Dissecting the Hippocratic Oath

Possibly the best enduring single document from Greek Antiquity, the Hippocratic Oath is the most famous text in Western medicine. It’s mordant, precise language is a key factor in its longevity.

We know almost nothing about its author, Hippocrates. He was born around 460BC into a family of illustrious doctors and lived to around 80 years old. Plato regarded him as a great logician.

Hippocrates is attributed with composing a substantial portion of the ‘Hippocratic Corpus’ a wide-ranging body of ideas and writings. Beyond that we know very little.

hippocrates

The difficulty in understanding Hippocrates is highlighted by the feats and theories falsely attributed to him. He formulated the theory of the 4 humours? No. He cured the plague of Athens? No.

The Corpus contains nuggets of bizarre theory, such as: ‘A woman can never be ambidextrous.’

However, we know that his novel approach to medicine was responsible for some superb insights. For example, he set out to debunk the notion that epilepsy was a ‘divine disease’ by providing a physiological explanation. This was a profoundly novel approach.

However, the summa of his work is undoubtedly the Hippocratic Oath.

hippocraticoath

Taking it apart, one can trace Hippocrates thought process and understand how he may have inadvertently come across some enduring rules.

I swear by Apollo the physician and Aesculapius, and Health

Hippocrates had a clear theocentric worldview, and submitted his oath to the ultimate authority.

And I will use treatments for the benefit of the ill in accordance with my ability and my judgment, but from what is to their harm and injustice I will keep them.

Translation: doctors should always act in the best interests of their patients.

And I will not give a drug that is deadly to anyone if asked, nor will I suggest the way to such a counsel.

In a modern context, this seemingly condemns euthanasia or assisted dying. However, it has been speculated that in fact this was a prohibition against poisoning, either directly or by supplying someone with poison.

And likewise I will not give a woman a destructive pessary.

A prohibition against abortion? Probably not. Abortion was legal at the time and abortive techniques are recorded elsewhere in the Corpus. It may be that Hippocrates was attacking a particularly dangerous method for abortion — ingesting a pessary. These were known to cause lethal infections. A final note: this line was cited in the famous Roe vs Wade Supreme Court case in 1973.

In a pure and holy way, I will guard my life and my art and science

Medical practitioners should maintain their personal and professional integrity at all times.

I will not cut, and certainly not those suffering from stone, but I will cede this to men who are practitioners of this activity.

This is often misconceived as forbidding surgery. However, it is quite clearly meant to impress on doctors that they should understand the limits of their abilities, and that some cases should be referred to specialists.

Into as many houses as I may enter, I will go for the benefit of the ill, while being far from all voluntary and destructive injustice, especially from sexual acts both upon women’s bodies and upon men’s.

Fairly straightforward. This suggests an issue with dodgy doctors and false medicine at the time.

And about whatever I may see or hear in treatment, or even without treatment, in the life of human beings, I will remain silent, holding such things to be unutterable.

Possibly the most novel concept within the Oath is doctor-patient confidentiality. This is essential to gathering full and useful information from a patient.

Full Text:

I swear by Apollo the physician and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgement, I will keep this Oath and this stipulation — to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgement, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons labouring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times. But should I trespass and violate this Oath, may the reverse be my lot.

Alex Browne studied History at Kings College London and is an Assistant Editor at Made From History. He specializes in post-war history in the USA and Central America.