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Hippocrates - Father of Medicine:

A brief review of his contribution to Medicine and the 'Theory of Humour'

Dr Sampurna Roy MD     

 J.G de Lint (1867-1936), - Atlas van de geschiedenis der geneeskunde, Amsterdam:Van Looy, 1925  (Wikimedia-commons)

 " It's far more important to know what person the disease has than what disease the person has." - Hippocrates

 

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If you are a doctor do you know when Medicine began? No you don't!

Nobody knows when medicine began.

As long as there have been men there have been wounds to heal and illnesses to cure, and men have tried as best as they could to heal and cure them.

In this way history of medicine should begin with history of man.

Perhaps it should begin even before there were men, because from watching animals today it can be seen that they too make some attempt to cure their hurts.

Hippocrates of Cos

The first truly scientific doctor, some of whose writings have come down to us was Hippocrates of Cos.

He was born about 460 BC and is said to have lived for over one hundred years.

It is the theory and practice of Hippocrates that still underlies modern medicine.

Some of his writings may in fact be by other doctors of his circle.

In his writings we find the still-accepted theory that every disease is subject to natural law just like everything else, and should be carefully observed.

Since all bodies have a natural tendency to recover the proper duty of medicine is to seek the best ways in which to help it.

Theory of Humours      Doctor are you using social media ?

Hippocrates introduced the 'Theory of Humours' which stated that the body contains four substances or 'humours' - blood, phlegm, yellow bile (or choler) and black bile (or melancholy).

 

These were associated with the four elements - earth, air, fire and water.

The perfectly sane and healthy man was believed to have an exact balance of the humours in his body.

This was rare and most people were characterised by having more of one humour than the rest, which caused them to have the 'complexion' or temperament associated with that particular humour.

This view dominated the ancient medicine world from his age until the 18th century.

Thus grew up the idea of :

- The 'Sanguine man' (meaning confident and hopeful)

- The 'Phlegmatic man' (meaning cold and not easily excited )

- The 'Choleric man' (meaning angry and excitable) and

- The 'Melancholy man' (meaning depressed and sad)

Image of woodcut from Physiognomische Fragmente zur BefĂrderung der Menschenkenntnis und Menschenliebe (1775-1778)

by Johann Kaspar Lavater   (Wikimedia-commons)

These are types which we still recognise and even refer to today, although the theory behind them is no longer accepted.

Developing from these types of temperament, it followed in the original doctrine that when the humours were ill- balanced in a man then his sanity and physical health were greatly affected, and it was duty of the doctors to bring about a more perfect balance of humours within him.

This was the most important and longest-held theory ever produced by ancient medicine.

Some of Hippocrates important views and observations :

- "As to diseases, make a habit of two things - to help or at least to do no harm". 

- "Those by nature over weight, die earlier than the slim."

- Hippocrates advice- 'Let food be thy medicine and medicine be thy food'.

- He suggested: "little exercise, walk and do not eat to saturation".

- He used as a pain relief, the abstract from a tree containing what he called "salycasia", like aspirin.

- He described for the first time epilepsy not as a sacred disease, as was considered at those times, but as a hereditary disease of the brain and added: "Do not cut the temporal place, because spasms shall occur on the opposite area".

- Hippocrates laid the foundation for modern-day neurosurgery.

He inspired several generations to follow his vision, by pioneering the rigorous clinical evaluation of cranial and spinal disorders. 

He introduced the terms kyphosis and scoliosis.

The application of axial traction and even the principle of trans-abdominal correction for correction of spinal deformities have their origin in Hippocrates.

- The first written description of the treatment of congenital foot deformity (clubfoot) was given by Hippocrates

- 2400-years ago Hippocrates suggested that children's hip dislocations are curable if treatment is started very early.

Hippocrates is the father of clinical nephrology and that Hippocratic medicine lies at the root of the development of clinical nephrology.

Hippocrates and the medical school of Kos were mainly concerned with the common elements of various diseases and the accurate description of symptoms and signs, as well as their prognostic implications.

Hippocrates noted that bubbles in urine were associated with kidney disease.

Urinary stone was well known to the ancient Greeks, as the reference to it in the Oath of Hippocrates shows.

- The first renal disease described in the book is nephrolithiasis with renal colic.

Its description is well known for its accuracy and clarity.

- The second disease corresponds to renal tuberculosis.

- The third resembles either renal vein thrombosis or bilateral papillary necrosis.

- The fourth disease, described in the greatest detail of all,  corresponds to a chronic suppurative renal infection or a sexually transmitted urethritis, complicated by renal involvement.

There are statements concerning treatment which consist of diet modification, physical exercise, ingestion of herbal extracts and surgery, as a last resort.  

Hippocrates taught and wrote under the shade of a big plane tree also known as Tree of Hippocrates, its descendant is now 500 years old.

It is the oldest tree in Europe (platanus orientalis Hippocraticus) with a diameter of 15 meters. He had many pupils who studied under him.

Among these were his own two sons.

He laid down the rules for his pupils to follow.

Hippocrates wrote these rules down in the form of a promise that his pupils had to obey. This promise is called the Hippocratic Oath.

When a medical student becomes a qualified doctor today she/he still takes the "Hippocratic Oath" which binds them to treat their patients with all the skill they possess, never to betray their patients' secrets, and to live and work honestly and well.

The Hippocratic Oath is twenty-five centuries old. It still remains one of the powerful symbols of the medical profession.

History of Medicine with special reference to India by Prof H. Roy MD

 

Further reading:

Trending in 2014: Hippocrates.

The Hippocratic Oath: back to the future?

'Let food be thy medicine, and medicine be thy food': Hippocrates revisited

The modern hippocratic tradition. Some messages for contemporary medicine.

Hippocrates of Kos, the father of clinical medicine, and Asclepiades of Bithynia, the father of molecular medicine. Review.

Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus.

[Hipoccrates and psychiatry].

Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus.

Surface tension, proteinuria, and the urine bubbles of Hippocrates.

Renal diseases in the Hippocratic era

Prevention of hip dysplasia in children and adults.

Historical overview of spinal deformities in ancient Greece.

Humility and respect: core values in medical education.

The Hippocratic Oath: source of medical ethics

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Dr  Sampurna Roy  MD

Consultant Histopathologist (Kolkata - India)

 

 


 

 

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