In what must still be termed the age of primitive medicine, but undoubtedly at an advanced stage of that epoch, there were performed surgical operations which imply a remarkable advance in the invention of cutting instruments and in the knowledge of the location and nature of certain comparatively rare diseases, and at the same time great courage and wonderful enterprise on the part of those early physicians. As evidence of the correctness of these statements the fact may be mentioned that trepanned skulls belonging to the neolithic period have been dug up in various parts of the world—in most of the countries of Europe, in Algiers, in the Canary Islands, and in both North and South America. From a careful study of these skulls it has been learned that the individuals upon whom such severe surgical work had been done—sometimes as often as three separate times—recovered from the operation. The instruments used were made of sharpened flint (saws or chisels). Pain in the head, spasms or convulsions, and mental disorders are suggested by Neuburger as the indications which probably led to the performance of the trepanning. This author also makes the further statement that the ancient Egyptians employed knives made of flint for opening the dead bodies which they were about to embalm and for the operation of circumcision. Recent excavations have thrown additional light upon the state of medical knowledge during this neolithic age. Thus, there have been found specimens of anchylosed joints, of fractured bones, of flint arrow heads lodged in different parts of the skeleton, of rhachitis, of caries and necrosis of bone, etc. The following quotation is taken from the printed report of a lecture recently delivered in London by Dr. F. M. Sandwith, Consulting Surgeon to the Khedive of Egypt. Speaking of certain excavations made in the Nubian Desert and of the oldest surgical implements yet discovered, he says:—

In one place a graveyard was found, and here were remains of bodies with fractured limbs that had been set with bark splints. One was a right thigh bone that had been broken, and was still held in position by a workmanlike splint and bandages. All the knots were true reef-knots, and the wrappings showed how the strips of palm-fibre cloth were set just as a good surgeon would set them in these days so as to use the full strength of the fabric.

Among the most ancient remedies may be mentioned talismans, amulets and medicine stones, which were furnished—presumably at a price—by the physician-priests, and which were believed to afford the wearers protection against evil spirits (the “evil eye,” for example). Various objects were used for this purpose, and among them the following deserve to be mentioned: disks of bone removed with the aid of a trephine from the skull of a dead human body and worn with a string around the neck; the teeth of different animals; bones of the weasel; cats’ claws; the lower jaw of a squirrel; the trachea of some bird; one of the vertebrae of an adder, etc. And where these measures failed, the priests resorted to incantations, religious dances, and the beating of drums or the rattling of dried gourds filled with pebbles. Primitive races of men inhabiting the most widely separated parts of the earth appear to have adopted means almost identical with those just described for driving away evil spirits. The holding of these superstitious beliefs is one of the most extraordinary characteristics of the human race. It played an important part throughout the classical period of Greek and Roman civilization, and also during the Middle Ages. Christianity undoubtedly was a most potent agency in hastening the eradication of the feeling, but even this great power has not yet sufficed entirely to do away with superstition; for traces of this weakness may still easily be detected in some of the men and women with whom we daily come in contact.

CHAPTER II
ORIENTAL MEDICINE

The researches of the scholar working in combination with the engineer have unearthed—more particularly in Mesopotamia, in Egypt and in Greece—evidences of an ancient medical science far advanced beyond that briefly described in the preceding chapter. These evidences relate to nations that flourished as far back as four thousand years B. C. While they are very fragmentary and cover historical events which are often separated from one another by long periods of time, these data nevertheless suffice to give one a fairly good idea of the then prevailing state of medical knowledge. Both Pagel and Neuburger adopt the plan of discussing these different nationalities separately, and I shall follow their example.

Medicine in Mesopotamia.—As appears from the most recent investigations the Sumerians were the first occupants of the region lying between the Euphrates and the Tigris rivers. It was from them that their Semitic conquerors, the Babylonians and the Assyrians, received a civilization which, already about 4000 B. C., had reached a wonderful degree of development. The canalization of the low-lying lands of that region, the organization of a religious and civil government of a most efficient type, the invention first of picture-writing and then of the cuneiform characters, the cultivation of the arts and natural sciences and especially of astronomy and mathematics to a high degree of perfection,—these are among the things which were accomplished by this very clever race of men. In addition, however, to these useful activities the Babylonians developed and cultivated diligently the science of astrology—that is, the science of predicting human events (such as the death of the king, the occurrence of the plague or of war, etc.) from various telluric and cosmic phenomena—an eclipse of the sun, peculiarities of the weather, the condition of vegetation, etc. The deeply rooted love of the human race for the supernatural—a characteristic to which I have already briefly referred—facilitated the development of this harmful practice, and kept it alive through many succeeding centuries. Walter Scott, in his romance entitled Quentin Durward, gives an admirable portrait of a typical astrologer whom Louis XI. of France maintained at his court during a part of the seventeenth century.

While in other parts of the Orient the science of medicine, as already stated at the beginning of this chapter, made a noteworthy advance beyond the conditions observed among the primitive races, in Mesopotamia this science, which was far more important to the welfare of its inhabitants than all the other branches of knowledge combined, received very little attention and consequently made only insignificant advances. The British Museum has in its possession several thousand tablets which were dug up from the ruins of Nineveh and which represent a part of the library of the Assyrian King, Assurbanipal (668–626 B. C.). Translations of the text of only a very few of these tablets have thus far been published, and from these, which embody the greater part of our knowledge of Assyrian medicine, it appears that, for the present at least, the estimate recorded above must stand. A few new facts, however, have been brought to light, and they appear to be of sufficient importance to merit brief consideration here.

In the first place, Herodotus, who visited Babylon about 300 B. C., has this to say in relation to the state of medicine in that city:—

The following custom seems to me the wisest of their institutions next to the one lately praised. They have no physicians, but, when a man is ill, they lay him in the public square, and the passers-by come up to him, and if they have ever had his disease themselves or have known any one who has suffered from it, they give him advice, recommending him to do whatever they found good in their own case, or in the case known to them; and no one is allowed to pass the sick man in silence without asking him what his ailment is.[2]

The Babylonians held some rather strange beliefs regarding the construction of the human body and the manner in which its functions are performed. The living being, as they maintained, is composed of soul and body. The intellect has its seat in the heart, the liver serving as the central organ for the blood, which they considered to be the true life principle. They divided this fluid into two kinds—blood of the daytime (bright arterial) and that of the night (dark venous). Although the blood was held by them to be the basis of life, they evidently attached a certain value to respiration, for one of their prayers begins with these words: “God, my creator, lead me by the hand; guide the breath of my mouth.” Disease was always looked upon as something (usually personified as a demon) that entered the body from without and that consequently had to be expelled. There were special demons for the different diseases. Thus, Asakku brought fever to the head, Namtar threatened life with the plague, and Utukku attacked the throat, Alu the breast, Gallu the hand, Rabisu the skin, and so on. The most dreaded demons were the spirits of the dead. Special amulets were employed as protective remedies. Prayer formulae were also used. Here is one among several that I find mentioned in Neuburger’s treatise:—