Lost Voices of the Nile: Everyday Life in Ancient Egypt
Page 21
Day 1: black mud
Day 2: excrement of small cattle (sheep etc.)
Day 3: resin of acacia, barley dough, carob, oil
Day 4: wax, oil, unwritten papyrus, wah-legume
Day 5: carob, red ochre, khes part of ima tree, copper flakes.34
How any of these ingredients would soothe the burn is unknown, other than perhaps the mud on the first day. The other ingredients, especially the excrement, could cause serious infection. Many prescriptions, however, were based on excrement, blood and urine from numerous species, including cats, asses, birds, lizards, crocodiles, flies and humans. For the most part excrement was applied externally, although excrement from lizard, crocodile, pelican and human infant were applied directly to the eyes (Ebers 344-70), and crocodile excrement was inserted into the vagina (see below). Blood of ox, asses, pigs, dogs and goats was also applied directly to the eye to prevent ingrowing eyelashes (Ebers 425) and the Ramesseum Papyrus III also prescribed human urine to be placed in the eyes.35 Other ingredients were chosen for different reasons. For example, a prescription containing ostrich shell was used to treat a fractured skull based on the skull’s similarity to a shattered eggshell.36 Granite was also finely ground and sprinkled over both eyes, perhaps in the hope that this would enable the characteristics of granite to penetrate into the person, in particular, strength, durability and beauty.37
It is hardly surprising that wound infections were rather common and in the Edwin Smith Papyrus there are some detailed descriptions: ‘High fever/inflammation comes forth from it; its two lips are red and its mouth is open … there is great swelling.’38 Quite often the cure would be a green pigment, either copper or malachite, which may have held some anti-bacterial properties.
The Egyptians’ reputation for wearing eye make-up derives from problems with eye infections caused by flies. It is thought that animal fat was originally smeared under the eye in order to prevent sand particles from entering, and ground malachite or galena could have been added39 to this in order to make it look more appealing. However, as the medical papyri mention eye make-up and in particular malachite in remedies for eye problems, the mineral and not the fat was the important ingredient. Malachite was also recommended on dressings for wounds and tests have shown that it could prevent the growth of some bacteria and therefore may have been effective.40
Other remedies simply stated that black eye paint should be applied to the eye, bandaged and left41 until the infection improved. General eye irritation or inflammation was also treated with black eye make-up or the ground-up tooth of an ass. Although some eye infections were very serious and led to blindness, the only other treatment was honey, ochre and galena, which was also used in cosmetics or an eye-wash made up of cooling agents mixed with ground celery and hemp.42 The lead in galena may have helped to kill the bacteria carried by disease-carrying flies.43
For sufferers of cataracts the cure was a mixture of ‘brain of tortoise with honey’, which was applied directly to the eye. While this was being applied a prayer was spoken asking gods to remove the ‘darkness’ from the eye. Here there is a clear juxtaposition of physical treatment for the visible aspect of the disease and religious treatment for the actual cause of blindness. It was generally believed that blindness was caused by a deity for some misdemeanour against them.
Ingredients for medication were chosen from animal, vegetable and mineral groups, although there are many which Egyptologists have been unable to identify. Even when the plant is known it is difficult to identify the part of the plant used or when they should be gathered. However, from those that we can identify some contained properties still considered useful in modern medicine. For example, the Edwin Smith Papyrus describes applying raw meat to a wound on the first day before it was stitched up with needle and thread; meat has an active enzyme which facilitates healing. This was followed on the second day by an application of oil and honey, the latter of which contains antibacterial and anti-inflammatory properties and would have helped to heal wounds quickly. Other drugs containing antibacterial or antiseptic ingredients included frankincense, cinnamon, willow leaves, acacia or fir oil.
The Egyptian doctors were incredibly skilled at stitching wounds and Case 28 on the Edwin Smith Papyrus describes an extreme wound where this was necessary: ‘If you examine a man with a gaping wound of his throat, penetrating his pharynx, and if he drinks water he chokes, it coming forth from the mouth of his wound. It is greatly inflamed and he develops fever because of it. You should then draw together that wound with stitching.’44 Alternative means of securing a gaping wound was to wrap it tightly, perhaps with an adhesive bandage, to hold the wound edges together.
