IPPOCRATES. — Greek physician, born on Cos around 460 B.C., died a centenarian at Larissa. He studied under the guidance of his father Heracleides, of Herodicus of Lentini, and perhaps also of the rhetorician Gorgias. He travelled as an itinerant physician, but gave his journeys the character of modern scientific expeditions, since he undertook them with his disciples for purposes of study. Having returned to Cos, he devoted himself to the profession and to teaching. His figure permeates the entire school of Cos, and his work symbolizes the highest development reached by Greek thought in the fifth century B.C.
The work of I. is collected in the Corpus Hippocraticum, consisting of his writings and those of his pupils (53 works in 72 books, collected by the Alexandrian librarians). Among them, the Aphorisms should be mentioned, expressing in brief the highest principles of the healing art; of the 7 books on epidemics, the first and third are by I., the fruit of observations made during his travels, which he also reports in the books On Waters, Airs and Places, to be regarded as the first genuine work on constitutional pathology. The prognostic books and, finally, several writings on surgery should also be recalled.
The basis of Hippocratic medicine is the humoral theory, according to which the state of health is determined by “crasis,” that is, by the equilibrium of the four humors: blood, originating in the heart; phlegm or pituita, from the brain; yellow bile, from the liver; and black bile (atrabilis), from the spleen. From a state of perfect equilibrium one may pass to that of “dyscrasia,” or disease. But the pneuma also contributes to the crasis: this vital air enters the heart from the lungs, where, through the heat of that organ, it is cooked and conveyed throughout the body to regulate the proper mixture of the humors. Thus, in I.’s medical conception, pathology, previously localized in individual organs, becomes general. With him there also arises the concept of constitution, since one of the humors may gain ascendancy over the others, resulting in a new organic equilibrium with well-defined psychic and somatic characteristics, in the individual sanguine, phlegmatic, bilious, and atrabilious types. I. nevertheless also possesses the concept and knowledge of certain definite diseases located in particular organs.
With I. the clinic comes into being, from the moment when he approaches the sick person’s bed, reading upon it as in an open book; semiotics likewise arises, since diagnosis is reached only after a long and meticulous examination of the patient and of the manifest signs of the disease, preceded by a careful interrogation. The name of I. still lives on in the designation of particular clinical conditions; thus, the Hippocratic facies is still recognized in cases of acute abdominal disease. He also made use of palpation, auscultation, and, in certain cases, percussion; he heard friction sounds and moist rales; the “Hippocratic succussion” is still used to reveal hydroaerial collections. On the other hand, he never mentions the pulse, and his surgery is limited to a few procedures of the most absolute necessity: a serious deficiency of Hippocratic medicine was its scant knowledge of, and importance attached to, anatomy and physiology. In treatment, I. relies on the vis medicatrix naturae, the force against disease inherent in nature itself and which the physician must assist in every possible way, using means that are rather hygienic than therapeutic and adhering to the golden precept: “Primum non nocere.” For this reason, too, he devoted much attention to dietetics, teaching the use of foods and beverages both in sickness and in health. With I. begins the subsequent evolution of medicine from its priestly form to its demotic form.