400 B.C.: Why was Hippocrates dubbed 'the father of medicine?'

A depiction of Hippocrates writing. 

Hippocrates might possibly be the most important figure in the history of medicine, and our history of asthma and respiratory therapy. His Hippocratic Corpus became the most essential medical document of all time. But, did he work alone, and did he deserve such an honor?

In the ancient world only a few people, called scribes, had the ability to write.  To garnish credibility for a document, the person given credit for writing it was usually a king. The reason for this was that most kings were believed to have the ability to communicate with the all-knowing gods. The document, therefore, contained the wisdom of the gods.  

This changed somewhat in ancient Greece, particularly in Athens. The Greeks liked to give credit for any important works. Still, in many cases, the author was some person who would garnish respect for the document. For instance, a document written by a group of unknown physicians at Cos may not garnish the respect as a document written by Hippocrates, the most famous physician in Greece.  

For this reason, and because many of the writings in the Hippocratic documents are suspected of being written by some hand other than that of Hippocrates, it is believed the Corpus Hippocraticum was a collaborative effort between various physicians of ancient Greece.  However, for posterity purposes, Hippocrates is most often given credit for the medical information it contains. Most medical writers after Hippocrates credit the document to Hippocrates.

Who actually wrote the Corpus Hippocraticum may probably never be known, although most modern experts on the subject would attest to the fact that most of the writings do not appear to be written by one person.  In fact, some experts suspect some were written prior to his birth, some during his lifetime, and some after his death.  So, chances are, he did not write the whole thing.

Max Neuburger, in his 1910 history of medicine, said: 

The wide range of opinion is shown by the fact that the number of "authentic writings (of which the commentator Erotianus at the time of Nero's time recognized thirty one and Galen thirteen) has sunk to two or even to nil, whilst modern criticism admits no more than six." (8, page 122)

So now we must ask: if Hippocrates did not write the whole thing, then who helped him out? Considering most of what we know about Hippocrates was written after his lifetime, we have no choice but to refer to speculation from the various experts on the subject.

In the ancient world there were a variety of diseases that plagued mankind, or that made their way through the cities killing hundreds, if not thousands, of people along its path.  Ancient physicians did not have knowledge of germs, so they simply referred to such epidemics as plagues.

Supposedly, sometime during the life of Hippocrates word got out that there was a plague in nearby city-states, and the people were, perhaps, in an all out panic. The leaders of the city-state must have approached the physician to see if he was privy to wisdom that might stop the plague from reaching the city.

Perhaps based on what he learned from his father, or from his teachings at the school of Cos, or by his travels to the school of Alexandria, he believed that strong winds could bring about disease, Hippocrates came up with an ingenious idea.

Of this, medical historian Edward Meryon wrote in 1861: (1, page 25-26)

Thucydides informs us that he kindled fires to neutralize the infection of a pestilence which broke out on two successive occasions in Attica, when the skill of the physicians could do nothing else to mitigate it."  (1, page 25-26)

Medical historian Thomas Bradford wrote in 1898:

He rendered a great service in stopping a plague which broke out in Athens in the time of Pericles, for which he was given a golden crown and the privilege of Athenian citizenship. (2, page 23)

So maybe such an act of heroism made him worthy of such fame.  

Medical historian Plinio Prioreschi said said in 1995 that there were many medical schools when Hippocrates walked the earth, the two most relevant to our history being the school of Cos and the school of Cnidian, which were near each other (about 20 miles apart) and were competing "in knowledge and effectiveness in curing disease." (3, page 28) 

Prioreschi mentions one theory where each school was stuck in it's own paradigm about diseases and its treatment. The Corpus Hippocraticum was the result of a koinon, or an association between the two schools.  It is thus a Treaties whereby the two schools compromised on how to treat medical conditions.  (3, page 208-209)

Medical historian John Watson wrote in 1855 of Mercuriali, who suggested:

"Not more than fourteen treaties out of the whole collection were published by Hippocrates himself.  Five others... may have been left by him unfinished to be completed either by his son in law and successor, Polybius, by his sons Thessalus and Draco, by his grandson Hippocrates, or by other members of his family." (4, page 49)

Watson also noted the following:

"A third portion, including about 22 treaties, though perhaps not even begun by Hippocrates, is in strict accordance with his doctrines, and is believed by Mercuriali to have emanated from the immediate descendants of Hippocrates or other disciples of the school of Cos.  The remaining portion of the collection, according to the same authority, consists of spurious writings, and as such as contains opinions not in accordance with the doctrines of Hippocrates, though published as his."
(4, page 49)

Another theory is that as many as seven Hippocrates worked on the documents. We know that his grandfather was named Hippocrates. In addition, Neuburger said:

In addition to his two sons Thessalos and Dracos, who also undertook journeys, his son in law Polybos, with Apollonios and Dexipos of Cos, probably also Praxagoras of Cos, ranked as his most famous pupils. It has been shown that Polybos took part in the formation of the Collection and acted as deputy in the school. Amongst the successors, there were five who bore the name of Hippocrates and represented themselves as medical authors. (8, page 125)

Prioreschi said that some parts of the Corpus may even have been written by physicians from the school of Cnidron. He said this may be evident in some of the passages that do not use theory to describe medicine.  He said  physicians of Cnidron tended to be more rational in their approach to medicine, compared to the speculative approach by the Con. (3, page 209-210, 214)

Whether or not parts of the corpus were written by Cnidron physicians may never be known. What is known is that, according to Neuburger:

"...the Hippocratic collection was brought together and edited in the beginning of the third century B.C. by a commission of Alexandrian scholars under order from the book loving Ptolomy. Even at that time doubt existed as to which of the writings could with certainty be ascribed to the great Hippocrates, and hardly one of the books had remained free from alterations and additions." (8, page 121)

So while they had the documents, they had no proof Hippocrates wrote them all. It's possible they attributed it to the great physician named Hippocrates.  However, it is also possible they ascribed the document to Hippocrates because this was a common name among the family of physicians at the School of Cos.

Medical historian Henry E. Sigerist suggested the entire treaties may be credited to Hippocrates because of his hard work, method of teaching, and skillful medical technique. It may have had nothing to do with Hippocrates being the superior physician at all, and mainly because later historians sought to credit someone for such important documents. (2, page 266)

Some historians speculate that Greek medicine had reached a point where a significant figure was needed to lift medicine to the next level, and the man born into, or raised into, this job was Hippocrates II.

It was, thus, his job to free medicine from the "fetters of oriental dogmatism... the leading-strings of the priestly caste... to rational science and moral dignity... (to) transition from the guild of the Asclepiads into the free profession of medicine." (8, pages 128-129)

Sigerist mentions another theory which postulates that Hippocrates was not superior to, but respected equally among his fellow physicians, with Hippocrates being the most senior.  With later Alexandrian physicians viewing these anonymously written medical texts as extremely important, they sought to give someone credit, and Hippocrates seemed the most logical choice.  (5, page 266)

Meryon goes as far to suggest that perhaps Hippocrates himself stole the best ideas of Cnidron. He said:

It has been stated, that having extracted all the information which the records contained in the temple of Cnidros could yield him, he set fire to it, in order that he alone might enjoy a monopoly of knowledge. (1, page 25)

Regarding this, Meryon stated in his notes:

The above calumy is attributed to Andreas, but Tzetstates said that it was the library of Cos, and not that of Cnidos, that was burnt. (1, page 25)

So was Hippocrates so selfish to earn credit for the documents that he was willing to destroy the information used in creating it?  Once again, there is no evidence to support this claim, so it is left to us as just another theory.

