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2. The Hippocratic Collection

We are now in a position to attempt a brief analysis of the Corpus Hippocraticum. For the moment the external evidence of Galen and other ancient commentators, for or against the authenticity of the various treatises, will be passed over. This evidence is of great importance, but may tend to obscure the issue, which is the mutual affinities of the treatises as shown by their style and content.

In the first place the heterogeneous character of the Corpus should be observed. It contains :--

(1) Text-books for physicians ;

(2) Text-books for laymen ;

(3) Pieces of research or collection of material for research.

(4) Lectures or essays for medical students and novices.

(5) Essays by philosophers who were perhaps not practising physicians, but laymen interested in medicine and anxious to apply to it the methods of philosophy.

(6) Note-books or scrap-books.

Even single works often exhibit the most varied characteristics. It is as though loose sheets had been brought together without any attempt at coordination or redaction. Epidemics I., for instance, jumps with startling abruptness from a " constitution " of the diseases prevalent at one period in Thasos to the function of the physician in an illness, passing on to a few disjointed remarks on pains in the head and neck. Then follows another " constitution," after which comes an elaborate classification of the

[p. xxiii] ordinary fevers, with their periods, paroxysms and crises. At the end come fourteen clinical histories.

I have already mentioned a pre-Hippocratic group and a Hippocratic group, and it has been noticed that the main task of Greek medicine was to free science from superstition and from philosophic hypotheses. The Corpus contains two polemical works, On Epilepsy and Ancient Medicine, which attack respectively the " divine " origin of disease and the intrusion into medicine of the hypothetical speculation of philosophers.

There is another group of works which, while they do not display to any marked degree the Hippocratic characteristics, are nevertheless practical handbooks of medicine, physiology or anatomy. The list is a long one, and includes works by different authors and of different schools :--

The Surgery.

The Heart.

Places in Man.

Glands.

Anatomy.

Nature of the Bones.

Sight.

Dentition.

Diseases I.

Diseases II. and III.1

Affections.2

Internal Affections.3

Sores.

Fistulae.

Hemorrhoids.

[p. xxiv] Prorrhetic II.

The Physician.

Crises.

Critical Days.

Purges.

Use of Liquids.

Seventh Month Child.

Eighth Month Child.

Generation.4

Nature of the Child.5

Diseases IV.6

Diseases of Women.7

Barrenness.8

Diseases of Girls.

Nature of Women.

Excision of the Foetus.

Superfoetation.

Regimen in Health.9

Regimen II. and III. with Dreams.

Another most important group of works consists of those in which the philosophic element predominates over the scientific, the writers being anxious, not to advance the practice of medicine, but to bring medicine under the control of philosophic dogma, to achieve in fact the end attacked by the writer of Ancient Medicine. These works are Nutriment, Regimen I. and Airs. The first two are Heraclitean ; the last is probably derived from Diogenes of Apollonia.

[p. xxv] Regimen I., however, while strongly Heraclitean, is eclectic. Animals are said to be composed of two elements, fire and water, fire being a composite of the hot and the dry, water of the cold and the moist. Certain sentences are strikingly reminiscent of Anaxagoras, so much so that it is impossible to regard the resemblances as accidental. Take for instance the following :--

(1) ἀπόλλυται μὲν οὐν οὐδὲν ἁπάντων χορμάτων, οὐδὲ γίνεται ὅτι μὴ καὶ πρός1θεν ἠν. ξυμμις1γόμενα δὲ καὶ διακρινόμενα ἀλλοιοῦται.--Regimen I. IV.

(2) οὐδὲν γὰρ χρῆμα γίνεται οὐδὲ ἀπόλλυται, ἀλλ᾽ ἀπὸ ἐόντων χρημάτων ς1υμμίς1γεταί τε καὶ διακρίνεται.--Anaxagoras, fr. 22 (Schaubach).

To assign exact dates to these works is impossible, but they are probably much later than Heraclitus himself. The interesting fact remains that Heraclitus had followers who kept his doctrine alive, second-rate thinkers, perhaps, and unknown in the history of science, but hearty supporters of a creed, and ready to extend it to embrace all new know ledge as it was discovered. Particularly interesting is the work Nutriment. This not only adopts the theory of Heraclitus, but also mimics his sententious and mysterious manner of expression. A few examples may not be out of place.

