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Hippocrates

2007 Schools Wikipedia Selection. Related subjects: Human Scientists

   Hippokrates of Kos
   ( Greek: Ἱπποκράτης)
   Engraving by Peter Paul Rubens, 1638, courtesy of the National Library
   of Medicine .
   Born c. 460 BC
   Died c. 370 BC
   Occupation Physician

   Hippocrates of Cos II. or Hippokrates of Kos (c. 460 BC–c. 370 BC,
   Greek: Ἱπποκράτης) was an ancient Greek physician who lived in the Age
   of Pericles and is one of the most outstanding figures in the history
   of medicine. He is often referred to as " The Father of Medicine" for
   his lasting contributions to the field as the founder of the
   Hippocratic school of medicine which revolutionized medicine in ancient
   Greece, separating the field from the other disciplines (notably
   theurgy and philosophy) and making a profession of practicing medicine.
   The school summed up the medical knowledge of previous schools and
   defined moral codes and good habits for physicians.

   The Hippocratic Corpus, or the collection of works commonly associated
   with Hippocrates, was the medium through which Hippocratic philosophy
   transmitted the above. It is largely responsible for Hippocrates's
   renown. The great detail and depth of the descriptions in its
   constituent works are still respected as is the Hippocratic Oath, the
   most famous work in it. The Corpus is not necessarily of Hippocrates's
   own hand, and there are many doubts as the the authenticity of the
   collection, the Oath included. As the Hippocratic Corpus is, however,
   the primary source for information concerning Hippocrates and the
   Hippocratic school of medicine, the achievements of all three are not
   generally separated.

Biography

   Askleipion on the Greek island of Kos
   Enlarge
   Askleipion on the Greek island of Kos

   Historians accept that Hippocrates actually existed, was born near the
   year 460 BC on the island of Kos and was a famous physician and teacher
   of medicine. All other biographical information is possibly apocryphal
   (See Legends). As no real biography was available until centuries after
   his death, those that are available today must be based on many years
   of oral tradition and are thus unreliable.

   Soranus of Ephesus, also a mysterious figure, was Hippocrates's first
   biographer and is the source of most information, however unreliable,
   on Hippocrates's person. Soranus stated that Hippocrates's father, a
   physician, was Heraclides, and his mother, daughter of Phenaretis, was
   named Praxitela. He had two sons, Thessalus and Draco, and a
   son-in-law, Polybus. All three were his students, but Polybus was
   Hippocrates’ true successor according to Galen, a later physician, who
   also stated that Thessalus and Draco each had a son named Hippocrates.
   Other biographers, in addition to Soranus and Galen, were Suidas, John
   Tzetzes, and Aristotle.

   Soranus said that Hippocrates was taught medicine by his father and
   grandfather, and other subjects by Democritus and Gorgias. Hippocrates
   could have been trained at the Asklepieion of Kos, and may have been a
   pupil of Herodicus of Selymbria: Plato, Hippocrates's only contemporary
   to mention him, describes him as an Asclepiad.

   Hippocrates taught and practiced medicine throughout his long life,
   traveling significantly to do so. He went at least as far as Thessaly,
   Thrace, and the Sea of Marmara. He may have died in Larissa at the age
   of 83 or 90, though his death date is speculated with very little
   certainty; some sources state that he lived to be over 100 years old.

Hippocratic theory

   Hippocrates is credited as the first physician to reject the divine
   origin and superstition of all sicknesses. He separated the discipline
   of medicine from philosophy and religions, believing and proffering
   that disease was not punishment of the gods but due to environmental
   factors, diet and living habits. Indeed, there is not a single mention
   of a mystical illness in the entirety of the Hippocratic Corpus.
   Hippocrates did not, however, hold entirely scientific beliefs; he held
   many pseudo-scientific convictions based on bad anatomy and physiology,
   such as Humorism.

