Friday, July 8, 2005
The Edwin Smith Papyrus
Filed under: the good old days...
With all the recent talk about robots encroaching on the domain of surgeons, we thought it'd be fun to take a look back to the beginning of the field.
The earliest known historical text on surgery is the Edwin Smith papyrus. Dating to 1600 BC, it is, in fact, the oldest known medical document. The practical material in the Edwin Smith papyrus stands in stark contrast to the magical incantations in another celebrated Egyptian medical text, the Ebers Papyrus.
There's some speculation that all surgery began as military surgery, specifically, the careful removal of arrows and darts. Fittingly, the material in the Edwin Smith Papyrus deals mostly with trauma.
Every surgeon knows the most important decision he or she makes is when NOT to operate. The Egyptians seemed to recognize this, too -- many of the ailments in the Edwin Smith papyrus are deemed untreatable.
Through the wonders of the web, you can play along at home, clicking on the various injuries and guessing Imhotep's recommendations. One favorite is ailment #47, "Instructions concerning a gaping wound in his shoulder," excerpted below:
If thou examinest a man having a gaping wound in his shoulder its flesh being laid back and its sides separated, while he suffers with swelling (in) his shoulder blade, thou shouldst palpate his wound, shouldst thou find its gash separated from its sides in his wound, as a roll of linen is unrolled, (and) it is painful when he raises his arm on account of it, thou shouldst draw together for him his gash with stitching.Thou shouldst say concerning him: "One having a gaping wound in his shoulder, its flesh being laid back and its sides separated while he suffers with swelling in his shoulder blade: An ailment which I will treat."
Thou shouldst bind it with fresh meat the first day.
You couldn't ask for a better assessment and plan. And Day 2 has some other interesting ingredients in store. In fact, we found another site that speculates on the Egyptian tendencies toward employing meat, honey, and grease, and lint:
Lint was a form of vegetable fiber, and grease was some form of vegetable oil. The grease could also be snake grease, or other grease from an animal. Honey was the most widely used of the three, in over 900 remedies. Such a mixture of grease and honey prevents bacteria from growing in an open wound, and thus decreases the risk of an infection. The lint would then cover up the wound. The meat was used as a clotting agent in the bleeding wound. It is thought that the Ancient Egyptians used fresh meat in some wound treatments because of the idea of "flesh healing flesh," like the old cliche of putting meat on a black eye.
The Edwin Papyrus is currently housed in the New York Academy of Medicine. Much more on ancient surgery, specifically approaches to wounds, can be found in Dr. Guido Majno's book, The Healing Hand.
That concludes our week. Thank you for stopping by!
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