In ancient Egypt, with its towering pyramids and bustling cityscapes along the Nile, there existed a deep-rooted civilisation that excelled in more than the grandeur of monumental architecture. Frequent wars and battles shaped Egyptian society, not only defining its political landscape but also driving advancements in medicine. Physicians were called upon to treat battle-inflicted injuries, spurring innovation in healing techniques. Against this backdrop, Egyptian medical papyri emerged as vital records of practical knowledge.
Most medical papyri of the time blended medicine with magic and religious beliefs. Healing often involved incantations, spells and rituals meant to drive out disease-causing spirits. However, one example, known as the Edwin Smith Papyrus, stands apart. With minimal reference to magical treatments, this 15-foot-long scroll is among the earliest-known medical treatises and may represent the dawn of otolaryngology. Acquired in 1862 by Egyptologist Edwin Smith, the document details 48 cases of trauma, focusing heavily on head and neck injuries. Although its authorship is unknown, some scholars speculate that it may be based on earlier texts from 3000 BC, possibly linked to the famed Egyptian physician Imhotep.
Anatomical distribution of cases in Papyrus Edwin Smith.
Credit: Sinuhe20, CC BY-SA 3.0 via Wikimedia Commons.
Medicine in ancient Egypt. An Egyptian physician (1500 BC) treats a patient for lockjaw in accordance with directions on a papyrus scroll, while priests perform prescribed rites. Egyptian medicine occupied a dominant position in the ancient world for 2500 years. One of a series: A History of medicine in pictures by Parke, Davis & Company, 1957, painted by Robert A Thom.
http://resource.nlm.nih.gov/101651528
While the origins of the papyrus remain debated, it offers a rare glimpse into early surgical knowledge, focusing on patient evaluation and treatment decisions. Each case records an examination, diagnosis and treatment, with emphasis on careful observation and palpation. For example, in Case 12, the text states, “Shouldst thou find his nose sunken in and his nasal bones loose under thy fingers, while blood runs from his nostrils, he suffers from a break in his nasal bones.” The physician then determines whether the injury is one they “can heal,” “will contend with,” or “cannot be treated,” demonstrating a pragmatic approach similar to modern medical decision-making.
Of the 48 cases, 33 focus on head and neck injuries, providing detailed anatomical descriptions, including references to the maxillary and frontal sinuses. Particularly relevant to otolaryngology, Cases 11-14 describe nasal trauma and document early surgical techniques. Case 12 outlines the closed reduction of nasal fractures using nasal packing with “two plugs of linen saturated with grease.” Case 14, on treating nasal wounds, stands out as it may represent the earliest recorded instance of nasal reconstruction, advising “Thou shouldst draw together for him the two lips of the wound with stitching,” followed by a treatment regimen using fresh meat, grease, honey and lint.
The Edwin Smith Papyrus is a testament to the advanced medical knowledge and practical skills of ancient Egyptian physicians. In a time where magic and superstition dominated much of the medical world, this text stands as an example of rational, evidence-based medicine. Its detailed descriptions of head and neck injuries, particularly nasal trauma, reveal a deep understanding of anatomy and surgical techniques. By documenting careful assessments of individual patients, practical treatments and early forms of nasal reconstruction, the papyrus not only sheds light on the medical practices of its time but also underscores the profound legacy of ancient Egypt in the history of surgery.
References
1. Breasted J .The Edwin Smith Surgical Papyrus. In: Facsimile And Hieroglyphic Transliteration with Translation and Commentary in Two Volumes. The University of Chicago Press; 1930.
2. Metwaly AM, Ghoneim MM, Eissa IH, et al. Traditional ancient Egyptian medicine: A review. Saudi J Biol Sci 2021;28(10);5823–32.
3. Stiefel M, Shaner A, Schaeffer SD. The Edwin Smith Papyrus: The Birth of Analytical Thinking in Medicine and Otolaryngology. Laryngoscope 2006;116(2):182–8.
