Hippocratic Corpus Research Articles

Medical practice in classical Greece : The neurological and psychiatric case reports of the Hippocratic Corpus

Which theoretical and practical competences do the neurological and psychiatric case histories of the Hippocratic Corpus convey? The 431 Hippocratic case histories have been studied for reports and communication on the diagnostics, treatment and prognosis of single persons and groups of patients suffering from neurological and psychiatric diseases. In the 7books of the Hippocratic Epidemics, atotal of 128 patients with neurological and psychiatric symptoms are described. Epidemic fever and its variants were the leading predisposing conditions and the main symptoms were delirium, coma, insomnia, headache, speech disorders and convulsions. Anumber of patients with phrenitis and opisthotonos are also reported. The majority of the sick persons were male, were teenagers or adults and 47of them are mentioned by name. The patient's information about the course is often just as informative as the doctor's observations. Treatment was limited to physical and dietary measures. The Hippocratic physician diagnosed and attempted to treat alarge number of neurological and psychiatric diseases. The often almost continuous observations of the patients led to astonishingly precise predictions of the course and the prospects of recovery. Numerous symptoms described in the case studies, including carphologia and opisthotonus, have entered the neurological vocabulary. The retrospective etiological analysis of the reports leads to the almost explicit identification of neurosyphilis and encephalitis lethargica. The therapeutic measures described by the author were, as the changeable course of the diseases shows, only of limited effectiveness despite a very differentiated application over time, both against the underlying diseases and the neurological and psychiatric complications.

Medical practice in Ancient Greece : The orthopaedic and trauma surgery case reports of the Hippocratic Corpus

Which theoretical and practical competences do the orthopaedic and trauma surgery reports of the Hippocratic Corpus reveal? The 431 Hippocratic case histories have been studied for reports and communication on diagnostics, therapy and prognosis of orthopaedic diseases and traumatic lesions. The seven books of the Hippocratic "Epidemics" describe atotal of 26patients with orthopaedic diseases and traumatic lesions. In the field of orthopaedic diseases, arthritis, myo- and tenopathia and gangrene play aprominent role, among the consequences of injury the fracture of the skull (n = 10) is in first place. Mainly individuals, but also groups of patients are reported. The clients' information on the course of the disease was often cautious. Diagnostics were limited to inspection and palpation. In addition to the measures of conservative treatment, four trepanations are described. The majority of traumatic brain lesions resulted in death. The Hippocratic doctor was faced with avariety of orthopaedic disases and traumatic lesions. Within the case reports, the subjective complaints, the objective findings and the course of the treatment are described in detail. Among the ailments of the musculoskeletal system, spinal disorders, especially hypercyphosis and scoliosis play an important role. The variety of reduction techniques reported suggests that most of the fractures detected were dislocated. Post-traumatic tetanus can be readily identified in several followup observations due to the development of opisthotonus. No other surgical intervention is discussed by Hippocrates as often and as variously as trepanation. It can be concluded with some certainty that perforating injuries of the skull were acommon challenge in the life of asurgeon of classic antiquity.

The Surgery of Celsus' De Medicina.

Celsus' De Medicina (first century ce) is the first comprehensive treatise on medicine and surgery to survive from antiquity. Bridging the gap between the Hippocratic Corpus and the works of Galen, it documents the important advances in anatomy and surgery of the Alexandrian school during the Hellenistic era. De Medicina contains an anatomically based system of surgery and strikingly modern concepts of wound management, as well as the first accounts of hemostasis by ligature, per primam healing of wounds, amputation, and complex, elective operations, including lithotomy and inguinal herniotomy. The possibility (and desirability) of per primam healing, thereby permitting elective surgical procedures, was ignored until rediscovered in the 19th century; its recognition by Celsus prompts a re-evaluation of the excellence of ancient surgery.

