In the world of medicine, few doctrines have such a distinguished reputation as the original Oath of Hippocrates. For centuries, physicians about to enter the profession routinely subscribed to the Oath before practicing their art. The Oath was an informal code of behavior that governed many of the roles physicians engaged in, including healer, dispenser of medicines, surgeon, dietician, and health adviser.
Although most people have heard of the Oath, few have ever read it or understand its importance. Furthermore, almost no medical schools today require students to recite or to take the Oath.
Hippocrates is the 'Father of Medicine'
As the editor of Heart Views (2005) noted, little is known about the man whose name is forever associated with the Oath. Most information about Hippocrates has been pieced together from inconsistent records.
Hippocrates (460-377 BC) was born on the Greek island of Cos in the eastern Aegean Sea. He studied science under his father, Heracleides, and eventually entered the profession of medicine. Hippocrates traveled extensively in Greece, where he was well known in Athens, and throughout the ancient world. In fact, he was a contemporary of the Greek philosophers Socrates and Plato.
Hippocrates founded a medical school on Cos, where he trained students in observation, prognosis, and the healing arts. Hippocrates is considered the 'Father of Medicine' because of the extensive treatises he wrote in the field of medical science. He died in the Thessaly district of Greece about 377 BC.
Hippocrates Wrote Books for Physicians and Laymen
During his lifetime, it has been estimated that Hippocrates produced between 60 and 70 treatises on various aspects of medicine. The body of his work is known as the Corpus Hippocraticum. Some of his works (e.g., On Fractures) were intended to be read and discussed by other physicians; others were intended for educated laymen wishing to know more about health, or how to prevent disease by proper diet and exercise (e.g., Regimen in Health).
Scholars, however, disagree about whether these medical books were actually written by Hippocrates, or “multi-author works . . . made at different stages by successive hands” (Lloyd, 1991). The works are believed to have been written sometime between 510 BC and 300 BC, and thus possibly before he was born or even after he died.
Curiously, no ancient philosopher quotes Hippocrates directly, but merely summarizes Hippocratic beliefs. This suggests that his teachings were compiled during his lifetime and disseminated afterward by disciples.
The Hippocratic Method Relies on Observation
When Hippocrates began to practice, medicine was still beset by superstition and fear. To his credit, Hippocrates tried to bring a more systematic approach to illness and healing. As Shuster (1998) noted, “Hippocratic medicine is contemplative and non-interventionist in nature.”
Hippocrates is credited with several important advances in medicine. First, he removed the shroud of mysticism from disease, which he attributed to “ignorance and wonder.” In his time, people believed that disease was caused by demons or supernatural causes, which often made doctors little more than exorcists. Hippocrates believed that there was a rational explanation for illness that could be obtained through careful observation and documenting of symptoms.
Second, Hippocrates believed in prevention as much as healing. Accordingly, he trained students in prognosis as much as in diagnosis. Hippocrates thought that it was as important for a physician to predict the conditions under which disease could occur (i.e., through poor diet, lack of cleanliness) than to treat the patient after the fact.
Third, Hippocrates realized that the body was more than just a collection of separate organs. He understood that diseases struck some people with more severity than others. Hippocrates also knew that the healing arts could cure illness with rest, cleanliness, and fresh air better than with drugs.
The Context of the Original Hippocratic Oath
It is unknown whether Hippocrates set out to create an informal code of conduct for physicians. The original Oath is in Greek and consistent with his known beliefs. Thus, there is little doubt about its authenticity. The Oath is brief — averaging less than 400 words in length.
The Oath begins with an incantation to the ancient healing gods. In Greek mythology, Apollo was the son of Zeus and the first god of medicine and healing. Apollo's son was Asclepius, and Asclepius had two daughters: Hygieia (the goddess of cleanliness, health, and disease prevention) and Panaceia (the goddess of healing remedies and medicinal cures).
The Oath itself consists of a series of promises that new physicians are admonished to obey:
- To honor former teachers with all assistance (including financial aid, if needed), while agreeing to pass along knowledge to all others who have “taken an oath according to the medical law.”
- To help the sick according to best “ability and judgment,” without also causing harm.
- To refuse to dispense a deadly drug, or to help any woman obtain an abortion.
- To leave surgery to those trained in the specialty.
- To live a pure life and never take sexual advantage of patients, or any member of the patient's household.
- To respect patient privacy and protect the confidentiality of all secrets disclosed during treatment.
The Oath concludes by promising a prosperous life to physicians who honor these principles, while also warning transgressors of future punishment.
Over time, the Oath has been honored in theory while ignored in practice. In many ways, however, modern medicine has undermined the intentions of the Oath.
References
-------. 2005. The Hippocratic Oath (original version translated by J Chadwick & W.N. Mann, 1950). Heart Views. 6(2):86-89.
-------. 2005. Hippocrates. Encyclopedia of World Biography. Thomson Gale, a part of the Thomson Corporation.
Lloyd GER. 1991. The Hippocratic Question, Methods and problems in Greek science. Cambridge, UK: University Press. pp. 192-223.
Shuster E. 1998. The Nuremberg Code: Hippocratic ethics and human rights. Lancet. 351:974-77.
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