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Historically, many Egyptologists focused primarily on the very visible
aspects of ancient Egyptian society, such as the pyramids, much to the bain of those
interested in more than just monumental architecture. From the beginning of the scholarly
study of Egypt's past there have been few scholars who recognized the importance of the
process of disease and health on a population. With the turn of the century, new
archaeological discoveries, increased knowledge of Egyptian language and writing, and the
advent of more sophisticated medical techniques, new life was breathed into the study of
disease and health in the ancient Nile Valley. It was this period that saw the academic
study of Egyptian disease segregated into three distinct categories.
The first is the study of medical Papyri. Early on it was recognized that the textual
material of the Dynastic Period pertaining to the recognition and treatment of disease was
extremely important for understanding both the state of health as well as the concept of
disease in ancient Egypt. The second is the study of the artistic representation of
disease in the Nile Valley. The Egyptian's predilection to portrayl life in a relatively
realistic manner offers an excellent opportunity for the study of disease. The third, and
perhaps most obvious, is the study of human remains, both skeletal and soft tissue, of
ancient Egyptians. With the advent of increasingly sophisticated medical techniques at the
beginning of the 20th century, as well as those complex medical techniques in use today,
the analysis of Egypt's veritable wealth of human remains provided a tremendous boost to
the study of the state of disease and health in the ancient Nile Valley.
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The Edwin Smith Surgical Papyrus is, without a doubt, one if the most
important documents pertaining to medicine in the ancient Nile Valley. Placed on sale by
Mustafa Agha in 1862, the papyrus was purchased by Edwin Smith. An American residing in
Cairo, Smith has been described as an adventurer, a money lender, and a dealer of
antiquities.(Dawson and Uphill: 1972). Smith has also been reputed as advising upon, and
even practicing, the forgery of antiquities.(Nunn 1996:26) Whatever his personal
composition, it is to his credit that he immediately recognized the text for what it was
and later carried out a tentative translation. Upon his death in 1906, his daughter
donated the papyrus in its entirety to the New York Historical Society. The papyrus now
resides in the collections of the New York Academy of Sciences.
In 1930, James Henry Breasted, director of the Oriental Institute at the University of
Chicago, published the papyri with facsimile, transcription, English translation,
commentary, and introduction. The volume was accompanied by medical notes prepared by Dr.
Arno B. Luckhardt. To date, the Breasted translation is the only one if its kind.
The Edwin Smith papyrus is second in length only to the Ebers papyrus, comprising
seventeen pages (377 lines) on the recto and five pages (92 lines) on the verso. Both the
recto and the verso are written with the same hand in a style of Middle Egyptian dating.
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The Ebers Papyrus
Like the Edwin Smith Papyrus, the Ebers Papyrus was purchased in Luxor by
Edwin Smith in 1862. It is unclear from whom the papyrus was purchased, but it was said to
have been found between the legs of a mummy in the Assassif district of the Theben
necropolis.
The papyrus remained in the collection of Edwin Smith until at least 1869 when there
appeared, in the catalog of an antiquities dealer, and advertisement for "a large
medical papyrus in the possession of Edwin Smith, an American farmer of
Luxor."(Breasted 1930) The Papyrus was purchased in 1872 by the Egyptologist George
Ebers, for who it is named. In 1875, Ebers published a facsimile with an English-Latin
vocabulary and introduction.
The Ebers Papyrus comprises 110 pages, and is by far the most lengthy of the medical
papyri. It is dated by a passage on the verso to the 9th year of the reign of Amenhotep I
(c. 1534 B.C.E.), a date which is close to the extant copy of the Edwin Smith Papyrus.
However, one portion of the papyrus suggests a much earlier origin. Paragraph 856a states
that : "the book of driving wekhedu from all the limbs of a man was found in writings
under the two feet of Anubis in Letopolis and was brought to the majesty of the king of
Upper and Lower Egypt Den."(Nunn 1996: 31) The reference to the Lower Egyptian Den is
a historic anachronism which suggesting an origin closer to the First Dynasty (c. 3000
B.C.E.)
Unlike the Edwin Smith Papyrus, the Ebers Papyrus consists of a collection of a myriad of
different medical texts in a rather haphazard order, a fact which explains the presence of
the above mentioned excerpt. The structure of the papyrus is organized by paragraph, each
of which are arranged into blocks addressing specific medical ailments.