The urological case reports of the Hippocratic Corpus : Medical practice in classical Greece

Which theoretical and practical competences do the urologic case histories of the Hippocratic Corpus convey? The 431Hippocratic case histories have been studied for reports and communication on diagnostic methods, treatment, and prognosis related to urologic diseases. Within the seven books of the Hippocratic Epidemics, atotal of 69patients with urologic symptoms are described; in 21 cases the urologic disease is dominant. The leading clinical signs were urine discoloration and urinary sediment, polyuria, testicular swelling and pain, hematuria, stranguria, anuria, and renal pain, the most frequent diseases were nephritis and urolithiasis. Most patients were men in juvenile and adult age; 33 sick persons are named. The statements of patients regarding the course of their illness were often sparse. Diagnostic tests were restricted to inspection and palpation. Otherwise, treatment was confined to conservative measures. The dietary decisions for treatment of nephritis were differentiated but nonuniform. The Hippocratic physician diagnosed and treated diseases of the urinary tract. Inflammatory conditions and traumatic lesions are described in detail. Highest priority was awarded to uroscopy. Nephritis was awidespread disorder und usually associated with other symptoms, above all fever. The urinary tract was often regarded as an indicator of physical and mental health. Conservative treatment measures dominate in the case reports.

“Eski Tıp” metni ve ampirik tıbbın kökenleri

OBJECTIVE: In our study, the relationship between medicine and philosophy, which are still in their infancy, will be analysed and the empirical understanding of medicine proposed against the rational methods of philosophy in the context of the text titled “Ancient Medicine” in the “Hippocratic Corpus” will be discussed. MATERIAL and METHODS: Academic research. RESULTS: The ancient origins of empirical medicine are investigated. CONCLUSION: The text entitled ‘Ancient Medicine’ in the Corpus Hippocraticum is the first known attempt to make medicine independent of philosophy as well as of mysticism and magic. Keywords: ancient Greek medicine, corpus hippocraticum, empirical medicine

Hippocrates: A Pioneer in Orthopaedics and Traumatology.

Hippocrates, the ancient Greek physician, is considered the father of Medicine; however, his contributions to Orthopaedics and Traumatology have not been highlighted enough. The present historical review represents an effort to present and categorize his work, in this field, per clinical disorder and anatomical region. The "Hippocratic Corpus" original text was thoroughly studied to identify all Hippocrates' contributions in Orthopaedics and Traumatology. Volume III of his works, especially "On Fractures", "On Joints", and "Mochlicon" includes a plethora of information regarding the management of traumas, as well as other disorders and clinical entities of the musculoskeletal system. In particular, Hippocrates describes reduction techniques for fractures, as well as joint dislocations, elaborates on the biology of the fractures' healing process and the basic principles of fracture management and fixation, presents the signs and symptoms of gangrene, teaches the treatment of osseous infections and offers valuable insight on the biomechanics and treatment of spinal diseases. Hippocrates' contributions in Orthopaedics and Traumatology are unprecedented, making him a true pioneer in this field, while the basic principles that he presented were further studied and confirmed in the 19th and 20th centuries.

On the Heart of the Hippocratic Corpus: its meaning, context and purpose.

Though the Hippocratic text On the Heart has garnered significant attention in the twentieth and twenty-first centuries from classicists, physicians and historians of medicine alike, no commentary on this important work currently exists. There remain, however, central questions of interpretation concerning a number of important points: in particular, how the author understands the structure and functioning of the heart.The significance of this text for the history of cardiovascular medicine can be found first in its position as being radically advanced in its portrayal of the inner structure of the heart when compared with any other Hippocratic text. At the same time, the text falls dramatically short of the discoveries of the Alexandrian researchers who studied during the Hellenistic period-that is, around the same period as this text's likely composition. In addition, this work contains the first extant description of the valves of the heart, and its detailed descriptions of a cuspid valve and the chordae tendineae have led several scholars to imagine that this text even contains evidence of either a systematic dissection of an animal heart or-what seems impossible outside of Alexandria, Egypt at that time-evidence of the dissection of a human heart.This article intends to provide a full commentary on the text by consolidating, and in some cases correcting, previous interpretive attempts to understand an often referenced, and at times misinterpreted, ancient medical treatise.

The Development of Physical Diagnosis: Historical Perspectives

The history of physical diagnosis started with Hippocrates and his school. History taking, inspection, palpation, and sometimes immediate auscultation and examination of the urine are fundamental diagnostic tools. The Hippocratic Corpus and Galen’s authoritative theoretical writings dominate medical thinking for over 1000 years. Clinical examination advances through Vesalius and Morgagni’s discoveries of human dissection (1543) and pathologic anatomy (1761) respectively. The Vienna school through Auenbrugger introduces percussion in 1760. The Paris school formally establishes physical diagnosis with the invention of the stethoscope by Laennec in 1816.

