THE OATH.

THE ARGUMENT.

THIS piece, as was stated in the Preliminary Discourse, is often referred to by ancient authors, and there seems little or no reason for questioning its authenticity. It is an interesting document, as exhibiting the practitioners of medicine in a very remote age, already formed into a regular corporation, bound by an oath to observe certain regulations, and having regular instructors in the art. The present piece would seem to be an indenture between a physician and his pupil; and it is most honorable to the profession, that so ancient. a document pertaining to it, instead of displaying a narrow-minded and exclusive selfishness, inculcates a generous line of conduct, and enjoins an observance of the rules of propriety, and of the laws of domestic morality.

There are few things in it which require either illustration or comment. M. Littré finds some difficulty in accounting for the circumstance that the noviciate in the art is interdicted from the practice of lithotomy. It is certain, however, that this operation was in antiquity always practiced by a separate class of operators, and that the regular members of the profession never meddled with it, on any account. Hence, in the whole compass of ancient medical literature, there is not a single description of the operation by a person who himself had actually performed it. Thus no mention of it is made in the Hippocratic treatises, although there is the clearest evidence that our author used to perform all the regular operations then recognized by the profession as legitimate. Galen also speaks of bold operations performed by him on the head and chest, but he never once hints that he meddled with the operation of lithotomy. The descriptions of the operation given by Celsus and Paulus Egineta are evidently copied. The Arabians were, if possible, still more prejudiced against lithotomy; for Avenzoar pronounces the operation be to one, which no respectable physician would witness, and far less perform.' And even in this country, at least in the North of Scotland, not perhaps much more than a hundred years ago, it was common for lithotomy to be performed by non-professional persons. Thus I remember having been told in my youth, by an old man residing in the district of Aberdeenshire, called Cromar, that in his younger days there was a miller in that

1ii., 27.

278

GENUINE WORKS OF HIPPOCRATES.

part of the country who was very famous for cutting persons for the stone. In many parts of the East the operation is still cultivated as a separate branch of the profession. See the Commentary on PAULUS EGIN ETA, Vol. II., p. 363. One, therefore, need not be at all surprised at our author's interdicting his pupils from the performance of an operation which, at that time, was not reckoned respectable. It is true that, as will be seen in our notice of the Books on Diseases, he makes mention there of the process of sounding a patient for the purpose of discovering whether or not there was a stone in the bladder; we can well suppose, however, that the general practitioner might be called upon to pronounce upon the nature of a case, although he had nothing to do with a particular operation practiced for the relief of it. At all events, there can be no doubt that, in ancient times, lithotomy was intrusted to a set of operators separate from the general profession. Why this operation in particular was proscribed, cannot indeed be satisfactorily ascertained; but the fact is as I have stated, that, through all antiquity, the higher medical authorities had nothing to do with it. The conjecture then advanced by René Moreau,' that castration, and not lithotomy, was meant in this place, appears to me utterly inadmissible, and is rejected by M. Littré in his Argument to this piece.

THE OATH.

I SWEAR by Apollo the physician, and Esculapius, and Health, and All-heal,' and all the gods and goddesses, that, according to my ability

1 Th. Bartholini Epist., Cent. I., epist. lxxxi.

2 Every person who is at all acquainted with ancient literature must be aware that Apollo, in the mythology of the Greeks and Romans, was regarded as the healing god. In this capacity he appears in the very beginning of the Iliad, as the divinity who causes and removes the pestilence; and in the Homeric Hymn to Apollo he is introduced in the same capacity. Hence the epithet "healing” (¿1⁄2ïoç) is applied to him by Sophocles (ŒEd. Tyr., 154.); and its synonyme, “the healer” or 'the physician” (intpòs), by our author in this place. The beautiful lines of Ovid, in reference to the healing powers of Apollo, are in everybody's mouth: "Inventum Medicina meum est; opiferque per orbem Dicor, et herbarum subjecta potentia nobis." (Met. i., 521.) Esculapius was universally represented as the son of Apollo, according to Pindar, the contemporary of our author, by the nymph Coronis (Pyth. iii.); but according to the later myths, by Arsinoe (Apollodor. Bibl. iii., 10). I need scarcely say that he was the patron-god of the Asclepiadæ, or priest-physicians, to which order Hippocrates belonged. In the ancient systems of mythology he is described as having two sons, Podalirius and Machaon, and four daughters, Ægle, Jaso, Hygeia, and Panacea. Of these it will be remarked that our author notices only the two last, whose names are here rendered Health and All-heal. Sprengel (Hist. de la Méd. tom. i., p. 468, and ix., 208) argues from this invocation of Apollo

and judgment, I will keep this Oath and this stipulation-to reckon him. who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture,' and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and

I

as a healing divinity, along with Hygeia and Panacea, that this treatise must have emanated from the school of Alexandria; I can see no force, however, in this argument.

There has been considerable difference of opinion what the two kinds of instruction are which Hippocrates adverts to here. See Zuinger, Foës, and Littré. The most probable supposition appears to be, that the former applies to general precepts, and the latter to professional lectures. Of the one we have a good specimen in the Hippocratic treatise entitled the Præcepts (apayyɛkiai), and of the other in the Auscultationes Naturales (akpóaσeç øvoikaì) of Aristotle. That our author delivered public lectures in the cities he visited there can be no doubt, for he is so represented by his contemporary, Plato, in his Protagoras. It will be seen, however, from this piece, that he confined his instruction to his own family and that of his teachers, and to such pupils as were bound by a regular stipulation or indenture.

* We have here another notable instance how much our author was superior to his age in humanity as well as in intelligence; for his contemporary, or rather his immediate successor, Aristotle, though the son of a physician, and although there be some reason to suppose that he was a dabbler in drugs before he betook himself to philosophy, treats very gravely of the practice of procuring abortion, and does not at all object to it, if performed before the child had quickened. (Polit. vii., 21.) Plato also alludes to the practice. (Theætetus.) Juvenal, in his Sixth Satire, speaks of artificial abortion as being a very common practice among the higher class of females in his time. The mode of procuring abortion is regularly described by Avicenna (iii., xxi., 212), and by Rhases (Contin. vii., 2),—not, however, to be applied for any wicked purpose, but in the case of women of small stature who had proved with child. The means recommended by these authors are, severe bleeding, especially from the ankle; leaping from a height; the administration of emmenagogues; the application of pessaries medicated with bellebore, stavisacre, mezereon, and the like; but more especially forcible dilatation of the os tincæ with a roll of paper, or a tube made of polished wood, or a quill. There can be no doubt, in short, that the ancients had anticipated all our modern methods of inducing premature delivery. Avicenna, moreover, also speaks of accomplishing the same purpose by fumigations, a mode which I believe has not been thought of in recent times since this operation was revived, but which one

280

GENUINE WORKS OF HIPPOCRATES.

practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!

can readily suppose well calculated to destroy the foetus when that was the intention. I may mention, by the way, that fumigation of the uterus was freely practiced by the medical authorities of the sixteenth century. An excellent drawing of an apparatus for this purpose is given in the works of Ambrose Paré, xxiii., 48.