Paragraphs 1-3 contain magical spells designed to protect from supernatural intervention
on diagnosis and treatment. They are immediately followed by a large section on diseases
of the stomach (khet), with a concentration on intestinal parasites in paragraphs
50-85.(Bryan 1930:50) Skin diseases, with the remedies prescribed placed in the three
categories of irritative, exfoliative, and ulcerative, are featured in paragraphs 90-95
and 104-118. Diseases of the anus, included in a section of the digestive section, are
covered in paragraphs 132-164.(Ibid. 50) Up to paragraph 187, the papyrus follows a
relatively standardized format of listing prescriptions which are to relieve medical
ailments. However, the diseases themselves are often more difficult to translate.
Sometimes they take the form of recognizable symptoms such as an obstruction, but often
may be a specific disease term such as wekhedu or aaa, the meaning of both of which remain
quite obscure.
Paragraphs 188-207 comprise "the book of the stomach," and show a marked change
in style to something which is closer to the Edwin Smith Papyrus. Only paragraph 188 has a
title, though all of the paragraphs include the phrase: "if you examine a man with
a…," a characteristic which denotes its similarity to the Edwin Smith Papyrus.
From this point, a declaration of the diagnosis, but no prognosis. After paragraph 207,
the text reverts to its original style, with a short treatise on the heart (Paragraphs
208-241).
Paragraphs 242-247 contains remedies which are reputed to have been made and used
personally by various gods. Only in paragraph 247, contained within the above mentioned
section and relating to Isis' creation of a remedy for an illness in Ra's head, is a
specific diagnosis mentioned.
The following section continues with diseases of the head, but without reference to use of
remedies by the gods. Paragraph 250 continues a famous passage concerning the treatment of
migraines. The sequence is interrupted in paragraph 251 with the focus placed on a drug
rather than an illness. Most likely an extract from pharmacopoeia, the paragraph begins:
"Knowledge of what is made from degem (most likely a ricinous plant yielding a form
of castor oil), as something found in ancient writings and as something useful to
man."
Paragraphs 261-283 are concerned with the regular flow of urine and are followed by
remedies "to cause the heart to receive bread." Paragraphs 305-335 contain
remedies for various forms of coughs as well as the genew disease.
The remainder of the text goes on to discuss medical conditions concerning hair
(paragraphs 437-476), traumatic injuries such as burns and flesh wounds (paragraphs
482-529), and diseases of the extremities such as toes, fingers, and legs. Paragraphs
627-696 are concerned with the relaxation or strengthening of the metu. The exact meaning
of metu is confusing and could be alternatively translated as either mean hollow vessels
or muscles tissue. The papyrus continues by featuring diseases of the tongue (paragraphs
697-704), dermatological conditions (paragraphs 708-721), dental conditions (paragraphs
739-750), diseases of the ear, nose, and throat (paragraphs 761-781), and gynecological
conditions (paragraphs 783-839)
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Kahun
Gynecological Papyrus
The Kahun Papyrus was discovered by Flinders Petrie in April of 1889 at the Fayum site of
Lahun. The town itself flourished during the Middle Kingdom, principally under the reign
of Amenenhat II and his immediate successor. The papyrus is dated to this period by a note
on the recto which states the date as being the 29th year of the reign of Amenenhat III
(c. 1825 B.C.E.). The text was published in facsimile, with hieroglyphic transcription and
translation into English, by Griffith in 1898, and is now housed in the University College
London.
The gynecological text can be divided into thirty-four paragraphs, of which the first
seventeen have a common format. The first seventeen start with a title and are followed by
a brief description of the symptoms, usually, though not always, having to do with the
reproductive organs.
The second section begins on the third page, and comprises eight paragraphs which, because
of both the state of the extant copy and the language, are almost unintelligible. Despite
this, there are several paragraphs that have a sufficiently clear level of language as
well as being intact which can be understood. Paragraph 19 is concerned with the
recognition of who will give birth; paragraph 20 is concerned with the fumigation
procedure which causes conception to occur; and paragraphs 20-22 are concerned with
contraception. Among those materials prescribed for contraception are crocodile dung, 45ml
of honey, and sour milk.
The third section (paragraphs 26-32) is concerned with the testing for pregnancy. Other
methods include the placing of an onion bulb deep in the patients flesh, with the positive
outcome being determined by the odor appearing to the patients nose.