Meryon suggests Hippocrates was simply the benefactor of the era he was born into.  He was, after all, the son of a family of physicians who were all taught at the School of Cos.  Meryon said:

Much of the information contained in his writings, and which has been transmitted to us, appears to have been the accumulated knowledge of his immediate ancestors; and it is supposed by competent judges in the matter, that many, if not most, of the numerous treaties which are commonly attributed to him, were simply collected and written by him; for he had the great advantage, which can scarcely be appreciated, since the introduction of printing, of acquiring a thorough knowledge of the observations of his predecessors; and having, moreover, access to all the records and votive tablets in the temple of Cos, he had peculiar facilities to achieve the honour which is universally accorded to him. (1, page 22)

Watson, likewise, credited the era he was born into for his fame. He said:

"He lived in an age of progress, and while other arts and sciences were thus springing into life, and rising at once to maturity, it is not surprising that some man of genius should appear in the ranks of medicine, to give to it's principles from the utterance. This man was Hippocrates." (4, page 47)

So it appears that Hippocrates probably didn't work alone in creating the Hippocratic Corpus.  What will never be known with any certainty is who helped him.  

Another question one might ask is: does Hippocrates deserve credit for the Corpus?  

Considering that the document attributed to Hippocrates became the most significant document in Greek medicine, and that Greek medicine became the key to all medical wisdom, then I think we're fine with giving Hippocrates credit for the whole thing.

Considering how dogmatic people can be when considering new ideas, it must have been many years in the workings to transform medicine from the primitive mindset to the ancient mindset.  The fact that it eventually happened at all can be considered a revolution of sorts.

What matters most is that Hippocrates, or the Hippocratic writers, helped transform medicine away from the primitive world to the ancient world. Or, as Meryon put it, Hippocrates helped transform medicine from a profession of superstition to one of speculation by 'vague hypothesis.'  (6, page 21)

Of this, Watson said: 

"According to Celsus (a physician of the 2nd century), his (Hippocrates) principle credit is removing the teaching of medicine from the schools of philosophy, where it had always received some attention, and treating it as a distinct department of practical knowledge.  Pliny the elder supposes he was the first to institute clinical instruction."  (4, page 46, also see 3 page 42)

Withington said: 

It has been well said that great men illuminate the world by gathering into a focus the rays emanating from itself, and this is well seen in Hippocrates' third great service to medicine -- his rejection of supernatural heroes of disease.  The age was one of transition, and the simple faith in the old mythology was giving way in all direction."  (6, page 50)

Garison said:

Instead of attributing disease to the gods or other fantastic imaginations, like his predecessors, Hippocrates virtually founded that bedside method which was afterword employed with such signal ability by (later physicians).  (7, page 87)

Bradford said:

So great was his influence on medicine that it was no longer called the art of Aesculapius, but the science of Hippocrates." (2, page 23)

Chances are, however, that he did not work alone.  If it were possible to jump into a time machine and travel back to the age of Hippocrates, we'd probably find him, along with many other physicians, writing the passages that would end up in the Corpus.

Regardless, Hippocrates was referred by his contemporaries, including Plato, as "The Great." (6, page 48) He was also referred to as "the Great" when Aristotle walked the earth. The great second century Greco-Roman physician Galen referred to him as "the divine." The rest of history knows him as the father of medicine, and medicine as the "Hippocratic art." (8, page 125)

Max Neurburger, in his 1910 history of medicine, said:

The achievements of Hippocrates' family, of the Coan (Con) school, of many of his predecessors and immediate successors, all these were placed to the credit of the one man, whilst the historic personality was more and more veiled by the nimbus of homage. (8, page 126)

Yet through most accounts of the historians he earned this honor by his hard work and gentle approach. While he may not have written the Corpus, his name made it famous.  Perhaps for that reason alone he is deserving of honor as the father of medicine.

Over time, said Neurburger:

The mysticism of the Asclepiads diminished on the one hand in proportion to the admission of strangers into their fraternity, whereby the preservation of professional secrets were relaxed, on the other through intercourse with physicians (particularly Pythagorean), who had derived a more extended outlook from the schools of philosophy or who by empirical capacity had earned the confidence of the people." (8, page 100)

Neuburger also said that physicians like...

...Pythagoras, Empedocles, and their pupils, who were not without medical knowledge and dexterity, proved that healing was to be found even remote from the Asclepion shrines. Philosophically educated physicians aroused by their speculative and theoretical writings -- and considerable medical literature was in existence long before Hippocrates -- general scientific interest. (8, pages 100-101)

Hippocrates expounded upon this literature, setting up a system of medicine that made medical wisdom available to all who wished to become physicians.

This was all made possible by the physician of Cos, and, more particularly, by the the Hippocratic writers.  Although, through it all, it was made possible by the greatest physicians of all time: Hippocrates.

Legend has it he died in Thesally at the ripe old age of 80 or 85 or 90 or 105, depending on the source of reference.  Perhaps the longevity of his life was due to his mythical legacy; the fact he was essentially deified by later physicians.

References:

1. Meryon, Edward, "The History of Medicine," Volume I, 1861, London, (6)
2. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey (7)
3. Prioreschi, Plinio, "A history of medicine: Primitive and ancient medicine," volume 1, 1995, NE, Horatius Press, (1)
4. Watson, John, "The Medical Profession from the Earliest Times: an anniversary discourse delivered before the New York Academy of Medicine November 7, 1855," 1856, New York, Baker & Godwin (4)
5. Sigerist, Henry, "A History of Medicine," volume 2, 1961, Oxford University Press  (2)
6. Withington, Edward Theodore, "Medical History from the Earliest Times: A Popular History of the Art of Healing," 1894, London, The Scientific Press. (3)
7. Garrison, Fielding Hudson, "An introduction to the history of medicine, 1922, (9)
8. Neuburger, Max, writer, "History of Medicine," 1910, translated by Ernest Playfair, Volume I, London, Oxford University Press

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400: What remedies did Hippocrates prefer?

Hippocrates treating a child. 

