The Hippocratic Oath for Hypocrites

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The Hippocratic Oath is an oath historically taken by doctors swearing to practice medicine ethically.  The Greek physician, Hippocrates, from the 5th Century B.C., is the author.  Adopted about 26 centuries ago it withstood the test of time for nearly 2,500 years before changes in 1948 and 1964, the last 67 years, effectively destroyed the original intent.

From the website Greek Medicine.net we learn the following.

HIPPOCRATES

Father of Medicine

Medical historians generally look to Hippocrates as the founder of medicine as a rational science.  It was Hippocrates who finally freed medicine from the shackles of magic, superstition, and the supernatural.  Hippocrates collected data and conducted experiments to show that disease was a natural process and that the signs and symptoms of a disease resulted from the natural reactions of the body to the disease process.  He also believed that the chief role of the physician was to aid the natural resistance of the body to overcome the metabolic imbalance and restore health and harmony to the organism.

Hippocrates was born on the island of Cos, off the southwest coast of Asia Minor, or present-day Turkey, around 460 B.C.  His father was a physician-priest in the Asclepion at Cos, and his family could trace its lineage back to the legendary Asclepius.  Hippocrates lived a very long life and died at a ripe old age in the town of Larissa in Thessaly.

The Hippocratic Revolution

When Hippocrates began to practice medicine, the established school of medicine was the Cnidian School, but this school's approach to medicine had several serious flaws, which were already becoming apparent and starting to cause a general dissatisfaction with the art of medicine.

The Cnidian School considered the body to be merely a collection of isolated parts, and saw diseases manifesting in a particular organ or body part as affecting that part only, which alone was treated.  Their system of diagnosis was also faulty, relying exclusively on the subjective symptoms related by the patient, while totally ignoring the objective signs of the disease.

 
Hippocrates radically disagreed with the Cnidian School, countering that the human body functioned as one unified organism, or physis, and must be treated, in health and disease, as one coherent, integrated whole.  In diagnosis, not only the patient's subjective symptoms, but the objective signs of the disease must also be considered to arrive at an accurate assessment of what was going on.

As his unifying theory for the holistic understanding of the human organism, and how it functions in health and disease, Hippocrates used the concept of the Four Humors.  Building on the groundwork of humoral physiology and pathology laid by his predecessors, Hippocrates finally brought the theory of the Four Humors into its classical form.

Health is a harmonious balance of the Four Humors.  Disease results from their disharmony and imbalance.  The physician's job is to restore health by correcting the imbalance and restoring harmony to the humors.

To quote Hippocrates:

"The body of man has in itself blood, phlegm, yellow bile, and black bile; these make up the nature of the body, and through these he feels pain or enjoys health.  Now, he enjoys the most perfect health when these elements are duly proportioned to one another in respect to compounding, power and bulk, and when they are perfectly mingled.  Pain is felt when one of these elements is in defect or excess, or is isolated in the body without being compounded with all the others."

The Nature of Man

Hippocrates took his band of renegade physicians with him to the island of Cos.  There, they set about to revolutionize the art of medicine and put its theory and practice on a truer, sounder footing.

Hippocratic Medicine

Physiology and pathology in Hippocratic medicine was based on the Four Humors.  A united confluence and sympathy between all four humors working together was necessary for good health.  Pneuma - the Breath or Vital Force, and the Innate Heat, which were suffused into the blood from the lungs via the heart, gave the blood the power to sustain life.

 
Hippocrates saw pepsis, or an orderly, balanced, harmonious digestion and metabolism of the Four Humors as being essential to all good health.  In disorders of pepsis Hippocrates saw the origin of most disease.

Hippocrates' anatomical knowledge was rather scant, but this is compensated for by his profound insights into human physiology and the soundness of his reasoning.  But even so, his surgical techniques for dislocations of the hip and jaw were unsurpassed until the nineteenth century.

In therapeutics, Hippocrates saw the physician as the servant and facilitator of Nature.  All medical treatment was aimed at enabling the natural resistance of the organism to prevail and overcome the disease, to bring about recovery.

In the treatments he prescribed, Hippocrates was very sensible, pragmatic and flexible in his approach, favoring conservatism and moderation over radical or extreme measures.  Bloodletting, which was much abused at other times in medicine's history, was used only rarely by Hippocrates, and even then, only applied conservatively.

Hippocrates placed great emphasis on strengthening and building up the body's inherent resistance to disease.  For this, he prescribed diet, gymnastics, exercise, massage, hydrotherapy and sea bathing.