The fourth and final section contains two paragraphs which do not fall into any of the
previous categories. The first prescribes treatment for toothaches during pregnancy. The
second describes what appears to be a fistula between bladder and vagina with incontinence
of urine "in an irksome place."
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The
Investigation of Disease Patterns Through Human
Remains and Artistic Representations
Parasitic Diseases
Schistosomiasis (bilharziasis)
Of the three main species of the platyhelminth worm Schistosoma, the most important for
Egypt are S. mansoni and S. haematobium. There is a complex life cycle alternating between
two hosts, humans and the fresh water snail of the genus Bulinus. The infection is caught
by humans who come into contact with the free swimming worm which the snail releases in
the water. The worm penetrates the intact skin and enters the veins of the human host. The
main symptom of the presence of the parasite is haematuria which results in serious
anemia, loss of appetite, urinary infection, and loss of resistance to other diseases.
There may also be interference with liver functions.
One of the finest archaeological examples for the existence of schistosomiasis in ancient
Egypt was the discovery of calcified ova in the unembalmed 21st Dynasty mummy of Nakht.
Upon medical examination, the mummy not only exhibited a preserved tapeworm, but also ova
of the Schistosoma haematobium and displayed changes in the liver resulting from a
schistosomal infection.(Millat et al. 1980:79)
Bacterial and Viral Infections
Tuberculosis (Mycobacterium tuberculosis)
Ruffer (1910) reported the presence of tuberculosis of the spine in Nesparehan, a priest
of Amun of the 21st Dynasty. This shows the typical features of Pott's disease with
collapse of thoracic vertebra, producing the angular kyphosis (hump-back). A well known
complication of Pott's disease is the tuberculous suppuration moving downward under the
psoas major muscle, towards the right iliac fossa, forming a very large psoas
abscess.(Nunn 1996:64)
Ruffer's report has remained the best authenticated case of spinal tuberculosis from
ancient Egypt. All known possible cases, ranging from the Predynastic to 21st Dynasty were
reviewed by Morse, Brockwell, and Ucko (1964) as well as by Buikstra, Baker, and
Cook.(1993) These included Predynastic specimens collected at Naqada by Petrie and Quibell
in 1895 as well as nine Nubian Specimens from the Royal College of Surgeons of England.
Both reviewers were in agreement that there was very little doubt that tuberculosis was
the cause of pathology in most, but not all, cases. In some cases, it was not possible to
exclude compression fractures, osteomyelitis, or bone cysts as causes of death.
The numerous artistic representation of hump-backed individuals are provocative but not
conclusive. The three earliest examples are undoubtedly of Predynastic origin. The first
is a ceramic figurine reported to have been found by Bedu in the Aswan district. It
represents an emaciated human with angular kyphosis of the thoracic spine crouching in a
clay vessel.(Schrumph-Pierron 1933) The second possible Predynastic representation with
spinal deformity indicative of tuberculosis is a small standing ivory likeness of a human
with arms down at the sides of the body bent at the elbows. The head is modeled with
facial features carefully indicated. The figure is shown with a protrusion of the back and
on the chest.(Morse 1967: 261) The last Predynastic example is a wooden statue contained
within the Brussels Museum. Described as a bearded male with intricate facial features,
the figure has a large rounded hunch-back and an angular projection of the
sternum.(Jonckheere 1948: 25)
As well, there are several historic Egyptian representations which indicate the
possibility of tuberculosis deformity. One of the most suggestive, located in and Old
Kingdom 4th Dynasty tomb, is of a bas relief serving girl who exhibits localized angular
kyphosis. A second provocative example has its origin in the Middle Kingdom. A tomb
painting at Beni Hasan, the representation shows a gardener with a localized angular
deformity of the cervical-thoracic spine.(Morse 1967: 263)
Poliomyelitis
A viral infection of the anterior horn cells of the spinal chord, the presence of
poliomyelitis can only be detected in those who survive its acute stage. Mitchell
(Sandison 1980:32) noted the shortening of the left leg, which he interpreted as
poliomyelitis, in the an early Egyptian mummy from Deshasheh. The club foot of the Pharaoh
Siptah as well as deformities in the 12th Dynasty mummy of Khnumu-Nekht are probably the
most attributable cases of poliomyelitis.
