Hippocrates of Kos (c. 460 BC): The Father of Western Medicine

Hippocrates of Kos (c. 460–370 BC) was a Greek physician from the Aegean island of Kos, regarded since antiquity as the father of Western medicine. Very little is known about his life, but a large body of medical writings, the Hippocratic Corpus, was attached to his name. These texts explained disease through natural causes and careful observation, and they produced the most famous code of medical ethics, the Hippocratic Oath.

Background: medicine in early Greece

Before and alongside Hippocrates, many Greeks sought cures at sanctuaries of the healing god Asclepius, where the sick slept in the temple hoping for a healing dream. Illness, especially sudden or frightening illness, was widely seen as sent by the gods.

From the sixth century BC Greek thinkers such as Thales of Miletus began seeking natural explanations for the world. Physicians absorbed this approach. Alcmaeon of Croton, in southern Italy, described health as a balance of opposing powers in the body, and a medical tradition also flourished at Cnidus, across the water from Kos.

Life of Hippocrates

The earliest evidence comes from Plato, who mentions Hippocrates of Kos as a well-known physician of the Asclepiad family who took paying students, and from Aristotle, who uses him as the obvious example of a great physician. This shows he was famous within his own lifetime or soon after.

Later biographies, written centuries afterwards, say he was born on Kos around 460 BC, the son of a doctor named Heraclides, trained in the family tradition, travelled widely in Thrace, Thessaly and other parts of Greece, and died at Larissa in Thessaly at an advanced age. Stories that he refused an invitation from the Persian king or ended the plague at Athens by lighting fires are legends; Thucydides, who survived the Plague of Athens, says the doctors were powerless against it.

The Hippocratic Corpus

The Hippocratic Corpus is a collection of about 60 to 70 medical works written in the Ionic dialect of Greek. Most date from about 430 to 330 BC, though some are later. They were gathered together, probably in the library of Alexandria in the third century BC, and they reflect many authors with different views. It is impossible to say for certain which, if any, Hippocrates wrote himself.

Among the most important texts:

• On the Sacred Disease argues that epilepsy, then thought to be caused by the gods, has a natural cause in the brain like any other illness, and attacks healers who rely on charms and purifications.
• Airs, Waters, Places explains how climate, water supply and seasons affect health, an early form of environmental medicine.
• Epidemics contains case histories of individual patients, recorded day by day, many ending in death.
• Prognostic teaches doctors to predict the course of a disease from signs such as the patient’s face, breathing and sleep.
• Aphorisms is a collection of short medical sayings; the first begins, in a common translation, “Life is short, the art long”.
• On Fractures and On Joints describe practical methods for setting broken bones and reducing dislocations.

Medicine without the gods

The key idea of the Hippocratic writers was that every disease has a natural cause that can be studied. The author of On the Sacred Disease does not deny the gods, but he insists that no illness is more divine than any other. This separation of medicine from magic and religion was the most lasting achievement of the tradition.

Treatment relied mainly on diet, exercise, rest and the healing power of nature, with drugs, bleeding and surgery used more cautiously. The treatise On the Nature of Man set out the theory of four humours, blood, phlegm, yellow bile and black bile, whose balance was thought to determine health. Galen later made this theory the foundation of European and Islamic medicine until the early modern period.

Hippocratic doctors also left their names on clinical signs still used today: the “Hippocratic face” describes the look of a dying patient, and “Hippocratic fingers” describes clubbing of the fingertips.

The Hippocratic Oath

The Oath begins with the physician swearing by Apollo the Physician, Asclepius, Hygieia, Panacea and all the gods. The doctor promises to respect his teacher and teach the art to his sons, to use treatment for the benefit of the sick and never to harm them, not to give a deadly drug if asked, not to give a woman a pessary to cause abortion, to leave cutting for bladder stones to specialists, to avoid wrongdoing in patients’ houses, and to keep secret what he sees and hears.

The Oath was probably sworn only by some groups of physicians in antiquity. Its oldest surviving copy is a papyrus fragment of the third century AD from Oxyrhynchus in Egypt. Revived in European universities from the Renaissance, it inspired modern codes such as the World Medical Association’s Declaration of Geneva of 1948.

Legacy through the centuries

The Hippocratic writings were studied and commented on by physicians in Alexandria and Rome. Galen of Pergamon, the most influential doctor of the Roman Empire, wrote long commentaries on them in the second century AD and presented Hippocrates as the founder of rational medicine, a view that shaped how later generations saw him.

In the Middle Ages the texts passed into Syriac and Arabic and were studied by scholars such as Hunayn ibn Ishaq, who translated many of them in ninth-century Baghdad. Through Arabic and later Latin versions they reached the medical schools of Salerno, Montpellier and Paris. Renaissance humanists printed the Greek text, and the first complete Latin edition appeared in 1525.

From the seventeenth century, physicians such as Thomas Sydenham, sometimes called the “English Hippocrates”, revived the Hippocratic emphasis on bedside observation. Even after humoral theory was abandoned in the nineteenth century, Hippocrates remained a symbol of the ideal doctor: careful, honest and devoted to the patient rather than to fame or profit.

Myths and facts

The phrase “First, do no harm” is often quoted as part of the Oath, but it is not. The nearest Hippocratic text, in Epidemics, says the doctor should help, or at least not harm.

The famous plane tree of Hippocrates in the town of Kos, under which he is said to have taught, is a later tree, probably a few hundred years old. The great Asclepieion of Kos, often linked with him, was largely built after his death. Statues and busts said to show Hippocrates are also later works, and none can be confirmed as a true likeness.

Timeline

• c. 460 BC: Hippocrates is born on Kos.
• c. 430 BC onwards: The earliest texts of the Hippocratic Corpus are written.
• 430 BC: Plague strikes Athens; Thucydides records the failure of doctors.
• c. 370 BC: Hippocrates dies at Larissa in Thessaly (dates given range from about 375 to 350 BC).
• 3rd century BC: The Hippocratic writings are collected, probably at Alexandria.
• 2nd century AD: Galen promotes Hippocrates as the model physician.
• 1948: The Declaration of Geneva modernises the Hippocratic Oath.

Why it matters

Hippocrates matters less as an individual, about whom almost nothing certain is known, than as the name attached to a new way of thinking about illness. The idea that disease has natural causes, that doctors must observe patients closely, and that they owe them ethical duties remains at the heart of medicine today.