   Indeed, Greek medicine at the time of Hippocrates knew almost nothing
   of human anatomy and physiology because of the Greek taboo forbidding
   the dissection of animals. Ancient Greek schools of medicine were split
   (into the Knidian and Koan) on how to deal with this. The Knidian
   school of medicine focused on diagnosis, but, dependent upon faulty
   assumptions about the human body, failed to distinguish when one
   disease caused many possible series of symptoms.

   The Hippocratic school or the Koan school, however, was more successful
   for its general diagnoses and passive treatments. The focus of
   Hippocratic medicine was on patient care and prognosis and not
   diagnosis. It could effectively treat many diseases, yet it allowed for
   a great development in clinical practice; it was more successful than
   the Knidian.

   Hippocratic medicine and philosophy, for all of its advances, is far
   removed from modern medicine. Today, the physician focuses on specific
   diagnosis and specialized treatment, which are much more of the Knidian
   ideals. Following, Hippocratic methods have seen some serious criticism
   in the past two millennia. M. S. Houdart, a French doctor, called
   Hippocratic treatment a "meditation upon death." He said the purpose of
   the doctor was to cure the patient, not simply predict how he will die.

Humorism

   Hippocrates, according to the Corpus, held that illness was the result
   of an imbalance in the body of the four humours, fluids which were
   naturally equal in proportion (pepsis). When the four humours, blood,
   black bile, yellow bile and phlegm, were unbalanced (dyscrasia, meaning
   "bad mixture"), a person became sick and would remain that way until
   the balance was somehow restored. Hippocratic therapy was directed
   towards this end, perhaps utilizing citrus, for instance, if there was
   thought to be an overabundance of phlegm.

Crisis

   An ancient Greek treatment of a thigh injury. Use of a complex bandage
   can be seen.
   Enlarge
   An ancient Greek treatment of a thigh injury. Use of a complex bandage
   can be seen.

   An important concept in Hippocratic medicine was that of a crisis, a
   point in the progression of disease at which either the illness would
   begin triumph and the patient would move to die, or the opposite, and
   natural processes would make the patient recover. After a crisis, a
   relapse might follow, and then another deciding crisis. By this
   doctrine, crises occur on critical days, which were supposed to be a
   fixed time after the contraction of a disease. If a crisis occurs on a
   day far from a critical day, a relapse may be expected. Galen believed
   that this idea originated with Hippocrates, though it is possible that
   it predated him.

Hippocratic therapy

Vis medicatrix naturae

   Another important precept of Hippocratic doctrine was based on "the
   healing power of nature", or in Latin, vis medicatrix naturae.
   According to this doctrine, the body contains within itself the power
   to rebalance the four humours and heal itself (physis). Hippocratic
   therapy was focused on simply easing this natural process. To this end,
   Hippocrates believed "rest and immobilization [were] of capital
   importance". By these beliefs, he was reluctant to administer drugs and
   engage in specialized treatment that could be wrong; generalized
   therapy followed a generalized diagnosis.

Methods of treatment

   A drawing of a Hippocratic bench from a Byzantine edition of Galen's
   work in the 2nd century A.D.
   Enlarge
   A drawing of a Hippocratic bench from a Byzantine edition of Galen's
   work in the 2nd century A.D.

   Hippocratic medicine was humble and passive. Whenever possible it was
   very kind to the patient: sterile and gentle. For example, only clean
   water or wine were ever used on wounds, though "dry" treatment was
   preferable. There were, however, times when potent drugs were used.

   Hippocratic method was very successful in treating simple ailments such
   as broken bones which required traction to stretch the skeletal system
   and relieve pressure on the injured area. The Hippocratic bench, which
   preceded the torture device rack, and other devices were used to this
   end.

   As was mentioned, one of the strengths of Hippocratic medicine was in
   its prognosis. At this time, medicinal therapy was quite immature, and
   often the best that physicians could do was evaluate an illness and
   induce the likely progression of it based upon data collected in
   detailed case histories.

