BLACK ASCLEPIUS, WHITE IMHOTEP

Alexandros Giannakoulas

Unpublished paper originally presented at the XIV Current Research in Egyptology Conference,
Cambridge, March 2013.

The issue of medicine in the Prehistoric Aegean is a difficult one. A common trend has always been
to compensate for the lack of contemporary documentation by looking at later sources. Classical
authors are very explicit about their admiration for Egyptian medicine, and one could be easily
tempted to project their statements back into Prehistoric times, thus assuming that contacts with
Egypt played a fundamental role in the emergence and development of Minoan and Mycenaean
medicine. Nevertheless, it would be naïve to believe that the attitude they espouse, even if we
believe it to be sincere, has remained unchanged for more than one thousand years. Moreover,
models implying the unidirectional transmission of knowledge from a “dominant” culture to a less
advanced one have long fallen out of fashion: not only they neglect the potential complexity in
patterns of transmission, way beyond what Ockham’s principle of simplicity would recommend;
they also do no justice to the active role that the local environments always play in selecting what to
adopt from the outside, and what to discard.
In the first part of this paper, I discuss the Egyptian medical texts with explicit references to
the Aegean, and try to assess their value for understanding the exchange of medical lore between
the two milieus. Then, after mentioning some possible non-written sources, I look at how science
can provide new tools for broadening our evidence. Acknowledging the advantages of such a multi-
disciplinary approach can lay down the foundations for intriguing new possibilities.

The first passage I discuss comes from the Ebers Medical Papyrus; notwithstanding the mention of
king Ahmose, part of the material included might be of greater antiquity. Some features in the
passage we are dealing with might suggest a Middle Kingdom origin; it must be kept in mind,
however, that this kind of texts can often display a deliberately archaising language.
The prescription no. 28 describes the medical properties of a plant, the gengenet bean, said to be
similar to a “bean of Crete” (Keftiu). Glosses were often included in such texts to clarify the
technical vocabulary, which was possibly already outdated when the manuscript was copied. The
gengenet grain, however, was well known in Egypt, so that the comparison seems to refer to its
pharmaceutical qualities alone, maybe as a surrogate. Possibly in this prescription it was meant to

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replace an ingredient which had to be imported from abroad, but was scarcely or discontinuously
available in Egypt at the time.
The second reference to Crete appears in the London Medical Papyrus, a palimpsest probably
dating to the later part of the 18th Dynasty. The prescriptions present a combination of practical
recipes with incantations, some of them in foreign languages. This would be consistent with what
has been described as a progressive increase of magical spells in the medical literature of the New
Kingdom. The remedies were apparently arranged according to the kind of ailments they aim to
cure. A “Cretan spell” can be found in relation to a so-called “Asiatic fever” (32 (20)). Previously
believed to be a “plague”, this fever has been suggested to be a form of leprosy; this would explain
its inclusion in a section on skin diseases. Several transliterations and interpretations have been
proposed, and I will just quote Wolfgang Helck’s reading:

śá-n-tá ka-pu-pi wa-ja ’a-ja-ma-n-tá ra-kú-ka-ra

The ingredients of the preparation that follows, such as a certain “gAS-liquid”, are no less obscure
than the incantation itself.

Walter Wreszinski (1912) suggested that the incantation that follows in the text (33 (21)) could also
be “in the language of Keftiu”. It is a cure for the smn-disease, which is the subject of a whole series
of incantations in the papyrus (transliteration after Helck 1995, 86).

w()-b(?)-qi(?) (“illness”) śá-tì śábu-’ê ja-sá h.à-m-ka-tu ra-śí-ja (“god”) p3 wr ’á-ma-’ê (“god”).

Although a Semitic (Steiner 1992, 198), and even a Greek interpretation have been suggested
(Stolk-Coops 1958), trying to link such extremely short texts with any particular language may
easily result in confirmation bias. Evangelos Kyriakidis (2002) has discussed the spells, together
with other available Egyptian documents possibly containing “Minoan” words. He does not himself
suggest any specific language, although his conclusions about the phonology do not seem to diverge
from what we know about the Cretan Linear A, which is however very little.
Spells used in a medical context often share a specific structure, with an injunction for the
illness to leave, or a “hymn” to some deity. As already noticed by Helck (1995, 86), the use of
determinatives reveals that the second spell (33 (21)) contains two names of male deities, “Ra-śí-ja”
and “’A-ma-’ê”. The first name is followed by the Egyptian epithet “the great” (pA wr).

