PAIN,DISEASE

ANDANALGESICS EGYPT
INANCIENT

by

ROYJAMESLANE

A thesissubmittedto the Universityof Birmingham

for the degreeof

OFPHILOSOPHY
DOCTOR

andAntiquity
Instituteof Archaeology
Schoolof HistoricalStudies
TheUniversityof Birmingham
June2003
 ABSTRACT

Painis theindexfeatureof diseasesinceit promptsa requestfortreatment

andits controlis

intrinsicto the medicalsystem.The ability to controlpain shouldreflectthe overall

of themedical
effectiveness Thishasnotbeenpreviously
system. studied.

ManyEgyptianmedicaltermsare unclear.Thethesisshowssomeunknown
terms

maylexicallyderivefroman adaptation in disease.Sucha

of the typeof painexperienced

systemof adaptivetenninology
wouldprovidea basisof nomenclature.
Othertermsof more

fundamentalimportance,such as aetiologicalmorbidfeaturesof disease,mightequallybe

moresimplyexplained.

Despite
thehighincidence
of painfuldiseases
in ancientEgypt,thecontrolof painwas

limited.Therewasa lackof powerful Othersubstances

analgesics. thatmighthavebeenused

to produce
analgesia Thismayhavebeendueto a'policy'of
seemnotto havebeenexploited.

multipleingredientpolypharrnacy
so that the individualpharmacological
propertiesof

substances
werenotseparately Thiswouldhavehindered
recognised. theprogress
of medical

Sucha systemmayhavebeenpartof thetreatment

treatment. (itualperse. It maybe thata

system'of hometreatments
'secondary existedwhicheitherforcedor perpetuated
thispolicy.

(74,014words)
 LISTOFCONTENTS

ChapterI- INTRODUCTION

1.1 TheReputation of Egyptian Medicine

- Brief
Background 1
1.2 Connections Between Egyptian andGreekMedicine - PreviousStudies
onPain,Disease andTreatment 5
1.3 PlantSubstances-Entries in theMedicalPapyri- Problemsof Identification
-
CurrentReference Sources 9
1.4 TheMedical Papyri- DescriptionandProblems 14
1.5(i)Table:Medical Papyri 14
1.5(ii)Plate:BerlinPapyrus(facing) 24
1.5(iii)Plate:LondonPapyrus (facing) 24
1.6AimsandMethods 27

Chapter2- PAIN

2.1Concepts 32
2.2PainRelief 40
2.3Physicians 41
2.4Useof Analgesics 44

TERMINOLOGY
Chapter3- EGYPTIAN

3.1WordsforPain 48
3.2 tfý,
bdw 50
3.2(i)Plate:BerlinPapyrus 154 59
3.2(ii)TheVesselBook(Ebers854/6,Berlin163) 66
3.2(iii)TheLeidenPapyrus 1,348- Spell13 70
3.2(iv)Admonitions of anEgyptian Sage 73
3.2(v)OtherPrescription Entriesfor wbdw 74
3.2(vi)TheConnections of uýbdwwith GreekMedicine 81
3.2(vii)Conclusionson tfýbdw 84
3.3stt 86
3.4Adaptive Terminology 100

Chapter4- DISEASE

4.1Background- Sources - Previous

Studies
4.2Table:Medical
Conditions andFirstIdentifications 121
4.3Carcinomas 122
4.4BoneandJointDisease 126
4.5DentalDisease 133
4.6Parasitic
Worms 137
4.7Respiratory
Disease 142
4.8AccidentsandInjuriies 145
4.9Summary 148
Chapter5 MEDICINAL
PAINKILLING
SUBSTANCES

5.1Introduction 152
5.2Opium 155
5.2(i)Plate:CyprioteRingBaseJuglet 163
5.2(ii)Plate:VesselsandStandsfromtheTombof Kha 164
5.2(iii)Table:OpiumUsagein EnglandandAncientEgypt-
A Comparison of LandRequired 171

5.3Cannabis in Egypt 172

5.4Cannabis, CocaineandTobacco Munich
Mummies 177
-The
5.4(i)Table:Summary of ResultsReported
byBalabanova
andTeam. 184

Chapter6- LETTUCE,CELERYFRUIT,MANDRAKE,
LOTUS

6.1Lettuce 185
Entriesfor eftintheMedical
6.1(i)Prescription Texts 187
6.1(ii)Melilot 192
6.1(iii)WildLettuce 192
6.2 (i)CeleryFruit 194
6.2(ii)Dawson andAft 195
6.2(iii)Mitt inTheMedical Texts 198
6.2(iv)Summary 206
6.3Mandrake 207
6.4Lotus 209
6.4(i)PrescriptionEntriesforLotus 211
6.4(ii)Summary of Prescription
Entries 213
6.4(iii)ConclusionsontheLotus 214

