102 Hippocratic Corpus and Diocles of Carystus
guiding principle,^3 understands this ‘causing harm’ in the sense of delib-
erately terminating a person’s life or otherwise purposively causing disad-
vantage to his or her situation. Thus, according to theOath, the doctor is
not allowed to give a woman an abortive, nor to administer a lethal poison,
not even when being asked to do so; and the doctor is instructed to refrain
from every kind of abuse of the relation of trust that exists between him and
the patient. Yet it is also possible – as the word ‘or’ suggests – to take the
formula in the sense of unintended harm: ‘To help,or at leastto cause no
harm’, that is to say, the doctor should be careful when treating the patient
not to aggravate the patient’s condition, for example in cases that are so
hopeless that treatment will only make matters worse, or in cases which
are so difficult that the doctor may fail in the execution of his art; and as
we shall see, there is evidence that Greek doctors considered this possibility
too.
In this chapter I will examine how this principle ‘to help, or to do no
harm’ is interpreted in Greek medical practice and applied in cases where
it is not immediately obvious what ‘helping’ or ‘causing harm’ consists in. I
will study this question by considering the therapeutic sections of a number
of Hippocratic writings (most of which date from the period 425 – 350 b c e)
and in the fragments of the fourth-centurybcemedical writer Diocles of
Carystus.
2 the early history of therapeutics
In the preface to hisOn Medicine(De medicina), the Roman encyclopaedic
writer Celsus (first centuryce) gives an account of the early history of
medical therapy from its beginnings in the Homeric era to the epistemo-
logical dispute between Dogmatists and Empiricists of his own time. This
passage has received ample attention in scholarship, and it is not my in-
tention to give a detailed interpretation or an assessment of its historical
reliability.^4 Instead, I will use it as a starting-point for a consideration of
some aspects of therapeutics in classical Greek medicine that may be sub-
sumed under the heading of what I would call the ‘systematic status’ of
therapy in medicine. By this I mean the position and relative importance
of therapeutics within the field of medicine as a whole, which gives rise to
(^3) ‘I will use dietetic measures to the benefit of the patients... I will keep them from harm and injustice’
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).
(^4) See the commentary by Mudry ( 1982 ); Serbat ( 1995 ) xxxviii–liii. For more general assessments of
Celsus as a source for the history of medicine see Smith ( 1979 ) 226 – 30 and ( 1989 ) 74 – 80 ; von Staden
( 1994 b) 77 – 101 and ( 1999 b); Stok ( 1994 ) 63 – 75 ; Temkin ( 1935 ) 249 – 64.