Once the diagnosis and prognosis was made, only then was it time for Hippocrates to prescribe the remedy.  
Hippocrates once wrote that he wasn't sure what remedies would provide heat, cold, moist or dry properties, so he preferred to leave this to nature.  This might explain why his most common remedy was to "assist nature" in the healing process with simple remedies such as: (1, page 28)(2, page 90)(3)

• Fresh air  (1, page 28) 
• Good diet: to excite natural heat and discharge it (1, page 28) (3)
• Exercise  (1, page 28)(3)
• Massage  (1, page 28)(4, page 148)
• Cleanliness: Such as soaking in hot or cold water at a bath house (1, page 28)(1, page 90)
• Sweating (by warm bath) (3)
• Acrid drinks: to excite natural heat and discharge it (3)
• Appropriate food or drinks: to aide the humors in their discharge (3)
• Withholding of food, particularly in acute affections (4, page 147)
• Drinking lots of fluid, especially for wounds (4, page 147)
• Bodily works (like sawing wood) (4, page 148
• Reading aloud
• Singing (4, page 148)

Only when these simple remedies failed did he resort to his stash of medicinal remedies, which mainly consisted of sedatives to relax the body and purging to cleanse the body.  (1, page 28)(2, page 90)  

Examples of Hippocratic remedies include (in parenthesis is the expected response of the remedy):  (1, page 27)(2,page 90)

• Hemlock (sedative
• Henbane (sedative)
• The juice of poppy or opium (sedative)
• Mandragora from the family of nightshades (eases breathing, sedative) 
• Hyssop (emetic)
• Black Hellebore (emetic, universal purge)
• White Hellebore (universal emetic)
• Elaterium (laxative)
• Scammony (laxative)
• Spurge (laxative)
• Mercurialis perennis (laxative) 
• Barley water
• Wine (2, pages 90-91)(4, page 147)
• Hydrotherapy (pain) (1, page 27)(2, page 90)
• A decoction of barley for a variety of ailments (4, page 147)
• Unstrained broth
• Honey water
• Sour honey
• Broths from millet, meal and wheat (4, page 147)
• Cooling demulcent drinks (facilitate elimination of the morbid humours) (4, page 148)
• Purgatives (causes a bowel movement to facilitate elimination of morbid humours (4, page 148)
• Emetics (causes vomiting to facilitate elimination of morbid humours) (4, page 148)
• Diruretics (causes urination to assist with incomplete elimination of humours)(4, page 148)
• Diaphoretics (causes sweating to assist with incomplete elimination of humours)(4, page 148)
• Blood letting (assisting incomplete elimination, particularly for inflammation) (4, page 148-149)
• Cupping (rarely) (4, page 148)
• Cauterization (rarely) (4, page 148)
• Scarification (rarely) (4, page 148)

The last four on this list are the invasive remedies.  He rarely resorted to these to treat internal diseases. Although, occasionally, they were necessary. For instance, Neuburger said blood letting (venesection) was sometimes necessary, and was...

...carried out mostly on the arm, foot, popliteal space, tongue, etc., and pushed as far as possible, even to the production of faintness, for, "in the treatment of advanced disease extreme remedies, employed with care, are the best."  Similar but far less efficacy was ascribed to cupping or scarification; the use of leeches was not yet known.  Blood-letting and cauterization were intended for the relief of pain as well as for the derivation of the humours.  (4, page 149)

He resorted to surgery only to treat external diseases, such as cuts, fractures, etc.  This, perhaps, was due to the effort of the Cos, and Hippocrates, to show the gentle side of medicine.

Neuburger said that "Hipocratists were far from establishing the principle of which later was enunciated, of 'Contraria contrariis.'  This meant that opposites were treated with opposites.  Hippocrates would sometimes treat opposites with opposites, and sometimes similar with similar.  An example of treating contraries with contraries would be blood letting to decrease blood in a person with inflammation. 

Remedies for some common respiratory ailments: (4, page 155)

• Pneumonia and Pleurisy:  
• Remedies that could be given immediately:
• Warm lotions,
• Poultices
• Innunctions with oil
• Warm baths
• Diet
• Infusions
• Remedies that couldn't be given until the seventh day:
• Sternutatories to get rid of mucus
• Expectorants to get rid of mucus (fat and salt articles of food, sour wine)
• Injection of fluid into the windpipe to provoke cough 
• Empyema:  
• Cauterizing the back
• Thorococentesis (aspirating a needle into chest to draw out pus)
• Other respiratory ailments, of which the remedies may be same as above:
• Haemoptysis (coughing up blood)
• Hydrothorax (fluid in lungs)
• Erysipelas of lung (cellulitis)
• Phthisis (tuberculosis, consumption) (4, page 155)

Neurburger also said that "disease only comes to an end through removal of its cause."  So the ultimate goal of remedies was not just to treat the symptoms, but to completely cure the malady that plagued the person.  It is for this reason that Hippocratists were concerned with cures more so than remedies.  (4, page 149)

References:

1. Meryon, Edward, "The History of Medicine," Volume I, 1861, London,  (6)
2. Garrison, Fielding Hudson, "An introduction to the history of medicine, 1922, (9)
3. Hippocrates, "The Art of Medicine," Section I, Treaties III, translated by John Redman Coxe, "The writings of Hippocrates and Galen," 1846, Philadelphia, Lindsay and Blakiston (10)
4. Neuburger, Max, writer, "History of Medicine," 1910, translated by Ernest Playfair, Volume I, London, Oxford University Press

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760-370 B.C.: How did Hippocrates determine diagnosis and prognosis?

Statue of Hippocrates

After a thorough examination of his patient and surroundings, Hippocrates was able to come to a diagnosis and prognosis. It was only from this diagnosis and prognosis that he was able to come up with a remedy that would assist nature in re-establishing a balance of the qualities and humors of the body.

The assessment of the patient was very thorough, and was essential to the later diagnosis, prognosis, and treatment.  Of this, medical historian Max Neuburger said:

Eyes and ears, indeed every means, sensory and intellectual, were employed in order to arrive at the opinion based upon experience as to the general condition of the patient. Without neglecting subjective symptomatology, the objective examination from head to foot was undertaken with the care and thoroughness which constitute so salient a feature of Hippocratism. The painfully minute observation and examination served, however, the additional purpose of explaining, by the combined action upon a particular case of external influences and individual peculiarities, those details in the course of an illness which might diverge from the disease-type. Hence the clinical history, as such, constitutes one of the most noteworthy characteristics of Hippocratic, in contrast with the rigid scheme of oriental medicine; the clinical history takes individuality into account. (4, page 144) 

Hippocrates wrote that there were two classes of disease: (1)

1. External
2. Internal (1)

External diseases would have been easy to see, as these were on the external surface of the body, such as inflammation (redness and swelling) of the skin.  By the time of Hippocrates the medical profession had been well acquainted with these types of diseases and how to treat them.

