Disease of the mind; The Sacred Disease, Hippocrates

 Why you might read The Sacred Disease?

The Sacred Disease is Hippocrates continuing to insist that medicine be a science. It carries on the trend previously set by works like Science in medicine. 

In my Self Education project, it serves to continue expanding my understanding of Hippocrates minds set toward medicine. As well as building on the foundations of his other works.

Content of the Sacred Disease

The sacred disease seems to be any disease acting on the brain. From Epileptic fits to strokes. From madness to sleepwalking. Hippocrates spends the book both describing these ailments and rebutting those who would call them Sacred. He describes them as standard diseases that have physical causes. Even if some of those causes have been since proven wrong. He calls those who treat them as sacred, charletons and faith healers. He tries to prove that the gods coming over someone would produce a blessing, not a curse. He points out that these so-called healers also use the basic principles of medicine to help the patient. 

Reflections on the Sacred Disease

Hippocrates idea of how air enters the body is a bit surprising. He thinks that air goes first to the brain, then to the stomach and then to the lungs. Of course, we know that now not to be true. His reasoning though is interesting. He thinks that air is cooling and so does not go to the lungs until it is warm. He has got the order of most important organs right though. His areas are those the body will priorities if we are short.

He also spends some time discussing the blood vessels and how they proceed through the body to the brain. He does not have a heart centric view like we do now. Instead says that one side comes from the liver and the other the spleen.

What others have to say about the Sacred Disease

"a Hippocratic inquiry into the so-called ‘sacred disease’ of epilepsy" From Portland State University

Comparisons with other Texts

Like Regimen in Acute Diseases Hippocrates does spend some time on how to treat the diseases of the mind. It is not his primary focus though, that is disputing Faith healers.

In some ways, it is a subset of what is discussed in the Science of Medicine. Both try to show the given diseases as having natural causes.

Conclusion

Hippocrates spends most of the book debating against those who would call these diseases sacred. That is from the gods. Once he is done with that he moves on to what he believes are the causes of these diseases. He closes with some discussion on how to treat them. This is an extension on his previous works and again shows us his focus on the science of medicine.

Have you read The Sacred Disease? If so what did you think of it? 

 
Want to read The Sacred Disease but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

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Pithy diagnostics; Aphorisms, Hippocrates

 Why you might read Aphorisms?

Aphorism isn't what you expect from the title. Instead, it is a series of diagnostic, treatment and prognosis statements. As such it has much to teach about illness and how it was treated in Ancient Greece. It may even be the most prescriptive text in the Corpus.

In my Self Education project, this hold pride of place in Hippocrates works. It is not the most well known by any stretch. Yet it covers the most ground about treatment and prognosis.

Content of Aphorisms

The book is broken into seven sections. These sections cover slightly different topics, from weather effects to age effects. Overall the book covers what symptoms mean in different illnesses. What symptoms mean death and which mean life. As well as how to treat given diseases with given symptoms. It gives specific instructions on how to proceed depending on symptoms. While it is presented as a series of Aphorisms the Aphorisms often flow together into a series of related comments.

Reflections on Aphorisms

Like I said in the content section, this book does not feel like a series of Aphorisms. Rather it is a much more useful medical text. It spends all its time explaining sicknesses and treatments. None of these Aphorisms are easily quotable as most require the context of those around them.

What others have to say about Aphorisms

"The Aphorisms are the most important works of the Hippocratic Corpus." From euphoriatric

Comparisons with other texts

Compared to the other works of the Hippocratic Corpus. This text is the most straight forward diagnostic we have seen. In Epidemics, we see diseases named with there seasons. As well as how individuals symptoms went. By comparison in this work, we have whole lists of what a symptom means for an illness. As well as how to treat given illnesses.

Proverbs in the Bible is another work of Aphorisms. Where proverbs can be quoted and used individually. These Aphorisms need each other for context.

Conclusion

This is an important diagnostic and treatment text and we should not get put off by the title. It is instead a treasure trove of medicine from the classical greek times. It is roughly grouped into sections of ideas. It covers diagnosis and treatment, as well as prognosis. These are covered in the general sense rather than in case studies.

