Saturday, June 14, 2014

Ancient Egyptian remedies

Does modern medicine have anything to learn from the medicine of the ancient Egyptians, asks Mai Samih

The ancient Egyptians, who embalmed their deceased so carefully, must have had a profound knowledge of anatomy. This is shown in tomb reliefs depicting surgeons dealing with patients and in famous medical texts such as those in the ancient Egyptian Ebers and Edwin Smith papyri.

The ancient Greek historian Herodotus who visited Egypt around 440 BCE wrote extensively of his observations of ancient Egyptian medical practices. The Roman writer Pliny the Elder also wrote favourably of them in his historical works. The ancient Greek fathers of medicine, Hippocrates, Herophilos, Erasistratus and later Galen, all studied at the temple of Amenhotep in Egypt and acknowledged the contributions of the ancient Egyptians to Greek medicine.

In his book Life of the Ancient Egyptians, author Eugen Strouhal quotes Herodotus describing Egyptian doctors by saying that “the practice of medicine is so divided among them that each physician treats one disease and no more. There are plenty of physicians everywhere; some are eye doctors, some deal with the heart, others with the teeth or the belly, and some with hidden maladies.”

Belgian Scholar Frans Jonckheere writes that there were 82 kinds of doctors known by name in ancient Egypt. No female nurses existed to help these doctors, but there were male nurses, dressers, masseurs, and lay therapists there for help. Czech physician Vincenc Strouhal wrote that the most advanced branch of medicine in ancient Egypt was surgery.

According to Alaaeddin Shaheen, a professor of archaeology at Cairo University, ancient Egyptian doctors were known around the ancient world for their skills. An inscription on the walls of the tomb of the New Kingdom scribe Nebamun in Thebes depicts a foreigner visiting an Egyptian doctor, for example, and descending from a boat as a nurse gives him a glass of medicine. The profession, according to Strouhal, was linked to the ancient Egyptian priesthood.

Strouhal added that the remains of a sanatorium have been found in the grounds of the Temple of Hathor at Dendera, where patients stayed isolated in small rooms to pray, meditate, and benefit from healing sleep during which truths would be revealed to them in dreams. The use of bathing pools fed from the Temple’s sacred lake was also part of the cure.

There was a complex hierarchy among doctors. Besides ordinary doctors, there were also senior doctors, inspectors, overseers, masters of physicians, and the chief of physicians of the south and the north, something like today’s minister of health. There were also specialties: for example, the Sixth Dynasty court physician and high priest Pepyankh, known as Iry, was not only the “doctor to the pharaoh’s belly,” but also his eye doctor.

Egyptologist Bassam Al-Shamaa divides the medical profession in ancient Egypt into two categories: traditional-folkloric and professional. He also says that the ancient Egyptians had the world’s first female doctor. According to an inscription on the false door of an Old Kingdom tomb on the Giza Plateau of a Fifth Dynasty dignitary Akhethetep, his mother, Peseshet, was the head of the court doctors and thus the first well-attested female doctor in history.

“This proves that women also practiced medicine and were given titles to do so,” Al-Shamaa said. Another example of a famous doctor is Imhotep, also the engineer who designed the Djoser Step Pyramids at the Saqqara Necropolis. In many cases, doctors in ancient Egypt were given the status of priests. According to Strouhal, the gods associated with healing were Amun, Thoth, Min, Horus, Isis, and Serapis.

The ancient Egyptians had an advanced medical system, Shaheen said, adding that Herodotus had commented on the high number of ancient Egyptian doctors by saying that “among every two Egyptians there is a doctor.” From papyri like the Carlsberg, Chester, Kahn and Ebers papyri, a picture can be built up of the way the ancient Egyptians dealt with diseases, dividing them into curable and incurable ones. The ancient Egyptians also had three branches of medicine, human, veterinary, and psychological, he said.

According to Strouhal, the Ebers papyrus has 700 prescriptions for different diseases while the Hearst papyrus is a memorandum of a practicing doctor that includes remedies he had compiled from other works including the Ebers papyrus. The Edwin Smith papyrus shows profound empirical knowledge of different types of injuries and how to treat them. Other medical documents from ancient Egypt include the great Berlin papyrus, the London papyrus, the Chester Beatty papyrus (number 6), the Carlsberg papyrus (number 8) and the Kahun papyrus. Many of these are copies of Old Kingdom treatises made during the Middle and New Kingdoms.

The Egyptian Museum in Cairo’s Tahrir Square contains examples of the medical implements used by doctors in ancient Egypt, as well as of the procedures they conducted on patients. These tools, Shaheen said, included forceps and scissors, and similar objects can be seen abroad, for example in the Brooklyn Museum in the United States. The Kom Ombo Temple in Aswan also contains important illustrations of the surgical instruments used by the ancient Egyptians.

Al-Shamaa adds that some of the instruments in the Kom Ombo illustrations are very much like the ones used by surgeons today. This is shown in the saw, the bifurcated sharp hook, scoop probe, crania clasp (used for making holes in the scalp and proof that the ancient Egyptians practiced some kind of brain surgery), tooth forceps, shears, sponges, scalpels, cauterising tools, cupping vessels, specula, mortars, needles and a copper pin with a loop head.

According to Shaheen, some medical practices in ancient Egypt can still be traced in folk medicine today, notably the cures for stomach aches and bodily deformations that are still used in Upper Egypt. The ancient Egyptians even invented anaesthesia in the form of a treatment given to patients before operations. They used plants for painkillers, such as the clover that is still used by the Bedouin today. They were believed to be able to treat brain damage, and this was confirmed by the UK scientists Douglas Derry and J.E. Harris who conducted research on mummies in the Egyptian Museum in the 1960s, finding traces of brain surgery on some of them in the form of small holes in their skulls.

