Reinventing Hippocrates
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Reinventing Hippocrates

David Cantor, David Cantor

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eBook - ePub

Reinventing Hippocrates

David Cantor, David Cantor

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About This Book

The name of Hippocrates has been invoked as an inspiration of medicine since antiquity, and medical practitioners have turned to Hippocrates for ethical and social standards. While most modern commentators accept that medicine has sometimes fallen short of Hippocratic ideals, these ideals are usually portrayed as having a timeless appeal, departure from which is viewed as an aberration that only a return to Hippocratic values will correct. Recent historical work has begun to question such an image of Hippocrates and his medicine. Instead of examining Hippocratic ideals and values as an unchanging legacy passed to us from antiquity, historians have increasingly come to explore the many different ways in which Hippocrates and his medicine have been constructed and reconstructed over time. Thus scholars have tended to abandon attempts to extract a real Hippocrates from the mass of conflicting opinions about him. Rather, they tend to ask why he was portrayed in particular ways, by particular groups, at particular times. This volume explores the multiple uses, constructions, and meanings of Hippocrates and Hippocratic medicine since the Renaissance, and elucidates the cultural and social circumstances that shaped their development. Recent research has suggested that whilst the process of constructing and reconstructing Hippocrates began during antiquity, it was during the sixteenth century that the modern picture emerged. Many scholastic endeavours today, it is claimed, are attempts to answer Hippocratic questions first posed in the sixteenth century. This book provides an opportunity to begin to evaluate such claims, and to explore their relevance in areas beyond those of classical scholarship.

