Sunday, December 01, 2013

460-370: What remedies did Hippocrates prefer?

Hippocrates treating a child. 
Once the diagnosis and prognosis was made, then it was time to prescribe the remedy.  

Hippocrates once wrote that he wasn't sure what remedies would provide heat, cold, moist or dry properties, so he preferred to leave this to nature.  This might explain why his most common remedy was to "assist nature" in the healing process with simple remedies such as: (1, page 28)(2, page 90)(3)
  • Fresh air  (1, page 28) 
  • Good diet: to excite natural heat and discharge it (1, page 28) (3)
  • Exercise  (1, page 28)(3)
  • Massage  (1, page 28)(4, page 148)
  • Cleanliness: Such as soaking in hot or cold water at a bath house (1, page 28)(1, page 90)
  • Sweating (by warm bath) (3)
  • Acrd drinks: to excite natural heat and discharge it (3)
  • Appropriate food or drinks: to aide the humors in their discharge (3)
  • Withholding of food, particularly in acute affections (4, page 147)
  • Drinking lots of fluid, especially for wounds (4, page 147)
  • Bodily works (like sawing wood) (4, page 148
  • Reading aloud
  • Singing (4, page 148)
Only when these simple remedies failed did he resort to his stash of medicinal remedies, which mainly consisted of sedatives to relax the body and purging to cleanse the body.  (1, page 28)(2, page 90)  

Examples include (in parenthesis is the expected response of the remedy):  (1, page 27)(2,page 90)
  • Hemlock (sedative
  • Henbane (sedative)
  • The juice of poppy or opium (sedative)
  • Mandragora from the family of nightshades (eases breathing, sedative) 
  • Hyssop (emetic)
  • Black Hellebore (emetic, universal purge)
  • White Hellebore (universal emetic)
  • Elaterium (laxative)
  • Scammony (laxative)
  • Spurge (laxative)
  • Mercurialis perennis (laxative) 
  • Barley water
  • Wine (2, pages 90-91)(4, page 147)
  • Hydrotherapy (pain) (1, page 27)(2, page 90)
  • A decoction of barley for a variety of ailments (4, page 147)
  • Unstrained broth
  • Honey water
  • Sour honey
  • Broths from millet, meal and wheat (4, page 147)
  • Cooling demulcent drinks (facilitate elimination of the morbid humours) (4, page 148)
  • Purgatives (causes a bowel movement to facilitate elimination of morbid humours (4, page 148)
  • Emetics (causes vomiting to facilitate elimination of morbid humours) (4, page 148)
  • Blood letting (assisting incomplete elimination, particularly for inflammation) (4, page 148-149)
  • Diruretics (causes urination to assist with incomplete elimination of humours)(4, page 148)
  • Diaphoretics (causes sweating to assist with incomplete elimination of humours)(4, page 148)
  • Cupping (rarely) (4, page 148)
  • Cauterization (rarely) (4, page 148)
  • Scarification (rarely) (4, page 148)
He rarely resorted to invasive remedies such as bleeding to treat internal diseases. Although, occasionally, blood letting (venesection) was necessary.  According to Neuburger it was...
...carried out mostly on the arm, foot, popliteal space, tongue, etc., and pushed as far as possible, even to the productoin of faintness, for, "in the treatment of advanced disease extreme remedies, employed with care, are the best."  Similar but far less efficacy was ascribed to cupping or scarification; the use of leeches was not yet known.  Blood-letting and cauterization were intended for the relief of pain as well as for the derivation of the humours.  (4, page 149)
He resorted to surgery only to treat external diseases, such as cuts, fractures, etc.  This, perhaps, was due to the effort of the Cos, and Hippocrates, to show the gentle side of medicine.

Neuburger said that "Hipocratists were far from establishing the principle of which later was enunciated, of 'Contraria contrariis.'  This meant that opposites were treated with opposites.  Hippocrates would sometimes treat opposites with opposites, and sometimes similar with similar.  An example of treating contgraries with contraries would be blood letting to decrease blood in a person with inflammation, or too much blood. 

Remedies for some common respiratory ailments: (4, page 155)
  • Pneumonia and Pleurisy:  
    • Remedies that could be given immediately:
      • Warm lotions,
      • Poultices
      • Innunctions with oil
      • Warm baths
      • Diet
      • Infusions
    • Remedies that couldn't be given until the seventh day:
      • Sternutatories to get rid of mucus
      • Expectorants to get rid of mucus (fat and salt articles of food, sour wine)
      • Injection of fluid into the windpipe to provoke cough 
  • Empyema:  
    • Cauterizing the back
    • Thorococentesis (aspirating a needle into chest to draw out pus)
  • Other respiratory ailments, of which the remedies may be same as above:
    • Haemoptysis (coughing up blood)
    • Hydrothorax (fluid in lungs)
    • erysipelas of lung (cellulitis)
    • Phthisis (tuberculosis, consumption) (4, page 155)

Neurburger also said that "disease only comes to an end through removal of its cause."  So the ultimate goal of remedies was not just to treat the symptoms, but to completely cure the malady that plagued the person.  It is for this reason that Hippocratists were concerned with cures more so than remedies.  (4, page 149)

  1. Meryon, Edward, "The History of Medicine," Volume I, 1861, London,  (6)
  2. Garrison, Fielding Hudson, "An introduction to the history of medicine, 1922, (9)
  3. Hippocrates, "The Art of Medicine," Section I, Treaties III, translated by John Redman Coxe, "The writings of Hippocrates and Galen," 1846, Philadelphia, Lindsay and Blakiston (10)
  4. Neuburger, Max, writer, "History of Medicine," 1910, translated by Ernest Playfair, Volume I, London, Oxford University Press

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