Représenter la flaua bilis: le portait du colérique dans l’Iconologia de Cesare Ripa

Representing the flaua bilis: the Portrait of the Choleric in Cesare Ripa’s Iconology. The theory of the four humours (blood, phlegm, yellow bile and black bile) forms the basis of ancient medicine. Coming from the Hippocratic corpus and completed by Galen of Pergamum (129–216 AD) in his De Temperamentis by means of individual complexions (blood, phlegmatic, angry, melancholic), this theory is essential in modern Europe after more than two thousand years of transmission, development and practice of medicine. Our article aims to examine its fortune in the Iconology of the Italian scholar Cesare Ripa (1555–1622). Starting with the Roman edition of 1603, he enriched his famous allegorical repertoire with a complex entry encoding the four temperaments: Collerico per il fuoco, Sanguigno per l’aria, Flemmatico per l’acqua, Malenconico per la terra. We work here only with the Choleric and undertake to determine the reasons which governed the choice of the attributes retained by C. Ripa (youth, nudity, sword, shield adorned with a flame, lion, fury in the gaze) to offer poets, painters and sculptors the archetype of a figure dominated by yellow, hot and dry bile. To this end, we analyze the medical, literary and iconographic sources on which the author relies, considering also the richness and complexity of the medical discourse he had at his disposal and the very purpose of his Iconology.

Apodictic Method in the History of Medicine

Philosophical interpretation of any scientific discipline is impossible without understanding the methods of cognition inherent in this discipline. The history of medicine is also formed by the understanding of the evolution of the methods of knowledge–clinical and experimental. Unfortunately, there is a tendency to describe the history of medicine as a set of individual events, but philosophy of medicine is understood as a system-forming phenomenon only from the moment of scientific revolutions (17th - 19th centuries). However, in relation to other natural science disciplines, for example, mathematics, the point of view regarding the apodictic method (i.e., the method of rigorous proof) is generally accepted as a method of knowledge that has determined the entire history of these disciplines. I argue that medicine was also strongly influenced by early Ionian physics (as well as astronomy or mathematics), and the apodictic method (methods of rigorous rational knowledge and proof) has existed in the history of medicine since antiquity. Even Sir Geoffrey Lloyd expressed this hypothesis, based on some treatises from the Hippocratic Corpus. In turn, I argue that the apodictic method in medicine had already been fully developed in the treatises of Galen. I propose to define the apodictic methodology in medicine as follows: the apodictic method of proof in medicine is anatomical dissections, clinical systematization and the rational doctrine of general pathology (the last one with certain limitations). The characteristics of the use of the method of rigorous proof in the work of ancient authors enables us to identify three stages in the development of the methodology of ancient medicine. The first stage ‒ the period of the inception of the apodictic method—defines the establishment of the foundations of Greek rational medicine, based on Hippocratic principles. The period of the establishment of the apodictic method is associated with the works of Aristotle devoted to the argumentation theory, the theory of motion and the practice of systematic dissection of animals based thereon. Most important was the establishment of comparative anatomy. The third stage—the period of the development of the apodictic method—is characterized by Galen’s work. Galen introduced the apodictic method in medical practice and substantiated its significance for further development of medicine as a science. The real keeper of Galenic-Hippocratic medicine during the 8th-11th centuries was the medicine of the Islamic world. In a certain sense, it was not only preserved, but also enriched. In this context the works of Muhammad ibn Zakariya al-Razi are of particular importance. He developed and critically rethought the teachings of Galen on the systematics of diseases. Most of al-Razi’s critical points were aimed at expanding and deepening clinical applications and general clinical logic reflected by this systematic approach. At the same time, we practically cannot speak about the development of anatomic dissections during the Islamic period of Galenic-Hippocratic medicine existence.

L’histoire de Delphes et les Asclépiades

Abstract The object of this communication is to contribute to a rehabilitation of the Presbeutikos of Hippocrates generally considered since Littré as a legendary writing on the life of Hippocrates. Since Littré, the archaeological and epigraphic discoveries on Delphi have provided the Presbeutikos with anchoring points in reality. Three stages were important : a first, dating from the first half of the 20th century, due to Hans Pomtow, a second in the second half of the 20th century, due to Jean Bousquet and a third stage at the start of the 21st century due to Denis Rousset. These advances due to archaeologists must be put in relation with the advances of philologists which are not negligible either on the edition of the Presbeutikos after Émile Littré, in particular by the examination of the Ionian vocabulary of this speech including the rare words, which are hapax in the Hippocratic Corpus and are also attested in Herodotus. The language of Presbeutikos, by its antiquity, differs from that of more recent Letters.

