|Painted wooden stele depicting the statue of|
the god Horus, to whom a sick man is bringing
gifts, Third Intermediate Period.
The Museum of Louvre
N. . Paris
According to a Christian writer, Alexandrinus Clemens, living in Alexandria in about AD, the priests of early-dynastic Egypt had written the sum total of their knowledge in sacred books kept in the temples and carried in religious processions. Six of these books were concerned totally with medicine and dealt with anatomy, diseases in general, surgery, remedies, diseases of the eye and diseases of women. No example of these books survive nor of the anatomy books said to have been written by Athothis, second Pharaoh of the First Dynasty.
During the Old Kingdom the medical profession became highly organized, with doctors holding a variety of ranks and specialities. The ordinary doctor or Sinw was outranked by the imy-r sinw (overseer of doctors) the wr sinw (chief of doctors), and smsw sinw (eldest of doctors) and the shd sinw (inspector of doctors). Above all these practitioners was the overseer of doctors of Upper and Lower Egypt. There is evidence that a
distinction was made between physicians and surgeons, the latter being known as the "priest of the goddess Sekhmet". There were also healers who used purely magic remedies or exorcism.
The hieroglyphs of sinw were usually written showing the man, the pot of medicine and the lancet. Sometimes this was written with the determinative sign showing an old man leaning on a stick. This was the hieroglyphic epithet for "old age" and probably indicated that the physician in quetion was a venerable doctor of many years of standing.
|The word for sinw or "physician" was written showing|
the man, the pot of medicine and the lancet.
|Limestone statuette of Imhotep,|
vizier and chief physician to
Pharaoh Djoser -
The Petrie Museum of Egyptian
Archeology, University of
Iry was chief of court physicians at Giza during the Fourth Dynasty. He was also "master of scorpions", "eye doctor of the palace", "doctor of the abdomen" and "guardian of the royal bowel movement". Sekhet-n-Ankh was "nose doctor" to Pharaoh Sahure (Fifth Dynasty) and successfully cured him of a "sickness of the upper air passages".
The only Egyptian lady doctor yet known was Peseshet (Fourth Dynasty or early Fifth Dynasty), whose title, imy-rt-swnt, may be translated as "lady director of lady physicians".
Each specialization of medicine had a patron god or goddess and physician worked directly under the auspices of his particular deity. Duaw was the god of eye diseases; Taurt was a goddess of childbirth, as was Hathor. Sekhmet, the lion-headed lady of pestilence, sent plagues all over the land and Horus had power over deadly stings and bites such as those of crocodiles, snakes and scorpions (the most common type of "everyday" injury appears to have been from bites). The human body was divided into parts and each part came under the protection of a god or a goddess.
- Isis protected the liver.
- Nephthys protected the lungs.
- Neith protected the stomach.
- Selket cared for the intenstines.
The House of Life (Per Ankh) was the medical study center where doctors were taught and these existed as major cult temples along with centers of healing. The remains of the magnificent temple excavated at Edfu date from the Greek Period although the western side has an inner and an outer enclosure which date to the Old Kingdom. There was a her garden to the right of the building in which many of the ingredients for the physicians' remedies and prescriptions would have been grown.
|Hieroglyphs representing the external parts of the body and|
the internal organs.
Sick people seeking help at the temples were expected to make an offering to the gods. This provided a useful source of income for the temple. Offerings were made according to means - perhaps clothes, bread, fruit, or, from wealthier patients, an ox or jewellry. Some patients underwent "sleep therapy", whereby a twilight sleep was induced by administering opium or an extract of the mandrake, and the sick person's demons were thus exorcised. Possibly too other more painful treatments may have been carried out whilst the patient was semi-conscious. Very often the sick person left a model of the area of the body which contained his pain or sickness so that the temple medicine might go on working while he remains outside its precincts. Amulets were worn to ward off sickness and tiny protective statuettes were kept in many homes.
Large collections of medical writings were kept in the temples even as late as the second century AD, when Galen wrote that Greek physicians still visited the library of the school at Memphis.
The hieroglyphic signs for the external parts of the body are mostly derived from human anatomy whilst the signs for internal organs are derived from animal parts. Whist this provides some evidence to suggest that the Egyptians did not dissect human bodies, descriptions of injuries from the Old Kingdom text of the Edwin Smith Papyrus suggest otherwise. A vertebral crush injury causing tetraplegia is so accurately described that anatomical exposure of the cervical spine may have been performed.
