The “Father” of Western Medicine

Hippocrates is widely regarded as the father of western medicine, is connected with the famous “Hippocratic Oath,” and is known for treating a plague in antiquity. But we actually know very little about him, what he wrote, what he taught, or what he may or may not have done. Plato (Protagoras 311b-c) and Aristotle (Politics 1326a14), in the fourth century BC, recognize Hippocrates as a physician of some renown, but by the first century BC he had become a heroic figure with star power, and was associated with different deeds, different beliefs, and different texts.

Galen (the personal physician to the emperor Marcus Aurelius and the physician on whom most western and Islamic medicine was based up until the late 1800s), elite physicians of the Renaissance and Enlightenment (such as Paracelsus and Thomas Syndenham), and even those of modern medicine (such as William Osler) have looked back to Hippocrates as a foundational hero in their own image. Suffice it to say that Hippocrates became, from very early on and through a process that we do not fully understand, an iconic figure onto whom doctors throughout the ages have projected their own ideas and ideals of medical knowledge, practice, and ethics.

The island of Cos.

We do know that Hippocrates was born on Cos, a Greek island just off the present-day coast of Turkey. We also are fairly sure that he was a member of the Asclepiadai (“Sons of Asclepius”), and that this clan claimed descent from both Asclepius (the god of healing) and Heracles (Hercules).  He seems to have been active as a physician and a teacher, primarily in northern Greece, in the last half of the fifth and early fourth centuries B.C.  His son Thessalus, his son-in-law Polybus, and his grandson Hippocrates (a physician to Alexander the Great) may also have become famous physicians.

The 1588 Hippocratic Corpus (Hippocrates burns a bonfire to cure the plague in the central panel).

However, most specific traditions about Hippocrates’ life are obviously fictions written long after Hippocrates’ death, and what he actually believed is disputed even by ancient authorities. Plato (Phaedrus 270c) says that Hippocrates thought it important to consider “the whole” (although what this means has been of debate since antiquity), while Aristotle (according to the anonymus Londinensis papyrus, whose source appears to go back to Aristotle’s pupil Meno), and even the physician Galen present differing versions of Hippocrates’ core beliefs.

Similar confusion attends the “Hippocratic Question,” namely which—if any—of the works of the “Hippocratic” Corpus (a group of medical texts first assembled in Alexandria in the third century BCE and finalized in the mid-second century CE) Hippocrates actually wrote. The works of the Hippocratic Corpus cover many different subjects and come from a variety of sources and authors with differing medical beliefs. The seven books entitled Epidemics are not about epidemics in the modern sense, but contain individual case studies and generalized observations concerning patients and locations in (mostly) northern Greece.  Among these, however, a plague at Thasos near Lemnos appears in Epidemics 3.3-4, and cases and observations concerning malaria, and possibly influenza, occur in Epidemics 1 and 2.

Hippocrates’ earliest association with epidemic plague (or loimos in Greek) comes from two works of the pseudepigrapha (texts written to appear to be something else, such as letters or speeches composed as if they were written by a famous person) found at the end of the Hippocratic Corpus: the Presbeutikos, a fictitious oration composed around 250 BCE, and the Decree, a fictitious Athenian honorary decree composed perhaps at the same time. They credit Hippocrates with diagnosing a plague in the late fifth century BCE and with saving Greece by circulated an effective therapy. In this early version, envoys from the barbarian kings of Illyria and Paeonia (roughly modern Albania and Kosovo) arrive at Hippocrates’ residence in Thessaly (northern Greece) and promise him great riches if he comes and helps them. Hippocrates questions the envoys and, once he has learned enough of the disease, pretends to be unable to travel and sends the envoys away. But he then composes a therapy, takes it around Greece, and sends out his sons and pupils with it to various areas (it is unspecified, however, just what this therapy entails). When he finally arrives in Athens, he and his son Thessalus are honored by the assembly.

Hippocrates refuses the wealth of the barbarians.

By the first century BCE, this episode became widely associated with the famous Athenian plague of 428/427 BCE (deemed incurable by the contemporary historian Thucydides in The Peloponnesian War 2.47-54). The Roman historian Varro (On Rural Farming 1.4.5; first century BC)  credits Hippocrates with saving “many cities” and Pliny the Elder (Natural History 29; first century CE) repeats the assertion, found in the Presbeutikos and Decree, that he was honored  for this service. In these and some other versions of the story, such as by Galen (Theriac to Piso 16), Plutarch (Isis and Osiris 383c) and Aetius (Tetrabibloi 5.95), Hippocrates uses a bonfire composed of various materials to dry and correct the imbalances in the air that were thought to cause plague according to the prevailing theories of the time. This tale survived through the Renaissance in medical literature and art, and is featured on the cover of the famous 1588 Venice edition of the corpus.

The famous Plane Tree on Cos.

Another famous story, found first in the pseudepigrapha (Letters 1-9) and in several later accounts (The Life of Hippocrates According to Soranus, the Suda, and the authro Johannes Tzetzes), involves a request made to Cos by the Persian king Artaxerxes. With a plague ravaging his army, the king sends for Hippocrates, promising him riches and honors. Hippocrates, supported by Cos, refuses to aid an enemy of the Greeks. While Greek writers (and others) saw this as an example of Hippocrates’ patriotism, courage, and character, the Roman Cato (Pliny, Natural History 29.13-14; Plutarch, Cato 23) may have had this story in mind when he criticizes Greek doctors and warns his son that “they have sworn to kill all barbarians with medicine, and to charge a fee for it as well.”

Hippocrates is said to have died at an extremely old age. His legacy lingers on in the medical world at large, and on his home island of Cos, where tourists can visit the Plane Tree under which he was said to have taught (unfortunately, Kos city was founded well after Hippocrates’ death — the main city in Hippocrates’ day was actually at the other end of the island and is now a Club Med resort) and the Ascleieion (the sanctuary of Asclepius that was part temple, part medical center, and part health resort). The latter, inaugurated in 246 BCE, probably made Hippocrates famous as a part a promotional campaign by the Coans that spanned the Hellenistic world of the time.