The Hippocratic Corpus
An Ancient Library, the Four Humors, and Greek Orthopaedics
The Hippocratic Corpus is a library, or rather, the remains of a library. Although the dozens of books included in the Collection were originally attributed to Hippocrates himself, scholars now know that they were more likely composed between the sixth and fourth centuries BCE. Between the career of Hippocrates and the pre-Socratic philosophers, a special kind of prose for medical writings developed in Greece. Although Cos, the island home of Hippocrates, is located within what was a Doric-speaking region, the medical writers of Cos (believed to have written the Hippocratic treatises) appropriated the more refined Ionic dialect of philosophy. Later, during the Renaissance, scientists like Andreas Vesalius would similarly shun using the vernacular, instead penning their medical treatises in Latin.
One of the earliest specimens of the Corpus is On Ancient Medicine, a tract written by an anonymous physician from the fifth century BCE. We can infer this author was both familiar with contemporary theory, and devoted to traditional lore and technique. On Ancient Medicine is one of two polemical works in the Hippocratic corpus; the other is On the Sacred Disease which includes an early observation of epilepsy. Both works attack the concept of divine origin of disease and the intrusion of hypothetical philosophers into medicine.
The Humoral Theory
The ancient doctrine of the Four Humors, as illustrated in this fourteenth century manuscript (MS C. 54, Zentralbibliothek Zurich, The Four Humors), stated that there were four basic human temperaments: melancholic, phlegmatic, sanguine, and choleric.
The elaborate doctrine of the Four Humors endured through many centuries and is one of the central tenets of the Hippocratic Corpus. This theory was grounded on the Empedoclean principle of the four supposed elements: earth, air, fire, and water. Man’s four constituent elements, or humors, were identified analogously as black bile, blood, yellow bile, and phlegm, all of which had to be in correct proportion to one another. This fourfold pattern was infinitely adaptable: to the seasons, the winds, the elements, and even, in due course, to the Evangelists. It offered a kind of universal holdall, in which tastes, temperaments, and a surprising number of diseases could find loose accommodation. Though virtually worthless as a theory, it remained the fundamental prop of European medicine for over two millennia.
There is something subtly seductive about the doctrine of the Four Humors; its widespread and lasting impact on European medical thought has been greatly out of proportion to its medical value. The success of the humoral theory put a heavy brake on physiological research since there were few phenomena for which the humors could not be made to yield some sort of easy explanation.
In this Byzantine manuscript from ca. 1100, the doctor seizes the jaw between his fingers and puts it in place while an assistant holds the patient’s head.
Orthopaedics originally was the branch of ancient Greek surgery that concerned itself with reducing or realigning bodily distortions. It is thought that it was strongly influenced by the techniques of treating athletes in the gymnasia. As far as written sources are concerned, the basic information comes indirectly from three Hippocratic treatises: On Joints, On Fractures, and Surgery. These original works are no longer in existence. Their content was introduced to the Western world through Greek manuscripts, compiled by Apollonius of Citium in the first century BCE and by Soranus in the second century CE. Of all the subjects covered in the Hippocratic corpus, those volumes treating dislocations and fractures demonstrate the most affinity to modern technique and practice.