The Origins of Wound Care in Ancient Egypt

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We know of nine principal Egyptian medical papyri. They are called after their original owners (Edwin Smith, Chester Beatty, Carlsberg), the site of their discovery (Kahoun, Ramesseum), the towns where they are kept (Leyden, London, Berlin) or their editor (Ebers).
 
The Kahun Papyrus is the most ancient scroll and was discovered at Fayoum. It consists of three sections: one dealing with human medicine, the second with veterinary science, and the third with mathematics.
 
The Ebers Papyrus is the longest of all the known papyri and the most important, considering the physiological and medical knowledge it reveals. It is complete in 108 pages and bears the date of the 9th year of the reign of Amenhotep I (1550 BCE). This papyrus dealt mainly with medical conditions. It specifically focused on the heart, the respiratory system, and diabetes. It carries a great deal of information about anatomy and physiology, toxicology, spells, and how to deal with diabetes. Among other remedies in the text, it mentions how to treat animal-borne diseases, plant irritation, and mineral toxins.
 
The Edwin Smith papyrus is the oldest known surgical treatise. It is believed to have been recorded between 1600 and 1500 BCE. However, the bulk of the main text goes back to the Old Kingdom believed to have begun circa 3200 BCE. That surgery assumed a high status at the time is supported that the author of the Smith papyrus is assumed to be Imhotep, who was the Pharaoh’s grand vizier (prime minister) and whose status and reputation became so great that he was declared a god and worshipped for many years. (This is the first recorded evidence that physicians thought they were gods.) He was also a great architect for the Step Pyramid at Saqqara built in 2650 BCE for King Zoser.
 
Edwin Smith was an American Egyptologist. Born in Connecticut in 1822, he studied hieroglyphics in London and Paris, then moved to Egypt in 1858. In 1862, he purchased the papyrus from an Egyptian dealer. He didn’t know how to read it, but figured it was something important and precious. He kept the papyrus scroll with him until his death in 1906, whereupon his daughter donated the papyrus to the New York Historical Society. It was there the importance of document, now known as the Edwin Smith Papyrus, was first understood.
 
Whereas the Ebers papyrus mainly discussed medical conditions and treatments, the Smith papyrus was exclusively devoted (pun intended because of the significant influence of religion on the medicine of the time) to surgery and wound care. Among some of the things that are mentioned in the papyrus are lint, swabs, adhesive plasters, postural support devices, surgical suturing, and circumcision.
 
The ancient Egyptian word for doctor is “swnw.” When combined with the word for magician, “hk’w,” the two became indistinguishable. Despite the fact that, in the United States, the first female physician, Elizabeth Blackwell, graduated from medical school in 1849, the Egyptians were well ahead of their time. Peseshet (2400 BCE) may be the first recorded female physician and she is referred to as “imy-r swnwt”—translated as “Lady Overseer of the Lady Physicians.”
 
Despite the rudimentary knowledge of physiology, Egyptian physicians (some of whom were also embalmers) had a better understanding of anatomy. Herodotus wrote, “Medicine is practiced among them on a plan of separation; each physician treats a single disorder and no more.” This is the first evidence of specialization—so specific that there was a specialty called “Shepherd of the Anus”—whose duty was to administer enemas.
 
The Egyptian physicians (since so much of the medical practice of the time was based on religious concepts—spells, potions, amulets) usually went through years of training at temple schools. Surgeons were a separate group (not unlike today), and there was a hierarchy system then, as is now (Table 1).
 
Dr. Bozzuto is the NE Section Chair, Wound Care at Geisinger Health System in Scranton, PA.

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