Have you read Aphorisms? If so what did you think of it? 

 
Want to read Aphorisms but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

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More plays from the Bible; Everyman and Medieval Miracle Plays(6-10), Various Unknown

 Why might you read the Miracle Plays?

The Miracle plays are a snapshot of how Medieval England saw the stories of the Bible.  I am just reading a collection of them rather than each version. This makes them great to compare how Christianity was understood across time, even if they are not directly about doctrine. 

For my Self Education project, they fill this role. They allow for a greater understanding of the way in which faith was a part of everyday life in medieval England. This will be important when I get to read more of the church fathers. As a narrative, they show a stage in the development of the play in the English speaking world.

Stories of the Miracle plays 6-10

Abraham and Issac

The play starts with Abraham praying for Issac his young son. We then see Issac also praying. There is a short scene in heaven where God tells his angels he will test Abraham. the test is to see whether he loves God or his son more.

Angels are then sent to instruct Abraham to go to the mountain and sacrifice Issac. While he prays it isn't so he complies. He takes Issac with wood for the fire up to the mountain.

Issac finds out he is to be the sacrifice and starts pleading with his father for his life. Abraham tells him he has been instructed by God to sacrifice him. Issac accepts his fate. Abraham dithers over doing the deed but eventually swings for the kill. He is stopped by an angel and is relieved. Issac asks why he has stopped and Abraham explains.

They sacrifice the ram God has arranged and descend the mountain praising God.

The Annunciation

The play opens with a Paraphrase of Isaiah's prophecy of the messiah. It continues with Mary being told she will have a child. And her marvelling about not having been with a man. And that the child would be from the holy spirit.

She then tells Joseph she's pregnant and he knows its not his. He will not listen and storms out. He is told by an angel and comes back home to Mary. The play finishes with them on the road to Bethlehem.

The Second Shepherds' Pagent

This play starts with the shepherds lamenting there state in life and lack of warm clothes. They are then joined by a man who is known to them. While they sleep he steals a sheep. He returns before they wake and bids them farewell. 

They then find there is a sheep missing and go to confront him in his house. They find him with his bedridden wife and are told she just gave birth. They go to leave as they cannot find any sign of the sheep. As they go to leave they realise they haven't seen the baby and given it gifts so they return and try and do so. When they do they see their sheep instead of a baby.

The shepherds return to the fields for another night. They meet an angel who tells them of Jesus birth in Bethlehem. So they go and visit the child and glorify him on arrival.

Herod the Great

The play starts with a messenger singing the praises of Herod. Herod enters and is angry that the wise men have gone without telling him who the child is. The child who will be king. So he ascertains the child approximate age. He then sends out his knights to kill every male child under the age of 2. When they return he rewards them well.

The Woman taken in Adultery

At the beginning we see a scribe and a Pharisee discussing Jesus. They focus on how to trap him into hypocrisy. They do so by presenting him with a woman caught in adultery. If he says kill he is a hypocrite because he has been preaching mercy. If he sends her away they have him breaking the law of Moses. Instead, he asks the man without sin to throw the stones. The men each leave bemoaning their sins. The woman then asks Jesus about it and he says she is free to go. She magnifies God for his mercy. 

Reflections on the Miracle plays 6-10

Abraham and Issac

Issac being described as Abrahams young son for this play. In the Bible, he is not described as such and it is common to describe him as full-grown today.

The play also adds Issac knowing he is to be sacrificed and accepting that. Again this is an extrapolation from the biblical text.

It is interesting to see Abraham dithering so much about the sacrifice. It brings some humanity to the story.

The Annunciation

It finishes in a rather interesting place, with them on the road. I would have expected it would either not add that part or go all the way to the birth of Jesus.

The play tells the story more like Mary and Joseph are already married and living together. Rather than being engaged like the Bible story. 

The Second Shepherds' Pagent

This play spends most of its time in the arguments between the shepherds and the stolen sheep. The visiting angel and baby Jesus take second best. This is interesting because it is a large departure from just a scriptural tale.

The missing sheep bit doesn't really end. They find the sheep but there is no talk of taking it back or of punishing the thief.