Professionalism

   A number of ancient Greek surgical tools. On the left is a trephine; on
   the right, a set of scalpels. Hippocratic medicine made good use of
   these tools.
   Enlarge
   A number of ancient Greek surgical tools. On the left is a trephine; on
   the right, a set of scalpels. Hippocratic medicine made good use of
   these tools.

   Despite all of its advancements in medical theory, it was truly in
   discipline, strict professionalism and rigorous practice that
   Hippocratic medicine excelled.<specify>

   The Hippocratic work On the physician recommends that physicians be
   always be well-kempt, honest, calm, understanding and serious. Careful
   attention is paid to all aspects of a physicians's practice.
   Specifications for, "lighting, personnel, instruments, positioning of
   the patient, and techniques of bandaging and splinting" in the ancient
   operating room are described in detail. Even the length of a
   physician's fingernails is exactly specified.

   The Hippocratic School is famous for its clinical doctrines of
   observation. These dictate that physicians record their findings and
   their medicinal methods in a very clear and objective manner, so that
   these records may be passed down and employed by other physicians.
   Hippocrates made careful, regular note of many symptoms including
   complexion, pulse, fever, pains, movement, and excretions. He might
   have even measured a patient's pulse when taking a case history to know
   if the patient lied.

   Hippocrates extended clinical observations into family history and
   environment in accordance with this theory. "To him medicine owes the
   art of clinical inspection and observation" For this reason, he may
   termed only the "Father of Clinical Medicine".

Direct contributions to medicine

   Hippocrates and his followers identified many diseases and medical
   conditions for the first time. He also began to categorize illnesses as
   acute, chronic, endemic and epidemic. Other medical terms that he
   introduced were, "exacerbation, relapse, resolution, crisis, paroxysm,
   peak, and convalescence."

   Great contributions of Hippocrates may be found in his descriptions of
   the symptomology, physical findings, surgical treatment and prognosis
   of thoracic empyema, i.e. suppuration of the lining of the chest
   cavity.His teachings remain relevant to contemporary students of
   pulmonary medicine and surgery. Hippocrates was the first documented
   chest surgeon and his findings are still valid.

   He is also given credit for the first description of clubbing of the
   fingers, an important diagnostic sign in chronic supperative lung
   disease, lung cancer and cyanotic heart disease. For this reason,
   clubbing is sometimes termed "Hippocratic fingers". Hippocrates was
   also the first one to diagnose Hippocratic face in Prognosis.
   Shakespeare famously aludes to this description when writing of the
   death of Falstaff in Act II, Scene iii. of Henry V.

The Hippocratic Corpus

   The Hippocratic Corpus (Latin: Corpus Hippocratum) is a collection of
   around seventy early medical works from ancient Greece strongly
   associated with Hippocrates and his teachings. Of the volumes in the
   Corpus, none is proven to be of Hippocrates' hand itself, though some
   sources say otherwise.Instead, the works were probably produced by
   students and followers of his ( Ermerins numbers the authors at
   nineteenCite error 1; Invalid <ref> tag; name cannot be a simple
   integer, use a descriptive title, maybe centuries after he died.
   Because of the variety of subjects, writing styles and apparent date of
   construction, scholars believe it could not have been written by one
   person. But the corpus carries Hippocrates's name as it was attributed
   to him in antiquity and its teaching generally follow principles of
   his. It might be the remains of a library of Kos, or a collection
   compiled in the third century B.C. in Alexandria.

Content

   The Hippocratic Corpus contains textbooks, lectures, research, notes
   and philosophical essays on various subjects in medicine, in no
   particular order. These works were written for different audiences,
   both specialists and laymen, and were sometimes written from opposing
   view points; significant contradictions can be found between works in
   the Corpus.

   One significant portion of the corpus is made up of case-histories, of
   which there are forty-two. Of these, 60% (25) ended in the patient's
   death. Nearly all of the diseases described in the Corpus are endemic
   diseases: colds, consumption, pneumonia, etc.