Although no surgical scars have been reported in mummies (apart from embalmers' incisions), there are thirteen references in the Smith Papyrus to ydr, which the Egyptologist James Breasted translated as "stitching". The papyrus also mentions wounds being brought together with adhesive tape which was made of linen.Linen was also available for bandages, ligatures and sutures. Needles were probably of copper.
A box of surgical instruments was carved in relief on the outer corridor wall of the temple of Kom Ombo, which dates from the Roman Period. These include metal shears, surgical knives and saws, probes and spatulas, small hooks and forceps. An oculist's box of instruments, as well as surgical instruments resembling cauteries and scalpels (Late Period), has also been found.
Egyptian doctors distinguished between sterile (clean) wounds and infected (purulent) wounds. The former were written using the determinative for "blood" or "phlegm" and the latter using the determinative for "stinking outflow" or "faeces". A mixture of ibex fat, fir oil and crushed peas was used in an ointment to clean an infected wound.
Sometimes the hieroglyphs provide insight into disease analogy and symptoms recognition. The word for "sweat" was written using the pictogram determinative for "water" and the word for "inflammation" used the sign for a brazier. The word for "flutter" was written using pictograms representing fluttering birds. Similar pictorial representations are used to convey the meaning of the words "weap" and "honey". The word for "injury", also meaning "to smite", shows a man about to strike an assailant with a stick. An illness causing shortness of breath would be written using the determinative of a "sail". Putting a fractured or dislocated bone back into its place was represented by two crossed bones.
A plaster for setting a fracture might be made from cow's milk mixed with barley (Hearst Papyrus ) or acacia leaves (Acacia nilotica Desf.) mixed with gum and water (Hearst Papyrus ). Two Fifth Dynasty fractures had been set with bark splints and bandages. Bandages and poultices were used to apply therapeutic subsctances to lesions and to "draw out" poinsons from internal ailments. A poulitice of porridge and myrtle (Myrtus Communis L.) was used to "remove mucus" from the right or left side of the chest (Berlin Papyrus ) - perhaps this was lobar pneumonia or pleurisy. The binding bases of other poultices were clay, sawdust, wax and pondweed.
A wall relief from the tomb of Ankh-ma-Hor at Saqqara depicts a circumcision scene. There seems to be no reason why some Pharaohs, priests and officials were circumcised and others were not. The Greek historian Strabo claimed that the Egyptians also practiced female circumcision but examinations of female mummies show that they have either not been circumcised or their condition is too decayed to be able to tell.
From the New Kingdom onwards Egyptian doctors were to be found as advisors or chief physicians at many of the most important foreign country, notably in Anatolia, Syria, Persia and mesopotamia. Expeditionary forces posted to Punt, Crete and Phoenicia were also equipped with doctors. The Greek historian Diodorus Siculus wrote:
"In wartime, and on journeys anywhere within Egypt, the physicians draw their support for public funds and administer their treatments in accordance with a written law which was composed in ancient times by many famous physicians."A Middle Kingdom mass grave (c. 2000 BC) held the bodies of sixtysoldiers who had fought in the north to reunite the country. Their wounds included arrow holes (with arrows in situ) and bludgeonings. A general who fought an elephant during the reign of Tuthmosis III (18th Dynasty) sustained a superficial scalp wound.
Herodotus says that it was an Egyptian oculist who aided the Persian Cambyses, son of Cyrus the Great, in his invasion of Egypt when he founded the 27th Dynasty in BC. The treacherous doctor was seeking revenge on the Pharaoh Ahmose II for sending him from his family to the Persian court.
By the time of the Persian invasion, it appears that medicine had suffered from the growing internal troubles and threats of invasion prevalent in the Late Period. User-hor-Resinet was chief of physicians to Darius I (521:486 BC), who, it appears, was concerned about this decline in medical practice;
"His Majesty, Darius I, lord of all lands and of Egypt also... ordered me to go to Sais in Egypt. He instructed me to restore the "house of life" which had fallen into despair. I did as His Majesty commanded... I filled them with students from the families of the nobles - taking no sons of the poor. I placed them in charge of wise men... His Majesty commanded me to provide them with all that they needed, with all instruments, according to the drawing of the old times..."