Medicine was practised from early times in Egypt and Mesopotamia, two great contemporary centres of civilisation. The first extant textual evidence of healing treatments is recorded in cuneiform script on clay tablets towards the end of the third millennium BC, but there may have been an equally early Egyptian tradition which has not survived because it was recorded on papyrus, a far less robust writing material.
Previous studies on ancient Egyptian medicine have generally categorised and described diseases and medical conditions identified in textual, iconographic, archaeological, and palaeopathological sources. These include medical papyri, and archaeological evidence from buildings, tomb reliefs, physicians’ stelae, votive offerings, surgical instruments, and equipment owned by magico-medical practitioners, as well as human skeletal and mummified remains.
Our research has taken a different, innovative approach, considering the subject afresh from the perspective of both healing professionals and the recipients of their care. We have examined the training and individual roles of the various groups of healers, and their interaction with each other and with their patients, and assessed their contribution, knowledge and expertise, and the extent to which the various treatments they used were efficacious.
People-focused approach
Healers and care providers were essential to the Egyptian medical system, and offered a wide range of treatment methods. Certain types of healthcare, training, and practice developed simultaneously in various locations including temples, palaces, towns, and villages, battlefields, and building sites.
Surgery, pharmaceutical therapy, and magico-religious treatments were available, which made use of bandages and splints, medical instruments, prostheses, and pharmaceutical prescriptions. But what was it like to be ill, deformed, or disabled in ancient Egypt? How were the particular health concerns of women, infants, and children managed? What particular dangers were encountered by builders and other workforces? This ‘people-focused’ approach tries to identify and explain the Egyptians’ perception of illness and disability, and their praiseworthy attitude towards overcoming both physical and mental afflictions (a reinterpretation of evidence for this subject has recently been published; see Further reading).
Medical care for women and children
Women and children faced particular health concerns. Challenges associated with conception, childbirth, and motherhood, and the special vulnerability of infants and young children, were addressed with special magical rituals and medical procedures designed to protect the recipients against disease, or provide an effective cure.
In general, women’s own thoughts and opinions about their special needs and circumstances relating to reproductive health are unrecorded and thus remain inaccessible. Fertility, conception and contraception, pregnancy, identifying the sex of the unborn, and treatment of neonates are all important sections in various medical treatises, notably the Ebers, Carlsberg, London, Berlin and Kahun Gynaecological Papyri. However, these documents are silent regarding normal childbirth, perhaps reflecting the fragmentary nature of surviving texts, or because there was no need to record what was probably regarded as a natural process.
From inscriptional, archaeological, and iconographic sources, we know that paramedical personnel – midwives and nurses – provided assistance to women during pregnancy and birthing procedures. However, although the titles, roles, and working practices of medical personnel are relatively well attested, only limited information is available about the working lives of paramedical personnel, and their relationship with each other and with the physicians. Nevertheless, there is sufficient evidence to show that they could exert considerable influence, especially in royal and elite households; even in a non-elite family, it is recorded that, on one occasion, a wet-nurse received higher payment than a physician.
Combatting old age
Ancient Egypt provides the earliest surviving evidence of a society that idealised youth and rigorously sought to combat or delay the ageing process. In life, Egyptians used a range of cosmetics to enhance their good looks and promote a youthful appearance, which included deodorants, depilatory and skin cleansing creams, and facial cosmetics, as well as treatments for greying hair.
A rejuvenating potion in the Edwin Smith Papyrus is entitled “recipe for transforming an old man into a youth”. The main ingredient in this recipe is the hemayet-fruit, translated as ‘bitter almonds’. One of the extracts, mandelic acid, is used today for skin care as it reputedly improves the quality of aged skin. There are also different recipes to encourage hair growth on a bald head, with animal fats being a popular ingredient.
Attitudes to deformity and disability
The Egyptians’ perception and treatment of disability and deformity differed greatly from the attitudes of the Babylonians, Greeks, and Romans, who barred people with physical differences from holding religious offices, and sometimes even exposed and killed infants born with deformities. This divergence was probably at least partly due to different religious beliefs. Greek deities were attributed with idealised physical perfection, and any human physical variation was regarded as ungodlike and therefore unacceptable. However, in Egypt, the dwarf-god Bes was included in the pantheon, and humans were only expected to achieve universal physical perfection in an idealised afterlife.
Deformity and disability arose from multiple causes, including genetic inheritance, congenital abnormality, disease, accidents, or general physical deterioration. Overall, there was a remarkable degree of medical and social support for the sick, disabled, and elderly, and the Egyptians adopted a pragmatic, practical attitude towards alleviating problems associated with these conditions. One example is the earliest-known prosthesis – a replica ‘big toe’ which enabled the owner to walk more easily.
Inscriptions and tomb wall-scenes confirm that disability or deformity did not bar individuals from holding religious or public office, even at a high level. There may also have been special employment opportunities for people with particular conditions. For example, some blind men may have been employed as harpists and singers, while dwarfs – noted for their nimbleness and dexterity – are commonly seen as jewellers or personal attendants in charge of their employers’ clothing and jewellery (as attested in the tomb of Mereruka at Saqqara).
Court punishments
In some instances, medical help was needed for wounds that had been inflicted intentionally. The main form of corporal punishment handed out by the courts was a beating, usually specified as “one hundred blows with a stick”. The medical papyri include several treatments for the lacerations left by such beatings, and one example, (P. Ebers 510): “a remedy to eliminate the weals following a beating”, recommends a mixture of “honey, ox-bile, potter’s clay, juice of sAr-plant, date-juice, to be cooked and bandaged therewith”. While honey would be soothing and reduce infection, the action of some of the other constituents is less obvious. Case 514 in the Ebers Papyrus advises a HmAjt-plant to be placed on a cake dipped in honey and then swallowed. This remedy is quite unusual in that it is one of the few occasions that an oral medicine is prescribed, and in this instance is probably intended as an analgesic preparation.
