- Introduction to Hippocrates
- Notes
- Bibliography
-
Return to Course Index
The Hippocratic Corpus
The class will study the writings associated with Hippocrates of Cos, whose life span was roughly coeval with that of Socrates of Athens (469-399 B.C.E.).
map
showing the area of scientific and philosophical
achievements in the vicinity of the Island of Cos: the Ionian colonies are to
the
north-east and the Doric states of the Hexapolis to the east and south-
east.]
Although the corpus of Hippocratic writings does not contain one single
composition
known for certain to have been written by Hippocrates, it does include a
number of
early documents that were actually composed
in his life-time.3 . The bulk
of the
Hippocratic corpus comprises about sixty compositions
that are possibly
the remnants
of book collections from a variety of sources:
some emanating from ancient
medical
centres from the eastern Aegean,
some comprising general medical works
of a
popular nature, and others composed
by individual doctors from various
parts of the
Greek world. Most of these works
had probably already been gathered
together and
edited in the Library of Alexandria
(Farrington 1966: 66-67). This may
account for the
variety of sources involved.
However, in basic essentials, the Hippocratic
corpus
probably originated in the island of Cos,
although some of it may also
reflect the
teaching of the rival medical school in neighbouring Cnidos.
4 . Traditionally,
the
keeper of these writings was
the guild of Coan physicians known as the
'Asclepiadae',
or 'Sons of Asclepius', God of Healing 5
. During the classical and the
Hellenistic period,
Cos had long served as a cult and healing centre
dedicated to the worship
of Apollo the
Physician (Ietros), Asclepius, his son -
as well as to the latter's daughters,
the
Goddesses Hygieia ('Health') and Panacea
('Complete Recuperation' or
'Recuperation
for All'). However, there are very few references to this cult
in the
Hippocratic
corpus itself.6 . For
the moment, we may note
that the Hippocratic collection
is
scientific, rather than cultic in tenor
and none of these practices form part
of its
discussions.
Nonetheless, the works of the corpus
do not advocate any single medical
method -
nor do they all subscribe to the same physiological theory. Let us take as
an example
two early works that examine the issue of medical theory each in
markedly different
way:
1) On Ancient Medicine (peri Archaies Ietrikes) is edited in Hippocrates
1923-1931: I
pp. 12-64.7 . It is in effect an attack on those physicians (ietroi) and
philosophers
(sophistai) who claimed that no one could acquire the medical art who did
not first
know what man is himself (cap. 20).8 . However, something very like the
hypothesis
criticised here was ascribed by Plato to Hippocrates himself.9 In place of
the
application of philosophic hypotheseis to medical science (cap. 1-2), the
author
proposes to return to the empirical methods of "ancient medicine (archaia
ietrike)"
(cap. 3-4), hence the title of his composition. For him, 'ancient medicine'
represents medical art before philosophers and theoreticians like
Empedocles
interfered with it. The author admits that ancient medicine did not achieve
accuracy (akribeia), but adds that we need not abandon its procedure of
inquiry
because of this (cap. 12). For him, ancient medicine belonged, as it were, to
a golden
age in the past, but, at the same time, bequeathed a methodology that the
author
applies to the empirical school of his own day. This methodology consisted
mostly in
the diagnosis, prognosis and record of the course of the disease; any
treatment was
of a mostly palliative nature.
2) On the Nature of Man (peri Physios Anthropou) is edited in Hippocrates
1923-1931:
IV. 2-41. It advocates a medical theory completely contradictory to the
previous
work: the author believes in the influence of the humours on the physical
constitution (caps. 1, 8), in a theory of the relationship between mind, body
and
disease (cap. 9), and in the influence of climate and environment on health
(cap.
13-18). The nature of man is thus to be understood as part of the same
cosmological
and physiological principle that governs all living creatures. In contrast to
the
previous work, On the Nature of Man presupposes a medical hypothesis
independent of the examination of individual cases.
The book of Regimen (peri Diaites) I - edited in Hippocrates 1923-1931:
IV. 224-295 -
embodies the type of philosophy attacked in On Ancient Medicine since it
claims that
to discuss a healthy way of life properly "we need first understand the
nature of man
as a whole" (cap. II). It attaches importance to philosophical terminology
(caps. IV),
but its hypothetical assumptions are different from those of On the Nature
of Man,
since it upholds a theory of health as a balance in temperature (hot-cold),
fluidity
(cap. III) and diet-activity (cap. II).
Other works in the Hippocratic corpus are devoted less to medical theory
per se, as to
the question of rational and empirical treatment of diseases and wounds -
e.g., On
Affections (peri Pathon) and On Diseases (peri Nouson) I-II . Nonetheless,
advice on
practical methodology is sometimes raised in their discussion. In On
Affections, the
first duty of the doctor is to question the patient about his symptoms
before
beginning the examination (Hippocrates 1923-1931: I cap. 37). In On
Diseases I, even
questions of medical ethics are raised:
"The following are correctly and incorrectly done: incorrectly done is
to tell (the patient) that the disease is one thing when it is another; to
say that it is serious when it is minor - or minor when it is serious; to
deny that (a patient) will survive when he will - and to one about to
die, to deny that he will die" (Hippocrates 1923-1931: I 'On Diseases I'
cap. 6).
Other works in the Hippocratic collection discuss causes of specific disease
and ill-
health. The early composition, On the Sacred Disease (peri Hieres Nousou) ,
for
instance, discusses mistaken and superstitious notions about the causes of
epilepsy. It
is edited in Hippocrates 1923-1931: II pp. 138-183. Yet other works, like
the first and
third books of Epidemics, comprise mere notes of case histories, but of a
purely
empirical and descriptive nature with little, or no suggestions for
treatment (edited
in: Hippocrates 1923-1931: I pp. 146-211, 218-287). Not always is the
purpose of
composition of these works totally clear: they sometimes resemble lists
and
procedural notes written by the doctor for his own use - e.g., Epidemics I
and III
(Jones in: Hippocrates 1923-1931: I pp. 141-142). Others resemble
fragments
reassembled out of the accumulated written experience recorded in a
school's
archive.10 . Yet other texts may be lecture notes - and not all of them
addressed to a
professional medical audience.11 .Some of them are composed with the
well-read
layman chiefly in mind - the sort of person who was interested in learning
about
health and disease.12 .
press for computerised map
showing the area of scientific and philosophical
achievements in the vicinity of the Island of Cos: the Ionian colonies are to
the
north-east and the Doric states of the Hexapolis to the east and south-
east.]
