Egyptian Medicine - II - Medical Texts

Medical Texts

Edwin Smith's Medical-Surgical Papyrus.

"After a pause, the cause of which we cannot guess, but during which his well-filled reed pen dried up, he resumed his work on the papyrus. He made two more barely perceptible strokes with the almost exhausted brush, which he then dipped deep into his inkwell. After drawing the two pale strokes again, hard but so carelessly that the original faded lines are still visible, he laid down his brush and pushed the surgical treatise he had copied away from his hand, leaving 39 bare centimeters unwritten at the end of the scroll...''

"...It was as if he had seen a hand lift a curtain covering a window, and then suddenly that hand had refused to lift it any further. That provincial scribe, sitting on that scroll three thousand five hundred years ago, could hardly have imagined that every word he added would one day be hungrily cherished as the only surviving copy of the ancient treatise he was transcribing."

I cannot resist copying the words James Henry Breasted wrote as he reached the end of the papyrus translation. Archaeology has an extraordinary charm, it is an interrogation of the past, with an alert spirit, with the living sensation of communicating with men and women of the past, apparently dumb, until the hand of the archaeologist makes them speak.

One fine day, Mustafa Agha, a man of good standing in the Egyptian community, appeared at the door of Edwin Smith, an American farmer who had lived in Luxor for years. After a first uninteresting visit in which nothing of importance was shown to him, Mr. Smith made it clear that he would be willing to buy something more interesting.

After a while the Egyptian returned, but this time with a kind of fake papyrus, prefabricated from pieces of three others, carefully glued together with glue. Mr. Smith could not help but notice the prefabricated nature of it, but at the same time his knowledge of Egyptology allowed him to realize that it was an important medical document. He accepted the deal and took the papyrus.

Edwin Smith, Egyptologist

Edwin Smith was born in Connecticut in 1822, coincidentally the same year that Champollion first deciphered Egyptian hieroglyphs. He was one of the first students of Egyptology in the world. He went to London and Paris to study hieroglyphs when the science was in its infancy. He was probably the first American to study scientifically what was then little known about the Egyptian language. He decided to live in Egypt in 1858. He settled in Luxor, where he remained for about twenty years. He acquired the papyrus that bears his name in 1862.

Although he recognized the importance of the papyrus as a medical treatise and devoted much time to its study, he never made any effort to publish it. However, he did not hesitate to show it to all the experts of the time who visited him in Luxor. The brief notes that were published or commented on the case did not arouse much interest. Perhaps because of Smith's peculiar personality, far from the university circuits and more interested in developing his own independent lifestyle, he refrained from any attempt at publication. On the other hand, the serious, conscientious translation of the papyrus and its publication required a considerable amount of time and money. For a time, the papyrus was forgotten, until fate pointed its finger at the eminent Egyptologist Dr. James Henry Breasted, who was commissioned by the New York History Society to undertake the task. 

Dr. James Breasted

The Society had owned the papyrus since 1906, when it was given to them by Mr. Smith's daughter. J.H. Breasted devoted nearly ten years of painstaking effort to its publication.

Where did Mustafa Agha get the papyrus, where did it remain hidden for thousands of years? It is not known for sure, it seems to have been in the hands of someone else who had died years before. This papyrus, along with another medical papyrus that we will talk about later, were both in the possession of Mr. Smith for some time. Some references say that it was found in a tomb at El-Asasif, between the legs of a mummy. 

El-Asasif, a necropolis on the west bank of the Nile, in front of Thebes, near Deir el Bahari.

Other suspicions suggest that the two papyri belong to the group found by the then Consul of England in Egypt, Mr. Harris, in 1857, in a grotto among the rocks, about 20 feet deep, in Deir el Medina, near exactly where the tomb of the mysterious vizier Amenhotep, son of Hapu, second version of Imhotep himself, who was worshipped for hundreds of years as a protector against disease, and of whom we will speak later.

Amenhotep, son of Hapu

What kind of papyrus was it? Was it a textbook, or a textbook, a teacher's notebook? The fact that there were independent annotations on the back, without any connection to the front, suggests that it was rather used as a personal notebook, either by a teacher or a student.

In fact, it has the character of a memorandum, where the brief notes and words suggest that the reader already understands them, without the need for further clarification. The form it takes is that of a teacher instructing a student, with frequent expressions such as "if you see such and such... you must do such and such a thing".

THE CONTENT

Forty-eight cases are discussed, classified in order, from the top down, from the outside in, in a very regular and systematic way, typical of teaching systems.

