PROFESSIONAL INSTITUTIONS. 173 



knife. And this may have been a part cause for the rise of those 

 secular medical practitioners who, having been educated in the 

 monastic schools, were, as barber-surgeons, engaged by the larger 

 towns in the public service. Probably this differentiation was 

 furthered by the papal edicts forbidding ecclesiastics from prac- 

 ticing medicine in general; for, as is argued, there may hence 

 have arisen that compromise which allowed the clergy to pre- 

 scribe medicines while they abandoned surgical practice into the 

 hands of laymen. 



Along with this leading differentiation, confused in the ways 

 described, there have gone on, within each division, minor differen- 

 tiations. Some of these arose and became marked in early stages. 

 In ancient India 



" A special branch of surgery was devoted to rhinoplasty, or operations 

 for improving deformed ears and noses, and forming new ones.' 1 



That the specialization thus illustrated was otherwise marked, is 

 implied by the statement that " no less than a hundred and 

 twenty-seven surgical instruments were described in the works 

 of the ancient surgeons ; " and by the statement that in the San- 

 skrit period 



" The number of medical works and authors is extraordinarily large. 

 The former are either systems embracing the whole domain of the science, 

 or highly special investigations of single topics." 



So was it, too, in ancient Egypt. Describing the results, Herod- 

 otus writes : 



" Medicine is practiced among them [the Egyptians] on a plan of separa- 

 tion ; each physician treats a single disorder, and no more: thus the coun- 

 try swarms with medical practitioners, some undertaking to cure diseases 

 of the eye, others of the head, others again of the teeth, others of the intes- 

 tines, and some those which are not local." 



Though among the Greeks there was for a long period no division 

 even between physician and surgeon, yet in later days " the sci- 

 ence of healing became divided into separate branches, such as 

 the arts of oculists, dentists, etc." 



Broken evidence only is furnished by intermediate times ; but 

 our own times furnish clear proofs of progress in the division of 

 labor among medical men. We have physicians who devote 

 themselves, if not exclusively, still mainly, to diseases of the 

 lungs, others to heart diseases, others to disorders of the nervous 

 system, others to derangements of digestion, others to affections of 

 the skin ; and we have hospitals devoted some to this and some 

 to that kind of malady. So, too, with surgeons. Besides such 

 specialists as oculists and aurists, there exist men noted for skill- 

 ful operations on the bladder, the rectum, the ovaria, as well as 

 men whose particular aptitudes are in the treatment of breakages 



