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This feature is largely about ancient Egyptian times, but two sections 'Diseases of Egypt' and 'Opthalmology' look at both Ancient Egypt and Egypt today.
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The Ancient Egyptians were respected as physicians in the ancient world, as recorded by Homer, Herodotus and Pliny the Elder.
Homer's Odyssey reads:
"In Egypt, the men are more skilled in medicine than any of human kind . . . the Egyptians were skilled in medicine more than any other art".
In Ancient Egypt, health problems were treated by means of both medicine and magic, often in combination. Doctors, or Sunus were appointed by the state, and every citizen of Ancient Egypt was entitled to medical care. Some Sunus were scribes, and could read medical texts, but it was not a requirement. Magic physicians were called 'sau'. The 'Priests of Sekhmet' were a combination of physician and magic physician - they healed the people whom Sekhmet had punished by disease.
Hesy-Ra, or Hesyre, the first physician to be documented by name, was 'Chief of Dentists and Physicians' to King Djoser (around 27th century BC). About 300 years later the first female doctor, Peseshet, was documented. Peseshet's title was 'Lady Overseer of the Lady Physicians'. She supervised women who were qualified physicians, not midwives. She also graduated midwives at the peri-ankh (medical school) of Sais.
Imhotep (3rd dynasty) was worshiped as the god of Healing and medicine, having, in life, been physician to Vizier of King Zoser as well as an astronomer and the architect responsible for the Stepped Pyramid at Saqqara.
Medical beaurocracy abounded in the guise of inspectors of doctors, overseers and chief doctors, who ruled over the various ophthalmologists, gastroenterologists, dentists and 'shepherds of the anus'. During the Old Kingdom and Late Period the title 'Shepherd of the anus of the Pharaoh', was given to the men sufficiently honored to administer an enema to the Pharaoh. There was even a 'doctor who supervises butchers' and an 'inspector of liquids'...
The nearest thing to a hospital, since the 1st Dynasty, at least, was probably the 'Peri-ankh' or 'House of Life', and were favoured with the protection of the Pharaoh. The 'House of Life' was a medical training centre - and a place where , medical training books were written and gathered into specialist medical libraries to preserve the collected medical knowledge. The most famous 'House of Life' was run by Imhotep, at Memphis. At Sais, midwives were trained and also passed on their knowledge to physicians specialising in obstetrics. The peri-ankh of Abydos and several others at Bubastis, Edfu, Tel-el-Amarna and Kom-Ombo were also known. By the 19th Dynasty employees of 'House of Life' were entitled to medical insurance, a pension and sick leave.
The inspiration for our Hippocratic oath, Hippocrates is regarded by some as the 'father of medicine' (others bestow the title upon Imhotep).
Hippocrates studied medicine at the Temple of Amenhotep, considering that Greek medicine had benefitted greatly from the medical knowledge of the Egyptians.
The ancient Egyptians used some sophisticated medical procedures, including non-invasive surgery, bone setting and a wide range of drug therapies - together with magic and incantations. Many healers were also priests of Sekhmet. The widespread belief in magic and religion culd have produced a placebo effect - and one perhaps difficult for the surrounding nations to reproduce.
Their medicine was often effective. Apparantly 67 percent of the drugs used are ones we might use in the same way today, although unspurprisingly some doctors were better than others. The vast majority of medical prescriptions in the Hearst Papyrus would not cure anyone, and most could have made matters worse. Other surviving medical texts - such as The Edwin Smith Papyrus - show that in many cases the processes of examination, diagnosis, prognosis and treatments that were sensible and appropriate - at least for some of the time.
The Edwin Smith Papyrus
The Edwin Smith Papyrus is a surgical, medical and anatomical textbook, probably written around 1600 BC, although some of it's medical information dates back to Imhotep's authoritative writings around 3000 BC.
The Ebers Papyrus
The Ebers papyrus (c.1550 BC), on the other hand, i describes healing based on magic. It is full of incantations and foul concoctions supposed to exorcise disease-causing demons, as well as 877 'prescriptions' to treat skin problems, digestive diseases, injuries, dental problems and gynecological conditions.
The Kahun Papyrus
The Kahun Gynecological Papyrus ( 1825 BC), found by Flinders Petrie, contains 35 separate paragraphs about women's health, majoring on diseases related to the reproductive organs. Disease during pregnancy is dealt with in detail.
Egyptologists have also discovered medical information from wall paintings and inscriptions.