Although there is no special indication, the cases are arranged in homogeneous groups related to a part of the body (head, neck, ribs, etc.) Each of these cases is arranged according to a criterion: Expression, Diagnosis and Treatment. The examination always begins with the statement: "If you examine a man who has...". The diagnosis, often a repetition of the statement, is usually introduced by the expression: "You must say about him (the patient)... that he has such and such a disease" and ends with a statement about the decision to be made: 

• "This is a case I will deal with."
• "This is a case I will struggle with."
• "This is a case I will not treat."

Sometimes pre-treatment conditions are added:

• "Until he recovers"
• "Until the period of damage is over"
• "Until you know he has reached a turning point (in his development)". 

The language used is striking, for some it represents the first babbling of the Egyptian language to create a technical and scientific vocabulary. However, it rather represents the natural way of explaining things, as can be seen in other classical medicines. Hippocrates himself advises to use a language that everyone can understand, closer to nature. Wisdom not only does not contradict simplicity, it is one of its distinguishing characteristics. Among the expressions used, we find descriptions such as the following: 

• The puncture in the skull bone is likened to a hole in an earthenware jar.
• The mandibular process is described as the double fingers of a bird.
• A piece of the skull is described as the shell of a turtle.
• The brain resembles the striations produced on the surface when copper is melted.
• The sinuses are called secret chambers. 

The means used in the cures are variable:

• Tape, made with bandages smeared with resins.
• Scabs of various kinds, slings.
• Sutures for wounds.
• Bandages of various kinds.
• Sophisticated systems of bandages. 

What does it teach us?

 The treatment is basically rational and surgical, with only one case of resorting to magic. The common opinion that the Egyptians always used magic and religious formulas in medicine is wrong in view of this papyrus. Remembering at the same time that even today there is no separation between science and religion, it is enough to observe the saints, scapulars, candles and prayers next to the sick, not to mention the chapels attached to all hospitals. If we call this the need for spiritual consolation, we will say that we agree. But if we want to accuse the ancient Egyptians of being superstitious, we will have to do the same with our contemporaries. Today, however, not even this exists, because our unbelieving and atheistic, hedonistic and individualistic society no longer relates to anything other than itself, not even doctors can maintain a certain friendship with the patient, they want to make them functionaries, mechanics, administrators of what the pharmaceutical industry points out.

A complete system of approach to the patient is described in the text:

• Examination of the character of the wound.
• Examination of the affected tissues.
• Interrogation and instructions to the patient: movements, postures.
• Data obtained by the doctor through direct inspection.
• Palpation.

The concept of prognosis was developed, a relatively recent conquest in the medical tradition, since it must be taken into account that until recently such a concept was not used. According to D. Gregorio Marañón, prognosis is "the art of the angels". It requires the use of all our knowledge and experience to determine whether someone will survive or not. Today it is no longer practiced, because what is offered today as a prognosis is merely a statistical statement: "Look, my friend, your wife has a ninety percent chance of surviving this surgery," which does not alleviate the poor husband's doubt, because where does his wife stand: in the ten percent that dies or the ninety percent that is saved?

The papyrus shows a knowledge that could only have been acquired through scientific judgment and direct observation of the anatomy of the living being, and is not the result of the accumulated experience of embalmers, who were not related to doctors. 

It also shows an interest in pure science. The Egyptian surgeon appears here as a man with the ability to observe, to draw conclusions from his own observations, and to maintain a scientific attitude toward phenomena. A profound knowledge of the pulse and the cardiac system, of the tendinous-muscular system, though not clearly of the circulation, is also shown.

Finally, we must mention the existence of one of the most extraordinary glosses, the extracts referring to the so-called Secret Book of the Physicians, of which we have no copy except for these annotations and some others in other papyri. In these extracts, the measurement and examination of the heart by means of the pulse is mentioned, and a general theory of the channels leading to the different parts of the body is introduced: these are the so-called met/metu, channels that have been identified with the blood vessels, with the muscles, and even with the peripheral nerves. As we shall see, they should really be translated as channels, in the same way that Chinese medicine uses the concept of meridians.

There are surgical practices described in the Smith Papyrus that were later passed on to the Greeks and Romans, such as in case number 26 of this papyrus, which discusses the maneuver to be performed to set a dislocated jaw:

``If you examine a man whose jaw is dislocated, you will find that his mouth is open and he cannot close it. You should place your thumbs over the ends of the two clusters (apophyses) of the jaw in his mouth, and the rest of your fingers under his chin, so that they move backward and fall into place.''