An 18th or 19th Dynasty funerary staele shows the doorkeeper Roma with a grossly wasted
and shortened leg accompanied by an equinus deformity of the foot. The exact nature of
this deformity, however, is debated in the medical community. Some favor the view that
this is a case of poliomyelitis contracted in childhood before the completion of skeletal
growth. The equinus deformity, then, would be a compensation allowing Roma to walk on the
shortened leg. Alternatively, the deformity could be the result of a specific variety of
club foot with a secondary wasting and shortening of the leg.(Nunn 1996: 77)
Deformities
Dwarfism
Dasen (1993) lists 207 known representations of dwarfism. Of the types described, the
majority are achondroplastic, a form resulting in a head and trunk of normal size with
shortened limbs. The statue of Seneb is perhaps the most classic example. A tomb statue of
the dwarf Seneb and his family, all of normal size, goes a long way to indicate that
dwarfs were accepted members in Egyptian society. Other examples called attention to by
Ruffer (1911) include the 5th Dynasty statuette of Chnoum-hotep from Saqqara, a
Predynastic drawing of the "dwarf Zer" from Abydos, and a 5th Dynasty drawing of
a dwarf from the tomb of Deshasheh.
Skeletal evidence, while not supporting the social status of dwarfs in Egyptian society,
does corroborate the presence of the deformity. Jones (Brothwell 1967:432) described a
fragmentary Predynastic skeleton from the cemetery at Badari with a normal shaped cranium
both in size in shape. In contrast to this, however, the radii and ulna are short and
robust, a characteristic of achondroplasia. A second case outlined by Jones (Ibid.:432)
consisted of a Predynastic femur and tibia, both with typical short shafts and relatively
large articular ends.
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Cited References
Breasted, J.H.
The Edwin Smith Surgical Papyrus (University of Chicago Press: University of Chicago,
1930)
Brothwell, D.
"Major Congenital Anomalies of the Skeleton," in Diseases in Antiquity: A Survey
of Disease, Injuries, and Surgery in Early Populations (eds.) A.T. Sandison and D.
Brothwell (Charles C. Thomas: Springfield, 1967)
Bryan, P.W.
The Papyrus Ebers (Geoffrey Bles: London, 1930)
Buikstra, J.E.; Baker, B.J.; Cook, D.C.
"What Disease Plagues the Ancient Egyptians? A Century of Controversy
Considered," In Biological Anthropology and the Study of Ancient Egypt (eds.) W,V.
Davies and R. Walter (British Museum Press: London, 1993)
Dasen, V.
Dwarfs in Ancient Egypt and Greece (Clarendon Press: Oxford, 1993)
Dawson, W.R. and E.P. Uphill
Who Was Who in Egyptology (Egyptian Exploration Society: London, 1993)
Jonckheere, F.
"Le Bossu des Mussées Royaux D'Art et D'Histoire de Bruxelles," Chronique
D'Égypt (45) 25, 1958.
Millet, N.; Hart, G.; Reyman, T.; Zimerman, A.; Lewein, P.
"ROM I: Mummification for the Common People," in Mummies, Disease, and Ancient
Cultures (eds.) Aiden and Eve Cockburn (Cambridge University Press: Cambridge, 1980)
Morse, D.
"Tuberculosis," in Diseases in Antiquity: A Survey of Diseases, Injuries, and
Surgery in Early Populations (eds.) A.T. Sandison and D. Brothwell (Charles Thomas:
Springfield, 1967)
Morse, D.; Brothwell, D.; Ucko, P.J.
"Tuberculosis in Ancient Egypt," in American Review of Respiratory Diseases
(90), 1964)
Nunn, J.F.
Ancient Egyptian Medicine (University of Oklahoma Press: Norman, 1996)
Ruffer, M.A.
"Potts'che Krankheit an Einer Ägyptischer Mumie aus der Zeiy der 21 Dynastie,"
in Zur Historischen Biologie der Krankheiserreger (3), 1910
"On Dwarfs and Other Deformed Persons," Bulletin de Societé D'Archéologie
D'Alexandrie (13)1, 1911
Sandison, A.T.
"Diseases in Ancient Egypt," in Mummies, Disease, and Ancient Cultures (eds.)
Aiden and Eve Cockburn (Cambridge University Press: Cambridge, 1980)
Schrumph-Pierron, B.
"La Mal de Pott en Égypt 4000 Ans Avant Notre Ére," Aesculpe (23)1933
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Revised: November 12, 2009.
Copyright © 1997 by Anthony C. DiPaolo, M.S. / Osiris Web Design.