The diseases suffered by the Egyptians were varied, although as the Egyptian environment was dusty, and exacerbated by regular sandstorms, most people suffered from sand pneumoconiosis. This is similar to the disease suffered by coal miners and stone masons, and was prevalent among tomb craftsmen. In the lungs of some mummies quartz silica, iron, titanium, granite and anthracite has been discovered,45 which could be from a combination of quarry work, tomb work or the general environment. It caused shortness of breath and severe coughs. There was no cure other than inhaling honey, cream, carob and date kernels.
Headaches were as common as they are today and there are twelve remedies recorded, one of which was for a severe case of migraine: ‘The skull of a catfish, fried in oil. Anoint the head therewith.’46 The common cold, however, had a religious incantation instead of a practical medicinal application, as the viral cause was not clear to the ancient doctors. The doctor needed to recite, ‘Flow out fetid nose! Flow out son of fetid nose. Flow out, you who break the bones, destroy the skull, and make ill the seven holes of the head.’47
There were of course ailments that are simply not identified in the medical papyri, although the symptoms are. The most common was infestation by parasitic worms. All mummies studied by the Manchester Mummy Project have shown evidence of at least one parasitic worm, some as many as three, indicating that most people suffered with this. The most common parasite in both ancient and modern Egypt is bilharzia (schistosomiasis), caused by the schistsoma haematobium worm, released by the water snail. In modern Egypt 12 per cent of the population suffers from this worm.48 It penetrates intact skin, entering the veins, resulting in anaemia, loss of appetite, urinary infection and loss of resistance to other diseases. Blood in the urine was the most common symptom and there are two columns of remedies on the Ebers Papyrus for this. As many Egyptians worked in stagnant water in the fields and marshes they came in contact with the water snail and bilharzia easily.
Water supplies situated near latrines49 or stagnant water were easily infected with numerous other worms. Mummy 1770 in the Manchester Museum shows remains of the Guinea worm, contracted through drinking water infected with a small crustacean containing immature forms of the parasite that developed in the stomach. The male was preserved in the calcium of the mummy’s abdomen. The female normally settles in the legs, causing ulcers that allowed eggs to be passed out of the body and back into the water supply.50 However, it is impossible to see the extent of such ulceration as this mummy’s legs had been amputated shortly before her death, although this is not thought to be as a result of this infestation.
The body of the weaver Nakht (twentieth dynasty) also had Bilharzia, in addition to Trichnella and Taenia. Trichnella is contracted by eating undercooked pork containing immature forms of the worm. These develop in the intestine and the female deposits up to 1,500 larvae which can travel into every organ of the body. Taenia is caught through consuming undercooked beef or pork. Nakht may have suffered with fever, muscle pain and weakness.
A difficult disease to diagnose in ancient Egypt was cancer, although the Ebers papyrus may include a description of cancer of the uterus, indicating it was not unknown: ‘Another for one in whom there is eating of her uterus and ulcers have appeared in her vulva.’51 As the disease was not really understood there was no viable cure for it.
