Ancient Egypt (3300BC to 525BC) is where we first see the dawn of what, today, we call "medical care". The Egyptian civilization was the first great civilization on this planet. Egyptians thought gods, demons and spirits played a key role in causing diseases. Many doctors at the time believed that spirits blocked channels in the body, and affected the way the body functioned.
Their research involved trying to find ways to unblock the "Channels". Gradually, through a process of trial and error and some basic science, the profession of a "doctor of medicine" emerged. Ancient Egyptian doctors used a combination of natural remedies, combined with prayer.
Unlike prehistoric peoples, ancient Egyptians were able to document their research and knowledge, they were could read and write; they also had a system of mathematics which helped scientists make calculations. Documented ancient Egyptian medical literature is among the oldest in existence today.
The ancient Egyptians had an agricultural economy, organized and structured government, social conventions and properly enforced laws. Their society was stable; many people lived their whole lives in the same place, unlike most of their prehistoric predecessors. This stability allowed medical research to develop. In this society, individuals were relatively wealthy, compared to their ancestors, and could afford health care.
They had temples, priests and rituals in which deceased people were mummified. In order to mummify you have to learn something about how the human body works. In one mummification process, a long hooked implement was inserted through the nostril, breaking the thin bone of the brain case, allowing the brain to be removed. A significant number of priests became medical doctors.
Ancient Egyptian doctors knew that the body had a pulse, and that it was associated with the function of the heart. They had a very basic knowledge of a cardiac system, but overlooked the phenomenon of blood circulating around the body - either because they missed it, or thought it did not matter, they were unable to distinguish blood vessels, nerves, or tendons.
The ancient Egyptians were traders, and travelled long distances, coming back with herbs and spices from faraway lands. Their relatively high standard of living gave them free time, which they could use for observing things and thinking about them. Medical research involves patience and observation.
The Channel Theory - this came by observing farmers who dug out irrigations channels for their crops. They believed that as in irrigation, channels provided the body with routes for good health. If the channels became blocked, they would use laxatives to unblock them.
They thought the heart was the center of 46 channels - types of tubes. To a certain extent, they were right, our veins, arteries, and even our intestines are types of tubes. However, they never came to realize that these channels had different functions.
The Gods were the creators and controllers of life, the Egyptians thought. They believed conception was done by the god Thoth, while Bes, another god, decided whether childbirth went smoothly. Blockages in the human "channels" were thought to be the result of the evil doings of Wehedu, an evil spirit.
The channel theory allowed medicine to move from entirely spiritual cures for diseases and disorders, towards practical ones. Many medical historians say this change was a major turning point, a breakthrough in the history of medicine.
Some recommendations made by physicians were fairly sound - they advised people to wash and shave their bodies as measures to prevent infections. They told people to eat carefully, and to avoid unclean animals and raw fish.
Some of their practices were bizarre, however, and most likely did more harm than good. Several medical prescriptions contained animal dung, which might have useful molds and fermentation substances, but were also infested with bacteria and must have caused many serious infections.
Egyptian doctors were sought after by kings and queens from faraway lands because they were considered as the best in the world.
Archeologists have found Papyri (thick paper-like material produced from the pith of the papyrus plant) where Egyptians had documented a vast amount of medical knowledge. They found that they had fairly good knowledge about bone structure, and were aware of some of the functions of the brain and liver.
These are medical documents which are thought to have been written around 1500 BC, and most likely include retranscribed materials dating back to 3400 BC. It is a 20-meter long scroll, which covers the equivalent of approximately 100 pages. The Ebers Papyrus, along with the Edwin Smith Papyrus, are the oldest preserved medical documents in existence.
Georg Moritz Ebers (1837-1898), a German novelist and Egyptologist, discovered this medical papyrus at Thebes (Luxor) in 1873-74. It is now in the Library of the University of Leipzig, Germany.The Ebers Papyrus was has over 700 remedies and magical formulae, as well as scores of incantations aimed at repelling demons which cause disease. However, it also has evidence of sound scientific procedures. The authors wrote that the center of the body's blood supply is the heart, and that every corner of the body is attached to vessels. The functions of some organs appear to have been overlooked, while the heart was the meeting point for vessels which carried tears, urine, semen and blood.