Herod the Great

Herod would not have had knights but rather warriors. Seems a bit nitpicky but knights were a thing of the middle ages. I must remember though that in the middle ages the idea that the past was different from now had not yet occurred to the scholars much less the laity.

Also, the messenger in the start makes Herod out to be larger and more powerful than he really was. His renowned would not have gone out to Syria and Greece.

The Woman taken in Adultery

It is interesting that the scribe and Pharisee both call him Jesu. We would now call him Jesus. The Editor calls him Jesus in the notes and when named as speaking. 

The plotting of the Pharisee is seen explicitly in the play. By comparison, the bible text just says they wanted to test him.

What others have to say about the Miracle plays 6-10

About Abraham and Issac enotes says "This miracle play does not specify where Abraham lives, apart from his early statement that he understands his home to be a gift from God."

Comparisons to other texts

In the earlier Miracle Plays, we see many things said that would only be true post the early church. Things like praying to the saints or referencing Christ. This was done in plays based on the old testament. In these Miracle plays this is still happening, though it is a little less jarring.

Compared to the Bible these stories have all been embellished. This is not necessarily a bad thing. But we do see one play go off on a tangent and be more about the tangent than the bible story. 

Conclusion

These plays have covered both old and new testament stories. These have ranged from Abraham and Issac to Jesus' ministry.  We have looked at how there are odd references that are out of their time. This is especially true in the old testament stories. Finally, they have said fairly true to the Biblical accounts but have added details. In one case this goes a little astray but it comes back to the point eventually.

Have you read The Miracle Plays? If so what did you think of it? 

 
Want to read The Miracle Plays but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

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Arguments against the treatment practices of Cnidus; Regimen in Acute Diseases, Hippocrates

 Why you might read Regimen in Acute Diseases?

This is Hippocrates' first work that systematically lays out how to treat disease. As such it gives us a better understanding of his cases studies.

It is in my  Self Education project because it informs how to understand other works in the corpus.

Content of Regimen in Acute Diseases

Hippocrates starts with how he does not agree with the Cnidus school of medicine. Especially about how to treat diseases. He states that their diagnosis is too simplistic. As well as their treatments being wrong. They are too simplistic because they miss things the physician could ascertain. These things cannot be gotten from asking the patient.

He spends the rest of the book giving his version of what to give as a treatment in what situation. He covers, barley meal or barley water and when to use each. As well as when to use fasting and when it only makes things worse. He covers drink as well when to give wine and what type. As well as when to use only water though he recommends this for very little.

At one point he recommends cutting a vein in the elbow and bleeding a patient. This is the only reference to that in this work. Hippocrates is more focused on food and drink as treatment.
Reflection on Regimen in Acute Diseases

Hippocrates was against taking just water in most cases. It is interesting that today water is the one thing we are told to consume when sick. Though Hippocrates is talking about Acute diseases i.e. those that might end in death. So maybe it isn't reasonable to compare those with a cold or flu. Also, he was not talking about treated water. Maybe that is also the reason for the difference.

The single reference to bleeding a patient is odd. It is offhand enough to think it was part of the common practice. And yet it is the only mention of it in the work. He also does not discuss its use but rather just adds it in as an afterthought.

It is also interesting that for gruel Hippocrates is focused on barley meal. Today when I think of gruel I would think of oats or wheat.

What others have to say about Regimen in Acute Diseases

"The main Hippocratic concepts on four still common acute and urgent respiratory diseases −pneumonia, pleurisy, thoracic empyema and upper airway obstruction− were identified and most of them were found to be in agreement with contemporary medical thinking and practice." From BMC Pulmonary Medicine

Comparisons with other texts

Like we see in Epidemics Hippocrates very rarely prescribes bloodletting. Though it is not common in his texts he is offhanded enough about it that it must have been common at the time.

Like Prognosis he deals with the acute diseases where there is a chance of death. But unlike prognosis where he is focused on survival this work is focused on treatments.

Conclusion
Hippocrates in refuting another school covers how to treat Acute Diseases. He is focused on food and drink. This includes how often to administer them. His philosophy of treatment could be summarised as; don't shock the body any more than you must. Hippocrates very rarely suggest bloodletting as a treatment. And this is the first book we have seen that is systematic about how to treat people rather than specific cases.

