Ancient Egyptian Surgery

The oldest known physician is Imhotep, who lived around 2725 B.C. in Egypt. Doctors in Ancient Egypt usually went through years of training at temple schools. They were able to set broken bones and studied brain structure. They also used magic spells and remedies to cure the sick. If someone did get sick, it was caused by the wrath of god or an evil spirit entering the body. The most common cure was an amulet and magic spell. Egyptian doctors didn’t realize the brain had anything to do with thinking. They thought the heart was the center of reason. They also thought that blood, urine, excrement, and semen circulated constantly around the body.

Contraception was practiced among Egyptian women. They used honey and natron. Egyptian women also devised the first known pregnancy test. They moistened a small sample of barley and wheat each day. If the barley grew, the child would be a male. If wheat grew, the child was a female. If neither wheat nor barley grew, then it meant the woman wasn’t pregnant.

Some common medicinal plants were:

1. Castor Oil - combined with figs and dates were used as laxatives.
2. Tannic Acid - commonly helped heal burns. It is usually derived from Acadia nuts.
3. Coriander - considered to have cooling, stimulant, carminative and digestive properties. It is also ingested as a tea for stomach illnesses.

The ancient Egyptians performed surgery on their wounded, but it was not quite the same as modern practices. Surgical tools included knives, drills, saws, hooks, forceps and pinchers, scales, spoons, and a vase with burning incense. Egyptian physicians classified wounds into three categories, depending on the chance of a successful treatment. These were ailments that could be treated, ailments that could be contended, and ailments that could not be treated. An ailment that was to be contended meant the physician had to wait and see if the patient was going to survive before starting the procedures. Some of the treatments of the wounded were written down on what has become known as the Edwin Smith Papyrus.

In 1862, in Luxor, Egypt, Edwin Smith bought a roll of ancient papyrus that was missing its outer portions. Two months later, he bought the outer fragments from the same people who had sold him the previous roll. They had glued the fragments to another roll to swindle him. Smith recognized it and reconstructed the papyrus and tried to translate what it meant. James H. Breasted, who saw the importance of the writings, deciphered it in 1930. He found that it was an ancient copy of a manuscript that contained 48 case histories of injuries. They were arranged starting at the head and continuing down the body. The manuscript only goes as far as injuries of the thorax and spine, after which it cuts off. Nowhere in this papyrus is the act of trepanation mentioned, which was thought to be practiced by the Ancient Egyptians. The cases discussed go through what should be done in the instance of certain injuries. Here is an example of one such entry (note that this is the translated version):

Case Three

Title: Instructions concerning a gaping wound in his head, penetrating to the bone and perforating his skull.

Examination: If thou examinest a man having a gaping wound in his head, penetrating to the bone, and perforating his skull; thou shouldst palpate his wound; shouldst thou find him unable to look at his two shoulders and his breast, and suffering with stiffness in his neck…

Diagnosis: Thou shouldst say regarding him: "One having a gaping wound in his head, penetrating to the bone, and perforating his skull, while he suffers with stiffness in his neck. An ailment which I will treat."

Treatment: Now after thou has stitched it, thou shouldst lay fresh meat upon his wound the first day. Thou shouldst not bind it. Moor him at his mooring stakes until the period of his injury passes by. Thou shouldst treat it afterward with grease, honey, and lint every day, until he recovers…

The phrase, "Moor him at his mooring stakes refers to putting him on his customary diet, without giving a prescription. Lint was a form of vegetable fiber, and grease was some form of vegetable oil. The grease could also be snake grease, or other grease from an animal. Honey was the most widely used of the three, in over 900 remedies. Such a mixture of grease and honey prevents bacteria from growing in an open wound, and thus decreases the risk of an infection. The lint would then cover up the wound. The meat was used as a clotting agent in the bleeding wound. It is thought that the Ancient Egyptians used fresh meat in some wound treatments because of the idea of "flesh healing flesh," like the old cliché of putting meat on a black eye.

Sutures are hardly mentioned in the Edwin Smith Papyrus. Breasted thought that the word ydr stood for sutures. Some of the cases referred to the ydr coming loose, and finding ydr sticking in the lips of the wound. A more common way to close wounds was by using tapes and adhesives. Infections sometimes arose from presence of stitches in the flesh, so the tapes removed on foreign objects within the skin. This procedure still is practiced in some ways.

Blades made of iron and bronze came relatively late to Egypt. When metal instruments were finally used to an extent, the act of cauterizing came with it. In some procedures, the blade would be heated until it glowed red, and then used to make incisions. It would cut as well as seal up the wound to limit bleeding.

References:

Majno, Guido. The Healing Hand: Man and Wound in the Ancient World. Harvard University Press, Cambridge, 1982. pp. 86-121

http://www.neurosurgery.org/pubpages/cybermuseum/pre20th/epapyrus.html

Authors: Matt Bune and Pam Gregor