Hippocrates in the Documents of the Church and in Works of Theology
This paper is a survey of Hippocrates and the presence of his principal
clinical-medical, philosophical-medical, and ethical ideas and beliefs in the
documents of the Church and in works of theology. It therefore carries on from
the study already conducted into references to Hippocrates in papal documents,
works which have already been published. [1], [2] In this paper I will dwell
upon those passages in the speeches and addresses of popes Pius XII, Paul VI,
John Paul I and John Paul II which emphasize th e ethical importance of this
famous physician of ancient Greece. This collection of quotations and
citations is not an exercise in medical history which aims at creating a
collection of documents. Nor is it an attempt to engage in a kind of literary
history. It is, rather, a collection of ethical observations and guidelines
which are to be found in surviving ancient Greek texts and which correspond in
certain ways and forms with Christian ideas and beliefs. We can safely
state that during the grea t periods of the history of Western civilization
there have always been examples of the influence of the ideas and ethical
principles of Hippocrates. At the time of early Christianity, the
essentially Christian basis and character of central Hellenic ideas was
demonstrated by the fact that in the preamble to the Hippocratic oath the
introductory words "Apollo soter" came to be replaced by the phrase "Christus
medicus." The doctrine of Hippocrates could easily be transplanted
into the patristic and scholastic traditions because it well corresponded to
the integral and personalist ideas of Christianity and because of the authority
of "Christus medicus," the phrase the doctor employed to swear to
uphold the ethics of the medical profession. This broad-ranging subject can
only be dealt with here by analyzing key moments. Indeed, the research which
lies behind this paper perhaps indicates that an overall and general picture may
well not be possible. There are also various other questions which mu st be
addressed, and most specifically the actual authenticity of the ideas which are
propounded in the works attributed to Hippocrates and of the texts which
constitute the Corpus.
1. Hippocrates in Papal
Documents In the works of Petrus Hispanus, a medical doctor with
academic qualifications who then became the doctor to Pope John XXI, we can find
two comments on Hippocrates [3] namely De Regimine Auctorum and Prognostica.
In our times, and more precisely in 1954, Pope Pius XII defined the
medical-ethical significance and meaning of the works of Hippocrates in the
following way: "The works of Hippocrates are without doubt the noblest
expression of a professional conscience which above all else calls for respect
for life and self-sacrifice in relation to sick people and also pays attention
to personal factors: self- control, dignity, reserve. He knew how to present
moral norms and to integrate them into a broad and harmonious program of study,
and he th us gave a present to civilization which was more even more magnificent
than that made by those who built empires." [4] Pope Paul VI had
similar observations to make and sought to warn doctors about the dangers which
were inherent in the advances in medical science: "It is clear that
these new inventions should not in any way prejudice the exercise of a medical
ideal which has guided medicine for millennia and has been expressed in a
tradition based the oath of Hippocrates, a figure who was a defend er of life. A
pollution of this cardinal principle would involve a fatal step backwards which
would have disastrous consequences. This is something which you will be aware of
more than any other category." [5] Under the title of "The
Illustrious," Pope John Paul I wrote a number of imaginary letters to
important historical figures, one of whom was Hippocrates-" a contemporary
of Socrates and like him a philosopher." Pope John Paul I called the Greek
physician: "The author of a famous oath...of an e thical code of
unending worth. Doctors swear by this oath to prescribe suitable treatment for
their patients and to protect them from injustice and above all else from what
is harmful. They solemnly promise to never induce an abortion; they undertake to
go to a home solely in order to treat sick people and promise that they will not
take bribes. In addition, they swear to uphold the sacredness of the
professional secret." [6] With this list of ethical-medical
undertakings and promises Pope John Paul I blessed the incorporation of the
ancient Greek code of professional conduct into the outlook and approach of the
Christian medical doctor. As early as 1978 John Paul II referred to
Hippocratic ethics during a reception for the Association of Italian Catholic
Doctors. He warned those present against the dangers of using medicines and
drugs which "not only contradict Christian ethics but every form of natural
ethics and which are in open contradiction with those professional duties
expressed in the famo us oath of the ancient pagan doctor." [7] In his
address to the members of the General Assembly of the World Union of Doctors
John Paul II, when discussing the question of genetic engineering and its
capacity to reduce the human being to an object, proffered the following
injunction: "Let all medical doctors be faithful to the Hippocratic oath
which they take when they graduate." [8] During his speech to the members
of the International Congress on the Humanization of Medicine held in 1987 John
Paul II spoke about the need for men to be aware of their true duties in the
exercise of their profession: "You should be deeply convinced of this truth
because of a long tradition which goes back to the intuitions of Hippocrates
himself." [9] And when nominating the members of the Pontifical Academy for
Life John Paul II made an explicit reference to Hippocrates when he spoke about
the need to "carry on the Hippocratic tradition." [10] On
November 26, 1994 Pope John Paul II referred again to Hippocrates when he spoke
about a Vatican codex which contains the Hippocratic oath transcribed in the
form of a cross, the symbol of the Christian understanding of human nature, of
holiness, and of the mystery of human life. [11] Under the unifying
influence of the model of Christus medicus, Hellenistic naturalism and
Semitic personalism were fused together in early Christianity, and this was a
direct result of a new diagnostic approach to the origins and causes of illness.
