his writings, and fearing detection, he is said to have set the library on fire. But the uniform respect, even veneration, with which he was regarded in his own day appears satisfactorily to contradict such a story. Plato, his contemporary, speaks of him in very high terms; and as to the conflagration, Pliny speaks of the destruction by fire of votive tablets, without reference to books or Hippocrates. The story appears to have been invented three centuries after Hippocrates by one Andreas. A similar story is told of Avicenna. Another story represents Hippocrates as sent for during the illness of the son of Perdiccas II. of Macedonia, and as discovering, by mere appearances, that the malady was caused by the young man's being in love with Philas, his father's concubine. A similar tale is told of Erasistratus at the court of Seleucus Nicanor. According to a third story the portrait of Hippocrates was taken, by some of his disciples, to a physiognomist. It was declared by him to be that of an old man of lascivious character. His disciples laughed at the conclusion as utterly incorrect; but Hippocrates declared that the physiognomist had rightly discerned his natural character, which, however, had been subdued by him. A similar story is told of Socrates. He is described as receiving extraordinary honours from the Athenians, and this connects him with another story, which relates to his removing a plague by keeping up large fires in the streets, and burning aromatic substances. By this means the atmosphere was purified. It is argued that this cannot refer to the celebrated plague by which Athens was devastated, else Thucydides, in describing it, would have made reference to Hippocrates. The other story is that which refers to the mission of Hystanus, the Persian satrap, from Artaxerxes Longimanus, to request Hippocrates to come to the Persian court, and give the king the benefit of his medical skill. Hippocrates replied that he would not accept of any presents to go and help the enemies of Greece.

Hippocrates created a new era in medicine. Up to his time medical knowledge was mainly monopolized by the priests, who kept to themselves as much as they did know. Emancipated from the jugglery of the priests, the study of medicine became henceforth an independent profession. Hippocrates theorized but little, his leading principles be- ing the result of extensive observation of facts. The infirmities to which men as nations or individuals were subject, he traced to two leading causes—climate and diet. Hence he inculcates the importance of considering the changes of the seasons, the state of the atmosphere, the distribution of heat, water, moisture, &c. Diet is to be regulated, not only by the state of the patient, but also by the season of the year. Thus wine is to be used more sparingly in summer than in winter. In cases of fever, diet is to be reduced to liquid, though not so as to starve the patient. Each period of the year, according to him, has its peculiar malady. Hippocrates excels especially in describing the symptoms of diseases. His description of the sharp nose, sunken eyes, leaden hue, and dry forehead, which often precedes death, has been called the Facies Hippocratica. He gives minute directions for the discovery of empyema in the chest, notices the changes which take place in ulcers before death, and points out how symptoms may be ascertained from the manner in which the patient lies in bed.

In his treatise on the Nature of Man he enounces the theory of elements. As there are the four elements—fire, air, earth, and water; so there are in the human composition the four humours—blood, phlegm, bile, and black bile. When these are mixed in certain proportions the human body enjoys health; but disease is the result of a want of the proper proportion. He was the first to assign three periods to the course of a malady, and for the last, or the crisis, he assigned certain days, known as the critical days. These were the 4th, 7th, 11th, 14th, 17th, and 20th, displaying a regularity which may have existed more in his day and in his country than among us, owing partly to climate and partly to the simple habits of the people.

His knowledge of anatomy was very defective. He speaks of the muscles simply as flesh; he confounds the veins and arteries, also the nerves, tendons, and ligaments. As to generation, he believed that the male child came from the right side of the matrix, and the female child from the left. However, he came to some correct conclusions regarding the cranium and the viscera. It is possible that this may have been the result of examinations in the case of severe accidents to patients. The dissection of the human subject, in those days, appears to have been avoided from superstitious motives. Hippocrates did not advance so far as to separate surgery from medicine. He employed the cautery in some cases, as appears from his maxim—that what cannot be cured by medicine must be cured by the knife; and what cannot be cured by the knife must be cured by fire.

He practised bleeding, and in cases of inflammation he recommended the bleeding to take place near the inflamed part. He was acquainted with cupping also. He knew the medicinal properties of several minerals and vegetables, and used to employ violent purgatives. He is known to have practised auscultation. He was not aware of the importance of the pulse in detecting symptoms. He recommended consultations of physicians.