Neuburger said:

External localized affections were most minutely examined by sight and touch from the point of view of position, size, shape, consistence, painfulness, temperature (taken by laying a hand on the chest), colour, etc.  (4, page 144-145)

Internal diseases, on the other hand, were a bit more complicated, as the scars inside the body were less readily seen.  Although, Hippocrates did describe that some internal diseases provided scars that:

...are apparent both to sight and to the touch, by tumours, redness, &c.; and evince themselves by hardness, coldness, moisture, heat, &c.,—and thus enable us to recognise the presence or absence of such or such qualities as may or may not belong to them. There ought to be no mistake as to these,—not that they are easy to be comprehended, but because they are readily discovered, at least by those who are qualified to seek for them, by industry and natural attainments. Our art abounds in resources for visible diseases,—nor are they less abundant for those of a hidden character, or which attack the cavities or bones. (1)

Neuburger said:

internal (invisible) maladies (were examined) by a number of methods both sensory and intellectual... The following had to be noticed: -- age, temperament, mental state (memory, delirium, picking at the bed clothes), facial expression, tongue, voice, attitude in standing or in bed, condition as to nourishment or strength, power of movement, sensibility to pain, behavior during sleep, sensation of hunger or thirst, temperature, abnormal pulsation (was it abnormally strong or weak?), breathing, exhalations, condition of the skin, hair and nails, state of the sense organs, particularly of the eyes, possible abnormalities of the hypochondrium (enlargement of liver or spleen), abdominal swellings, possible tumours, abscesses, amount, color, consistence, smell, taste of blood and excretions, exceptional symptoms, such as gnashing the teeth, yawning, hiccough, sneezing, epistaxis, flatulence, itching, shivering, twitching, etc. (4, page 144-145)

There were certainly internal diseases that did not readily show their scars, such as hypochondria, hysteria, epilepsy and asthma.  Even upon the rare inspection, no scars were found on asthmatic lungs.  For this reason, Hippocrates created theories to help him understand these diseases.

After his thorough assessment he would make a diagnosis based on his education and experience.

Of diagnosing, Hippocrates wrote:

The possibility of this depends very much, nevertheless, on the accuracy of the report by the patient of his complaint, and the tact of the physician in his interrogatories. Sometimes this seems to be attained as by intuition, although more time and labour are required than in the case of external diseases. (1)

This was the basis of Hippocratic medicine. Asthma was more likely described by vague symptoms, such as shortness of breath.  Catarrh was another vague symptoms, which designated inflammation, or an accumulation of phlegm (fluid) from the brain.  Pleurisy was pain caused by inflammation of the pleura due to a swollen lung rubbing up against it.  Catarrh might have been your common cold, which may occur as inflammation of the nose or lungs. Hydropsy would have been fluid in the lungs. (5, pages 154-155)

A more specific diagnosis of lung diseases might be empyema (pus in lungs or pleura), pleuritis (inflammation on one side of lung), peripneumonia (inflammation on both sides of lung), phthsis (tuberculosis, consumption) or tumours. (5, pages 154-155)

All of these symptoms or diseases would be caused by an accumulation of phlegm from the brain to the lungs. Tumors, however, were caused by by an accumulation of blood or salt phlegm. (5, page 155)

Meryon said that upon assessing his patient, by observing his symptoms and his surroundings, he came to a prognosis, and this determined the cause and then the cure. Thus, determining the prognosis was the key to Hippocratic medicine.

Of this, Neuburger said:

The method of arriving at a prognosis is an inductive one, taking its starting-point from the clinical history, the importance of which is to be estimated by former individual experience and external evidence, taking into consideration the age, sex, habits of life and residence of the patient, the climate and epidemic conditions. (4, page 143)

Hippocrates said that each disease had "different symptoms... through which the physician becomes enabled to estimate the treatment he ought to pursue." (1)

For instance, if the physician observed a recent change in weather from hot to cold, and the patient presented with sneezes, inflamed nasal passages, runny nose, and maybe shortness of breath, he may be diagnosed with catarrh, or a cold in the head, or asthma.  Regardless, it was caused because the patient was exposed "to the kind of humour (phlegm) coming from the brain."   (2)

Palsy and epilepsy were also caused by too much phlegm, only in this case it was contained in the head.  The cause was the same as for catarrh, a cold, and asthma, and therefore the cure for all these ailments was the same.  (2)

Since he believed nature worked to maintain, or re-establish, a balance of the qualities and humors within a patient, his cure was therefore meant to assist nature. His most common remedies were the same for all diseases, and included a bath, sleep, diet, and exercise. Yet as the disease became stubborn to these simple remedies he resorted to more complex remedies such as purging or bleeding.

So he assessed the constitution of the patient, he assessed the surroundings of the patient, which included an assessment of the weather, of the city he lived in, and of the diseases that were prevalent for that city.  All of these would have bearing on his diagnosis. (2)

Once the diagnosis was made, the cause was known, and the cure was likewise known.

Hippocrates said:

It is then by no means surprising, that the physician should be slow in forming his judgment of diseases, before he undertakes their cure; since he has, as it were, to negotiate with them, by the agency of an interpreter. It appears, then, from all I have said, that medicine has an appropriate means of discovering the mode of cure, or at least of assuaging the sufferings of disease. (1)

Garrison said prognosis was based on one of the four categories of diseases that were created by Hippocrates: (3, page 90)

• Acute (it's happening now)
• Chronic (it's always present)
• Endemic (found among certain people)
• Epidemic (rapidly spreading) (3, page 90)

These, too, would have a bearing on the cure prescribed.

References:

1. Hippocrates, "The Art of Medicine," Section I, Treaties III, translated by John Redman Coxe, "The writings of Hippocrates and Galen," 1846, Philadelphia, Lindsay and Blakiston (10)
2. Hippocrates, On Airs, Waters, and Localities, Section III, translated by John Redman Coxe, "The writings of Hippocrates and Galen," 1846, Philadelphia, Lindsay and Blakiston (11)
3. Garrison, Fielding Hudson, "An introduction to the history of medicine, 1922, (9)
4. Neuburger, Max, writer, "History of Medicine," 1910, translated by Ernest Playfair, Volume I, London, Oxford University Press

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400 B.C.: How did Hippocrates assess his patients

Hippocrates examining a child, a painting by Robert Thom, 1950's.

Hippocrates became the most famous physicians of ancient Greece during the Age of Pericles by his skill and gentle approach as a physician. His approach to medicine was highly regarded not just by his patients, but by his peers. By his example, and through his writings, he would almost single handily improve the image of medicine.

In order to help future physicians develop the skills and technique needed to become a respected physician, and to create a good image of the profession, he compiled all the medical wisdom from the school of Cos into a series of 60 medical treaties called The Hippocratic Corpus.  

Most historians now believe that he did not write all of the Corpus by himself, although most would agree that he was, for whatever reason, the most significant and respected physician of his era, and for this reason his name is attributed to the treaties.  It would go on to become the cornerstone of Greek medicine, and all of medicine for the next 2,000 plus years.  

In this way, Hippocrates became the most famous physicians of his era and all time.  Not only was he referred to as "The Great Physician" during his time by the philosopher Plato, but he is referred to by most historians as "The Father of Medicine." 

By resorting to simple or natural remedies first, Hippocrates, like other physicians at the school of Cos, preferred the medical philosophy of looking out for the best interest of the patient, and to avoid risky treatment.  Such may be evident by the motto "first do no harm."