In a Byzantine manuscript from 1100 A.D., exactly the same maneuver of reduction of mandibular dislocation described in the papyrus can be observed. 

To be continued

EGYPTIAN MEDICINE - I - Science, Magic and Spirituality.

EGYPTIAN MEDICINE - I

Science, Magic and Spirituality

With this article we begin a series on Egyptian medicine that we hope will be helpful and clarify the main ideas about it. First of all, we must say that ancient Egyptian medicine was very advanced for its time. It had the ability, like other great classical medicines, to combine practical knowledge with religious beliefs, in addition to the support of psychology and spirituality in general. The ancient Egyptians developed effective medical treatments based on clinical observations, although they also relied on the subtle and magical, since diseases were not only primarily caused by physical accidents, but were also often seen as the result of divine punishment (karma) and as diseases caused by supernatural forces.

Today, in the 21st century, analyzing and using the medicine of Pharaonic Egypt in a practical way is an almost impossible task if we only take into account the material and technical details, such as the formulas and drugs used. Modern Egyptology has tried to approach it by focusing its interest, in a special way, on the detailed description of the mummification process, or on photographing and scanning the mummies to describe the broken bones or signs of aging, the dental condition, as well as to calculate the probable age of the mummified corpses and the methodology used to embalm them. There are also studies that try to decipher the existing papyri and the names of the plants used in the past that are unknown today. Likewise, various aspects of the medical profession have been described, as well as the extent of their knowledge in anatomy, physiology and surgery.

However, this ancient medicine, even if it could be salvaged in detail, would probably be of no value for our time, since the methods, means and ends of Egyptian medicine have nothing to do with modern and scientific medicine, except in secondary aspects.

As we will see, there were various moral elements, as well as general principles and a philosophical context and understanding of life, illness and death, which have nothing to do with those of our time, but from which we could really learn a lot. In addition, there is another important aspect to consider: beliefs and magic, without which the type of medicine practiced by the ancient Egyptians cannot be understood.

We will go through these aspects one by one so that we can extract useful elements for ourselves. Some of the most important aspects of Egyptian medicine that we will analyze in the following articles are:

THE MEDICAL TEXTS

We have inherited from the past several medical texts that describe diseases as well as treatments and surgical procedures. We will focus our description on two of them, the Surgical Papyrus of Edwin Smith and the Medical Pathology described in the Ebers Papyrus. There are other texts, but an understanding of these two will be sufficient to begin to see that Egyptian medicine was "something else" quite different from our medicine today. In the "recipes" of the Ebers papyrus, we can have a glimpse of the plants used and, above all, of the physiopathology, that is, the medical theory that the Egyptians had about diseases, in addition to some very curious recipes that indicate magical aspects and natural correspondences. Above all, in the Smith papyrus we find the description of an energetic and physical conduction system that is strangely similar to the system used in classical Oriental medicine.

MEDICAL SPECIALTIES AND THE "MEDICAL CAREER".

There were medical specialists in various fields, ophthalmologists, dentists, specialists in women's diseases and the digestive system, surgeons, etc. The existence of these specialties indicates a highly organized knowledge and teaching of medicine; this complexity implies that the knowledge possessed was much more than the few references that appear in the papyri we possess. Logically, all of the above points to a system of teaching, a medical ladder, and special places of teaching, the so-called Houses of Life.

REMEDIES AND TREATMENTS:

They used a wide variety of herbs, minerals, and animal substances as remedies, but as we pointed out earlier, some of the hieroglyphic names do not correspond to modern nomenclature, and it is difficult to know why they were used, although we will find examples that remind us of modern uses, such as garlic and onion to improve circulation and prevent disease. Opium was used as an anesthetic, honey and myrrh to heal wounds. In addition, there were special containers to hold the medicines with prayers; there were also sacred steles that gave a certain magical value to the water poured over them. It was necessary as well to take into account the magical way of administering the remedies, the prayers that accompanied them, and the hypnotic effect of some of them.

RELIGION AND MEDICINE

Physicians were priests, and therefore medical and religious practices operated in parallel and in unison. Treatments required the thaumaturgic intervention of the gods, and images, amulets, and recitations were also part of the treatment. The gods symbolized both the healing powers and the karma transmitted through them, resulting in disease and plague.