The Hippocratic Tradition and the Beginnings of Rationalism
It is not pure chance that the Hippocratic tradition developed in Cos along
the lines
that it did. There are two aspects that need be noticed: first the indigenous
Doric
society in the island; secondly, its Ionic literary affiliation. Like its rival,
Cnidos, its
medical school was situated in an area that was linguistically and socially
part of a
Doric tradition (Schmitt 19912: 43-45). The original Doric Hexapolis once
embraced
cities in the islands of Cos and Rhodes, as well as mainland Cnidos and
Halicarnassus
on the opposite shores. However, the proximity of the Ionic cultural
centres at
Miletus, Samos, Ephesus and Colophon, meant that not only did Ionic
scientific and
philosophic thought reach Cos, but also a tradition of composing medical
writings in
an artificial Ionic language. Close to Cos, there had also evolved a tradition
of
preserving and analysing factual records, that culminated in the Histories
of
Herodotus from neighbouring Halicarnassus (c. 484-420 B.C.E.). However,
by classical
times, his native city of Halicarnassus had left the Hexapolis, no longer
maintaining
its Doric religious and social obligations (Herodotus 1967: I. 144) and had
adopted the
cultural traditions of Ionia (Schmitt 19912: 98-99). Consequently, it was in
this dialect
that Herodotus composed his works.13 . To a certain extent, the Ionic dialect
and factual
descriptions of the Hippocratic corpus can be said to have been preceded
by prose
writers like Herodotus.
The early Ionic philosophers working in Miletus and Ephesus were
described by
Aristotle as physikoi and physiologoi, those who give an account of nature
(physis).14 . The research and theory developed at Miletus by the 6th-5th
century
physiologists, Thales, Anaximander and Anxaximenes, touched on
questions relating
to nearly every aspect of nature - ranging from cosmology to the origins of
the
humankind. However, there is no evidence that they examined questions
of a purely
medical nature. It is true that the 5th-4th century Pythagoreans did
develop a special
medical theory of their own, but it seems to have flourished in Italy,
rather than in
Pythagoras' native Samos. What characterised philosophy at its earliest
period was
the struggle to explain the universe in non-supernatural terms, by seeking
a cause
(aitia) for cosmological, meteorological and terrestrial phenomena in a
rationalistic and consistent manner.
Scholars have understood the concept of a gradually emergent
rationalism in a variety of ways. Many have equated this process with
the 'scientific' (i.e., speculative) spirit of Ionia, although these two
developments should be clearly distinguished as far as the early period
is concerned. Mythologists like Hesiod speculated on the order of cosmic
creation no less than 'thinkers' like Anaximander. Others have pointed
to the abandonment of personification in early cosmological and
theological discussions as an indication of the distinction between the
thought of the early Ionians and the poetry of Homer and Hesiod
(Cornford 1957: 15-16). This tendency to offer a humanly subjective,
rather than objective account of the universe does not in itself
contradict the presence of a logical and rational process even in
mythopoeic thought (Frankfort-Wilson-Jacobsen 1964: 18-20). Neither
does it maintain that philosophers were ever pure rationalists right
down to the Hellenistic period (Dodds 1966: 254). Both approaches are
necessary to explain an emergent rationalism: an objective account of
reality as well as a process of ratiocination of some fashion. For this
reason, it has been suggested that the rationalism characterizing both
Hesiod and Ionian thought begins not only with apersonalization of
speculative accounts, but also with the ability to analyze, synthesize and
systematize complex accounts of the universe (Kirk-Raven-Schofield
19832: 72-73). I have my doubts, however, concerning to what extent the
early thinkers were aware of the revolution that they were innovating
(Lloyd 1987: 49) since the first book of Aristotle's Metaphysics goes out
of its way to stress the continutiy with the older thought of the
mythological poets. But a revolution there was in medicine as well as
philosophy.
When Xenophanes (c. 570-478 B.C.E.) of Ionic Colophon said, "What they
call Iris
this too is by nature a bright, purple and yellowish cloud in appearance
(Diels -
Kranz 1969 14: I. 21 B32), he was rationalising the Goddess Rainbow as a
cloud and a
meteorological, cosmological principle (Kirk-Raven-Schofield 19832: Fr.
178). While
we hear of philosophers like Anaxagoras and Protagoras who were
punished and
exiled for questioning the role of the gods in the universe, we do not hear
of doctors
who suffered for seeking a rational rather than divine cause for disease.
The author
of On the Sacred Disease argued that "man's body is not defiled by a god"
(Hippocrates
1923-1931: II. cap. IV. 40-50) and that "this disease (scil. epilepsy) is in
my opinion no
more divine than any other" (cap. V. 61). Similarly, the author of On the
Art (peri
Technes) replies to "those who do not reason logically (ouk orthos
logizomenoi)"
concerning the art of medicine (edited in: Hippocrates 1923-1931: II. pp.
190-217).15 .
He thus denies that the cause of recovery is spontaneous (automaton; cap.
vi.10) or
due to chance (tyche; cap. vii). In his opinion, "the cures should be
infallible, not
because they are easy, but because they have been discovered" (cap.
ix.10).
Illustration 4 (Cos slide a):
Text to Illustration 4 ["The arrival of the
God Asclepius at Cos, greeted by a
Coan
and showing Hippocrates seated at a school exedra (2nd-3rd century A.D.
mosaic). Cos
Museum. Photo: S. Stournaras"]
Cult Practice and the Medical Art
Notes
3 The relationship of the corpus to the historic Hippocrates is problematic
since the
testimonies of Plato and Aristotle concerning Hippocrates' medical theories
do not
conform closely to the corpus. For general discussions, see: L. Edelstein
19792, s.v.
'Hippocrates'; Singer-Wasserstein 19792, s.v. 'Medicine VII'; Lloyd 1978,
9-12, 21-37.
4 Nonetheless, the opinions of the Cnidians are attacked in the early
Hippocratic
work, Regimen in Acute Diseases (Hippocrates 1923-1931: II, caps. I-
III).
5 On the various theories concerning the meaning of the term Asclepiadae,
see: Jones,
in: Hippocrates 1923-1931: I pp. xliv-xlvi, II p. 335.
6 Exceptions are: 1) the famous Hippocratic Oath (text in: Hippocrates
1923-1931: I pp.
298-301) addressed to Apollo the Physician, Asclepius, Hygieia and
Panacea - but as
an oath it is sui generis and not part of a treatment process; 2) the late
pseudo-
Hippocratic Letter xv, written as a report of a supposed epiphany
recounted by
Hippocrates.
7 This is an old composition (c. 430-420 B.C.E.), whose author is presumed
to be "either
Hippocrates or a very capable supporter" (Jones, in: Hippocrates 1923-
1931: I p. 5).
8 Of the philosopher-medical writers that the author has in mind, he
names only
Empedocles specifically. A later product of this school is Regimen I
(discussed
below).
9 Plato 1964: Phaedrus 270c. For background, see: Hackforth 1952: 151.
This, of course,
would mean that On Ancient Medicine was composed by one of
Hippocrates'
opponents.
10 As in the book of Precepts (Parangeliai) - edited in: Hippocrates 1923-
1931: I. pp.
312-333. In the editor's opinion, it represents a collection of jottings
derived from
works of differing methodologies and theories (Jones in: Hippocrates 1923-
1931: I.
pp. 305-307). We may also compare the more famous seven books of
Aphorisms
(Hippocrates 1923-1931: IV, pp. 98-221), with their gnomic parabolizing
form,
famous for the saying 'Life is short, the (medical) art is long etc.' (cap.
I).
11 The early composition, On Breaths (peri Physon) is described by its
editor as "a
sophistic essay, probably delivered to an audience" (Jones in: Hippocrates
1923-
1931: II p. 221).
12 Cf. On Affections cap. 1 (Hippocrates 1988: V p. 6), that opens in this
fashion: "An
intelligent man who considers health of importance to humans, will have
an
understanding of disease. He need understand what doctors tell him and
what they
intend to do to his body, having a lay knowledge of these matters".
13 The question of the actual spoken language of Halicarnassus - as
opposed to its
Ionian literary and inscriptional veneer - is still undetermined since many
of the
inhabitants were of mixed Carian stock. The spoken language may well
have been
some patois.
14 The original application of these Greek terms is thus much broader than
the
modern derivations of 'physiologist' and 'physician'.
15 Many consider this work to be the product of a sophist who had studied
some
medicine.
return to top
Bibliography for the notes of this section
-
Aristotle, 19752 On the Soul, Parva Naturalia , On Breath (trans.-ed. W.S. Hett), Cambridge, Mass.
-
Dodds, E.R. 1966 The Greeks and the Irrational, Berkeley-L.A.
-
Diels, H. - Kranz, W. 1969 14 Fragmente der Vorsokratiker I-III, Dublin-Zurich
-
Edelstein, L. (19792) in: Oxford Classical Dictionary, Oxford, s.v. 'Hippocrates'
-
Farrington, B. 1966 Greek Science., Harmondsworth
-
Galen 1952 On the Natural Faculties (ed.-trans., A.J. Brock), Cambridge, Mass.
-
Grant, F.C. 1953 Hellenistic Religions, Indianapolis-N.Y
-
Guthrie, W.K.C. 1968 The Greeks and their Gods, Cambridge
-
Cornford, F.M. 1957 From Religion to Philosophy A Study in the Origins of Western Speculation
-
Frankfort, H. & H.A., Wilson, J.A., Jacobsen, J. 1964, Before Philosophy
-
Hackforth, R. 1952 Plato's Phaedrus, N.Y
-
Herodotus 1967 Herodoti Historiae, Oxford
-
Hippocrates 1923-1931 Hippocrates I-IV (ed.-trans. W.H.S. Jones), Cambridge, Mass.
-
Hippocrates 1988 Hippocrates V-VI (ed.-trans. P. Potter), Cambridge, Mass.
-
Hippocrates 1996 Hippocrates VII (ed.-trans. W.D. Smith), Cambridge, Mass.
-
Hippocrates 1996 Hippocrates VIII (ed.-trans. P. Potter), Cambridge, Mass.
-
Jones, W.H.S. 1979 Philosophy and Medicine in Ancient Greece, Chicago
-
Kirk, G.S. - Raven, J.E. -Schofield, M. 19832 The Presocratic Philosophers Cambridge
-
Knox, E.D. 1953 Herodes, Cercidas and the Greek Choliambic Poets, Cambridge, Mass.
-
Lloyd, G.E.R. (ed.) 1978 Hippocratic Writings, Aylesbury
-
Lloyd, G.E.R. 1979 Magic, Reason and Experience, Cambridge
-
Lloyd, G.E.R. 1987 The Revolutions of Wisdom - Studies in the Claims and Practice of Ancient Greek Science (Sather Classical Lectures, 52), Berkeley
-
Plato 1964 Platonis Opera (ed. J. Burnet), Oxford
-
Rice, D.G. - Stambaugh, J.E. 1979 Sources for the Study of Greek Religion, Scholars Press
-
Schmitt, R. 19912 Einführung in die griechischen Dialekte, Darmstadt
-
Singer, C. - Wasserstein, A. 19792 in: Oxford Classical Dictionary, s.v. 'Medicine VII', Oxford
The Hippocratic Corpus
map
showing the area of scientific and philosophical
achievements in the vicinity of the Island of Cos: the Ionian colonies are to
the
north-east and the Doric states of the Hexapolis to the east and south-
east.]
Although the corpus of Hippocratic writings does not contain one single
composition
known for certain to have been written by Hippocrates, it does include a
number of
early documents that were actually composed
in his life-time.3 . The bulk
of the
Hippocratic corpus comprises about sixty compositions
that are possibly
the remnants
of book collections from a variety of sources:
some emanating from ancient
medical
centres from the eastern Aegean,
some comprising general medical works
of a
popular nature, and others composed
by individual doctors from various
parts of the
Greek world. Most of these works
had probably already been gathered
together and
edited in the Library of Alexandria
(Farrington 1966: 66-67). This may
account for the
variety of sources involved.
However, in basic essentials, the Hippocratic
corpus
probably originated in the island of Cos,
although some of it may also
reflect the
teaching of the rival medical school in neighbouring Cnidos.
