Medicine at The Bedside

Dr. Kıymet Saniç

Medicine at The Bedside
 Medicine at The Bedside
 When there were no hospitals, the
bedside medicine meant that

“the treatment in patient’s own home”

Hippocrates (Medicine at
the Bedside)

Hippocrates has
became the
favored Father
of healers.
Hippocrates (Medicine at the
Bedside)
 He lived on the island of Cos, off the coast of
present-day Turkey, from about 460 BCE to
370 BCE.

 This makes him a bit older than Plato,

Aristotle, and the other cosmopolitan
creators of classical Greek culture, centered
in Athens.
Cos island
Cos
 Hippocrates

He also achieved a fair

(just,reasonable,suitable) degree of
fame (reputation, name), since
Plato mentioned him.
 Hippocrates (Medicine at the
bedside)
 He practiced medicine
 He educated students for a fee.
 ‘Med’ that the root of the word ‘medicine’ which is used in India-
European languages as a physician, means to measure, to be
measured.
 The words docteur in French and doctor in English mean
’scholar, wise person’ as in Arabic.
 Hippocratic Medicine
 There were no medical schools in
the modern sense of the term.

 How did they learn medical?

 Which methods were used to
teach?
 Hippocratic Medicine
 Students learned through their masters
(Apprenticeship)
(Apperenticeship: someone learns skill to do job by working for someone who
has skill and experience)
 Hippocrates- Events
Hippocrates introduced some significant events
1-developed an organizational method to
observe the human body
2-recorded signs and symptoms of many
diseases
3-created a high standard of ethics, The Oath of
Hippocrates, being used by physicians today.
(ethics: ideas and beliefs about what type of behaviour is morally right and
wrong)
1-Organizational method to observe the
human body
 Hippocratic Medicine
Consist of a shrewd
(smart, clear
understanding) sense
of looking carefully at
their patients for signs
and
 Suggesting (come
up with) the likely
cause of the
disease.
 Hippocratic Medicine
They knew surface anatomy
-The ancient Greeks
disliked dissection of human
bodies (holistic)
-They performed no
autopsies to determine the
cause of death
-Greek doctors taught no
deep anatomy to their
apprentices
 Hippocratic Medicine, Holistik

 Hippocratic medicine was holistic. The doctor will

likely take a look (observe) at all the potential
factors that may be causing the person’s illness:
 For example headaches, such as
 other health problems, diet and sleep habits, stress and
personal problems, and preferred spiritual practices.

Holistic: (complate, whole; Dealing with or treating the 

whole of something or someone and not just some parts)
 Hippocratic medicine, Holistic
 The Hippocratic doctor needed to know his patient thoroughly:
 what his social, economic, and familial circumstances were,
 how he lived,
 what he usually ate and drank,
 whether he had travelled or not,
 whether he was a slave or free,
 what his tendencies to disease were.
 At the present time ??????
 What do you thing about this approach?

 What is the current name of this

application?
Patient History Taking
 Anamnesis

 Anamnesis: Patient history; to gather

all basic information related to the
patient’s illness, and the patient’s
adaptation to illness.
 These approaches of
Hippocratic medicine built
THE PROTOTYPE OF
MODERN PRIMARY
CARE
(initial approach to patients by doctors or
nurses for treatment)
 Hippocratic Medicine, Holistic

 The treatment plan may involve

drugs to relieve symptoms,
but also lifestyle modifications to help
prevent the headaches from recurrence
(repeat, happening again ).
2-RECORDED SIGNS and
SYMPTOMS
 Hippocrates Corpus
Hippocratic collection was a
compilation (editing, collection,
summary) of 70 books that
contained detailed list of
symptoms and their treatments.
The collection was so
influential that it was in use for
hundreds of years.
Corpus: A collection of the written tests.
 Hippocrates Corpus

 What do you think about whether

Hippocrates actually wrote any of the
works attributed to him?
 He did not write them all, because they
were written in over two centuries by
various unknown hands.
 Hippocratic Medicine
 These ‘Hippocratic’ writings cover:
Many aspects of medicine and surgery, as well as
diagnostics, therapeutics, and disease prevention.
 The Hippocrates offered advice on diet and
other aspects of healthy living
 There was a particular thesis about the role of
the environment on health and disease.
Hippocrates offered advice on diet
 Hippocrates
offered advice
on some
aspects of
healthy living
There was a particularly thesis about the role of the environment on health and disease.
 In Hippocrates’ era, doctors believed that
patients had a natural ability to overcome
disease.

