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Hippocrates is credited with being the first physician to reject superstitions, legends and beliefs that credited supernatural or divine forces with causing illness. Hippocrates was credited by the disciples of Pythagoras of allying philosophy and medicine.[16] He separated the discipline of 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. However, Hippocrates did work with many convictions that were based on what is now known to be incorrect anatomy and physiology, such as Humorism.[17][18][19]

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.[20] The Hippocratic school or Koan school achieved greater success by applying general diagnoses and pbumive 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.[21][22]

Hippocratic medicine and its philosophy are far removed from that of modern medicine. Now, the physician focuses on specific diagnosis and specialized treatment, both of which were espoused by the Knidian school. This shift in medical thought since Hippocrates’ day has caused serious criticism over the past two millennia, with the pbumivity of Hippocratic treatment being the subject of particularly strong denunciations; for example, the French doctor M. S. Houdart called the Hippocratic treatment a “meditation upon death”.[23]

[edit]Humorism and crisis

Main article: Humorism

The Hippocratic school held that all illness was the result of an imbalance in the body of the four humours, fluids which in health were naturally equal in proportion (pepsis).[24] When the four humours, blood, black bile, yellow bile and phlegm, were not in balance (dyscrasia, meaning “bad mixture”Log in to see images!, a person would become sick and remain that way until the balance was somehow restored. Hippocratic therapy was directed towards restoring this balance. For instance, using citrus was thought to be beneficial when phlegm was overabundant.[25]

Another important concept in Hippocratic medicine was that of a crisis, a point in the progression of disease at which either the illness would begin to triumph and the patient would sucgreat timesb to death, or the opposite would occur and natural processes would make the patient recover. After a crisis, a relapse might follow, and then another deciding crisis. According to this doctrine, crises tend to occur on critical days, which were supposed to be a fixed time after the contraction of a disease. If a crisis occurred on a day far from a critical day, a relapse might be expected. Galen believed that this idea originated with Hippocrates, though it is possible that it predated him.[26]

A drawing of a Hippocratic bench from a Byzantine edition of Galen’s work in the 2nd century AD

Hippocratic medicine was humble and pbumive. The therapeutic approach was based on “the healing power of nature” (“vis medicatrix naturae” in Latin). According to this doctrine, the body contains within itself the power to re-balance the four humours and heal itself (physis).[24] Hippocratic therapy focused on simply easing this natural process. To this end, Hippocrates believed “rest and immobilization [were] of capital importance”.[27] In general, the Hippocratic medicine was very kind to the patient; treatment was gentle, and emphasized keeping the patient clean and sterile. For example, only clean water or wine were ever used on wounds, though “dry” treatment was preferable. Soothing balms were sometimes employed.[28]

Hippocrates was reluctant to administer drugs and engage in specialized treatment that might prove to be wrongly chosen; generalized therapy followed a generalized diagnosis.[28][29] Potent drugs were, however, used on certain occasions.[30] This pbumive 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. The Hippocratic bench and other devices were used to this end.

One of the strengths of Hippocratic medicine was its emphasis on prognosis. At Hippocrates’ time, medicinal therapy was quite immature, and often the best thing that physicians could do was to evaluate an illness and induce its likely progression based upon data collected in detailed case histories.[19][31]

[edit]Professionalism

A number of ancient Greek surgical tools. On the left is a trephine; on the right, a set of scalpels. Hippocratic medicine made good use of these tools.[32]

Hippocratic medicine was notable for its strict professionalism, discipline and rigorous practice.[33] The Hippocratic work On the Physician recommends that physicians always be well-kempt, honest, calm, understanding, and serious. The Hippocratic physician paid careful attention to all aspects of his practice: he followed detailed specifications for, “lighting, personnel, instruments, positioning of the patient, and techniques of bandaging and splinting” in the ancient operating room.[34] He even kept his fingernails to a precise length.[35]

The Hippocratic School gave importance to the clinical doctrines of observation and dogreat timesentation. 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 pbumed down and employed by other physicians.[36] Hippocrates made careful, regular note of many symptoms including complexion, pulse, fever, pains, movement, and excretions.[31] He is said to have measured a patient’s pulse when taking a case history to know if the patient lied.[37] Hippocrates extended clinical observations into family history and environment.[38] “To him medicine owes the art of clinical inspection and observation”.[19] For this reason, he may more properly be termed as the “Father of Clinical Medicine”.[39]

[edit]Direct contributions to medicine