Human and Divine in Hippocratic Concepts of Health Ralph M. Rosen

Galen (r.) and Dioscorides University of Pennsylvania LJS 62 (15th C)

Hygieia, most august of the blessed gods—may I dwell with you for the rest of my life, and may you always willingly remain with me! For if any pleasure can be got from wealth, children, royal power (which human beings regard as almost like a god), or the longings we pursue using Aphrodite’s hidden nets, or if the gods have revealed any other pleasure or respite from their labors to human beings, all of these flourish with you, blessed Hygieia, and shine in the Graces’ conversation. No one is happy when you are absent. (σέθεν δὲ χωρὶς οὔτις εὐδαίμων < . . . >). (Ariphron, Fragment 813 (= PMG 813 < Athenaeus 703a-b, tr. Olson, p. 215)

I swear by Apollo the Physician, by Asklepios and Hygieia and Panakeia, and by all the gods and goddesses, making them my witnesses, that I will carry out this oath and this contract according to my ability and judgment. Ὄμνυμι Ἀπόλλωνα ἰητρὸν καὶ Ἀσκληπιὸν καὶ Ὑγείαν καὶ Πανάκειαν καὶ θεοὺς πάντας τε καὶ πάσας, ἵστορας ποιεύμενος, ἐπιτελέα ποιήσειν κατὰ δύναμιν καὶ κρίσιν ἐμὴν ὅρκον τόνδε καὶ συγγραφὴν τήνδε· (Opening of the Hippocratic Oath)

For previously the tribes of men used to live upon the earth entirely apart from evils, and without grievous toil and distressful diseases, which give death to men…But the woman removed the great lid from the storage jar with her hands and scattered all its contents abroad—she wrought baneful evils for human beings. Only Anticipation [‘Hope’; Ἐλπὶς] remained there in its unbreakable home under the mouth of the storage jar, and did not fly out; for before that could happen she closed the lid of the storage jar, by the plans of the aegis-holder, the cloud-gatherer, Zeus. But countless other miseries roam among mankind; for the earth is full of evils, and the sea is full; and some sicknesses come upon men by day, and others by night, of their own accord, bearing evils to mortals in silence (νοῦσοι δ᾿ ἀνθρώποισιν ἐφ᾿ ἡμέρῃ, αἱ δ᾿ ἐπὶ νυκτὶ / αὐτόμαται φοιτῶσι κακὰ θνητοῖσι φέρουσαι / σιγῇ) since the counsellor Zeus took their voice away. Thus it is not possible in any way to evade the mind of Zeus. (Hesiod, Works and Days, 90-105, tr. Most, mod.)

Golden was the race of speech-endowed human beings which the immortals, who have their mansions on Olympus, made first of all. They lived at the time of Cronus, when he was king in the sky; just like gods they spent their lives, with a spirit free from care, entirely apart from toil and distress. (ὥστε θεοὶ δ᾿ ἔζωον ἀκηδέα θυμὸν ἔχοντες, νόσφιν ἄτερ τε πόνου καὶ ὀιζύος·) Worthless old age did not oppress them, but they were always the same in their feet and hands, and delighted in festivities, lacking in all evils; and they died as if overpowered by sleep. They had all good things: the grain-giving field bore crops of its own accord (αὐτομάτη), much and unstinting, and they themselves, willing, mild-mannered, shared out the fruits of their labors together with many good things, wealthy in sheep, dear to the blessed gods.  (Hesiod, Works and Days, 109-18, tr. Most)

(3.1) For the art of medicine would never have been discovered to begin with, nor would anyone have sought for…if it were beneficial for the sick to follow the same regimen and diet as the healthy…(2) But in fact necessity itself [αὐτὴ ἡ ἀνάγκη] caused medicine to be sought for and discovered by human beings, for it was not beneficial for the sick to take the same foods as the healthy, just as it is not beneficial for them to do so today. (3) And, to go still further back, I hold that not even the regimen and nourishment that the sick make use of today would have been discovered if it were sufficient for the human being to eat and drink the same things as an ox and a horse and all the animals other than man—for example, the things that grow from the earth: fruits, brush, and grass. (“Hippocrates”, On Ancient Medicine 3.1-3, tr. Schiefsky)

… (3) For from these things they [non-human animals] are nourished, grow, and lead their lives free of trouble, having no need of any other regimen. And indeed I believe that in the beginning, human beings too made use of such nourishment;as for our current regimen, I believe that it arose through a process of discovery and artful elaboration over a long period of time. (4) For human beings endured much terrible suffering because of their strong and brutish regimen, consuming foods that were raw unblended, and possessing great powers—suffering like that which they would experience from these foods today as well, falling into severe pains and diseases followed by a speedy death. (“Hippocrates”, On Ancient Medicine 3.1-3, tr. Schiefsky)

(3.1) For the art of medicine would never have been discovered to begin with, nor would anyone have sought for…if it were beneficial for the sick to follow the same regimen and diet as the healthy…(2) But in fact necessity itself [αὐτὴ ἡ ἀνάγκη] caused medicine to be sought for and discovered by human beings, for it was not beneficial for the sick to take the same foods as the healthy, just as it is not beneficial for them to do so today… (“Hippocrates”, On Ancient Medicine 3.1-2, tr. Schiefsky)

