It is simple to picture supplications to healing gods and spiritual rituals as the go-to method of ancient medicine. Yet, when analyzing the writings of the Hippocratic Corpus, it is clear that the study of medicine was defined by rationality and precision. Even without the aid of modern technology, physicians were able to gain a great understanding of the human body. One key idea agreed upon by most Hippocratic writers was that every disease had a natural cause, a concept that is exemplified in the Hippocratic writing, The Sacred Disease. In clarifying and defining epilepsy as something other than a ‘sacred’ disease, this work epitomizes many commonplace beliefs about the natural causes of disease, such as environmental factors, age, and a balance of bodily elements, while also arguing for its own anatomical theories, demonstrating the widely used methods of persuasion employed by medical theorists at the time.

 

The author of The Sacred Disease pushes back against popular superstitions about epilepsy, giving his own account of the cause and process of the disease throughout the body. He begins by giving detailed descriptions of his previous cases and of both human and animal anatomy, demonstrating his advanced medical training and credibility in this field, a stratagem utilized by multiple Hippocratic writers. From section five onward, the writer begins to define epilepsy in terms of its symptoms and likely causes. First, that “it is hereditary” (The Sacred Disease 5). He clarifies,“The seed comes from all parts of the body; it is healthy when it comes from healthy parts [and] diseased when it comes from diseased parts” (The Sacred Disease 5). This opinion reveals that ancient doctors had an understanding of genetics and heredity even without advanced technology, like microscopes. The second argument is that “the brain is the seat of this disease,” labeling the brain as not only “the organ of comprehension,” which manages all executive functioning and reasoning, but also as the “most potent organ in the body” (The Sacred Disease 6, 19). Because of this, the author classifies a disease of the brain as the most complex and the most fatal. The author’s third argument is that “this disease attacks the phlegmatic but not the bilious,” making phlegm the main element impacting the onset of epilepsy. He explains that the spread of phlegm to the heart causes “palpitations or asthma” and when it enters the blood vessels, it could cause “loss of voice, choking, foaming at the mouth... and convulsive movements” (The Sacred Disease 9, 10). His position ties into the greater theory about an imbalance of elements within the body being a cause of disease—epilepsy is caused by an overabundance of phlegm that spreads through the body and upsets the natural balance. Additionally, the author discusses how the mixing of hot and cold elements is another cause of imbalance. In the case of epilepsy, “all [the] symptoms are produced when cold phlegm is discharged into the blood which is warm, so chilling the blood and obstructing its flow” (The Sacred Disease 10). In this way, the author endorses the widespread theory of multiple humors throughout the body, which is often discussed in the Hippocratic Corpus.
 

Besides bolstering his own credibility, the writer also persuades his audience by discrediting opponents of his theory, especially those who support the idea that epilepsy is a ‘sacred’ or divine disease. He states definitively that “this disease is not in the least more divine than any other but has the same nature as other diseases and a similar cause” (The
Sacred Disease 5). He goes on to say that “those who first called this disease ‘sacred’ were the sort of people we now call witch-doctors, faith-healers, quacks and charlatans” (The Sacred Disease 2). Other Hippocratic writers would agree with him and often begin their works by describing the ideal practitioner as a scholarly and knowledgeable person, not someone who blindly follows their faith or merely hypothesizes about medical theory without actually practicing it themself. It is important to note that the author is not disagreeing with these superstitious beliefs because he does not have faith or does not believe in the gods. In fact, he writes, “Personally I believe that human bodies cannot be polluted by a god” and that “the presence of a god would be more likely to purify and sanctify [the body] than pollute it” (The Sacred Disease 4). Thus, the author is not against healing gods because he is unfaithful, but because he does not see the merit of mixing faith and medicine when medicine should be an empirical and logical science, as many other Hippocratic writers also believe. In addition, although the author argues that an imbalance of phlegm exacerbates epilepsy, he does not fully acknowledge the popular ‘four humors’ theory, as seen in The Nature of Man. Indeed, he believes that “consciousness is caused by air,” meaning that the flow of air is one of the most important functions in the body (The Sacred Disease 19). Blood-vessels “allow the body to breathe by absorbing air,” so the excess amount of phlegm is critical because it clogs the blood-vessels which humans need to breathe (The Sacred Disease 7). The insertion of original hypotheses alongside
general beliefs could indicate that this essay is meant to be viewed by other scholars and specifically doctors, who could learn from and verify his claims, rather than an unsuspecting member of society who would not entirely understand.

 

Much of the ideas and writing devices in The Sacred Disease can be broadened to the other Hippocratic writers and the medical community as a whole. For instance, the author asserts that epilepsy “can be cured no less than other diseases so long as it has not become inveterate and too powerful for the drugs which are given” (The Sacred Disease 5). This claim reflects the widespread belief that diseases are naturally generated and that they can be treated by a doctor with the proper knowledge. However, the final words state that an illness can be cured if it is not too “inveterate” or “powerful” (The Sacred Disease 5). This caveat reveals the importance of giving a prognosis in ancient medicine, which reinforces the physician’s reputation if their predictions are accurate and protects the doctor from blame if they fail. The author of The Sacred Disease also cites the impact of climate and seasonal factors as both a way to treat the disease and to aggravate it. This view is strongly agreed upon by other Hippocratic works, such as Airs, Waters, Places, which expresses clearly that “whoever would study medicine aright...must study the warm and the cold winds...” (Airs, Waters, Places 1). Both the direction and temperature of the wind were believed to impact the course of disease. Furthermore, The Sacred Disease discusses how age can be another influential factor in one’s health. It explains, “Infants who suffer from this disease usually die if the phlegm is copious,” but also that “adults neither die from an attack of [epilepsy], nor does it leave them with palsy” (The Sacred Disease 11, 12). This judgment is corroborated by the author of Prognosis, who notes, “Just as people under thirty are specially liable to abscession, so those above that age are specially liable to quartan fevers” (Prognosis 24). Therefore, while many of the Hippocratic works introduce their own ideas, many corroborate and build on one another to form a greater understanding of medicine as a complete science during this period.

 

Using The Sacred Disease as a case study, it’s clear that ancient physicians understood much about the nature and causes of disease. While they could not track the spread of microorganisms, medical practitioners understood that expanses of air or water could become contaminated, that certain diseases thrived in specific climates or regions, and that diseases have individual and general characteristics. Age, gender, diet, region, and climate were all factors that influenced the course of disease and one’s chances of recovery. By defining medicine, outlining the ideal physician, and defending the study of medicine, Hippocratic writers were able to establish the foundation of medical theory as it is known today.

Works Cited

 

Chadwick, J. and W.N. Mann, trans. “The Sacred Disease.” In Hippocratic Writings, ed. G.E.R. Lloyd, New York:
Penguin Classics (1983), 237-251.
 

Chadwick, J. and W.N. Mann, trans. “Airs, Waters, Places.” In Hippocratic Writings, ed. G.E.R. Lloyd, New York: Penguin Classics (1983), 148-169.

 

Chadwick, J. and W.N. Mann, trans. “Prognosis.” In Hippocratic Writings, ed. G.E.R. Lloyd, New York: Penguin Classics (1983), 170-185.