An acquaintance with the views and the knowledge of epochs already submerged in the shoreless ocean of time, frees the mind from the fetters and currents of the day, with its often oppressive restraint, widens the horizon for a glance into the past, and an insight into the present of human activity, deepens the view for a comprehension of the ideas which guided the earlier and the more recent physicians, and gives, on the other hand, to our daily professional labor a higher consecration, by inserting it as a most useful and necessary link in the chain of development of past and future humanity. The significance of the work of the individual, and his true value and true position with regard to all humanity, are first revealed to us clearly in and through history.

When, however, we have reviewed the labors of thousands of years, and have seen how in their course our science has been advanced, albeit in unexpectedly tedious ways; when too we have found how little service, on the whole, has been rendered to the main object of medicine—the cure of disease and above all in internal medicine, which enjoys the most extensive field of activity, we are at first sadly disappointed. For in spite of all therapeutics, the word of the Psalmist preserves its internal truth: "As for man his days are as grass: as a flower of the field so he flourisheth. For the wind passeth over it, and it is gone." But on a closer study of the subject, this knowledge awakens another feeling.

For as no other department of the medical sciences is so well adapted to educate the physician in conscious modesty, so on the other hand, none is so fitted to fill his consciousness with just pride in his often contested and self-sacrificing labors. As the history of medicine shows him the inadequacy of medical knowledge and, in the majority of cases, the absolute nullity of medical skill in the struggle with the laws of an all-powerful nature, so it places before his eyes the unwearied struggles of the physicians of all ages-struggles to investigate those laws, and to appropriate to the healing and blessing of suffering humanity the knowledge already acquired, or to be acquired, thereby. Hence we prize infinitely less the fact that history, among almost all people, presents to our eyes the immortal gods as the authors of medical art, than that it teaches us how mortal men have struggled continually after god-like aims-the prevention, the cure, or at east the alleviation lof the woe and suffering imposed as an unavoidable heritage, and in a thousand different forms, upon us created beings—even though to-day, as in the past, these aims have been only imperfectly attained. The history of medicine also teaches us to honor, indeed to admire. humanity, particularly physicians and their past and present struggles, while our daily practice and the daily actions of individuals might perhaps readily lead us to an opposite feeling. It shows us how many a noble man has served medical science, and art, and humanity, devoting his self-denying strength and life to the sick, the feeble, the persecuted, the poor, and the insane, and performing deeds which have not, indeed, dazzled and carried away the multitude by their brilliant results, but

have worked on quietly and beneficently through all futurity, leading humanity nearer to the lofty aims of humane thought and action. For the consolation of these men there has often remained only the beautiful saying, that even had their life been glorious, yet it would have been but labor and sorrow.

In like manner history brings before us those spirits who have struggled for such noble aims throughout the whole course of the known centuries, both the highly-gifted, victorious and great, who have borne aloft before our eyes the brightness of their immortal names, and those who, less favored by nature, have shone with a more modest light, and must thus be sought for in their homes, only that we may learn to prize and honor their struggles and their perseverance the more freely, because their desires were supported by less eminent natural endowments. History shows us, too, those whose actions have shone with a false and almost unearthly gleam in times of intellectual night. It teaches us how those spirits strove to recognize—and in some small degree did actually recognize the forces acting upon and in man, how they pointed them out, and utilized them, how in the midst of, and in spite of this constant struggle and search, that saying from the mouth of the most gracious of mankind has proven its eternal truth: "Fragmentary are all our knowledge and our actions, and our gaze ambiguous as in a mirror."

Thus change in our views seems to be the only permanent phenomenon, and in no science has the maxim: "Much arises which has already perished, and what is now honored is already declining," attained such extended verification as in the very science of medicine. Even so in this same science has been proven the truth of that other saying: "As long as man struggles he errs". To err in its struggles after the truth is, however, according to the resigned expression of Lessing, the portion of humanity, and absolute truth is of God alone.

This observation, however, ought not to discourage us. On the contrary it should spur us on, that each individual, as a member of the great whole, in the flight of moments, days and years, may add his allotted share, however great or modest it may be, to the completion of the work of thousands of years of pure sense and sincere heart. For a thousand years are, indeed, to humanity "as a watch in the night. Thou carriest them away as with a flood"; but on history and in history, great and small work equally in the service of that supreme power, whose laws, to our comprehension inherent and active in matter, are but very partially explored and understood that power to whose purposes, unfathomed, though freely discussed from the origin of the human race, we mortal creatures, living and struggling, dying and vanishing in the twilight of consolatory hopes, are inevitably committed. History-that of medicine included-seems to the mind's eye like an immense wave of past and present action, now strong and rushing, now quietly advancing, with sparkling mountains and valleys deep as night, a wave whose ebb and flow in the eternity of the past

we understand not and can but dimly conjecture. A supreme power, whatever its essence and however named of men. gives to it its direction and individual phases in accordance with a design and purpose to us forever inscrutable. The eternal wave rises up to heaven, it sinks again into the dark depths, bearing mankind ever upon its rolling crest and billowy field, through hundreds and thousands of years, uniting organically with each other the epochs and grades of human development, both past and future. Millions on millions have perished without contributing to the progress of humanity they have no history. Thousands have promoted at least the foundations of future knowledge history records their names, for they labored. But only a few chosen spirits have performed the highest services allotted to man. They summed up the past and discovered new and great truths, the intellectual product of many bygone factors of knowledge; they led humanity onward, and thus form the landmarks of its history. The study of the history of medicine, above that of all other medical branches, should give a more ideal direction to our conception of our calling by showing that its duties and its rewards are not to be found exclusively in our daily labors and scanty pay (as is, alas, too often the popular belief), and by pointing out the fact that only in struggles and labors directed to the intellectual advancement of humanity-struggles unnoticed even in the present, and probably, too, long in the future-lie the fertile germs of futurity and a scion of improvement for all mankind.

