THE HISTORY OF MEDICINE

In its Salient Features

CHAPTER I

THE PRIEST-PHYSICIANS OF EGYPT AND

BABYLONIA

THE medical lore of a very remote past was handed down from generation to generation by the Egyptian priests, the overseers of the general welfare of the people, to become ultimately known, at least in part, to Hippocrates and other Greeks of the Periclean age. The tendency to perpetuate traditional teachings and practices, natural to the priestly caste everywhere, was enhanced in Egypt through the early development of the hieroglyphic and hieratic systems of writing from the pictorial, and encouraged by the preservative nature of the dry Egyptian climate. The written records of the scribes and clerics, their incantations, spells, exorcisms, prescriptions, and clinical observations, were maintained intact from age to age, and finally embodied in compilations, of which a few specimens survive in the medical papyri of our libraries and museums. At the same time the ease with which the dead

could be preserved from putrefaction in the plateaus above the Nile Valley led to improved methods of tomb construction, which culminated in the erection of the pyramids between the thirtieth and twenty-fifth centuries, as well as to the development of the art of embalming, which reached its highest perfection about the middle of the sixteenth century, B.C. It is natural to find that in these circumstances therapeutics and religious superstition were not mutually exclusive, and that the efforts of the Egyptian priest-physicians to promote hygienic living and the attainment of longevity were closely associated with a transcendental vision of a material life everlasting.

In Egypt more clearly than elsewhere can be traced a rapid advance from barbarism to a high degree of civilization. In the Nile Delta, not far from the pyramids, are still to be seen the graves of neolithic man containing such evidence of his primitive industries as stone implements, pottery, fragments of linen, grains of barley and split wheat. These graves are not unlike those of primitive and prehistoric men elsewhere, as, for example, the graves of some of the aborigines of North America. In fact, the early Egyptian, watering his fields by a simple system of irrigation, living in huts of mud-brick, employing an undeveloped method of chronology, and unacquainted with copper or iron,

is in many respects comparable with the ancient Pueblo Indian of New Mexico and Arizona. The transition to a more advanced stage of development came for the Egyptians when in the fifth millennium B.C. they added to the use of gold and the rarer silver that of copper, found native or obtained by smelting from malachite. This acquisition led in turn, about the middle of the thirty-first century, to the employment of prepared stone as building material, and, about the beginning of the thirtieth century, to the erection of the first pyramid. This step-pyramid was designed by Imhotep, the first of the priest-physicians whose name is known to us. In later centuries his memory was held sacred in hundreds of temples, and he became identified in the minds of many Egyptians with Thoth, the god of healing.

It is not strange that some resemblance should exist between the surgery of Egypt, where, in the desert sands, stone tools and flint arrowheads are still to be found, and the surgery of primitive and prehistoric peoples. Before the dawn of history trephining, cupping, circumcision, castration, venesection, the use of the cautery and of splints were known in many parts of the earth; though the motives that led to the employment of these practices were not in each case identical with those of modern surgery. Skulls recovered by the archæ

ologist bear witness that trephining was practiced among prehistoric peoples in the western as well as in the eastern hemisphere. It was performed for a variety and mixture of motives — to relieve headache, to cure epilepsy, to let out the tormenting spirit, to obtain amulets, or to propitiate the gods. Even among primitive peoples to-day trephining is sometimes effected by means of knives of flint or obsidian. A slight link is established between the surgery of barbarian and that of civilized Egypt by some representations of surgical operations of 2500 B.C. They were discovered on the doorpost of a tomb in a necropolis near Memphis. Among the pictures are two of circumcisions, in which the surgeon is shown in the act of operating with a flint knife. The Jews, who learned this adolescent rite from the Egyptians, were still in their ceremonies using the same sort of neolithic instrument centuries later, as we know from the fifth chapter of the Book of Joshua.

On account of the conservatism of the priestphysicians, Egyptian medicine never advanced far beyond primitive medicine with its simple faith in magic spells and the virtue of a rich pharmacopoeia, and its belief that the cause of disease was the malice of a demon, the justice of an avenging god, the ill-will of an enemy, or the anger of the dead. The medicine chest of an early Egyptian queen