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But even within the Arian stock we do not observe an equal advance among all its branches. The peculiar medical cultures of the Egyptians, Jews, Babylonians, Assyrians, Phoenicians and Medo-Persians, with their respective states and the independent existence of their supporters, have utterly disappeared; the science of the Indians has remained stationary, and the medical culture of the Greeks, with its offshoots the medicine of the Romans and Arabians, existed and in part still exists only in very late, though certainly decided, after-effects. The offspring of the Romans, the Romanic peoples, however, are struggling to-day on even terms with the far younger, and therefore more vigorous Germans, for the olive-braneh of victory and the laurel of fame. The Sclaves too have recently entered independently into the struggle, and long hereafter, when the former nations have become old and feeble in the progress of the world, the Sclaves will probably dispossess both the Romanic nations and the Germans of their pre-eminence. The negroes have been from the outset, and now are, without any importance in the development of the medical sciences, as well as in every other way, and the Indians, devoted, alas, to destruction by that vampire of human races, the whites, though intellectually much more highly organized than their destroyers, have exercised no influence upon the progress of medical science. The same remark may also be made of the inhabitants of the Australian archipelago.
As regards the periods within which the different branches of the human race entered upon medical culture, on a general survey the writings still preserved to us furnish for very ancient times the most secure basis. In this way it may be regarded as settled for the Egyptians that some of their extant special medical works were composed in the 17th century B. C. On the other hand the Indians are able to exhibit such works only from the 11th century before our era. The medical knowledge of the Jews (Moses, about B. C. 1500), the ancient Persians (Zend Avesta about B. C. 500), and the Chinese, is scattered through, and incorporated in their religious and poetical writings of very early date, while of the equally ancient Phoenicians no written remains are preserved to us. The Greeks, whose spirit was destined to rule all later humanity, show some traces of medical knowledge in poems whose contents are assigned to the period about B. C. 1000, but they did not begin to create a medical literature proper until the fifth century before Christ. After the death of Alexander the Great (B. C. 323), the city of Alexandria became the chief nursery of medical science. From Alexandria and the schools founded by her pupils, the latter was transplanted among the Romans about B. C. 100. From Byzantium, by way of Alexandria, an offshoot of Greek medicine of historical importance was imported to the Persians and Arabians by the Nestorians, who were banished for heresy in the fifth century and founded or continued schools in Gondisapor and other places. Under the indirect influence of the latter, and chiefly by means of Jewish physicians, there arose in the 9th century the medical schools of lower Italy at Monte Casino
and Salerno, which in the darkest periods of the Middle Ages preserved for medicine a secure but narrow place of refuge, until through the Italians in the 14th century human anatomy was created to furnish a foundation for a new science of medicine. The new epoch was also specially inaugurated by the Greeks banished from Byzantium on the capture of this city by the Turks (1453). Henceforth, however, medicine entered upon a broader road and extended its influence over a larger number of people. Among the French, Paré, about the middle of the 16th century, created modern surgery in a method characteristic and valid even down to the present day, while the Englishman Harvey in the following century by his discovery of the circulation laid the foundation of physiology, and Paracelsus, earlier than either, created among the Germans a new science of medicine. Thus general medicine in these lands celebrated a new Springtime and a veritable Easter festival, while preserving the impulse for further development--a development which in power and extent left far behind that of the earlier ages, and seems in our own age to be passing through its proper fructification. In the most recent times, however, the advancing wave of medical culture, chiefly by the aid of American and Australian representatives of the white race, has reached Japan, one of the oldest homes of medicine in eastern Asia, and thus the circuit of the world is being completed, centuries after its commencement.
The form of development of medicine in its entirety may, accordingly, be compared to a tree, whose perennial stem is formed by the Egyptians, Indians, Babylonians, Persians, Chinese, etc., and its tap-root, by which the stock is continued, is represented by the Greeks. From this stock, which first pushed forth the barren shoot of Roman medicine, and subsequently that of the Arabians during its miserable existence in the course of the Middle Ages, there finally developed a powerful branch at the beginning of the modern era, and after its transplantation into the soil of the West. Gradually there appeared five main branches, the Italian, the French, the German, and the English, with the less vigorous Spanish, which originally promised so much, but yet remained feeble and miserable. These first four main branches, with their dependent twigs, now tower above all small and modern civilized peoples and states. But in the formation of the complete crown, as in the system of universal medicine, all people will, at some time, take part.
THE DIVISION OF MEDICAL HISTORY INTO PERIODS
is commonly made in such a way that the era of Antiquity closes with Galen; then follow the Middle Ages of medicine, and the modern history of this science begins with Harvey.
If we look upon the history of medicine as a department entirely separable from the general history of civilization, it is justifiable to fix upon special epochs, and to regard particular services of representative persons within these epochs as special landmarks. The propriety of this
idea we certainly cannot deny. Yet the history of medicine may, with equal justice, claim to be exclusively a part of the general history of culture, with whose course, as may readily be seen, it keeps pace, and from which it cannot ever be entirely separated-and we believe that from this point of view the generally received divisions of the latter ought also to be preserved as the most practical in the history of medicine, inasmuch as they have received general acceptance, and maintain the idea of the unity of the history of medical and general culture. Again, the landmarks mentioned above do not limit with absolute truth and precision the beginning and end of the medical epochs in question. For the Greco-Roman medicine e. g., though, like the ancient peoples themselves, it had greatly deteriorated, still existed and exercised exclusive control over medical science long after the days of Galen. It was not until the downfall of the Roman Empire in the West that medical culture was gradually transferred to new peoples, and began a new phase of development upon a new soil. By such phenomena, however, the epochs of a science, as of culture in general, are most distinctly divided. The same thing occurred at the beginning of the modern era, when medicine migrated from Italy to the civilized nations of the Germanic stock, who now control it, and thus won a field for development much broader than in the times past.
Another point of view from which this subject may be regarded, is found in the following facts:
Nations, as regards their services to medicine, may be divided into two sufficiently sharply defined groups, the one embracing those nations who have withdrawn from the stage of history, or who, though still present, no longer manifest any progress or independence in their medical knowledge; the other including those who possessed at one period, or who still possess, a progressive development of their own in medicine.
Accordingly we present the following division:
The Medical Culture of those Nations whose Development in Medicine is either already closed or is stationary (or not independent). The His
tory of the Most Ancient Medicine and the Medicine of Primeval Peoples.
The Medicine of the Egyptians.
II. The Medicine of the Ancient Persians (Chaldeans, Babylonians, As
syrians, Syrians, Medes) and Phoenicians (Carthagenians).
III. The Medicine of the Jews.
IV. The Medicine of the Indians.
V. The Medicine of the Chinese and Japanese. ·
VI. Medical Views and Economy among other Nations, of whom some have disappeared from history, some are stationary in their development, and others possess as yet no medical culture of their own (Scythians, Kalmucks, Siamese, Turks, etc., etc.).