A note for parents: The Hippocratic books describe illness and injury frankly, and the Epidemics record many deaths. The lesson keeps to the ideas; the young readers' path has no medical detail.
For young readers
About ages 8 to 12. Read it together, or on your own.
Long ago, when people got sick, many thought an angry god had sent the illness. About 2,400 years ago, on the Greek island of Cos, a doctor named Hippocrates and the doctors who learned from him said something new: illness has natural causes, like food, weather, water and the way people live. If you watch carefully, you can learn those causes.
These doctors wrote down what they saw, day by day, for each sick person they visited: the fever, the sleep, the breathing, whether the person got better. Their notes are some of the oldest doctors' records in the world.
Key idea
Try this
Be a weather watcher, like the Hippocratic doctors. For one week, write down each morning: Is it warm or cold? Wet or dry? Windy? Which way is the wind blowing? At the end of the week, look at your notes. Did anything happen more on some kinds of days than others? (Maybe your dog was sleepier on rainy days, or the laundry took longer to dry.) You have just made a small study, the way they did.Young doctors today often still make a promise when they finish their training. The oldest promise of this kind is the Hippocratic Oath: to help the sick as well as they can, to keep their secrets, and never to use their skill to hurt anyone.
For teens and adults
The full lesson.
Who, when and why
Hippocrates of Cos (c. 460–c. 370 BC) was a famous physician in the time of Socrates. Plato mentions him as a well-known doctor who taught medicine for a fee. Almost everything else told about his life comes from biographies written centuries later.
The books under his name, the Hippocratic Corpus, are about sixty works written by many authors, mostly between about 430 and 350 BC, with some later. They disagree with one another in places. Which of them, if any, Hippocrates wrote himself is unknown. When we say "Hippocrates says", we mean "a writer in the Hippocratic Corpus says".
The problem these writers faced was how to make medicine a craft that could be learned and trusted. Around them were healers who blamed gods or spirits, and philosophers who explained the body from a single principle such as heat or water. The Hippocratic writers wanted medicine built on what can be observed in patients.
A disease with a natural cause
It is thus with regard to the disease called Sacred: it appears to me to be nowise more divine nor more sacred than other diseases, but has a natural cause from which it originates like other affections. Men regard its nature and cause as divine from ignorance and wonder, because it is not at all like to other diseases.
The "sacred disease" is epilepsy. The writer argues that it has the same kind of cause as other diseases, and places that cause in the brain. He also criticizes healers who claimed to cure it with charms and purifications. Modern medicine agrees that epilepsy is a condition of the brain, though not with his explanation of how it arises.
Place, weather and health
Whoever wishes to investigate medicine properly, should proceed thus: in the first place to consider the seasons of the year, and what effects each of them produces (for they are not at all alike, but differ much from themselves in regard to their changes). Then the winds, the hot and the cold, especially such as are common to all countries, and then such as are peculiar to each locality.
On Airs, Waters, and Places tells a traveling doctor to study a new town before treating anyone: which way it faces, its winds, its water and how its people live. It is one of the first works to link health with environment, an idea at the heart of modern public health.
Watching patients
The Epidemics record what happened to particular patients, day by day, named by where they lived: their fevers, sleep, thirst and recovery or death. Many of the patients died; the writers recorded failures as well as successes. The Prognostics teach how to foresee the course of an illness from signs, so the doctor can tell the family what to expect.
The physician must be able to tell the antecedents, know the present, and foretell the future, must meditate these things, and have two special objects in view with regard to diseases, namely, to do good or to do no harm.
Common mistake
Life is short, and the Art long; the occasion fleeting; experience fallacious, and judgment difficult. The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and externals cooperate.
The Oath
The Oath is a short text in which a new physician swears by the gods of healing to honor his teacher, to teach medicine to his teacher's sons and to his own pupils, to treat the sick for their benefit, never to give a deadly drug, to keep secret what he sees and hears, and to live a pure life. Medical schools today use many rewritten versions, and people disagree about some of its old promises and how they apply now. The original Oath was a pledge for one group of Greek doctors; it was never a law.
The four humors
One Hippocratic work, On the Nature of Man (not in the Great Books selection; Aristotle says it was by Polybus, Hippocrates' son-in-law), says the body contains four humors, blood, phlegm, yellow bile and black bile, and that health is their right mixture. Galen made this theory central, and it ruled Western and Islamic medicine until the 1800s. Not every Hippocratic writer agreed: On Ancient Medicine attacks doctors who reduce the body to hot, cold, wet and dry.
What later medicine kept, and what it changed
- Kept: looking for natural causes; careful case records; prognosis; the link between environment and health; confidentiality and the duty to the patient.
- Changed: the humors were abandoned. Cell theory (Virchow, 1858) and germ theory (Pasteur and Koch, 1860s–1880s) explained disease in new ways, and treatments built on the humors, such as bleeding patients, were given up.
- Still debated: how the old ideals of the Oath apply to new questions in medicine.
Going deeper
Context, the big questions, and how later books answered.
Medicine and philosophy
On Ancient Medicine argues that medicine is an old craft, discovered by long trial, like cooking: people found which foods made them strong and which made them ill. It warns against new theories that start from an assumed principle, such as "the hot", and deduce everything else. Philosophers, the writer says, should learn from medicine about human nature, not the other way round. This is one of the earliest arguments for experience over theory, and it anticipates Bacon's attack, much later on this ladder, on reasoning that runs ahead of observation.
Yet the same collection also contains bold theory, such as the four humors. The Hippocratic Corpus is less a single doctrine than a long argument among doctors about how medicine should be done. Reading two of its works side by side shows that argument.
Big questions
- What should a doctor do when they do not know what will help? "At least do no harm" sounds simple; when is it hard?
- Why would a writer 2,400 years ago record cases where the patient died? What does that tell you about his aims?
- Is a promise like the Oath still useful when the old version has been rewritten many times?
Galen, later on this ladder, took Hippocrates as his hero and built a whole system on him. Harvey's discovery of the circulation of the blood, much later, began the end of that system.
Talk about it together
- People once thought some illnesses were sent by gods. Why might it be hard to change a belief like that?
- The Hippocratic doctors studied a town's winds and water. What about where you live might affect people's health?
- Doctors promise to keep patients' secrets. Why is that important?
- "Life is short, and the Art long." What do you think it means? Is it true of anything you are learning?
- If you were writing a promise for doctors today, what would you put in it?