Primum non nocere.

Thomas Morris (“Making you grateful for modern medicine”) discusses the history of the famous aphorism “First, do no harm,” or, in its Latin guise, primum non nocere:

In this form you will often see it referred to as the Hippocratic injunction, and many people assume that it has its origins in the Hippocratic Corpus, the body of early medical texts attributed to the ancient Greek physician Hippocrates and his followers. And there is indeed a similar form of words in the Hippocratic Oath, which affirms that ‘I will abstain from all intentional wrongdoing and harm’. Elsewhere in the Hippocratic Corpus (in a work entitled the Epidemics) there is the instruction ‘either help or do not harm the patient’.

But is it really Hippocratic? The attribution is far from clear. Firstly, although the sentiment is very similar, the form of words is rather different. And, more obviously, the Hippocratic Corpus and Oath are both in Greek. Where, then, did the Latin phrase come from?

My gold standard for this sort of thing is Robert K. Merton’s On the Shoulders of Giants (see this ancient post), and Morris’s investigation, though of course shorter and less anfractuous, is worthy of that giant’s vision. I will leave you to discover the delightful details at the link, and just quote the concluding paragraph:

Strangely, we have come full circle. I began by attempting to debunk the old chestnut that primum non nocere is Hippocratic. But the debunker has been debunked, since it seems that the old aphorism is indeed Hippocratic, albeit filtered through the mind of an early Christian writer from North Africa, writing in Latin almost 1700 years ago.

Thanks, hat_eater!


  1. David Eddyshaw says

    Primum non nocere is for physicians. Red-blooded surgeons know that faint heart never won fair lady.

  2. This looks dangerously close to advocating rape

  3. PlasticPaddy says

    I am sure DE can answer for himself, but I took his meaning to be that surgeons like to have a go with real man tools like saws and drills.

  4. David Eddyshaw says

    Indeed. DO, perhaps you haven’t encountered the idiom? I can assure you that I am by no means in favour of rape.

    I’ve always disliked the primum non nocere, and was delighted when I first discovered that its attribution to Hippocrates was spurious. (Interesting about Lactantius.)

    On one level, of course, its impossible to argue with: the level at which it is also pretty vacuous.

    The problem I have with it is that I’ve almost only ever heard it deployed by armchair theorists in the process of preaching that some treatment is obviously unethical because it might possibly do harm. As all treatments that actually do anything at all can in fact potentially do harm, and quite often serious harm, it is a worthless guide as it stands, and its seeming wisdom just conceals the fact that the speaker is too idle, ignorant or self-opinionated to do the real work (along with the patient) of properly weighing up risks and benefits.

    There are (moreover) definite domains in which it can be vital to make up your mind quickly to do something, even though you don’t have all the information you need to make a watertight reasoned choice: you can and will do serious harm simply by faffing about indecisively.

    William Osler is another great medical false-attribution magnet. In a discussion on euthanasia, I once saw him cited as the source of

    Thou shalt not kill,
    Yet needst not strive, officiously to keep alive …

  5. As seen in this thread.

  6. David Eddyshaw says

    Ah, yes. I repeat myself (my trainees have taken to gently pointing this out …)

  7. John Cowan says

    “Faint heart never won fair lady” = “If you (male) don’t even try to attract someone, you’re unlikely to succeed at it.” Of course, men and women are in different positions in this game, something Dorothy Sayers explained very well.

  8. David Eddyshaw says

    That is altogether wonderful. No less than one would have expected from the author of “Guinness is Good for You”, of course.

  9. That was a joke, ok?

  10. John Cowan says

    Indeed. And I see that the great (but fictional) Whiffler’s Club is firmly based on the Mustard Club.

    The introductions to her translations of Hell, Purgatory, and Paradise are in their entirety altogether brilliant. Unlike the translations themselves, they don’t date. I particularly remember Hell canto 18, the pimps and the rapists (seducers is traditional but not strong enough), where Dante is talking to one of the former, a man who pimped out his sister for political advantage:

    «O tu che l’occhio a terra gette,

    se le fazion che porti non son false,
    Venedico se’ tu Caccianemico.
    Ma che ti mena a sì pungenti salse?»

    That’s a pun: the Salse (as Sayers explains) was a steep valley near Bologna where the bodies of executed criminals were thrown, and Venedico is now in the first ravine of the Eighth Circle, which Dante calls Malebolge (Sayers: Malbowges).

    Sayers renders the passage thus:

    “Hey, there! thou whose eyes are bent so low,

    Thy name’s Venedico — or thy features lie —
    Caccianemico, and I know thee well.
    What wormwood pickled such a rod,” said I,

    “To scrub thy back?”

    (Dante addresses the sinners in Hell as tu, of course, since they are infinitely beneath him. There are a very few exceptions, which are quite significant).

    ObHat: Venedico says that this particular bowge is full of Bolognese, those who say sipa instead of si ‘yes’:

    «E non pur io qui piango bolognese;
    anzi n’è questo luogo tanto pieno,
    che tante lingue non son ora apprese

    a dicer ’sipa’ tra Sàvena e Reno […]»

    The 19C-20C jeweler Giulio Veronesi, in addition to founding a business named after him that survives to this day, also apparently made a Bolognese translation of the entire Comedy (1927); his version of this passage is:

    Però an zigh megga què sòul me Bulgnèis;

    Anzí ste sit l’è pein ed lòur tant bèin,
    Che tanti lèinghu ch’ein què lòur n’han intèis
    A dir èl Seppa tra i fiùm Sávna e Rèin […]»

  11. Roberto Batisti says

    For those interested, more excerpts from Veronesi’s translation may be found here (updated to the current Bolognese orthography, and with facing Italian text).

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