Regarding the diseases the ancient Egyptians suffered from, Shaheen notes that Strouhal and his team had found traces of tuberculosis, pneumonia, and anthracosis in samples of lung tissues from 175 mummies they had examined between 1971 and 1974. They also found traces of fine desert sand, and microscopic investigations of other organs had confirmed the existence of parasitic diseases, especially those caused by bilharzia, trichinosis, thread worms, tape worms, liver flukes, strongyloides, trichuris, trichiura, ancylostoma duodenale, and dracunculus medinensis. Amoeboid cysts have also been discovered in ancient Egyptian mummies, with Shaheen noting that the presence of these diseases indicates the poor standards of hygiene in the countryside, where people were accustomed to go barefoot through water and eat unwashed fruit and vegetables.

The Strouhal team had discovered a case of the enlargement of the spleen, for example, probably due to malaria or bilharzia, in the mummy of a weaver called Nakht that dates back to the 19th Dynasty, Shaheen said. They had also found signs of smallpox and poliomyelitis, as well as over 30 cases of spinal tuberculosis, often with vertebral collapse and angular deformation. “Bone fractures were found three times more frequently in men than in women,” Shaheen said, adding that cases of degenerative diseases of the joints had also been noticed. A case of cancer had been found in the mummy of a man aged 40 to 50 from the Old Kingdom, originally found in a cemetery at Naga Al-Deir in Sohag. Cases of teeth decay and periodontitis had also been found in the examined mummies.

Al-Shamaa added that the list of diseases in the Ebers papyrus included a prescription for a disease called “a’ae,” believed to be heart disease. The papyrus mentions cases of “shaking” and damage to the heart, for example. Proof that the ancient Egyptians were advanced in ophthalmology and reflexology is found in the reliefs in the Ipuy Temple, which show a snwt iryt (oculist) curing one of the workers. There is also a painting showing a doctor putting back the arm of one of the workers into its original place in a procedure now known as Kocher’s Method. “This proves that the workers received medical care at work,” Al-Shamaa said.  

According to Strouhal, the ancient Egyptians distinguished a simple fracture, called sedj, where a bone is split in two, from a complicated fracture where a bone has many breaks, called peshen shetut. “Near the Sphinx in Giza are the tombs of workers who have traces of fractures in their legs, hands and necks,” Shaheen comments

Remedies, continued Shaheen, were derived from some 70 species of animals, 25 plants, 20 minerals, and a number of common food stuffs, drinks, and secretions. For example, the flesh, fat, blood, milk, gall, and urine of animals and humans were used in ancient Egyptian medicine, as were the leaves, fruit and powdered roots of plants like henbane, thorn apple and mandrake. Active ingredients were mixed by the doctor himself with bases such as milk, honey, sweetened beer or oil, or, for ointments, oil or fat.

The ancient Egyptians often resorted to fasting that could last for three days or so in some cases in order to enhance their health. They were very skilled in dressing wounds, using linen bandages, sutures, pads, and swabs. They normally drew the edges of wounds together with bandages. For the first day, they would cover a wound with fresh meat and on the second with a dressing soaked in honey or oil. Severe or inflamed wounds were left uncovered, drenched in oil, kept cool and allowed to dry.

 “Ancient Egyptian medicine still influences modern medicine,” said Shaheen, adding that dates and sycamore were very important resources for ancient Egyptian doctors. The seeds of dates were used to treat cancer. Fennel, called besbes, and watermelon were also used. “They had names for the parts of the body that can still be traced today, like the pupil of the eye, called boboon, which resembles the Arabic word bo’boa,” Al-Shamaa said.

They also invented the “prescription papyrus” on which a doctor would draw an eye that symbolised healing and resembled the eye of the god Horus. They developed replacement hands and other amputated parts of the body. At Deir Al-Medina on Luxor’s west bank, Shaheen said, Egyptologists had found a chair that resembles those used by women to give birth, this dating back to the Old Kingdom. However, by far the most famous procedure invented by the ancient Egyptians was embalming. “It is believed that they may have used uranium to preserve the bodies, as one colleague has spotted traces of uranium in a mummy at the Egyptian Museum,” said Shaheen.

“Houses of life,” buildings that functioned as hospitals, were closely linked to temples and existed at Memphis, Akhetaten, Akhmin, Abydos, Koptos, Esna, and Edfu, among other places. The ancient Greeks called those who worked in the Houses of Life hierogrammatiki, or “experts.” Doctors studied in such places, as they did at Per Bustet in the New Kingdom and at Abydos and Sais in the Late Period. They learnt from the texts left by their ancestors and from practical experience, according to the Ebers papyrus. A doctor who did not follow the prescribed rules could be punished by death. However, if he followed the rules and still could not cure a patient he was absolved from any charge.

According to Al-Shamaa, various ancient Egyptian papyri mention surgery especially in cases of labour and the diseases that can follow it. Four or more thousand years ago, there was an ancient Egyptian goddess named Neith who had an institute named after her that taught midwives medical skills as male doctors did not participate in delivering children. “This was the first childbirth hospital in the world,” al-Shamaa asserted.

Al-Shamaa said that the social status of doctors in ancient Egypt was very high. They were well paid and were given all sorts of privileges. For example, the pharaoh Djsor put his doctor’s name next to his own on the base of his statue, a considerable honour as the use of hieroglyphics was restricted. The pharaohs also had long life spans, which may say something about ancient Egyptian healthcare. Ramses II died at 90 years of age and queen E’aa Hetb at 84, while Thutmosis III ruled for 54 years.

“I believe that ancient Egyptian medicine should be taught in medical schools today, as it is the origin of modern medicine,” Al-Shamaa concluded.


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