The physicians' advice for staying healthy included washing and shaving the body, including under the arms, and Egypt was probably the first country to cut hair as a preventative for lice or other insect infestation. Copper and bronze razors were used, and a barber was a respected professional. Priests ritually shaved their bodies and removal of all body hair became a status symbol - probably a painful one. A hot mixture of crushed bird bones, oil, sycamore juice and gum was smeared over the entire body, allowed to cool, then peeled off, taking the hair with it. Physicians also advised against eating raw fish or other 'unclean' animals. On the other hand, some of the medicines they precribed included faeces! Rich people could afford to fumigate their houses with incense and myrrh to kill insects. Rats were recognised as a health risk and cats were useful as rodent control although they were regarded as sacred animals.
Herodotus records that the pyramid builders were administered enormous quanitite of radish, garlic and onion, which we now recognise as a sensible precaution where overcrowding would have carried high risks of infection; during the 20th century AD we have extracted an antibiotics from these vegetables. The diet of most of the population was heavy on vegetables; meat was reserved for high priests and their families, and mummies of priests have deen found to have high cholesterol levels. Several texts suggest that there was a social stigma attached to eating and drinking to excess, although there are texts and pictures showing obese musicians, scribes and doormen - the sedentary professions.
The people carrying out the process of mummification certainly knew where all the internal organs were, and how to get at them - however, they didn't necessarily share the knowledge with the doctors.
The Edwin Smith Papyrus papyrus documents surgical procedures based on anatomy and physiology and shows that Egyptians knew of the heart, liver, spleen, kidneys, ureters, and bladder, and understood that the blood vessels were connected to the heart. They knew that the pulse and the heart were related, but not how, and they didn't believe that there was any inportant difference between blood vessels, tendons and nerves . . . They viewed them all as 'channels' (carrying air, water or blood to the body). If the 'channels' got blocked then the body would suffer, just as crops suffered if the River Nile was blocked. Consequently, laxatives were frequently prescribed. the Ebers Papyrus describes healing based on magic.
The Ancient Egyptians were experts at surgery - the oldest known surgical texts date back to ancient Egypt about 3500 years ago, and the earliest known surgery was performed in Egypt around 2750 BC. Drilling holes into bones was a speciality - through the skull for trepanning and, as in the case of a 4th dynasty mummy, through the jawbone to drain an abscess. Various papyrus documents describe how to treat a dislocated jaw.
Egyptologists have dicovered a prosthetic toe made from wood and leather, which would have been used by an amputee to help him walk. A mummy with an artifical arm has also been discovered, and a dental prosthetic (an artificial tooth) was found in a Greco-Roman mummy.
Egyptian physicians knew a lot about chemistry - it is even possible that the word 'chemistry' comes from 'Kemet', the ancient name for Egypt.
Taking medicine, combined with rest, a proper diet and 'purges' was thought to be the way to cure almost any ailment.
The vast pharmocopoaia was imaginative in its administration - oral, rectal, vaginal routes could all be used, as were topical application (to the skin), inhalation and fumigation. Ancient Egyptians considered the anus to be the most efficacious route. Preparations were made into pills, cakes, suppositories, unguents, drops, mouth washes, and baths. Ox meat, liver and other animal products (bile, liver, brain, urine and excrement, horns, fat, teeth, bones, milk, eggs and hair) and hundreds of plants (including Senna, sycamore, castor oil, acacia gum, mint and linseed) found their way into pills, powders and suppositories. Sulphur, antimony and zinc were used for eye and skin ointments. Yeast was swallowed for indigestion, and applied topically to treat leg ulcers. When milk, mucus, beer or wine were used they were always sweetened with honey or dates.
The ingredients for the many remedies appear to include almost anything - but they were not used at random. Remediess often used the 'simila similibus' ('similar with similar') principle - an idea which continues today in homeopathy. Some British plants named in Victorian times use a similar logic: the blue-flowered pulmonaria, syn. 'lungwort', which looks slightly like a lung was supposed to cure respiratory (or 'pulmonary') problems.
Dosage was controlled by changing the quantitiy according the to patient's age, weight and height, and by specifying the duration of treatment, as well as by specifying the route of administration.
These are the instructions for an oral medication, and for an eye ointment:
'If it is a big child, he should swallow it like a draught, if he is still in swaddles, it should be rubbed by his nurse in milk and thereafter sucked on 4 days'
and 'the eye is painted therewith in the evening, its other half is dried, finely ground, and the eye is painted therewith in the morning'.
Prescribed durations in the Smith Papyrus vary from 'until he recovers', 'until the period of his injury passes by' or 'until thou knowst that he has reached decision point'.
