The Invention of Medicine: From Homer to Hippocrates

Disease tearing through a community; mass fatalities; and no apparent end in sight: the pestilences plaguing Greeks at Troy at the start of Homer’s Iliad or Thebes in Sophocles’ Oedipus the King seem all too familiar in our COVID-haunted world. However, while we pin our hopes on scientists and vaccines, many in ancient Greece relied on priests for their salvation, believing that pandemics were unleashed by angry gods. Yet, already in the 5th century BC, a quiet revolution was afoot as doctors, beginning to understand more fully humanity’s place within the natural world, through observation and experimentation diagnosed and (sometimes) cured. At their forefront was Hippocrates, an almost legendary yet elusive figure, credited with a mighty corpus of medical writings, including the famous Hippocratic Oath. But who was Hippocrates? Where and when did he practise? And what was his contribution to scientific development? These questions lie at the heart of Robin Lane Fox’s compelling book, a quest that takes us to the hidden heart of ancient Greek society and whose findings (if true) cast important new light on Greek history and historiography.

For millennia, war-wounds and other man-made injuries had been a part of life (or death) described in such detail in the Iliad that the Roman physician Galen called Homer the founder and patron of medicine. They were treated by sometimes drastic intervention – trepanning was practised in the early Bronze Age. From the 6th century BC onwards comes evidence of individual (often travelling) doctors: Sombrotidas, honoured with an expensive statue in Sicily; Onesilas and his brothers, rewarded for treating wounded without charge in the siege of Citium; Alcmaeon, perhaps an Athenian refugee in south Italy, who eschewed divine involvement, and using intriguingly political language wrote that the human constitution consisted of paired opposites, calling good health ‘equality’ and sickness the ‘monarchy’ of one element over others. Yet even they were shackled by tradition. Disease still seemed god-sent.

The turning point, Lane Fox believes, occurred on Thasos around 470 BC, when, he argues (using historical and epigraphic evidence to reach a controversially early dating), the first two works in the Hippocratic Corpus were written. Known as Epidemics Books 1 and 3, they contain weather records for each year, with individual case observations including such detailed topical descriptions that patients’ ‘addresses’ can be located with some accuracy in the modern town. What makes these works remarkable is not their records of diagnoses or treatments (there are none), but their meticulous observations of the course of illnesses, recorded in a pared-down no-nonsense style unique for the time. And their purpose? To aid future treatment so that (in their author’s words) it ‘will be easy to examine the order of critical days… and to predict them. For someone who knows about these things, it is possible to know for whom and when and how a regimen must be established.’ So precise are his observations that, from them, modern doctors can retrospectively diagnose cases of tuberculosis, typhoid, malaria – and mumps, apparently confined to the male population and transmitted through close contact in gymnasia. Not all the later Hippocratic Corpus shows such scientific rigour, but one near-contemporary writer comes very close – the historian and local mine-owner Thucydides, who (Lane Fox argues) read Epidemics Books 1 and 3 and reveals his debt to them not least in his own account of the Athenian plague of 430 BC.

Despite graphic descriptions and reminders that anaesthetics and sterilising medical equipment were unknown in antiquity, even squeamish readers will enjoy this vital, vibrant book and relish the brilliant light it sheds on everyday life in mid-5th-century Thasos. Undoubtedly some will quibble about its conclusions, but Lane Fox’s arguments (including that the author of our Epidemics was none other than Hippocrates himself) are so cogent and convincing that even sceptics may find themselves recalling the observations of that other great empiricist, Sherlock Holmes: ‘Once you have eliminated the impossible, whatever remains… must be the truth.’

The Invention of Medicine: From Homer to Hippocrates by Robin Lane Fox Penguin, £25, Hardback ISBN 978-0241277058. Reviewed by David Stuttard.