May 1st, 2023 #005 - "A solemn oath has been taken for granted."
Every want to know the history of Hippocrates? Well, here is a little bit of it for you including the Hippocratic Oath for anyone who has an inquisitive mind.
Click this link for a video alternate of this article!
"Foolish the doctor who despises the knowledge acquired by the ancients."
- Hippocrates
Hippocrates of Kos (c.460 – c.370 BC), also known as Hippocrates II, was a Greek physician of the classical period who is considered to be the "Father of Medicine" and made contributions to the field of medicine that stand alone and is still being used today. He was the first to employ the use of prognosis and clinical observation, the systematic categorization of diseases or also known as humeral theory. The Hippocratic school of medicine revolutionized the practice of medicine, establishing it as a discipline distinct from other fields with which it had traditionally been associated (theurgy or magical practice and philosophy). This made is possible for the practice of medicine to become a legitimate profession.
The Hippocratic Corpus might be the first official medical study guide offered to the field of medicine for all practicing physicians to refer to. Hippocrates is commonly portrayed as the shining example of the physician and credited with creating the Hippocratic Oath, which is 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.
Hippocrates thought that a complete knowledge of the nature of the body was necessary for medicine. He taught and practiced medicine throughout his life as a traveling physician. He is believed of being the first person to confirm that diseases were caused naturally, not because of superstition and gods. He distinguished the difference of practicing medicine from religion, believing and arguing that disease 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 a mystical illness in the entirety of the Hippocratic Corpus.
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. The Knidian school consequently failed to distinguish when one disease caused many possible series of symptoms.
The Hippocratic school of 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 but because of this advancement in the ancient times modern day physicians can focus more on specific diagnosis and specialized treatment, both of which were espoused by the Knidian school.
Hippocratic medicine was humble and passive. The therapeutic approach was based on "the healing power of nature". According to this doctrine, the body contains within itself the power to re-balance the four humors and heal itself. Hippocratic therapy focused on simply easing this natural process. To this end, Hippocrates believed "rest and immobilization were of capital importance". Treatment was gentle and emphasized keeping the patient clean and sterile.
Hippocrates was reluctant to administer drugs and engage in specialized treatment that might prove to be based off of a misdiagnosis. Treatments he prescribed included fasting and the consumption of a mix of honey and vinegar. However, potent drugs were used if seen as necessary. This passive approach was very successful in treating relatively simple ailments such as broken bones which required traction to stretch the skeletal system and relieve pressure on the injured area. This may be were the concept of physical therapy was first employed in practicing medicine.
One of the strengths of Hippocratic medicine was its emphasis on prognosis. In Hippocrates' time, medicinal therapy was quite immature, and often the best thing that physicians could do was to evaluate an illness and predict its likely progression based upon data collected in past detailed case histories.
Hippocratic medicine was notable for its strict professionalism, discipline, and rigorous practice. The Hippocratic work "On the Physician" recommends that physicians always be well-kept, honest, calm, understanding, and serious. The Hippocratic physician were meant to pay careful attention to all aspects of his practice and presentation.
The Hippocratic School gave importance to the clinical doctrines of observation and documentation. These doctrines dictate that physicians record their findings and their medicinal methods in a very clear and objective manner, so that these records may be passed down and employed by other physicians such as taking regular notice of many symptoms including complexion, pulse, fever, pains, movement, and excretions including extended clinical observations into family history and environment. He set the standard that to practice medicine one owes the art of detailed clinical inspection, observation and investigation.
Hippocrates and his followers were first to describe many diseases and medical conditions. He 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. Hippocrates began to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence. Another of his major contributions may be found in his descriptions of the symptomatology, physical findings, surgical treatment and prognosis of thoracic empyema. His teachings remain relevant to present-day students of pulmonary medicine and surgery. He was also the first documented chest surgeon and his findings and techniques, while crude, such as the use of lead pipes to drain chest wall abscess, are still valid and used with more modern, less invasive technology.
