"Airs, Waters, Places" and Other Hippocratic Writings: Inferences for Control of Foodborne and Waterborne Disease

By Franco, Don A.; Williams, Charles E. | Journal of Environmental Health, June 2000 | Go to article overview

"Airs, Waters, Places" and Other Hippocratic Writings: Inferences for Control of Foodborne and Waterborne Disease


Franco, Don A., Williams, Charles E., Journal of Environmental Health


Abstract The Hippocratic writings foreshadowed some current understandings of disease and epidemiology. Notwithstanding differences in time and medical knowledge, the ancient writers understood, as we do, that food, water, and the environment can be sources of disease. A comparison of current observations with some Hippocratic concepts reveals common principles that are applied in disease prevention and control programs. One constant that must be emphasized is that, while public health programs play a crucial role, preventive health practices must ultimately involve the individual.

Introduction

Contemporary interest in the relationship between the environment and human health was an original preoccupation of Western science and medicine, Ancient Greek philosophers and medical thinkers seeking rational explanations for disease studied and discussed the relationship between health and environment. By the fifth century B.C., they had come to recognize that evil spirits did not invade the body and cause disease and that magical incantations or potions were not curative. Preeminent among these thinkers were the members of the Asclepiad medical community on the island of Cos, the most noteworthy of whom was Hippocrates (460-370 B.C.), "the father of medicine" (see photo on page 10).

The Hippocratic Writings

A collection of about 60 eponymous "writings of Hippocrates," the work of a number of authors, has come down to us. The Hippocratic writers viewed humans as situated in and subject to the order of nature and as composed of natural substances. They assimilated to their doctrine the teachings of pre-Socratic philosophers like Empedocles (circa 493-433 B.C.), who posited the existence of four basic elements: air, water, fire, and earth. This assimilation is reflected in the Hippocratic doctrine of the four humors--blood, phlegm, yellow bile, and black bile--which had to be in harmony for good health (1). Under the normal functioning of the human organism, a balance of substances or proper mixture was maintained in the body, and the body and its organs were sound and whole.

The Hippocratic writers saw diseases as processes whose causes could' be rationally understood as observable disturbances of normal functioning (1,2). This concept is not greatly different from a typical modern definition of disease as "any deviation from, impairment of, or interruption of the normal structure or function of any part, organ, or system of the body that is manifested by a characteristic set of one or more signs or symptoms" (3).

The Hippocratic physician understood that diseases had discernible origins and stages of development, crisis, and resolution. It was the physician's role to understand the signs and stages and to assist the patient in struggling against the disease so that a natural resolution could be achieved. This role usually meant ensuring that the patient adopted an appropriate regimen, or combination of diet and exercise. The Hippocratics tried to distinguish the diet appropriate for people in good health from that appropriate for people who were ill. They characterized diseases and conditions according to the perceived excess or deficiency of a humor, and treatment involved counterbalancing the excess or deficiency. For example, a patient suffering from a fever that appeared to induce dryness was to be put on a liquid diet consisting of barley gruel and drinks of wine or water and honey [4].

To the Hippocratic writers, the environment was an important factor in people's health and well being. Infection resulted when environmental influences involving air, water, food, or other aspects of life and health--whether seasonal or otherwise--destabilized people's "humoral equilibrium." Changes in the seasons and other natural influences, as well as characteristics of climate and location, could and did give rise to diseases.

Seasonal Influences

The seasons, like the bodily humors, were thought to correspond to the four elements. …

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