Hippocratism

 The great physician Hippocrates of Cos (c450–c370 BC) left no identifiable writings, and his opinions as recorded by contemporaries are not distinctive. He considered ‘the whole’ in looking at a diseased person or part, carried out a method of logical division of possibilities in diagnosis, and taught for money. His reputation was such that many works passed under his name or were later catalogued as his by credulous librarians to form our ‘Hippocratic corpus’. Among these varied treatises, some, especially Epidemics, Prognostic and Aphorisms, were regarded as preserving genuine theories, and their doctrines can loosely be said to constitute Hippocratism.

 In Hippocratism, the patient was viewed as an individual; his diseases were his own, depending on the imbalance of humours. Anatomy played little part in diagnosis, and physiological theories were usually simple. Treatment was largely allopathic and based on diet. Such drugs as were used were almost all herbal, and surgery was minimized. Expertise in bone-setting and reducing dislocations was highly valued, but this was the limit of manual intervention. Stress was laid on securing the cooperation of the patient in fighting disease, and the special and psychological value of prognosis was emphasized as much as the diagnostic. There were few general diseases, and their cause should be sought within the patient, although general climatic and environmental factors were not disregarded, e.g. contagion.

 Because of the heterogeneity of the treatises forming the ‘Hippocratic corpus’ and the deliberately obscure and oracular way in which many doctrines are expressed, Hippocratism was never as systematic as Galenism (itself an interpretation of Hippocrates), and its flexibility enabled it to be interpreted in many ways from Meno (fl 320 BC) to the present day. As late as the end of the 17th century, Friedrich Hoffmann (1660–1742) claimed Hippocrates anticipated Descartes (1596–1650) in understanding the essentially mechanistic workings of the body [man-machine]. The emphasis in Hippocratism on clinical observation and on following Nature’s way made it particularly attractive in the mid-19th century, the age of the greatest editor of Hippocrates, Littré (1801–81), as a way out of therapeutic nihilism. Its constant reappearance in the 20th century is as a reaction against ‘disease-orientated’ medicine and towards a consideration of the patient viewed as an individual whole. The ‘Hippocratic’ Oath (which cannot be by the historical Hippocrates) is often claimed as a medical ideal of service to the art and the community, and its precepts are invoked as if eternally and universally valid. Others have found many modern concepts, including the blood-circulation, pre-figured in the ‘Hippocratic corpus’.

 Although historians like Edelstein (1902–65) have sought to abolish the myth of Hippocrates as ‘father of Western medicine’, and to interpret the ‘Hippocratic corpus’ in accordance with the social, philosophical and medical conditions of its time, they have not succeeded in alerting the medical profession to the complexities and contradictions inherent in any revived Hippocratism. 

SOURCE: Vivian Nutton, “Hippocratism.” In Dictionary of the History of Science. Edited by W. F. Bynum, E. J. Browne, and Roy Porter. Princeton, NJ: Princeton University Press, 1981. 188.
     The comment about Edelstein’s work refers to:
Ancient Medicine; Selected Papers of Ludwig Edelstein. Edited by Owsei Temkin and C. Lilian Temkin. Translations from the German by C. Lilian Temkin (Baltimore: Johns Hopkins Press, [1967]).