Style

          "Life is short, [the] art long, opportunity fleeting, experiment
                                         treacherous, judgment difficult."
                                                           —Aphorisms i.1.

   The writing style of the Corpus has been remarked upon for centuries,
   being described by some as, "clear, precise, and simple". It is often
   praised for its objectivity and concisesness, yet some have criticised
   it as being "grave and austere". Francis Adams, a translator of the
   Corpus, goes further and calls it sometimes “obscure”. Of course, not
   all of the Corpus is of this “laconic” style, though most of it is. It
   was Hippocratic practice to write in this style.

   The whole corpus is written in Ionic Greek, though the island of Kos
   was in a region that spoke Doric Greek. This use of Ionic instead of
   the native Doric dialect is analogous to the practice of Renaissance
   scientists, using Latin instead of the vernacular for their treatises.

Printed editions

   The entire Hippocratic Corpus was first printed as a unit in 1525. This
   edition was in Latin and was edited by Marcus Fabius Calvus in Rome.
   The first complete Greek edition followed the next year in Venice. An
   English translation was first published about 300 years later.

   A significant edition was that of Émile Littré who spent twenty-two
   years (1839-1861) working diligently on the Hippocratic Corpus. This
   was scholarly, yet sometimes inaccurate and awkward. Another edition of
   note was that of Franz Z. Ermerins, published in Utrecht between 1859
   and 1864. Beginning in 1967, an important modern edition by Jacques
   Jouanna and others began to appear (with Greek text, French
   translation, and commentary) in the Collection Budé. Other important
   bilingual annotated editions (with translation in German or French)
   continue to appear in the Corpus medicorum graecorum published by the
   Akademie-Verlag in Berlin.

The Oath

   The most famous work in the Hippocratic corpus is the Hippocratic Oath,
   a landmark declaration of doctoral ethics historically taken at the
   beginning of a doctor's career. While the oath is rarely used in its
   original form today, it serves as a foundation for other, similar oaths
   and laws that define good medical practice and morals; derivatives of
   it are taken.

Legacy

   The Plane Tree of Hippocrates, under which Hippocrates is said to have
   worked.
   Enlarge
   The Plane Tree of Hippocrates, under which Hippocrates is said to have
   worked.

   For all of these above achievements, Hippocrates is widely considered
   the first great physician; however, for a long time, he was also the
   last. He is readily named the most important influence on medicine for
   over a thousand years, yet after him there was a dearth of medical
   advancement. Medical practitioners who followed him sometimes moved
   backwards. For instance, "after the Hippocratic period, the practice of
   taking clinical case-histories died out...", according to Fielding
   Garrison.

   After Hippocrates, the next significant physician was Galen, a Greek
   who lived from 129 -200 AD. Galen perpetuated Hippocratic medicine,
   moving both forward and backward. In the Middle Ages, Arabs too,
   adopted Hippocratic methods. After the European Renaissance,
   Hippocratic methods were revived in Europe and even further expanded
   upon in the 1800s. Others that employed Hippocrates' rigorous clinical
   techniques were Sydenham, Heberden, Charcot and Osler. It has been said
   that these revivals make up "the whole history of internal medicine".

Image

   An image of Hippocrates on the floor of the Asclepeion of Kos, with
   Asclepius in the middle.
   Enlarge
   An image of Hippocrates on the floor of the Asclepeion of Kos, with
   Asclepius in the middle.

   According to Aristotle's testimony, Hippocrates was known as "the Great
   Hippocrates".So revered was Hippocrates at the time of his death that
   honey (from a beehive) on his grave was believed to have healing
   powers. But so revered was he, that, after him, no significant
   advancements were made for a long time. His teachings were largely
   taken as too great to be improved upon.

   Concerning his disposition, Hippocrates was first portrayed as a,
   "kind, dignified, old 'country doctor'" and later as, "stern and
   forbidding". He is certainly considered wise and of very great
   intellect. He is seen as very practical, and Francis Adams (translator)
   describes him as "strictly the physician of experience and common
   sense".

