The Edwin Smith Papyrus: What It Reveals About Ancient Egyptian Medicine

In the vast landscape of ancient history, few writings contradict modern perceptions of early science as much as the Edwin Smith Papyrus does. The prevailing classical popular perception about Egyptian healing is that it was a realm of mystical incantations, magical amulets, and exorcisms. However, this remarkable manuscript provides us with a wholly different perspective on ancient Egyptian medicine. This Papyrus was written in approximately 1600 BC, coming from the Second Intermediate Period, but is a copy of an even older manuscript from the Old Kingdom. Edwin Smith Papyrus is the world’s first surgery and trauma manual, describing treatment and diagnosis procedures.

The scroll is more than four and a half meters long and is written in an elegant hieratic script. Within the papyrus, there are forty-eight detailed clinical cases. By studying the cases described in the Edwin Smith Papyrus, we gain remarkable insight into the empirical, scientific tradition of ancient Egyptian medicine.

1. Background context: Acquisition, discovery, and decipherment

The modern history of the Edwin Smith Papyrus is also of considerable interest. It connects us with the annals of both the nineteenth-century Egyptology and the twentieth-century medicine.

A. The purchase in Luxor

An American by the name of Edwin Smith bought the ancient scroll in Luxor in 1862. Unlike many of his contemporaries who were more interested in ancient gold, amulets, and hieroglyphic tomb paintings, Smith was fascinated by hieratic scripts. He soon realized that he had stumbled upon something rare and valuable — an authentic scientific text, which was exceptionally well organized. Rather than cutting the scroll into smaller pieces to sell, Smith kept the Papyrus whole until his death in 1906, when his collection was donated to the New York Historical Society.

B. James Henry Breasted’s masterpiece

In 1920, the manuscript was passed to the Oriental Institute at the University of Chicago, founded by James Henry Breasted. With the help of medical consultants, Breasted worked on the scroll for ten years, deciphering, transcribing, and translating it from the original Egyptian. The results of his research were published in 1930 as a two-volume treatise, in which Breasted described the ancient Papyrus in all its scientific and medical glory. Ancient Egyptian physicians developed an astounding set of practices that were surprisingly objective for their time.

2. Origins of the scientific method in the Edwin Smith Papyrus

Unlike other surviving medical papyri, such as the Ebers or the London Medical Papyrus, the Edwin Smith text is devoid of spells, save for one single instance. Of the total number of cases, forty-seven mention no magical spells at all.

A. A case study format

Every case follows a simple, yet comprehensive format, aimed at assisting a practicing physician with the daily triage and treatment of his patients:

Title: Describes the nature and location of the injury (e.g., “Instructions concerning a gaping wound in his head, reaching to the bone”).

Examination: Recommends a battery of tests: palpitation of the wound, inspection of body movement range, olfactory assessment of the injury, temperature measurement.

Diagnosis: States the medical professional’s opinion on the case.

Verdict: Offers a triage guidance based on the severity of the injury.

Treatment: Prescribes a set of physical therapies, reductions, or wound-dressing instructions.

Glossary: Explains hieratic terms for students.

B. The triage verdicts

The author of the.scroll also develops, by default, three triage verdicts long before the modern hospital triage systems were created:

“An ailment which I will treat”: A favorable prognosis signifying possibility of a complete recovery.

“An ailment with which I will contend”: An uncertain prognosis requiring continuous supportive therapy.

“An ailment not to be treated”: An unfavorable prognosis signaling an inevitable demise, for which the surgical intervention should not be attempted.

3. Revolutionary anatomical and neurological observations

The cases are organized according to the vertical zonation of the human body, going downwards from the skull, facial bones, and jaw, into the collar bones, shoulders, and thorax, and finally the spine. Such anatomical organization allowed the ancient author to make remarkable observations of the human body.

A. The brain and the meninges

The Edwin Smith Papyrus contains the earliest known recorded use of the word “brain” (ais) in history. The physician described the brain as having a consistency similar to the slag from copper smelting, but with a furrowed surface texture. The text also specifies the brain’s meninges and fluid-filled cranial cavity, which constitutes a significant contribution to the emerging understanding of human anatomy.

B. Localization of brain functions

Centuries before the classical period, the author of the scroll described the phenomenon of focal brain damage observed in the patients, who presented with various motor and speech impairments. The text specifically mentions left-side paralysis, aphasia, and involuntary eye movements or localized hand shaking following a skull fracture on the right side. Moreover, the Papyrus contains the earliest recorded description of paralysis of the upper limbs, lower limbs, and trunk sensory function as a result of a severe neck injury. Such injuries often resulted in inevitable bladder or bowel accidents as well as impairment of the sensory functions.

4. Practical surgery, pharmacology, and wound healing

The actual surgical interventions described in the cases are equally impressive. Overall, the Edwin Smith Papyrus represents a remarkably practical approach to the treatment of battlefield and industrial injuries.

A. Wound closure

The manuscript describes the ancient Egyptian method of suturing the deep wounds of the face, scalp, or neck, using a needle and thread. If such interventions were not feasible, the surgeons used a linen tape to hold the edges of the cut together, similar to the modern-day application of the butterfly bandage.

B. Infection prevention

The scrolls also describe a set of measures designed to prevent infection of an open wound and promote healing. On the first day following an injury, the Egyptians would apply raw meat, which acted as a natural cauterizing agent, gently pressing it to stop a bleeding. Beginning from the second day, the bandage would be changed using a thick layer of lint, honey, and animal fat. Honey, in particular, is a superior humoral antibacterial agent due to its low water content and high osmotic pressure: it would dehydrate any bacteria present in the wound and prevent its inward penetration.

C. Orthopedic treatment

For nasal, jaw, collarbone, or rib injuries, the ancient doctors recommend a battery of mechanical interventions to reposition the affected bones back to their physiological location. The fractured bones were then stabilized using wooden or leather splints, or linen rolls dipped in hardened resins. Spinal dislocations were immobilized with special bolsters made out of sand or clay.

5. Industrial and military context

The concentration of injuries described in the cases strongly suggest that the Edwin Smith Papyrus represents a proto-medical textbook, written by an Egyptian state doctor for his students. The cases strongly point to the treatment of industrial injuries occurring in the large-scale building projects of the Old and Middle Kingdoms. The long hours spent by thousands of quarrymen, stonemasons, and carpenters in the service of the state resulted in countless number of workplace accidents, which the state physicians had to treat. Likewise, the military confrontations with the neighbors, particularly Nubians and the Levant states, resulted in a number of battlefield injuries that the army doctors had to address. The text contains the accumulated experience of hundreds of clinical cases, providing treatment algorithms for the most prevalent injuries seen in the local workforce.

Conclusion

The Edwin Smith Papyrus is far more than an interesting artifact. By examining this ancient manuscript, we learn how people perceived the world around them thousands of years ago. Most importantly, the text teaches us to value reason and the scientific method that underpins all modern empirical disciplines, such as medicine, physics, or chemistry. By observing a simple rational mind, the authors of the scroll demonstrated us the beginnings of the rational scientific tradition that eventually led to the development of modern medicine and surgery.