Hippocrates was a great believer in dietary measures in the treatment of disease.  He prescribed a very slender, light diet during the crisis stage of an acute illness, and a liquid diet during the treatment of fevers and wounds.  

Hippocratic medicine was constitutionally based, so its approach to diagnosis and treatment was quite flexible.  As a holistic healing system, Hippocratic medicine treated the patient, and not just the disease.

Hippocrates was the first physician to systematically classify diseases based on points of similarity and contrast between them.  He virtually originated the disciplines of etiology and pathology.  By systematically classifying diseases, Hippocrates placed their diagnosis and treatment on a sounder footing.

The Hippocratic Corpus

The Hippocratic Corpus is a collection of over 60 works.  Although all of them are attributed to Hippocrates, the Corpus is of a heterogenous character, and many, if not most, of its works may actually have been written by his students.

 
Still, we can be fairly certain that Hippocrates actually did author many books in the Corpus, including many original, groundbreaking works.

These include:
Airs, Waters and Places - the first major work on medical meteorology, climatology, geography and anthropology.
Aphorisms - a collection of wise, pithy sayings giving advice on practical matters of diet, prognosis and therapeutics.
Ancient Medicine - a defense of the empirical study of medicine against one biased by preliminary axioms and assumptions.  Also deals with the Four Humors.

 

The Legacy of Hippocrates

Hippocrates was the personification of the ideal physician - wise, caring, compassionate, and honest.  His Hippocratic Oath, which set high ethical standards for the practice of medicine, is his most remembered achievement.  His exemplary life has been a constant and enduring source of inspiration for doctors and healers down through the ages.

The Hippocratic Oath

Contrary to popular myth, the phrase "First do no harm" (Latin: Primum non nocere)) is not part of the Hippocratic oath. Strictly speaking, the phrase does not appear in the oath, though an equivalent phrase is in Epidemics, Book I, of the Hippocratic school: "Practise two things in your dealings with disease: either help or do not harm the patient".  The exact phrase may have originated with the 19th-century surgeon Thomas Inman.

There were several modifications to the oath, with a significant revision in 1948 by the World Medical Association (WMA) called the Declaration of Geneva.  During post World War II and immediately after its foundation, the WMA showed concern over the state of medical ethics in general and over the world. The WMA took up the responsibility for setting ethical guidelines for the world physicians. It noted that in those years the custom of medical schools to administer an oath to its doctors upon graduation or receiving a license to practice medicine had fallen into disuse or become a mere formality". In Germany during the Third Reich, medical students did not take the Hippocratic Oath, although they knew the ethic of "nil nocere" - do no harm.

In the 1960s, the Hippocratic Oath was changed to require "utmost respect for human life from its beginning", making it a more secular obligation, not to be taken in the presence of God or any gods, but before only other people. When Louis Lasanga, Academic Dean of the School of Medicine at Tufts University, rewrote the Oath in 1964, omitted the prayer, and that version has been widely accepted and is still in use today by many medical schools.

Following are the Classic (original) version of the Oath, and the modern version resulting from the Lasanga revisions in 1964.  Note in the original version content in red represents sections altered in the modern version.

The Hippocratic Oath (Classic Version)

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, 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.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

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. 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 honored 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.

The Hippocratic Oath (Modern Version)

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 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, 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 Modern Version, written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, is used in many medical schools today.

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Triple Crown Recap - American Pharoah Great but No Secretariat

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Secretariat remains record holder of every Triple Crown race as American Pharaoh finishes 12 seconds behind Secretariat combined times.  It has been 42 years since Secretariat broke the last drought between Triple Crown champions, a twenty-five year wait.

Since that day when all America was watching and listening, when Secretariat turned in one of the most remarkable achievements in all of sports history while blazing to a 31 length victory in the Belmont no one has come close to his record rides.

Secretariat wins Belmont - Triple Crown

In horse racing winers are determined in milli-seconds and photo finishes yet Secretariat won the longest of the races by a record shattering 31 lengths to also win the Triple Crown.

Over 52 percent of the television viewers watched that 1973 classic.  This past weekend 30 percent of the television viewers watched American Pharoah win the Triple Crown after 37 years with no winner.

American Pharoah

Here is what people thought as Secretariat blazed to his victory.

American Pharoah

Notable & Quotable: Secretariat and American Pharoah

In the three combined races of the Triple Crown, Secretariat’s margin over American Pharoah was something like 12 seconds—an eternity in horse racing.