I am about to discuss the disease called ‘sacred I am about to discuss the disease called ‘sacred.’ It is not, in my opinion, any more divine or more sacred than other diseases, but has a natural cause (φύσιν μὲν ἔχει), and its supposed divine origin is due to men’s inexperience, and to their wonder at its peculiar character (ὑπὸ ἀπειρίης καὶ θαυμασιότητος). Now while men continue to believe in its divine origin because they are at a loss to understand it, they really disprove its divinity by the facile method of healing which they adopt, consisting as it does of purifications and incantations. (“Hippocrates”, On The Sacred Disease 1, tr. Jones)

(2) These observances [various purifications and incantations] they impose because of the divine origin of the disease, claiming superior knowledge and alleging other causes, so that, should the patient recover, the reputation for cleverness may be theirs ; but should he die, they may have a sure fund of excuses, with the defence that they are not at all to blame, but the gods. (ἔχοιεν πρόφασιν ὡς οὐδὲν αἴτιοί εἰσιν, ἀλλ᾿ οἱ θεοί·) (“Hippocrates”, On The Sacred Disease 2, tr. Jones)

(4) If these people claim to know how to draw down the moon, cause an eclipse of the sun, make storms and fine weather, rain and drought, to make the sea too rough for sailing or the land infertile, and all the rest of their nonsense, then, whether they claim to be able to do it by magic or by some other method, they seem to be impious rogues. Either they do not believe in the existence of the gods or they believe that the gods are powerless or would not refrain from the most dastardly acts. Surely conduct such as this must render them hateful to the gods… [if a man does these things…] I should not call any of these things a divine visitation but a human one, because the divine power has been overcome and forced into subjection by the human will. (οὐκ ἂν ἔγωγέ τι θεῖον νομίσαιμι τούτων εἶναι οὐδέν, ἀλλ᾿ ἀνθρώπινον, εἰ δὴ τοῦ θείου ἡ δύναμις ὑπὸ ἀνθρώπου γνώμης κρατεῖται καὶ δεδούλωται.) (“Hippocrates”, On The Sacred Disease 4, tr. Chadwick and Mann, in Lloyd)

In using purifications and spells they perform what I consider a most irreligious and impious act, for, in treating sufferers from this disease by purification with blood and like things, they behave as if the sufferers were ritually unclean (ὥσπερ μίασμά τι ἔχοντας), the victims of divine vengeance (ἀλάστορας) or of human magic (πεφαρμακευμένους ὑπὸ ἀνθρώπων) or had done something sacrilegious (τι ἔργον ἀνόσιον εἰργασμένους). (“Hippocrates”, On The Sacred Disease 4, tr. Chadwick and Mann, in Lloyd)

Yet, if a god is indeed the cause, they ought to have taken them to the sanctuaries and offered them to him. However, I for my part hold that a man’s body is not defiled by a god (οὐ μέντοι ἔγωγε ἀξιῶ ὑπὸ θεοῦ ἀνθρώπου σῶμα μιαίνεσθαι), the basest object by the most pure. Nay, even should it have been defiled or in any way injured through some different agency, a god is more likely to purify and sanctify it than he is to cause defilement. It is the deity who purifies, sanctifies and cleanses us from the greatest and most unholy of our sins…This then is my opinion of the purifications (οὕτω μοι δοκεῖ ἔχειν). (“Hippocrates”, On The Sacred Disease 4, tr. Chadwick and Mann, in Lloyd, mod.)

I believe that this disease is not in the least more divine than any other but has the same nature as other diseases and a similiar cause. Moreover, it can be cured no less than other diseases so long as it has not become inveterate and too powerful for the drugs which are given. Τὸ δὲ νόσημα τοῦτο οὐδέν τί μοι δοκεῖ θειότερον εἶναι τῶν λοιπῶν, ἀλλὰ φύσιν ἔχει ἣν καὶ τὰ ἄλλα νοσήματα, καὶ πρόφασιν ὅθεν ἕκαστα γίνεται· (“Hippocrates”, On The Sacred Disease 5, tr. Chadwick and Mann, in Lloyd)

Like other diseases it is hereditary (κατὰ γένος) Like other diseases it is hereditary (κατὰ γένος). If a phlegmatic child is born of a phlegmatic parent, a bilious child of a bilious parent, a consumptive child of a consumptive parent and a splenetic child of a splenetic parent, why should the children of a father or mother who is afflicted with this disease not suffer similarly? The seed comes from all parts of the body; it is healthy when it comes from healthy parts, diseased when it comes from diseased parts. Another important proof that this disease is no more divine than any other lies in the fact that the phlegmatic are constitutionally liable to it while the bilious escape. If its origin were divine, all types would be affected alike without this particular distinction. (“Hippocrates”, On The Sacred Disease 6, tr. Chadwick and Mann, in Lloyd)

