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Milestone #6 Where the two worlds meet: a holistic approach to medicine

  • “It is necessary for a physician to know about nature, and be very eager to know, if he is going to perform any of his duties... what man is in relation to what he eats and drinks, and in relation to his habits generally, and what will be the effect of each upon each individual.”
  • Hippocrates, Ancient Medicine, 420-350 BC

It is not too great a leap to connect the philosophy of Anaxagoras with the holistic views that underlie much of Hippocratic medicine. According to some accounts, it was not long after he met with Anaxagoras in the ancient city of Miletus and learned of the philosopher’s theory of matter and infinity that Hippocrates developed his view that human health cannot be separated from the natural surroundings. Whether or not the story is true, it points to a fundamental insight that forms the core of Hippocratic medicine. It can be found in his specific prescriptions for disease, as well as his general theories on medicine and on staying healthy. It points to the importance of the inner world, a person’s own body or “constitution,” and the outer world, the environment. In so doing, it points also to a place where the two worlds meet.

And where do the two worlds meet? From the perspective of patients and the extent to which they have any control over their health, there are at least three places where the internal (their bodies) meets the external (the outside world): food (diet), physical movement (exercise), and air (breathing). Hippocrates frequently emphasizes all of these factors and more in discussing his holistic view of medicine. And of course, regardless of which factor he is discussing, the overall goal of good health is to use these factors to maintain or restore balance.

For example, regarding diet and exercise, Hippocrates advises in Regimen I that physicians must understand not only a patient’s individual constitution, but also the role of diet and exercise in his or her life:

  • “He who is intending to write correctly about human regimen must first acquire knowledge and discernment of the nature of man as a whole...and the power possessed by all the food and drink of our diet... [But] eating alone cannot keep a man healthy if he does not also take exercise. For food and exercise, while possessing opposite qualities, contribute mutually to produce health.”

In other writings, Hippocrates regards diet as indistinguishable from other treatments of the time, including bleeding and drugs. For example, the book Regimen lists the various qualities of different foods, while Ancient Medicine discusses the innumerable “powers” of food.

Hippocrates also writes often about the importance of air and breathing. In Breaths 4, he notes that “All activities of mankind are intermittent, for life is full of changes, but breathing alone is continuous for all mortal creatures as they exhale and inhale.” In another writing, he adds, “It is air that supplies intelligence... For the whole body participates in intelligence in proportion to its participation in air.... When man draws in breath, the air first reaches the brain, and so is dispersed into the rest of the body, having left in the brain its essence and whatever intelligence it possess.”

Although Hippocrates’ theories of the environment would strain the capacity of even twenty-first century technology to verify, the concepts nevertheless have an underlying ring of holistic truth. In addition to explaining that different seasons play a key role in health and disease, he also contends that different regions, warm and cold winds, the properties of water, and even the direction that a city faces are important considerations. In Airs, Waters, and Places, he writes:

  • “When a physician arrives at an unfamiliar city, he should consider its situations relative to the winds and the risings of the sun... He must consider as thoroughly as possible also the nature of the waters, whether the inhabitants drink water that is marshy and soft, or hard from high and rocky ground, or brackish and costive.”

Finally, it’s important to note that despite all we have said of Hippocrates’ rational approach to medicine and denunciation of supernatural forces as a cause of disease, he was no atheist. Whether out of respect for the family tradition of Asklepieion priests or from the same intuition that informed his other philosophies, Hippocrates also believed that a higher power was a necessary precondition for good health.

Thus, while few people today understand the full range of Hippocrates’ contributions to medicine, we should not forget that he is an original proponent of a uniquely holistic approach to medicine. In fact, this holism included what we now think of as both western and eastern medicine, with its acknowledgement of the importance of:

  1. Rationale thinking and natural causes
  2. The individual nature of health and illness
  3. The role of diet, exercise, and environment
  4. The value of ethics and compassion
  5. A respect for a higher power

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