Amulets worn around the neck or belly were believed to have magical properties. They were rather like a charm bracelet. According to some written records some were made with linen packages of herbs and animal remains, although obviously these have not survived. Homeopoetic amulets portray an animal or part of an animal, from which the wearer hopes to gain positive attributes like strength or speed. Phylactic amulets protected against harmful gods and demons, which is why they often depict the watchful Eye of Horus. We still use the concept of prophylaxis today; prophylactic treatment prevents health problems from developing, rather than waiting to cure them after the event. Theophoric amulets represented Egyptian gods; one represented the 'girdle of Isis' and was intended to stem the flow of blood at miscarriage.
Eye problems in Ancient Egypt included strabismus, cataracts, conjunctivitis and trachoma (Chlamydia trachomatis). Blinding dust was also a huge hazard for workmen - at Deir el-Medina the workers suffered badly. Blindness was incapacitating, and attempting to prevent or cure it was a high priority. Medical papyri suggest mixing honey (which we now know has antiseptic properties) with ochre, to 'cool the eyelids and reduce swelling'.
The habit of painting the skin around the eyes with a green malachite preparation may not simply have been decorative - the colour may also have toned down the dazzle of Egypt's brilliant sunshine. Other cosmetic powders using mesdemet or galena, and perfumes and hair dyes, although used for cosmetic purposes, may have protected the eyes, hair or body from insects.
Today rates of blindness in Egypt are amongst the highest in the world, and trachoma still common, especially amongst children. This and other acute eye infections affect both rural and urban populations. Trachoma leads to severe disability in adult life, causing blindness in many cases.
Injuries and ulceration secondary to infections are also common causes of blindness in Egypt today.
A 4th dynasty mummy was found to have had a loose tooth wired to a neighboring good tooth - and in greco-roman times artificial teeth were been used. Medical treatment of infected gums, tooth decay, abcesses and loose teeth has been described in many manuscripts, and these treatments can be seen on mummies.
The Egyptians suffered from migraines, but couldn't agree on a cause. Magical papyri proposed demonic and supernatural activity, but medical papyri related migraine to trauma or other bodily pains. Consequently, magical, pharmacological and surgical treatments were all tried - showing a desperation that migraine sufferers today may recognise.
The Ancient Egyptians did not differentiate between the heart and the mind; thus depression was referred to as 'fever', 'dryness', 'falling' or 'debility of the heart' and 'kneeling of the mind'. Other mental health problems were known too. One treatment, 'incubation' or 'temple sleep', involved spending a night - and dreaming - in the court of a temple. Dream interpretation wasthe responsibility of 'divine healers'. Philae Temple was an important sleep treatment centre.
Physiotherapy, Hydrotherapy and Heliotherapy (exposure to ultraviolet sunrays) , as well as treatment by mud and clay, are all described in various manuscripts.
Apparently the Egyptians also learned to use Enemas from the ibis! The bird (apparently a contortionist!) pushes water into its rectum using its long beak, in order to empty its bowel.
Now that ancient mummies have been examined byPaleopathologists using X-Rays, CAT Scans, Electron microscopes, mass spectrometry and various forensic techniques we have a much clearer idea of the health of Ancient Egyptians - they can even solve the mystery of how a pharaoh died.
The two diseases associated with both Ancient Egypt and Egypt today are trachoma and bilharzia (schistosomiasis). We know that schistosomiasis has been endemic in Egypt throughout history because the works have been found in mummies.
Neither disease is a particular threat to visitors on holiday, but to local people the are a problem.
People 'catch' bilharzia during normal daily contact with water bathing, swimming, fishing, cultivating crops grown in water or irrigating field crops, if that water is inhabited by freshwater snails parasitized by bilharzia. The snails excrete parasites into the water, and these, having taken only seconds to penetrate human skin, enter the victim's bloodstream, and over 30 to 45 days turn into long , egg-laying worms. Only half of their eggs are excreted. The remaining eggs stay behind to wreak destruction in the vital organs of the unfortunate host.
Unfortunately it's frighteningly easy to continue the cycle. The moment the eggs (carried in faeces or urine from an infected person) touch water they split open to release a parasite, the miracidium. And if the miracidium can find a fresh water snail . . . the story begins again.
Today, urinary schistosomiasis is linked with one form of cancer of the bladder amongst farmers in Egypt. This is the primary cause of death among men aged between 20 and 44 years. In industrialized countries where schistosomiasis is not a problem, cancer of the bladder is less common, and usually affects workers aged around 65.