June 7, 2015 6:06 p.m. ET

Secretariat

From a June 7 editorial, “Pharoah Without Tears,” in the New York Sun:

The roar and clapping, though, wasn’t what people remember from the Belmont in 1973, when Secretariat hurtled into the stretch. They remember what passes, in grandstand terms, for a silence. Oh, the crowd was clapping and cheering, for sure. But somewhere around the three quarter mark, something strange had started to come over the track, a sense that something impossible, mysterious, and inexplicable—and maybe even dangerous—was happening before their eyes. . . .

Secretariat Time cover

Jack Whitaker of CBS described it. “I actually saw people crying,” he said. George Plimpton described a group “of co-eds” lining the rail and weeping as Secretariat careered past. Heywood Hale Broun quoted Jack Nicklaus as saying relating that as—alone in his own living room—he watched on television as Secretariat barreled down the stretch, the great golfer also began weeping. Broun told him, “Jack, don’t you understand. All of your life, in your game, you’ve been striving for perfection. At the end of the Belmont, you saw it.”

“You’re not supposed to win the Belmont by 31 lengths,” is the way Steve Crist of the Daily Racing Form once put it. In the three combined races of the Triple Crown, Secretariat’s margin over American Pharoah was something like 12 seconds—an eternity in horse racing. It’s not our intention here to rain on American Pharoah’s parade. He is such a beautiful horse, with one of the most graceful gallops. But it is important, including for the children, to understand why, for all the glory of American Pharoah’s moment, our eyes were dry.


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NBA Finals - Battle for Supremacy - Records shattered in Greatest of all Championships

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LeBron James and Stephen Curry have now met three times in the playoff and records are falling to the wayside.

After three games and 583 points scored, the combined scoring difference between the two teams is just ONE POINT, Golden State has 292 and Cleveland 291, though Cleveland holds a 2-1 lead in games.

The first two games ended in overtime, a new NBA record, and LeBron James scored 123 points in the first three games, another new NBA record.

As the referees allow an amazing amount of physical contact, the floor of the game is often covered with bodies in hot pursuit of the ball.  Such enthusiasm was almost lost in the deluge of cash pumped into professional basketball and it is great to see it resurface.

The Cleveland Cavaliers, in existence since 1970, have never won an NBA Championship during the forty-five year history, although LeBron James won two while with the Miami Heat.  Unlike his stint at Miami, James is no longer surrounded by a supporting cast of superstars.

Out west the Golden State Warriors, who were founded in Philadelphia in 1946 and moved to the west coast in 1962, have won three NBA championships but it has been forty years, 1975, since they last won.

In terms of television interest, and noting that TV viewership nationally continues to fall, the first two games drew the largest audiences since ABC took over the broadcast in 2003.  Game 1 drew about 17.8 million viewers and game two 18.8 million viewers, new ABC records and up 26% from last year.

Highlights include a maturing of LeBron James into one of the greatest team leaders, most inspirational motivators, and relentless physical stalwarts to ever play the game.

His success in leading the Cavaliers is in spite of the loss of two stars at the beginning of the finals, and being the decided underdog against the Warriors.

As for the favored Golden State, Curry knows he must be far more aggressive from the start of the game, take more shots rather than pass off so often, and turn up the emotion in order to lead his team back into the lead.

America is being served a dose of basketball the way it used to be before money dominated the game. This series is all about passion, grit, and guts and the battle between the opposing superstars.  It should be a great finish.
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Will American Pharoah bring America together during trying times? The Triple Crown, perhaps the most difficult achievement in all of sports

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In 1973 the world was in turmoil and America was just finishing one of the most challenging decades in the history of our nation.  There were student riots, anti-Vietnam war riots, Civil Rights riots, assassinations of major public figures, and we were ending ten years of war in Asia leaving over 57,000 dead.

Towns were in flames as wave after wave of social issues pummeled America, shaking it to the very foundation.  Then there was the Cold war, Bay of Pigs, Cuban missile crisis, and even Watergate break in.  Our institutions were under assault by the very citizens of our country.

In 1973 it had been twenty-five years since a horse had won horse racing's coveted Triple Crown, the Kentucky Derby, Preakness Stakes, and Belmont Stakes.  We were barely out of the second World War when Citation won in 1948.

There have only been 11 Triple Crown Champions since 1875.  The longest drought without a champion since the first Triple Crown in 1919 is the current 37 years.  Second longest was the 25 years before Secretariat became champion in the most remarkable series of races in thoroughbred history.  As I have outlined, it came when the nation was in need of a new hero and in need of hope. To this day Secretariat holds the record for fastest in all three races.

