Page:Encyclopædia Britannica, Ninth Edition, v. 15.djvu/831

SYNOPTICAL VIEW.] MEDICINE 799 tion " to certain powers possessed by it of visiting the examinations of the universities and corporations, and certain ill-defined powers of visiting the medical schools. The council may, if they see fit, report to the privy council any deficiencies that they may have discovered in the teaching or examining, and the privy council may proceed to further steps. But, beyond publishing the reports of their visitations, the medical council do not appear to have had occasion to put the machinery in force. The state has not otherwise interfered to prescribe the subject- matter or the minimum standard of medical education, although there has been at least one unsuccessful attempt by the Government of the day to establish a uniform minimum. By an Act of 1876 parliament has interposed to affirm the principle that women are entitled to become registered practitioners of medicine. Under the Dentists Act of 1878 the profession of dentistry acquired a legal status corresponding to that of the medical profession, the general medical council having charge of its register also. Pharmaceutical chemists are now licensed under an Act passed in 1876 ; since that date licences are granted only to those who pass either the minor or the major examina tion of the Pharmaceutical Society of Great Britain, a Pharmacy Act for Ireland (1876) having corresponding provisions. The Medical Profession in other Countries. In the United States there are usually no restrictions upon the practice of medicine, and in only a few of the States has the medical profession any legal standing. The ordinary medical title is that of doctor of medicine, and that degree is conferred by a large number of institu tions after a curriculum of study that varies much in length, and after examinations that are equally various as tests of proficiency. In France the medical profession is divided into two grades : those in the higher grade are all doctors of medicine of the faculties of Paris, Lille, Nancy, Bordeaux, Lyons, or Montpellier; those in the lower grade are officiers dc sante. In Germany the right to practise is ronterred by a state licence granted on passing the staats-examcn: .ie examination, which is almost entirely oral and practical, may be passed in stages at any one of the universities in the empire, the pro- lessors of anatomy, physiology, and pathological anatomy being practically ex officw examiners, while the other examiners tire very frequently also professors in the medical faculty. The staats-cxamcn is usually passed before the candidate seeks the degree of doctor of medicine; that degree is almost always taken by those who mss the examination for the state licence, and it is usually conferred after a more or less formal examination of the candidate before the medical faculty, and on the approval of his thesis. In Austria the right to practise is carried by the degree of doctor of medicine; there is no separate state licence, and no examination except that of the medical faculty of the universities (see Billroth s Lchrcn and Lcrnen dcr mcdicimschcn IVisscnschaJten, Berlin, 1876). In most Continental countries there are penalties directed in effect against practising medicine without the state licence, or the university degree equiva lent thereto, and in France the law now extends to resident foreign practitioners who have qualified only in their own country. The regulations for the practice of pharmacy in Germany and other Con tinental countries have long been of a very stringent kind. The training and licensing of midwives is also under state control. 4. Lastly, the state has interposed to restrict the " practice " of anatomy and physiology. By the Anatomy Act of 1832 (amended in 1871) licences are required for schools of anatomy, as well as licences for teachers, "to practise anatomy." Licensed teachers of anatomy are empowered to receive subjects for dissection under certain conditions. The Act is administered by the home office, with a staff of four inspectors of anatomy, one for the metropolis, one for provincial medical schools in England, and one each for Ireland and Scotland. The Act restricting the practice of physiology is the Vivisection Act of 1876 ; it is intended for the protection of vertebrate animals liable to be employed alive in physiological experiments, and it resorts to a controlling machinery of licence and inspection similar to that of the Anatomy Act, and under tho same Government department. (e. c.) PART II. HISTOKY. The history of medicine falls naturally under two heads, or might be conceivably written from two different points of view. It might be a history of the medical profession or a history of medical doctrine, in other words, the history of medicine in its relation to society or in its relation to science. We shall here deal chiefly with the history of nudical knowledge, remembering also that the histories of anatomy, of physiology, and of surgery are dealt with in the articles referring to those subjects. But a still more trenchant limitation is necessary to preserve the unity of the subject. Attention can be given to so much only of the history as is directly antecedent to and leads up to the medical science of modern Europe. For this purpose, the history of medicine must start with the earlier period of Greek civilization. Medicine as Portrayed in the Homeric Poems. In the state of society pictured by Homer it is clear that medicine has already had a history. We find a distinct and organized profession ; we find a system of treatment, especially in regard to injuries, which it must have been the work of long experience to frame ; we meet with a nomenclature of parts of the body substantially the same (according to Daremberg) as that employed long afterwards in the writings of Hippocrates : in short, we find a science and an organization which, however imperfect as compared with those of later times, are yet very far from being in their beginning. The Homeric heroes themselves are represented as having considerable skill in surgery, and as able to attend to ordinary wounds and injuries, but there is also a professional class, represented by Machaon and Podalirius, the two sons of Asclepius, who are treated with great re spect. It would appear, too, from the jEthiopis of Archinus (quoted by Welcker and Haeser) that the duties of these two were not precisely the same. Machaon s task was more especially to heal injuries, while Podalirius had received from his father the gift of " recognizing what was not visible to the eye, and tending what could not be healed." In other words, j a rough indication is seen of the separation of medicine and surgery. Asclepius appears in Homer as a Thessalian king, not as a god, though in later times divine honours werfiP paid to him. There is no sign in the Homeric poems 01 . the subordination of medicine to religion which is seen in ancient Egypt and India, nor are priests charged, as they j were in those countries, with medical functions, all cir cumstances which throw grave doubts on the commonly received opinion that medicine derived its origin in all countries from religious observances. Although the actual organization of medicine among the Homeric Greeks was thus quite distinct from religion, the worship of Asclepius (or ^Esculapius) as the god of healing demands some notice. This cult spread very widely among the Greeks ; it had great civil importance, and lasted even into Christian times ; but there is no reason to attribute to it any special connexion with the development of the science or profession of medicine. Sick persons repaired, or were conveyed, to the temples of Asclepius in order to be healed, just as ^in modern times relief is sought by a devotional pilgrimage or from the waters of some sacred spring, and then as now the healing influence was sometimes sought by deputy. The sick person, or his representative, after ablution, prayer, and sacrifice, was made to sleep on the hide of the sacrificed animal, or at the feet of the statue of the god, while sacred

rites were performed. In his sleep (incubatio, ty*oi -