Angina Pectoris (heart attack), another common modern affliction, also appears to be mentioned in the Ebers Papyrus: ‘If you examine a man because of suffering in his stomach and he suffers in his arm, his breast, and the side of his stomach. One says concerning him: It is the wadj disease. Then you should say concerning it. Something has entered his mouth. Death is approaching.’52
A much easier ailment for the doctors to deal with were broken bones, and mummies show breaks to the forearm and leg which had healed completely, indicating they were set correctly in splints, as explained in the Edwin Smith Papyrus, which mentions ‘two splints [covered] in linen’.53
A study was carried out in 1908 on 6,000 bodies from Nubia, dated from the Pre-Dynastic Period to the fifth century. It was discovered that while breaks of the arm, tibia, fibula and femur were common, there were no examples of fractured patella and breaks below the knee were rare. It has been suggested that this was due to the environment, as people walked around barefoot and did not have to contend with the hazards of stairs, kerbstones and pavements.54
In 1908 Elliot Smith discovered in Naga ed-Deir two sets of splints attached to fifth-dynasty mummies. One was attached to the femur of a girl aged fourteen and the other was attached to the forearm of another individual where both the radius and ulna were fractured. The splints were made of wood padded with linen for the young girl and acacia bark, also wrapped in linen, for the second mummy.55 In both cases a pad of fibre had been used to staunch the blood flow and still retained blood stains, indicating both breaks were compound fractures.56 Both individuals died shortly after their accidents as there is no sign of healing. The Egyptian method of splinting a bone was to create a tube out of wood wrapped in linen that was then wrapped around the limb, creating a protective shell. This protected the limb from further damage but did nothing to reset the bone. With the broken arm of the second mummy this was enough to set the bone in the correct position, but in the first mummy the broken femur would not have set straight.
Also in 1908, Wood Jones discovered a number of bodies at the site of Dakka (dated from 4000 BCE to the first century CE) which had suffered from blows with a stick to the forearm and clavicle. Many of the fractures had been so well set that the fractures were barely visible.57 In the workman village near to the Giza pyramids numerous bodies were found with breaks to the forearm and the leg. Most of the fractures had healed completely and indicate they had also been set correctly in splints. Moreover, two skeletons even show complete amputation of a leg and an arm, which show signs of healing, suggesting successful surgeries.
Two skeletons discovered in 2012 and 2013 at El Amarna were wearing copper-alloy toe rings, which are the only such items discovered in Egypt. One of the mummies was male, aged thirty-five to forty years old and had a broken femur which had healed badly and a fractured foot. The ring was discovered on the second toe of the injured foot and is thought to have been worn for medicinal, healing purposes. Unfortunately, the other skeleton wearing a copper toe ring does not appear to have any injuries, which seems to discredit the argument, although this body has not been studied extensively yet and may still uncover evidence to support the theory.
The Edwin Smith Papyrus describes how fractured or broken noses were set by inserting rolls of linen into the nostril like a splint:
Clean out for him what is in his two nostrils with two swabs of linen, until every worm of blood which coagulates in the interior of his nostrils, comes forth. Now, afterwards, you put two swabs of linen, moistened with oil, placed in his two nostrils. You then place for him two stiff rolls of linen, bandaged on it. You should treat him afterwards with oil and honey and lint, every day until he is well.58
The tomb of Ipuy (TT217) from Deir el-Medina contains a wall scene showing a number of accidents taking place in the workplace, which includes a man suffering with a dislocated shoulder. The arm is being stretched out and manipulated in order to allow the shoulder to fall back into place.
In addition to trauma to the bones, bites and stings were also easy to treat, but only if they could identify what had bitten them. It was the identification of the snake which caused the doctor the most trouble when dealing with snake bites, but it was the first thing the doctor did as the creature ascertained which treatment was most effective. For snake bites, once the species had been identified, the doctor made a prognosis which included ‘One does not die because of it’, ‘He who is bitten by it will not die’, ‘Death hastens very quickly’ or ‘If it bites someone he will die immediately’.59 The treatments often included ‘knife treatment’ in order to reduce swelling and then packing the wound with natron, 60 or ‘very good remedies to be made for those suffering from all snake bites; onion, ground finely in beer. Eat and spit out for one day’.61 The most common snake bite was that of the horned viper and it was curable, although ‘the fever [due to the wound] lasts for nine days’. However, should the person be bitten by a cobra or ‘the apopi snake, it is entirely red, while its belly is white. There are four teeth in its mouth. If it bites a man, he dies at once.’62