A man with the knowledge of how to produce by means of a regimen dryness and moisture, cold and heat in the human body, could cure this disease too provided that he could distinguish the right moment for the application of the remedies. He would not need to resort to purifications and magic spells. ὅστις δὲ ἐπίσταται ἐν ἀνθρώποισι ξηρὸν καὶ ὑγρὸν ποιεῖν, καὶ ψυχρόν καὶ θερμόν, ὑπὸ διαίτης, οὗτος καὶ ταύτην τὴν νοῦσον ἰῷτο ἄν, εἰ τοὺς καιροὺς διαγινώσκοι τῶν συμφερόντων, ἄνευ καθαρμῶν καὶ μαγείης. (“Hippocrates”, On The Sacred Disease 21, tr. Chadwick and Mann, in Lloyd)

In fact it is especially knowledge of the gods that by medicine is woven into the stuff of the mind. For in affections generally, and especially in accidents (?), medicine is found mostly to be held in honor by the gods. Physicians have given place to the gods. For in medicine that which is powerful is not in excess. In fact, though physicians take many things in hand, many diseases are also overcome for them spontaneously. All that medicine has now mastered, it will offer from that point on …let this serve as a summary on knowledge of these things.   Καὶ γὰρ μάλιστα ἡ περὶ θεῶν εἴδησις ἐν νόῳ αὐτὴ ἐμπλέκεται· ἐν γὰρ τοῖσιν ἄλλοισι πάθεσι καὶ ἐν συμπτώμασιν εὑρίσκεται τὰ πολλὰ πρὸς θεῶν ἐντίμως κειμένη ἡ ἰητρική. οἱ δὲ ἰητροὶ θεοῖσι παρακεχωρήκασιν· οὐ γὰρ ἔνι περιττὸν ἐν αὐτῇ τὸ δυναστεῦον. καὶ γὰρ οὗτοί πολλὰ μὲν μεταχειρέονται, πολλὰ δὲ καὶ κεκράτηται αὐτοῖσι δι᾿ ἑωυτῶν. †ἃ δὲ καταπλεονεκτεῖ νῦν ἡ ἰητρική, ἐντεῦθεν παρέξει…τὸ δὲ κεφαλαιωδέστατον ἔστω ἐς τὴν τούτων εἴδησιν. (“Hippocrates”, Decorum 6, tr. Jones)

Now such dreams as are divine, and foretell to cities or to private persons things evil or things good, have interpreters in those who possess the art of dealing with such things. But all the physical symptoms foretold by the soul, excess, of surfeit or of depletion, of things natural, or change to unaccustomed things, these also the diviners interpret, sometimes with, sometimes without success. But in neither case do they know the cause (δι᾿ ὅ τι γίνεται), either of their success or of their failure. They recommend precautions to be taken to prevent harm, yet they give no instruction how to take precautions, but only recommend prayers to the gods. Prayer is indeed good (τὸ μὲν εὔχεσθαι ἀγαθόν), but one should call on the gods after having helped the process along [sc. by attending to the body with specific regimen] [mod.from Jones: ‘but while calling on the gods a man should himself lend a hand’]. (“Hippocrates” Reg. 4.87, tr. Jones, mod.)

I maintain that he who aspires to treat correctly of human regimen must first acquire knowledge and discernment of the nature (φύσιν) of man in general—knowledge of its primary constituents and discernment of the components by which it is controlled…but a man who [only] eats is not able to stay healthy if he doesn’t [also] exercise. (οὐ δύναται ἐσθίων ὁ ἄνθρωπος ὑγιαίνειν, ἢν μὴ καὶ πονῇ.) (“Hippocrates” Reg. 1.2, tr. Jones, mod.)

Now first of all I shall write, for the great majority of men, the means of helping such as use any ordinary food and drink, the exercises that are absolutely necessary, the walking that is necessary, and the sea-voyages required to collect the wherewithal to live—the persons who suffer heat contrary to what is beneficial and cold contrary to what is useful, making use of a regimen generally irregular. These are benefited by living as follows...  (“Hippocrates” Reg. 3.68, tr. Jones)

It comprises prognosis before illness and diagnosis of what is the matter with the body (προδιάγνωσις μὲν πρὸ τοῦ κάμνειν, διάγνωσις δὲ τῶν σωμάτων τί πέπονθε), whether food overpowers exercise, whether exercise overpowers food, or whether the two are duly proportioned… Now these different conditions I will set forth, and explain their nature and their arising in men who appear to be in health, eat with an appetite, can take their exercise, and are in good condition and of a healthy complexion. (“Hippocrates” Reg. 3.69, tr. Jones)

Using these means in the way I have described a man will live a healthy life (ὑγιανεῖ τὸν βίον): in fact I have discovered regimen, with the gods’ help (σὺν τοῖσι θεοῖσιν) as far as it is possible for mere man to discover it. (“Hippocrates” Reg. 4.93, tr. Jones)

For chance/luck (τύχη) operates autonomously/independently/ arbitrarily (αὐτοκρατής) and cannot be controlled/governed (οὐκ ἄρχεται), and it doesn’t come in answer to one’s desires/prayer. But knowledge is controllable, and is itself lucky (εὐτυχής) whenever the person who has knowledge wishes to use it. (“Hippocrates” Places in Man 46)