Humanitext Reader

Hippocrates · On the Art §7-8

Responsibility for Failure and Limits of Medicine

Passage 3 of 6 · Greek

Summary

In Chapter 7, the author argues that when treatment fails and patients die, the cause lies in the patients' disobedience or poor condition rather than the physicians, and in Chapter 8, explains the validity of physicians refusing incurable cases, acknowledging the limits of medicine.

§77.
7.
Τοῖσι μὲν οὖν τῇ τύχῃ τὴν ὑγιείην προστιθεῖσι, τῆς δὲ τέχνης ἀφαιρέουσι, τοιαῦτ’ ἄν τις λέγοι·
Therefore, to those who attribute health to chance and take it away from the art, one might say such things.
τοὺς δ’ ἐν τῇσι τῶν ἀποθνησκόντων ξυμφορῇσι τὴν τέχνην ἀφανίζοντας θαυμάζω, ὅτεῳ ἐπαιρεόμενοι ἀξιοχρέῳ λόγῳ τὴν μὲν τῶν ἀποθνησκόντων ἀκρησίην οὐκ αἰτίην καθιστᾶσι, τὴν δὲ τῶν τὴν ἰητρικὴν μελετησάντων ξύνεσιν αἰτίην·
But I wonder at those who make the art disappear in the misfortunes of those who die, by being prompted by what worthy argument they make the lack of self-control of those who die not the cause, but make the understanding of those who have studied medicine the cause.
ὡς τοῖσι μὲν ἰητροῖσιν ἔνεστι τὰ μὴ δέοντα ἐπιτάξαι, τοῖσι δὲ νοσέουσιν οὐκ ἔνεστι τὰ προσταχθέντα παραβῆναι.
As if it were possible for physicians to prescribe what is not appropriate, but not possible for those who are sick to transgress what has been ordered.
Καὶ μὴν πολύ γε εὐλογώτερον τοῖσι κάμνουσιν ἀδυνατέειν τὰ προστασσόμενα ὑπουργέειν, ἢ τοῖσιν ἰητροῖσι τὰ μὴ δέοντα ἐπιτάσσειν·
And indeed, it is much more reasonable for those who are sick to be unable to perform what is prescribed, than for physicians to prescribe what is not appropriate.
οἱ μὲν γὰρ ὑγιαινούσῃ γνώμῃ μεθ’ ὑγιαίνοντος σώματος ἐγχειρέουσι, λογισάμενοι τά τε παρεόντα, τῶν τε παροιχομένων τὰ ὁμοίως διατεθέντα τοῖσι παρεοῦσιν, ὥστε ποτὲ θεραπευθέντα εἰπεῖν, ὅτι ἀπήλλαξαν·
For the former, with a healthy mind along with a healthy body, undertake the treatment, having calculated the present circumstances and those of past illnesses which were in a similar state to the present, so that the patient once cured may say that they freed them.
οἱ δὲ οὔτε ἃ κάμνουσιν, οὔτε δι’ ἃ κάμνουσιν, οὔθ’ ὅ τι ἐκ τῶν παρεόντων ἔσται, οὔθ’ ὅ τι ἐκ τῶν τουτέοισιν ὁμοίων γίνεται, εἰδότες, ἐπιτάσσονται, ἀλγέοντες μὲν ἐν τῷ παρεόντι, φοβεύμενοι δὲ τὸ μέλλον, καὶ πλήρεες μὲν τῆς νούσου, κενεοὶ δὲ σιτίων, ἐθέλοντες τὰ πρὸς τὴν νοῦσον ἡδέα μᾶλλον, ἢ τὰ πρὸς τὴν ὑγιείην προσδέχεσθαι, οὐκ ἀποθανεῖν ἐρῶντες, ἀλλὰ καρτερεῖν ἀδυνατέοντες.
But the latter, neither knowing what they suffer, nor why they suffer, nor what will come of the present circumstances, nor what comes from things similar to these, receive orders, while suffering pain in the present, fearing the future, full of disease, empty of food, wishing to receive what is pleasant for the disease rather than what is for health, not desiring to die, but unable to endure.
Οὕτω δὲ διακειμένους, πότερον εἰκὸς τούτους τὰ ὑπὸ τῶν ἰητρῶν ἐπιτασσόμενα [μὴ] ποιέειν, ἢ ἄλλα ποιέειν, ἃ οὐκ ἐπετάχθησαν, ἢ τοὺς ἰητροὺς τοὺς ἐκείνως διακειμένους, ὡς ὁ πρόσθεν λόγος ἡρμήνευσεν, ἐπιτάσσειν τὰ μὴ δέοντα;
In such a state, is it likely that these should [not] do what is prescribed by the physicians, or do other things which they were not ordered, or that the physicians who are in the state described by the previous argument should prescribe what is not appropriate?
ἆρ’ οὐ πολὺ μᾶλλον, τοὺς μὲν δεόντως ἐπιτάσσειν, τοὺς δὲ εἰκότως ἀδυνατέειν πείθεσθαι, μὴ πειθομένους δὲ περιπίπτειν τοῖσι θανάτοισιν, ὧν οἱ μὴ ὀρθῶς λογιζόμενοι τὰς αἰτίας τοῖς οὐδὲν αἰτίοις ἀνατιθέασι, τοὺς αἰτίους ἐλευθεροῦντες;
Is it not much more the case that the former prescribe appropriately, while the latter expectedly are unable to obey, and by not obeying they fall into death, the causes of which those who do not reason correctly attribute to those who are not at all to blame, while freeing those who are to blame?
§88.
8.
Εἰσὶ δέ τινες οἳ καὶ διὰ τοὺς μὴ ἐθέλοντας ἐγχειρέειν τοῖσι κεκρατημένοισιν ὑπὸ τῶν νουσημάτων μέμφονται τὴν ἰητρικὴν, λέγοντες ὡς ταῦτα μὲν καὶ αὐτὰ ὑφ’ ἑαυτῶν ἂν ἐξυγιάζοιτο, ἃ ἐγχειρέουσιν ἰῆσθαι, ἃ δ’ ἐπικουρίης δεῖται, οὐχ ἅπτονται, δεῖν δὲ, εἴπερ ἦν ἡ τέχνη, πάνθ’ ὁμοίως ἰῆσθαι.