Chapter7- DILL,JUNIPER,
WILLOW,
HENBANE,
MYRHH

7.1Dill 217
EntriesforDill
7.1(i) Prescription 218
7.1(ii)Conclusions on EntriesforDill 219
7.2Junipe 221
7.2(ii)Juniperin TheMedical Texts 222
7.2(iii)Conclusionson EntriesforJuniper 228
7.3Willow 230
7.3(i)PrescriptionEntriesforWillowin theMedical
Texts 231
7.5Henbane 234
7.5(i) PossiblePrescriptionEntriesforHenbane 235
7.5(ii)Henbane Toxicity 236
7.6Myrrh 239
7.6(ii)Characteristics
of Myrrh 241
7.6(iii)Myrrhin theMedical Texts 242
Chapter8 -ALCOHOL,
SURFACE
ANALGESICS

8.1Alcohol 249
8.1(i)AlcoholAbuse 251
8.1(ii)Plate:Ladyat Banquet,
Guestsat Banquet
(facing) 253
8.1(iii)TheMedicinalUsesofAlcohol 254
8 (iv)Dioscorides
andAlcohol 256
8 (v)TheUseof AlcoholoutsidetheMedical
Texts 257
8.2Surface Analqesics 258
8.2(i)Surface Analgesia
andtheTombof Ankhmahor 261
8.2(ii)Circumcision
ScenefromtheTombof Ankhmahor (facing) 263

Chapter9- PRESCRIPTION
ANALYSIS

9.1Introduction 268
9.2Collation
of Material 271
9.3Tables:PrescriptionEntriesin theMedical
Texts
Tables10.3(i)- (ix) 272
9.4Discussion 278
9.5Table:Percentage RatiosforInternal/External
Treatments 279
9.6Table:Complex/ MinorConditions 282
9.7Conclusions 284

Chapter10- GENERAL
CONCLUSIONS 286

11.Appendix- THEUSEOFEXCREMENT
INPRESCRIPTION
FORMULATIONS

in Prescription
11.1Excrement Formulations 291
11.2HumanFaeces 291
11.3AnimalFaeces 293
11.4Summary 296

GLOSSARY
- Medical
Terms

BIBLIOGRAPHY
 CHAPTER1: INTRODUCTION

of Egyptian
1.1TheReputation Medicine
- Brief
Background

for theirskillsin medicine

The ancientEgyptianshavelong enjoyeda greatreputation

due
principally to the from
reports classical the
writersoutside Egyptian This
world. reputation

was not only to

restricted the area of medicineas the Greekslater believedthat their very

muchto thelandof thePharaohs.

philosophy'owed '

Forexample,Homerdescribes the wifeof Thonis,as givingmedicinal

Polydamna,

plants'to Helenin Egypt,a countryproducingan infinitenumberof drugs...whereeach

knowledge
possesses
physician aboveall other 2
men'. from
Similarly, the Bible:'0 virgin

45,11).3 Clementof
(Jeremiah
daughterof Egyptin vainshaltthouuse manymedicines'

in thesecondcenturyAD4tellsus morespecifically,
Alexandria, hadsome
thattheEgyptians

booksof knowledge,
Oforty-two six of whichwereof It
content.
medical hasbeensuggested

thatthesesixbooksmaycorrespond withinthe
of diseaseandtreatments
to thosecategories

known
currently medical 5
papyri.In fact,Ebers
quitefirmlybelieved
thathis medicalpapyrus

bookNumber
represented 6
40-'Remedies'.

Herodotus
discusses 'Nextto the Libyans'
of theEgyptians.
thehealthandmedicine

they(theEgyptians)
are'thehealthiest
peoplein theworld- aneffectof theirclimate which
...
7Thereputation
hasnosuddenchange'. of Egyptian wassuch
physicians thatbothCyrus
and

