HIPPOCP ATES AND THE MIPPOCRATIC OATH Hippocrates of Kon, ales Lnawn av Hippoerites I, was a Greek physician of the Age of Poricles (Clannieal Grecee), and by considered one of the mot outstanding, figures in the history of 1 Medicme” in recognition of his lasting Medicine, He iy referred ta is the "Vather of Wee contributions ta the flak ve the Inunder of the Hippocratic School of Medicine. ‘this intellectual school revolutionized medicine in ancient Greece, establishing it as a discipline distinct from other Holds with whieh it had traditionally been ausincinted, thus lishing medicine as a profession, Hippocrates in commonly portrayed as the paragon of the ancient physician, and credited With coining the Hippocratic Oath, still relevant and in use today. He is also credited with greatly advancing the systematic study of clinical medicine, summing up the medical knowledge of previous schools, and prescribing practices for physicians through the Hippocratic Corpus and other Works, Historians agree that Hippocrates was born around the year 460 BC on the Greek island of Kos; other biographical information, however, is likely to be untrue. Sorunus of Ephesus, a 2nd-century Greck gynecologist, was Hippocrates’ first biographer and is the source of most personal information about him. Soranus wrote that Hippocrates’ father Was Hernclides, « physician, and his mother was Praxitela, daughter of Tizane. The two sons of Hippocrates, Thessalus and Draco, and his son-in-law, Polybus, were his students, According to Galen, a later physician, Polybus was Hippocrates’ true successor, while Thessalus and Draco each had a son named Hippocrates (Hippocrates {M1 and IV). Hippocrates taught and practiced medicine throughout his life, traveling at least as far as Thessaly and Thrace. Several different accounts of his death exist, He died, probably in Larissa, at the age of 83, 85 or 90, though some say he lived to be well over 100, Hippocrates is credited with being the first person to believe that diseases were caused naturally, not because of superstition and gods. He separated the discipline of medicine from religion, believing and arguing that discase was not a punishment inflicted by the gods but rather the product of environmental factors, diet, and living habits. Indeed there is not a single mention of 4 mystical illness in the entirety of the Hippocratic Corpus. However, Hippocrates did work with many convictions that were based on what is now known to be incorrect anatomy and physiology. such as Humorism. Ancient Greek schools of medicine were split (into the Knidian and Koan) on how to deal with disease, The Knidian school of medicine focused on diagnosis. Medicine at the time of Hippocrates knew almost nothing of human anatomy and physiology because of the Greek taboo forbidding the dissection of humans; thus we find him writing of the tissues without distinguishing between the various textures of the body, confusing arteries, veins and nerves, and speaking vaguely of the muscles as "flesh." The Knidian school consequently failed to distinguish when one disease caused many possible series of symptoms. The Hippocratic school or Koan school achieved greater success by applying general diagnoses and passive treatments. Its focus was on patient care and prognosis, not diagnosis. It could effectively treat diseases and allowed for a great development in clinical practice. Hippocratic medicine and its philosophy are far removed from that of modern medicine. Now, the physician focuses on specific diagnosis and specialized treatment, both of which were espoused by the Knidian school Another important concept in Hippocratic medicine was that of a crisis, a point in the progression of disease at which either the illness would begin to triumph and the patient would succumb to death, or the opposite would occur and natural processes would make the patient recover. After a crisis, a relapse might follow, and then another deciding crisis. According to this doctrine, crises tend to occur on critical days, which were sunposed to be a fixed time after the contraction of a disease. If a crisis occurred on a day far from a critical day, a relapse might be expected. Galen believed that this idea originated with Hippocrates, though it is possible that it predated him.Hippocratic meet healing power of natures oe 2s hime and passive, The therapeutic approach was based on "the Fontains within itsetf the: payer tM Naturne” in Latin), According to this doctrine, the body A eg AO Fe-balance the four humours and heal itself (physis). The Hippocratic therapy believed "rest aoe on simply casing this natural process. To this end, Hippocrates medicine was very kind to lization {were} of capital importance.” In general, the Hippocratic clean and sterile, For exam rete: eatment was gentle, and emphasized Keeping the patient tentment was rete 8 “lean water of wine were ever used on wounds, though "dry" sates wae: Soothing balms were sometimes emploved oD : os Peo int ‘0 administer drugs and engage in specialized treatment that Generalized treatments he cece eeets_ Seteralized therapy followed a generalized diagnosis Hippocrates once said thet me snr ec, nelode fasting and the consuraption of apple cider vinegar, sod cul that "to eat when you are sick, isto feed your sickness However, potent Hippocets Of the strengths of Hippocratic: medicine was its emphasis on prognosis. At COU daa gim®; Medicinal therapy was