Hippocrates: The Father of Modern Medicine“醫(yī)學(xué)之父”希波克拉底

特蕾西·佩德森

Hippocrates of Kos1 was a Greek physician who lived from about 460 B.C. to 375 B.C. At a time when most people attributed sickness to superstition2 and the wrath3 of the gods， Hippocrates taught that all forms of illness had a natural cause. He established the first intellectual school devoted to teaching the practice of medicine. For this， he is widely known as the “father of medicine.”

Approximately 60 medical documents associated with his name， including the famous Hippocratic oath4， have survived to this day. These documents were eventually gathered into a collection known as the Hippocratic Corpus5. While Hippocrates may not have written all of them himself， the papers are a reflection of his philosophies. Through Hippocrates’ example， medical practice pointed in a new direction， one that would move toward a more rational and scientific view of medicine.

The four humors

Hippocrates is often credited with developing the theory of the four humors6， or fluids. Philosophers Aristotle and Galen7 also contributed to the concept. Centuries later， William Shakespeare incorporated the humors into his writings when describing human qualities.

The humors were yellow bile8， black bile， blood and phlegm9， according to “The World of Shakespeare’s Humors，” an exhibition by the National Institutes of Health （NIH） 10. Each humor was associated with a particular element （earth， water， air or fire）， two “qualities” （cold， hot， moist， dry） 11， certain body organs and certain ages （childhood， adolescence， maturity， old age）.

The interactions among the humors， qualities， organs and ages—as well as the influence of the seasons and planets—determined a person’s physical and mental health， as well as their disposition12 or personality. （Galen used the term “temperament13” and literally14 meant that health and personality were affected by temperature—cold， hot， dry or wet. This notion is reflected in the idioms “catching a cold” or having a “dry sense of humor.”）

According to the theory：

Yellow bile is related to the choleric15 disposition and the qualities of hot and dry. It is associated with fire， summer， the gallbladder16 and childhood.

Black bile is related to the melancholic17 disposition and the qualities of cold and dry. It is associated with earth， winter， the spleen18 and old age.

Blood is connected to the sanguine19 disposition and the qualities of hot and moist. It is linked to air， spring， the heart and adolescence.

Phlegm is related to the phlegmatic20 disposition and the qualities of cold and moist. It is connected to water， the brain and maturity.

Differences due to age， gender， emotions and disposition could be attributed to the interactions of the humors， according to the NIH exhibition. Heat stimulated action; cold depressed it. Someone with a choleric disposition was courageous， but phlegm caused cowardice21. Youth was hot and moist; age was cold and dry.

According to the ancient theory， the key to good health was to keep the humors in balance; an excess22 or deficiency23 in one or more of the humors was associated with disease. Sometimes the doctor would let blood （open a vein24 and drain25 the patient’s blood） or prescribe26 emetics27 （medicine that causes vomiting） in order to balance the humors.

These ideas represented the first step away from the predominantly28 supernatural view of sickness and a step toward a new idea that illness is related to the environment and what is going on inside the body.

Hippocratic oath

Often included in the Hippocratic Corpus is the Hippocratic oath， an ancient code of ethics29 for doctors. Today， the oath is valued as more of a historic example of medical ethics and principles rather than one to be taken completely literally.

The following is a modern version of the oath written in 1964 by Dr. Louis Lasagna， then a professor of medicine at Johns Hopkins University and later dean of the Sackler School of Graduate Biomedical Sciences at Tufts University：

I swear to fulfill， to the best of my ability and judgment， this covenant30：

I will respect the hard-won31 scientific gains of those physicians in whose steps I walk， and gladly share such knowledge as is mine with those who are to follow.

I will apply， for the benefit of the sick， all measures [that] are required， avoiding those twin traps of overtreatment 32 and therapeutic nihilism33.

I will remember that there is art to medicine as well as science， and that warmth， sympathy， and understanding may outweigh34 the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say “I know not，” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

I will respect the privacy of my patients， for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life， all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty35. Above all， I must not play at God.

I will remember that I do not treat a fever chart36， a cancerous37 growth， but a sick human being， whose illness may affect the person’s family and economic stability. My responsibility includes these related problems， if I am to care adequately for the sick.

I will prevent disease whenever I can， for prevention is preferable to cure.

I will remember that I remain a member of society， with special obligations to all my fellow human beings， those sound of mind and body as well as the infirm.

If I do not violate this oath， may I enjoy life and art， respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

Though many of today’s physicians believe the oath is inadequate to address today’s economic， political and social challenges， doctors still hold sacred its principles： treat the sick to the best of one’s ability， keep them from harm and injustice， preserve patient privacy and teach the secrets of medicine to the next generation.