Dariussentto Egyptformedicalassistance.
8Thedescription
by Herodotus
of thetreatment
of

the bodyduringthe embalming detailedandobserved

processappearsto be an accurate,

I J. Barnes,EarlyGreekPhilosophy (London,
1987),15.Theprocess between
ofconnection Egyptian andGreek
viewsis,in part,explained byA. B.Lloyd,Herodotus BookI/,Introduction 1975),50-3.
(Leiden,
2Homer,TheOdyssey. TranslatedbyJ. Lombardo (Indianapolis,2000),iv,229Theinfluenceof theOdyssey
on
Herodotus isdiscussed byLloyd,Herodotus Book/1,Introduction, 122-3.
3TheHolyBible,Authorized Version,
1611.
4C.Bryan,ThePapyrus Ebers(London, 1930),2-3.
5J. F.Nunn,Ancient Egyptian Medicine(London,1996),24.
6TheotherfivebookswereAnatomy, Disease, Surgery,
Diseases theEyeandDiseases of Women. Theywere
referredto bytheGreeks asthe'HermeticBooks',afterHermes. Bryan,ThePapyrusEbers,3.
7Herodotus, Histories
11:77,Translation,
G.Rawlinson (London, London,
1858).Reprinted 1996.
8Herodotus, Histories
III:I andHistories
111:
132.
 of
summary the 9He
process. alsotellsus that was
medicine 'on
practised a planof separation;

treats
eachphysician a singledisorder 10
and no more'. Certainly,
the title of 'physician'

to
appeared carryan elementof kudos
withinEgypt it not
since appeared infrequently
within

the 'titlelists'of important " Someof thesemedicaltitleshaveadditional

people. qualifying

following
words theword'doctor
whichimply e.
g.
medicalspecialisation swnwbt, 'doctor
of
12However,thisdivisionof the medicalsystemintospecialists(oculists,dentists
the stomach'?

whichHerodotus
and evenproctologists) existedto the extentthat 'the country
maintains

is notsupported
withpractitioners'
swarms 13Infact,themainmedicalpapyri
byothersources.

all containan amalgam whichimpliestheiruseby generalpractitioners

of conditions rather

in medicalmatters,as in others,mustbe
It is obviousthat Herodotus
thanby specialists.

with
approached some 14
circumspection.It is that
significant any aspects
suspect to his work

mightbeattributed of theEgyptian
partlyto hislackof knowledge In thesamevein,
language.

manyof the presumptions the prowessof the Egyptians

regarding from,andwere
emanate

because
perpetuated of,theverynatureof theEgyptian
script.

werefor a long-time
Hieroglyphs andsymbolicsuchthat,
regardedas metaphysical

'theycausedto beerectedanenormous onthetotallyfalseassumption

edificeof learning that

9 Herodotus,
Histories11:86. Fora discussion 1-
Book11,Commentary
on the methodsseeA. B. Lloyd,Herodotus
98,(Leiden,1976),354-64.
10Herodotus, Histories11:
84.
11Udjahorresnet a highofficerunderCambyses reportsintal that,'Hismajesty assigned to metheofficeof chief
Fromhis'autobiography
physician'. ona standing naophorous statue(nowin theVatican Museum), M.Lichtheim,
AncientEgyptian Literature- Volume 3: The Late Period(Berkeley, 1980),37.
12Nunn,Ancient EgyptianMedicine, 118.
13Infact thetitleswhichdenotespecialism arerelativelyfewin percentage of thetotalandseemto relateto the
OldKingdom. Ghalioungui brieflysuggests thatthismaybedueto someunderlying changein medical theory.A
moveawayfromtheconcept of 'compartmental' theoryto oneof unityof thebody.P. Ghalioungui, Magicand
Medical Sciencein Ancient Egypt(London, 1963),74.However it seemsaslikelythatthesetitlesmerelylosttheir
originalimplicationsanddeveloped a honorary form.ThiscanbeseenwithEnglish ties e.g. thetitle'knighthas
lostitsoriginaladversarialimplication.Equally,thepresenttitleof 'Secretary of Statefor Health'is a political
not
medical appointment
14Thepointof medical specialism is discussed byLloydwhoalsoconsiders thatHerodotus has'gonetoofar in
hisconclusions. HemakesthepointthatEgyptian physicians 'accumulated a widerangeof medical officesand
dutiesandsocouldhardlybecalledspecialists', Lloyd,Herodotus, Book//, 1-98,350.

