5 · Ancient Greece science and technology

Hippocrates and medicine

about 400 BC Island of Kos (Greece)

In short

Hippocrates, a doctor born on the island of Kos, taught that illnesses have natural causes and are not punishments from the gods. To treat a patient you had to observe them carefully, listen to them and note down how the symptoms changed. He recommended rest, diet and clean air even before medicines. He and his students are credited with the oath from which the one doctors still take today comes.

Why it matters He gave medicine a method based on observation, which is still at the heart of doctors' work.

Source: Treccani, entry “Ippocrate”

See it on the line Era quiz Read the full card Printable worksheet

Illustration: Hippocrates and medicine (Island of Kos (Greece)) — Illustration created with AI for Storiascopio

Where: Island of Kos (Greece)

Study card about 6 minutes of reading

The story

The doctor of Kos

Kos is a small Greek island in the Aegean, very close to the Turkish coast. Here, around 460 BC, Hippocrates was born. We know very little about his life. Plato and Aristotle remembered him as the most famous doctor of his time. According to the sources he practised and taught in various parts of Greece, including Athens and Thessaly, and died around 370 BC (some sources say 377). His family, according to tradition, belonged to the Asclepiads, a lineage said to descend from Asclepius, the god of medicine.

Almost everything else is open to debate. Scholars call it the “Hippocratic question”: Hippocrates was a real man, but the books that bear his name are many and come from different periods and authors. The “Hippocratic Corpus”, the collection of writings attributed to him, includes about seventy works. The oldest core dates from the end of the 5th and the beginning of the 4th century BC, others are later. The collection was probably formed at Alexandria, in the 3rd century BC, where very different texts were put together. So we do not know which ones he really wrote.

Medicine without magic

Before Hippocrates, in Greece part of the care of the sick was tied to religion, and Asclepius was the god to whom people turned. The texts of the Corpus show a different way of reasoning. Disease is not a punishment from the gods, but a natural event, with its own rules, which follows a course and passes through phases of worsening and improvement, the “crises”. One of the works in the Corpus harshly criticises healers who claim to cure with rites and spells, accusing them of quackery.

The causes, for these texts, are to be sought in the body and the environment: the climate, the place where one lives, above all diet and lifestyle. A very famous theory, set out in the treatise “On the Nature of Man”, attributed to a pupil named Polybus, says the body contains four “humours”: blood, yellow bile, black bile and phlegm. When these are in balance, there is health; when one of the four prevails, there is disease. Today we know the theory is not right, but it guided medicine for almost two thousand years.

Observing the patient

The strongest point of Hippocratic medicine is its method. The doctor must carefully observe the signs of the disease: the symptoms, but also the urine, the sweat, the breathing, the skin. He must look at the patient as a whole, with his way of life, not just the illness. With these observations he tries to make the diagnosis, that is, to recognise the illness, and the prognosis, that is, to predict how it will end. The records in which cases were noted, in the treatise “Epidemics”, are among the first examples of what we now call clinical histories.

Treatments were mostly dietary. Diet, for the Greeks, included the whole rule of life: food, exercise, baths. Drugs had a secondary role, mostly herbal infusions. Bloodletting and surgery were also practised, especially for fractures and dislocations. It was above all a medicine that let nature do its work: the doctor had to assist the body's healing power, an idea later summed up in the Latin formula vis medicatrix naturae, the “healing power of nature”.

The Oath

The most famous text linked to Hippocrates is the Oath. Those who swore it called on Apollo the physician, Asclepius, Hygieia and Panacea, and promised to treat their teacher like a father, to do good to the sick and not to harm them, not to give deadly drugs even if asked, and to keep secret what they saw or heard in the practice of the profession. Scholars are not sure it is Hippocrates' work: the text is probably from the 4th century BC or later, and may reflect the rules of a group of doctors with Pythagorean leanings. In antiquity it was not used as we use it today; it became a kind of moral code of the profession mainly in Christian times.

“Life is short”

A famous maxim is also linked to the Hippocratic tradition: “life is short”. It reminds us that the time for learning and for healing is little, and that the doctor must therefore use it well.

Why it happened

In the 5th century BC the Greeks were learning to explain nature without resorting to the gods. Philosophers like Thales had looked for natural causes for the phenomena of the sky and the earth. Doctors applied the same way of thinking to the human body: if the world has laws, illnesses must have them too.

In addition, Greece was a suitable place: small cities, many travellers, constant exchange of ideas. Doctors travelled from city to city, saw many different cases and compared their experiences. Writing these cases down, in books that could be discussed and corrected, made medicine a body of knowledge that grew over time.

What changed

From the Hippocratic school came the idea that medicine is a rational craft: you observe, you reason, you record cases. From the 3rd century BC the scholars of Alexandria collected and commented on the Corpus, and this tradition of commentary lasted until the 19th century. Galen, the great Roman doctor, considered himself an heir of Hippocrates, and for centuries European and Islamic medicine was built on his texts.

The theory of the four humours remained in use for a very long time, until the discovery of microbes and the study of the body with modern instruments replaced it. But the habit of carefully observing the patient, noting the symptoms, assessing the course of the illness and not promising impossible cures has remained.

The Oath is still a reference today. Italian doctors recite a modern text, updated by their federation in 2014, which takes up its principles: to treat every patient without discrimination, to respect professional secrecy, not to carry out acts aimed at causing death. It is an example of how an idea born more than two thousand years ago can still guide the behaviour of a profession.

Key people and places

People

Hippocrates of Kos: Greek doctor (about 460–370 BC), considered the founder of rational medicine in Greece.
Polybus: Pupil of Hippocrates, to whom the treatise on the nature of man with the theory of the four humours is attributed.
Galen: Doctor of the 2nd century AD, a great commentator on Hippocrates.
Asclepius: The Greek god of medicine: the Asclepiad doctors said they were his descendants.

Places

Kos: Aegean island where Hippocrates was born.
Thessaly: Region of northern Greece where Hippocrates practised.
Alexandria, Egypt: The city where, in the 3rd century BC, the collection of Hippocratic writings was probably put together.

Good to know

The “Hippocratic Corpus” includes about seventy writings, but scholars think few are really by Hippocrates.
For Hippocratic doctors the body contained four humours: blood, yellow bile, black bile and phlegm.
The Oath begins by calling the gods of medicine as witnesses: Apollo the physician, Asclepius, Hygieia and Panacea.
The maxim “life is short” is linked to the Hippocratic tradition: it was even taken up in an inscription on a tomb at Ostia.
Italian doctors still recite an oath inspired by the ancient one, updated in 2014.