Hippocrates and the Hodos

hippocratesHippocrates was, in fact, not one guy. There was a physician named Hippocrates, about the time of Plato, practicing in Athens in the Golden Age of Greece, during the late 5th and early 4th century BCE.

But the writings that we attribute to this one person are undoubtedly a collection of works from the Golden Age of Greek medicine. It is collectively referred to as the Hippocratic Corpus. Most historians, though, use the convention of referring to him in the singular, just because it’s easier that way.

In Hippocratic medicine, women were hollow. There was one tube, which ran from the mouth to the vagina, known as the “hodos.” The uterus was an outpouching of this tube, located somewhere along the way. In fact, pretty much anywhere along the way. It travelled, you see.

Ancient Greek medicine was big on “humors.” The older systems relied on earth, fire, water, and air.

Men, you see, were hot and dry. When they started retaining water, it was a bad thing. Women, though, were wet and cold (Freud, anyone?).  If women became TOO dry or hot, they turned into men. Thus, the Athenian angst over the Spartan’s tendency to allow their women to exercise with the men. TOO hot, too dry. Spartan women were men, with breasts.

Greek women were spongy. Their bodies soaked up water. This extra water caused an imbalance in the classic humoral system—too much water was bad, and had to be removed. Normally, this removal happened naturally, when the woman menstruated. When she didn’t, though, bad things happened.

During pregnancy, the extra moisture that built up was stored for use in producing milk, so that was okay. It was during ordinary times that failure to menstruate was catastrophic. And not just a little—Hippocrates defines normal menstruation at somewhere around a pint of blood. That’s about eight times the average menstrual accumulation.

A buildup of fluid was a bad, bad thing. It could lead to melancholy, or outright mania. It could cause weakness, exhaustion, or edema (which is the one thing that actually is caused by too much fluid). It was sometimes relieved through bleeding elsewhere—especially nose bleeds and lung hemorrhages. Even bleeding from a finger could be considered diverted menstrual flow in a woman who was not eliminating her fluid in the normal way.

Virtually any symptom could be attributed to this horrid fluid buildup. The cure was, of course, blood letting.

On the other end of the spectrum, if a woman was too DRY, her womb, that voracious consumer of fluid, went looking for moisture. Since it was capable of wandering anywhere on the hodos, it did. If it wandered up into the neck, it could cause dropsy, madness, and even strangle her.

Treatments of this disorder were aimed at drawing the womb back into its normal position. Fragrant incenses were burned, and the woman was placed on a stool over them, to fumigate the vagina. At the same time, noxious smells were placed at the nose. This enticed the womb back into its proper place.

A virgin left too long a virgin was in dire danger of having her uterus go wandering, with all of its attendant risks. She required “opening.” This was generally accomplished by marriage, as this was the only societally acceptable method of opening, unless, of course, you happened to be one of the virgins chosen to be given to Apollo.

The famous Oracle at Delphi was always a virgin. She sat on a tripod stool, over a volcanic vent, through which fragrant steam Apollo entered her, allowing her to speak for him.

Just in case I had left you with the idea that all Greeks were prudes.

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165 Comments

Even modern men usually have no clue or overestimate as to the regular amount of blood lost (at least the few I've quizzed).
Whenever I read about blood-letting it just amazes me. I've been learning about Lewis and Clark and they did some bloodletting to Sacagewea (1805) when she was ill.

At least four skits from the old classic SNL came to mind while reading this, most with Steve Martin in them. I'm sure some of our practices will seem archaic centuries if not decades from now. I read somewhere that blood letting still goes on today though I can't remember what for.

I remember my first husband's reaction when I told him I'd started my period that morning. He was, "Oh, ok. So, wanna have sex?"

"You don't mind?" I asked.

"What, you're STILL on it?" Apparently he envisioned me standing over a bucket and just releasing.

I don't think Greeks were prudes; if I remember correctly, they applied the repression pretty much solely to women.

Some things really don't change.

Dang–now you've got me thinking that there was at least one famous person in history who died from blood-letting and it's on the tip of my brain and I just can't remember and it's going to be bothering me all day until I remember….

Evil thought…homeschool lesson, children: who was the famous person….. :-)

George Washington, just before he died (and likely contributing to his demise) had a large volume blood letting as treatment for an infection.
Probably other famous folks as well.

We use leeches on occasion for stimulating blood vessel development in reattached limbs. The only modern indications for blood letting that I know of are a type of leukemia consisting of too many red blood cells (polycythemia vera), and hemochromatosis (a condition with iron buildup).

Blood letting was still fashionable clear into the late 19th century, when it was gradually phased out as the humoral theory of disease was replaced by, ahem, science.

LOTS of famous people died, more or less, from complications of bloodletting, since it was used for millennia. But rarely did it get reported that way. Doctors of the old days were, just as we are now, more likely to blame the disease being treated than the interventions. And of course, there wasn't much accountability in the old days–JCAH wasn't standing over every doctor's shoulder counting his iatrogenic infection rate.

Looks like despite Hippocrates' admonition that "to do nothing is also a good remedy," the men of that time just couldn't help themselves when it came to the perceived maladies of women.

I always found it ironic that blood letting was frequently used to "treat" a wound via gunshot or sword, particularly if you got an infection afterwards. Fever? Better bleed.

My father believed that his giving blood frequently was good for him, which is not the same as being let when you're sick. I remember reading a story in Science magazine that there might be some health benefits with giving/letting blood periodically while healthy (I was in high school and have no strong opinions on the matter). I know my father used to go in and give platelets every 10 days. Before he died, he had his fifty gallon pin.

I don't give blood as regularly as he did (because I'm forgetful), but I know I haven't ever had any ill effects other than a bit of bruising.

Ewww! And a wandering womb? Super Eww. I'm glad I didn't live back then.

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