φύς1ις2 ἐξαρκέει πάντα πᾶς1ιν.--Nutriment XV.

κρατέει γὰρ [sc. θεῖος2 νόμος2] . . . καὶ ἐξαρκέει πᾶς1ι.--Heraclitus apud Stob. Flor. III. 84.

μία φύς1ις2 εἶναι καὶ μὴ εἶναι.--Nutriment XXIV.

εἶμέν τε καὶ οὐκ εἶμεν.--Heraclitus Alleg. Hom. 24.

ὁδὸς2 ἄνω κάτω, μία.--Nutriment XLV.

[p. xxvi] ὁδὸς2 ἄνω καὶ κάτω μία καὶ ὡυτή.--Heraclitus apud Hippolyt. IX. 10.

πρός2 τι πάντα φλαῦρα καὶ πάντα ἀς1τεῖα.--Nutriment XLV.

θάλας1ς1α ὕδωρ καθαρώτατον καὶ μιαρώτατον, ἰχθύς1ι μὲν πότιμον καὶ ς1ωτήριον, ἀνθρώποις2 δὲ ἄποτον καὶ ὀλέθριον.--Heraclitus apud Hippolyt. IX. 10.

χωρεῖ δὲ πάντα καὶ θεῖα καὶ ἀνθρώπεια, ἄνω καὶ κάτω ἀμειβόμενα.--Regimen I. V.

Similar to these philosophic treatises are the essays, ἐπιδείξεις2 or displays, which propound theses which are not the ὑποθές1εις2 of philosophers. These are The Art, the object of which is to show that there is an art of medicine, and Nature of Man, which combats the monist philosophers, and sets forth the doctrine of the four humours as the cause of health, by their perfect crasis, and of disease, through a disturbance of that crasis. To this group we may perhaps add the treatise Decorum, which deals (among other things) with bed-side manners, and Precepts, a work similar in style and subject.

The last two works are interesting for their introductory remarks. Decorum practically identifies medicine and philosophy, which term is used to denote the philosophic spirit, with its moral as well as its intellectual attributes, and recognises the working of an agency not human ; it is in fact typical of the ethical science, practical if occasionally commonplace, which came into vogue towards the end of the fourth century B.C. The introduction to Precepts is Epicurean. The first chapter, in fact, is a summary of Epicurean epistemology, and is full of the technical terms of that school. A single quotation will suffice :--

[p. xxvii] γὰρ λογις1μὸς2 μνήμη τίς2 ἐς1τι ξυνθετικὴ τῶν μετ᾽ αἰς1θής1ιος2 ληφθέντων: ἐφαντας1ιώθη γὰρ ἐναργέως2 αἴς1θης1ις2, προπαθὴς2 καὶ ἀναπομπὸς2 ἐοῦς1α εἰς2 διάνοιαν τῶν ὑποκειμένων.--Precepts I.

This definition of λογις1μός2 is practically the same as that of the Epicurean πρόληψις2 given in Diogenes Laertius X. 33.

A few of the contents of the Corpus Hippocraticum remain unclassified. Of these, by far the most Hippocratic are Epidemics II., IV. VII. It is indeed remarkable that in antiquity they were not generally assigned to the " great " Hippocrates. The clinical histories are invaluable, although they are not so severely pertinent as those of Epidemics I. and III., betraying sometimes an eye for picturesque but irrelevant detail.

The treatise curiously misnamed Fleshes contains, amid a variety of interesting anatomical and physiological detail, traces of Pythagoreanism in the virtue attached to the number seven, and of Heracliteanism in the view put forward that warmth is the spirit that pervades the universe.

Humours deals with the relations of humours to the seasons and so on.

The Oath and The Law are small but interesting documents throwing light on medical education and etiquette.

Finally, the Epistles10 and Decree, although merely imaginary essays, show what manner of man Hippocrates was supposed to have been by the Greeks of a later age.

[p. xxviii] The Hippocratic collection is a medley, with no inner bond of union except that all the works are written in the Ionic dialect and are connected more or less closely with medicine or one of its allied sciences. There are the widest possible divergences of style, and the sharpest possible contradictions in doctrine. The questions present themselves, why were they united, and when did the union occur?