Without doubt it is to Hippocratic t hought that we must attribute the move
towards a sense of ethical responsibility which in turn gave rise to the
creation of medical oaths which had preambles with a monotheistic character and
conclusions with explicit reference to a transcendental reality, to God, before
whom such oaths was sworn. [13]
2. Hippocrates in the Patristic and Scholastic Traditions During the
patristic age there was an abundance of quotations from the authentic works of
Hippocrates and from the Corpus, and these have survived to us. Indeed,
Cyprian of Carthage, Gregory Nazianzen, Gregory of Nyssa, and Eusebius of
Cesarea all held to a theory of the natural sciences about the origins and
causes of illness which went back to Hippocrates. However there were also
magical and demoniacal theories. It should also be observed that Eusebius
makes repeated reference to Hippocrates in a chapter on the theory of illness,
in reflection upon free will, and knew the ancient Greek's theory of diet. He
was also familiar with the motto: "nature is the best physician."
Eusebius also invokes Hippocrates when stressing the importance of prognosis and
in expounding the idea that the soul is of primary importance in the
relationship between the body and the soul [14], [15]. In discussing the
Patristic tradition reference should also be made to the ethical-medical
chapters of the Didaché of the first century after Christ: you must not
induce the abortion of a child and you must not kill a newly-born baby. [16]
Research into Hildegard of Bingen (1098-1179) has drawn a blank as far as
references to Hippocrates are concerned. Heinrich Schipperges writes: "Hildegard
of Bingen does not offer an explicit theory in this matter. He does not repeat
the oath of Hippocrates and he does not speak about medical ethics. We do no t
find direct references to the goals of health care and no methods are offered in
relation to caring for the sick person. There is nothing which offers
instruction and nothing of a dogmatic character which could give rise to a
theory on duties and their categorization. However his works are a contribution
to Medieval deontology and are all the more valuable because such works were
absent at the time. But because they are often not presented in a serious way
they cannot be considered seriously." [17] H onorius Augustodunensis,
who died after 1150, wrote the following of Hippocrates: "per medelam
corporum deducit ad medelam animarum." [18] Knowledge about
Hippocrates and about the Corpus was kept and handed down by
Nestorian-Syrian Christianity. This branch of Christianity dedicated space in
its schools and monasteries to the conservation and transmission of
philosophical and scientific learning, and gave especial room to the
Aristotelian part of this inheritance: not only Aristotle him self but also
Euclides, Hippocrates, Galenus and Archimedes. The philosophical, mathematical
and medical works of these authors were first translated from Greek into Syriac
and then into Arabic. [19] The concept of "potentia" can be
attributed to the Greek concept of "dynamis" which is also to
be found in the Corpus Hippocraticum where it is used with reference to
illness. [20] The recent computer work on the writings of Thomas Aquinas
gives us greater confidence and security in re lation to our subject. In
discussing the meteorology of Aristotle, Aquinas makes a number of references to
Hippocrates. He does so when discussing the meaning and role of stars in the
cosmic order, theological questions, metaphysical principles, scientific
theories, astronomy and astrology. [21]
3. Pastoral Medicine Another category of sources where we find
Hippocrates cited and quoted in church and theological documents is that of
textbooks dedicated to pastoral medicine. Indeed there is a close relationship
between the Corpus hippocraticum and theology not only because the Hippocratic
writings constitute a tried and tested system of diagnosis and treatment but
also because of their human image, their essential Christian basis, and their
stress upon the notable similarities between sick and healthy people. We
should also take note of the ethical-medical chapters of the Didaché
and the way in which they correspond to the writing and ideas of Hippocrates.
The Greek physician is referred to on two occasions: when the behaviour of the
marriage partners during pregnancy is discussed, and where there is a debate
about the therapeutic opportunities offered by folk medicine in cases of
epilepsy, something, of course, which today appears highly disputable. [22]
In 1893 E.W.M . di Olfers referred to Hippocrates in his book on pastoral
medicine. He was much ahead of his time in his definition of epilepsy as a "holy
disease" in the same way that every other illness is holy, and
observed, in addition, that it was no more holy than any other. [23] August
Stohr makes repeated reference to Hippocrates, in part because he wants to
attack a certain form of medicine proposed by the ancient Greeks, a form of
medicine which has much in common with the therapeutic treatment of t he soul.
