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Hippocratic Cobblers. February 15, 2012

Author: Beach Combing | in : Ancient, Contemporary, Modern , trackback

***Dedicated to good and honest doctors: a pox on the others…***

Beachcombing has suffered greatly under the tyranny of white-coats over the years: blame a long undiagnosed and thus untreated condition – uncovered eventually after about ten minutes on Wikipedia. He has come then to expect problems in the medical sector. But nothing prepared him for the comparison between the modern Hippocratic Oath and the pristine original, as fine a bit of cobblers as he has seen this long year. The original comes first below in italics and is then compared with the modern version in bold.

I swear by Apollo the healer, by Aesculapius, by Health and all the powers of healing, and call to witness all the gods and goddesses that I may keep this Oath and Promise to the best of my ability and judgment.

I swear in the presence of the Almighty and before my family, my teachers and my peers that according to my ability and judgment I will keep this Oath and Stipulation.

Well, Beach’ll let this pass. After all, a multitude of fairy-tale gods is hardly going to encourage monotheists or atheists to keep their word. But this brings us already into the world of far out translation: we are not just translating words here but also ideas and cultural baggage is being thrown onto or cut off the train of thought with alarming insouciance.

I will pay the same respect to my master in the Science as to my parents and share my life with him and pay my debts to him. I will regard his sons as my brothers and teach them the Science, if they desire to learn it, without fee or contract. I will hand on precepts, lectures and all other learning to my sons, to those of my master and to those pupils duly apprenticed and sworn, and to none other.

To reckon all who have taught me this art equally dear to me as my parents and in the same spirit and dedication to impart a knowledge of the art of medicine to others. I will continue with diligence to keep abreast of advances in medicine. I will treat without exception all who seek my ministrations, so long as the treatment of others is not compromised thereby, and I will seek the counsel of particularly skilled physicians where indicated for the benefit of my patient.

Note the way that ‘fee or contract’ slipped out of the window? As properly did the exclusivity of ‘to none other’ and the gentle nepotistic cliquishness of the ancient world. But this is small beer compared to what comes next. Beach actually went to look up the ancient Hippocratic oath because of an argument over ancient surgery with a Christian Scientist: it has been an interesting weekend in the snow-bound village that Beachcombing calls home. The text does not say, of course, that surgery should not be carried out, but rather that specialist surgeons should do the cutting: this is the ancient and arguably sensible division that survives in Europe up until the eighteenth century, that the man carrying the cure is not the man carrying the knife – a job left to stone-masons, horse veterinarians and barbers.

I will use my power to help the sick to the best of my ability and judgment; I will abstain from harming or wronging any man by it. I will not give a fatal draught to anyone if I am asked, not will I suggest any such thing. Neither will I give a woman means to procure an abortion. I will be chaste and religious in my life and in my practice. I will not cut, even for the stone, but I will leave such procedures to the practitioners of that craft. Whenever I go into a house, I will go to help the sick and never with the intention of doing harm or injury. I will not abuse my position to indulge in sexual contacts with the bodies of women or of men whether they be freemen or slaves.

Of course, it would be plain silly for upper middle class Britons/Americans/Spaniards etc etc in their late twenties to swear to not seduce slaves, and understandably this reference is altered (rather elegantly). But the abstention from surgery also goes and the whole consent theme is introduced only to be bound around with suspicious-sounding conditions. Then the reference to euthanasia and abortion is nowhere in view. Beach is not clear whether this is because it is a controversial addition to the original: it is not in all of his sources and perhaps it is not in every  Greek version? Nor is he clear why this wouldn’t appear in a nineteenth-century translation into English. It seems so much more nineteenth-century in tone than antique!

With purity, holiness and beneficence I will pass my life and practice my art. Except for the prudent correction of an imminent danger, I will neither treat any patient nor carry out any research on any human being without the valid informed consent of the subject or the appropriate legal protector thereof, understanding that research must have as its purpose the furtherance of the health of that individual. Into whatever patient setting I enter, I will go for the benefit of the sick and will abstain from every voluntary act of mischief or corruption and further from the seduction of any patient.

The last section is faithfully reproduced in the modern translation, even down to the unlikely final choice of a self curse: but then even the most rational of us like a bit of modern magic, some sparks around the podium with five hundred eager faces looking on.

Whatever I see or hear professionally or privately, which ought not to he divulged, I will keep secret and tell no one. If, therefore, observe this Oath and do not violate it, may I prosper both in my life and in. my profession earning good repute among all men for all time. If I transgress and forswear this Oath may my lot be otherwise.

Whatever in connection with my professional practice or not in connection with it I may see or hear in the lives of my patients which ought not be spoken abroad, I will not divulge, 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 and science of medicine with the blessing of the Almighty and respected by my peers and society, but should I trespass and violate this Oath, may the reverse by my lot.

Beach understands that there are various nineteenth- and twentieth-century versions of the oath. Presumably you could write a history of modern medicine looking at what was left to rot on the tree of the original Greek.

Anything else on the history of the Hippocratic Oath? drbeachcombing AT yahoo DOT com


16 Feb 2012: Mikulpepper writes: ‘Many medical schools in the US (don’t know about Europe) quit using the Hippocratic Oath in the 1870s because it was old-fashioned or something. Some substituted other ancient oaths (Maimonides, for instance), others wrote up a new version. The man who saved the Oath was William Osler whose book The Evolution of Modern Medicinecalled it the “high-water mark of professional morality”. He quotes the orginal version, too. Osler invented the ideal of the family doctor/general practitioner which has slowly been fading the last forty or fifty years. Osler taught at McGill, Johns Hopkins, and Oxford, thus spreading his vision to three nations and, probably, the entire English-speaking world. His use of the Hippocratic Oath as a moral standard made it a monument.’ Thanks Mikukpepper!

22 Feb 2012: Leslie H. writes in with this thought: I recently did some research on the Hippocratic Oath for a story I was writing. I seem to remember seeing a version that mentioned not charging exhorbitant amounts for healing, but only reasonable fees, or even working for free, as even the poor had a right to good health. Did you come across this at all?‘ On the basis of this and some other comments Beach would like to look at a good critical edition of the ancient Greek. So where is the best one? Thanks Leslie!