4 . Traditionally,
the
keeper of these writings was
the guild of Coan physicians known as the
'Asclepiadae',
or 'Sons of Asclepius', God of Healing 5
. During the classical and the
Hellenistic period,
Cos had long served as a cult and healing centre
dedicated to the worship
of Apollo the
Physician (Ietros), Asclepius, his son -
as well as to the latter's daughters,
the
Goddesses Hygieia ('Health') and Panacea
('Complete Recuperation' or
'Recuperation
for All'). However, there are very few references to this cult
in the
Hippocratic
corpus itself.6 . For
the moment, we may note
that the Hippocratic collection
is
scientific, rather than cultic in tenor
and none of these practices form part
of its
discussions.
Nonetheless, the works of the corpus
do not advocate any single medical
method -
nor do they all subscribe to the same physiological theory. Let us take as
an example
two early works that examine the issue of medical theory each in
markedly different
way:
1) On Ancient Medicine (peri Archaies Ietrikes) is edited in Hippocrates
1923-1931: I
pp. 12-64.7 . It is in effect an attack on those physicians (ietroi) and
philosophers
(sophistai) who claimed that no one could acquire the medical art who did
not first
know what man is himself (cap. 20).8 . However, something very like the
hypothesis
criticised here was ascribed by Plato to Hippocrates himself.9 In place of
the
application of philosophic hypotheseis to medical science (cap. 1-2), the
author
proposes to return to the empirical methods of "ancient medicine (archaia
ietrike)"
(cap. 3-4), hence the title of his composition. For him, 'ancient medicine'
represents medical art before philosophers and theoreticians like
Empedocles
interfered with it. The author admits that ancient medicine did not achieve
accuracy (akribeia), but adds that we need not abandon its procedure of
inquiry
because of this (cap. 12). For him, ancient medicine belonged, as it were, to
a golden
age in the past, but, at the same time, bequeathed a methodology that the
author
applies to the empirical school of his own day. This methodology consisted
mostly in
the diagnosis, prognosis and record of the course of the disease; any
treatment was
of a mostly palliative nature.
2) On the Nature of Man (peri Physios Anthropou) is edited in Hippocrates
1923-1931:
IV. 2-41. It advocates a medical theory completely contradictory to the
previous
work: the author believes in the influence of the humours on the physical
constitution (caps. 1, 8), in a theory of the relationship between mind, body
and
disease (cap. 9), and in the influence of climate and environment on health
(cap.
13-18). The nature of man is thus to be understood as part of the same
cosmological
and physiological principle that governs all living creatures. In contrast to
the
previous work, On the Nature of Man presupposes a medical hypothesis
independent of the examination of individual cases.
The book of Regimen (peri Diaites) I - edited in Hippocrates 1923-1931:
IV. 224-295 -
embodies the type of philosophy attacked in On Ancient Medicine since it
claims that
to discuss a healthy way of life properly "we need first understand the
nature of man
as a whole" (cap. II). It attaches importance to philosophical terminology
(caps. IV),
but its hypothetical assumptions are different from those of On the Nature
of Man,
since it upholds a theory of health as a balance in temperature (hot-cold),
fluidity
(cap. III) and diet-activity (cap. II).
Other works in the Hippocratic corpus are devoted less to medical theory
per se, as to
the question of rational and empirical treatment of diseases and wounds -
e.g., On
Affections (peri Pathon) and On Diseases (peri Nouson) I-II . Nonetheless,
advice on
practical methodology is sometimes raised in their discussion. In On
Affections, the
first duty of the doctor is to question the patient about his symptoms
before
beginning the examination (Hippocrates 1923-1931: I cap. 37). In On
Diseases I, even
questions of medical ethics are raised:
"The following are correctly and incorrectly done: incorrectly done is
to tell (the patient) that the disease is one thing when it is another; to
say that it is serious when it is minor - or minor when it is serious; to
deny that (a patient) will survive when he will - and to one about to
die, to deny that he will die" (Hippocrates 1923-1931: I 'On Diseases I'
cap. 6).
Other works in the Hippocratic collection discuss causes of specific disease
and ill-
health. The early composition, On the Sacred Disease (peri Hieres Nousou) ,
for
instance, discusses mistaken and superstitious notions about the causes of
epilepsy. It
is edited in Hippocrates 1923-1931: II pp. 138-183. Yet other works, like
the first and
third books of Epidemics, comprise mere notes of case histories, but of a
purely
empirical and descriptive nature with little, or no suggestions for
treatment (edited
in: Hippocrates 1923-1931: I pp. 146-211, 218-287). Not always is the
purpose of
composition of these works totally clear: they sometimes resemble lists
and
procedural notes written by the doctor for his own use - e.g., Epidemics I
and III
(Jones in: Hippocrates 1923-1931: I pp. 141-142). Others resemble
fragments
reassembled out of the accumulated written experience recorded in a
school's
archive.10 . Yet other texts may be lecture notes - and not all of them
addressed to a
professional medical audience.11 .Some of them are composed with the
well-read
layman chiefly in mind - the sort of person who was interested in learning
about
health and disease.12 .
press for computerised map
showing the area of scientific and philosophical
achievements in the vicinity of the Island of Cos: the Ionian colonies are to
the
north-east and the Doric states of the Hexapolis to the east and south-
east.]
The Hippocratic Tradition and the Beginnings of Rationalism
It is not pure chance that the Hippocratic tradition developed in Cos along
the lines
that it did. There are two aspects that need be noticed: first the indigenous
Doric
society in the island; secondly, its Ionic literary affiliation. Like its rival,
Cnidos, its
medical school was situated in an area that was linguistically and socially
part of a
Doric tradition (Schmitt 19912: 43-45). The original Doric Hexapolis once
embraced
cities in the islands of Cos and Rhodes, as well as mainland Cnidos and
Halicarnassus
on the opposite shores. However, the proximity of the Ionic cultural
centres at
Miletus, Samos, Ephesus and Colophon, meant that not only did Ionic
scientific and
philosophic thought reach Cos, but also a tradition of composing medical
writings in
an artificial Ionic language. Close to Cos, there had also evolved a tradition
of
preserving and analysing factual records, that culminated in the Histories
of
Herodotus from neighbouring Halicarnassus (c. 484-420 B.C.E.). However,
by classical
times, his native city of Halicarnassus had left the Hexapolis, no longer
maintaining
its Doric religious and social obligations (Herodotus 1967: I. 144) and had
adopted the
cultural traditions of Ionia (Schmitt 19912: 98-99). Consequently, it was in
this dialect
that Herodotus composed his works.13 . To a certain extent, the Ionic dialect
and factual
descriptions of the Hippocratic corpus can be said to have been preceded
by prose
writers like Herodotus.