He often used lifestyle modifications such as diet and exercise to treat diseases such as diabetes, what is today called lifestyle medicine. Hippocrates may be the first to quote "Let food be your medicine, and medicine be your food" but this may be based on his past with educating himself on medicinal history practiced by others and his own experience practicing medicine. The exact origins remain unknown for this quote as we do not know all of his personal history or where his inspirations came from. Regardless of the origin, it is true in nature and should be considered wise advise.
The Hippocratic Corpus is a collection of around seventy early medical works collected in Alexandrian Greece. The question of whether Hippocrates himself was the author of any of the treatises in the corpus has not been conclusively answered, but current debate revolves around only a few of the treatises seen as potentially authored by him. Because of the variety of subjects, writing styles and apparent date of construction, the Hippocratic Corpus could not have been written by one person. The corpus came to be known by his name because of his fame, possibly all medical works were classified under 'Hippocrates' by a librarian in Alexandria. The volumes were probably produced by his students and followers. The collection contains textbooks, lectures, research, notes and philosophical essays on various subjects in medicine. Notable among the treatises of the Corpus are The Hippocratic Oath, The Book of Prognostics, On Regimen in Acute Diseases, Aphorisms, On Airs, Waters and Places, Instruments of Reduction, On The Sacred Disease.
The Hippocratic Oath, a seminal document on the ethics of medical practice, was attributed to Hippocrates in antiquity although new information shows it may have been written after his death to serve as an example of how to conduct yourself properly as a physician. In modern times it serves as a foundation for other, similar oaths and laws that define good medical practice and morals.
After Hippocrates time many aspiring scholars who practiced in science and medicine used his knowledge to enhance the field of medicine. A Greek physician named Galen (AD 129 to AD 200) perpetuated the tradition of Hippocratic medicine, making some advancements, but also some regressions. In the Middle Ages, the Islamic world adopted Hippocratic methods and developed new medical technologies. After the European Renaissance, Hippocratic methods were revived in western Europe and even further expanded in the 19th century. Notable among those who employed Hippocrates' rigorous clinical techniques were Thomas Sydenham, William Heberden, Jean-Martin Charcot and William Osler. Henri Huchard, a French physician, said that these revivals make up "the whole history of internal medicine."
It is interesting to note that Hippocrates focused on natural medicine and had specialty interest in pulmonology health. I would wonder what he may think of our most recent events of medical tyranny using lockdowns, masks and forced medical treatment to heal the "sick". Would he coldly evaluate this and find this to be ethical practice or would he be shocked to find a lack of consideration in medical investigation?
Somehow I do not think he would have approved of such fear-mongering behavior. A man who is able to take such steps as he did for the better of man-kind is not a man who fears truth.
The Hippocrates' Oath (translated by Amelia Arenas):
"I swear before my gods, my ancestors, my teachers, my fellow healers and apprentices, and by the arts and knowledge I was privileged to learn, that I will stand by these words:
I will love those who taught me these arts as I love my parents and I will offer my skills to the young with the same generosity that they were given to me. And I will never ask them for gold, but demand that they stand by this covenant in return. I also swear that if I earn fame and wealth, I will share it with my masters and my students.
I will soothe the pain of anyone who needs my art, and if I don't know how, I will seek the counsel of my teachers.
I will offer those who suffer all my attention, my science and my love. Never will I betray them or risk their well-being to satisfy my vanity. I will not hurt my fellow or put a knife to his flesh if I do not know how, or give him an herb to soothe his pain, even if he begs for it in anguish, if it may take away his breath.
I will never harm my suffering friend, because life is sacred, from the tender fruit that he once was in his mother's womb to that first sigh he gave out between her legs when he opened his eyes to the world.
I will try to understand his sorrows but his secrets will never leave my ears. Under no circumstance I will use his body to advance my knowledge or my fame, unless in his last moment, he or his widow give me his corpse, so that his death may help me understand how to soothe another's pain.
