Part 13 (1/2)

We are very prone in thein each successive generation is of so nificance than as accomplished before our tiive much attention to the past This self-sufficient coard to the present would be quite unbearable only that each successive generation in its turn has had the saht little of by subsequent generations We shall have our turn with those we affect to despise

It is supposed to be particularly true in every department of science and, above all, in medicine that there is such a wide chas now and as accoent they were in the long ago, that to occupy ourselves seriously with the history of medicine may be a pleasant occupation for an elderly physician who has nothing better to do, but canupon practice or for the physician busy with his patients Medical history h for some book-worm interested in dry-as-dust details for their own sake and perhaps because he rejoices in the fact that other people do not know thenificance for the up-to-date physician This is an i We are learning that there is very little that we are {353} doing even now that has not been done before us and that, above all, the great physicians, no o they wrote, always have precious lessons for us that we cannot afford to neglect, even though they be 300 or 600 or 1,800 or even 2,500 years ago At all of these dates in the past there were physicians whose works will never die

In every department of human history the inificant has been receiving a sad jolt in recent years, and perhaps in no branch of science is this so true as into realize howdistant ti to appreciate that they approached problems in medicine at many periods of medical history in the best scientific temper of the modern time Of course there were abuses, but, then, the Lord knows, there are abuses now Of course their therapeutics had et that Professor Charles Richet, the director of the departy at the University of Paris, declared not long ago in an article in the best known of French azines, the _Revue des Deux Mondes_, that the therapeutics of any generation of the world's history always contained eneration The curious thing about it is that some of these supposed absurdities afterward coerms of discovery, or remedies of value that occasionally even develop into excellent systems of treatment

Of course there were superstitions in the old days, but, then, there have been superstitions in medicine at all times Any one who thinks that we are without superstitions in medicine at the present tiular practising physicians, y a survival It comes from the Latin _superstes_, a survivor

It is the acceptance of soress of knowledge or the developh the doctrine itself still maintains a hold on thenecessarily to do with religion, though it is with regard to religion that doctrines are particularly apt to be accepted after the reasons for them have disappeared In medicine, however, superstitions are alet a discussion with two of the most prominent physicians of this country on this subject

One of thereat teacher of clinical h cheard to the che the question of how much serious es and how, in spite of the nificent work done, so many superstitions in medicine continued to maintain themselves I ree bodies oftheht truths but which were only theories and which they insisted on holding after the reasons for theht that there were as reat significance as those that es

My cheht side said, ”Let us not forget in this regard the hold the uric acid diathesis has on the English-speaking ist on the left side: ”Well, and what shall we say of intestinal auto-intoxication?”

Perhaps you will not realize all the force of these expressions at the present time, but after you have been five years in the practice of medicine and have been flooded by the literature of the advertisingpharmacist and by the saestion of principles of practice, if you will listen to them, perhaps you will appreciate howthe medical superstitions of our time

Surely ho have for years been much occupied with the superstition, for such it now {356} turns out to be, of heredity in enerations and their superstitions

Until a few years ago ere perfectly sure that a number of diseases were inherited directly Tuberculosis, rheuout, various nutritional disturbances all were supposed to pass frohter, or sometimes to cross the sex line For a tiree at least Now most of us know that probably no disease is directly inherited, that acquired characters are almost surely not transmitted, and that while defects may be the subject of heredity, disease never is Not only this, biological investigations have served to show that what is the subject of inheritance is just the opposite,--resistance to disease A person whose father and mother had suffered from tuberculosis used to think it almost inevitable that he too should suffer from it If they had died that he too would die Our experts in tuberculosis declare now, that if tuberculosis has existed in the preceding generation there is afro time, than if there had been no tuberculosis in the fa the superstition of heredity, the surviver opinion froeneration, until we learned better by observation

Let us turn fros of the story of our medical profession as it has been revealed to us in recent years

The first picture that we have of a physician in history is, indeed, one to make us proud of our profession The first physician was I-eer of peace” He had two other titles according to tradition, one of which was ”the master of secrets,” evidently in reference to the fact that more or less necessarily many secrets must be entrusted to the physician, but also, doubtless, in connection with the knowledge of the secrets of therapeutics which he was supposed to possess Another of his titles was that of ”the scribe of numbers,” by which, perhaps, reference is thy, for there are many ”calendar” prescriptions in the early days, but hts and measures and numbers very exactly for professional purposes I-e Tchser, a ypt, the date of which is souished this first physician was in his tiathered from the fact that the well-known step pyramid at Sakkara, the old cereat was the honor paid to him that, after his death he orshi+pped as a God, and so we have statues of hi man with a certain divine expression, seated with a {358} scroll on his knees and an air of benignant knowledge well suited to his profession

