Hippocratic CorpusBMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d688 (Published 20 April 2011) Cite this as: BMJ 2011;342:d688
Here is a term almost synonymous with “medical classic”—the Hippocratic oath. Attributed to contemporary or later generations of physicians rather than to Hippocrates (ca 5th century BC) himself, the oath forms an essential part of the Corpus Hippocraticum or Hippocratic Canon, which was first printed in Venice in 1526. The corpus comprises an eclectic, rather heterogeneous collection of about 70 medical treatises, largely gathered during the Alexandrian era (4th century BC), reflecting the teaching of the school of the Ionic island of Cos. The most famous Coan resident was, as Galen of Pergamum (AD 2nd century) put it, “the best of all physicians—Hippocrates—and the first who brought the medicine of the Greeks to its luminous excellence.”
Hippocratic medicine was in many ways a reaction to medicine based on religion, magic, and superstition. In a successful attempt to understand medicine through ideas as opposed to beliefs, and to explain disease through natural rather than supernatural means, the term τέχνη ιατρική (Latinised as ars medica, or the art of medicine) was introduced by Hippocratic doctors, laying the foundations for modern scientific medicine. The first medical text to break free from superstition and quackery was the 5th century BC monograph On the Sacred Disease. Its anonymous Coan author uses epilepsy as a paradigm to claim that every illness has a natural cause, and seeks rational explanations, rather than the supernatural means by which disease had been understood until then.
The Hippocratic Oath is the first extant medicoethical and medicolegal writing we have, and it discusses abortion, euthanasia, and patient confidentiality. It is also an idealised deontological code of practice, advising on doctors’ medical competence, clinical ability, and reasonable judgment in the best interest of patients.
It begins, “I swear by Apollo the Physician and by Asclepius and by Hygieia and Panacea and by all the gods as well as goddesses, making them judges [witnesses], to bring the following oath and written covenant to fulfilment …” This is an invocation to the medical deities of the Greeks, showing that religion was still also considered an integral part of medicine. Indeed, the rite of incubation carried on taking place in temples dedicated to the god Asclepius well into Roman times. Hospitals, from their creation in the Middle Ages, epitomise this fusion of religion (though by then monotheistic) with the practice of medicine. Western hospitals were a Christian invention to provide food and shelter for poor, sick, and abandoned people; clinical and scientific medicine were only later incorporated. Even though scientific reasoning and religious beliefs may be seen as contradictory and incompatible, history has shown a coexistence not as disharmonious as previously thought.
The Epidemics states that “many women with that aspect died” or “patients with phthisis did not become ill in the typical way,” indicating an approach to disease based on pattern recognition skills beyond purely holistic views.
Traditional Western medicine has changed in many ways since the canon was written, not least by establishing a formal way of teaching at universities, incorporating surgery into the academic curriculum, and bringing science to medicine. However, the essence of the Hippocratic Corpus remains as influential in 21st century evidence based medicine as ever.
Cite this as: BMJ 2011;342:d688
First published about 350 BC
Competing interests: None declared.
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