The regimen I adopt shall be for the benefit of my patients accord ing to my ability and judgment, and not for their hurt or for any wrong. I will give no deadly drug to any, though it be asked of me, nor will I counsel such, and especially I will not aid a woman to pro cure abortion. Whatsoever house I enter, there will I go for the bene fit of the sick, refraining from all wrongdoing or corruption, and espe cially from any act of seduction, of male or female, of bond or free. Whatsoever things I see or hear concerning the life of men, in my attendance on the sick or even apart therefrom, which ought not to be noised abroad, I will keep silence thereon, counting such things to be as sacred secrets.
The treatise of the Hippocratic Collection On wounds of the head has always drawn attention as bespeaking especial ingenuity and experience. The description of trephining is of peculiar interest, because the practice was known in prehistoric times, and is still found among savage and semi-civilized peoples. (See MEDICINE: Prescientific.) The process recommended for cases of fracture of the skull and injury to the underlying structures re sembles, in many details, the modern surgical procedure. Another important surgical treatise of the Collection is that On Fractures and Dislocations.
In the Hippocratic Collection the physician attends cases of every type. He is no "specialist." But the mass of his practice lay with cases to which instrumental treatment was inapplicable. In these he tended to adopt the "expectant" line of treatment. Realizing that the tendency of the body is to recover, he con tented himself with "waiting on nature." This does not imply that he was helpless, for much could be done by nursing, regimen and diet to aid the patient in that conflict which he alone must fight. For the conduct of that great battle wise and useful direc tions are recorded. But believing in the healing power of nature— the phrase is characteristically Hippocratic—the physician was not eager to administer drugs.
Life is short and Art is long; the Crisis is fleeting, Experiment risky, Decision difficult. Not only must the physician be ready to do his duty, but the patient, the attendants, and external circumstances must conduce to the cure.
Old persons bear fasting most easily, next adults, and young people yet less ; least of all children, and of these least again those who are particularly lively.
When sleep puts an end to delirium, it is a good sign.
Weariness without cause indicates disease.
To eat heartily after a long illness without putting on flesh is a bad portent.
Food or drink slightly inferior in itself, but more pleasant, should be preferred to that better itself, but less pleasant.
The old have fewer illnesses than the young, but if any become chronic with them, they generally carry it with them to the grave. Convulsions supervening on a wound are deadly.
Phthisis comes on mostly from i8 to 35 years of age.
Apoplexy is commonest between the ages of 4o and 6o.
If you give the same nutrient to a patient in a fever and to a person in health, the patient's disease is aggravated by what adds strength to the healthy man.
The chief clinical achievement of the Hippocratic Collection lies In the descriptions of actual cases. These are not only without parallel during nearly 2,000 years, but are models of what succinct clinical records should be. They are clear and short, give all the leading features and yet show no attempt to prejudge the im portance of any particular feature. It is a reflex of the spirit of honesty in which the Hippocratic physicians worked that in the majority of the cases they record that death ensued.
Immense importance is attached by the Hippocratic writings to the art of "Prognosis," that is of predicting the course which the disease will take. The work to which the title Prognostics is attached represents a very lofty standard of practice. Very famous is the description in it of the signs of impending death to which the name of Hippocratic facies has become commonly attached. It is imitated by Shakespeare in his description of the death of Falstaff in Henry V.: You should observe thus in acute diseases ; first the countenance of the patient, if it be like those of persons in health, and especially if it be like itself, for this is best of all. But the opposite are the worst ; such as these—a sharp nose ; hollow eyes ; collapsed temples ; the ears cold, contracted, and their lobes turned out ; the skin about the fore head rough, stretched and parched ; the colour of the face greenish, dusky livid or leaden. If the countenance be such at the beginning of the disease, and if this cannot be accounted for by the symptoms, and if the symptoms do not subside in a day and a night, be it known for certain that the end is at hand.