   His image as the wise, old doctor is reinforced by the busts of him,
   which all wear large beards. The image is probably close to the truth,
   though: the physicians of the time wore their hair in the style of Jove
   and Asclepius. Accordingly, the busts of Hippocrates that we have could
   be only altered versions of portraits of these deities. As is
   demonstrated by his mythical busts, Hippocrates and the beliefs that he
   embodied are considered medical ideals. "He is, above all, the exemplar
   of that flexible, critical, well-poised attitude of mind, ever on the
   lookout for sources of error, which is the very essence of the
   scientific spirit."(Garrison) "His figure... stands for all time as
   that of the ideal physician”(Singer and Underwood), inspiring the
   medical profession since his death.

Legends

   Some stories of Hippocrates's life are likely to be untrue because they
   are considered inconsistent with other historical evidence. Even during
   his life, Hippocrates's renown was great, and stories of miraculous
   cures arose. For example, Hippocrates was supposed to have aided in the
   healing of Athenians during the Plague of Athens by lighting great
   fires as "disinfectants".There is a story of Hippocrates curing
   Perdiccas, a Macedonian king of " love sickness". Neither of these
   accounts are corroborated by any historians and is thus unlikely to
   have ever occurred.

   One more probable legend concerns how Hippocrates rejected a formal
   request to visit the court of Artaxerxes, the King of Persia. The
   validity of this is accepted by ancient sources, denied by some modern
   ones and is thus under contention. In another tale, Democritus was
   supposed to be mad because he laughed at everything, and so he was sent
   to Hippocrates to be cured. Hippocrates diagnosed him as having a
   merely happy disposition. Democritus has since been called "the
   laughing philosopher".

   Of course, not all stories of Hippocrates were postive. Indeed, in one,
   Hippocrates did his traveling only after he set fire to a healing
   temple in Greece; he fled from his crime. Soranus, the source of this
   story, names the temple as the one of Knidos. Tzetzes writes, however,
   that it was his own Temple of Cos that was burned; that he did it to
   maintain a monopoly of medical knowledge. This account is very much in
   conflict with traditional estimations of Hippocrates's personality.

Genealogy

   With this figure of legend, comes a legendary genealogy, which traces
   Hippocrates’ heritage directly to Asclepius. It has also been said that
   in his mother's ancestry lies Hercules. The ahnentafel of Hippocrates
   II. is, according to Tzetzes’s Chiliades:

   1. Hippocrates II. “The Father of Medicine”
   2. Heraclides
   4. Hippocrates I.
   8. Gnosidicus
   16. Nebrus
   32. Sostratus III.
   64. Theodorus II.
   128. Sostratus, II.
   256. Thedorus
   512. Cleomyttades
   1024. Crisamis
   2048. Dardanus
   4096. Sostatus
   8192. Hippolochus
   16384. Podalirius
   32768. Asclepius

Namesakes

   A drawing of a Hippocratic traction device.
   Enlarge
   A drawing of a Hippocratic traction device.

Ancient

     * Hippocratic bench — a device which uses tension to aid in setting
       bones
     * Hippocratic face — the change produced in the countenance by death,
       or long sickness, excessive evacuations, excessive hunger, and the
       like
     * Hippocratic fingers — a deformity of the fingers and fingernails
     * Hypocras — a drink whose invention is attributed to Hippocrates
     * Hippocratic succussion — the internal splashing noise of
       hydropneumothorax or pyopneumothorax

Modern

     * Hippocratic Museum
     * The Hippocrates Project — A program of the New York University
       Medical Centre to enhance education through use of technology
     * Project Hippocrates — "HIgh PerfOrmance Computing for
       Robot-AssisTEd Surgery"
     * Digital Hippocrates — "a collection of Ancient Medical texts"
     * Digital Hippocrates System — an anonymous, on-line, medical
       reference source directed at educating adolescents
     * Hippocrates Project — A tissue engineering project

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