Littré's problem, "When was the Hippocratic collection published?"11 cannot be answered, for it is more than doubtful whether, as a whole, the collection was ever published at all. The publication of a modern work must in no way be compared with the circulation of a book in ancient times. Printing and the law of copyright have created a revolution. As soon as an ancient author let go out of his possession a single copy of his book, it was, to all intents and purposes, "published." Copies might be multiplied without permission, and a popular and useful work was no doubt often circulated in this way. Now at least one hundred, perhaps three hundred, years separate the writing of the earliest work in the Corpus from the writing of the latest. Diocles knew the Aphorisms, Ctesias probably knew Articulations, and Menon certainly knew two or three treatises. Aristotle himself quotes from Nature of Man, though he ascribes it to Polybus. It is surely impossible to suppose with Littré that there was anything approaching a publication of the Corpus by the Alexandrian librarians. Even if they had published for the first time only a large portion of the collection, such a momentous event would scarcely have passed unnoticed by the

[p. xxix] long series of commentators culminating in Galen. The librarians of Alexandria could not have done more than establish a canon, and if our present collection represents their work in this direction it was done very badly, as the most superficial critic would not fail to notice that a great part of its contents is neither by Hippocrates himself nor by his school.

The Hippocratic collection is a library, or rather, the remains of a library. What hypothesis is more probable than that it represents the library of the Hippocratic school at Cos? The ancient biographies of Hippocrates relate a fable that he destroyed the library of the Temple of Health at Cnidos (or, according to another form of the fable, at Cos) in order to enjoy a monopoly of the knowledge it contained. The story shows, at least, that such libraries existed, and indeed a school of medicine, like that which had its home at Cos, could not well have done without one. And what would this library contain? The works of the greatest of the Asclepiads, whether published or not ; valuable works, of various dates and of different schools, bearing on medicine and kindred subjects ; medical records and notes by distinguished professors of the school, for the most part unpublished ; various books, of no great interest or value, presented to the library or acquired by chance.

The Hippocratic collection actually corresponds to this description. This is nearly all the historian is justified in saying. Beyond is mere conjecture. We can only guess when this library ceased to be the property of the Hippocratic school, and how it was transferred to one or other of the great libraries

[p. xxx] which were collected in Alexandrine times, to be re-copied and perhaps increased by volumes which did not belong to the original collection.

It may be urged that if the Hippocratic Corpus were originally a library, it is improbable that all the treatises composing it would be written in Ionic. But it is by no means certain when Ionic ceased to be the normal medium for medical science ; for all we know the dialect may have been in vogue until long after the κοινή established itself throughout the Greek world. Moreover, we do not know what levelling forces were at work among copyists and librarians, inducing them to assimilate the dialects of medical works to a recognized model. We do know, however, that as centuries passed more and more Ionisms, most of them spurious, were thrust upon the Hippocratic texts. The process we can trace in the later history of the text may well have been going on, in a different form, in the fourth and third centuries B.C.

It is because I regard the Hippocratic collection as merely a library that I do not consider it worth while to attempt an elaborate classification, like those of Littré, Greenhill, Ermerins, and Adams. A library is properly catalogued according to subject matter, date, and authorship ; it is of little use to view each separate volume in its relationship to a particular writer. The Hippocrates of tradition and the Hippocrates of the commentators may well be left buried in obscurity and uncertainty. What we do know, what must be our foundation stone, is that certain treatises in the Corpus are impressed with the marks of an outstanding genius, who inherited much but bequeathed much more. He stands for

[p. xxxi] science and against superstition and hypothetical philosophy. The other contents of the Corpus are older or later than this nucleus, either in harmony with its doctrines or opposed to them. More than this we cannot hope to know for certain.

1 Shows influence of Cnidian school. So possibly do other books.

2 Shows influence of Cnidian school. So possibly do other books.

3 Shows influence of Cnidian school. So possibly do other books.

4 Shows influence of Cnidian school. So possibly do other books.

5 Shows influence of Cnidian school. So possibly do other books.

6 Shows influence of Cnidian school. So possibly do other books.

7 Shows influence of Cnidian school. So possibly do other books.

8 Shows influence of Cnidian school. So possibly do other books.

9 Really a continuation of Nature of Man.

10 It is interesting to note that the Platonic collection and the New Testament, like the Corpus, end with a series of letters.

11 Vol. I., chap. xi.

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