The candour and openness of Hippocrates stand out in noble relief from the secrecy and trickery of the priests, from whose monopoly he wrested the profession of medicine. On several occasions he mentions the mistakes into which, in his earlier practice, he had fallen, that others might have the benefit of his warning. More lofty and humane views than those which occur in his writings regarding the work of a physician are nowhere else to be met with—“Be not too eager merely to get wealth by your profession. Give medical aid at times gratuitously, satisfied with the gratitude and esteem of others. Give assistance, as occasion presents itself, to the poor and the stranger; for if you love mankind you will love your profession. When you are required at a consultation, do not use great words, and do not speak in a studied and pompous manner—no-

thing more surely indicates incapacity.” In the “oath” the physician is represented as solemnly promising, “My sole object shall be to afford consolation and medical relief to the sick, to be true to the confidence which they repose in me, and to avoid even the suspicion of having abused it, particularly in regard to women.” He appears to have been very conscientious in the discharge of his professional duties. It has been objected that, by merely observing the course of nature, and trusting too much to her vis medicatrix, Hippocrates allowed his patients to die; and there appears to be some truth in the allegation.

Hippocrates wrote in the Ionic dialect, but numerous Atticisms occur in his works. What is known as the Hippocratic Collection is a great number of works, amounting to about 70, of which only a few are certainly known to be from the Hippocrates of whom we are speaking. The works to be ascribed to him are the Aphorisms, Prognostics, Epidemics, the treatise on Air, Water, and Locality, the treatise on the Diet to be used in acute diseases, &c. Of the others, some are probably by him, others possibly by him, and many certainly not by him. This confusion has been ascribed to two causes—First, There were many medical writers not only of the same name, but also of the same family of Hippocrates. Thus the family of Hippocrates contained not fewer than seven physicians of greater or less eminence, spreading over a period of about 300 years. The tendency in such a case is to ascribe to the most distinguished the works of those less distinguished. But, secondly, when the Ptolemaean kings were founding the celebrated Alexandrian library, which was to surpass that of the kings of Pergamos, the works of Hippocrates were eagerly sought, and purchased at a high price. The consequence was that there was an inducement to the dishonest to palm off upon the Alexandrians books under the name of Hippocrates which were not his. Several of the works falsely ascribed to him can be at once set aside by the pomposity of style so totally different from the brevity of Hippocrates, bordering, as it often does, on obscurity. In cases of mutilation and interpolation, where an attempt has been made to imitate the Hippocratic conciseness, the critic has to look for statements which are contradictory of those in works known to be by Hippocrates, or inconsistent with the medical knowledge possessed in his day. The Alexandrian librarians set about effecting a discrimination between the genuine and the spurious; and Galen professes, in his day, to have been able to distinguish the works of Hippocrates from those merely ascribed to him. Many editions of his works have existed, and vast quantities have been written upon them. There have been 70 editions of his Prognostics, and 300 of his famous Aphorisms. The most eminent men have been his editors and commentators, e.g., Celsus, Galen, &c. Amongst his biographers are to be mentioned especially Soranus, also Dacier, Le Clerc, Grimm, Sprengel, &c. The Paris edition by Littre contains a French translation and critical notes.

The following classification is made on the principle recommended by Eroten, the eldest glossator of Hippocrates, and adopted and improved by Foes:—1. Greek Editions, Venice, 1526, in folio; Aldus and Asulanus; Basil, 1538, in folio; Froben, a more complete and exact edition than the preceding. 2. Greek and Latin editions, Venice, 1588, in folio; Mercuriali; Frankfort, 1595, 1621, 1624, and 1645, in folio; Geneva, 1657, in two vols. folio; Leyden, 1655, in two vols. 8vo; the Variorum edition, Vienna, 1743-49, in two vols. folio, Stephen Mack. 3. Latin editions, Rome, 1525, in folio; Calvo; Rome, 1549, 1610, 1619, in folio; Basil, 1526, in folio; Venice, 1545, in folio, the version of Cornarius; Basil, 1558, in folio; Venice, 1575, in folio; Marinelli; Frankfort, 1596, in 8vo, Foes; Altenburg, 1806, in three vols. 8vo, Pierer, with a learned dissertation on the state of medicine before the time of Hippocrates. 4. Greek