On the Role of Research Travel in Medical Education in the 2nd – 3d Centuries AD

The role of travel in obtaining medical education in Antiquity is well known from the texts of the “Hippocratic Corpus”. However, the most valuable evidence about this aspect of the medical profession can be found in the texts by Galen of Pergamum (129-210/217), whose works are the main source of this study. Galen's numerous autobiographical notes allow us not only to trace the routes of his voyages, but to uncover their goals as well. After receiving his initial medical education in Pergamum, Galen travelled to Asia Minor, particularly to Mysia, Phrygia, and Cappadocia, attending lectures of famous physicians and philosophers and studying the local traditions of medicine. After that he spent some years in Alexandria. An analysis of a number of texts allows us to conclude that Alexandria in the 2-3 centuries AD was a center for the study of anatomy and commenting on Hippocrates’ texts. To study medicine in this city was considered a necessary stage in the career of a successful physician and a prerequisite for recognition in the profession. Important evidence should also be noted regarding the existing medical specialization in Alexandria, the features of the local dietetics and medicinal substances. An important stage in Galen's medical career was the theoretical and practical study of surgery at the gladiatorial school of Pergamum, where his knowledge was expanded not only with the rules for suturing, but also with hemostatic and wound healing prescriptions. From his extant works on pharmacology (“De simplicium medicamentorum temperamentis ac facultatibus”, “De compositione medicamentorum per genera”, “De compositione medicamentorum secundum locos”), we know that Galen also visited a number of places in the Eastern Mediterranean: Thrace, Macedonia, Cyprus and even Palestine. The purpose of these journeys was to observe the local climate that affects human health and causes diseases, to study the peculiar properties of the local herbs and minerals, and to collect medicinal substances for his personal apothecary. According to the evidence preserved in one of his latest works, “De indolentia”, Galen managed to collect one of the richest pharmacopoeias of his time and a unique collection of prescriptions that was destroyed by a fire in Rome in 192.

Beneath the skin: method and perception in Hippocratic medicine

AbstractThis paper examines some neglected aspects of Hippocratic medicine, drawing special attention to certain methodological questions concerning the role of sense perception in the acquisition of medical knowledge. I argue that there is greater epistemological uniformity among the texts of the Hippocratic Corpus than is sometimes assumed. I provide a careful reading of seemingly inconsistent Hippocratic treatises in the light of a plausible and coherent epistemological model. The impression that we are dealing with different, indeed inconsistent, epistemological views can be explained away by the specific dialectical contexts of each work and their historical background. Most importantly, a proper justification of this model will require us to delve into the epistemological foundations of Hippocratic medicine.

The image of Empedocles in the Hippocratic treatises and the interpretation of some biographical evidences

Empedocles is spoken of as a physician by various ancient authors. However, none of the medical works attributed to him has survived. These may have been the treatise of Empedocles mentioned by Pliny the Elder on the deliverance of Athens from the plague and the medical treatise in six hundred verses. Nevertheless, we have at our disposal a number of fragments of his poem, in which the structure of various parts of the body is described, an attempt is made to explain the functioning of the processes of perception, some physiological processes and the structure of living organisms are described. Empedocles is also mentioned in some treatises of the Hippocratic corpus, but rather as a fake doctor in comparison with the real, i. e. Hippocratic doctors. This study aims to resolve the conflict that exists between the fragments of Empedocles’ poem, in which he speaks in the first person and promises to teach various “magical” techniques, the testimonies of Heraclides and Timaeus based on these statements, and the reaction to Empedocles by representatives of the Hippocratic school. For this we will have to turn both to doxographic evidence and to some treatises of the Hippocratic corpus — “Ancient Medicine”, “The Sacred Disease” and “Decorum”. The article examines what medicine was in antiquity, what was the reason for the institutionalization of the medical profession, and whether a clear disciplinary boundary could be drawn between medicine and natural philosophy at the time. These questions are included in the general discussion of the relation between religious and scientific views in the philosophy of Empedocles, as well as in the mentioned treatises of the Hippocratic corpus. In addition, the article attempts to interpret the story of the miraculous resurrection of the breathless by referring to contemporary research in the field of resuscitation.

Aphasia localization: was Pierre Marie right?

