One of the most interesting cases is that of the boy who was kicked in the head by a horse.(25) The physician would first examine the wound with a metal probe; a sanitary procedure if the probes were kept clean. He attempts to determine if the impact of the hoof fractured the skull or merely dented it. In order to determine if a fracture exists, he must shave the patient’s head, enlarging the superficial skin wound in the process. He packs this with a concoction made of vinegar and barley flour, and covers the now-gaping wound with a bandage.(26) The next day he removes the wound ointment, and covers the bare skull with a black pasty substance.(27) The third day he scrapes the skull with a knife; the black paste will come off everywhere except from fractures.(28) If the skull is fractured, he will not operate; if the skull is not fractured, he will drill a hole! (29)
The physician drills when there is no apparent need to do so because humoral theory dictates that the blow to the head causes humors to accumulate around the injury. Pus will form if the humors are allowed to accumulate, so the humors need a way out; hence the physician’s decision to drill a hole in the skull. The physician puts his patient on a regimen and treats the open wound with a cathartic, a harsh mustard-seed based cream that is used to draw out the excess humors.(30) Then he sends the patient on his way, quite possibly in worse shape than when he first arrived!
Most sick people would have been better off not visiting the physician who practiced Hippocratic medicine. Yet this physician was a learned and scholarly man who practiced his craft in accordance with the prevailing theory of disease, humoral theory. Humoral theory held that the key to health was the successful balancing of the four humors present in the body. This theory was based upon the philosophical contributions of the Presocratics, who first reasoned that man and nature were of the same ilk and followed the same laws, and then reasoned that because of this similarity, the rules for change in the outside world applied to man as well. When these two themes were interpreted by physicians, the humoral theory was created. We know today that the physician did indeed come into contact with such material, and that some were even skeptical and critical of it. Ultimately the humoral theory was an educated guess about the inner workings of the body which was based upon Presocratic assumptions about natural phenomena.
Goold, ed., Hippocratic Treatises. Cambridge: Harvard University Press,
1984.
Kirk, G.S., Raven, J.E., and Schofield, M., The Presocratic Philosophers.
Cambridge University Press, 1957.
Lloyd, G. E. R., ed. Hippocratic Writings. London: Penguin Books Ltd.,
1983.
Majno, Guido., The Healing Hand: Man and Wound in the Ancient World.
Cambridge: Harvard University Press, 1975.
Phillips, J. H. , "The Hippocratic Physician and Astronomie," Actes du
IVe Colloque International Hippocratique, Lausanne, Switzerland, 1981
(Geneva: 1983).