I called attention in 1907 [Footnote 21] to the fact that the earliest pictures of surgical operations extant had recently been uncovered in the ceypt These pictures show that surgery was probably an organized branch of medicine thus early, and the fact that they are found in a very important toeon held at that tiard toof which was done probably about 1600 BC This, however, is only a copy of an older manuscript or series of manuscripts, and there seems to be no doubt that the text, which contains idioms of a much older period, or, indeed, several periods, probably represents accu 2,000 or even 3,000 years before the date of our manuscript Indeed, it is not improbable that the oldest portions of the ”Ebers Papyrus” owe their origin to yptian dynasties, nearly 5,000 years BC

To be members of a profession that can thus trace its earliest written docuo, is an honor that may be readily appreciated and that may allow of some complacency

[Footnote 21: _Journal of the American Medical association_, Noverounded tradition which shows {359} us that an Egyptian h we may not be able to pronounce it very well--he was Athothis, the son of Menes--wrote a work on anatomy The exact date of this monarch's death is sometimes said to be 4157 bc We have traces of hospitals in existence at this ti of the nature of a medical school Indeed, one may fairly infer thatfor some time, probably for some centuries, took a definite form at this time in connection with the temples of Saturn

Priests and physicians were the same, or at least physicians fory and the teachers of yion and medicine continued down to the fifteenth century

Ho of us there are who realize that until the fourteenth century the professors of reat universities were not married men, because members of the faculty, as is true at the present tilish universities, were not allowed toitself even with regard to theabout this early history of ypt is that, with the very earliest dawn of hly developed specialism in medicine

There were thirty-six departments of medicine, or {360} at least there were thirty-six medical divinities who presided over the particular parts of the huer temples, at least, there was a special corps of priest physicians for each one of these departments

Herodotus, the Father of History, is particularly full in his details of Egyptian history, and though he wrote about 400 BC, nearly 2,300 years ago, his attention was attracted by this highly developed specialisyptians He tells us in quaint fashi+on, ”Physicke is so studied and practised with the Egyptians that every disease hath his several physician, who striveth to excell in healing that one disease and not to be expert in curing many Whereof it cometh that every corner of that country is full of physicians Some for the eyes, others for the head, many for the teeth, not a few for the sto to realize that the saraduates will co out to find an opportunity to practise for yourselves at the end of the first decade of the twentieth century, is not very different froreat Father of History chronicles as the state of affairs ayptians between 600 and 1,000 before Christ,--let us say about 3,000 years ago You, too, will find that every corner is full of physicians, some for the eyes, others for the head,else under the sun quite as in {361} ancient Egypt After a time you will probably find that some little corner has been left for you, and you ork hard enough to get into it first, and then to fill it afterward The story of how young physicians have got on in their first few years has probably been interesting at all times in the world's history I think that I know about it at five different periods, and in every one of these there seemed to be no possible rooh only after there had been a struggle, in thephysicians found another sphere of activity besides medicine

Of course it is easy to think that these specialties did not aht is the le instance will show you how completely at fault this assumption is Dentistry is presumed to be a very modern profession As a matter of fact mummies were found in the cemetery of Thebes whose bodies probably come froold fillings that ell put in, and show good worko [Footnote 22] After dentistry, the specialty that ould be sure could not have had any significant existence so long ago would be that of ophthale of eye diseases displayed by these early teachers of {362}It is especially full in diagnosis and contained y and rhinology, one of the earliestby one of the kings of Egypt of an early dynasty (nearly 4000 BC), of a physician who had cured hi, that see

[Footnote 22: Burdett: ”History of Hospitals”]

It is easy to think in spite of all this, that the Egyptians did not knowabout it thinks so

According to Dr Carl von Klein, who discussed the ”Medical Features of the Ebers Papyrus” in the _Journal of the Ao, over 700 different substances are mentioned as of remedial value in this old-time an hich we are familiar in the nificance of diseases of such organs as the spleen, the ductless glands, and the appendix was, of course, ical condition was either expressly named or at least hinted at The papyrus insists veryin medicine, and hints that the reason why physicians fail to cure is often because they have not studied their cases sufficiently While the treatreat deal of therapeutics {363} at the present tiular school of medicine The number and variety of their re them is so marvellous, that I prefer to quote Dr von Klein's enumeration of them for you:

”In this papyrus are etable and doms which act as stimulants, sedatives, motor excitants, esics, anodynes, antispasmodics, ogues, antisialics, refrigerants, eatives, astringents, cholagogues, anthelmintics, restoratives, haeistics, antiperiodics, diuretics, diluents, diaphoretics, sudorifics, anhydrotics, eues, irritants, escharotics, caustics, styptics, haemostatics, emollients, demulcents, protectives, antizymotics, disinfectants, deodorants, parasiticides, antidotes and antagonists”

Scarcely less interesting than the variety of remedies were their methods of administration: