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Hippocrates


The following is courtesy of Wikipedia, the free encyclopedia

Historians accept that Hippocrates existed, was born around the year 460 BC on the island of Kos, and was a famous physician and teacher of medicine; however, all other biographical information is probably of doubtful authorship or authenticity. As no real biography was available until centuries after his death, those that are available today might be based on hundreds of years of oral tradition and are thus unreliable.

Soranus of Ephesus, a Greek gynecologist of 2nd century AD was Hippocrates's first biographer and is the source of most information on Hippocrates's person. Later biographers of Hippocrates were Suidas, John Tzetzes, and Aristotle. Soranus stated that Hippocrates's father was Heraclides, a physician; his mother was Praxitela, daughter of Phenaretis. The two sons of Hippocrates, Thessalus and Draco, and his son-in-law, Polybus, were his students. According to Galen, a later physician, Polybus was Hippocrates’s true successor while Thessalus and Draco each had a son named Hippocrates.

Soranus said that Hippocrates learned medicine from his father and grandfather, and other subjects from Democritus and orgias. Hippocrates was probably trained at the Healing temple of Kos, and took lessons from Herodicus. Plato, Hippocrates's only contemporary to mention him, describes him as an Asclepiad (Greek). Hippocrates taught and practiced medicine throughout his life, traveling at least as far as Thessaly, Thrace, and the Sea of Marmara. He died probably in Larissa at the age of 83, 90, 100 or even later; different accounts of his death exist.

Hippocrates is credited as the first physician to reject the divine origin and superstition of sicknesses. He separated the discipline of medicine from philosophy and religion, believing and proffering that disease was not punishment of the gods but due to environmental factors, diet and living habits. Indeed, there is not a single mention of a mystical illness in the entirety of the Hippocratic Corpus. Hippocrates did not, however, hold entirely scientific beliefs; he had many pseudo-scientific convictions based on incorrect anatomy and physiology, such as Humorism.

Greek medicine at the time of Hippocrates knew almost nothing of human anatomy and physiology because of the Greek taboo forbidding the dissection of animals. 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, but, dependent upon faulty assumptions about the human body, failed to distinguish when one disease caused many possible series of symptoms.[15] The Hippocratic school or the Koan school was more successful for its general diagnoses and passive treatments. Its focus was on patient care and prognosis, but not diagnosis. It could effectively treat diseases and allowed for a great development in clinical practice.

Despite all of its advances Hippocratic medicine and philosophy is far removed from modern medicine. Today, the physician focuses on specific diagnosis and specialized treatment, which are much more of the Knidian ideals. Because of this, Hippocratic methods have seen some serious criticism in the past two millennia, often focusing on the passivity of Hippocratic practice. M. S. Houdart, a French doctor, called Hippocratic treatment a "meditation upon death", for example.

Humorism

The Hippocratic school held that illness was the result of an imbalance in the body of the four humours, fluids which were naturally equal in proportion (pepsis). When the four humours, blood, black bile, yellow bile and phlegm, were not in balance (dyscrasia, meaning "bad mixture"), 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, utilizing citrus was thought to be beneficial when an overabundance of phlegm was suspected.

Crisis

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

Hippocratic therapy

Another important precept of Hippocratic doctrine 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). Hippocratic therapy focused on simply easing this natural process. To this end, Hippocrates believed "rest and immobilization [were] of capital importance". He was reluctant to administer drugs and engage in specialized treatment that could be wrong; generalized therapy followed a generalized diagnosis.

Methods of treatment

Hippocratic medicine was humble and passive. Whenever possible it was very kind to the patient: sterile and gentle. For example, only clean water or wine were ever used on wounds, though "dry" treatment was preferable. Soothing balms, too, were often employed. There were, however, times when potent drugs were used.

Hippocratic method 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 in its prognosis. At this time, medicinal therapy was quite immature, and often the best that physicians could do was to evaluate an illness and induce the likely progression of it based upon data collected in detailed case histories.

Professionalism

Hippocratic medicine was notable for its strict professionalism, discipline and rigorous practice.[28] 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. He even kept his fingernails to a precise length.

The Hippocratic School gave importance to the clinical doctrines of observation and documentation. 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 passed down and employed by other physicians. Hippocrates made careful, regular note of many symptoms including complexion, pulse, fever, pains, movement, and excretions. He is said to have measured a patient's pulse when taking a case history to know if the patient lied. Hippocrates extended clinical observations into family history and environment. "To him medicine owes the art of clinical inspection and observation". For this reason, he may be termed the "Father of Clinical Medicine".

Direct contributions to medicine

Hippocrates and his followers identified many diseases and medical conditions for the first time. He also began to categorize illnesses as acute, chronic, endemic and epidemic. Other medical terms that he introduced were, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence."

Great contributions of Hippocrates may be found in his descriptions of the symptomatology, physical findings, surgical treatment and prognosis of thoracic empyema, i.e. suppuration of the lining of the chest cavity. His teachings remain relevant to contemporary students of pulmonary medicine and surgery. Hippocrates was the first documented chest surgeon and his findings are still valid.

He is given credit for the first description of clubbing of the fingers, an important diagnostic sign in chronic supperative lung disease, lung cancer and cyanotic heart disease. For this reason, clubbing is sometimes termed "Hippocratic fingers". Hippocrates was also the first one to diagnose Hippocratic face in Prognosis. Shakespeare famously alludes to this description when writing of Falstaff's death in Act II, Scene iii. of Henry V.

Hippocratic Oath

The Hippocratic Oath, a seminal document on ethics of medical practice, was attributed to Hippocrates in antiquity. This is probably the most famous document of the Hippocratic Corpus. Recently the authenticity of the document has come under scrutiny. While the Oath is rarely used in its original form today, it serves as a foundation for other, similar oaths and laws that define good medical practice and morals. Such derivatives are regularly taken today by medical graduates about to enter medical practice.

Hippocrates is widely considered as the "Father of Medicine". His contributions revolutionized the practice of medicine. However, after him there was a dearth of medical advancement. Medical practitioners who followed him sometimes did not further the advancement started by him, rather moved backwards. For instance, "after the Hippocratic period, the practice of taking clinical case-histories died out...", according to Fielding Garrison. After Hippocrates, the next significant physician was Galen, a Greek who lived from 129 – 200 AD. Galen perpetuated Hippocratic medicine, moving both forward and backward. In the Middle Ages, Arabs adopted Hippocratic methods. After the European Renaissance, Hippocratic methods were revived in Europe and even further expanded in the 19th century. Notable among those who employed Hippocrates's rigorous clinical techniques were Sydenham, Heberden, Charcot and Osler. Henri Huchard, a French physician, said that these revivals make up "the whole history of internal medicine."


All of the information listed above is courtesy of the many editors of the wonderful Hippocrates wikipedia page which you can view by clicking here: Wikipedia, the free encyclopedia


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