The early Ionic philosophers working in Miletus and Ephesus were
described by
Aristotle as physikoi and physiologoi, those who give an account of nature
(physis).14 . The research and theory developed at Miletus by the 6th-5th
century
physiologists, Thales, Anaximander and Anxaximenes, touched on
questions relating
to nearly every aspect of nature - ranging from cosmology to the origins of
the
humankind. However, there is no evidence that they examined questions
of a purely
medical nature. It is true that the 5th-4th century Pythagoreans did
develop a special
medical theory of their own, but it seems to have flourished in Italy,
rather than in
Pythagoras' native Samos. What characterised philosophy at its earliest
period was
the struggle to explain the universe in non-supernatural terms, by seeking
a cause
(aitia) for cosmological, meteorological and terrestrial phenomena in a
rationalistic and consistent manner.
Scholars have understood the concept of a gradually emergent
rationalism in a variety of ways. Many have equated this process with
the 'scientific' (i.e., speculative) spirit of Ionia, although these two
developments should be clearly distinguished as far as the early period
is concerned. Mythologists like Hesiod speculated on the order of cosmic
creation no less than 'thinkers' like Anaximander. Others have pointed
to the abandonment of personification in early cosmological and
theological discussions as an indication of the distinction between the
thought of the early Ionians and the poetry of Homer and Hesiod
(Cornford 1957: 15-16). This tendency to offer a humanly subjective,
rather than objective account of the universe does not in itself
contradict the presence of a logical and rational process even in
mythopoeic thought (Frankfort-Wilson-Jacobsen 1964: 18-20). Neither
does it maintain that philosophers were ever pure rationalists right
down to the Hellenistic period (Dodds 1966: 254). Both approaches are
necessary to explain an emergent rationalism: an objective account of
reality as well as a process of ratiocination of some fashion. For this
reason, it has been suggested that the rationalism characterizing both
Hesiod and Ionian thought begins not only with apersonalization of
speculative accounts, but also with the ability to analyze, synthesize and
systematize complex accounts of the universe (Kirk-Raven-Schofield
19832: 72-73). I have my doubts, however, concerning to what extent the
early thinkers were aware of the revolution that they were innovating
(Lloyd 1987: 49) since the first book of Aristotle's Metaphysics goes out
of its way to stress the continutiy with the older thought of the
mythological poets. But a revolution there was in medicine as well as
philosophy.
When Xenophanes (c. 570-478 B.C.E.) of Ionic Colophon said, "What they
call Iris
this too is by nature a bright, purple and yellowish cloud in appearance
(Diels -
Kranz 1969 14: I. 21 B32), he was rationalising the Goddess Rainbow as a
cloud and a
meteorological, cosmological principle (Kirk-Raven-Schofield 19832: Fr.
178). While
we hear of philosophers like Anaxagoras and Protagoras who were
punished and
exiled for questioning the role of the gods in the universe, we do not hear
of doctors
who suffered for seeking a rational rather than divine cause for disease.
The author
of On the Sacred Disease argued that "man's body is not defiled by a god"
(Hippocrates
1923-1931: II. cap. IV. 40-50) and that "this disease (scil. epilepsy) is in
my opinion no
more divine than any other" (cap. V. 61). Similarly, the author of On the
Art (peri
Technes) replies to "those who do not reason logically (ouk orthos
logizomenoi)"
concerning the art of medicine (edited in: Hippocrates 1923-1931: II. pp.
190-217).15 .
He thus denies that the cause of recovery is spontaneous (automaton; cap.
vi.10) or
due to chance (tyche; cap. vii). In his opinion, "the cures should be
infallible, not
because they are easy, but because they have been discovered" (cap.
ix.10).
Illustration 4 (Cos slide a):
Text to Illustration 4 ["The arrival of the
God Asclepius at Cos, greeted by a
Coan
and showing Hippocrates seated at a school exedra (2nd-3rd century A.D.
mosaic). Cos
Museum. Photo: S. Stournaras"]
Cult Practice and the Medical Art
Notes
3 The relationship of the corpus to the historic Hippocrates is problematic
since the
testimonies of Plato and Aristotle concerning Hippocrates' medical theories
do not
conform closely to the corpus. For general discussions, see: L. Edelstein
19792, s.v.
'Hippocrates'; Singer-Wasserstein 19792, s.v. 'Medicine VII'; Lloyd 1978,
9-12, 21-37.
4 Nonetheless, the opinions of the Cnidians are attacked in the early
Hippocratic
work, Regimen in Acute Diseases (Hippocrates 1923-1931: II, caps. I-
III).
5 On the various theories concerning the meaning of the term Asclepiadae,
see: Jones,
in: Hippocrates 1923-1931: I pp. xliv-xlvi, II p. 335.
6 Exceptions are: 1) the famous Hippocratic Oath (text in: Hippocrates
1923-1931: I pp.
298-301) addressed to Apollo the Physician, Asclepius, Hygieia and
Panacea - but as
an oath it is sui generis and not part of a treatment process; 2) the late
pseudo-
Hippocratic Letter xv, written as a report of a supposed epiphany
recounted by
Hippocrates.
7 This is an old composition (c. 430-420 B.C.E.), whose author is presumed
to be "either
Hippocrates or a very capable supporter" (Jones, in: Hippocrates 1923-
1931: I p. 5).
8 Of the philosopher-medical writers that the author has in mind, he
names only
Empedocles specifically. A later product of this school is Regimen I
(discussed
below).
9 Plato 1964: Phaedrus 270c. For background, see: Hackforth 1952: 151.
This, of course,
would mean that On Ancient Medicine was composed by one of
Hippocrates'
opponents.
10 As in the book of Precepts (Parangeliai) - edited in: Hippocrates 1923-
1931: I. pp.