Language and its associated disorders have puzzled humanity since the dawn of civilization. The first descriptions of aphasia go back to classical antiquity. The Egyptians and Babylonians believed speech was a divine gift to mortals, and their descriptions of aphasia attributed these events to their Gods' anger and disfavour. The Edwin Smith Surgical Papyrus and the Hippocratic Corpus report several aphasia cases, relating this phenomenology to apoplexy, epilepsy, and other illnesses.

Genetics Awakens the Complex Relationship Between Sleep and Psychiatric Disorders

The complex relationship between mental health and sleep disturbances was recognized by Hippocrates, who argued that sleeplessness is a sign of suffering and may lead to mental illness, while daytime sleepiness is an indication of malady (Hippocratic Corpus, about 400 bc). However, with sleep disturbances common among patients with psychiatric disorders, the prevailing modern view has been that psychiatric disorders have a major impact on sleep; indeed, sleep problems are listed as symptoms and diagnostic criteria for many psychiatric conditions (1).

Special Issue Introduction

In the mid-sixteenth century, Girolamo Cardano emerged as one of the major opponents of the view that Aristotle (or philosophy in general) advocated for the soul’s mortality. Cardano argues passionately that not only had Aristotle held the soul to be immortal, but so had Hippocrates, whom Cardano considered the greatest physician of antiquity. Cardano no doubt thought that he was bolstering the agreement of philosophy and theology. Yet, his manner of doing so was rather disturbing to censors of the Roman Inquisition and Index. Jonathan Regier, in his contribution to this volume, “A Hot Mess: Girolamo Cardano, the Inquisition, and the Soul,” considers Cardano’s doctrine of celestial heat, a principle of life and generation in the cosmos. Regier examines how and why Cardano drew this doctrine from the Hippocratic corpus. He then goes on to discuss the nature of this celestial heat in Cardano’s De subtilitate, Cardano’s best known work of natural philosophy. There, Cardano seems with only the slightest qualification to equate all souls with this celestial heat. Regier considers this position in detail, especially as it manifests in discussions of human desire and love, and he examines the response of an important Vatican censor.

From the anatomical teaching dissection to tuition at the bedside-A historical appraisal

Zu allen Zeiten waren die Anatomen bemüht, der Medizin wissenschaftliche Grundlagen zu vermitteln. Der Anatom hat den toten Körper zergliedert, um damit den Lebenden zu dienen. Das Verständnis physiologischer und pathophysiologischer Prozesse setzt die Kenntnis der Anatomie voraus. Im Corpus Hippocraticum findet man keinen sicheren Hinweis auf die Durchführung menschlicher Sektionen. In Alexandria wurde um 300 vor Christus zum ersten Mal Anatomie an der menschlichen Leiche gelehrt. Mehr als 1300 Jahre standen die Anatomie und die Heilkunde dann unter dem Einfluss des Galen von Pergamon (131–201 n. Chr.). Der Italiener Mondino dei Luzzi (1275–1326) war der Erste, der den systematischen Anatomieunterricht unter regelmäßiger Einbeziehung von Lehrsektionen in den Lehrbetrieb in Bologna eingeführt hat. Andreas Vesalius (1514–1564) aus Belgien hat in der Neuzeit die wissenschaftlich fundierte Humananatomie begründet und viele Fehler der von Galen tradierten Ansichten der Anatomie korrigiert. Im 17. und 18. Jahrhundert waren die niederländischen Universitäten, allen voran die Universität in Leiden, führend im Hinblick auf die klinische und praktische Studentenausbildung.

Doṣas by the Numbers

This paper explores the origins of the Indian medical nosology involving the three doṣas from the perspective of its formulation into three or four distinct types. The essay compares similarities in passages from three different literary sources: Pāļi texts of early Buddhism, early Sanskrit medical literature, and Greek texts from the Hippocratic Corpus and the Anonymus Londiniensis. The study reveals that the tridoṣa-theory, common to āyurvedic literature from an early time was based on the adoption and then adaption of ideas nourished by an intellectual exchange with the Greek-speaking world.

Santé et environnement à l'âge prépastorien (xvie-xixe siècles)

The environmental history of health is rooted in a double tradition: medical representations from the Hippocratic corpus were revisited at different times; the geography and history of epidemics and ill health were developed from the middle of the 20th century within the context of an increasing globalization of exchanges and systemic fight against the most virulent diseases. On both sides of the Pasteurian medicine rupture, the change in the scientific paradigm may seem to have created an insurmountable hiatus. However, the social and political implications of taking into account the relationships between health and environment on different scales still bear many lessons for our time.