



mrpoc RATES. 



HIPPOCRATES. 



modifications. He thus wnt hack to the materialism of the early 

 look Mhool ; and as Thalrs had Uken water, so Hippo took moisture 

 to be the principle of all things. (Aristot. De Anima,' i. 2 ; Plutarch, 

 ' De PUcit Phila*,' 5.) Ua explained his view* in a work which seems 

 to have been called fve-uca Uynara, which however owing to ita 

 iiwignifioance, appears to hare fallen into oblivion at a very early 

 period, and soaroely any fragment* of it have come down to ua. 

 qjaaene of Alexandria (' CohortaU ad Gent,' voL L p. 48, ed. Potter) 

 baa preferred an epigram of Hippo, which ia also printed in the editions 

 of the Greek Anthology. (lambliohua, De Vita Pythay. 36 ; Sextus 

 Empir. Pfrrko*. Hyp. iii. 30, adv. Matkm. ix. 361 ; Scholiast ad 

 ArvtofJi. aub. 97; compare Brandia, (ietekickte der Griech. RiJmitcften 

 PkUotopkit, rol. L p. 121, Ac.; Bakhuuen ran den Brink, Varitr 

 Ltetwntt tf Hittoria Philotopkuf Antiqure, pp. 86-59; Brucker, Hitt. 



HIPPO'CRATES wan born at Cos, B.C. 460. His family followed 

 the pursuit of medicine for near three hundred years, and produced 

 oven physicians, who attained considerable celebrity, and who are 

 supposed to have written the numerous treatises which are commonly 

 attributed to Hippocrates alone. Before their time the knowledge of 

 medicine was either confined to the priests, who employed their skill 

 in maintaining their influence over the people, and carefully concealed 

 the little knowledge they possessed, or was merely followed as a 

 subordinate pursuit by the philosophers of the day. It is to the 

 Asclepiadn that the science of medicine is indebted for a separate 

 existence, and the great progress which it made in their hands after 

 this separation sufficiently proves the wisdom of their proceeding. 



The most celebrated of the family was the subject of the present 

 notice, Hippocrates, the eon of Heraclides and Phaanarete, who is 

 supposed to have been the author of this important revolution in 

 medicine. It would have been interesting to give some details of bis 

 personal history, but unfortunately we possess few authentic materials 

 for this purpose, except some fragments contained in his life by 

 Soranus. His medical studies were pursued under the superintend- 

 ence of his father and of Herodicus ; and he is said to hare had for 

 his masters in philosophy Gorgias of Leontini, the celebrated sophist, 

 and Democritus of Abdera, whose cure he afterwards effected. We 

 are told that he spent some time at the court of Perdiccas, king of 

 Macedonia, and visited Thrace and Scythia; and it is probable that 

 these statements are true, as mention is made in his writings of several 

 towns in Thrace (Suidas, 'Iinroitpoin)!). Soranus states that he delivered 

 Athens from the ravages of a dreadful plague which was raping in the 

 city : but this can hardly be the one which occurred in the second 

 year of the Feloponnesian war, of which such a graphic description is 

 given by Thucydidos ; for though Thucydides Fullered from the disease 

 himself, and was a witness of its ravages, he makes no mention of the 

 name of Hippocrates, but on the contrary declares that medical skill 

 was of no avail against it 



We have already observed that many of the works usually attri- 

 buted to Hippocrates were in reality the productions of various 

 members of his family. This circumstance alone would render it 

 impossible to determine accurately the amount and value of bis con- 

 tributions to the science of medicine. But this difficulty has been 

 still further increased by the manner in which his writings were 

 mutilated, and fresh passages interpolated by later editors. This con- 

 fusion is supposed to have been introduced into his writings at the 

 time when the Ptolemies were forming their celebrated library at 

 Alexandria, for the high value which was set upon ancient writings 

 by these monarchs induced men to collect and forge copies of ancient 

 authors, which they passed off for the genuine works of those to 

 whom they were attributed. It appears that in the time of Galen 

 they were able in some degree to distinguish the genuine writings of 

 Hippocrates from those falsely attributed to him. All the writings 

 assigned to Hippocrates are written in the Ionic dialect, but he does 

 not adhere so closely to its forms aa Herodotus. 



The principles of Hippocrates were those of rational empiricism. 

 Ho did not attempt to form his theories from it priori reasoning, but 

 lie observed the phenomena of nature and deduced from them such 

 conclusions as these phenomena would justify. That ho adhered to 

 this principle in all cases however is not to be supposed. He taught 

 that the body is composed of four primary elements fire, water, 

 earth, and air ; that these elements, variously combined, produce the 

 four cardinal humours, and these again the different organs of the 

 body. These doctrines are principally developed in the treatise ' On 

 the Nature of Man ; ' and Galen assert* that he was the author of this 

 theory, which was afterwards adopted and more generally promulgated 

 by the genius of Plato. His knowledge of anatomy seems to have 

 been very limited. The superstitious respect which was paid to the 

 remains of the dead among the Greeks prevented him from acquiring 

 any knowledge on this subject by dissection of the human body. He 

 gives such descriptions of the bones as show that be had 'indeed 

 ntudied the (abject, bat not acquired any very accurate knowledge. 

