Hippocrates of Cos
HIPPOCRATES OF COS
Celebrated as the Father of Medicine, Hippocrates (460–377 B.C.E.) was born on the Island of Cos, traveled widely throughout classical Greece in the period of its civilization's greatest achievements, and died in Thessaly. He and his pupils made contributions to medical thinking that have endured for 2.5 millennia. His therapies, based on the humoral theory that imbalance among the four "humors" (phlegm, blood, black bile, and yellow bile) caused most diseases, were flawed, but this does not detract from the excellence of the meticulous descriptions of diseases and their accounts of their natural history that have come down to us in the Hippocratic aphorisms and other writings. Pupils in the Hippocratic medical school were apprentice priest-physicians—for medicine was then a priestly calling.
Hippocrates' work Epidemics must have been based on prolonged and careful observation of the diseases described—all that is missing are numbers and statistical significance tests to make this work suitable for modern courses of epidemiology. Airs, Waters, and Places describes both healthy and unhealthy environments and ways of living, offering timeless advice to physicians who seek to assess these determinants of health and disease:
Whoever would study medicine aright must learn of the following subjects. First he must consider the effects of each of the seasons of the year and the differences between them. Secondly he must study the warm and the cold winds, both those which are common to every country and those peculiar to a particular locality. Lastly the effect of water on the health must not be forgotten. Just as it varies in taste and when weighed, so does its effect on the body vary as well. When, therefore, a physician comes to a district previously unknown to him, he should consider both its situation and its aspect to the winds. The effect of any town upon the health of its population varies according as it faces north or south, east or west…. Similarly, the nature of the watersupply must be considered; is it marshy and soft, hard as it is when it flows from high and rocky ground, or salty with a hardness that is permanent? Then think of the soil, whether it be bare and waterless or thickly covered with vegetation and well-watered; whether it is in a hollow and stifling, or exposed and cold. Lastly, consider the life of the inhabitants themselves; are they heavy drinkers and eaters and consequently unable to stand fatigue, or being fond of work and exercise, eat wisely but drink sparely? (Lloyd 1978, p. 148)
The aspects of Hippocrates' teaching that relate most closely to public health are contained in Air, Waters, and Places, but much of the wisdom that permeates the rest of the Hippocratic corpus is as applicable to public health as it is to the practice of clinical medicine, and is as true today as when it was recorded twenty-five centuries ago. However, the Hippocratic oath, which is one of the basic texts of medical ethics and is still taken by medical school graduates, is no longer believed to have been written by Hippocrates, and it is unknown exactly how many of the seventy-odd Hippocratic treatises he did write.
JOHN M. LAST
(SEE ALSO: Ethics of Public Health; History of Public Health)
