Hipocrates, together with his colleagues, students and followers, set the foundations for modern medicine, as described in the books attributed to the great physician, the Hippocrates Corpus. The following three principles, that were introduced by Hippocrates, revolutionised the way medicine was practiced:
(1) medicine is based on scientific truth and not superstitions or magical beliefs,
(2) there is always a natural cause to each illness,
(3) observation is the most important tool and the best diagnostic method.
Hippocrates achieved significant breakthroughs in various fields of medicine:
Hippocrates developed knowledge of human anatomy, only through studying wounded soldiers, victims of accidents, animals and sacrifices, as the dissection of human bodies was forbidden. In the Hippocrates Corpus, the heart, blood vessels, meninx of the brain and eardrum are described in detail. Hippocrates also had a perfect knowledge of the human skeleton.
Physiology (or how the body works)
Hippocrates believed there is a natural force within each human being, called “Physis”. This internal energy oversees all body functions, conserves health and is the biggest therapeutic factor. Under appropriate conditions and if certain strengths of the human organism are invigorated, the natural resistance of the human body (or immune system) can overcome illness.
Hippocrates also developed a medical theory called Humorism or the Four Temperament theory. The human body contains four vital bodily “fluids” (humors): blood, yellow bile, phlegm and black bile, with four “elements” functioning within it: dry, hot, cold and liquid. When the humours are in harmonic proportion and the elements function normally, the body is in excellent health. An imbalance, i.e. an excess or deficiency, of fluids provokes illnesses.
As stated by Hippocrates himself in his work “On the Nature of Man”: “The Human body contains blood, phlegm, yellow bile and black bile. These are the things that make up its constitution and cause its pains and health. Health is primarily that state in which these constituent substances are in the correct proportion to each other, both in strength and quantity, and are well mixed. Pain occurs when one of the substances presents either a deficiency or an excess, or is separated in the body and not mixed with others.”
Pathology (or the study of diseases)
According to Hippocrates, the patient, and not the illness itself, should be at the centre of the physician’s interest. Furthermore, the causes of sickness lie in the imbalance of fluids, caused by various factors, like climatic conditions, seasonal variations, diet, and digestion.
Hippocrates attached a lot of importance to diagnosis, through in depth observation. He always asked for the patient’s medical history and examined him thoroughly, through palpation and hearing. The colour of the patient’s head, his eye expression, the state of his teeth, his tongue, the aspect of his hands, his breath, temperature, heart beats, body’s stance etc. were all annotated in detail. The composition, colour and odour of the patient’s urine, excrements, saliva, sweat, vomit etc. were also examined in detail
Hippocrates was one of the first physicians to attach importance to preventive medicine. Prognosis, based on good diagnosis, earns the trust of the patient and is paramount to good therapy. Favourable prognosis could derive from good sleep, mobility, hot sweat on specific days, appetite, lucidity etc., whereas unfavourable prognosis could derive from sleeping with an open mouth, insomnia and oversleeping, cold sweat, violent gestures etc. Certain days (4th, 5th, 11th….) were considered crucial for the prognosis
The therapeutic methods of Hippocrates were based on the a) composition of the human body of the patient and the natural resistance of the organism, b) diet, c) pharmaceutical medication and d) chirurgy.
In order to increase the body’s resistance, Hippocrates used therapeutic methods that provided opposite effects to the symptoms of the illness: “contraria contrabirus curantur”. In order to increase the natural strengths of the organism, apart from the right diet and medication, Hippocrates also recommended a healthy way of living, fresh air, balneotherapy, thermal springs, physiotherapy and massage. Hippocrates believed strongly that human nature itself cures all diseases.
The pharmacological knowledge of Hippocrates and his students were very developed. Plants, minerals and animals were the foundations of their medicine. As far as plants are concerned, most commonly used were:
Vitex agnus-castus (vitex, chaste tree): for spleen disease and wound cleansing
Asparagus: to counter diarrhea and promote fertility.
Artemisia arborescens (tree wormwood): an antitetanic when mixed with wine.
Dragon lily: for hemoptysis (coughing up of blood) and gynecological diseases.
