Orac from Respectful Insolence visited the Metropolitan Museum of Art in New York to see The Art of Medicine in Ancient Egypt exhibit. His account, originally published in this Respectful Insolence post, is reproduced below with his kind permission. As you might recall, the Edwin Smith Papyrus has been covered by us on a number of previous occasions. Now we wanted to bring to your attention, dear reader, an account by someone in the medical field who has made it to the exhibit. Thanks, Orac!


And you wonder where alties got their ideas from.

However, reading some of these cases was quite instructive. The papyrus presents the cases in terms of diagnosis and practical treatment, dividing the conditions into three categories: “An ailment I will handle” (meaning there was a practical treatment available); “an ailment I will fight with” (for ailments for which the treatment and outcome was less certain); and “an ailment for which nothing is done” (for ailments for which no treatment is known). For ailments falling in the first two categories, the papyrus provides a description of the recommended treatment. Take these two cases, one of a head wound with skull damage (case 3) or a head wound with damage to the plates of the skull (case 4):
Case 3. A head wound with skull damage.
Title: Practices for a gaping wound in his head which has penetrated to the bone and violated his skull.
Examination and prognosis: If you treat a man for a gaping wound in his head, which has penetrated to the bone and violated his skull, you have to probe his wound. Should you find him unable to look at his arms and his chest and suffering from stiffness in his neck, then you say about him: “One who has a gaping wound in the head, which has penetrated to the bone and violated his skull, who suffers from stiffness in his neck: an ailment I will handle.”
Treatment: After you stitch him, you have to put fresh meat the first day on his wound. You should not bandage him. He is to be put down on his bead until the time of his injury passes, and you should treat him afterward with an oil and honey dressing every day until he gets well.
This sounds like a description of a serious gaping scalp laceration without an underlying skull fracture, and the treatment here is not all that different than what we’d do today (the raw meat and oil and honey dressings excepted, of course). Contrast this to s more serious head wound:
Case 4. A head wound with damage to the plates of the skull.
Title: Practices for a gaping would in his head, which has penetrated to the bone and split his skull.
Examination and prognosis: If you treat a man for a gaping wound in his head, which has penetrated to the bone and split his skull, you have to probe the wound. Should you find something there uneven under your fingers, should he be very much in pain at it, and should the swelling that is on it be high, while he bleeds from his nostrils and his ears, suffers stiffness in his neck, and is unable to look at his arms and chest, then you say about him: “One who has a gaping wound in his head, which has penetrated to the bone and split his skull, while he bleeds from his nostrils and his ears and suffers stiffness in the neck: an ailment I will fight with.”
Treatment: Since you find that man with his skull split, you should not bandage him. He is to be put down on his bead until the time of his injury passes. Sitting is his treatment, with two supports of brick made for him, until you learn that he arrives at a turning point. You have to put oil on his head and soften his neck and shoulders with it. You should do likewise for any man you find with his skull split.
Explanations: As for “which has split his skull,” it is the pushing away of one plate of his skull from the other, while the pieces staying in the flesh of his head and do not fall down. As for “the swelling on it is high,” it means that the bloating that is on the split is great and lifted upward.” As for “you learn that he arrives at a turning point, ” it is to say that you learn that he will die or until he has revived, since it is an “ailment I will fight with.”
This is a startlingly good description of a head injury with a skull fracture (probably a basilar skull fracture, given the bleeding from the ears), and the examination is not too different from what is done in the trauma bay today: Probe the wound and see if you can feel any fractures. Also surprisingly accurate is the observation that “sitting is his treatment.” Elevated intracranial pressure can occur with fractures of this sort, and keeping the head elevated is one way to minimize the rise in intracranial pressure. Indeed, even today, we often keep head-injured patients in a partial sitting position to try to minimize the tendency to intracranial pressure to rise. Of course, we now have CT scans and MRIs to delineate the full extent of the injury and intracranial pressure monitors to determine the extent of the brain selling. We also have hyperventilation and mannitol as adjuncts to try to lower intracranial pressure, and, if they fail, there is always the last resort of the phenobarbital-induced coma. However, given the primitive resources available to ancient Egyptian doctors, it is impressive indeed that they were able to figure out that sitting the patient upright would be helpful for this sort of injury.
I just love this sort of exhibit, as it lets me indulge my interest in both medicine and history. You know, since I happened to have purchased the exhibit book, which contains the complete translations of all the cases in the papyrus, I might have to make this a recurring series, in which I discuss some of the more interesting cases. Maybe later this week…



We’ll follow more cases from the exhibit when they become available.
To stroll through an online exhibit: The Art of Medicine in Ancient Egypt.
That’s all for this week. Thanks for stopping by. See you on Monday!