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Monday, December 1st 2008

The Edwin Smith Papyrus

A Roll From The Restored Edwin Smith Papyrus

In 1862 an American Egyptologist was far from the war that was engulfing America. In that year Edwin Smith bought a manuscript from an Egyptian collector in Luxor. A prolific collector of Ancient Egyptian manuscripts and finds, Smith was, apparently, never the less not the most gifted translator. He held onto the manuscript for more than forty five years, until his death in 1906 and in that time was not able to make substantial progress in translating the papyrus. At his death his daughter donated the papyrus, and other parts of her father’s collection, to the New York Historical Society.

In 1920 the Historical Society brought on the famous Egyptologist James Breasted to translate the papyrus. His completed translation was published a decade later.

What he translated was pretty fascinating

The papyrus is a medical textbook. Its clarity, conciseness and organization are remarkable for a medical treatise of the time. But perhaps even more impressive is its presentation of incredibly accurate physical examination and anatomical findings; along with rather reasonable treatment options.

It is also the first real neuroanatomical study. The document is broken up into forty eight cases and is an incomplete copy of a previous work. Of the 48 cases, 27 deal with head trauma and another 6 with spinal trauma. In presenting these cases the papyrus is the oldest surviving document to describe the sulci and gyri on the surface of the brain, the meninges, and the cerebral spinal fluid.

Breasted Translated This Hieroglyph As The Membrane Covering The Brain

Consider the following Breasted translation of one of the cases.

Title: Instructions concerning a smash in his skull under the skin of his head.

Examination: If thou examinest a man having a smash of his skull, under the skin of his head, while there is nothing at all upon it, thou shouldst palpate his wound. Shouldst thou find that there is a swelling protruding on the out side of that smash which is in his skull, while his eye is askew because of it, on the side of him having that injury which is in his skull; (and) he walks shuffling with his sole, on the side of him having that injury which is in his skull…

Diagnosis: Thou shouldst account him one whom something entering from outside has smitten, as one who does not release the head of his shoul fork, and one who does not fall with his nails in the middle of his palm; while he discharges blood from both his nostrils (and) from both his ears, (and) he suffers with stiffness in his neck. An ailment not to be treated.

Treatment: His treatment is sitting, until he [gains color], (and) until thou knowest he has reached the decisive point….

Gloss: As for: “He walks shuffling with his sole,” he (the surgeon) is speaking about his walking with his sole dragging, so that it is not easy for him to walk, when it (the sole) is feeble and turned over, while the tips of his toes are contracted to the ball of his sole, and they (the toes) walk fumbling the ground. He (the surgeon) says: “He shuffles,” concerning it…

This appears, per many people’s interpretation, to refer to a closed skull fracture; with a pretty interesting description of some occular motor palsy and an ipsilateral lower extremity paralysis. Of the cases dealing with neurotrauma, they break down like this,

[The neurotrauma cases,] according to our present day terminology would be classified as follows: two compound linear fractures; four compound depressed fractures; four compound comminuted fractures; and one comminuted fracture without external wound. The symptoms and signs of head injury are given in considerable detail. Feeble pulse and fever are associated with hopeless injuries and deafness as well as aphasia are recognized in fractures of the temporal region.

James Breasted attributed the original treatise to Imhotep, the “Father of Medicine.” Such attribution would put the original work (of which the Edwin Smith Papyrus is clearly a transcription of) a 1000 years earlier. That would mean that these description of the brain and its coverings and the cerebrospinal fluid and all these detailed examination findings were recorded more than 5000 years ago.

Pretty incredible.