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The Hippocratic Oath is one of the most popular selections of ancient literature, even though the original Oath is rarely read or recited. Physicians have for centuries recited some form of this Oath upon entering the medical profession, but the oaths taken today are much altered and barely recognizable when compared to the original. The original oath, presented hereafter, was almost undoubtedly not written by Hippocrates, but the work is traditionally included in the Corpus Hippocratum, a collection of medical writings attributed to Hippocrates, written between the fifth and fourth century, BC.

Hippocrates of Cos lived between 469-399 B.C. (OCD), though some have claimed that he lived to be much older. It is known that this most famous of Greek physicians wrote several works, but it is doubtful that any of these are preserved, at least in their original form, in the Corpus Hippocratum.1 Celsus, writing nearly four hundred years later, said that Hippocrates was the first to separate medicine from philosophy. According to Soranus, Hippocrates traced his descent from Heracles and Asclepius.

After receiving medical training in Cos, Hippocrates became much traveled through Greece. He was highly esteemed by his contemporaries and by other ancients. Pliny the Elder listed Hippocrates among the most outstanding men in the medical sciences, recounting the following encomium:

"Countless people have become eminent in the knowledge of the different sciences, and it is proper to touch upon these when we are culling the flower of mankind ... in medicine, Hippocrates, who foretold a plague that was coming from Illyria, and sent his students round the cities to help; for this service Greece decreed to him the honors it had bestowed on Hercules" (Natural History, 123).

This story is particularly relevant given Thucydides ... comment on the contemporaneous plague in Athens in 430 BC:

"The physicians were of no avail. At first they treated without any knowledge; but they themselves were most likely to die inasmuch as they were the ones who chiefly visited [the afflicted] (2.47.4)."

Hippocrates ... students and his two sons continued the Hippocratic tradition, and much of the Corpus Hippocratum, including the Oath, was written by these students. Since this school of thought was founded in Ionia, the Oath, along with the rest of the Corpus, is written in the Ionic dialect. The Hippocratic tradition became the accepted standard for medical education throughout most of the ancient West, and during the Renaissance, this tradition was revived and the Corpus Hippocratum was used as a basis for continuing medical exploration. Concomitant to this important position of the Hippocratic tradition, the Oath was continually used and the tradition continues today.

Portions of the Oath itself are suspected of having been written at different times. In particular, the clause preventing surgery under any circumstance is suspected by many of having been written during Christian times. Littré, the most important Hippocratic scholar, documents that surgery was regularly performed by members of the Hippocratic medical guilds, but this alone cannot totally prove that this clause was an addition, because there are three other competing explanations - first, that the clause was a prohibition of castration, which was looked down upon in Greek society; second, that the oath was taken by medical students at some early stage of their training and, therefore, this clause was only binding during their training; third, that there was perhaps a specialization between physicians and surgeons, and the oath as we have it now was intended for physicians not trained in a surgical specialty. Each of these theories has problems. The castration theory seems contradicted by the following line, which indicates that someone who was specialized could perform the surgery. The second theory is problematic because every other clause in the Oath seems permanent, and there is no specific indication that this clause alone is temporary. The third theory, although seemingly supported by the following clause, indicating specialization, suffers because there is no historical indication that physicians of the Hippocratic tradition divided up such tasks.

The idea that the Oath was meant to be taken at the beginning of a medical apprenticeship seems most plausible, because it is certainly conceivable that a doctor-in-training would inherit such qualifications and rights to perform surgery, and this also would explain the following clause because it would simply refer to other, more experienced and more qualified physicians.

This is important for two reasons. First, it may indicate whether portions of the Oath are later interpolations and, secondly, it may indicate when the Oath was recited. Modern versions of the Hippocratic Oath are also recited at various times during medical education. Some schools require a form of the Oath at the very beginning of the training; others require that the Oath be recited at the end of the medical education but before the term of practical education such as internships and residencies. Someone who took the Oath at this time would also be unlicensed to perform unsupervised surgeries.

The ancient version of the Oath is rarely used for several reasons. The most obvious reason is that few students today would take swearing by Apollo and Asclepius seriously; additionally, however, the prohibitions of abortions and surgeries, as well as the unique financial arrangements and indenturements to the teacher and the teacher's family, are far removed from modern medical ethics and the practical process of medical education. In reading the ancient Oath, it is interesting to compare it to the modern oaths, one of which is:

"You do solemnly swear, each by whatever he or she holds most sacred:

"1. That you will be loyal to the Profession of Medicine and just and generous to its members.

"2. That you will lead your lives and practice your art in uprightness and honor.

"3. That into whatsoever house you shall enter, it shall be for the good of the sick to the utmost of your power, your holding yourselves far aloof from wrong, from corruption, from the tempting of others to vice.

"4. That you will exercise your art solely for the cure of your patients, and will give no drug, perform no operation, for a criminal purpose, even if solicited, far less suggest it.

"5. That whatsoever you shall see or hear of the lives of men or women which is not fitting to be spoken, you will keep inviolably secret.

"These things do you swear. Let each bow the head in sign of acquiescence. And now, if you will be true to this, your oath, may prosperity and good repute be ever yours; the opposite, if you shall prove yourselves forsworn" (American Medical Association).

Though the wording of this modern version of the Oath departs from the ancient version, omitting portions and synopsizing the portions it does contain, still it represents many of the main points of the ancient Oath. In particular, the underlined portions of the above oath correspond to ideas in the ancient Oath, though additions of words such as "for a criminal purpose" change the purpose of the words of the ancient Oath. Also, prohibitions of euthanasia and abortion have been omitted altogether, and the treatment of the relationships between student, teacher, and fellow physician has been greatly reduced.

The Oath

I swear by Apollo Physician and Asclepius and Health and Panacea and all the gods and goddesses, making them witnesses, that I will make complete this oath and this written covenant according to my ability and discernment:

- To regard my teacher of this art as equal to my parents and to share my livelihood (with him), and to make a contribution to him when he is in need of a debt, and to judge his offspring as equal to my brothers in manhood, and to teach this art - if they want to learn it - without wage and written covenant (to them), to make an imparting of the set of rules and lecture and all the rest of instruction to my sons and those of my teacher, and to those pupils who have been indentured and who have taken an oath according to the medical law, but to no one else.

- I will use diets for the assistance of the sick according to my ability and discernment; but also to keep away injury of health and injustice.

- I will neither give any deadly drug, having been asked for it, nor will I guide the same advice. Similarly, I will not give an abortifacient pessary to a woman. In purity and in holiness I will maintain my life and my art.

- I will not use the knife, not even on those suffering from the stone, but I will give way to those who are practitioners of this work.

- And as many houses as I may go into, I will go in for the assistance of the sick, being free from all voluntary injustice and mischief and the rest, even abstaining from sexual pleasures of both female and male persons, both free and slaves.

- That which I may see or hear during treatment, or even outside of treatment concerning the life of men, which must not in any way be divulged outside, I will not speak, regarding such things to be unutterable.

And so may it be to me making complete my oath and not making it of no effect that I enjoy the benefits of my life and art and be honored by all men for time eternal; but may it be the opposite of this to me transgressing and swearing falsely.