I pray that the attention I give to those who put themselves in my hands be rewarded with happiness. And in honor of the knowledge I've received from my teachers, I swear to care for anyone who suffers, prince or slave.
If I ever break this oath, let my gods take away my knowledge of this art and my own health.
Here speaks a citizen, a servant of people. May I be destroyed if I betray these words."
This is the solemn oath taken by Hippocrates and the students of the Hippocratic School of Science and Medicine. They wrote this, included it and intended for it to be part of and practiced while one was entrusted with the people's needs. It was considered the obligation one took on and a contract one verbally agreed to before they were given the privilege of treating humanities well-being.
If you are a doctor, a healer, a scientist or any other student in health read this statement as many times as is necessary for it to really sink in. If you are someone who wants to benefit humanity by "healing the sick" read this statement very carefully. Think about it in detail. Analyze every single fragment of this statement. Think about what each portion is really saying. Hold it up to all science and practicing medicine.
Does todays’ use of science and medicine line up with this statement that is meant to be the standard for ethical and moral practice? If you think that this statement is meant to be taken as subjective and is matter of perspective you would be misguided. This is a definitive description that is meant to be the parameters for the practice of ethical science and medicine.
This is a promise to the people, to those in need from the people who feel a soul-deep obligation to humanity. Recent modern events has betrayed this promise. What are going to do about it? The Oath itself gives us the answer to this question.
This is an example of how the Hippocrates Oath is stated today in modern times.
Declaration of a New Doctor (by the University of Exeter; College of Medicine and Health)
"As a new doctor, and a member of the medical profession:
I solemnly pledge that I will do my best to serve humanity - caring for the sick, promoting good health and alleviating pain and suffering.
I will care for all patients equally and not allow prejudice to influence my practice.
I will respect the autonomy and dignity of my patients, and will uphold their confidentiality.
I will acknowledge my patients' physical, psychological, and social needs and assist them to make informed decisions that reflect their own value and beliefs.
I will respect, support and give gratitude to my teachers, colleagues and all those who sustain the NHS.
I will reflect on my practice and recognize my limits.
I will seek to increase my understanding a skills, and promote the advancement of medicine as both a teacher and a learner.
I will work towards a fairer distribution of health resources and oppose policies in breach of human rights.
I will look after my own physical, mental and emotional well-being in my personal and professional life.
I shall never intentionally cause harm to my patients, and will have the utmost respect for human life.
I will practice medicine with integrity, humility, honesty and compassion.
I recognize that the practice of medicine is a privilege with which comes considerable responsibility and I will not abuse my position.
I make this declaration sincerely, freely and upon my honor."
This is rewritten in more recent day terminology but the promise that is made from speaking these words remains the same.
If you are a doctor, a scientist or a student of science and medicine and you have not taken this oath I would take the time to reevaluate if you are able to truly uphold this promise to the people.
If you have taken this oath at your graduation from medical school and you have wavered from this promise you have sworn to than I would suggest you reflect on your actions as a practicing medical professional and figure out if you have gone wrong. If you have not upheld all the principles of this oath you have broken your promise to all humankind.
I would even suggest that if you have not held up to the standards of this oath you should resign from your career immediately as you have brought shame to your field and have shown your lack of respect for humanities well-being. There are consequences to all actions. The consequence to breaking this promise is that the privilege of receiving trust and being allowed to treat the health of your fellow man is revoked.
When you put the white lab-coat on you are now a servant of the people. You are choosing to take on the burden of humanities weaknesses, illnesses and deaths. You are choosing to sacrifice your time and energy for the physical betterment of others.
If you cannot find yourself being able to uphold this oath than it is your responsibility to choose another path. Make this choice in a conscientious way after you have reflected on this promise you are thinking about taking. Do not take the lives of your fellow human beings for granted by becoming a medical professional if you are unable to uphold and stand up for this promise that is being made.
Humanity needs its healers and scientists.
Do not abuse our trust.