 Medical treatments were meant to

support the natural healing processes.
Today????
Placebo effect
How ironic that twenty-five centuries later we
are re-discovering and proving, through the
modern science of neuroimmunology,

that patients’ frame of mind and perception of

their disease predict their treatment success
and cure rate more than many of the technical
details of their condition or its treatment.

.
When we comfort a patient, we may be
doing more than consoling him or her. We
may be stimulating the patient’s immune
system to overcome disease and return the
body to a healthful balance.

We used to call that the Placebo Effect.

Placebo effect
Placebo effect
 Placebo effect
 https://www.theguardian.com/science/p
unctuated-equilibrium/2011/feb/15/1
-THE OATH of HIPPOCRATES
Modern hospital consultants, many
of whom would have repeated his
Oath, or a version of it, when they
took their medical degrees.
Consultant: Hospital doctor who is an expert in a particular area of
medicine
The World Medical Association
Declaration of Geneva
on Hippocratic Oath
The World Medical Association Declaration
of Geneva

At the time of being admitted as a

member of the medical profession:
 I SOLEMNLY PLEDGE to consecrate
my life to the service of humanity;
(I seriously and sincerely promise
myself to dedicate my life to the service of
humanity)
The World Medical Association Declaration of Geneva

 I will PRACTISE my profession with

conscience and dignity.
(I will apply my profession with an inner feeling-voice and honor.)

 THE HEALTH OF MY PATIENT will be

my first consideration;
(My priority will always be the health of my patient)
The World Medical Association Declaration of Geneva

 I will RESPECT the secrets that are

confided (safe)in me, even after the patient
has died;
 I will MAINTAIN (continue, protect) by all
the means in my power, the honor and the
noble (great) traditions of the medical
profession;
The World Medical Association Declaration
of Geneva

 MY COLLEAGUES will be my
sisters and brothers;
The World Medical Association Declaration
of Geneva

 I will NOT PERMIT considerations of age,

disease or disability, creed (belief), ethnic
origin, gender, nationality, political affiliation
(membership), race, sexual orientation
(hetero-homo-bisexual), social standing
(social position) or any other factor to
intervene between (cut in, interfere) my duty
and my patient;
The World Medical Association Declaration
of Geneva

 I will MAINTAIN the utmost (highest)

respect for human life;
 I will NOT USE my medical knowledge to
violate ( break, abuse) human rights and
civil liberties (even under threat);
 I MAKE THESE PROMISES solemnly (in
a serious manner, with deep sincerely) ,
freely and upon my honor.
https://www.youtube.com/w
atch?
v=QbU61uO3Vdw&t=53s
&frags=pl%2Cwn
 Hippocratic Medicine
 Mix of magico-religious medicine was also part of
the Greek landscape during the Hippocratic period.
 Healing temples dedicated to the Greek god of
medicine, Asclepius, effected all over the Greek
sphere.
 These healing temples were an important part of
Greek medical care but the values they represented
had little impact on the Hippocratic Corpus
 Asclepius: A hero and god of healing, son of Apollo.
Hippocratic Medicine

Hippocratic medicine resonated within

contemporary scientific medicine because of
underlying naturalism. In another saying, it
was believed ILLNESS was a result of
NATURAL CAUSES.
Hippocrates also encouraged doctors to
look for natural treatments and explanations
through the natural world one.
Hippocratic Medicine

 They used the botanical basis of most drugs in

their treatment.
 Doctors looked to the botanical kingdom for
medicines to combat (battle) diseases.
 One doctor in particularly organized the
ancient pharmacopoeia (medicine book) into a
form that others found useful for centuries.
 The Theory of Four Humours
 Body regulated by 4 fluids or humour.
Imbalance in those fluids cauases illness.
 The four humours were blood, yellow bile,
black bile, and phlegm.

