Edwin Smith Medical Papyrus

Edwin Smith Papyrus

The Edwin Smith Papyrus is the only surviving copy of part of an Ancient Egyptian textbook on trauma surgery. It is among the world's earliest surviving examples of medical literature, the Kahun Gynecological Papyrus being older, and is the world's oldest surgical document. Written in the hieratic script of the ancient Egyptian language around the 16th century BCE, it is based on material from a thousand years earlier. This brief document, the entire translation of which can be seen online,

consists of a list of 48 traumatic injury cases, each with a description of the physical examination, treatment and prognosis.

The surgical procedures in the papyrus were quite rational given the time period, although it does describe magical incantations against pestilence. The text begins by addressing injuries to the head, and continues with treatments for injuries to neck, arms and torso, where the text breaks off. Among the treatments are closing wounds with sutures (for wounds of the lip, throat, and shoulder), preventing and curing infection with honey and mouldy bread, and stopping bleeding with raw meat. Immobilisation was often advised for head and spinal cord injuries, which is still in practice today in the short-term treatment of some injuries. The use of magic for treatment is resorted to in only one case (Case 9).

The papyrus also describes anatomical observations in exquisite detail. It contains the first known descriptions of the cranial sutures, the meninges, the external surface of the brain, the cerebrospinal fluid, and the intracranial pulsations. The papyrus shows that the heart, vessels, liver, spleen, kidneys, ureters and bladder were recognized, and that the blood vessels were known to be connected to the heart. Other vessels are described, some carrying air, some mucus, while two to the right ear are said to carry the breath of life, and two to the left ear the breath of death. The physiological functions of organs and vessels remained a complete mystery to the ancient Egyptians.

Authorship

Imhotep, credited with being the founder of Egyptian medicine, was also thought to be the original author of the text, but internal evidence suggests it was written and edited by at least three different authors.

History

Edwin Smith bought the ancient manuscript from a dealer named Mustapha Aga in 1862 in the city of Luxor, Egypt. Although he recognized the importance of the manuscript and attempted to translate it, he never published it. He died in 1906, leaving the papyrus to his daughter who gave it to the New-York Historical Society.

In 1920, the Society asked James Breasted to translate it, a task he completed by 1930. It changed the understanding of the history of medicine, demonstrating that Egyptian medical care of battlefield injuries was based on observable anatomy and experience in stark contrast with the often magical modes of healing described in other Egyptian medical sources, such as the Ebers Papyrus. In 1938 the Smith Papyrus was sent to the Brooklyn Museum, and in 1948 it was transferred to the New York Academy of Medicine where it remains.

The Papyrus was exhibited for the first time since 1948 at the Metropolitan Museum of Art from September 13 2005 to January 15 2006. Coinciding with the exhibition James P. Allen, curator at Met, prepared a completely new translation of the papyrus, which is included in the catalog for the exhibition.

References

James Henry Breasted, The Edwin Smith Papyrus, New-York Historical Society 1922
Ira M. Rutkow, The History of Surgery in the United States, 1775-1900, Norman Publishing 1988
Robert H. Wilkins, Neurosurgical Classics, Thieme 1992
Leonard Francis Peltier, Fractures: A History and Iconography of Their Treatment, Norman Publishing 1990
Ann Rosalie David, The Experience of Ancient Egypt, Routledge 2000
Nadey S. Hakim, Vassilios E. Papalois eds., Surgical Complications: Diagnosis & Treatment, Imperial College Press 2007