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Information

Publisher
Routledge
Year
2017
ISBN
9781351905299
Topic
Storia
Edition
1
CHAPTER ONE
Introduction: The Uses and Meanings of Hippocrates
David Cantor
The recent enthusiasm for computer games may not seem the most obvious place to begin a book on the father of medicine. But, at the end of the twentieth century, Hippocrates found his way into those imaginary worlds, and in such a bewildering variety of guises! In the late 1990s he was the joint ruler of the Beastmaker Mountain, a medical swordfish, a beast or monster, the member of an Immortal Staff, and the founder of the Hippocrates Circle which manipulated medical technology for the purposes of world domination. His name was adopted by game players in at least three role-playing games; there were starships called Hippocrates in two others, and the Hippocrates Ambulance ran through another. Elsewhere, he appeared in a virtual version of Dante’s Hell, provided clues as to the rescue of a kidnap victim, and inspired a group called the healercraft. One game claimed to be based on his insights into personality type; and he was cited in instructions on how to decide when a player should go mad. Such were some of the uses of Hippocrates at the turn of the millennium.1
These varied uses of Hippocrates may be historically specific, but they highlight a general problem in the historiography of his legacy. Until recently, most accounts of the Hippocratic tradition tended not to explain variety, but to consider whether or not the various visions and uses of Hippocrates captured something of the original historical figure or his insights.2 From such a perspective, the historiographical task was to identify the ‘true’ Hippocrates, and then to assess the authenticity of subsequent depictions of him and his medicine. While such an approach might help to make the obvious point that none of the ‘Hippocrateses’ in late twentieth-century computer games measured up to current scholarly conceptions of the man and his medicine, that is hardly the point. With few exceptions these games made no pretensions to historical accuracy, and those that did made no claim to rigorous academic scholarship. The reasons why game players or others might wish to portray Hippocrates in a particular way would be unexplored in traditional scholarship, if it ever looked at popular culture as more than a curiosity. It is one of the points of this book that such scholarship also tells us little about the meanings and uses of Hippocrates for the many groups and individuals that do assert some claim to historical accuracy, and so also tells us little about the related question of how Hippocrates came to have such a pervasive presence in Western medicine and culture.3
There are other reasons why older accounts of Hippocrates created problems for understanding the various ways in which he has been portrayed and used since antiquity. Firstly, they tended to give Hippocrates or his ideas the primary role in influencing subsequent generations. Somehow Hippocrates reached out from death and the distant ancient world to shape the thoughts and actions of later peoples. The emphasis was on the ways in which ideas were transmitted from one generation to another. But these ideas were problematically connected to those people who held them. The interests and agendas that shaped their reading of Hippocrates were often of interest only to the extent that they hindered or facilitated the uptake of his ideas. Secondly, Hippocratic values were often regarded as unproblematic and unchanging – despite a growing literature on diversity and contradiction within the Hippocratic Corpus. From such a perspective it was quite possible to measure those who claimed to be Hippocratic against ‘true’ Hippocratic values. If they failed to live up to such values, then the historian’s task was to set out the reasons why they strayed from the path, and to pinpoint those who brought medicine back to the light.4 There may have been many portrayals of Hippocrates but, in such accounts, only one authentic vision. Thirdly, traditional approaches tended – and still tend – to tell tales of decline and degradation. Thus one recent historian urges a study of the ‘corruption of the Hippocratic Corpus’,5 while survivalist accounts discuss the ‘simplification’ or ‘degeneration’ of a ‘stripped down’ Hippocratic medicine in the Horn of Africa, South Asia and Latin America.6 This emphasis on corruption and simplification tends to downplay the possibility of creative reinventions of Hippocrates and his medicine.7
Some of these features are exemplified by Wesley Smith’s path-breaking account of the abandonment since the Renaissance of Galenic interpretations of Hippocrates. Smith argues that accounts of Hippocrates and Hippocratic medicine have been shaped by what he calls the ‘scientific’8 interests of doctors and that these accounts have been taken up uncritically by subsequent historians and philologists. He focuses on what he calls the ‘errors’ or ‘aberrations’ of past interpretations in order to overcome them.9 Unlike the contributors to this book, Smith is concerned to recover ‘genuine’ Hippocratic texts, as well as to show how such allegedly aberrant interpretations came about. His focus on how scientists’ progressive attitudes ‘infected’ medical history also points to differences with many of the contributors to this book.10 Most would question the notion that science (or any cultural artifact) infects an otherwise healthy body of historical knowledge. Instead, these papers tend to see the cultural and social shaping of historical knowledge – including the papers presented here – as a normal, routine part of knowledge production.
Whilst the papers in this book vary considerably in approach and topic there are a number of themes that unite them. For most, the existence of an historical Hippocrates is less important than the various ways in which Hippocrates has been used over time. Hippocrates is not so much a ‘real’ person as a malleable cultural artifact, constantly moulded and remoulded according to need. The identification of ‘genuine’ Hippocratic texts is less important to most authors than changing historical perceptions of what may be genuine or useful Hippocratic texts. As the following essays show, different writers have chosen quite different and often contradictory messages from the Corpus by favouring one or other of the texts – perhaps the Oath, perhaps Epidemics, perhaps On Ancient Medicine. Contributors to this volume tend not to see Hippocrates or his ideas as primary actors, but focus instead on the ways in which Hippocrates and his medicine have been represented or read by particular groups and individuals within particular historical, cultural and social circumstances. The key words of ‘constructing’, ‘shaping’, ‘using’ and ‘reading’ all evoke active attempts by various groups and individuals to imagine the father of medicine and to bring specific social, cultural and technical resources to such visions. The Hippocratic tradition is, therefore, an ‘invented tradition’, constantly reinvented over time.11 It is not passed unproblematically from one generation to another, nor is it a refuge for backward minds – those unable to cope with modernity. On the contrary, the classical world has often provided a fruitful way of way of shaping and making sense of the modern world.12 Indeed, as Thomas RĂŒtten notes in this collection, key modernist concepts such as ‘progress’ have sometimes been oriented as much to the past as to the future.
