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A.A. SHOKEIR and M.I. HUSSEIN
orthodox modern standards, it was highly advanced.However, it is clear that modern methods of investigationreveal only one aspect of Egyptian medicine, i.e. scientific.It is equally clear that Egyptian medicine was as muchan art as a science and the secrets of this art are
aaa
inaccessible to analysis. The testimony of ancient sources
Fig. 1.
Hieroglyphic script of haematuria referring to schistoso-miasis (a˜-a-a˜disease) as it appears in Kahun papyrus.
refers to the Egyptians as the healthiest race of theancient world.Herodotus, the ‘father of history’, noted the practice from the penis and in this case it is possible to representhaematuria [7]. To the ancient Egyptian physicians, theof specialization among Egyptian physicians, stating that‘the practice of medicine they split into separate parts, symptom was always regarded as the disease. As haema-turia is the chief symptom of urinary schistosomiasis,each doctor being responsible for the treatment of onlyone disease. There are, in consequence, innumerable Kamal assumed that it refers to this disease [8]. Thedisease was mentioned 50 times in the medical papyri, i.e.doctors, some specialized in diseases of the eye, others of the head, others of the stomach, and so on; while others, 28 times in the Ebers, 12 in the Berlin, nine in the Hearstand once in the London papyri. Kamal presumed thatagain, deal with the sort of troubles which cannot beexactly localized [2]’. In the tomb of an eminent man these frequent mentions indicated an endemic disease [9].A causal relationship to a verminous parasite namedwho lived at Saqqara during the time of the pyramids,we find his title, i.e. ‘priest of Selkis, goddess of magic, ‘hr wt’ is reported in prescription 62 of the Ebers papyrus(1550 BCE) [10]. The hieroglyphic script of that prescrip-royal physician, and interpreter of a di
B
cult science’ [4].The court was served by a specialist who designated tion and its English translation is given in Fig. 2. Severalclinical symptoms were mentioned for the disease in thehimself as ‘palace eye physician, palace physician of thebelly, one understanding the internal fluids, and a guard- Ebers and Berlin papyri, including haematuria, frequencyof micturition, painful micturition, e
C
ects on the anus,ian of the anus’. Egyptian physicians had ranks, e.g.generalist, specialist, chief of physicians, inspector of abdominal pain, diarrhoea and blood in the stool, cardiacdisturbances and mental weakness. These symptomsphysicians, superintendent and ‘greatest physician’ of Upper and Lower Egypt [5]. represent both urinary and intestinal bilharziasis. Thecardiac disturbances and mental weakness referred to inCase presentations, particularly in the Edwin SmithPapyrus, are systematic and meticulous. Every case starts the papyrus possibly represent a picture of chronicanaemia [11]. Engravings of Egyptian patients withby the words ‘information regarding...’ suggesting thehistory of the disease, then an examination follows and abdominal swellings, umbilical hernia and scrotal swell-ings are displayed at the tombs of Ptah-Hetep andstarts with ‘if you examine a patient with...’, then thephysician expects the prognosis of the disease by writing Ankha-ma-Hor in Saqqara (Fig. 3). These probably rep-resent the late manifestations of bilharzial hepatic fibrosisone of the following expressions: ‘I will treat’, ‘I willfight’, or ‘I will not treat’, and finally the treatment is with ascites [6].Several drugs for the treatment of schistosomiasis weredescribed [6].Philologists have translated a few of the Egyptian described in the Ebers, Berlin and Hearst papyri. Theseincluded palliative drugs, i.e. sedatives (
Hyoscyamus
),papyri that discuss medical subjects. These translationsconfirm the existence of medical literature and a fairly antispasmodics (ammi-visnaga), diuretics (juniper andbeer) and colon evacuation (caster oil). In the Hearstextensive pharmacopoeia in ancient Egypt. Treatmentwas o
C
ered on a rational basis and it was in co-operation papyrus, prescription 83, antimony (inset) was men-tioned for the first time as a treatment for schistosomiasiswith nature, i.e. a diet was prescribed for the patient,strict hygienic regulations were enforced and medic- [11] (Fig. 4). Ancient Egyptians also pioneered the pre-vention of this disease by discouraging people fromaments were administered. When ordering a drug, theEgyptian not only gave the name of the drug, but polluting and contacting polluted water. One of theconfessions noted in the Book of the Dead reads: ‘I havestipulated the quantity needed and advised a method of preparation. not waded water’ [12].
Egyptian knowledge of schistosomiasis Egyptian knowledge of bladder tumour
Ancient Egyptians were one of the first people to recog-Schistosomiasis was first recorded in the oldest papyrusof Kahun (1900 BC
E)
. It was named a˜-a-a˜disease, the nise urinary bladder tumours as disease entities called
‘bn wt’
, the hieroglyphic script of which is shown inhieroglyphic script of which is presented in Fig. 1. Thephallus symbol was used to represent any fluid emitted Fig. 5, as it appears in the Edwin Smith papyrus [13].
© 1999
BJU International
84
, 755–761
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