In addition Stohr refers to Hippocrates when he discusses the classical idea of
sex res non naturales and dwells upon diet and upon general customs and
habits of an individual's life. [24], [25] When considering the middle of
the twentieth century we can cite Albert Niedermayer who makes frequent
references to the Corpus Hippocraticum and to its ethical-medical
high-point, the famous Hippocratic Oath. Like many other authors (Lichtenthaeler
and others) he believes that this oath forms an authentic part of the
Hippocratic writings. In the work of Niedermayer there are arguments in
favour of Hippocrates but also controversial statements, especially in the
gynaecological field. Albert Niedermayer has clear ideas about the
importance of Hippocrates: "Even though he was a pagan he could today-some
two thousand years after Christ's preaching of the Gospel-act as an example and
model for doctors who proclaim themselves Christians." [26] Albert
Niedermayer anticipated later overa ll and Wholistic approaches to medicine when
he expressed his belief that a true and authentic doctor has a vision of his
profession which "has at its base a fusion of biological, anthropological,
medical-human, social, and ethical-metaphysical considerations, elements, and
factors." [27]
Gottfried Roth Professor of Pastoral
Medicine at the University of Vienna
Notes 1. GOTTFRIED ROTH, "Hippokrates in Päpstlichen
Dokumenten," in Acta Medika Catholika (Belgica), 2 (1995), pp.
101-102. 2. GOTTFRIED ROTH, "Hippokrates in Päpstlichen
Doukumenten, 2, Erweirte Fassung," in Mitteilungen der Katholischen
Ärztegilde Österriechs, 246 (1995), pp. 3-6. 3. M.A. ALONSO,
PEDRO HISPANO: Sciencia Libri de Anima (Barcelona, 1961). 4. PIUS
XII, "Zur Geschicte der Medizin, Ansprache am September 19, 1954," in
Pius XII, Discorsi ai Medici. S.349 f. (Rome, 1959). 5. PAUL VI,
"Das Ärztliche Ideal Nicht Beeinträctigen,"
L'Osservatore Romano (German edition), January 19, 1973. 6. POPE JOHN PAUL
I, Illustrissimi (Padova, 1970). 7. JOHN PAUL II, Wort und
Weisung im Jahr 1979 (Rome and Kevelaer, 1979). 8. JOHN PAUL II, Der
Apostolische Stuhl 1983, S. 1155 (Rome and Köln, 1983) 9. JOHN
PAUL II, Der Apostolische Stuhl 1987, S. 1699 (Rom and Köln,
1987). 10. Pontificia Academia Pro Vita, Rome, 1994. 11. JOHN
PAUL II, Discorso del Santo Padre in Occasione della Conferenza
Internationale Promossa dal Pontificio Consiglio della Pastorale per gli
Operatori Sanitari e dell Plenaria della Pontificia Accademia per la Vita (Rome,
1994). 12. PEDRO LAIN ENTRALGO, Heilkunde in Geschichtlicher
Entscheidung (Salzburg, 1956). 13. GOTTFRIED ROTH, "Die
Monotheistischen Präarmbeln und Schulßforme n in den Ärztlichen
Eiden," in Wissenschaft und Glaube, 3 (1990), pp. 115-121.
14. O. TEMKIN, Hippocrates in the World of Pagans and Christians (Baltimore
and London, 1911). 15. KARL-HEINZ LEVEN, Medizinisches bei Eusebios von
Kaiserea (Dusseldorf, 1987). 16. Didaché 1, 6, 2, in
Fontes Christiani. Didache, traditio apostolica (Herder, Freiburg,
Basel, Vienna, Barcelona, Rome, New York, 1991), p. 103. 17. HILDEGARD VON
BINGEN, Heilkunde < /i>(Salzburg, 1957). 18. CHRISTIAN PROPST,
Der Deutsche Orden und Sein Medizinalwesen in Preußen (Bad
Godersberg, 1969). 19. JOSEF PIEPER, Scolastik (Munich, 1960), p.
141 f; Johannes Hirschberger, Geschichte der Philosophie, vol. 1 (Basel,
Freiburg, and Vienna, 1965), pp. 417 20. LEO J. ELDERS, Die Metaphysik
des Thomas Von Aquin (Salzburg and Munich, 1985), vol. 1, p. 124. 21.
S. Thomae Aquinatis Opera Omnia. Comentarium in Aristoteles et Alios. (
Stuttgart/Bad Cannstatt, 1980). 22. FR. X. BRITZGER, Handbuch der
Pastorlalmedizin (Regensburg, 1859). 23. E.W.M. VON OLFERS, Pastoralmedizin.
24. AUGUST STÖHR, Die Naturwissenschaft auf dem Gebiete der
Katholischen Moral und Pastoral (Herder, Freiburg /B, 1893), p. 141f. 25.
AUGUST STÖHR, Handbuch der Pastoralmedizin mit Besonderer Berüchsichtigung
der Hygiene (Herder, Freiburg /B 1900). 26. A. NIEDERMEYER, Compendium
der Pastoralmedizin (Vienna, 1953). 27. A. NIEDERMEYER, Grundrib
der Sozialhygiene (Vienna and Bonn, 1957), p. 30.
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