Although Egyptian medicine combined both practical and other metaphysical elements, this did not prevent Egyptian physicians from achieving fame throughout the world for centuries, from Mesopotamia and the Middle East to places as far away as northwestern Spain, where temples dedicated to Egyptian healing deities were built, It also influenced Galen, a Roman physician whose texts were used well into the Middle Ages, as well as Hippocrates, a Greek physician who can be considered one of the first naturalistic physicians and who established the famous oath based on the temples and secret brotherhoods of Egypt. Both physicians studied Egyptian medicine and drew their principles from it. But we will talk about this and much more in the following articles.

To be continued

Sacred Geography of Egypt IV - The 7 Directions of Space

The 7 Directions of Space

 

"In the beginning of everything, God created heaven and the earth. 2 The earth had no form then; all was a deep sea covered with darkness, and the spirit of God moved over the waters..." Genesis 1:2

 

The above Bible verses are equivalent to the Babylonian sacred texts. In the Babylonian myth the swampy and sweet waters, Apsu, were mixed and stirred together with the deep and salty waters, Tiamat. The biblical writers give a similar version, although eliminating the names of the Babylonian gods. The Dark and Primordial Waters of the theogonies represent two things, on the one hand they are waters because these are considered the origin of life, and on the other they are dark because they represent non-existence prior to manifestation.

 

The Sacred Geography that we are analyzing in this series of articles means the possibility for human beings to establish a link between the terrestrial world and the cosmic mythical world. There is a geo-graphy as a result of a geo-metry, and there is no geometry without mathematics. Numbers in their symbolism, in their generation, represent the unfolding of intelligence and its accompanying forces and the movement of consciousness. Precisely, in the heliopolitan theogony, the Egyptian creation myth is a succession of states and numbers.

 

THE HELIOPOLITAN CREATION MYTH

 

Hidden in the Primordial Waters of the Nun, lies Atum, like an invisible serpent that bites its own tail, that is, the infinite cycles of time. "Atum" is a curious name, because in Egyptian grammar, depending on where the word is placed, it means "Nothing" or "Everything", because Atum, although hidden and submerged in the primordial waters of the origin as well as the end of the world, possesses the seeds of what will be, of the entire universe that will appear from those waters. It is a state that we could be defined... as Nothingness, Inertia, Stillness, Full Emptiness, its mathematical symbol is 0.

 

In those still waters, inert from the human point of view, suddenly something stirs, something stirs, and time begins... and this is marked by the appearance of Khepri, the beetle, whose hieroglyph means "evolution", "movement", "time"... and who "pushes" Atum, makes it move and evolve. The mysterious Atum, the Nothing-All, becomes Atum-Ra, the Sun in its beginnings. Ra is represented by a hieroglyph that has the shape of a mouth, the Word, the mouth that emits the first creative words:

It represents the First Unity of Creation from which everything starts. We have gone from 0 to 1. 

 

Creation has already begun, and that one becomes two: Shu and Tefnut. The First Couple, the first yin-yang we would say using Chinese terms. Shu the dryness, bright and ethereal, and Tefnut the dark humidity. This couple together with Atum-Ra form the first Triad, the number three.

 

The process is repeated and the couple Shu and Tefnut give birth to Nut and Geb, the sky and the earth. Here we have arrived at the number 4, the 4 elements, because Shu is the Ethereal Fire, Tefnut the Water or moisture, Nut or Air, and Geb or Earth.

 

 

 

The union of Earth and Heaven, Geb and Nut, generate the first gods close to human beings, the four brother gods: Osiris, Isis, Seth and Nephtys and one more: Horus the Elder, the celestial Horus, not to be confused with Horus the son of Osiris and Isis. Thus we reach the number five completing the series from 0. It is the number of the stars that cover the roof of the temples and that fly towards the sacred spot of the main altar, it is the number that represents the human beings that have awakened: the next step of semi-divine beings.

 

 

As in other peoples, the 4 directions of space were fundamental for orientation, but also, since we are talking about Sacred Geography, these directions are also related to celestial concepts and to the gods themselves. In such a way that the 4 gods, sons of heaven and brothers, Isis, Osiris, Seth and Nepthys, form a game of light and shadow, day and night, dry and wet, that is to say, all the possible intercalated polarities. Thus, Osiris represents the life-giving waters of the Nile, while Seth, his opponent and brother at the same time, is the dry and arid desert. On the other hand, the ever-fertile part of the banks of the Nile represents Isis, while the adjoining strip towards the desert, which only in the flood becomes wet and then dry, is her sister Nepthys, wife of Seth. Isis is the bright side of the Moon, Nepthys its dark side. Isis is the East, goddess of births, and Nepthys the west where the dead go.

