Perspectives
The art of medicine
The art of healing in ancient Egypt: a scientific reappraisal
The ancient Egyptians developed one of the earliest recorded our knowledge of ancient Egyptian medicine and pharmacy,
systems of medical treatment. Over the past 100 years, and provide a more accurate assessment of their legacy.
knowledge and appraisal of these procedures have been Alongside the papyri, there is a wealth of other evidence
largely based on evidence provided by twelve documents from ancient Egypt: mummified and skeletal remains;
inscribed on papyrus: the so-called medical papyri. One plant, animal, and mineral ingredients used in medicine;
manuscript is written in Egyptian hieroglyphs, whereas the temples and tombs; and artifacts such as stelae (tombstones)
others are in the Hieratic script, a cursive form of hieroglyphs. inscribed with autobiographies of medical practitioners,
The papyri date between about 1820 BCE and 250 ACE, statuary and amulets associated with healing, and some
although some may be copies of earlier works. Most were surgical instruments. Multidisciplinary research on such
acquired by modern owners in private sales during the late source material is yielding new insights into the occurrence
19th and early 20th centuries, and perhaps originated from of disease and treatment methods in ancient Egypt.
temple libraries, doctors’ houses or tombs, or town archives. Anatomical and radiological studies on skeletal and
Egyptian hieroglyphs were first deciphered by the French mummified remains provide extensive information relating
Egyptologist J F Champollion in the early 19th century, to disease in the teeth and the skeleton; these techniques
and this led to translations of the previously inaccessible have also revealed healed fractures and amputation sites,
literature of ancient Egypt. Translations of the medical papyri confirming that the Egyptians did successful surgery. It is
have shown that each deals with a variety of subjects, with noteworthy that, at least in some cases, there was no apparent
some material repeated in more than one document. These difference in the quality of treatment and care afforded to
compilations cover remedies to treat symptoms of a range of different social classes. Research on two artificial great toes
illnesses and physical conditions, although some also discuss associated with mummies suggests that, in each case, the
the Egyptian notion of the cardiovascular system. One—the prosthesis was probably worn during the owner’s lifetime; if
Edwin Smith papyrus—is notable for its structured approach, their functionality is confirmed by a current biomechanical
being based on a series of case studies that each includes a assessment of replicas of the toes, then these pieces could
title, instruction on the examination of the patient, diagnosis be the earliest surviving intravital limb prostheses. Since the
and prognosis, and recommended treatment. The translations early 20th century, Egyptologists and dentists have debated
have led scholars to conclude that Egyptian medical practice the existence of an operative dental profession. Although
included two main strands: “rational” treatments based on the medical papyri contain some prescriptions for dental
so-called scientific principles and observation of the patient, problems, neither literature nor skeletal material provides
and “irrational” methods that involved magico-religious convincing evidence of professional, interventional dental
beliefs and relied on the use of amulets, incantations, and rites treatment. Samples of tissue, bone, hair, and teeth taken
to drive out the unseen and supernatural agents presumed to from mummies can now be examined using a range of
cause some diseases. Although this contemporary separation techniques that include histology, immunocytochemistry,
and distinction of approaches would have been meaningless enzyme-linked immunosorbent assay, and DNA analysis.
to the ancient Egyptians, scholarship has hitherto attributed Such diagnostic tools have helped identify diseases in the
a predominantly magic-based medical system to ancient mummies; it has even been possible to amplify and sequence
Egypt, while according the discovery of rational medicine to ancient Schistosoma DNA fragments in the remains of a
the Greeks in the 5th century BCE. disease-causing parasite found in a 2000-year-old mummy.
The Egyptian papyri are, however, a limited and Some diseases were treated with pharmaceutical remedies
problematic source. Known examples represent only a small listed in the medical papyri, but until recently, the therapeutic
proportion of similar, undiscovered works that presumably efficacy of many of these prescriptions has been doubted.
once spanned 3000 years of civilisation. Also, modern About 2000 remedies recorded in the medical papyri provide
translators have encountered particular problems with details of the ingredients, method of preparation, dose, and
the vocabulary of these documents. Usually, identification route of administration. Ingredients were sourced from
of words and terms found in one text are independently within Egypt, or from trade with the Near East, Africa, and
attested by their use in other inscriptions, but some words southern Mediterranean lands. Difficulties with translating
in the medical papyri are unique and cannot be confirmed the names of some ingredients mean that the identification
elsewhere. Therefore, some of these translations remain of about 30% of them have been disputed. Archaeobotany
speculative. Difficulties posed by the papyri have persuaded and phytogeography have recently been used to re-evaluate
Egyptologists to consider other evidence that might verify or these prescriptions and their therapeutic efficacy and given
correct the perspective provided by the literary texts, expand more credible identifications for 284 ingredients.