Have you read Regimen in Acute Diseases? If so what did you think of it? 
 
Want to read Regimen in Acute Diseases but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

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How to tell if your patient is going to die; Prognosis, Hippocrates

 Why you might read Prognosis?

Prognosis is Hippocrates list of symptoms and their effects. As such it informs how he wrote his case studies. In doing so we gain a better understanding of his case studies.

It is in my Self Education project because it helps me understand his other works. On its own, it is a book of science about medical prognosis at the time. But as part of the corpus, it gives greater meaning and understanding to the books around it.

Content of Prognosis

Hippocrates systematically moves through different classes of symptoms. He uses this to categories if a patient will recover or die. He at times is very specific detailing in how many days death or recovery will happen.

He starts with classifications of the state of the face. Then continues on with phlegm, stool and urine descriptions. In each case, he classifies what are positive signs as well as what is negative. As well as what signs will lead to further illnesses or symptoms. He even spells out how some of these symptoms interact. These then tell us about the prognosis for the patient. 

Reflections on Prognosis

Hippocrates is systematic in his listing of classes of symptoms. Yet he gives us very little information as to how these symptoms mesh together. He does give us some but they are few and far between. This work does not contain enough synthesis for a Physician to make their own prognosis'. Unless of course, they had a wealth of experience to go with it. As such this is not a teaching text for beginners. Rather it is a complementary text for those already practising.

This is the first time I have struggled with Hippocrates' use of words. In this piece, he uses a lot of specific medical terminology. So if you're going to read it you might want to have your phone handy to look up some terms.

What others have to say about Prognosis

From STMU History Media "Hippocrates’s ability to give an accurate prognosis led to a greater amount of trust in physicians, ultimately increasing the demand for medical professionals across the Greek world."

Comparisons with other texts

Prognosis explains what we saw in Epidemics. There we saw lists of patients symptoms and whether they survived or not. This was given case by case. Here in prognosis, we see why these symptoms were important to Hippocrates. Possibly they were even more important to those reading his texts at the time. Prognosis lays out the overview and Epidemics shows those principles at work.

It takes the ideas of the Science of Medicine and puts them to work. It does this by classifying and quantifying how to make prognosis'.

Conclusion

Hippocrates in this work lays out symptoms and how to use those to make prognosis'. He does so systematically and completely. Though it is a little lacking of synthesis of those symptoms. It gives the structure for what we see in the way of listed symptoms in Epidemics. We have also seen this as the first time that Hippocrates has heavily relied on medical terminology.

Have you read Prognosis? If so what did you think of it? 

 
Want to read Prognosis but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

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Why location and weather matter in medicine; Airs, Waters and Places, Hippocrates

Why you might read Airs, Waters and Places?

Airs, Waters and Places is another foundational work of Hippocrates. It gives us a great overview of illness and Europe. As well as insight into the weather of the time. 

It has a place in my Self Education project both because of what it contains about health and location. But also because other works of Hippocrates stand on top of it. So it carries meaning through the rest of the corpus.

The content of Airs, Waters and Places

Hippocrates starts by describing how winds affect the population of a town. He covers all the compass points. When the town is exposed in that direction this is what health conditions will be prevalent. This includes what the population will look like. As well as what diseases they will be susceptible to and how deadly these illnesses will or will not be.

He then continues to do the same sort of analysis based on the water. He differentiates between lake water, spring water and brackish water. As well as rain and melted ice. He finds the ice to be the worst and the spring water from the mountains the best.

He spends the rest of the book detailing different places. This takes up most of the book. He first spends time on what he calls Asia and the Asian people but today we would call this the Middle East. He suggests that they are less prone to rashness because of their stable climate. That they get different diseases to Europe. And that their environment gives them a certain temperament. He then moves on the Scythian nomads and details why they are as they are. This includes that they have men who choose to be a woman. He suggests this is because of a practice of cutting behind the ear. They do it to fix one illness but Hippocrates says it causes impotence. He posits that after finding himself impotent many times a man of the Scythian gives up and chooses to be as a woman. He also suggests that this is more a problem for the wealthy. As the first illness, he recons is bought on by too much horse riding.

