superstition aside, and to base the practice of medicine on the principles
of inductive philosophy. It is impossible to trace directly
the influence exercised upon him by the great men of his time,
but one cannot fail to connect his emancipation of medicine from
superstition with the widespread power exercised over Greek life
and thought by the living work of Socrates, Plato, Aeschylus,
Sophocles, Euripides, Herodotus and Thucydides. It was a
period of great intellectual development, and it only needed a
powerful mind such as his to bring to bear upon medicine the
same influences which were at work in other sciences. It must be
remembered that his training was not altogether bad, although
superstition entered so largely into it. He had a great master in
Democritus, the originator of the doctrine of atoms, and there is
every reason to believe that the various “asclepia” were very
carefully conducted hospitals for the sick, possessing a curious
system of case-books, in the form of votive tablets, left by the
patients, on which were recorded the symptoms, treatment and
result of each case. He had these records at his command; and
he had the opportunity of observing the system of training and
the treatment of injuries in the gymnasia. One of his great
merits is that he was the first to dissociate medicine from priest-craft,
and to direct exclusive attention to the natural history of
disease. How strongly his mind revolted against the use of
charms, amulets, incantations and such devices appears from his
writings; and he has expressly recorded, as underlying all his
practice, the conviction that, however diseases may be regarded
from the religious point of view, they must all be scientifically
treated as subject to natural laws (De aëre, 29). Nor was he
anxious to maintain the connexion between philosophy and
medicine which had for long existed in a confused and confusing
fashion.[1] His knowledge of anatomy, physiology and pathology
was necessarily defective, the respect in which the dead body was
held by the Greeks precluding him from practising dissection;
thus we find him writing of the tissues without distinguishing
between the various textures of the body, confusing arteries,
veins and nerves, and speaking vaguely of the muscles as
“flesh.” But when we come to study his observations on the
natural history of disease as presented in the living subject, we
recognize at once the presence of a great clinical physician.
Hippocrates based his principles and practice on the theory of
the existence of a spiritual restoring essence or principle, φύσις,
the vis medicatrix naturae, in the management of which the art
of the physician consisted. This art could, he held, be only
obtained by the application of experience, not only to disease at
large, but to disease in the individual. He strongly deprecated
blind empiricism; the aphorism “ἡ πεῖρα σφαλερή, ἡ κρίσις χαλεπή” (whether it be his or not), tersely illustrates his position.
Holding firmly to the principle, νούσων φύσιες ἰητροί, he did not
allow himself to remain inactive in the presence of disease; he
was not a merely “expectant” physician; as Sydenham puts it,
his practice was “the support of enfeebled and the coercion of
outrageous nature.” He largely employed powerful medicines
and blood-letting both ordinary and by cupping. He advises,
however, great caution in their application. He placed great
dependence on diet and regimen, and here, quaint as many of his
directions may now sound, not only in themselves, but in the
reasons given, there is much which is still adhered to at the
present day. His treatise Περὶ ἀέρων, ὑδάτων, καὶ τόπων (Airs,
Waters, and Places) contains the first enunciation of the principles
of public health. Although the treatises Περὶ κρισίμων cannot
be accepted as authentic, we find in the Προγνωστικόν evidence of
the acuteness of observation in the manner in which the occurrence
of critical days in disease is enunciated. His method of
reporting cases is most interesting and instructive; in them we
can read how thoroughly he had separated himself from the
priest-physician. Laennec, to whom we are indebted for the
practice of auscultation, freely admits that the idea was suggested
to him by study of Hippocrates, who, treating of the presence of
morbid fluids in the thorax, gives very particular directions, by
means of succussion, for arriving at an opinion regarding their
nature. Laennec says, “Hippocrate avait tenté l’auscultation
immédiate.” Although the treatise Περὶ νούσων is doubtfully
from the pen of Hippocrates, it contains strong evidence of
having been the work of his grandson, representing the views of
the Father of Medicine. Although not accurate in the conclusions
reached at the time, the value of the method of diagnosis is
shown by the retention in modern medicine of the name and the
practice of “Hippocratic succussion.” The power of graphic
description of phenomena in the Hippocratic writings is illustrated
by the retention of the term “facies Hippocratica,”
applied to the appearance of a moribund person, pictured in the
Prognostics. In surgery his writings are important and interesting,
but they do not bear the same character of caution as the
treatises on medicine; for instance, in the essay On Injuries of
the Head, he advocates the operation “of trephining” more
strongly and in wider classes of cases than would be warranted
by the experience of later times.
