Georg Ivanovas From Autism to Humanism - systems theory in medicine
Was Hippocratic medicine effective? The simple answer is: we do not know.
Historians tend to be quite fatal, saying that prognosis was the only thing Hippocratic medicine had to offer (Lichtenthaeler: 148). It has even be called “a meditation on death” (Asclepiades cited in Hippoc I: xviii)
The therapies mentioned by Hippocrates include herbal therapy, aromatherapy, local applications (Regimen XX-XXIII; Hippocrates II: 79-83), the correct administration of gruel (Regimen XVI-XIX; Hippocrates II: 75-79) and other dietetic measures. All that does not sound very impressive. But before judging, some important misunderstandings should be cleared.
The first major misunderstanding is that the many fatal cases reported by Hippocrates are due to his helplessness and that our medicine is effective in the control of infectious and acute disease. This misjudgement overestimates by far the effects of modern medicine. The epidemiological figures do not support such a view. Infectious disease is not less mortal due to medical treatment and the prognosis of polytraumatized persons seems not to be much better than in ancient times (chap. 2.2).
The second misunderstanding is that minor interventions have minor effects whereas major interventions have major effects. This trivial relation of dose and effect is, as has been demonstrated, only true if no positive or negative feedback mechanisms are induced. Of course, gruel has no special physiological effect, but if used to induce or change inner rhythms, the effect might be major. Also a glass of water, by drinking a sip of water every hour is said to be useful in infections (Kneipp 1954b: 92). Such a continuous stimulus might have a rhythmizing and therapeutic effect, far beyond our current models. The CHARM study including 7.599 patients with heart failure showed a decline of hospital admissions and early deaths when a drug is regularly taken. It made no difference whether it was a verum (Candesartan) or a placebo. Regularity was the main beneficial factor (Granger et al 2004). As similar results have been found in a lot of trials (Simpson et al 2006) there is some probability that regularity induces inner rhythms. This “adherer effect”, as it is called today, is nothing else than a structural therapy (chap. 5.2.a).
Furthermore, when we assume that an inflammation has a certain goal, its development follows an equifinal order with a clear-cut proceeding. In such an order of events ‘minor’ interventions, such as cold or warm compresses, might, indeed change some feedback-loops, that is, the operator. Actually, in hydrotherapy (chap. 5.4.c) there is a lot of knowledge how to change the inner reaction with such applications. This is in line with the observation of chronobiology that a stimulus according to inner rhythms supports the development, whereas interventions against inner rhythms are suppressed (Hildebrandt et al, 1986: 195). Minor interventions using the abilities of self-healing are theoretically as effective or more effective than strong interventions against them. Even chemotherapy in cancer is much more effective when it observes inner rhythms (Gorbacheva et al 2005).
In order to treat in line with inner rhythms it is necessary to use the right stimulus to the right time. For Hippocratic medicine timing was extremely important. Everything had to be done to the right time. Modern medicine does not pay attention to rhythms and timing is no issue, or if, it only concerns the metabolism of an administered drug. But in not using or violating inner rhythms the applied therapeutic means have to be so powerful that they overthrow the inner equifinal mechanisms.
As a conclusion it can be said that although there is no knowledge on the effectiveness of Hippocratic medicine, there is some evidence that by understanding inner rhythms and their teleological behaviour major changes might have been produced even through a small stimulus.