HIPPOCRATES AND THE BIOLOGICAL MOVEMENT

     Hippocrates had the notion that psychopathology was due to disturbances
within the balances of the four humours. He dismissed all ideas of
possession , and created several therapeutic techniques. Although his
theories did have a significant impact at the time , there was little
substantiative evidence for his theories because of the stigma against
anatomy work . An indepth description of hysteria and melancholy gives
insight into the ancient physicians' conceptualized and treatment of
disease.
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 Hippocrates

     "The Greek physician Hippocrates, c. 460 - 377 B.C, is often called the
'father of medicine'. Little is known about him, but a great tradition
surrounds his name. The famed Hippocratic Collection probably contains only
a few of his own works and may be the remains of the Hippocratic School at
Cos. It includes writings on illnesses, surgery, fractures, anatomy, and
dreams as well as an attack on the view that diseases were of divine origin.
Perhaps the most important idea associated with Hippocrates is that of
relying on facts, clinical observation and experiment. The Hippocratic oath,
although probably not the work of Hippocrates, serves as an ideal of ethics
for physicians."

     (CD Rom Encyclopedia)
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 The Four Humors

     This theory was devised to explain disease in general, however, the
effects of the four humors on the mind and psychological processing were
noted.

     The Four Humors consisted of BLOOD, PHLEGM, YELLOW BILE and BLACK BILE,
that are produced by several organs throughout the body. Diseases were
caused by the over manufacturing of one of these substances causing
disharmony. Psychopathology was also produced by excessive or insufficient
amounts of a humour. Black bile was specifically noted for causing
melancholia.

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 Therapeutic Techniques

     This more gentle approach was not the only manner in dealing with the
mentally ill. Other physicians used more brutal methods in working with the
deranged. These methods lasted until the late 19th century. "Severe physical
restraint, extremely limited diets, keeping the patient in a dark room,
violent purges, excessive bleeding, plunging the patient suddenly into cold
water, beating and whipping him..." (Rosen, 1968)

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 Cultural Impact

     The theories of Hippocrates have been suggested to have had a
substantial effect on popular culture. This can be seen through the use of
his terminology in every day use. For example, the public adopted the term
"black bile" to by used synonomously with madness.

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 Anatomy

     Little work was done by the ancients regarding anatomy. This is due to
cultural and religious taboos that forbade the dissection of humans. Their
inability to do significant anatomical work lead them to develop theories
regarding the functioning of the body, like Hippocrates theory of the four
humours

.
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 The Brain

     In the book, On the Sacred Disease, a thorough description of the brain
and illnesses effecting it are given.

     Men ought to know that form the brain, and from the brain only,
     arise our pleasures, joys, laughter and jests, as well as our sorrows
     pains, grieves and tears. Through it, in particular, we think
(phroneomen)
     see, hear, and distinguish (diaginoskomen) the ugly from the beautiful
     the bad from the good, the pleasant from the unpleasant, in some cases
     using custom as a test, in others perceiving them from their utility.
It
     is the same thing which makes us mad (mainometha) or delirious
     (paraphroneomen), inspires us with dread and fear, whether by night
     or by day, brings sleeplessness, inopportune mistakes, aimless
anxieties,
     absentmindedness, and acts that are contrary to habit. These things
     that we suffer all come from the brain, when it is not healthy, but
     becomes abnormally hot, cold, moist, or dry, or suffers any other
     unnatural affection to which it was not accustomed. Madness comes
     from moistness.
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 Hysteria

     Hysteria is not a single disorder, but encompasses an entire range of
phenomena. Recognized as a disorder which primarily affects women, there are
three main subtypes included under the general term "hysteria". Hysterical
conversion, is a complaint of a bodily disorder where there is no clear
organic cause. Hysterical character is a personality type where the woman
tends to be repressive in social interactions and sexuality. Finally,
hysteria and massive dissociative phenomena, is a more complicated group of
disorders, where the individual manufactures an entire different existence,
for example multiple personality disorder, to escape from reality. Much of
Freud's work was based on this phenomena.

     A description of hysteria comes from Hippocrates' Diseases of Women.

     If a woman suddenly becomes voiceless you will find her legs cold,
     as well as the knees and the hands. And if you then palpate the
     uterus, it is not in its proper place; her heart palpitates, she
gnashes
     her teeth, there is copious seat, and all the other features
characteristic
     of those who suffer from the "sacred disease" (epilepsy), and they do
     all sorts of unheard-of- things.

     In ancient Greek medicine, hysteria was thought to be a result of the
wandering of the uterus.

     When remaining unfruitful long beyond its proper time,
     [the uterus] gets discontented and angry, and wandering
     in every direction through the body, closes up the passages
     of the breath, and , by obstructing respiration, drives them
     to extremity, causing all variety of disease, until at length
     the desire and love of the man and the woman, bringing
     them together and as it were plucking the fruit from the tree,
     sow in the womb, as in a field, animals unseen by reason
     of their smallness and without form.
     Plato's Timaeus

     The most common treatment for women suffering from hysteria was
marriage and child rearing. Other treatments were given to attempt to move
the uterus back into its proper alignment including, "bandaging (to prevent
further ascension of the uterus), orally administered medicaments ..., fetid
fumigations to the nose (to repel the ascended uterus), and aromatic
fumigations inserted into the vagina (to attract the wandering uterus...)"
(Simon, 1978).

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 Melancholia

     In the Hippocratic Corpus, there is not much information regarding
melancholy, however a description of anxiety, a disorder often associated
with, or accompanies, melancholia, is present.

     Anxiousness - a difficult disease. The patient thinks he has something
like
     a thorn, something pricking him in his viscera, and anxiety (perhaps
     the loathing or nausea) tortures him. He flees from light and from
     people, loves the dark, and is attacked by fear. His diaphragm swells
     and he feels pain at the touch. He worries and sees frightening
visions,
     fearful dream images, and occasionally dead people. The disease attacks
     mostly in the spring.

     Melancholia, another term for depression, was noted by Aristotle not to
be only an illness, but also a personality trait.

     Why is it that all those who have become eminent in philosophy or
     politics, or poetry or the arts are clearly melancholics, and some to
     them to such an extent as to be affected by diseases caused by
     black bile? ... For many such people have bodily disease as the
     result of this kind of temperament (krasis); some of them have only
     a clear constitutional (phusis) tendency toward such affliction, but
     to put it briefly, all of them are, as has been said before,
melancholics
     by constitution.
     Aristotle's Problematica

     Melancholy was attributed to over production of black bile causing the
individual to become depressed, or anxious. The effect that the black bile
had was dependent upon its temperature. "Cold black bile leads to apoplexy,
numbness, fearfulness, and being disheartened (athumia). Hot black bile
produces 'cheerfulness, bursting into song, and ecstasies, and the eruption
of sores' ... the nature of which depends on the proportions of hot and cold
black bile. Coldness and a moderate amount of bile make men sluggish and
stupid, while excessive quantity and heat lead to euphoric, erotic,
impulsive and garrulous behavior. If hot black bile is too near the seat of
intelligence...the individual is affected by a 'manic' ... state," (Simon
1978).

     A variety of treatments were given to offset the effects of the black
bile, ranging from "ass' milk" to lifestyle changes. The chronicity of
melancholia was realized, for it was noted that, if the treatments were not
initially effective, the individual would live with melancholia for a
lifetime.