When Hippocrates was called to help a patient, he would pack his bags and travel to the patient's home.  As he was taught by his predecessors at the school of Cos, he would consider the patient as a whole.  As noted by 18th century physicians Bernardino Ramazzini, Hippocrates encouraged the following: 

'When you come to a patient's house, you should ask him what sort of pain he has, what caused them, how many days he has been ill, whether the bowels are working and what sort of food he eats.' (1, page 15)

Of the assessment of the patient, Garrison said:

Hippocrates instituted, for the first time, a careful, systemic, and thorough-going examination of the patient's condition, including the facial appearance, pulse, temperature, respiration, excreta, sputum, localized pains, and movements of the body. (2, page 89-90) 

Medical historian Max Neuburger said the following were also assessed:

Odour of the sweat, of the sputum, of the vomit, the urine, the faeces, of the discharge from wounds; the taste of skin secretions, of wax from the ear, of nasal mucus, of the tears and sputum (sweet or the contrary) and of diverse other body fluids had to be investigated, partly by the physician, partly by the patient himself.  (5, page 145)

The color, consistency, and smell of phlegm was also assessed.  The assessment was useful in helping the physician come up with a diagnosis and prognosis, which would help determine if the patient was curable.  If the patient was curable, the prognosis was used to determine the eventual remedy or cure. 

For instance, as noted by Neuburger:

Yellow sputum, mixed with a little blood, occurring at the beginning of the illness in a patient suffering from inflammation of the lungs is a sign that he will recover, and is beneficial, occurring for the first time about the seventh day it is a somewhat surer sign.  (5, page 145)

Hippocrates himself wrote the following of his assessment:

Thus, it considers the voice, as to its clearness or hoarseness. It examines the discharges from certain regular channels; and drawing consequences from their odour, colour, consistence or fluidity,—he judges of the character of the disorders, and the existing state of the patient; and by the same means, medicine is even enabled, not only to ascertain the past, but likewise his future state. After having thus become acquainted with diseases, by their symptoms, if nature is unable to effect a cure, art then teaches how to excite those salutary movements, by which, without danger, the system may discharge itself of what is injurious to it. (3)

Regarding the movements of the body, Hippocrates was known to listen to a patient's heart and lung sounds by placing his ear upon his patient's chest, although if he wanted a more thorough examination of the humours inside the patient's chest, he would shake the patient, gently perhaps. This allowed him to hear secretions, if they were present, in the patient's chest.  (2, page 90)(5, page 146)

The procedure was called succussion, and was mainly used to recognize the presence of pus in the lungs to diagnose the presence of an empyema (pus in the pleural cavity, or the cavity surrounding the lungs. In fact, if a physician performed the procedure and failed to diagnose empyema when it was present, this was considered a "sign of lack of surgical dexterity," said Neuburger. (5, page 157)

According to Neuburger:

This shaking was supposed to effect the outflow of pus from the parenchyma of the lung by way of the bronchi... Recognition during this process of the splashing sound which occasionally occurred (in pyo- and hydropneumothorax, but also in bronchiectasis and cavities) resulted in the employment of succussion (known now as Hippocratic succussion) as a diagnostic method in order to determine whether and where pus were situated in the pleural cavity, also the most suitable spot for incision in thoracocentesis (a procedure involveing placing a needle into the chest and drawing up the excessive pus in the pleural space, or the cavity surrounding the lungs). (5, page 146)

Neuburger said succussion, "If it, and the pouring of fluid into the throat to excite coughing and expulsion of the pus, fail, then the operation of thoracocentesis is called for." (5, page 146)

Sounds other that the rare secretions heard upon succussion were also listened for by auscultation.  Some conditions caused a rattling sound in the trachea.  Diseases such as pneumothorax might cause crepitations, which is air bubbles under the surface of the skin, particularly on the upper chest area.  Pleuritic frictions, or what is now called a pleural rub, was also listened for.  This might indicate a collapsed lung (pneumothorax) or other such malady.

Certain noises in the chest may indicate hydrops of the lungs, or what would now be considered pulmonary edema caused by heart failure, kidney failure, or sometimes pneumonia.  Hydrops is an old term for water in the lungs.  Of this, Neuburger wrote:

Of the diagnosis of "Hydrops of the lung" it is stated: "When the ear is held to the side and one listens for some time, it may be heard to seethe inside like vinegar."  A pleuritic friction is well described... "A grinding may be heard which sounds as if it came from two leather straps." (5, page 147)

The Hippocratic concept also took into consideration the desires of the patient. As noted by Withington:

The wishes, and even the whims of the patient are to be indulged as far as possible, and a physician should rather lose his fee than trouble a sick person about it, for the memory of a good deed is better than a temporary advantage. He should also neglect no opportunity of serving the poor and the stranger, for "where the love of the art is, there is the love of man. "  This last quotation, indeed, is from a work of very doubtful authorship, but it expresses the spirit, if not the words of Hippocrates. (4, page 51)

Hippocrates paid attention to the prognosis more so than the diagnosis. Neuburger said this was so "that the preservation of the organism be his goal." (5, page 147)

He said Hippocrates was well aware of the "limitations and of the potentialities of his art."

And he made sure he "occupied himself only with those diseases in which a cure might be anticipated and approached the sick-bed inspired by the principle: 'Do good, or at least do no harm.'" (5, page 147)

He spared no effort to ease the mind of the suffering, even when he knew there was no chance that his remedies would cure the patient's disease.

References:

1. Ramazzini, Bernardino, writer, "Disease of Workers," Wilmer Cave Wright, translator, 1964, New York, Hafner,  (8)
2. Garrison, Fielding Hudson, "An introduction to the history of medicine, 1922, (9)
3. Hippocrates, "The Art of Medicine," Section I, Treaties III, translated by John Redman Coxe, "The writings of Hippocrates and Galen," 1846, Philadelphia, Lindsay and Blakiston (10)
4. Withington, Edward Theodore, "Medical History from the Earliest Times: A Popular History of the Art of Healing," 1894, London, The Scientific Press.  (3)
5. Neuburger, Max, writer, "History of Medicine," 1910, translated by Ernest Playfair, Volume 1, London, Oxford University Press

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400 B.C.: The Hippocratic Oath

Wall plaque of Hippocratic Oath

What good is a physician who cannot be trusted.  If you were wounded in battle and had access to a physician, then you could get a soothing salve to allay your pain and speed your recovery.  Yet amid rumors your doctor took a bribe to poison a friend of yours, you wonder if you should avoid your doctor at all costs.

It was such poor ethics among the medical community around 400 B.C. that enticed the writers of the Corpus Hippocraticum to write an oath.  The goal was to improve ethics among physicians, and increase respect for the profession among the peoples.  The original oath was as follows:

I swear by Apollo the Physician and Asclepius and Hygieia and Panaceia and all the gods, and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art – if they desire to learn it – without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken the oath according to medical law, but to no one else.

I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep myself holding such things shameful to be spoken about.

If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honoured with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

Like many ancient oaths it begins with an acknowledgement of the gods. Considering Apollo, Asclepius, Hygieia and Panaceia were the gods of health and healing, it's only fitting they were the gods noted.  Every person seeking good health would worship and make sacrifices to one of these gods.

This oath appears in the Corpus Hippocraticum, and is generally attributed to Hippocrates or one of his students.  Although, some historians place it's origin after the death of Hippocrates, and it's these historians who think it was written by some other physician and later added to the Corpus. Although the true origin may never be known.

