The genuine works of Hippocrates, Vol. 1 · Hippocrates
SECTION I
Seeing, then, that these letters are admitted on all hands to be very ancient, that is to say, of a date not much later than the time of Hippocrates, we may rest assured that the main facts to which they allude were believed at the time to be of an authentic nature. For the like reasons I am disposed to think that, although the letters in the Collection which refer to a pretended correspondence between him and Democritus are most probably to be regarded as spurious, it is far from being improbable that the physician may have rendered the services of his profession to the philosopher. Had there been no grounds whatever for this story, why so many ancient authors should have agreed in giving credit to it I cannot imagine. According to all the accounts which have come down to us of his life, he spent the latter part of it in Thessaly, and died at Larissa, when far advanced in years. The corruptions with regard to numbers which, in the course of transcription, have crept into all works of great antiquity, sufficiently account for the differences already mentioned in the statements respecting his age at the time of his death.
These are all the particulars of any importance which can now be gathered regarding the life of him who has been venerated in all ages as “The Father of Medicine.” That they are scanty and rather unsatisfactory, must be admitted; but yet what more, in general, can we desire to know respecting the biography of a physician than the manner in which he was educated, how he was esteemed by his contemporaries, and what he did and wrote to reflect credit on his profession? The approbation and gratitude of those who have consulted him for the cure of their maladies are the best testimony to the public character of a physician, and the estimation in which his writings are held by the members of his own profession is what constitutes his professional reputation. I need scarcely say that, as a medical author, the name of Hippocrates stands pre-eminently illustrious. In this way he has left monuments of his genius more durable than the marble statues of Phidias, his contemporary, and as enduring as the tragedies of Sophocles, or the Olympian odes of Pindar.
In the next section I intend to give a careful analysis of all the writings which have come down to us from antiquity under the name of Hippocrates, and to state clearly the grounds upon which some are to be received as genuine, and others rejected as supposititious. I shall conclude the present section, although it may appear that I am anticipating some things which had better have come after the succeeding one, with a brief account of our author’s general principles, both as regards the theory and the practice of medicine; and in doing this I mean not to confine myself strictly to the treatises which are acknowledged to be genuine, as they are unfortunately so few in number, that we are often obliged to guess at the tenets of our author from those held by his immediate successors and disciples.
The opinions which he held as to the origin of medicine, and the necessities in human life which gave rise to it, are such as bespeak the soundness of his views, and the eminently practical bent of his genius. It was the necessity, he says,[39] which men in the first stages of society must have felt of ascertaining the properties of vegetable productions as articles of food that gave rise to the science of Dietetics; and the discovery having been made that the same system of regimen does not apply in a disordered as in a healthy condition of the body, men felt themselves compelled to study what changes of the aliment are proper in disease; and it was the accumulation of facts bearing on this subject which gave rise to the art of Medicine. Looking upon the animal system as one whole, every part of which conspires and sympathizes with all the other parts, he would appear to have regarded disease also as one, and to have referred all its modifications to peculiarities of situation.[40] Whatever may now be thought of his general views on Pathology, all must admit that his mode of prosecuting the cultivation of medicine is in the true spirit of the Inductive Philosophy; all his descriptions of disease are evidently derived from patient observation of its phenomena, and all his rules of practice are clearly based on experience. Of the fallaciousness of experience by itself he was well aware, however, and has embodied this great truth in a memorable aphorism,[41] and therefore he never exempts the apparent results of experience from the strict scrutiny of reason. Above all others, Hippocrates was strictly the physician of experience and common sense. In short, the basis of his system was a rational experience, and not a blind empiricism, so that the Empirics in after ages had no good grounds for claiming him as belonging to their sect.[42]
What he appears to have studied with particular attention is the natural history of diseases, that is to say, their tendencies to a favorable or fatal issue; and without this knowledge, what can all medical practice be but blind empiricism?--a haphazard experiment, which perchance may turn out either to cure or to kill the patient? In a word, let me take this opportunity of saying, that the physician who cannot inform his patient what would be the probable issue of his complaint, if allowed to follow its natural course, is not qualified to prescribe any rational plan of treatment for its cure. One of the most distinguishing characteristics, then, of the Hippocratic system of medicine, is the importance attached in it to _prognosis_, under which was comprehended a complete acquaintance with the previous and present condition of the patient, and the tendency of the disease. To the overstrained system of Diagnosis practised in the school of Cnidos, agreeably to which diseases were divided and subdivided arbitrarily into endless varieties, Hippocrates was decidedly opposed; his own strong sense and high intellectual cultivation having, no doubt, led him to the discovery, that to accidental varieties of diseased action there is no limit, and that what is indefinite cannot be reduced to science.[43]
Nothing strikes one as a stronger proof of his nobility of soul, when we take into account the early period in human cultivation at which he lived, and his descent from a priestly order, than the contempt which he everywhere expresses for ostentatious charlatanry, and his perfect freedom from all popular superstition.[44] Of amulets and complicated machines to impose on the credulity of the ignorant multitude, there is no mention in any part of his works. All diseases he traces to natural causes, and counts it impiety to maintain that any one more than another is an infliction from the Divinity. How strikingly the Hippocratic system differs from that of all other nations in their infantine state must be well known to every person who is well acquainted with the early history of medicine.[45] His theory of medicine was further based on the physical philosophy of the ancients, more especially on the doctrines then held regarding the elements of things, and the belief in the existence of a spiritual essence diffused through the whole works of creation, which was regarded as the agent that presides over the acts of generation, and which constantly strives to preserve all things in their natural state, and to restore them when they are preternaturally deranged. This is the principle which he called Nature, and which he held to be a _vis medicatrix_. “Nature,” says he, or at least one of his immediate followers says, “is the physician of diseases.”[46] His physical opinions are so important, that I have resolved to devote an entire section to an exposition of the ancient doctrines on this head. (See Sect. III.)
