The Evolution of Modern Medicine | Page 8

William Osler
because a black speck in the flower suggested the pupil of the eye. The old herbals are full of similar illustrations upon which, indeed, the so-called doctrine of signatures depends. Observation came, and with it an ever widening experience. No society so primitive without some evidence of the existence of a healing art, which grew with its growth, and became part of the fabric of its organization.
With primitive medicine, as such, I cannot deal, but I must refer to the oldest existing evidence of a very extraordinary practice, that of trephining. Neolithic skulls with disks of bone removed have been found in nearly all parts of the world. Many careful studies have been made of this procedure, particularly by the great anatomist and surgeon, Paul Broca, and M. Lucas-Championniere has covered the subject in a monograph.[2] Broca suggests that the trephining was done by scratching or scraping, but, as Lucas-Championniere holds, it was also done by a series of perforations made in a circle with flint instruments, and a round piece of skull in this way removed; traces of these drill-holes have been found. The operation was done for epilepsy, infantile convulsions, headache, and various cerebral diseases believed to be caused by confined demons, to whom the hole gave a ready method of escape.
[2] Lucas-Championniere: Trepanation neolithique, Paris, 1912.
The practice is still extant. Lucas-Championniere saw a Kabyle thoubib who told him that it was quite common among his tribe; he was the son of a family of trephiners, and had undergone the operation four times, his father twelve times; he had three brothers also experts; he did not consider it a dangerous operation. He did it most frequently for pain in the head, and occasionally for fracture.
The operation was sometimes performed upon animals. Shepherds trephined sheep for the staggers. We may say that the modern decompression operation, so much in vogue, is the oldest known surgical procedure.
EGYPTIAN MEDICINE
OUT of the ocean of oblivion, man emerges in history in a highly civilized state on the banks of the Nile, some sixty centuries ago. After millenniums of a gradual upward progress, which can be traced in the records of the stone age, civilization springs forth Minerva-like, complete, and highly developed, in the Nile Valley. In this sheltered, fertile spot, neolithic man first raised himself above his kindred races of the Mediterranean basin, and it is suggested that by the accidental discovery of copper Egypt "forged the instruments that raised civilization out of the slough of the Stone Age" (Elliot Smith). Of special interest to us is the fact that one of the best-known names of this earliest period is that of a physician--guide, philosopher and friend of the king--a man in a position of wide trust and importance. On leaving Cairo, to go up the Nile, one sees on the right in the desert behind Memphis a terraced pyramid 190 feet in height, "the first large structure of stone known in history." It is the royal tomb of Zoser, the first of a long series with which the Egyptian monarchy sought "to adorn the coming bulk of death." The design of this is attributed to Imhotep, the first figure of a physician to stand out clearly from the mists of antiquity. "In priestly wisdom, in magic, in the formulation of wise proverbs, in medicine and architecture, this remarkable figure of Zoser's reign left so notable a reputation that his name was never forgotten, and 2500 years after his death he had become a God of Medicine, in whom the Greeks, who called him Imouthes, recognized their own AEsculapius."[3] He became a popular god, not only healing men when alive, but taking good care of them in the journeys after death. The facts about this medicinae primus inventor, as he has been called, may be gathered from Kurt Sethe's study.[4] He seems to have corresponded very much to the Greek Asklepios. As a god he is met with comparatively late, between 700 and 332 B.C. Numerous bronze figures of him remain. The oldest memorial mentioning him is a statue of one of his priests, Amasis (No. 14765 in the British Museum). Ptolemy V dedicated to him a temple on the island of Philae. His cult increased much in later days, and a special temple was dedicated to him near Memphis Sethe suggests that the cult of Imhotep gave the inspiration to the Hermetic literature. The association of Imhotep with the famous temple at Edfu is of special interest.
[3] Breasted: A History of the Ancient Egyptians, Scribner, New York, 1908, p. 104.
[4] K. Sethe: Imhotep, der Asklepios der Aegypter, Leipzig, 1909 (Untersuchungen, etc., ed. Sethe, Vol. II, No. 4).
Egypt became a centre from which civilization spread to the other peoples of the Mediterranean. For long centuries, to be learned in all the wisdom of
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