Dr. Ron Paul, in his 2011 book "Liberty Defined," said the oath became so famous that one version of it or another was cited by all medical students until the 1960s. He said this was when the issue of physicians performing abortions was raised.   Rather than face the issue, medical schools stopped requiring graduating students from citing the pledge.

Today, however, a modified version is optional.

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

I will respect the hard-won 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 over treatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh 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 to 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 frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous 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, be 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.

The integrity of the medical profession has grown exponentially since the time of the Hippocratic writings, in part due to the ethical standards set forth by this oath. Some of the most respected people in any community are your doctors.

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1700 B.C.: Hebrew health and healing

Each Hebrew village had a physician who specialized in medicine and a surgery.  Some specialized in internal medicine, some external medicine, and others both.  (3, page 28-29) Permission to practice medicine had to be obtained by the magistrates where the physician wished to settle.  If you were sick (perhaps with asthma) you had the option of seeking out this physician to heal you.

This physician, however, also must obtain permission from the Beth-din, which was the council of the town. Did the doctor have to pass a test? Was he interviewed? What questions were asked? Did he otherwise have to prove his competency? The answers to these questions remain a mystery, explains Robley Dunglison in his 1872 history of medicine. (4, page 31-32)

Jewish physicians were knowledgeable of the basics of anatomy, although their knowledge was quite primitive, as it was for most ancient societies.  They did not understand the concept of internal diseases, nor the link between anatomy and disease.  However, as noted by Garrison, they did have a basic understanding of the most common diseases that left visible signs, such as leprosy, syphilis, phthisis, scabies, anthrax, epilepsy, and the various plagues (such as the plague of Ball Peor (numbers 25: 9) in which 24,000 perished. (7, page 59)

The best remedy was the one preached by Moses: good hygiene.  This included bathing, hand washing, sexual restraint, etc. Although, if someone did get sick, the remedies were simple.  For instance, the remedy for leprosy was washing in the Jordan, or "dipping seven times in the Jordan. (2 Kings 5: 14)" (7, page 59-60)

These physicians were educated in "sanitary administration and jurisprudence," says Puschmann.  Along with good hygiene, they were also required to do other things to prevent disease, which included circumcision.  (3, page 28-29)  While modern experts think they have disproved this theory, ancient people believed uncircumcised penises were more likely to become infected.  This was how circumcision made its way into the Bible.

Physicians were also, as noted by Garrison, required to isolate people with infectious disease such as leprosy, syphilis, gonorrhea and leukorrhea, as noted in Leviticus 12-15. (7, page 60)  This was another significant measure of preventing healthy people from getting these diseases.  It must also have been observed that many diseases were spread through sexual contact, and so sexual abstinence prior to marriage was encouraged, and loyalty to one man or one woman was also encouraged.

Puschmann notes that when a person was sick he called upon his physician, who paid the sick a visit. Then the physician was paid by the sick or his family, and not by a collective tax. (3, page 28-29) Although, "Jewish medicine was almost exclusively a medicine of the state, not a private profession," writes Thomas Bradford in his 1898 book "Quiz questions on the history of medicine." (9, page 9)(5, page 31)

The neat thing about ancient people such as Egyptians, Greeks, Romans, and Hebrews, is you didn't have to be a physicians to be an expert in medicine, says Puschman. He explains this was because medicine was included in the list of knowledge  taught at schools.  It would be like going to college today for Journalism, and having to take classes in math, English and Business.  So many of the people mentioned in the Bible, particularly prophets such as Solomon, Elijah, Elisha and Ahijah, had medical wisdom, and this wisdom allowed them to "become famous for their successful cures."  (3, page 29)

Baas says King Solomon (who reigned 1020-980 B.C.) was a prophet who had the ability to cure, (2, page 32) and Bradford said of Solomon that "tradition attributes to him a medical work which taught how to cure diseases by natural means. Arabian authorities assert that he left a history of plants and animals, and a number of other works." (9, page 8)

There are various, and random, references to the healing powers of the prophets in the Bible.  Elisha, who lived in the 9th century B.C., healed the water that causes miscarriages:

Some men from Jericho went to Elisha and  said, "As you know, sir, this is a fine city, but the water is bad and causes miscarriages." Elisha said, "Put some salt in a bowl and bring it to me." They brought it to him, and he went to the spring, threw in the salt in the water, and said, "This is what the Lord says: 'I make this water pure, and it will not cause any more  deaths or miscarriages.'" And that water has been pure ever since, just as Elisha said it would be. (Kings 2: 19-22)

Elisha also resurrected a Shunammite's son:

When Elisha arrived, he went alone into the room and saw the boy lying dead on the bed.  He closed the door and prayed to the Lord.  Then he lay down on the boy, placing his mouth, eyes, and hands on the boy's mouth, eyes, and hands.  As he lay stretched out over the boy, the boy's body started to get warm.  Elisha got up, walked around the room, and then went back and again stretched himself over the boy.  the boy sneezed seven times and then opened his eyes.  Elisha called Gehazi and told him to call the boy's mother.  When she came in, he said to her, "Here's your son." She fell at Elisha's feet, with her face touching the ground; then she took her son and left." (Kings 4: 32-37) 

He also healed Naaman:

"Naaman was commander of the army of the king of Aram.  He was a great man in sight of his master and highly regarded.  because through him the Lord had given victory to Aram. He was a valiant soldier, but he had leprosy. Now bands of raiders from Aram had gone out and had taken captive a young girl from Israel, and she served Naaman’s wife.  She said to her mistress, 'If only my master would see the prophet who is in Samaria! He would cure him of his leprosy.'” (2Kings 5:1-2)

Naaman's master allowed him to see the king of Aram, who allowed Naaman to see the king of Israel for permission, although the king of Israel " tore his robes and said, “Am I God? Can I kill and bring back to life? Why does this fellow send someone to me to be cured of his leprosy? See how he is trying to pick a quarrel with me!”

The next passages says that:

When Elisha the man of God heard that the king of Israel had torn his robes, he sent him this message: “Why have you torn your robes? Have the man come to me and he will know that there is a prophet. So Naaman went with his horses and chariots and stopped at the door of Elisha’s house. Elisha sent a messenger to say to him, “Go, wash yourself seven times in the Jordan, and your flesh will be restored and you will be cleansed.”   