Snakes and scorpions
Scorpion stings and snake bites would have been a common hazard in ancient Egypt and would have required prompt attention. The Brooklyn Papyrus is concerned exclusively with such bites and stings and includes local measures such as the ‘knife treatment’, which probably involved incising the wound to relieve tissue fluid and limit the absorption of the venom. Bandaging was advised in several cases and was used to retain specific medications, rather than as a tourniquet to prevent the spread of venom. Natron was one of the agents recommended, and would have been a logical compound to utilise as it has the capacity to reduce swelling by means of osmosis. In addition, almost 100 prescriptions are listed in the Brooklyn Papyrus, many of them of herbal origin. Onion is the commonest ingredient of these remedies, probably because of its ability to repel snakes. The sulfonic acid present in onions – the same chemical that causes tears when onions are chopped – has a deterrent effect on snakes. The papyrus also includes a number of incantations, many of which are intended for use with a particular remedy.
Insecticides and pesticides
The medical papyri also include a number of insecticides, pesticides, and treatments to fumigate the house – and even to freshen the clothes you wore. Ebers 840 advocates sprinkling natron around the house; as natron, when mixed with water, is alkaline, it creates a hostile environment for bacteria and insects. Ebers 845 and 846 are both recipes for insect repellents and involve smearing agents on the skin to deter the insect from landing and biting; case 845 uses the fat of the gnw bird – thought perhaps to be the golden oriole. Many fatty acids are known to be insect repellents, so the ancient Egyptians may have discovered that the fat from the golden oriole was particularly effective.
Ebers 846 recommends smearing the skin with behen oil – or moringa oil as it is perhaps better known. Moringa oil is light and spreads easily over the skin surface, and the phytochemicals (the biologically active chemical compounds that occur naturally in plants) are known to be able to control insect infestations. So, a logical approach was adopted, probably based on observation of the effects that various agents had in deterring insects.
Trauma
Sophisticated though it was by the standards of its time, life in ancient Egypt presented many hazards, and traumatic injury would have been an everyday occurrence. The Edwin Smith Papyrus is a valuable resource for understanding ancient Egyptian trauma care. A number of the cases are aimed at reducing fractures, and some of the methods and treatment plans, which include the manipulative reduction of fractures, stand up to scrutiny today. These include splints made out of wood, or linen rolls used to immobilise fractured limbs, and casts made of starches incorporated into bandages.
The ancient Egyptians also recognised the need to correct joint dislocations. Descriptions in the medical papyri demonstrate a considerable understanding of the anatomical and functional aspects of particular joints, and the concepts of dislocation and fracture. Minor surgical procedures – such as incisions to drain or excise swellings, cauterisation, and sutures to close wounds – were routinely practised techniques.
The Ebers Papyrus includes a section describing medicaments for the treatment of burns, some with beneficial properties recognisable today. One example is honey, used to reduce swelling and now known to exert an anti-bacterial effect. Other recommended compounds included copper flakes and malachite, which are also bactericidal. However, for other suggested ingredients, including plant and herbal products, no health benefit has yet been demonstrated.
Egypt’s contribution to other medical systems
Throughout much of its history, ancient Egypt exerted considerable political, military and cultural influence over neighbouring lands. The resulting two-way transmission between Egypt and other areas included an exchange of medical concepts and treatments, although Egyptian medicine always retained a unique profile. A comparison of the Egyptian healthcare system and its achievements with medicine practised in contemporary societies in Mesopotamia, Greece and Rome demonstrates that Egypt’s status in this field, although widely praised in antiquity, is often not fully recognised today. Nevertheless, there is sufficient evidence to demonstrate the legacy of this pharaonic medicine: transmitted via Greek, Roman and Arabic sources, its traditions entered medieval and later practices in Europe, and some aspects still survive today in modern ‘Western’ medicine.
Emerita Professor Rosalie David OBE is renowned for establishing the new university specialisation of biomedical research within the field of Egyptology, at the University of Manchester. She is the author of over thirty books and many articles and holds Fellowships in The Royal Society of Medicine and the Royal Society of Arts. She is also Consultant Editor of AE magazine.
Roger Forshaw is an honorary lecturer in Biomedical Egyptology at the University of Manchester and a former dental surgeon. He studied Egyptology at the University of Exeter and obtained his PhD at the University of Manchester. He has published on the Saite Period, the role of the lector, and medical and dental care in ancient Egypt.
Their forthcoming book, Medicine and Healing Practices in Ancient Egypt, will be reviewed in a future issue of AE.
Further reading
Clayton, J. (2022). Mental Illnesses in the Ancient Egyptian “Book of the Heart”: A Reassessment of paras 854A-855Z. Wallasey, UK: Abercromby Press.
David, R. and Forshaw, R. (2023). Medicine and Healing Practices in Ancient Egypt. Liverpool: Liverpool University Press.
Finch, J. (2018). ”The complex aspects of experimental archaeology: the design of working models of two ancient Egyptian Great Toe prostheses.” In J. Draycott (ed.), Prostheses in Antiquity (Medicine and the Body in Antiquity). London and New York: Routledge, pp. 29-48.
Nunn, J. (1996). Ancient Egyptian Medicine. London: British Museum Press.
