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his earliest knowledge from the observation of certain practices in animals；
as the natural phlebotomy of the plethoric hippopotamus； or the use of
emetics from the dog； or the use of enemata from the ibis。 On the other
hand； Celsus is probably right in his account of the origin of rational
medicine。 〃Some of the sick on account of their eagerness took food on
the first day； some on account of loathing abstained； and the disease in
those who refrained was more relieved。 Some ate during a fever； some a
little before it； others after it had subsided； and those who had waited to
the end did best。 For the same reason some at the beginning of an illness
used a full diet； others a spare； and the former were made worse。
Occurring daily； such things impressed careful men； who noted what had
best helped the sick； then began to prescribe them。 In this way medicine
had its rise from the experience of the recovery of some； of the death of
others； distinguishing the hurtful from the salutary things〃 （Book I）。 The
association of ideas was suggestivethe plant eyebright was used for
centuries in diseases of the eye 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
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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
physicianguide； philosopher and friend of the kinga 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
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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 the Egyptians meant the possession of all knowledge。 We must
come to the land of the Nile for the origin of many of man's most
distinctive and highly cherished beliefs。 Not only is there a magnificent
material civilization； but in records so marvellously preserved in stone we
may see； as in a glass； here clearly； there darkly； the picture of man's
search after righteousness； the earliest impressions of his moral awakening；
the beginnings of the strife in which he has always been engaged for social
justice and for the recognition of the rights of the individual。 But above all；
earlier and more strongly than in any other people； was developed the faith
that looked through death； to which； to this day； the noblest of their
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monuments bear an enduring testimony。 With all this； it is not surprising to
find a growth in the knowledge of practical medicine； but Egyptian
civilization illustrates how crude and primitive may remain a knowledge
of disease when conditioned by erroneous views of its nature。 At first； the
priest and physician were identified； and medicine never became fully
dissociated from religion。 Only in the later periods did a special group of
physicians arise who were not members of priestly colleges。＇6＇ Maspero
states that the Egyptians believed that disease and death were not natural
and inevitable； but caused by some malign influence which could use any
agency； natural or invisible； and very often belonged to the invisible world。
〃Often； though； it belongs to the invisible world； and only reveals itself by
the malignity of its attacks： it