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The First Medical Text

The Edwin Smith Surgical Papyrus

Medical Trivia

Cervical spine cases in the Edwin Smith Papyrus
Cervical spine cases in the Edwin Smith Papyrus

Written in approximately 1700 BC, the Edwin Smith surgical papyrus is the oldest written medical text. It contains 48 cases of traumatic injury and how to evaluate and treat them.  It was found in a tomb in 1862, in Thebes, Egypt and sold to Edwin Smith, an antiquities dealer.  It was later donated to the New York Historical Society and a translation was first published in 1930. The papyrus is now felt to be a copy of an even older document of an uncertain age.  The cases include injuries to the head, face, throat and neck, spine, clavicle, humerus, sternum, and shoulders. 


Each case describes the problem and then suggests a treatment (an ailment I will treat) or recommends no treatment (an ailment not to be treated), if the medical issue is too severe to effectively treat. 


In one example, a method is described for reducing a dislocated jaw (mandible) that is still used today.  For nasal fractures, recommendations included relocation, and insertion of linen plugs with honey and some form of lubricant and the nose was to be externally splinted. There are instructions on how to treat a fractured or dislocated clavicle as well as a fractured humerus, including setting, relocation and splinting.  In the case of a fractured humerus with a deep wound injury down to the fracture the author describes it as “An ailment not to be treated.” and it seems an open fracture in ancient Egypt was considered a lethal injury.  It also discusses catastrophic cervical spine injuries. “One having a crushed vertebra in his neck; he is unconscious of his two arms (and) his two legs (and) he is speechless. An ailment not to be treated”  For scalp lacerations, the author describes how to examine them, and the treatment recommended was to bind fresh meat on it the first day and apply two strips of fresh linen.  This was followed by application of grease, honey and lints every day until recovery.  Lints made from linen or vegetable fibers were used to absorb secretions and linen strips were used to hold wound edges together. There are many other traumatic injuries discussed in the papyrus.    


Comments:

It is truly amazing that one or more Egyptian physicians over 3,700 years ago had invented and documented treatment procedures that in some cases are similar to what is still practiced today. 


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