Our knowledge of ancient Egyptian medicine has crossed the millennia primarily in the form of medical papyri. Over a dozen documents have been discovered and translated. But in all of Egypt there are only a few obscure tombs and reliefs that give us any pictorial scenes which pertain to medical practices and procedures. Those few that exist represent a challenge to the hardy tourist curious enough to seek them out.

Where to Start

Since Cairo is the usual point of entry to Egypt, the nearest place to find insights into ancient medicine is at nearby Saqqara - the Old Kingdom necropolis. The tomb of Ptah-Hotep, Inspector of the Priests, contains a relief with several boats. While this is not really a medical scene, it is of interest to the medical profession since physical ailments depicted in the figures are readily identifiable.

In the first barge a man at the stern has an abdominal protrusion. On the third barge the man in the centre has an umbilical hernia and another suffers from genital hypertrophy. Tombs at Saqqara are known for their intricate detail. The boatmen were no doubt personally known to the artist who included them just as they were in real life.

Nearby is the tomb of Ankh-Mahor, known as The Tomb of the Physician. On the left wall, two men are having something done to their hands and feet. Different explanations include massage, manicure, and pedicure as well as surgery. Since the text reads "Do not let it be painful," scholars argue it is likely to illustrate some kind of joint manipulation.

Near the doorway is a detailed scene of a circumcision. In hieroglyphics, the man performing the procedure says, "The ointment [thought to be a local anaesthetic] is to make it acceptable."

Opium appears frequently in the medical literature, indicating Egyptians of old were quite familiar with its properties. The knife appears to be of flint or obsidian. Modern research has vindicated flint scalpels. For certain neurological and optical procedures, obsidian possesses qualities unmatched by the finest surgical steel. It is quite possible that circumcisions were also conducted by priest cults, but if so, scholars wonder why in all of Egypt no other scene of a circumcision has ever been found. The scenes at Ankh-Mahor are unique.

Ptolemaic Treasures

North of Luxor lies the Temple of Hathor at Dendera - perhaps best known for its frequent visitor, Cleopatra. From earliest times special attention was paid to the ritual of childbirth. Among upper classes, expectant mothers retired to special birth-houses. Most were located in Ptolemaic temples, of which the one at causeway are the remains of the birth-house with many reliefs of the dwarf-god, Bes, the patron god of pregnant women.

Hathor was a patroness of healing, leading us to believe that the entire temple compound may have been an important hospital.

Sobek's Secret

Upriver enroute to Aswan, cruise ships stop at the Ptolemaic site of Kom Ombo, home of the magnificent ruin of the Temple of Sobek - the Crocodile God. Here is one of the most controversial medical reliefs. The emperor Trajan is kneeling before Imhotep (the same who built the Step Pyramid at Saqqara). Imhotep held many titles, among them that of Physician. Such was his fame and genius in the Old Kingdom that he was elevated by later priests to the status of a god.

Nearby are reliefs of medical instruments depicting suction cups, scalpels, retractors, scales, lances, bone saws, chisels and dental tools. Above is a relief of a pregnant woman sitting on a birthing chair which features a hole through which the new-born infant drops. One school of 20th century childbirth endorses this method where gravity assists in the process.

The Lore of the Ancients

Old Kingdom papyri detailed a strict practical approach to the treatment of injury and illness. The Edwin Smith surgical papyrus is considered the oldest medical text in the world. It presents an astonishing compendium of injuries - wounds, fractures and dislocations - in systematic order. Forty-eight case studies are outlined, complete with treatments.

The literature makes it clear that examination by the Egyptian doctor was a thorough process. Recommended treatments included reducing dislocations, healing fractures by using splints and casts, and closing wounds with sutures, clamps and adhesive plaster.

Mummies have revealed numerous examples of fractures which healed without complication. Mummies also tell us that dental surgery was known early on. And many remedies in the medical papyri were no doubt effective. The Ebers papyrus prescribes castor oil as a laxative. Some scholars believe that the peculiar symbol Rx which precedes a prescription is actually an invocation to the Egyptian god Ra. It signifies "In the name of Ra..." or "Oh Ra, God of Light and Health, inspire me!"

Poultices and Potions

Disease was believed to be the work of the gods - the presence in the body of spirits, or poisons injected by the spirits. There is no disputing the fact that magic and divine intervention were frequently invoked as cures. While ancient texts were carefully preserved, copies made by later physicians were embellished with added "improvements", accompanied by a fair amount of gibberish.

In potions and ointments, it was believed that the rarity of ingredients contributed to the cure's effectiveness. However, much was known about plants with definite medical value - and if a remedy contained useless components, no harm was done as long as at least one of them actually worked.

Concoctions for treatments contained many common ingredients such as honey, wax, beer, herbs, and various vegetables and fruits. Common among questionable animal ingredients were lizard's blood, teeth of swine, putrid meat, stinking fat and moisture from a pig's ear. Excrement from adults, children and animals was also valued. For most ailments it was thought that a medicine should be neither too simple nor too exotic to be effective.

Age-Old Problems

The physician was also required to furnish cosmetics, colour the hair, improve the skin and beautify the limbs. Egyptians were obsessed with baldness and grey hair. As a remedy against hair turning white, the head was anointed with blood drawn from the horn of a black bull, boiled in oil. Hair loss required a more complicated concoction for renewal: fats of lion, hippopotamus, crocodile, cat, snake and ibex - mixed together in a vile goo "guaranteed" to encourage growth. To really strengthen it, a crushed donkey tooth mixed with honey was added.

Jealousy in the harem sometimes generated requests for physicians to prepare substances which would have a negative effect upon a targeted competitor. To cause the hair of a rival to fall out, certain worms and ill-smelling flowers were boiled in oil and applied to the head of the victim. Of course, the shrewd physician ensured his own favour with the target by providing the antidote - a tortoise shell, boiled, pounded and mixed with hippo fat.

As if these additional responsibilities weren't already enough, the physician was also expected to act as exterminator. To drive flies from the house, he might order the sprinkling of natron water. The fat of a woodpecker was insurance against fly stings while fresh palm wine would protect against gnats.

As we poke about in a 4,500 year-old doctor's tomb or gaze upon scenes created by artists long-departed, we are tempted to chuckle at the outrageous "cures" prescribed in the ancient papyri. But like many elements of Egyptian society, medicine was a highly formalised affair. Such was the fame of Egypt's doctors that foreign emissaries often requested their services and advice.

While much of the ancient knowledge and theory may have been misplaced and misdirected, there can be no doubt that ancient Egyptian medicine is at the very root of modern medicine. At times the parallels with today's world are truly remarkable.

Canadian Bob Burch is a regular contributor to Travel Africa, as well as to other international publications. He has made more than 30 trips to Africa.

Published in Travel Africa Edition Five: Autumn 1998. Text is subject to Worldwide Copyright (c)