Crocodile bites were no doubt common for those who worked in the Nile, such as fishermen, laundrymen or boatmen. The Ebers Papyrus claims, ‘If you examine the bite of a crocodile and you find it with the flesh pulled back, while the two sides are separated, then you should first bandage it with fresh meat, as for every wound.’63
E. Tomb of Ipuy (TT71): (1) a dislocated shoulder is repositioned; (2) a hammer is dropped on a workman’s toe; (3) a doctor applies cosmetics or ointment to a workman’s eye. (Drawing after Nunn, 1996, fig. 3.6)
Scorpion stings were greatly feared as it was easy for barefoot workmen to accidently tread on one and the stings were often deadly. The doctors appealed to the gods for help and the victim of a scorpion sting was given sacred water to drink, which had been poured over a healing statue or Horus Cippi.64
It is rather bizarre than in addition to the expected bites from crocodiles, scorpions and snakes, human bites were common enough to justify four paragraphs in the Ebers Papyrus: ‘Another [remedy] for the bite of mankind. A measure of dough which is in a jar and a leek. Pound and make into one mass, and bandage with it.’65
In the absence of sophisticated medication, and the reliance of magic and religion in the treatment of illnesses, the Egyptians were open to trying what we call alternative therapies in the modern world. These treatments included reflexology, heliotherapy and sleep therapy. In the Tomb of Ankhmahor at Saqqara there is an image which many believe depicts reflexology or physiotherapy. There are two men having their hands and feet massaged by a practitioner66 in order to relieve aches and pains. Another scene in the tomb of Ankhmahor and a similar one in the tomb of Khentika show a patient having his hands rubbed. The therapists in both tombs comment that their actions will make the limbs ‘pleasant’.67 Macy Roth, however, suggests these scenes are not a form of therapy but a form of grooming, with the therapists performing manicures and pedicures as part of a purification ritual.68 However, in literary texts reflexology is used in order to relax. In Papyrus Westcar the magician Djedi had ‘his servant at his head to smear him and another to rub his legs’.69
Depression was described as ‘fever in the heart’, ‘dryness of the heart’, ‘falling of the heart’ and ‘kneeling of the mind’, and is described in the Kahun Papyrus: ‘A woman who loves bed, she does not rise, and does not shake it.’70
Temple sleep was thought to be a remedy in which entering the sanatorium and falling into a drug-induced sleep would bring a message from the god giving an indication of how the ailment could be cured. It has also been suggested that patients with more extreme illnesses may have undergone more painful treatments while in this drug-induced sleep.71
The records have provided the names and titles of more than 100 doctors,72 many of whom worked within the royal household.73 Only seven also held the title of dentist. One such man was Hesyre (third dynasty), who had the title of chief of dentists and physicians.74 He is the earliest known doctor in
the world.75 His tomb was just north of the Step Pyramid of Djoser, and he was clearly a man of high position in Djoser’s royal court, and held numerous titles.
An Egyptian dentist dealt purely with the symptoms of dental problems and did not offer much advice in regard to preventative care. The most common ailment for the Egyptians was extreme attrition brought on by collagen in meats, cellulose and silica structures in plants and sand in the flour either from soft grinding implements or the soil in which the grain was grown.76 In some instances the enamel was completely destroyed, exposing the sensitive inner pulp. Wear of this nature affected both rich and poor members of society.
Pliny (23–79 CE) suggested sand or powdered brick was intentionally added by the Carthaginians when grinding corn to facilitate the grinding process and the same may have been true of Egypt. Evidence of quartz, greywacke, amphibole and mica grains have been discovered in bread samples77 and all were possibly added to make grinding easier. However, studies carried out in the early 1990s show that grinding emmer or barley wheat to make bread did not require any sand to be added in order to make flour,78 and there were possibly enough opportunities for sand and dust to enter the bread and flour at all stages of the process, from growing and harvesting the grain, through to grains chipping off the pestle or millstone.79
A common ailment, possibly an indirect symptom of tooth attrition, was a dislocated jaw and marked osteoarthritic changes to the jaw.80 The Edwin Smith Papyrus describes the remedy for this:
When you examine a man with a lower jaw that is displaced, and you find his mouth open, so that you cannot close his mouth; then you should put your finger on the end of both jaw bones in the inside of his mouth, and put your thumbs under his chin; then you must let them [the displaced joint bone] fall together in their places ... bandage them with the imr.w [unknown] and honey every day until he is better.81