The Book of Hearts, a section of the Ebers Papyrus, described in great detail the characteristics, causes, and treatment for such mental disorders as dementia and depression. It appears they viewed mental diseases as a combination of blocked channels and the influence of evil spirits and angry Gods.
There is even a section on family planning, contraception, how to tell if you are pregnant, and some other gynecological issues. They wrote about skin problems, dental problems, diseases related to the eyes, intestinal disease, parasites, and how to surgically treat an abscess or a tumor. The ancient Egyptians clearly knew how to set broken bones and treat burns.
Below are some quotes from the Ebers Papyrus (adapted into familiar modern day phrases):
Egyptian physicians were trained and good at practical first aid. They could successfully fix broken bones and dislocated joints.
Basic surgery, meaning procedures close to the surface of the skin (or on the skin) was a common and well learnt skill. They knew how to stitch wounds effectively. They did not, however, perform surgery deep inside the body. They had no effective anesthetics, only antiseptics. Performing surgery deep inside a human body would have been impossible.
They had excellent bandages, and would bind certain plant products, such as willow leaves, into the bandages for the treatment of inflammation.
Circumcision of baby boys was common practice. It is hard to tell whether female circumcision existed; there is one mention, but several experts believe the text has not been translated properly.
Egyptian doctors said there were three types of injuries:
Surgeons had an array of instruments, such as pincers, forceps, spoons, saws, containers with burning incense, hooks and knives.
Prosthetics did exist, but archeologists say they were probably not that practical and were used either to make deceased people look more presentable during funerals, or were simply for decorative purposes.
The aim of public health is to protect the community from the spread of disease, and too keep everybody as healthy as possible. The provision of water so that people can wash themselves, their animals and their homes is a vital part of preventing the spread of disease. Cleanliness was an important part of Egyptian life; however, it was promoted for social and religious reasons, and not health ones.
Their homes had rudimentary baths and toilets. Personal cleanliness and appearance were an important part of life; many even wore make-up around their eyes to protect from disease. Most people used mosquito nets during the hot months - we cannot know whether this was to protect against malaria and other diseases, or simply because they did not want to be bitten.
Priests washed themselves and their clothing and eating utensils regularly. But they did it for religious reasons. Although hygiene practices did help protect their health, this was not their reason. Cleanliness was an appeal to their gods.
There was no public health infrastructure as we know of today, with sewage systems, proper medical care and public hygiene.
Everyday life in Egypt involved beliefs and fear of magic, gods, demons, evils spirits, etc. Luck and disaster were caused by angry celestial beings or evil forces. They believed that if illnesses and physical and mental disorders were partly caused by supernatural forces, then magic and religion were required to deal with them and treat people.
Anthropologists, archeologists, and medical historians say there did not appear to be a clear difference between a priest and a doctor in those days. Many healers were priests of Sekhmet, and used science as well as magic and incantations when treating people. (Sekhmet was an Egyptian warrior goddess).
The religious and/or magic rituals and procedures probably had a powerful placebo effect, which were likely seen as proof of their effectiveness.
Some treatments used products or herbs or plants that looked similar to the illness they were treating, this is known as simila similibus (similar with similar). This practice has existed all over the world, even in modern alternative medicine (homeopathy, treating like with like). In Egyptian times ostrich eggs were used to treat a fractured skull.
The earliest ever record of a physician was Hesy-Ra, 2700 BC, who was "Chief of Dentists and Doctors" to King Dioser.
The first female doctor was probably Peseshet 2400 BC, who was known as the supervisor of all female doctors.
The top doctors worked in the royal court. Below them there were inspectors who would supervise the proper actions of doctors. There were specialists, such as dentists, proctologists, gastroenterologists, and ophthalmologists. A proctologist was called "nery phuyt" which means "shepherd of the anus".
On the next page, we look at ancient greek medicine.
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