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 Among the words in the second spell there is hmkt. Christian Leitz (1996, 63 n.3) links this
word with a similar one mentioned elsewhere in the same papyrus,1 where it is accompanied by the
illness determinative. Here the determinative has been read as either A1 (seated man), with the
possible implication that the illness is “personified as a demon”; or A2 (seated man with hand on
his mouth); maybe we are dealing with the same word, but as pronounced in a foreign language.
Remarkably, the hmkt-disease seems to be related to the smn disease which the second spell is
presumed to cure, since the two are attested in parallel in other documents.2 Perhaps the Asian
fever, the smn disease and the hmkt disease were common to both Crete and Egypt, but in Crete
there was only one word for what the Egyptians considered to be two different, albeit related
diseases (smn and Hmqt).
Helck (1995, 85-86) suggested that an additional spell, from the Harris Magical Papyrus,
could also be“in the language of Keftiu”, but the different kind of writing adopted does not allow a
close comparison. Helck links the three spells only on account of the presence in both of the group
sá-n-ta; there is little that a single word can tell, although it might attest some shared
religious/cultural elements, as it is the case with some Arabic expressions among non-Arabic
speaking Muslims.
The imbalance of sources – that is, the lack of Prehistoric Aegean medical texts, which could
have recorded Egyptian remedies or incantations – might generate the impression that in this case a
“unidirectional” cultural transmission worked from the Aegean to the Nile Valley.
We do have, however, some possible evidence for a transmission of healing practices the
other way round. For reasons of time, I’ll go through them very quickly. The earliest possible
example are the amulets resembling human limbs, especially feet, appearing in Crete in the Early
Minoan; although more could be said, the similarities do not necessarily suggest a direct influence.
An Egyptian influence can be, however, most definitely be recognised in the development of
the so-called “Minoan Genius” in Middle Minoan times; this motif was clearly inspired by Egyptian
hippopotamus deities such as Toeris/Taweret (Weingarten). There are reasons to believe that in
Crete this figure had both lustral and apotropaic connotations, which can pertain to the same sphere
of action as healing.
Finally, I cannot help mentioning the Egyptian anthropomorphic parturient vessels, the so-
called Gravidenflaschen (Brunner-Traut 1970). They were only produced during the 18th Dynasty,
and they may have been used to store a preparation for pregnant women, perhaps some kind of oil.
One specimen has been fund in Crete, where it was converted into a rhyton by drilling a hole on its

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Incantation 27 (15).
2
It is possible that both the smn and the “Asiatic” diseases were common to Crete and Egypt (Kyriakidis 2002, 213).
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bottom. This would certainly imply a different use than in Egypt; nevertheless, this and similar
objects must have left a certain impression in Crete, since sometime later a handful of clay vessels,
also shaped as pregnant women, also appear on the island.

Now, it is time to turn to science in search of additional pieces for the puzzle. Whereas
similarities between Egyptian and Mesopotamian pharmacological preparations can be sought by
confronting the textual material, this is not the case with the Aegean. One possibility is provided by
residue analysis. Several types of organic molecules leave their traces on ceramic sherds, including
those belonging to vessels used to mix and store medical preparations (e.g. Tzedakis, Martlew &
Jones 2008). Some interesting results have come from the smelting workshop of Chrysokamino,
East Crete (EM III/MM IA (ca. 2000 B.C.). The number of preparations whose components have
been reasonably identified remains scarce; nevertheless, it could be interesting to check whether we
can find any correspondences in the Egyptian papyri.
Some of the vessels in Chrysokamino may have been used for herbal remedies. Working in a
smelting workshop meant a constant exposure to arsenic poisoning; besides causing skin irritation
and dermatitis, it would eventually lead to respiratory and chronic gastrointestinal problems (Arnott
2008, 115-16). Many of the ingredients used were not native to Crete, and may have been imported
from abroad.
The first step is to see if any combination of two or more ingredients identified in
Chrysokamino also features in preparations described in the Egyptian medical literature. Among the
ingredients which recur frequently together in Crete, the only ones which can be (possibly)
recognised in the Egyptian texts are cumin and anise (although there are some slight doubts about
the identification of anise with the Egyptian inst).
The Egyptian word tpnn has been identified with cumin. Originally it was not native to Egypt,
but it was already present in the Delta at the beginning of the New Kingdom. It is not native to
Crete either, yet it was already cultivated in the island during the Bronze Age. As to its medical
properties, cumin is an efficient remedy for treating digestive problems, but has a great variety of
uses.
Anise seeds are known to have a wide range of medical uses. If the identification with the
Egyptian inst is correct, Anise and cumin appear together in a few Egyptian preparations.
Notwithstanding the several problems connected to the obscure vocabulary of the medical texts, the
preparation in Ebers 632 is quite clear; besides anise and cumin, it includes edible cyperus, figs,
grapes, honey, water, and possibly pine nuts. Provided that all the identifications are correct, these

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ingredients would all have all been available in Egypt as well as in Crete during the Middle and
Late Bronze Age.
Notwithstanding a few unusual features, the doses and the structure of the preparation are
typically Egyptian. If we take the Egyptian ideas about human physiology into account, it is not
surprising that ingredients effective for diseases of digestive nature were used, as the text states, to
“remove” some evil matter “from the heart” (or from the conducts allegedly connected to it). In
several thought systems, the same result is believed to be reinforced by a sum of causes with similar
effects. This is why a single preparation may include two or more ingredients which would seem
redundant. The rarity of this combination in the Egyptian medical corpus as compared to its
frequency in Chrysokamino is interesting, and may suggest that it was not part of the mainstream
medical practice in Egypt.

