The basic principles of medicine in the primitive mind.

THE DESIRE to maintain, reinforce or restore health, has everywhere followed initially two distinct trends-that of instinctive or empirical medicine, and that of magic or sacerdotal medicine. The fusion of these two accidental at first, then systematic and by intent-had as a happy and paradoxical consequence the progressive laicization of the profession; a preliminary condition necessary to its development. Instinctive and empirical medicine has had to start with a very limited field of action-that of morbid conditions, the cause or the agent of which is evident and directly recognizable. This means that it applied itself mainly to superficial traumatic complaints. Long before the appearance of Homo Sapiens, the instinct of the-animals had taught them how to immobilize a broken leg; to lick a wound; to get rid of a thorn; or even to absorb a purgative herb. Pliny considers that animal medicine has directly inspired that of man. Then man put to the service of his own instinct the resources of an elementary logic. Later, medical empirical knowledge was born from occasional and repeated findings, and from remembering and recording certain happy results fortuitously obtained. At this stage man learned how to summarily reduce, and later how to immobilize a fracture or a luxation; how to extract an accessible foreign body, manifestly causing his pain; and how to resort to baths and diet. The relief brought about by the spontaneous opening of an abscess prompted him to incise, with a stone splinter or a bronze blade, the superficial collections of pus. Aware of the fact that repeated ingestion of the same noxious substance regularly brings about the same disorders, he doubtless and precociously had the idea of evacuating it as soon as possible by using vegetable drugs, ofwhich he had noticed the emetic or purgative effects. Through the following ages, intuitive and intelligent empiricism has been at the origin of countless therapeutic discoveries. Fortuitous comparisons probably brought to light, in the East or in Byzantium, the antigouty virtues of colchicum; and thanks to the same mental process, the American Indian tribes used for the first time the febrifuge action ofcinchona bark and the antidiarrhoeic effect ofipecacuanha. For having at all times practised deep-sea fishing, the natives of Polynesia spontaneously conceived artificial breathing in case of drowning. Many other similar examples could indeed be quoted. Medical empiricism has thus been the earliest precursor of observation, and later of experimental medicine. It seems to have existed in the remotest times, and one *A lcture given at the Welcome Historical Medical Library on 12 July 1966. The author is highly indebted to Mr. and Mrs. James Black for their help in the translation.