312-333. In the editor's opinion, it represents a collection of jottings
derived from
works of differing methodologies and theories (Jones in: Hippocrates 1923-
1931: I.
pp. 305-307). We may also compare the more famous seven books of
Aphorisms
(Hippocrates 1923-1931: IV, pp. 98-221), with their gnomic parabolizing
form,
famous for the saying 'Life is short, the (medical) art is long etc.' (cap.
I).
11 The early composition, On Breaths (peri Physon) is described by its
editor as "a
sophistic essay, probably delivered to an audience" (Jones in: Hippocrates
1923-
1931: II p. 221).
12 Cf. On Affections cap. 1 (Hippocrates 1988: V p. 6), that opens in this
fashion: "An
intelligent man who considers health of importance to humans, will have
an
understanding of disease. He need understand what doctors tell him and
what they
intend to do to his body, having a lay knowledge of these matters".
13 The question of the actual spoken language of Halicarnassus - as
opposed to its
Ionian literary and inscriptional veneer - is still undetermined since many
of the
inhabitants were of mixed Carian stock. The spoken language may well
have been
some patois.
14 The original application of these Greek terms is thus much broader than
the
modern derivations of 'physiologist' and 'physician'.
15 Many consider this work to be the product of a sophist who had studied
some
medicine.
return to top
Bibliography for the notes of this section
-
Aristotle, 19752 On the Soul, Parva Naturalia , On Breath (trans.-ed. W.S. Hett), Cambridge, Mass.
-
Dodds, E.R. 1966 The Greeks and the Irrational, Berkeley-L.A.
-
Diels, H. - Kranz, W. 1969 14 Fragmente der Vorsokratiker I-III, Dublin-Zurich
-
Edelstein, L. (19792) in: Oxford Classical Dictionary, Oxford, s.v. 'Hippocrates'
-
Farrington, B. 1966 Greek Science., Harmondsworth
-
Galen 1952 On the Natural Faculties (ed.-trans., A.J. Brock), Cambridge, Mass.
-
Grant, F.C. 1953 Hellenistic Religions, Indianapolis-N.Y
-
Guthrie, W.K.C. 1968 The Greeks and their Gods, Cambridge
-
Cornford, F.M. 1957 From Religion to Philosophy A Study in the Origins of Western Speculation
-
Frankfort, H. & H.A., Wilson, J.A., Jacobsen, J. 1964, Before Philosophy
-
Hackforth, R. 1952 Plato's Phaedrus, N.Y
-
Herodotus 1967 Herodoti Historiae, Oxford
-
Hippocrates 1923-1931 Hippocrates I-IV (ed.-trans. W.H.S. Jones), Cambridge, Mass.
-
Hippocrates 1988 Hippocrates V-VI (ed.-trans. P. Potter), Cambridge, Mass.
-
Hippocrates 1996 Hippocrates VII (ed.-trans. W.D. Smith), Cambridge, Mass.
-
Hippocrates 1996 Hippocrates VIII (ed.-trans. P. Potter), Cambridge, Mass.
-
Jones, W.H.S. 1979 Philosophy and Medicine in Ancient Greece, Chicago
-
Kirk, G.S. - Raven, J.E. -Schofield, M. 19832 The Presocratic Philosophers Cambridge
-
Knox, E.D. 1953 Herodes, Cercidas and the Greek Choliambic Poets, Cambridge, Mass.
-
Lloyd, G.E.R. (ed.) 1978 Hippocratic Writings, Aylesbury
-
Lloyd, G.E.R. 1979 Magic, Reason and Experience, Cambridge
-
Lloyd, G.E.R. 1987 The Revolutions of Wisdom - Studies in the Claims and Practice of Ancient Greek Science (Sather Classical Lectures, 52), Berkeley
-
Plato 1964 Platonis Opera (ed. J. Burnet), Oxford
-
Rice, D.G. - Stambaugh, J.E. 1979 Sources for the Study of Greek Religion, Scholars Press
-
Schmitt, R. 19912 Einführung in die griechischen Dialekte, Darmstadt
-
Singer, C. - Wasserstein, A. 19792 in: Oxford Classical Dictionary, s.v. 'Medicine VII', Oxford
map
showing the area of scientific and philosophical
achievements in the vicinity of the Island of Cos: the Ionian colonies are to
the
north-east and the Doric states of the Hexapolis to the east and south-
east.]
Although the corpus of Hippocratic writings does not contain one single
composition
known for certain to have been written by Hippocrates, it does include a
number of
early documents that were actually composed
Hippocratic corpus comprises about sixty compositions
of book collections from a variety of sources:
centres from the eastern Aegean,
popular nature, and others composed
Greek world. Most of these works
edited in the Library of Alexandria
variety of sources involved.
probably originated in the island of Cos,
teaching of the rival medical school in neighbouring Cnidos. Traditionally,
the
keeper of these writings was
or 'Sons of Asclepius', God of Healing 5
. During the classical and the
Hellenistic period,
Cos had long served as a cult and healing centre
Physician (Ietros), Asclepius, his son -
Goddesses Hygieia ('Health') and Panacea
for All'). However, there are very few references to this cult
corpus itself.6 . For
the moment, we may note
scientific, rather than cultic in tenor
discussions.
Nonetheless, the works of the corpus
nor do they all subscribe to the same physiological theory. Let us take as
an example
two early works that examine the issue of medical theory each in
markedly different
way:
1) On Ancient Medicine (peri Archaies Ietrikes) is edited in Hippocrates
1923-1931: I
pp. 12-64.7 . It is in effect an attack on those physicians (ietroi) and
philosophers
(sophistai) who claimed that no one could acquire the medical art who did
not first
know what man is himself (cap. 20).8 . However, something very like the
hypothesis
criticised here was ascribed by Plato to Hippocrates himself.9 In place of
the
application of philosophic hypotheseis to medical science (cap. 1-2), the
author
proposes to return to the empirical methods of "ancient medicine (archaia
ietrike)"
(cap. 3-4), hence the title of his composition. For him, 'ancient medicine'
represents medical art before philosophers and theoreticians like
Empedocles
interfered with it. The author admits that ancient medicine did not achieve
accuracy (akribeia), but adds that we need not abandon its procedure of
inquiry
because of this (cap. 12). For him, ancient medicine belonged, as it were, to
a golden
age in the past, but, at the same time, bequeathed a methodology that the
author
applies to the empirical school of his own day. This methodology consisted
mostly in
the diagnosis, prognosis and record of the course of the disease; any
treatment was
of a mostly palliative nature.