To the physician is assigned in the first place the difficult, frequently the impossible, task of preserving the corporeal health, and of restoring it when disturbed or endangered by disease; next, and partly necessarily and consequently, the duty of preserving or restoring the faculties of the mind. Impotent, however, as it, alas, often is and must remain in opposition to the irreversible laws of nature-and history teaches most strikingly this impotence-the medical profession when no longer able to supply the technical aid which we think ought to be expected of it, must claim as its right a still higher significance, a duty far above the technical services of its own department-the duty of being in truth and in deed a humane calling. For there can be no doubt that we physicians too are active coworkers in the sublimest task assigned to humanity:

"Dass das Gute wirke, wachse, fromme,

Und der Tag des Edlen endlich komme!" "That the good may work, increase, profit, And the day of the noble come at last."

MEDICAL SCIENCE ON THE WHOLE,

as regards its various phases or epochs of development, may be likened to a large picture, whose atmosphere, tinted by unmeasured distance, displays only a few clearer cloudforms in somewhat definite outlines and masses, while the limited background exhibits in perspective lofty temples, about

whose portals wander priests in ample mantles, to guard them from the entrance of the uncalled. On either side appear mighty crags and groups of lofty trees, whose foliage is penetrated by the powerful rays of the noonday sun, while the foreground greets us in undimmed brilliancy and instinct with life. To the distant sky with its cloudy forms we may compare the mythical era of medicine, with its storied gods and demigods of punishment and of healing. To the background, the cognate priestly era, with its sacerdotal physicians and theurgic medicine, and its works hallowed by faith. The middle ground may be likened to the union of terrestial and celestial philosophy with medicine, the philosophic period; and finally the clear foreground, to the scientific epoch, with its practical principles and ideas. These various periods of development with different nations extend over distinct and long eras. Some of these periods with certain people have never been abandoned; others have not been traversed, and still others never attained. All, however, encroach on each other more or less, and the last two particularly are practically distinguished from each other only by adopting as the basis of such a distinction the tendency to abstract philosophical reasoning or to reasoning based upon the observation of the senses. The predominance of the one or the other of these intellectual tendencies then affixes its stamp to the whole period, though a complete separation of the two has never existed.

THE DEVELOPMENT OF MEDICAL SCIENCE

is best traced in some one people, and most easily among the Greeks, inasmuch as a number of their works, following each other in regular succession from the earliest to the later periods of development, have been preserved to us. Thus in the earliest writings we can perceive that the first medical services were of a surgical character, and that these had already attained a certain degree of perfection at a period when scarcely any traces of internal medicine were to be found. That the latter-undoubtedly anticipated by ophthalmology-was also preceded by a knowledge of midwifery, which, indeed, until a late day was generally regarded as belonging to surgery, seems apparent from the early appearance of midwives-and obstetrical goddesses, a species of divinity now, alas, extinct and frequently substituted by individuals of the masculine gender. What we now call internal medicine first developed, at all events, after the mythical or heroic period, and probably not until the end of the philosophic period of Greek medicine. Medical services too in those days were not divided into separate departments, but the various branches were first separated from the original and long pre-existing trunk of general medicine some centuries before the commencement of our era-in the Alexandrian periodto be once more subdivided during the age of the Roman Empire, an age in which the Greeks were almost the sole representatives of medical science. In the course of later ages (particularly in the beginning of the 16th century) this subdivision, in proportion to the increasing material of the

science and the greater number of physicians, became still more marked. Indeed at the present day the numerous special departments represent a kind of German Bund', within which the unity of medical science and the appreciation of that unity appear and live almost entirely in those medical circles composed of what we call practising physicians, while the great potentates in this medical confederation must, for the most part, be contented to cultivate and to understand their special states, be they larger or smaller, but are often not required to investigate in any way the departments of others.

THE DEVELOPMENT OF THE MEDICAL PROFESSION,

as the practical evidence of the tendency of medical science, naturally took about the same course as the latter itself. For a long period there were general physicians only; then they divided themselves into some few departments; but as the medical profession became overcrowded and began to decline there have always appeared specialists, frequently an infinite number of them.

PROGRESS OF MEDICAL CULTURE IN THE VARIOUS GEOGRAPHICAL DIVISIONS OF THE EARTH.

This followed such a course that, as early as the beginning of the second millennium B. C., northern Africa and eastern Asia possessed an independent medical literature (corresponding to the development of the period), and the countries between the limits mentioned, e. g. Palestine, Phoenicia, Babylonia, Syria, Persia, as well as China and Japan, were also at a very early date in the enjoyment of a medical literature, though all did not, like the countries first mentioned, possess a purely professional literature. After these, Europe, the youngest member of the old world, was the first to enter upon a medical culture of its own. It, however, in contrast to the others, continued a permanent and wider development. Within the countries of Europe, however, medicine followed the general direction of all culture, tending from the south-east toward the west. In the socalled New World were found only traces of a mythical, theurgic, utterly gross and empirical medicine, whose nutrient vessels, tied, alas, by the whites, were prevented from supporting a further development. The civilzed America and Australia of the present day were (and are still) in great part educated, in both medicine and all other departments of science, by Europe and her sons, though they are now beginning in many respects a development of their own.

While in the earliest ages the Arian stock had attained a tolerably high, and the Mongolian a less elevated, grade of medical knowledge, subsequently the latter race, disappeared utterly from the ranks of progressive medical science-the Japanese, however, seem desirous recently of resuming their lost position-and at the present day the Arians alone, in their various branches, are the sole representatives of such scientific progress.