Ancient Egypt

The papyri

Medicine written down and kept

Egypt is where medicine becomes a written record. A dozen medical papyri survive, and two carry most of the weight: the Edwin Smith Papyrus, a surgical text, and the Ebers Papyrus, a much longer collection of remedies and physiology.

Both were copied around 1600 to 1550 BCE, and the Edwin Smith material is roughly a thousand years older than the copy that survives. The Ebers Papyrus is held today at the University of Leipzig.

The professions were organized. The swnw was the physician, working alongside priests of Sekhmet and practitioners of magic, with titles for specialists and for those who supervised them.

The Edwin Smith Papyrus

Forty-eight cases in a fixed format

The Edwin Smith Papyrus is the oldest surgical document on earth. It presents 48 cases in a single repeating structure: title, examination, diagnosis, verdict, and treatment.

The cases run from the head downward. 27 concern the head and 6 concern the spine. Along the way the text produces the first written occurrence of the word brain in any language, and the earliest surviving descriptions of the meninges and the cerebrospinal fluid.

The examinations are hands-on and precise. The physician is told to probe the wound, to test whether the patient can turn the neck, to watch the eyes, and to note what the patient does without being asked.

Injury and consequence

What the Egyptians learned from broken heads

The papyrus records that an injury to one side of the skull is followed by effects on the opposite side of the body. It records that crushing injuries to the vertebrae impair movement and sensation together.

It describes a man with a head wound who has lost the power of speech, which is the oldest surviving clinical description of aphasia.

Nobody in Egypt dissected a living nervous system or had a word for a nerve. Egyptian physicians worked out the connection between the head, the spinal column, and function elsewhere from what happened to injured people, written down case by case until the pattern was undeniable.

The three verdicts

Prognosis written into the format

Every case in the Edwin Smith Papyrus closes with one of three judgments. An ailment which I will treat. An ailment with which I will contend. An ailment not to be treated.

The third verdict, an ailment not to be treated, is written up in the same detail as the rest. Recording a case that cannot be helped is what keeps the record honest.

Prognosis is separated from diagnosis and given its own line. The physician states the expected course before acting, which makes the record checkable and makes experience accumulate.

The metu

A body mapped as one network

Egyptian physiology is built on the metu, the channels running through the body. Paragraph 856b of the Ebers Papyrus says a man has 22 metu running to his heart, and that they give to all his limbs.

The metu carried blood, air, water, and waste, and they ran to and from the heart. Egyptian medicine treated the heart as the center of the body and the seat of thought and feeling. The pulse was understood as the heart speaking through the metu, and physicians were instructed to feel it at several places.

Illness was read as a problem of what moves in the channels. Blockage, and the rot the Egyptians called wekhedu, produced disease at a distance from where the trouble began, which is why an Egyptian physician treating a limb might work on the abdomen.

Purgation and the calendar

Treating the body on a schedule

Egyptian medicine treated accumulation as the enemy. Herodotus reports that Egyptians purged themselves for three days each month to keep health, and the medical papyri are full of preparations for clearing the belly.

The reasoning follows the metu. What gathers in the channels and cannot leave becomes the source of illness, so the channels are cleared on a schedule rather than only when something has gone wrong.

Treatment is therefore timed as well as targeted. The regimen assumes that what accumulates does so gradually, and that removing it before symptoms appear is cheaper than treating what it causes.

Hands, splints, and honey

The physical treatments and what they specify

The surgical papyrus prescribes manual reduction of dislocations, splinting of fractures, sutures, and dressings, with the position of the patient and the direction of pull described in each case.

Wounds were dressed with honey, grease, and lint. Honey is hygroscopic and antibacterial, which is why the practice worked and why it outlasted the theory that justified it.

The instructions specify amount, place, and sequence. Egyptian physicians had learned that the same maneuver helps or harms depending on where and how hard it is applied.

Transmission

What flowed on

Egyptian medicine was studied by outsiders throughout antiquity. Greek physicians traveled to Egypt, Homer credits Egyptian practitioners with unmatched skill, and Alexandria later became the one place in the ancient world where human dissection was performed.

Imhotep built the Step Pyramid in the twenty-seventh century BCE. More than two thousand years after his death he was deified as a god of medicine, which is a measure of how the tradition regarded its own founders.

What Egypt handed forward is a method: examine in a fixed order, write down what you find, name the expected course, and keep the cases you could not help.

Common questions

Frequently asked