Sage: styptic attributes (constricting blood flow), breast milk stimulant, used also for pulmonary diseases.
Thyme: a mucus expellant and stimulant for defecation and urination.
Urtica (nettle): poultice for fungal head infections, uterus cleansing.
Dittrichia viscosa (from the family of daisies): energiser, diuretic, birth facilitator, used falso or the cleansing of female genital organs after birth.
Fennel: for uterus pains, cranial lesions
Tamarix: for hemorrhoids
Oregon: for gall-related issues.
Potentilla: for severed nerves and high fever, like malaria.
Rhamnus: ideal for wounds
Celery: for constipation, menstruation and wound healing
Drimia: diuretic, expectorant, and heart stimulant. Used also for lung infections and wound healing.
Hippocrates and his pupils used at least 300 plant-based medicine drugs. Heavy medication was never administered for light illnesses, but only for difficult cases and according to the patient’s constitution. In some cases, Hippocrates even chose not to administer medication, when nature itself was enough to cure the illness.
Hippocrates attached great importance to the patient’s diet and studied systematically the effects of various foods and beverages on the human body. Each diet was tailored to the patient’s composition, habits, age and needs, and according to the sickness itself, the season, the climatological conditions etc. The objective of the individualised diet was to increase the natural defenses of the organism.
Moderation, light exercise and walks were the key to a healthy living. The amount of eaten food should be proportionate to the efforts and the needs of the body.
Hippocrates also developed the idea that someone’s mental and body health is greatly influenced by the environment, especially climate, seasons, winds, water, soil, diet, exercise, laws, customs, etc.
As far as other medical specialisations are concerned, Hippocrates’ contribution to rheumatology is considered highly important. He described in detail arthritis and singled out gout, a non-lethal but long-term torturous type of arthritis.
In the domain of nosology, Hippocrates highlighted the multiple symptoms and variations of each illness. He was the first to use the notions of rash, jaundice, fracture, kidney stone, pleurisy (inflammation of lungs), melancholy, angina, nephritis (kidney inflammation), and epidemic to describe illnesses. His descriptions of epilepsy, malaria, parotitis (mumps), tuberculosis, cancer or Pott disease are extraordinarily accurate.
Hippocrates was one of the first to show the importance of heredity in certain illnesses and the role of microbial factors in the development and causes of certain ailments.
Hippocrates and the medical School of Kos made a lot of progress in the domains of surgery and orthopedics. They took specific measures of sepsis and antisepsis to avoid infections. They used various methods to achieve hemostasis (prevent and stop bleeding), like desiccants, styptics, bandages, local cautery etc. They also used fire, wine and sea water as antiseptics. Hippocrates also developed new medical instruments, like the orthopedic table to realign dislocated thighs, and other surgical or orthopedic equipment. He had extensive knowledge on fractures, dislocations, joint and bone damage, scoliosis, kyphosis, hemorrhoids, wounds and how to heal them. His craniectomy method is considered a classic. He also observed that blood flow is essential to avoid infection in all wounds, apart from the stomach area.
Hippocrates also made some noteworthy remarks on midwifery and gynecological issues. He studied the menstruation cycles, fertility, sterility, pregnancy, childbirth, puerperium, gynecological diseases, and the development of the foetus.
In olphamology, Hippocrates and his pupils believed that eye diseases were due to atmospheric conditions, visible external causes and invisible internal ones. They studied and described ocular migraines, hemianopsia, ophtalmy, surgical cure of trichiasis, conjunctivitis cure, trachoma cure by curettage and cautery. They examined eye-lids to detect severe body illnesses.
In dentistry. Hippocrates undertook tooth extractions, cured tooth decay and caries, and other mouth diseases. He was the first to describe dentition and to link tooth diseases with body illnesses.
Hippocrates also studied otorhinolaryngological diseases and had knowledge of venereology and dermatology.
Hippocrates and his Medical School practised also some form of psychiatry and neurology. They always examined the body and mind condition of the patient as a whole and believed that the human body functions perfectly when body and mind are in harmony. They were the first to state that the brain is the center of feelings, movement and thought. They also described clinically the state of depression, that they named melancholy and attributed to the dysfunction of the black bile.