2) On the Nature of Man (peri Physios Anthropou) is edited in Hippocrates
1923-1931:
IV. 2-41. It advocates a medical theory completely contradictory to the
previous
work: the author believes in the influence of the humours on the physical
constitution (caps. 1, 8), in a theory of the relationship between mind, body
and
disease (cap. 9), and in the influence of climate and environment on health
(cap.
13-18). The nature of man is thus to be understood as part of the same
cosmological
and physiological principle that governs all living creatures. In contrast to
the
previous work, On the Nature of Man presupposes a medical hypothesis
independent of the examination of individual cases.
The book of Regimen (peri Diaites) I - edited in Hippocrates 1923-1931:
IV. 224-295 -
embodies the type of philosophy attacked in On Ancient Medicine since it
claims that
to discuss a healthy way of life properly "we need first understand the
nature of man
as a whole" (cap. II). It attaches importance to philosophical terminology
(caps. IV),
but its hypothetical assumptions are different from those of On the Nature
of Man,
since it upholds a theory of health as a balance in temperature (hot-cold),
fluidity
(cap. III) and diet-activity (cap. II).
Other works in the Hippocratic corpus are devoted less to medical theory
per se, as to
the question of rational and empirical treatment of diseases and wounds -
e.g., On
Affections (peri Pathon) and On Diseases (peri Nouson) I-II . Nonetheless,
advice on
practical methodology is sometimes raised in their discussion. In On
Affections, the
first duty of the doctor is to question the patient about his symptoms
before
beginning the examination (Hippocrates 1923-1931: I cap. 37). In On
Diseases I, even
questions of medical ethics are raised:
"The following are correctly and incorrectly done: incorrectly done is
to tell (the patient) that the disease is one thing when it is another; to
say that it is serious when it is minor - or minor when it is serious; to
deny that (a patient) will survive when he will - and to one about to
die, to deny that he will die" (Hippocrates 1923-1931: I 'On Diseases I'
cap. 6).
Other works in the Hippocratic collection discuss causes of specific disease
and ill-
health. The early composition, On the Sacred Disease (peri Hieres Nousou) ,
for
instance, discusses mistaken and superstitious notions about the causes of
epilepsy. It
is edited in Hippocrates 1923-1931: II pp. 138-183. Yet other works, like
the first and
third books of Epidemics, comprise mere notes of case histories, but of a
purely
empirical and descriptive nature with little, or no suggestions for
treatment (edited
in: Hippocrates 1923-1931: I pp. 146-211, 218-287). Not always is the
purpose of
composition of these works totally clear: they sometimes resemble lists
and
procedural notes written by the doctor for his own use - e.g., Epidemics I
and III
(Jones in: Hippocrates 1923-1931: I pp. 141-142). Others resemble
fragments
reassembled out of the accumulated written experience recorded in a
school's
archive.10 . Yet other texts may be lecture notes - and not all of them
addressed to a
professional medical audience.11 .Some of them are composed with the
well-read
layman chiefly in mind - the sort of person who was interested in learning
about
health and disease.12 .
press for computerised map
showing the area of scientific and philosophical
achievements in the vicinity of the Island of Cos: the Ionian colonies are to
the
north-east and the Doric states of the Hexapolis to the east and south-
east.]
The Hippocratic Tradition and the Beginnings of Rationalism
It is not pure chance that the Hippocratic tradition developed in Cos along
the lines
that it did. There are two aspects that need be noticed: first the indigenous
Doric
society in the island; secondly, its Ionic literary affiliation. Like its rival,
Cnidos, its
medical school was situated in an area that was linguistically and socially
part of a
Doric tradition (Schmitt 19912: 43-45). The original Doric Hexapolis once
embraced
cities in the islands of Cos and Rhodes, as well as mainland Cnidos and
Halicarnassus
on the opposite shores. However, the proximity of the Ionic cultural
centres at
Miletus, Samos, Ephesus and Colophon, meant that not only did Ionic
scientific and
philosophic thought reach Cos, but also a tradition of composing medical
writings in
an artificial Ionic language. Close to Cos, there had also evolved a tradition
of
preserving and analysing factual records, that culminated in the Histories
of
Herodotus from neighbouring Halicarnassus (c. 484-420 B.C.E.). However,
by classical
times, his native city of Halicarnassus had left the Hexapolis, no longer
maintaining
its Doric religious and social obligations (Herodotus 1967: I. 144) and had
adopted the
cultural traditions of Ionia (Schmitt 19912: 98-99). Consequently, it was in
this dialect
that Herodotus composed his works.13 . To a certain extent, the Ionic dialect
and factual
descriptions of the Hippocratic corpus can be said to have been preceded
by prose
writers like Herodotus.
The early Ionic philosophers working in Miletus and Ephesus were
described by
Aristotle as physikoi and physiologoi, those who give an account of nature
(physis).14 . The research and theory developed at Miletus by the 6th-5th
century
physiologists, Thales, Anaximander and Anxaximenes, touched on
questions relating
to nearly every aspect of nature - ranging from cosmology to the origins of
the
humankind. However, there is no evidence that they examined questions
of a purely
medical nature. It is true that the 5th-4th century Pythagoreans did
develop a special
medical theory of their own, but it seems to have flourished in Italy,
rather than in
Pythagoras' native Samos. What characterised philosophy at its earliest
period was
the struggle to explain the universe in non-supernatural terms, by seeking
a cause
(aitia) for cosmological, meteorological and terrestrial phenomena in a
rationalistic and consistent manner.