科斯島的希波克拉底是古希臘醫(yī)師，大約生活于公元前460年至公元前375年。時人大都將疾病歸咎于迷信和神怒，而希波克拉底則教導(dǎo)世人，舉凡疾病，不論類型，皆由自然原因所致。他創(chuàng)立了第一所研究學(xué)校，專門傳授醫(yī)道。為此，世人將他尊為“醫(yī)學(xué)之父”。

與其名相關(guān)的醫(yī)學(xué)文獻(xiàn)，約有60種存世至今，包括著名的希波克拉底誓詞。這些文獻(xiàn)最終匯編成集，稱作《希波克拉底文集》。雖然這些文獻(xiàn)可能并非全部出自希波克拉底一人之手，卻反映了他的哲學(xué)思想。希波克拉底垂范后世，為行醫(yī)之道指明了新的方向，這一新的方向趨于一種更加理性、合乎科學(xué)的醫(yī)學(xué)理念。

四種體液

眾所周知，希波克拉底提出了四種體液或流質(zhì)的學(xué)說。哲學(xué)家亞里士多德和蓋倫也為這一思想作出了貢獻(xiàn)。幾百年后，威廉·莎士比亞描述人類特性時將體液的概念融入了其作品。

根據(jù)美國國家衛(wèi)生研究院舉辦的“莎士比亞筆下的體液世界”展覽，這四種體液是黃膽、黑膽、血液和黏液。每種體液都和某種元素（土、水、風(fēng)、火）、兩種“特質(zhì)”（冷、熱、潮、干）、某種身體器官和某種年齡（童年、少年、壯年、老年）息息相關(guān)。

體液、特質(zhì)、器官、年齡之間的相互作用——以及季節(jié)、星球的影響——決定了一個人的身心健康，以及性格或個性。（蓋倫使用“氣質(zhì)”一詞，字面意思是健康和個性都受溫度影響——冷、熱、干、濕。catching a cold[“得了感冒”]或者h(yuǎn)aving a dry sense of humor[“有種冷幽默”]這樣的習(xí)語就反映了這一觀念。）

根據(jù)這一理論：

黃膽質(zhì)的人性格易怒，體質(zhì)干熱。黃膽與火、夏天、膽囊和童年有關(guān)。

黑膽質(zhì)的人性格憂郁，體質(zhì)干冷。黑膽與土、冬天、脾臟和老年有關(guān)。

多血質(zhì)的人性格樂觀，體質(zhì)濕熱。血液與風(fēng)、春天、心臟和少年有關(guān)。

黏液質(zhì)的人性格冷靜，體質(zhì)濕冷。黏液與水、大腦和壯年有關(guān)。

根據(jù)國家衛(wèi)生研究院的展覽，年齡、性別、情感和性格所產(chǎn)生的差異可歸因于體液之間的相互作用。熱促進(jìn)行動，冷抑制行動。性格易怒的人膽大，黏液質(zhì)的人則膽小。青春濕熱，老年則干冷。

根據(jù)古代理論，平衡體液是健康的關(guān)鍵;疾病與某種體液或多種體液過剩或不足有關(guān)。有時候，為了平衡體液，醫(yī)生會放血（割開靜脈讓病人的血淌出）或者開催吐劑（促使嘔吐的藥物）。

這些觀念代表了擺脫關(guān)于疾病的主流迷信說的第一步，這一步邁向了一種全新的理念，即疾病與環(huán)境以及身體的內(nèi)部運作有關(guān)。

希波克拉底誓詞

《希波克拉底文集》往往收錄希波克拉底誓詞，這篇誓詞是古代行醫(yī)倫理規(guī)范。今天，這篇誓詞更被人奉為醫(yī)者倫理和職業(yè)操守的歷史典范，而非讓人照本宣科。

以下是這篇誓詞的現(xiàn)代版本，由時任約翰·霍普金斯大學(xué)醫(yī)學(xué)教授、后任塔夫茨大學(xué)薩克勒生物醫(yī)學(xué)研究生院院長路易·拉薩尼亞博士于1964年所撰：

我誓盡己力與識見所及，矢守此約：

我將尊重步其履后的先賢醫(yī)者得來不易的科學(xué)成果，凡我所知，亦樂與后來者共享。

我將竭盡一切方法，造福病者，避免治療過當(dāng)與治療虛無主義的雙重陷阱。

我將謹(jǐn)記，醫(yī)療既是科學(xué)，亦是藝術(shù)，熱誠、體恤、諒解勝于外科醫(yī)生的手術(shù)刀與藥劑師的藥物。

我將不以“不懂”為恥，病者痊愈若需他人之助，我亦不避援請同業(yè)。

我將尊重病者隱私，因病患相告，本恐他人知曉。生死攸關(guān)之事，我猶應(yīng)小心處理。若能救人一命，心存感念。然我能力所及，亦可奪人性命;重任在前，須懷有極大的謙卑之心，認(rèn)清自身弱點。首先，切莫以上帝自居。

我將謹(jǐn)記，我治療的并非一張發(fā)熱圖，亦非癌癥的增殖，而是一個患病之人，他的病可能會影響其家人與經(jīng)濟(jì)穩(wěn)定。如我充分關(guān)懷病者，我的職責(zé)亦當(dāng)包括這些相關(guān)問題。

我將隨時預(yù)防疾病，因為預(yù)防勝于治療。

我將謹(jǐn)記，我是社會一員，對人類同胞懷有特殊義務(wù)，不論老弱抑或身心健全之人。

我若守此約誓，愿我安享人生及技藝，有生之年受人尊敬，待到身后受人緬懷。愿我一如既往，守醫(yī)業(yè)優(yōu)良傳統(tǒng)。病者求援，手到病除，愿我長得此樂。

盡管今日許多醫(yī)者認(rèn)為這篇誓詞不適于應(yīng)對今日的經(jīng)濟(jì)、政治和社會挑戰(zhàn)，但是醫(yī)生仍然堅守這神圣的原則：盡己之力醫(yī)治病者，使病者免遭傷害與不公，保護(hù)病者隱私，將醫(yī)學(xué)之秘傳于后代。

（譯者為“《英語世界》杯”翻譯大賽獲獎選手）