But Naaman went away angry and said,

“I thought that he would surely come out to me and stand and call on the name of the Lord his God, wave his hand over the spot and cure me of my leprosy. Are not Abana and Pharpar, the rivers of Damascus, better than all the waters of Israel? Couldn’t I wash in them and be cleansed?” So he turned and went off in a rage. Naaman’s servants went to him and said, “My father, if the prophet had told you to do some great thing, would you not have done it? How much more, then, when he tells you, ‘Wash and be cleansed’!”So he went down and dipped himself in the Jordan seven times, as the man of God had told him, and his flesh was restored and became clean like that of a young boy. (2Kings 5:9-15)

To finish this neat story, Naaman offered payment, or at least to be a servant to the prophet, but Elisha would not take payment, saying, "go in peace."  Gehazi, the servant of Elisha, was upset that Elisha didn't take payment, and so he did so himself.  Elisha punished Gehazi:

But Elisha said to him, “Was not my spirit with you when the man got down from his chariot to meet you? Is this the time to take money or to accept clothes—or olive groves and vineyards, or flocks and herds, or male and female slaves? Naaman’s leprosy will cling to you and to your descendants forever.” Then Gehazi went from Elisha’s presence and his skin was leprous—it had become as white as snow. (2Kings 5: 27-28)

In another Biblical story, King Asa (10th century B.C.) was king of Judah, and he was among the first kings to be faithful to the worship of God.  In fact, even his name, Asa, means physician.  He opposed idolatry and all immoral behavior.  Yet despite his faithfulness, when he was struck with disease at the end of his life, he consulted physicians instead of the Lord (2Chronicles 16: 12-14)

"In the thirty-ninth year of his reign Asa was diseased in his feet, and his disease became severe; yet even in his disease he did not seek The Lord, but sought help from physicians. And Asa slept with his fathers, dying in the forty-first year of his reign. They buried him in the tomb which he had hewn out for himself in the city of David. They laid him on a bier which had been filled with various kinds of spices prepared by the perfumer's art; and they made a very great fire in his honor." (2Chronicles 16: 12-14

King Jeroboam, who died in 910 B.C., prayed to an old prophet for healing:

The prophet prayed to the Lord, and the king's arm was healed. (Kings I 13: 7) 

The prophet Elijah, who lived around 869-850 B.C., healed a widow's son:

"Give the boy to me," Elijah said.  He took the boy from her arms, carried him upstairs to the room where he was staying, and laid him on the bed.  Then he prayed aloud, "O Lord my god, why have you done such a terrible thing to this widow?  She has been kind enough to take care of me, and now you kill her son!" Then Elijah stretched himself out on the boy three times and prayed, "O Lord my god, restore this child's life!" The Lord answered Elijah's prayer; the child started breathing again and revived. (Kings I 17: 19-22)

Isaiah cured king Heekiah's illness:

Isaiah left the king, but before he had passed through the central courtyard of the palace the Lord told him to go back to Hezekiah, ruler of the Lord's people, and say to him, "I, the Lord, the god of your ancestor David, have heard your prayer and seen your tears.  I will heal you, and in three days you will go to the temple.  I will let you live fifteen years longer.  I will rescue you and this city Jerusalem from the emperor of Assyria.  I will defend this city, for the sake of my own honor and because of the promise I made to my servant David." (Kings II 20: 4-6)

There are many more references to health and healing in the Bible, from Adam all the way to Jesus. Consider the following:

•  “If you will diligently listen to the voice of the your God, and do that which is right in his eyes, and give ear to his commandments and keep all his statutes, I will put none of the diseases on you that I put on the Egyptians, for I am the healer.” (Peter 2:24)
• Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer of faith will save the one who is sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven. Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working. (James 5:14-16
• And he called to him his twelve disciples and gave them authority over unclean spirits, to cast them out, and to heal every disease and every affliction. (Matthew 10:1)
• And he went throughout all Galilee, teaching in their synagogues and proclaiming the gospel of the kingdom and healing every disease and every affliction among the people. (Matthew 4:23)
• “But he was pierced for our transgressions, he was crushed for our iniquities; the punishment that brought us peace was upon him, and by his wounds we are healed."  (Isaiah 53:5, and 1Peter 2:24)

Most of these passage are not necessarily about medical healing, but spiritual healing.  Basically, by learning from the sins of others, we can be healed.  By not doing the evil things other people have done, the things that make you spiritually or physically sick, you will stay healthy, or be healed.

So the Bible, while not a medical texts, provides us with some vague information of medical wisdom from around 1500 to 1700 years before the birth of Christ. Most diseases at this time were best left to nature (4, page 30), as the remedies provided (bleeding, purging, emetics) often made the patient feel worse, and sometimes caused death.  The Bible offered a hope and a prayer, perhaps the best remedy of all.

Reference:  See "1700 B.C.: Hebrew Bible influences medicine"

1700 B.C.: Hebrew Bible influences medicine

The Bible only has a few vague descriptions of diseases, and none of these vagaries refer to respiratory diseases such as asthma.  However, the Bible does show what life was like for asthmatics in ancient Egypt, Mesopotamia, and the Jewish (Israelite, Hebrew) Community.

The Bible was probably written in the 1000 years that preceded the birth of Christ (10, page 511), although the information obtained in it goes back much farther.  Some experts estimate the Biblical date for the beginning of time as 4004 B.C.  

Now, before we delve into a discussion on the Biblical impact on history, we must first understand the Bible and the people who wrote it. You see, the style of writing at this time was pithy and allegorical, and they told truths about God, not so much about history.  For this reason, Biblical stories may allude to true events, and allude to scientific and medical achievements, yet not provide any detail to help historians paint a detailed picture.

The key to understanding the Bible is to understand the difference between truth and fact.  Simply put, something can be truthful without being factual.  For example, if you are trying to download a large file onto your computer and it is taking a long time, you might say that it is "taking a million years." You would be speaking the truth: the file is taking a long time to download.  Figurative language such as this communicates truth without relying totally on facts.

A good example from the Bible is the Bible saying that Adam lived 930 years.  Here again you have to consider the era in which the Bible was written.  People back then never even considered the idea of keeping track of a person's time in this world.  When the Bible says that Adam lived to be 930 years old, it is teaching the religious truth that he lived a long life, which is a sign of God's blessing.

Likewise, since the authors of the Bible, particularly the Old Testament, were recording stories that had previously been relayed by word of mouth from generation to generation, probably through prose, and probably around nighttime campfires, such stories are pithy.  They had to be pithy, because long stories would never be remembered in the days prior to writing.

So this is another cause of confusion regarding events recorded in the Bible.  Adam, for example, lived many years before his story was written, so there is no way of knowing exactly how long he lived.  Likewise, no one knows how long creation took, so the Bible makes it easy by summing these events into seven days

Okay, so that said, now we can get on with our history lesson.

Hebrew history is interesting because the people were nomads, meaning they had no home, or at least they were in search of a home.  Where they came from and why they left remains a mystery, and this is true of many of the societies that made their way to Egypt and Mesopotamia.

Because the Hebrews were nomads,  they lived among, and therefore were influenced, by the various cultures they came into contact with.  Among these cultures were those present in and around ancient Mesopotamia and Egypt.

The Babylonians believed that all disease was punishment from the gods, and some speculate this is why the Jews/ Hebrews likewise believed that their God, the only God, was responsible for causing all diseases and healing all diseases.  Through priests, who acted as mediators, the Hebrew God healed, or he allowed the prophets to heal.  (5, page 28)

The Hebrew were held captive in Egypt for several centuries prior to the exodus around 1550 B.C., and they were also held captive in Babylon around 604 B.C.  So there are various references to both the Mesopotamian and Egyptians medical beliefs, providing evidence that the early Jews were influenced by both.