Scholars have understood the concept of a gradually emergent
rationalism in a variety of ways. Many have equated this process with
the 'scientific' (i.e., speculative) spirit of Ionia, although these two
developments should be clearly distinguished as far as the early period
is concerned. Mythologists like Hesiod speculated on the order of cosmic
creation no less than 'thinkers' like Anaximander. Others have pointed
to the abandonment of personification in early cosmological and
theological discussions as an indication of the distinction between the
thought of the early Ionians and the poetry of Homer and Hesiod
(Cornford 1957: 15-16). This tendency to offer a humanly subjective,
rather than objective account of the universe does not in itself
contradict the presence of a logical and rational process even in
mythopoeic thought (Frankfort-Wilson-Jacobsen 1964: 18-20). Neither
does it maintain that philosophers were ever pure rationalists right
down to the Hellenistic period (Dodds 1966: 254). Both approaches are
necessary to explain an emergent rationalism: an objective account of
reality as well as a process of ratiocination of some fashion. For this
reason, it has been suggested that the rationalism characterizing both
Hesiod and Ionian thought begins not only with apersonalization of
speculative accounts, but also with the ability to analyze, synthesize and
systematize complex accounts of the universe (Kirk-Raven-Schofield
19832: 72-73). I have my doubts, however, concerning to what extent the
early thinkers were aware of the revolution that they were innovating
(Lloyd 1987: 49) since the first book of Aristotle's Metaphysics goes out
of its way to stress the continutiy with the older thought of the
mythological poets. But a revolution there was in medicine as well as
philosophy.
When Xenophanes (c. 570-478 B.C.E.) of Ionic Colophon said, "What they
call Iris
this too is by nature a bright, purple and yellowish cloud in appearance
(Diels -
Kranz 1969 14: I. 21 B32), he was rationalising the Goddess Rainbow as a
cloud and a
meteorological, cosmological principle (Kirk-Raven-Schofield 19832: Fr.
178). While
we hear of philosophers like Anaxagoras and Protagoras who were
punished and
exiled for questioning the role of the gods in the universe, we do not hear
of doctors
who suffered for seeking a rational rather than divine cause for disease.
The author
of On the Sacred Disease argued that "man's body is not defiled by a god"
(Hippocrates
1923-1931: II. cap. IV. 40-50) and that "this disease (scil. epilepsy) is in
my opinion no
more divine than any other" (cap. V. 61). Similarly, the author of On the
Art (peri
Technes) replies to "those who do not reason logically (ouk orthos
logizomenoi)"
concerning the art of medicine (edited in: Hippocrates 1923-1931: II. pp.
190-217).15 .
He thus denies that the cause of recovery is spontaneous (automaton; cap.
vi.10) or
due to chance (tyche; cap. vii). In his opinion, "the cures should be
infallible, not
because they are easy, but because they have been discovered" (cap.
ix.10).
Illustration 4 (Cos slide a):
Text to Illustration 4 ["The arrival of the
God Asclepius at Cos, greeted by a
Coan
and showing Hippocrates seated at a school exedra (2nd-3rd century A.D.
mosaic). Cos
Museum. Photo: S. Stournaras"]
Cult Practice and the Medical Art
3 The relationship of the corpus to the historic Hippocrates is problematic
since the
testimonies of Plato and Aristotle concerning Hippocrates' medical theories
do not
conform closely to the corpus. For general discussions, see: L. Edelstein
19792, s.v.
'Hippocrates'; Singer-Wasserstein 19792, s.v. 'Medicine VII'; Lloyd 1978,
9-12, 21-37.
4 Nonetheless, the opinions of the Cnidians are attacked in the early
Hippocratic
work, Regimen in Acute Diseases (Hippocrates 1923-1931: II, caps. I-
III).
5 On the various theories concerning the meaning of the term Asclepiadae,
see: Jones,
in: Hippocrates 1923-1931: I pp. xliv-xlvi, II p. 335.
6 Exceptions are: 1) the famous Hippocratic Oath (text in: Hippocrates
1923-1931: I pp.
298-301) addressed to Apollo the Physician, Asclepius, Hygieia and
Panacea - but as
an oath it is sui generis and not part of a treatment process; 2) the late
pseudo-
Hippocratic Letter xv, written as a report of a supposed epiphany
recounted by
Hippocrates.
7 This is an old composition (c. 430-420 B.C.E.), whose author is presumed
to be "either
Hippocrates or a very capable supporter" (Jones, in: Hippocrates 1923-
1931: I p. 5).
8 Of the philosopher-medical writers that the author has in mind, he
names only
Empedocles specifically. A later product of this school is Regimen I
(discussed
below).
9 Plato 1964: Phaedrus 270c. For background, see: Hackforth 1952: 151.
This, of course,
would mean that On Ancient Medicine was composed by one of
Hippocrates'
opponents.
10 As in the book of Precepts (Parangeliai) - edited in: Hippocrates 1923-
1931: I. pp.
312-333. In the editor's opinion, it represents a collection of jottings
derived from
works of differing methodologies and theories (Jones in: Hippocrates 1923-
1931: I.
pp. 305-307). We may also compare the more famous seven books of
Aphorisms
(Hippocrates 1923-1931: IV, pp. 98-221), with their gnomic parabolizing
form,
famous for the saying 'Life is short, the (medical) art is long etc.' (cap.
I).
11 The early composition, On Breaths (peri Physon) is described by its
editor as "a
sophistic essay, probably delivered to an audience" (Jones in: Hippocrates
1923-
1931: II p. 221).
12 Cf. On Affections cap. 1 (Hippocrates 1988: V p. 6), that opens in this
fashion: "An
intelligent man who considers health of importance to humans, will have
an
understanding of disease. He need understand what doctors tell him and
what they
intend to do to his body, having a lay knowledge of these matters".
13 The question of the actual spoken language of Halicarnassus - as
opposed to its
Ionian literary and inscriptional veneer - is still undetermined since many
of the
inhabitants were of mixed Carian stock. The spoken language may well
have been
some patois.
14 The original application of these Greek terms is thus much broader than
the
modern derivations of 'physiologist' and 'physician'.
15 Many consider this work to be the product of a sophist who had studied
some
medicine.
return to top
in his life-time.3 . The bulk
of the
that are possibly
the remnants
some emanating from ancient
medical
some comprising general medical works
of a
by individual doctors from various
parts of the
had probably already been gathered
together and
(Farrington 1966: 66-67). This may
account for the
However, in basic essentials, the Hippocratic
corpus
although some of it may also
reflect the
4 .
the guild of Coan physicians known as the
'Asclepiadae',
dedicated to the worship
of Apollo the
as well as to the latter's daughters,
the
('Complete Recuperation' or
'Recuperation
in the
Hippocratic
that the Hippocratic collection
is
and none of these practices form part
of its
do not advocate any single medical
method -
Notes
Bibliography for the notes of this section