It’s Time to Remember Hippocrates

The Washington Post reported on December 16, 2017, that the government had informed the Centers for Disease Control and Prevention (CDC) to not use 7 words in official documents to be drafted for the 2019 budget, including vulnerable, entitlement, diversity, transgender, fetus, evidence-based, and science-based. The report stated that the suggestion was to use “science in consideration with community standards and wishes” instead of “evidence-based” and “science-based.” ¹ Subsequently, the CDC director denied that there was a ban on any words at the agency. ² An unconfirmed but believable explanation, put forward by some who understand the procedures at the CDC, proposed that the directive not to use certain words was an internal tactical attempt by the agency to minimize budgetary scrutiny of potentially controversial areas of research. The response of the medical community was mixed. ³ Some called the Washington Post report fake news. Many others saw these events as an assault on science and reason in favor of dogma and beliefs.

We ought to believe the CDC director when she said that there was no word ban at the agency. Yet, it would be naïve of anyone even remotely involved with medicine to remain unconcerned about recent events. This, then, is an opportune time to fall back on history and remind ourselves of the fundamentals of our field. It is time to remember Hippocrates—the Father of Medicine from antiquity.

Hippocrates, born on the island of Kos in the Aegean Sea in 5th century BCE, is acknowledged to have established medicine as a science and as a distinct profession. ⁴ This was achieved primarily through the writings of the Hippocratic Corpus and the founding of the Hippocratic School of Medicine. Though Hippocrates is traditionally credited with the 60-odd writings of the Corpus, there has been considerable debate that the work may belong to several authors because of the variability in length, purpose, and style. ⁵

Of the multitudinous contributions of Hippocrates, 4 quotes ascribed to him are remarkably relevant to the present-day United States and the world at large.

The first refers to the fact that medicine is an imperfect science and has limitations, and that the absolute truth is often elusive. It helps us remain humble and not become dogmatic about our science.

Perfectly exact truth is but rarely to be seen. ⁶

The second is particularly endearing to us neurologists, as it talks about the stigma and the misinformation that surround seizures and epilepsy even today.

People think that epilepsy is divine simply because they don’t have any idea what causes epilepsy. But I believe that someday we will understand what causes epilepsy, and at that moment, we will cease to believe that it’s divine. And so it is with everything in the universe. ⁷

The message conveyed here is symbolic of that time in Greece when the intellectual movement had gathered momentum and was led by rationalists. The world’s first nonbeliever—Diagoras of Melos—was a poet and a contemporary of Hippocrates. ⁸ It is unknown if Diagoras ever met Hippocrates or influenced him, but it is obvious that the latter was convinced about the difference between the unknown and the unknowable.

The third is again in reference to epilepsy, which was dubbed the sacred disease then. The message overlaps with the one from the second quote above.

I am about to discuss the disease called “sacred.” It is not, in my opinion, any more divine or more sacred than other diseases, but has a natural cause, and its supposed divine origin is due to men’s inexperience, and to their wonder at its peculiar character. ⁹

The fourth, and the last to be mentioned here, is perhaps the most critical.

There are in fact two things, to know and to believe one knows; to know is science; to believe one knows is ignorance. ¹⁰

Contrary to popular belief, evidenced-based medicine is not a modern-day concept and was popularized 2500 years back by Hippocrates. The above quote should serve as inspiration to continue our present-day approach to science and evidence-based medicine.