Fielding Hudson Garrison, in his 1922 history of medicine, explains that:

In the Old Testament, disease is an expression of the wrath of God, to be removed only by moral reform, prayers and sacrifice; and it is God who confers both health and disease: 'I will put none of these diseases upon thee, which I have brought upon the Egyptians: for I am the Lord that healeth thee.' (7, page 57)(Exodus 15:26)

After God gave Moses the laws, the Lord said, "If you will obey me completely by doing what I consider right, and by keeping my commands, I will not punish you with any of the diseases that I brought on the Egyptians.  I am the Lord, the one who heals you." (Exodus 15: 26)

The Bible also refers to the Babylonian method of diagnosing through hepatoscopy, or inspecting the liver of sacrificial animals.  It is by this means they diagnose through divination or omens:

"For the king of Babylon stood at the Paring of the ways, at the head of the two ways to use divination:  he made his arrows bright, he consulted with images, he looked in the liver." (Ezekiel 21:21)

There are many references to God's ability to cause sickness and to heal, such as is mentioned by Job:

"God bandages the wounds he makes; his hands hurt you, and his hands heal you." (Job 5: 18) 

Abraham, who was labeled as "Father of Israel" by Israel's God, and who set the Israelites off on a quest for the land of Canaan, the promised land, mentions it sometime around the 2nd century B.C.:

Because of what had happened to Sarah, Abraham's wife, the Lord had made it impossible for any woman in Abimelech's palace to have children.  So Abraham prayed for Abimelech, and God healed his wife and his slave girls, so that they could have children. (Genesis: 20:17)

The prophet Jeremiah, who lived in the later part of the 7th century B.C., mentions it:

"But I will heal this city and its people and restore them to health.  I will show them abundant peace and security.  I will make Judah and Israel prosperous, and I will rebuilt them as they were before.  I will purify them from the sins that they have committed against me, and I will forgive their sins and their rebellion.  Jerusalem will be a source of joy, honor, and pride to me; and every nation in the world will fear and tremble when they hear about the good things that I do for the people of Jerusalem and about the prosperity that I bring to the city." (Jeremiah 33: 6)

"I will make you well again; I will heal your wounds." (Jeremiah 30:17 

Moses, who lived around 1550 B.C., mentions it as he calls for the Lord to heal his wife Miriam:

So Moses cried out to the Lord, "O God, heal her!"  (Numbers 12:13) 

Isaiah, who lived in the 8th century B.C., believed that not only was Assyria a great threat to Judah, but so too was the sin of the people.  In the Book of Isaiah, the Lord said of the Israelites:

"I have seen how they acted, but I will heal them. I will lead them and help them, and I will comfort those who mourn. I offer peace to all, both near and far! I will heal my people. But evil men are like the restless sea, whose waves never stop rolling in, bringing filth and muck. There is no safety for sinners," says the Lord. (Isaiah 57:18-21)

The prophet Hosea, who lived sometime before the fall of Samaria in 721 B.C., mentions it:

The people say, "let's return to the Lord!  He has hurt us, but he will be sure to heal us; he has wounded us, but he will bandage our wounds, won't he? In two or three days he will revive us, and we will live in his presence.  Let us try to know the Lord.  He will come to us as surely as the day dawns , as surely as the spring rains fall upon the earth." ( Hosea 6:1-3)

According to Garrison, priests were hygiene police, meaning that they made sure the people of Israel washed and purified their bodies in order to prevent the spread of disease.  Yet the priests, he says, did not act as physicians.  Instead, this task was left to the physician.  (7, page 57)

In the Bible, the various references to magi, or physicians, or high priests, are usually in reference to Egyptian or Babylonian healers  So there was definitely a crossover of the beliefs of the various ancient societies.

The Bible has perhaps the first recorded evidence that physicians existed in Egypt about 1,700  years before the birth of Christ.  When Jacob died, "Joseph commanded his servants, the physicians, to embalm him; and the physicians embalmed Israel, and forty days were fulfilled for him, for so are fulfilled the days of those that are embalmed." (1, page 26)(10, page 17)(7, page 57)(Genesis 50: 2)

Garrison explains that "the king Asa consulted physicians instead of the Lord and 'slept with his fathers' for his pains (II Chronicles 16: 12-13), or that if two men fight and one of them be injured to the extent of having to keep his bed, she or her 'shall pay for the loss of his time, and shall cause him to be thoroughly healed.(Exodus 21:19)" (7, page 57-58)

While the Bible makes no mention of asthma nor asthma remedies, it does make (perhaps) the first reference to a narcotic: (9, page 9)

During wheat harvest, Reuben went out into the fields and found some mandrake plants, which he brought to his mother Leah. Rachel said to Leah, “Please give me some of your son’s mandrakes.”  But she said to her, “Wasn’t it enough that you took away my husband? Will you take my son’s mandrakes too?” (Genesis 30: 14-15)

Mandrakes are a member of the nightshade family (solanaceae) of plants that, when ingested or inhaled, can make breathing easier and cause a hallucinogenic effect, easing pain and suffering.  The sonanaceae family of plants will play a significant role later in our asthma history, although it's doubtful (although possible) this was used as a remedy for dyspnea in the Biblical age.

Further reading:

• 5000-50 B.C.: Asthma in Ancient Egypt, and Physicians
• 5000-50 B.C.: Asthma in Ancient Egypt, and Eber Papyri 
• 2700 B.C.: Imhotep invents rational medicine

References:

1. Renouard, Pierce Victor, "History of Medicine: From it's origin to the 19th century," 1856, Cincinnati, Moore, Wistach, Keys and Co., page 26, chapter 1, "Medicine of the Antique Nation."
2. "Moses," Catholic Encyclopedia, http://www.newadvent.org/cathen/10596a.htm, accessed 3/21/13
3. Puschmann, Theodor, translated by Evan H. Hare, "A history of medical education from the most remote to the most recdent times," 1891, London, H.K. Lewis
4. Dunglison, Robley, author, Richard James Dunglison, editor,  "History of Medicine from the earliest ages to the commencement of the nineteenth century," 1872, Philadelphia, Lindsay and Blakiston
5. Baas, John Herman, "Outlines in the history of medicine and the medical profession," translated by H.F. Handerson, 1889, New York, J.H. Vail and Co.
6. Wilder, Alexander, "History of Medicine: a brief outline of medical history and sects of physicians, from the earliest historic period; with an extended account of the new schools of the healing art in the nineteenth century, and especially a history of the american Eclectic practice of medicine, never before published," 1901, Maine, New England Eclectic Publishing, Co.
7. Garrison, Fielding Hudson, "An introduction to the history of medicine, with medical chronology, suggestions for study, and bibliographic data," 3rd edition, 1922, Philadelphia and London, W.B. Saunders Company
8. "The Assiatic Journal, for British adn foreign India, China and Australia," volume VIII, New Series, May-August, 1832, London, Parbury, Allen and Co.
9. Bradford, Thomas Lindsley, "Quiz questions on the history of medicine: from the lectures of Thomas Lindsley Bradford," edited by Robert Ray Roth, 1898, Philadelphia, John Joseph McVey
10. Prioreschi, Plinio, "A history of medicine: Primitive and ancient medicine," volume I, 1991, New York, The Edwin Mellen Press