The Hippocratic Collection consists of eighty-seven treatises, of which a part only can be accepted as genuine. The collection has been submitted to the closest criticism in ancient and modern times by a large number of commentators (for full list of the early commentators, see Adams’s Genuine Works of Hippocrates, Sydenham Society, i. 27, 28). The treatises have been classified according to (1) the direct evidence of ancient writers, (2) peculiarities of style and method, and (3) the presence of anachronisms and of opinions opposed to the general Hippocratic teaching—greatest weight being attached to the opinions of Erotian and Galen. The general estimate of commentators is thus stated by Adams: “The peculiar style and method of Hippocrates are held to be conciseness of expression, great condensation of matter, and disposition to regard all professional subjects in a practical point of view, to eschew subtle hypotheses and modes of treatment based on vague abstractions.” The treatises have been grouped in the four following sections: (1) genuine; (2) those consisting of notes taken by students and collected after the death of Hippocrates; (3) essays by disciples; (4) those utterly spurious. Littré accepts the following thirteen as absolutely genuine: (1) On Ancient Medicine (Περὶ ἀρχαίης ἰητρικῆς); (2) The Prognostics (Προγνωστικόν); (3) The Aphorisms (Ἀφορισμοί); (4) The Epidemics, i. and iii. (Ἐπιδημιῶν α′ καὶ γ′); (5) On Regimen in Acute Diseases (Περὶ διαίτης ὀξέων); (6) On Airs, Waters, and Places (Περὶ ἀέρων, ὑδάτων, καὶ τόπων); (7) On the Articulations (Περὶ ἄρθρων); (8) On Fractures (Περὶ ἀγμῶν); (9) The Instruments of Reduction (Μοχλικός); (10) The Physician’s Establishment, or Surgery (Κατ᾽ ἰητρεῖον); (11) On Injuries of the Head (Περὶ τῶν ἐν κεφαλῇ τρωμάτων); (12) The Oath (Ὅρκος); (13) The Law (Νόμος). Of these Adams accepts as certainly genuine the 2nd, 6th, 5th, 3rd (7 books), 4th, 7th, 8th, 9th and 12th, and as “pretty confidently acknowledged as genuine, although the evidence in their favour is not so strong,” the 1st, 10th and 13th, and, in addition, (14) On Ulcers (Περὶ ἑλκῶν); (15) On Fistulae (Περὶ συρίγγων); (16) On Hemorrhoids (Περὶ αἱμοῤῥοΐδων); (17) On the Sacred Disease (Περὶ ἱερῆς νούσου). According to the sceptical and somewhat subjective criticism of Ermerins, the whole collection is to be regarded as spurious except Epidemics, books i. and iii. (with a few interpolations), On Airs, Waters, and Places, On Injuries of the Head (“insigne fragmentum libri Hippocratei”), the former portion of the treatise On Regimen in Acute Diseases, and the “obviously Hippocratic” fragments of the Coan Prognostics. Perhaps also the Oath may be accepted as genuine; its comparative antiquity is not denied. The Aphorisms are certainly later and inferior. In the other non-Hippocratic writings Ermerins thinks he can distinguish the hands of no fewer than nineteen different authors, most of them anonymous, and some of them very late.
The earliest Greek edition of the Hippocratic writings is that which was published by Aldus and Asulanus at Venice in 1526 (folio); it was speedily followed by that of Frobenius, which is much more accurate and complete (fol., Basel, 1538). Of the numerous subsequent editions, probably the best was that of Foesius (Frankfort, 1595, 1621, Geneva, 1657), until the publication of the great works of Littré, Œuvres complètes d’Hippocrate, traduction nouvelle avec le texte grec en regard, collationnée sur les manuscrits et toutes les éditions, accompagnée d’une introduction, de commentaires médicaux, de variantes, et de notes philologiques (10 vols., Paris, 1839–1861), and of F. Z. Ermerins, Hippocratis et aliorum medicorum veterum reliquiae (3 vols., Utrecht, 1859–1864). See also Adams (as cited above), and Reinhold’s Hippocrates (2 vols., Athens, 1864–1867). Daremberg’s edition of the Œuvres choisies (2nd ed., Paris, 1855) includes the Oath, the Law, the Prorrhetics, book i., the Prognostics, On Airs, Waters, and Places, Epidemics, books i. and iii., Regimen, and Aphorisms. Of the separate works attributed to Hippocrates the editions and translations are almost innumerable; of the Prognostics, for example, seventy editions are known, while of the Aphorisms there are said to exist as many as three hundred. For some notice of the Arabic, Syriac and Hebrew translations of works
- ↑ “Hippocrates Cous, primus quidem ex omnibus memoria dignus, ab studio sapientiae disciplinam hanc separavit, vir et arte et facundia insignis” (Celsus, De medicina).