1802 www.thelancet.com Vol 372 November 22, 2008
Perspectives
The printed journal
includes an image merely
for illustration
AKG Images
Temple of Hathor, Denderah by David Roberts in Egypt and Nubia (1846–49) by David Roberts and William Brockedon
The prescriptions in the medical papyri are presented in when a trance-like state was induced by use of lamps, burning
sufficient detail to make them reproducible today. Current perfumed wood, and sacred songs, so that the sufferer could
research confirms that from at least 1820 BCE, the Egyptians approach the gods and seek healing. Archaeological evidence
prepared and delivered drugs, and from 1550 BCE precise has shown that part of a temple at Deir el-Bahri was also
measurements were introduced for prescribing each drug. used as a healing centre. Both sites date to the later periods Further reading
Indeed, 50% of the drug sources used by the ancient Egyptians of ancient Egyptian history, contemporary with temples in Campbell J. Pharaohs and the
remain in use today, although many are now synthetised. Greece where similar treatments were pursued. However, first prescriptions. Pharmaceutical
Also, a first attempt to estimate the pharmaceutical value inscriptional evidence confirms that these healing procedures J 2007; 279: 735–37.
of these remedies has shown that 64% are therapeutically were already used in Egypt at least a 1000 years earlier. Daumas F. Le sanatorium de
Dendara. Bulletin de l’Institut
effective, and that, although some treatments still relied on Paul Ghalioungui suggested in 1963 that the Egyptians
Francais d’Archeologie Orientale
the power of magic, most were based on rational protocols “were the first in History to dare look at the other side of the 1957; 56: 35–58.
and standards. Analytical scrutiny of seemingly irrational abyss that separates magic from science”. Nonetheless, he and David R, ed. Egyptian mummies
treatments, such as the use of crocodile excrement as a later writers generally regarded the Egyptian medical system and modern science. Cambridge:
contraceptive and the recipe to anoint the head of a migraine as a mixture of rational and irrational treatments, largely Cambridge University Press,
2008.
sufferer with part of a catfish, may ultimately lend some reliant upon magico-religious procedures. Now, based on a
David R. Rationality versus
support to the Egyptians’ view of them as effective cures. review of the evidence provided by multidisciplinary studies, irrationality in Egyptian
Analytical techniques such as gas chromatography-mass it seems that, although the medical practitioners followed medicine in the Pharaonic and
spectrometry and liquid chromatography-mass spectrometry several approaches to healing, the prevalence and influence Graeco-Roman Periods. In:
Horstmanshoff HFJ , Stol M, eds.
have added yet another dimension. They have been used to of “irrational” treatments were probably less important than Magic and rationality in ancient
investigate whether the blue lotus flower (Nymphea caerulea) previously supposed. From an early date, doctors certainly Near Eastern and Graeco-Roman
was used as a narcotic or aphrodisiac; to examine samples of had the knowledge and skills to provide rational and effective medicine. Leiden: Brill, 2004.
hair and scalp tissue from mummies for physical evidence treatment for their patients. Nevertheless, magico-religious Ghalioungui P. Medical science in
ancient Egypt. London: Hodder
of preparations described in the papyri to treat baldness and practices undoubtedly continued throughout the millennia; and Stoughton Ltd, 1963.
greying hair; and to identify the botanical and geographical and, in the absence of an effective rational remedy, the Nunn J. Ancient Egyptian
origins of resins and unguents so that ancient trade routes of Egyptians could always resort to magic, as in the following medicine. London: British
medicinal and other ingredients can be established. incantation to cure the common cold: Museum Press, 1996.
Archaeological excavation has revealed how some temples “Flow out, fetid nose, flow out, son of fetid nose! Flow out,
had a reputation as centres of healing. The Egyptologist you who break bones, destroy the skull and make ill the Reference is made to research for
the Pharmacy in Ancient Egypt
Francois Daumas identified as a sanatorium the brick building seven holes of the head!” Project at The University of
excavated in the enclosure of the Temple of Hathor at Manchester. I am the Principal
Papyrus Ebers 763
Denderah. Here, water drawn from the temple’s Sacred Lake Investigator for this project that
was awarded a Research Grant by
and believed to have curative properties, was used to bathe Rosalie David
The Leverhulme Trust (2006–09).
patients. The sanatorium had a series of small, dark cells Director, KNH Centre for Biomedical Egyptology at the University of The funder has had no
where patients were prepared for the “Therapeutic Dream”, Manchester, Manchester M13 9PL, UK involvement in this essay.
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