2
 had
eachsign a complex ' 5It is this
that
significance'. probable
andallegorical Egypt
resultedlin

becoming in
renowned the Roman
Empire
andevenverymuchlateras a of
source learning

and 16Consequently,
theoCCUlt. anyconsiderations Egyptian
of ancient may
medicine have
the

Indeedsomemodemstudieshavefalselyattributeda
inherentdangerof overestimation.

to
modernmedicalunderstanding Egyptian and
medicine have to
attempted it
explain 'in part

notionsof Egyptianinfluenceon Greek

by fillingin the gaps,andby recourseto preconceived

17
theories'.
medical Even the
now, Egyptians
ancient are alleged
notonlyto have'practiced

in a rationalanddeductive
medicine butalsoto havebeenthe'inventors
manner', of clinical

18Conversely
observation'. there be
mightpossibly a to
tendency regard Egyptian
ancient
19
and essentiallywithoutany rationalelements.
medicineas eithermagicor magico-religious

Medicalpracticelike religionand magichad a stronglyritualisedaspectand the borders

between
thethreewereoftenfluid.Equally,
themagical gave
element line
another of approach

to a medical foranexcuseuponfailure.
andmustalsohaveallowed
problem

Mostrecently
withEgyptian there
medicine hasbeena to
tendency focuson specific

andoftenesotericareasof medicine. in termsof resources

Whilstthiscanbeappreciated and

specialism, Specific
it canalsoserveto distractfroma holisticassessment. aregiven
examples

laterwithinthe text.20A holisticoverviewis imperativein orderto assessthe actualabilityof the

ancientEgyptian Anassessment
practitioner. of Egyptian in termsof medicalmatters
prowess

fromsucha holisticoverview.
mightbeachieved

15P. R. S. Moorey,AncientEgypt(Oxford,1992),3. A recentstudyon the significance of hieroglyphs

to
anatomical knowledge concluded that the 'djed' column'previously
thoughtto have a primaryreligious
wasusedto symbolise
significance' thespinalcolumn', J. K.LangandH.Kolenda,
'Firstappearance
andsenseof
theterm'spinalcolumn'in Historical
ancientEgypt. JoumalofNeurosurgery97,
vignette', 152-5.However,
(2002),
it seemsnotto be so sinceratherthetermn2k3tseemsto apply,seeJ. Walker,Studiesin AncientEgyptian
AnatomicalTerms(Warminster, 1996),197-202.
16Therewasgeneral secrecysurrounding knowledge, Ghalioungui,
MagicandMedical 31-2.
Science,
17M.Marganne, 'GreekMedicalTerms',Forum3 (1993), 37.
18A. Martin-kaguz inancientEgyptandtheSchool
etal.,'Neuroscience Neurology
ofAdexandria', Review34,
(2002),1183-94.
19G.Pinch,MagicinAncient Egypt(London, 1994),140-2.
20See,forexample, pages111-2.

3
 The essentialingredientto the understanding system
of any scientific is the

understanding
of howa particular
process
worksat the'sub i.
level' e. theunobserved
process.

Intermsof medicine
thisequatesnotto theanatomy
of thebodybutto its Without
physiology.

the knowledge the

of physiology aetiology
of disease be
cannot For
appreciated. example,

manyearlysocieties have
would beenawareof theheart its with
andof connections theblood

thatthearteriescarriedblood,otherwise
andbloodvessels.Galen,whodemonstrated gavea

confusingdescription
of the bloodvesselssincehis knowledge was strictly
of physiology
21It wasnot untilHarvey,in the seventeenth
limited. century,whodemonstrated
the flowof

bloodwithinthecirculatory
systemthathuman came
physiology to be 22
understood. in
Thus,

of ancientEgyptian
an evaluation oneproblem
medicine, theextentto which
is to appreciate

I considerthat we muststart with the

the Egyptianswere awareof basicphysiology.

that,
presumption at best,this musthavebeen and
very selective If
patchy. the ancient

Egyptians
wereunawareof basic then
physiology internal
diseases
couldhaveno obvious

Thiswasessentially
aetiology. of theRomanphysicians.
theposition whilstGalen
Forexample,

coulddeal with (obvious)externalproblemshe acceptedthat internaltreatmentswere

diffICUlt.23 Withouta properknowledge treatmentwith medicinalsubstances
of physiology

cannotproperlybe targeted.Anydrugregimewould,at best,be an ad hoc administration

decideduponthe basisof any observed

followedby rejectionor selectionof a compound

requiredor adverseeffects.Thatis notto saythatadministration fromempirical

of medicines

wouldproducean inefficient
experience Forthisreasonit is important
systemof treatment. to

examinethe Egyptianprescriptions in detail.Thiswill be carriedout in

andtheiringredients

Chapter
9.

21G.Sarton,Galenof Pergamon (Lawrence Kansas, 1954),48-51.Galenwasa Greekbomin 0 30in Pergamon

andwholeftfor Romein 175.Therehe wascourtphysician to MarcusAurelius. Therearesome16booksof
MateriaMedica to him,although
ascribed mostarespurious.
22In fact Harveywasreluctant Sarton,Galenof
to publishbeing'carefulnot to offendthe Galenicreaders',
Pergarnon, 47.Thisshowstherehadbeenlittleadvance in medicalthoughtforover1500years.
23L. G. Ballester,
'Galenasa Medical Practitioner, andProspects
in V. Hutton(ed.), Galen:Problems (London,
1981).