Though his belief in this restorative principle would naturally dispose him to watch its operations carefully, and make him cautious not to do anything that would interfere with their tendencies to rectify deranged actions, and though he lays it down as a general rule by which the physician should regulate his treatment, “to do good, or at least to do no harm,”[47] there is ample evidence that on proper occasions his practice was sufficiently bold and decided. In inflammatory affections of the chest he bled freely, if not, as has been said, _ad deliquum animi_,[48] and in milder cases he practised cupping with or without scarification.[49] Though in ordinary cases of constipation he merely prescribed laxative herbs, such as the mercury (_mercurialis perennis_),[50] beet,[50] and cabbage,[50] he had in reserve elaterium,[51] scammony,[52] spurges,[53] and other drastic cathartics, when more potent medicines of this class were indicated. And although when it was merely wished to evacuate upwards in a gentle manner, he was content with giving hyssop,[54] and other simple means, he did not fail, when it was desirable to make a more powerful impression, to administer the white hellebore with a degree of boldness, which his successors in the healing art were afraid to imitate.[55] A high authority has expressly stated that he was the discoverer of the principles of derivation and revulsion in the treatment of diseases.[56] Fevers he treated as a general rule, upon the diluent system, but did not fail to administer gentle laxatives, and even to practise venesection in certain cases.[57] When narcotics were indicated, he had recourse to mandragora, henbane, and perhaps to poppy-juice.[58]
In the practice of surgery he was a bold operator. He fearlessly, and as we would now think, in some cases unnecessarily, perforated the skull with the trepan and the trephine in injuries of the head. He opened the chest also in empyema and hydrothorax. His extensive practice, and no doubt his great familiarity with the accidents occurring at the public games of his country, must have furnished him with ample opportunities of becoming acquainted with dislocations and fractures of all kinds; and how well he had profited by the opportunities which he thus enjoyed, every page of his treatises “On Fractures,” and “On the Articulations,” abundantly testifies. In fact, until within a very recent period, the modern plan of treatment in such cases was not at all to be compared with his skillful mode of adjusting fractured bones, and of securing them by means of waxed bandages. In particular, his description of the accidents which occur at the elbow- and hip-joints will be allowed, even at the present day, to display a most wonderful acquaintance with the subject. In the treatment of dislocations, when human strength was not sufficient to restore the displacement, he skillfully availed himself of all the mechanical powers which were then known.[59] In his views with regard to the nature of club-foot, it might have been affirmed of him a few years ago, that he was twenty-four centuries in advance of his profession when he stated that in this case there is no dislocation, but merely a declination of the foot; and that in infancy, by means of methodical bandaging, a cure may in most cases be effected without any surgical operation. In a word, until the days of Delpech and Stromeyer, no one entertained ideas so sound and scientific on the nature of this deformity as Hippocrates.
But I must not allow my enthusiastic admiration to carry me too far. I will therefore conclude the present section by making a few observations on the peculiar style of our author’s writings. According to Galen, whose extensive acquaintance with Greek literature rendered him a most competent judge, the characteristics of his style are extreme conciseness, precision, and, in certain cases, obscurity, as the natural result of labored brevity.[60] To these traits of character he adds, elsewhere, that Hippocrates makes it a rule to avoid all superfluity of discussion and unnecessary repetitions, and never says more than what is indispensable.[61] Now, it is no proper objection to this general view of the character of his style, as stated by M. Littré, that it is not the same in all his works; as, for example, in his treatise “On Airs, Waters, and Places,” where the style is certainly not so laconic as in some of his others; although, even with regard to it, I must be permitted to say that I agree with a most competent authority, the late Dr. Coray, that its style is remarkable for conciseness.[62] And, indeed, if brevity of expression, bordering at times upon obscurity, be not the characteristic of the style of Hippocrates, we must admit that his mode of composition is not in accordance with the taste of his age.
There can be no doubt that the style of Hippocrates is nearly akin to that of his contemporary, the historian Thucydides, which is thus described by a very acute and original critic: “The most obvious and characteristic of his peculiarities is an endeavor to express as much matter as possible in as few words as possible, to combine many thoughts into one, and always to leave the reader to supply something of his own. Hence his conciseness often becomes obscure.”[63] I would beg leave to add that other peculiarities in the style of Thucydides, which are severely animadverted upon by Dionysius, may be clearly recognized also in the writings of Hippocrates, especially irregularities of syntax, with a somewhat rude and inartificial mode of constructing his sentences. I mention this the rather that the English reader may not expect to find in my translation any of those well-turned periods and graceful modes of construction by which elegant composition is now distinguished. I wish it to be known that in making this translation, I have followed the example of the modern authority lately referred to, that is to say, I have been more studious of fidelity than of elegance, and have endeavored to give not only the matter, but also the manner, of my author.[64] * * * * * As promised above, I here subjoin that Mythical Genealogy of Hippocrates from Tzetzes.
Text from Project Gutenberg, public domain in the United States.