And there are some who blame medicine because of those who are unwilling to undertake patients who have been overcome by diseases, saying that these things which they undertake to cure would be cured even by themselves, while they do not touch those which stand in need of help, and that if the art existed, it ought to cure all things alike.
Οἱ μὲν οὖν ταῦτα λέγοντες, εἰ ἐμέμφοντο τοῖς ἰητροῖς, ὅτι αὐτέων τοιαῦτα λεγόντων οὐκ ἐπιμελοῦνται ὡς παραφρονεύντων, εἰκότως ἂν ἐμέμφοντο μᾶλλον ἢ ἐκεῖνα μεμφόμενοι·
Therefore, if those who say these things blamed the physicians because they do not care for them when they say such things, as if they were out of their minds, they would blame them more reasonably than in blaming those things.
εἰ γάρ τις ἢ τέχνην, ἐς ἃ μὴ τέχνη, ἢ φύσιν, ἐς ἃ μὴ φύσις πέφυκεν, ἀξιώσειε δύνασθαι, ἀγνοεῖ ἄγνοιαν ἁρμόζουσαν μανίῃ μᾶλλον ἢ ἀμαθίῃ.
For if anyone should demand that an art be able to do what is not for art, or nature to do what is not for nature by nature, he is ignorant of an ignorance fitting madness rather than lack of learning.
Ὧν γάρ ἐστιν ἡμῖν τοῖσί τε τῶν φυσίων τοῖσι τε τῶν τεχνέων ὀργάνοις ἐπικρατέειν, τουτέων ἐστὶν ἡμῖν δημιουργοῖς εἶναι, ἄλλων δὲ οὔκ ἐστιν.
For in those things which we can overcome by the instruments of nature or of arts, in these we can be craftsmen, but in others we cannot.
Ὅταν οὖν τι πάθῃ ἄνθρωπος κακὸν ὃ κρέσσον ἐστὶ τῶν ἐν ἰητρικῇ ὀργάνων, οὐδὲ προσδοκᾶσθαι τοῦτό που δεῖ ὑπὸ ἰητρικῆς κρατηθῆναι ἄν·
Whenever, therefore, a man suffers an evil which is stronger than the instruments in medicine, it must not even be expected that this would be overcome by medicine.
αὐτίκα γὰρ τῶν ἐν ἰητρικῇ καιόντων τὸ πῦρ ἐσχάτως καίει, τουτέου δὲ ἧσσον καὶ ἄλλα πολλά·
For instance, among the things that burn in medicine, fire burns to the greatest degree, and many other things less than this.
τῶν μὲν οὖν ἡσσόνων τὰ κρέσσω οὔπω δηλονότι ἀνίητα· τῶν δὲ κρατίστων τὰ κρέσσω πῶς οὐ δηλονότι ἀνίητα;
Clearly, then, things that are stronger than the lesser means are not yet incurable; but how are things that are stronger than the strongest means not clearly incurable?
ἃ γὰρ πῦρ οὐ δημιουργέει, πῶς οὐ τὰ τούτῳ μὴ ἁλισκόμενα δηλονότι ἄλλης δεῖται τέχνης, καὶ οὐ ταύτης, ἧς ἔνι τὸ πῦρ. ὄργανον;
For what fire does not accomplish, how does that which is not captured by this not clearly require another art, and not this one in which fire is an instrument?
ωὑτὸς δέ μοι λόγος καὶ ὑπὲρ τῶν ἄλλων, ὅσα τῇ ἰητρικῇ ξυνεργέει, ὧν ἁπάντων φημὶ δεῖν ἑκάστου μὴ κατατυχόντα τὸν ἰητρὸν τὴν δύναμιν αἰτιᾶσθαι τοῦ πάθεος, μὴ τὴν τέχνην.
And the same argument holds for me also concerning the other things that cooperate with medicine, of all of which, I say that if the physician fails in any one of them, he should blame the power of the disease, and not the art.
Οἱ μὲν οὖν μεμφόμενοι τοῖσι κεκρατημένοισι μὴ ἐγχειρέοντας παρακελεύονται καὶ ὧν μὴ προσήκει ἅπτεσθαι οὐδὲν ἧσσον ἢ ὧν προσήκει·
Therefore, those who blame them for not undertaking those who have been overcome, recommend that they touch no less those whom it is not proper to touch than those whom it is proper.
παρακελευόμενοι δὲ ταῦτα, ὑπὸ μὲν τῶν οὐνόματι ἰητρῶν θαυμάζονται, ὑπὸ δὲ τῶν καὶ τέχνῃ καταγελῶνται.
And in recommending these things, they are admired by those who are physicians in name, but are laughed at by those who are so also in art.
Οὐ μὴν οὕτως ἀφρόνων οἱ ταύτης τῆς δημιουργίης ἔμπειροι οὔτε μωμητῶν οὔτ’ ἐπαινετῶν δέονται·
Yet those who are experienced in this craft are not in need of such foolish blamers or praisers.
ἀλλὰ λελογισμένων πρὸς ὅ τι αἱ ἐργασίαι τῶν δημιουργῶν τελευτώμεναι πλήρεις εἰσὶ, καὶ ὅτευ ὑπολειπόμεναι ἐνδεεῖς, ἔτι τε τῶν ἐνδειῶν, ἅς τε τοῖς δημιουργοῦσιν ἀναθετέον, ἅς τε τοῖσι δημιουργεομένοισιν.
But rather they need those who have reasoned about what the works of the craftsmen are complete in when brought to an end, and what they are deficient in when falling short, and furthermore, of the deficiencies, which are to be attributed to the craftsmen and which to the things being worked upon.