 The muscle* are described under the general term of jloh (trdpnts), 

 and though some explanation ia given of them in the treatise 'On 

 Art,' thin is probably spurious. The term plilebt (^Aif>) is applied 

 indiscriminately to the veins and arteries, while arierin (apriiphi) is 

 confined exclusively to the trachea. His description of the vessels is 

 confined to the course of tome of the larger one*, without expressing 



any opinion as to their origin. He doe* not seem to have supposed 

 that they originate either in the heart or liver. These views were 

 first propounded in the school of Alexandria. Under the term nrrrtt 

 (nvpa) he confounds all the white tissues of the body, the nerves, 

 properly so called, the tendons, and ligaments. According to Hippo- 

 crates the brain is glandular and secretes the pituita, or mucus. In 

 his pathology he confines himself principally to the investigation of 

 the remote cause* of diseases, without entering into many speculations 

 on their nature. However he explains inflammation by the passage 

 of blood into those parts which did not previously contain it In this 

 case we still require to be informed how the blood passes into these 

 put*. He paid great attention to the effects of changes in the external 

 conditions of life, namely air, warmth, moisture, food, upon its phe- 

 nomena, and those of disease. He recommended that particular 

 attention should be paid to the constitution of the seasons. 



Among the doctrines of Hippocrates, that of critical days, upon 

 which he supposed the evacuation of the morbific matter when con- 

 cocted to take place, is the most remarkable. In his ' Pncnotionea ' 

 he says, fevers come to their crisis on the same days, both those which 

 turn out fatally and those which turn out well. These days are tho 

 fourth, the seventh, the eleventh, fourteenth, seventeenth, and 

 twentieth. The next stage is of thirty-four days, the next of forty, 

 and the next of sixty. It appears very doubtful how far this theory 

 was borne out by actual observation, but it is possible that it may 

 have been more nearly true under the treatment of Hippocrates, 

 which was not usually very active, than under the more energetic 

 treatment of modern physicians. Of the indications to be drawn from 

 examination of the pulse Hippocrates was not aware, and the word 

 tphygmut (o<t>vyn'os) is usually employed by him to denote some 

 violent pulsation only. It is however upon the accuracy with which 

 he observed the leading features of disease, and his vivid descriptions 

 of them, that the fame of Hippocrates is principally and justly 

 founded. Nowhere is the peculiar power of the Greeks in expressing 

 their conceptions more strikingly shown. Wo have extracted one or 

 two of the most marked descriptions from his ' Prognostica." " If the 

 appearance of the patient be different from usual, there is danger. 

 If the nose be sharp, the eyes hollow, the temples collapsed, the ears 

 cold and contracted, and the lobes inverted, whilst the skin of the 

 forehead is hard, dry, and stretched, and the colour of the face palo 

 or block, or livid or leaden, unless these appearances are produced by 

 watching or diarrhoea, or under the influence of malaria, the patient 

 is near death." This description has obtained the title of Facies 

 Hippocratica, And other descriptions of premonitory symptoms of 

 danger are no less graphic and precise. In the remainder of this 

 treatise ho goes through the different evacuations from the bladder 

 and the bowels, by vomiting and by expectoration, describing their 

 characters and appearances, and the conclusions that may be drawn 

 from them. His directions for the examination of a patient supposed 

 to be labouring under empyema present an example of sound and 

 cautious investigation. " If there is empyema on one side of the chest, 

 we must turn the patient, and learn whether he has pain in one side, 

 and if one side be hotter than the other ; while he is lying on the 

 sound side, we must ask if he feels any weight hanging from above. 

 For if this be the case, the empyema is on that side on which he feels 

 the weight. We may recognise the presence of empyema by these 

 general signs : if the fever does not remit, but is moderate during 

 the day and increased at night, and considerable perspirations occur, 

 and there is great inclination to cough and but little expectoration ; 

 while the eyes become hollow, the cheeks are flushed, the finger-nails 

 curved, and the fingers hot, especially the tips, and the feet swell, 

 and pustules are formed over the body these symptoms denote 

 chronic empyema, and may be greatly relied on." We must not 

 forget that Hippocrates asserts that auscultation may be employed to 

 distinguish between the presence of pun and serous fluid in the cavity 

 of the pleura. No attention seems to have been paid to this remark- 

 able statement until the time of Laennec's great discovery, by whom 

 the passage is noticed and referred to. The statement of Hippocrates 

 is in itself incorrect, but the fact of his having actually practised 

 auscultation is no less interesting. 



Hippocrates appears also to have introduced some valuable improve- 

 ments in tho treatment of disease. During health he recommends 

 that the diet should not be too exact, lest any unavoidable change 

 should bring on disease. Of wine he says it must not be taken pure 

 during the summer, but in the winter he allows a more liberal use 

 of it. In his treatise ' On Diet ' he claims to have been the li 

 recognise the importance of diet in the treatment of disease, which 

 had been neglected by all previous physicians ; and in this statement 

 he is in some measure borne out by the authority of Plato (' De Hep.,' 

 iii. 14), who praises the ancient physicians for having neglected it; 

 whereas the modern ones, by this system, convert life into a tedious 

 death. However, he attributes the introduction of the new system to 

 Herodicus. In fevers and acute diseases he confined his patients to 

 a liquid diet, but not so strictly a* some other physicians, whom be 

 charges with starving their patients to death. In his general treatment 

 he employed purgatives, some of which were of the most violent 

 character, as the black and white hellebore and ulaterium, which 

 generally produce excessive vomiting at the same time. He mixed 

 up & little theory with his treatment ; for he would not allow purga- 



