Topics: INSTITUTIONAL INNOVATION

Essay by Robin Lane Fox: “The Hippocratic books now known as the Epidemics are entitled in Greek epidemiai. This title does not refer to epidemics as we now painfully recognize them, individual diseases which are spread widely through a population, whether by touch, inhaling, contact with wildlife, eating, drinking, kissing (which the elder Pliny, c. AD 70, recognized to be a means of transmitting diseases) or sex, while remaining one and the same disease. In the mid-fifth century BC, the amiable Ion, a poet and author from the island of Chios, composed Epidemiai which referred to his visits to the demos, or people, of individual city-states around the Greek world. His title has sometimes misled readers of the medical Epidemiai into thinking that their title, too, refers to traveling doctors’ visits to particular places. They refer to such visits, but their use of the verb epidemein shows that for them the word epidemia referred to the presence of a disease in a community. It was not necessarily a rampant disease in our sense of the word “epidemic,” and it was not contrasted with diseases which were endemic, a category the authors did not distinguish, but it was certainly a disease at large. This meaning was still correctly understood in later ancient commentaries on the Epidemic books.

By the mid-first century AD, seven books were grouped under this title: the grammarian Erotian referred then to “seven books of Epidemics” in the list of works which he considered, over-optimistically, to be by Hippocrates himself. The title went back to earlier editors, probably at least as early as the third century BC, but it may not have been used by any of the books’ original authors. All seven books share a distinctive feature. Whereas the other texts in the Hippocratic Corpus refer to patients in general, and only once, in passing, name an individual, the Epidemic books are quite different. They contain individual case histories, most of which specify the very place where the named patient lived, even the house or location. They are the very first observations and descriptions of real-life individuals during a number of days which survive anywhere in the world. In Babylonia written case histories of named individuals are unknown.

In China none survives until c. 170 BC, and even then they were presented for a different purpose, to defend their doctor-author’s reputation. In ancient Egypt, cases were discussed individually in the now-famous medical papyri whose contents date back into the second millennium BC, but they never name patients or describe observations of them day after day, let alone locate them at an exact address….(More)”.