Hippocrates and Hippocratism
Considered the father of medicine according to the historiography of the Great Figures, Hippocrates practiced medicine in the Aegean area and in northern Greece during the fifth and early fourth century BC. As the descendent of a family of physicians in the island of Kos, he lived a twofold transformation of medicine and the medical profession, from a hereditary to an open profession and from tradition to observation. Although he did not necessarily write any work (or none of his works has been preserved), he has been credited with the writing of over 60 works of different types on a broad range of medical topics that gradually became what is currently known as the Hippocratic Corpus (Jouanna 1999). This collection was transmitted without interruption in Byzantium (though with a differentiated tradition according to the texts), and several treatises were translated into Latin as early as the sixth century AD (Temkin 1932) and into Arabic mostly during the ninth century. The several Hippocratic works were differently transmitted in the Middle Ages, until they were rediscovered during the Renaissance with several printed editions of Latin translations at the end of the fifteenth century, a complete collection in Latin in 1525 and in Greek in 1526 (Temkin 1979). After it was eclipsed by the Corpus Galenicum until the mid-sixteenth century, the Hippocratic Corpus became again a major reference among physicians and in medical schools, being commented on by Herman Boerhaave in Leiden in the eighteenth century (Cantor 2002).
Almost nothing sure is known of Hippocrates’ life because of divergences in the biographies that circulated already in antiquity. Born sometimes around 460 BC in the Aegean island of Kos to a family of physicians (who identified themselves as Asclepiades, as did all physicians in that time who considered themselves as descendants of the god of medicine Asclepius), Hippocrates learned medicine with his father, got married in the island, and had three children. Hippocrates practiced and taught himself medicine in his native Kos. Soon famous in the Greek world and beyond as a passage in Plato indicates, he is supposed to have been called to Abdera in northeastern Greece to examine Democritus, accused by his co-citizens to suffer from dementia. Also he was invited to the court of the Persian king Artaxerxes I (reign 465–424 BC), but he declined. After his parents’ death, Hippocrates left Kos for Thessalia, in continental Greece, sometimes around 420, possibly to expand his experience by diversifying the areas where he was practicing medicine. From there he seems to have traveled in northern Greece, including the northern Aegean island of Thasos. Whereas the place of Hippocrates’ death is known – the city of Larissa in Thessalia – the date is not and must have been between 375 and 351 BC (Jouanna 1999).
Heritage and Rupture with the Tradition
As the son of a family of physicians claiming to descend from the god of medicine Asclepius, Hippocrates certainly inherited the medical tradition of his time. At the same time, he was living a period of unprecedented scientific developments in the Greek world, which went together with a societal transformation that included a professionalization of intellectual activities. As a consequence, medical education was no longer limited to families of Asclepiades but became open to other members of society through apprenticeship. This transformation is best represented by the Oath attributed to Hippocrates, which is in fact a contract between a student and a mentor and does not only define the practice of medicine (for which the Oath is most known) but also stipulate the duties of the student to his mentor.
Innovative and Original Aspects
Hippocratic medicine – often defined by opposition to the medicine taught and practiced in the so-called School of Cnidus, supposedly proceeding according to more rigid prescriptions codified in the Cnidian Sentences – is characterized by its concept of the body and its method. Human body is considered as an assemblage of parts and constituents which interact and are influenced by external factors (including the environment). The body and the bodily processes can be known through observation, correlations between facts (internal and external), and deductions. Health results from the equilibrium of all bodily constituents, whereas disease is provoked by the qualitative or quantitative alteration of any of the bodily elements (including because of environmental imbalances). Hippocratic method is based on the attention to the natural environment of the patients and, as a corollary, the morbidity of populations (epidemiology); a close observation of the signs presented by the patients (clinical analysis) and the comparison of different cases of the same diseases; the notion of the cycle of diseases culminating with the crisis; the identification (diagnosis) and knowledge of diseases (nosology), together with the prevision of their evolution (prognosis); the use of natural resources as therapeutic substances; the attention to nutrition for the maintenance of health and the prevention of diseases; and the use of exercise and physical therapy. Ethics and the regulation of the profession are essential components of Hippocratic medical practice. The whole Hippocratic approach to medicine was best expressed by the Aphorisms, each of which crystalizes one component of Hippocratism.
Impact and Legacy
Hippocratic medicine codified in writing the practice of the fifth- and fourth-century health care and provided it with a theoretical corpus in the form of a great variety of treatises that began to be collected as early as the Alexandrine period, while it was still increased with further treatises until the second century AD. The Hippocratic Collection was abundantly commented on, and interpreted, by Galen, and these commentaries were studied in Alexandria in late antiquity. A limited number of treatises were translated into Latin, possibly in Ravenna or in North Africa, sometimes around the sixth century (Temkin 1932). From Byzantium, where the collection was transmitted in a canonical form and some treatises (e.g., the Aphorisms) had a wider diffusion, several works were translated into Arabic in the ninth century. In the West, new Latin translations were made from Arabic, focusing on Galen’s commentaries. These translations circulated widely and were gradually grouped in a small collection identified as the Articella, which was repeatedly printed as early as the late fifteenth century. After new humanistic translations were made on the basis of the Greek text and printed from 1476 on, the whole collection was printed in Latin in 1525 and for the first time in Greek in 1526, the latter by the Aldine press (Temkin 1979). Hippocratic medicine did not enter university teaching until the mid-sixteenth century. From then on, Hippocratic treatises were commented on in very different ways by numerous physicians who saw Hippocrates as the founder of clinical medicine. This interpretative reappropriation culminated with Hermann Boerhaave (1668–1738) at Leiden, who considered himself as the new Hippocrates (Cantor 2002).
- The Greek text of the full Hippocratic Collection can be found in the critical edition (with French translation) prepared by the French scholar, historian of medicine, and lexicographer Emile Littré and published under the title Oeuvres complètes d’Hippocrate, 10 vols. Paris: Baillière, 1839–1861. New editions of the Greek text (respectively, with French and English translations) are currently being published in the Collection des universités de France (Paris: Belles Lettres, 15 vols published) and the Loeb Classical Library ( Cambridge, MA, and London: Harvard University Press, 10 vols published).Google Scholar
- Cantor, David, ed. 2002. Reinventing hippocrates (the history of medicine in context). Aldershot/Burlington: Ashgate.Google Scholar
- Jouanna, Jacques. 1999. Hippocrates. Baltimore/London: Johns Hopkins University Press.Google Scholar
- Kibre, Pearl, and Hippocrates Latinus. 1985. Repertorium of hippocratic writings in the Latin middle ages. New York: Fordham University Press.Google Scholar
- Temkin, Owsei. 1932. Geschichte der Hippokratismus in ausgehenden Altertum. Kyklos 4: 1–80.Google Scholar
- Temkin, Owsei. 1979. The Hippocratic tradition. Ithaca/London: Cornell University Press.Google Scholar