Reflections on Airs, Waters and Places

Hippocrates makes some interesting generalisation. He characterises people in ways we would never think of today. His focus on how the environment affects the people. He takes it to great lengths in classifying what that does to people is interesting. He goes into the realms of personality which we would now not connect with the environment of this type. Yet he must have been speaking from a place of some knowledge.

He takes us on a trip across Europe and we can learn much about the weather of parts of Europe and beyond. Almost more than we can learn about medicine and disease.

What others have to say about Airs, Waters and Places

"The presentation falls roughly into two halves, the first detailing various environmental factors that contribute to specific diseases, the second more ethnographic in its account of the differences between Asians and Europeans as a function of their environment and customs." From Faenum Publishing

From  Researchomatic "He advises the physician coming upon a city that is new to him to take note of the environmental factors that determine the kinds of diseases endemic to that location." 

Comparisons with other texts

Airs, Waters and Places is the explanation piece for what we see in Epidemics. In Epidemics the weather and conditions are listed. The Hippocrates moves on to the description of the diseases. Here in Airs, Waters and Places, we see why Hippocrates thinks that is of such importance. While in Airs, Waters and places we are given the overview in Epidemics we are given the specifics.

Conceptually it follows on from The science of Medicine. It follows because it is still overview type content and because it starts to detail some of that science.

Conclusion

Airs, Waters and Places cover how prevailing winds affect the health of a town. As well as their water supply. It also spends time discussing different people groups. Including how their environment affects them. We have discussed how this informs what we have seen in previous texts. As well as how much further Hippocrates is willing to take generalisations than we are today.

Have you read Airs, Waters and Places? If so what did you think of it? 

 
Want to read Airs, Waters and Places but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

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Discussion on why Medicine is a science not an art; The Science of Medicine, Hippocrates

Why you might read the Science of Medicine?

The Science of Medicine gives us more insight. Especially into how Hippocrates separated the Charlatans and the actual practitioners. It follows on from his previous work to define good practice and good science.

In my Self Education project, it fills the role of completing a corpus. While it may have only a little to add by itself it is a part of a greater whole of what Hippocrates wrote.

The content of the Science of Medicine

The Science of Medicine covers Hippocrates arguments for medicine as a science. He argues against it being an art. He covers it both in the positive, that it is a science. He does this via arguments about a physician being able to learn from his patient's condition. That this learning lets him better help future patients. He also covers some of the objections. For example, the idea that even some untreated patients get well, while some who are treated die. He explains this by saying that the one that gets well has followed the advice a practitioner would give. Though he does so unknowingly and that is why he gets well. While the one who dies he says is likely not to have followed the advice given through lack of strength. 

Hippocrates also spends some time discussing the difficulties of treating internal diseases. Because they cannot be seen often they are given remedy far to late and the disease wins.

Reflection on the Science of Medicine

Hippocrates is almost a Philosopher with his arguments in this work. I am a little surprised in fact at how much of this he has done. How little, so far, has been written about the actual practice of Medicine.

We see again Hippocrates' passion for the role of Physician. How much he wants to protect the position from the falsehoods that are around. This is especially true as he works through objections to medicine being a science.

What others have to say about the Science of Medicine.

From Dr Axe "Still to this day medical doctors and historians consider Hippocrates to be the founder of medicine as a “rational science.”"

Comparisons to other texts

This text is really a continuation of The Oath and The Canon as it continues to expand upon the nature of medicine and what it is to be a good practitioner. It continues to expand upon the idea that medicine can be learned both from a teacher as well as through scientific methodology. So that a practitioner never stops learning from his patients' conditions and taking that to the next patient.

Conclusion

This text is Hippocrates proving that medicine is a science. He does this by first proving the positive and giving reasons why this is so. He then spends time dispelling the questions and ideas against his point. Finally, he distracts himself a little with a discussion on internal diseases.

Have you read The Science of Medicine? If so what did you think of it? 

 
Want to read The Science of Medicine but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

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