Humour: Secretion, excretion, humor.

The Theory of Four Humours
 The Theory of Four Humours

The four humours were blood, yellow bile,

black bile, and phlegm
1. Blood: The red liquid that flows around your body
2. Black bile: A humor of medieval physiology believed
to be secreted by the kidneys or spleen
3. Yellow bile: A humor was believed in medieval
physiology to be secreted by the liver
4. Phlegm: The thick mucus secreted in the 
respiratory passages, sputum.
 The Theory of Four Humours

 Each of the humours was

identified with a bodily organ
related (connect) to
 phlegm with the brain,
 blood with the heart,
 yellow bile with the liver, and
 black bile with the spleen.
 The Theory of Four Humours

The theory of four humours come from four

elements. The ancient Greeks believed the
everything in the world composed the four
elements: Water, earth, fire and air. Each of
element has different qualities that could be
easily seen through observation.
For example: FIRE was hot and dry; WATER
was cold and wet.
The Theory of Four Humours

Each of the
humours was also
linked to one of
the four elements:
air, fire, earth,
water.
The Theory of Four Humours
 The Hippocratic Explanation
 Functions of the brain
 Hippocratic fingers
 The doctor must ask about sleeping, diarrhea and
eating
 Febrile
 Jaundice and dehydration
 The Hippocratic Explanation
 Hippocratic authors mentioned functions of the
brain.
 They said the epilepsy was caused by a
blockage in the brain. This thesis is not correct
in modern medicine, but it is important that
they try to find out the cause of Epilepsy.
It is important that epilepsy is found to be
caused by malfunctioning of the brain.
 The Hippocratic Explanation
 Hippocrates and his followers were the first to
accurately (correct) describe and analyze some
medical conditions.
 This included determining the clubbing of fingers (stick,
fingertips) , sometimes referred to as “
Hippocratic fingers”,
 as an important diagnostic sign in chronic lung disease, 
lung cancer and cyanotic heart disease.
 The Hippocratic Explanation

Clubbing of fingers- Hippocratic fingers

 The Hippocratic Explanation

 Sharp nose, hollow eyed, cold ears, dry skin on the

forehead, strange face color such as green, black,
red or lead colored.
 If the face is like this at the beginning of the illness, the
doctor must ask the patient if he has lost sleep, or had
diarrhea, or not eaten.”
 The Hippocratic Explanation

 When the sick person is febrile;

 the skin becomes flushed (turn reddish)
 people cough up phlegm (sputum) or blood;
 eyes water and noses run;
The Hippocratic Explanation

Jaundice (icterus) or dehydration;

_the urine turns dark if there is the skin can
become clammy (damp,moist), sweaty
(damp,moist), or pale (light in color);
_diarrhea or vomiting may be prominent
features of illness.
Symbol of Medicine
 

The symbol originated by

Asclepius (the Ancient Greek God
of Healing) is often confused with
the Caduceus, which includes a
similar staff (rod), with two snakes
and wings.
 Asklepius

Asclepius:
The Ancient Greek
God of Healing
Symbol of Medicine
 

The Rod of Asclepius

According to Asclepius,
the physician should be
like a snake, not tell the
secret of their patients to
anyone.
Symbol of Medicine
 
Symbol of Medicine
 
It had nothing to do with
medicine at all until the 19th
century, when the US Army started
using it on the uniforms of its
medical personnel. The modern use
of the caduceus as a symbol of
medicine became established in the
United States as a result of
documented mistakes.
https://www.youtube.com/
watch?v=
pZTQzDDxzHU
 Medical Symbol
 The medical symbol was officially
accepted by the World Medical
Association in 1956. Two snakes,
poison and antidote, the rod is the
balance between disease and health, and
the silver bowl depicts the production
of drugs very well.
Symbols of Medical Departments
Hippocrates 0- 2:59 minute

https://www.youtube.co
m/watch?
v=9tx1zlbtHAw&frags=
pl%2Cwn