Trachoma has already been discussed here
Health for Travellers in Egypt
There are good hospitals and chemists in all the major towns for people who can afford them, but poor hygiene, crowding and poor nutritional habits cause many common illnesses seen throughout Egypt - and the poor are treated at very basic hospitals far removed from the western standard 'international hospitals'.
There are health risks from cholera, hepatitis B, polio and typhoid, and a limited risk of malaria in the El Faiyoum area, especially from June to October -but Cairo and Alexandria are considered Malaria free.
Bilharzia is a risk in the Nile Valley and Nile Delta. Bird flu and swine flu have been problematic, and towards the end of 2010 another outbreak of swine flu infected 1,172 people in Egypt, killing 56 people.
Women's reproductive health, in rural Egypt particularly, is poorly served. UNICEF has spoken out against female genital mutilation (aka 'Female circumcision' or 'pharaonic circumcision'), which, although theretically banned in recent years, remains a problem in Egypt.
Traditionally the waterpipe (shisha) has been regarded as less harmful and less addictive than cigarettes. But the World Health Organisation has revealed evidence that the waterpipe is as harmful and as addictive as cigarettes.
Discover what the Ancient Egyptian believed about illness and the human body - and how effective their herbal remedies. were.
This is part of a series designed to show how hunter-gathering peoples treated everyday illnesses and broken bones, what the skeletons of early people can tell us about the diseases they suffered from, medical contributions and advances made over the centuries - from prehistoric times to the present day. The books evaluate the major medical issues of the time and consider the key individuals who pushed medical knowledge into new territory.
Exploring The History Of Medicine is written from a Christian perspective, but without preaching, and doesn't take the rather manic approach of many recent historical books for this age group.
A comprehensive study of pharaonic medicine, in the light of contemporary scientific discoveries about the lives (and deaths) of farmers, fishermen, miners, soldiers, scribes and priests, embalmers, construction workers, bakers and prostitutes in ancient Egypt.
The authors call upon evidence from sources as diverse as tomb paintings, mummies, bones, papyri and ostraca, jars (examining the liquid residues and the labels), prostitutes' tattoos and inscriptions in the tombs of physicians and laymen. They also devote a whole chapter to the Biblical 'Plagues of Egypt'
by John F. Nunn (1997)
by Carole Reeves (Shire Egyptology)
An overview of the discoveries produced by applying modern scientific methodlogy to palaeopathology and palaeopidemiology modern scientific studies is included along with specific case studies detailing evidence of disease. Features include the constituents and efficacy of the pharmacists' remedies, a brief overview of the medical papyri and medical inscriptions .
Written and illustrated by a medical illustrator who has won a prestigiious award for her work on Ancient Egyptian medical illustration.
The cutting-edge research by the team of specialist scientists who wrote this book used multidisciplinary, investigative methods and the resources of the Egyptian Mummy Tissue Bank. They incorporate plenty of background information about technical matters and previous scientific research, whilst demonstrating how these techniques can contribute to a new perspective on Egyptology and the history of disease in general.
The true story of a young French scientist, Louis Thuillier, as he and his colleagues race to discover the microbe responsible for the 1883 cholera outbreak in Alexandria, Egypt.
The facts are woven into a fictional love story between Thuillier and the daughter of the city's Jewish doctor, but the result is a novel that reads more like nonfiction, with poor characterisation and a predictable storyline. It is 'heavy on vile and overwrought detail' in its depiction of the ravages wrought by the cholera epidemic, but we are limited to the inadequate scientific insights available in 1883, without the scientific detail which we have come to expect in these days of techno-thrillers. A drama-documentary may have been better suited to the subject matter, rather than a novel.
Medicine is one of the topics covered by 'Science In Ancient Egypt' (as well as the achievements of the ancient Egyptians in science, mathematics, astronomy, agriculture and technology).
The author points out gaps in our knowledge of Egyptian technology and explaining when the techniques described (eg. used for shaping stones) are theoretical. More illustrations would help - but its a good brief introduction to the subject and works well as a classsroom 'read aloud'.
Brief (only 64 pages) but interesting.
Reading level: Ages 9-12
The causes of illness were a mystery to the Ancient Egyptians. They blamed evil sprits or the gods, so most of their medicine was based on superstition. Find out the very peculiar way that Ancient Egyptians tried to cure burns, amongst other medical curiosities and lots of other technologica detail.
Also available in a School & Library Binding (Aug 2008)