Triple Crown Champions 

1919    Sir Barton

1930    Gallant Fox

1935    Omaha

1937    War Admiral

1941    Whirlaway

1943    Count Fleet

1946    Assault

1948    Citation

1973    Secretariat

1977    Seattle Slew

1978    Affirmed

Once again we are coming off a rather tough decade of wars, political animosity,strained relations with most of our allies, threats from terrorists that have already killed thousands of Americans, a fractured economy, financial collapse, corruption, political constipation, and about all the things needed to result in a Triple Crown winner at last.

Saturday we might get to watch history being made when American Pharaoh attempts to win the magical Triple Crown in the Belmont Stakes, the longest race the horse has ever run. Many get the chance but few have captured the brass ring and walked away with the Triple Crown.

Following is a very good article analyzing the prospects in the race.

The Horse I'll Bet to Upset American Pharoah

By David Papadopoulos

Pharoah on this day.

The math looks like this: Belmont Park officials forecast Pharoah will go off at odds of 3-5 while Materiality will be 6-1. Those prices spit out implied win probabilities -- after factoring in the track’s cut -- of 53 percent and 12 percent, respectively. In my own fair odds estimate, those numbers would look something more like 43 percent for Pharoah and 22 percent for Materiality.

Combined, that’s a 20-percentage point gap between market prices and my true-value calculations. For any gambler worth his salt, that’s a huge green light to go ahead and bet the undervalued horse.

So I will.

Here’s a breakdown of the full Belmont field. Runners are listed by post position. Odds are the racetrack’s estimate of how the public will bet.

-No. 1 Mubtaahij (10-1) -- I was underwhelmed by his effort in the Kentucky Derby. He made the same basic mechanical mistakes that he had in his previous races, and his daily workouts at Belmont since then have gotten mediocre reviews. If he were 20-1, maybe I’d dabble, but not at this price.

-No. 2 Tale of Verve (15-1) -- This colt’s trainer, Dallas Stewart, is cut from the same cloth as the men in charge of numbers 4 and 7 (Nick Zito and Dale Romans): Dreamers who ambitiously place their horses in America’s biggest races. All three have pulled off shocking upsets over the years but have more often seen their charges go down in lopsided defeats. Tale of Verve is a classic case. He finished second behind Pharoah -- albeit a distant-second -- at odds of 28-1 in the Preakness Stakes. Could he duplicate that effort on Saturday? Maybe, but I wouldn’t bet on it.

-No. 3 Madefromlucky (12-1) -- This horse has the right running style for the Belmont’s marathon 1 1/2-mile distance: He’s a one-paced sort who has no real burst of speed but just keeps grinding away. I can’t knock anyone for taking a shot on him at this kind of a price.

-No. 4 Frammento (30-1) -- He was in over his head in the Kentucky Derby and he is again here. For those looking for reasons to bet him, though, note that Zito has spoiled two Triple Crown bids in the past 11 years, knocking off Smarty Jones in 2004 and Big Brown four years later. Both times, his horses paid over 30-1.

-No. 5 American Pharoah (3-5) -- The big horse. He has all the tools. Questions are, especially for those inclined to back him at such prohibitive odds: Will he handle Belmont’s deep sandy surface (There’s something about the way he spun his wheels a bit over a very dry track on Derby day that suggests he might not)? Will the wear and tear of four races in eight weeks catch up to him late in the stretch? Will his jockey Victor Espinoza keep him out of trouble? If the answers to those questions are yes-no-yes, then the Triple Crown drought will end late Saturday afternoon.

-No. 6 Frosted (5-1) -- A very talented, well-bred colt that ran big in the Derby to get up for fourth place despite getting caught wide on the turns. And by all accounts, he’s been training great here in New York. Dangerous horse.

-No. 7 Keen Ice (20-1) -- He stumbled into some traffic in the Derby that slowed him down a bit, and that’ll lure some bettors to him in the Belmont. I won’t be one of them.

-No. 8 Materiality (6-1) -- He’s fast, he’s rested and he’s much more seasoned now after getting bounced around early in the Derby (he surged by 11 horses in the stretch that day to finish sixth). Now some touts spotted flaws in his final major workout last week, but they’re nitpicking. To my eye, it looked good. And when I asked his trainer Todd Pletcher what he made of the chatter, he was unmoved: “I wouldn’t listen to any of that.” This is where I’m putting my money.

(David Papadopoulos, managing editor for the Americas editing hub at Bloomberg News, has been following thoroughbred racing for more than two decades and was runner-up in 2008 Eclipse Award voting for feature writing on the sport.)

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