 

But the waters of the Nile not only relate the East and the West, or the coming to life and the sacred passage of death symbolized in the setting of the sun, also the waters of the Nile link the Egypt of the South and the Egypt of the North, again the duality: the dry Egypt of the south and the wet Egypt of the north.

 

Neith and Serkit

Neith is the protector goddess of the humid North, while Serkit, the scorpion goddess is the protector of the dry South. Thus the four goddesses, Isis, Nepthys, Neith and Serkit are the protectors of the four directions of space and of the canopic vessels where the sacred entrails of the osirified are guarded in the tomb.

 

 

 

All these relationships and many others that we do not mention, make up a living world, where nothing is dead matter, but magical forces that interact with all living things. But in order to form the necessary connections between things it is also necessary to know the geometric and mathematical relationships, because after all, that is what the space we inhabit is all about.

 

And the goddess of Measurements, Mathematics and Sacred Geography, is none other than Seshat, the feminine counterpart of Thoth, the god of Wisdom. She is always to be reckoned with in the sacred act where a new bond is formed between heaven and earth, in the act of inaugural settlement of a new temple or pyramid. Seshat is the goddess who, together with the pharaoh, establishes the measures and coordinates that relate space and time to the sacred moment of the beginnings.

Seshat, takes measures and notes on a palm branch, symbol of the infinite years that repeat themselves, and that is sustained by the by the little frog Heket below, rebirth and life, and both the branch and the frog rest on a ring: infinite time.

 

In the ceremony of "extension of the rope", the pharaoh assisted by Seshat measures the correct time and place to establish the sacred place. This ceremony connected the celestial meridian with the earth:

Rope Extension Ceremony

 

"I hold the staff. I grip the handle and hold the measuring string next to Seshat. I direct my sight towards the movement of the stars.... I set the corners of my temple..." (Inscription in the temple of Edfu).

 

 

The goddess Seshat carries a curious sign on her head. It is an inverted pair of horns, its translation is "uap pt", the "opening of the sky", and below it there is a headdress with 7 leaves. Each of them represents a direction of space:

Six directions of the Space

 

The Seventh direction is the one that goes to the opening of the sky: "uapt", the one that connects with another dimension, which it is precisely the internal or mystical direction of space, the one that connects with the Sacred in the Universe and in Man... The Egyptian Creation Myth shows us numerically how beings unfold, and the Sacred Geometry and Mathematics of the goddess Seshat show us the way of return.

 

Sacred Geography of Egypt III

 The 4 Helmsmen of the Sky

In the previous article we established the fundamental relationships with the stars, with the directions of space, and with the Milky Way and the Nile. Now we will go a little deeper into the understanding of the four directions of space.

More than 5,000 years ago —when the first rudiments of the zodiacal system that we use today probably appeared (which does not mean that it had not been born before)—, any observer of the celestial vault could visualize among the 25 brightest stars four that were of great importance. These stars were called by the Persians the Royal Stars, because not only their position, but also their isolation and brightness made them special.

Sacred Geography of Egypt II

 Egypt: Golden Capsule Out of Time

The multiple correspondences ─ between heaven and earth, the directions of space, between the terrestrial Nile and the celestial Nile (the Milky Way) ─ are integrated with the "Mythical Time": the time of Beginnings and of the Gods, a time to which the Egyptians always tried to return, an ancient nostalgia always present in their history. That is why each new Pharaoh began his reign beginning with the year one, the first year. Egypt was a Golden Capsule, eternal, always repeated, a habitable place for gods, men and animals, beyond time.

Sacred Geography of Egypt

 Sacred Geography of Egypt 

The sky, the Milky Way, is reflected in the Sacred Nile.

There are three related concepts on different levels or dimensions: Sacred Geography, Sacred Architecture, and Sacred Geometry. 

In all three cases, a territory is defined, a space, and a direct relationship to the agent that defines it. Reduced to its simplest expression, it is the application of a physical or visual form to a more or less extensive territory, and the form applied is nothing more or less than an intelligent idea. 

The potter imagines the object in his mind, which he then shapes in clay. In the same way, the perception of a sacred idea, a heavenly cause, may be reflected in the earth, and it is man with his perceptions of the ideal archetypes who impresses the earth, or the building or temple, which corresponds to that sacred idea.