To summarise what I have said so far: the earliest direct evidence for contacts is the mention
of the “Keftiu bean” in the Ebers Papyrus. This is a purely pharmacological prescription, suggesting
that some knowledge of Aegean (Minoan) healing was already available in Egypt at the outset of
the New Kingdom, and maybe earlier. It is not possible to determine whether there was also a trade
of medical ingredients, or even preparations, but the mention of the gngnt bean as an alternative to a
Cretan plant, may indicate that the latter was currently unavailable in Egypt. If this is the case, we
can presume that this prescription was conceived during a phase of reduced contacts between the
two milieus; this may correspond with the Proto-Palatial (MM IB-IIB, ca. 1900-1700 BC), when
there is an apparent discontinuity in the Egyptian imports in Crete. The assumption of an earlier
knowledge of Minoan medicine is consistent with the combination of anise and cumin in both Ebers
632 and Chrysokamino; it can belong to a first phase of exchanges of healing knowledge, and
maybe related products, such as the “Keftiu bean.” Due to our lack of Aegean medical texts, it is
impossible to assess whether any elements of Egyptian pharmacology were acquired in Crete;
future studies on Aegean pottery may provide some insights.
The remedy in which the “Keftiu bean” is mentioned (Ebers 28) is intended to be a laxative.
This would fit with the Egyptian preoccupation for emptying the metu (channels) from the noxious
matter allegedly causing the illnesses. The remedy in Ebers 632, mixing anise and cumin, probably
had a similar function. We cannot infer to what extent the Minoans’ ideas about human physiology
resembled the Egyptian ones, but in order for a remedy to be included in the Egyptian medical
literature, it had to conform to the local beliefs.
Let us now return to the London Medical Papyrus. I have suggested that the Egyptians knew
that in Crete there was no difference between the smn and the hmkt diseases, which would imply a

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remarkable understanding of Cretan medical notions during the mid to late 18th Dynasty, when
contacts were at their peak. Several sources indicate that there was a considerable circulation of
physicians between the courts of Egypt and the Near East during the Late Bronze Age (e.g.
Zaccagnini 1983, 247-248 and 250-253). ).
Maybe the incantations in the London Papyrus were dictated by a native speaker, perhaps a
specialist in healing. Given the increasing Egyptian interest in healing spells during this period, it is
possible that some features of the religion practised in Crete, with its ecstatic connotations, now
seemed more appealing in Egypt. It must be stressed, however, that we must not overestimate the
difference between pharmacology as we conceive it and the use of magical or symbolic means.
It is not impossible that one or more Aegean physicians were sent to Egypt as part of a
diplomatic exchange: in his later years, Amenhotep III experienced a declining health; it appears
that he sought help abroad, including asking the Mitannian king Tushratta (his father-in-law) for a
statue of Ishtar allegedly displaying healing powers. During Amenhotep’s reign, contacts between
Egypt and the Aegean were particularly intense (Cline 1987), so that it is legitimate to wonder
whether Amenhotep asked for the assistance of one or more Aegean physicians. And, besides the
official envoys, it could be that some private practitioners also crossed the Great Green. Such
scenario is of course just speculation, but I would like to conclude with a last consideration about
how science can contribute to the issue, not only in relation to pharmacology but also in relation to
surgery.
An enhanced ability to recognise surgical procedures may help us to assess the possible
presence of foreign specialists. The scarcity of trephination in Egypt is surprising, when compared
to their developments in other branches of medicine, so that it legitimate to wonder whether it was
performed by foreign specialists – perhaps as the result of some taboo. In that case a physician
coming from overseas, not being bound to the local beliefs, may have been provided an alternative
for those who could find no relief in the local practices.

REFERENCES

Arnott, Robert (2008). “Chrysokamino, occupational health and the earliest medicines in the
Aegean”, in Tzedakis, Y., Martlew, H. & Jones, M. K. (eds.), Archaeology meets science,
biomolecular investigations in Bronze Age Greece (Oxford: Oxbow Books), 108-120.
Cline, Eric H. (1987). “Amenhotep III and the Aegean: A reassessment of Egypto-Aegean relations
in the 14th century B.C.”, Orientalia 56, 1-36.

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Helck, Wolfgang (1995). Die Beziehungen Ägyptens und Vorderasiens zur Ägäis bis ins 7.
Jahrhundert v. Chr., Erträge der Forschung 120 (Darmstadt: Wissenschaftlische
Buchgesellschaft).
Kyriakidis, Evangelos (2002). “Indications on the nature of the language of the Keftiu from
Egyptian sources”. Ägypten und Levante 12, 211-219.
Leitz, Christian (1999). Magical Papyri of the New Kingdom (London: British Museum Press).
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Stolk-Coops, Titia (1958). “Note on two Keftiu incantations”, Minos 6, 66.
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