quite immature, and efter the best thing that physicians eaee oa Yaluate an illness and predict its likely progression based upon data collected in Hippocrates a Te is given credit for the first description of clubbing of the fingers, an important diagnostic sign in chronic lung disease, lung cancer and cyanotic heart disease For this reason, clubbed fingers are Sometimes referred to as "Hippocratic fingers" Hippocrates was the first physician to systematically classify diseases based on points of sinjlarity and contrast between them. He virtually originated tne disciplines of etiology and Pathology. Hippocrates began to categorize illnesses 28 seule, chronic, endemic and epidemic, and Another {uch a, “exacerbation, relapse, resolution, crisis, paronysm, peak, and core len nnd Another of Hippocrates’ major contributions may be found in he descriptions of the capmmiometology, physical findings, surgical treatment and prognosis of thoracic empyema, in still valid. Hippocrates’ anatomical knowledge was rather scant, but this is compensated for by his Profound insights into human physiology and the soundness of his reasoning, But event 50, his surgical techniques for dislocations of the hip and jaw were unsurpassed until the nineteenth century. In therapeutics, Hippocrates saw the physician as the servant and facilitator of Nature, All medical treatment was aimed at enabling the natural resistance of the organism to prevail and overcome the disease, to bring about recovery. In the treatments he prescribed, Hippocrates was very sensible, pragmatic and flexible in his approach, favoring conservatism and moderation over radical or extreme measures. Bloodletting, which was much abused at other times in medivine's history, was used only rarely by Hippocrates, and even then, only applied conservatively. Hippocrates placed great emphasis on strengthening and building up. the body's inherent resistance to disease. For this, he prescribed diet, eymnastics, exercise, massage, hydrotherapy and sea bathing. Hippocrates was a great believer in dietary measures in the treatment of disease. He prescribed a very slender, light diet during the crisis stage of an acute illness, and a liquid diet during the treatment of fevers and wounds. - The Hippocratic Corpus is a collection of over 60 works. Although sll of them are attributed to Hippocrates, the Corpus is of a heterogeneous character, and many, if not most, ofits works may actually have been written by his students.Sull, We ean be fuinly cert i lusty vad wuihur matty books in Une Corpus, including many 6 ert tha Lisppouaaies Many original, eroundbvea ing works, these meiude: ae Airs, Waters and Places ~ the {ivst najor work on medical meteorology, elim tology, Seography and anthropology, ie Aphorisms - 4 collection of wise, pithy suyinys giving advice on practical matters of diet, Prognosis und therapeutics. ¢.g, “Let food be thv medicine and medicine be thy food."; “There are im fact two things, science and opinion; the former begeis knowledge, the latter ignorance.” “Mherever the art of Medicine 1s loved, there is also a love of liumanity."; "Declare the past, diagnose the present, foretell the future.” “Walking is man's best medicine. "; “As to diseases, make a habit of two things — 10 help, or at least, to do no harm.”; “The life so short, the craft so Jong to learn.”; “It is far more important to know what ‘person the disease has than what disease the person has." “If we could give every individual the right amount of nourishment and exercise, not to9 little and not too much, we would have found the safest way to health." “Ifyou are ina bad mood go for a walk. If you are still ina bad mood go for another walk."; “What medicines do not heal, the lance will; what the lance does not heal, fire will.” Ancient Medicine - a defense of the empirical study of medicine against one biased by Preliminary axioms and assumptions. Also deals with the Four Humors. Hippocrates was the personification of the ideal physician - wise, caring, compassionate and honest. He is most remembered today for his famous Oath, which set high ethical standards for the Practice of medicine. His exemplary life has been a constant and enduring source of inspiration for doctors and healers down through the ages. i The Hippocratic Oath: Modern Version - Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today. Y Iswear to fulfill, to the best of my ability and judgment, this covenant: % Iwill respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. Y Iwill apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism, Y Lnwill remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. Y Iwill not be ashamed 10 say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. Y Iwill respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If itis given me to save a life, all thanks. But it may also be within my power to take a’ life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty, Above all, I must not play at God. ¥ Twill remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if] am to care adequately for the sick. Y Iwill prevent diseuse whenever I can, for prevention is preferable to cure. Y Iwill remember that T remain a member of society, with special obligations to all_my fellow human beings, those sound of mind and body as well as the infirm. Y I 1do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long\experience the joy of healing those who seek my help.