Notes

  1. §7ἀκρησίην — An Ionic form corresponding to Attic ἀκρασίαν. Here it means 'lack of self-control' or 'disobedience (to the physician's regimens)', directly pointing to the patient's own failure. It functions as the direct object of καθιστᾶσι, with οὐκ αἰτίην as the predicate accusative.
  2. §7ὥστε ποτὲ θεραπευθέντα εἰπεῖν, ὅτι ἀπήλλαξαν — A result clause with ὥστε. The subject of the infinitive εἰπεῖν is the masculine accusative singular participle θεραπευθέντα, modifying an omitted indefinite pronoun τινά, meaning 'so that someone once cured may say'. The verb ἀπήλλαξαν is the 3rd person plural active aorist of ἀπαλλάσσω, meaning 'they (the physicians) freed/released (them from the disease)'.
  3. ¦p.12¦[μὴ] ποιέειν — The presence of the negative particle μὴ varies among editions. Retaining μὴ contrasts 'not doing what is prescribed' with 'doing other things not ordered'. Omitting it compares 'doing what is prescribed' with 'doing other things'. In either case, the context emphasizes the likelihood of the patient failing to follow instructions due to their distressed state.
  4. §8εἰ ἐμέμφοντο... ἂν ἐμέμφοντο — A present contrary-to-fact conditional sentence (protasis with εἰ + imperfect indicative, apodosis with ἄν + imperfect indicative). The author ironically argues that if the critics blamed the physicians for ignoring them as madmen, that blame would be more reasonable than their actual, unjustified complaints.
  5. ¦p.14¦ἀγνοεῖ ἄγνοιαν — A cognate accusative construction, where the verb ἀγνοεῖ takes the cognate noun ἄγνοιαν in the accusative as its object. Literally 'is ignorant of an ignorance', meaning 'exhibits a profound ignorance' or 'falls into utter ignorance'.
  6. ¦p.14¦ἀλλὰ λελογισμένων — A masculine genitive plural perfect middle/passive participle. Following the negative statement οὔτε μωμητῶν οὔτ’ ἐπαινετῶν δέονται (they need neither blamers nor praisers), this participle is introduced by ἀλλά and functions as the genitive object required by the verb δέονται (they need rather those who have reasoned).

Cite this passage

Hippocrates, On the Art §7-8. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0627.tlg018.humanitext-grc1:7-8

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