The book also seeks to address some of the ways in which a focus on the invention and reinvention of the past might be achieved. Contributors to this volume attempt to tie the many variants of Hippocrates and Hippocratism into broader concerns about personal, professional, class, regional and national identity. Some invoke pre-existing ‘interests’ and ‘forces’ to explain such variants; others focus on the practices of medicine, science and politics to explore the production of ‘Hippocrateses’; and others explore the histories of readings that shape and reshape conceptions of Hippocrates. Alongside such causal explanations of the constructions and reconstructions are others that provide interpretative accounts of the variants of Hippocrates. From this perspective, the social mechanisms by which various ‘Hippocrateses’ have been produced are less a concern than what such variants say about the particular cultures that produce them. As John Harley Warner states in his essay, there is a growing appreciation that cultural heros embody the aspirations of the groups and individuals that create them; they validate their endeavours and reaffirm their perceptions of self.
A focus on the cultural meanings and constructions of Hippocrates has been facilitated by recent scholarship that highlights differences between modern and ancient understandings of Hippocrates and his medicine. For example, although Hippocrates is often portrayed as the founder of modern observational methods, Geoffrey Lloyd has shown that the ancient Greeks had no exact equivalent to our word ‘observation’:13 the Greek word teresis did not appear until later. Indeed, some ancient observational methods appear to be quite the opposite of those of today. Volker Langholf notes that the verb skopĂ©omai used in the Epidemics meant to ‘consider’ in the light of existing rules or theories:14 the observation of individual cases in the Epidemics is in fact not done in order to move from observation to theory, but rather to extend the applicability of existing theories. The authors of the Epidemics, according to Langholf, do not consider abstract rules or theories in the light of cases.15 ‘Never’, he writes,16 ‘does a question restrict the validity or applicability of any medical theory’; the Epidemics shows ‘a tendency to present reality in conformity with theory’.17 Thus, Hippocrates the observer is an invention rather than an original subsequently misrepresented by those who wish him to support their cause.
A similar point can be made about Hippocratic ethics. Today the roots of modern medical ethics are constantly traced to Hippocrates, as if the meaning of the Oath is timeless and unproblematic.18 ‘Hippocrates, schmippocrates,’19 is all that Dr Hibbert in television’s The Simpsons (1995) has to say to evoke his unethical behaviour in agreeing to the request of some children for an unnecessary surgical operation. But there have been many versions of the Oath, and the original document is probably not from the Hippocratic period.20 Indeed, the Oath and other ‘ethical’ writings such as Decorum and The Physician can been seen as quite unethical in modern terms. They can be read to advocate a morality of deceit, teaching physicians the correct way to look in order to fool patients by giving a convincing impression. The notion of a timeless set of Hippocratic ethics is therefore problematised, as is the notion of later corruptions of Hippocrates’s ‘high’ ideals.
Transformations of Hippocrates
This book begins with sixteenth-century transformations of Hippocrates, the time when, according to Vivian Nutton, the modern picture of Hippocrates was formed and the historical figure first took on flesh and blood.21 Yet transformations of Hippocrates can be traced almost back to the man himself;22 his younger contemporary, Plato, being perhaps the first, as Langholf puts it, to interpret ‘the available information about Hippocrates’s method on the basis of his own system of thought’.23 Galen subsequently adopted this procedure, constructing an image of Hippocratic medicine that was remarkably like his own, and which he bolstered by classifying as ‘genuine’ those Hippocratic writings that echoed his own ideas.24 On the basis of such a classification, Galen was able to combine often conflicting Hippocratic writings into a unitary theory of fluids, organs and pepsis. It was thus not so much the originality of Galen’s work as the immense magnitude of his invention that allowed Galenic medicine to dominate in the West until the sixteenth century. Some Hippocratic works had been part of the Latin medical curriculum since the early Middle Ages,25 but the Hippocrates known to writers of the late Middle Ages was essentially Galen’s Hippocrates, and the abandonment of such a portrayal of Hippocrates was neither inevitable nor sudden.
The story of a gradual abandonment of Galen’s Hippocrates reflects a broader tendency within Renaissance scholarship to avoid accounts that portray the sixteenth century as a sudden breach with the medieval or early Renaissance medical past.26 Humanist scholars started to study Hippocratic texts in the late fifteenth century, a study that represented a greater reliance on the ancient past, but also led to a repudiation of some parts of that past.27 Crucial to this patchwork process of reclamation and abandonment was the availability of the entire Latin printed edition of the Hippocratic Corpus in 1525, and of a complete Greek edition the following year, followed by the appearance of numerous other new translations, editions and commentaries.28 The fact that readers had to master a much broader range of Hippocratic texts, and in two ancient languages, may help to explain why Hippocrates tended to remain subordinate to Galen until the 1560s.29 Those who quoted Hippocrates may not have read him or, if they did, they read him through Galen’s eyes. Galen portrayed himself as merely an interpreter of Hippocrates, and subsequent generations accepted his claim, seldom distinguishing the two.
From the fifteenth century the dominance of Galen was threatened by the arrival of ‘new diseases’ for which there was no precedent in his medicine. As Jole Shackelford notes in his contribution, practitioners began to attempt to shape a new medicine that could address such new diseases. One solution to the problem could be found in the classical authors themselves. Pliny, for example, blamed the new diseases of his day on the new foodstuffs imported from areas newly conquered by the Romans.30 Another solution was to study more deeply the ancient medical texts in the belief that they included a description of every disease. Far from being a dry academic issue, this study had immediate implications for treatment. If Hippocrates or Galen mentioned a particular condition, it followed that the medical treatment was worth...

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