4
1.2 Connections
betweenEqyDtian
and Greekand Medicine Studies
Previous on Pain,
-
Disease
andTreatment

Beforethe understanding
of the Egyptianlanguagebecamepossible,throughthe

deciphering
of its hieroglyphs, historical
most accounts
of Egypt 24
sources.
reliedon classical

Egyptianmedicineis no exception wasonlyreallypossiblewiththe

and its understanding
translationof the medicalpapyriin the last century.Priorto this, reliancewas from Greek

accounts, by Herodotus,
principally Diodorus However,
andDioscorides. thisprevious
reliance

andthepractice
sources
onclassical duringtheGreekperiodswithinEgypt
of Greekmedicine
hascreatedpresumptions mustderivefromEgyptian
thatsomeaspectsof Greekmedicine

theory.Thisis particularly
so in the aetiologyof the diseaseprocess.Medicalelementsof

Aristotle's
workandthatof the CnidianSchoolaresaidto be basedon an Egyptian
theory

whichitselfresultedfromthe observation 25It is

of the decayprocessduringmummification.

generally thatthenaturaldesiccation
accepted to givethe human
of buriedbodiesappeared
forman immortality
whichwasartificially During
by the processof mummification.
attempted

anyintestinal
mummification withdecayandso became
spillagewouldhavebeenassociated

theantithesis
to preservation.
Thisphenomenon it as
bySteuerwhoproposed
wasrecognised

the basisfor the Egyptian of the diseaseprocess.

understanding to Steuerwaste
According

in thebody'sintestinal
elements tractnotonlybecame withdecaybutwerethought
associated

to containa precursor
agentto disease.Importantly
he alsoproposed
thatthis agentwas

actuallynamedbytheEgyptians This
- tvhdw. waslater by
proposed Steuer
andSaunders
to

betheseminallinkbetween
GreekandEgyptian 26It
medicine. a is linkthatit often by
assumed

24Thisis demonstrated by Brugsch'sreconstructionof theTwenty-fifthDynasty, relianton classical

previously
sourcesuntilthediscovery
(andtranslation)
of the'Victory GebelBarkal.
Stelaof Piye'from
25S.lkrarnandA.Dodson, TheMummy inAncient Egypt(London, 1998),15.
26R.0. Steuer,' "dw'. aetiological
principle
of pyaemia in ancientEgyptian Supplement
medicine', to Bulletin
of
Historyof Medicine10 (1948).R. 0. Steuer,AncientEgyptian and CnidianMedicine 1959).
(Berkeley, J. B.
Saunders, TheTransition
fromAncientEgyptian to GreekMedicine (Lawrence 1963).
Kansas,

5
 in 27In there
otherwriters passim. reality to
appears be little for
evidence linkswithEgyptian

andGreekmedicine theclaimsof Greekwriters.Mostof theseareimprecise

beyond andoften

subsequently 28It is, therefore,

plagiarised. thattherecan be shownto be actual
important

for theconnections
evidence by Steuer.
proposed 29However,
thishasproduced
a somewhat

confused withcertainEgyptian
situation asindicators
medicaltermseitherbeingconsidered of

processor merelydescriptions
a pathological of painin The
disease. in
terminology respectof

thishasrecently
beenreviewed,
summarised 30Theydo
byKoltaandTessenoW.
andappraised

notentirelyconcurwithSteuerbutstillviewivbdwas an agentwhichactsas a precursor

to

disease.However,
theirreviewfailsto considerthe negativeimplications
of the argument.

Asidefrom any significance if the termdescribesa

of Egyptianand Greekconnections,

precursoragentratherthan pain per se then the terminologyfor pain is reduced.That is, if

certaintermsarediseaseindicators forevidence
ratherthantermsforpainthenthepotential of

painfuldiseaseis reducedandviceversa.Thisis important it wouldwilllimitcertain

because

to thediseaseprocess
terminology ratherthanactualtermsforpainandso reducethenumber

identified
of painfulconditions withinthe Egyptian framework.
medical if
Equally, theseterms

referto thediseaseprocess of diseaseit questions

ratherthanthesymptoms thesignificance

and reasonsfor sometreatments.

It also createsproblemswhen attemptingto match

in orderto identifydiseases
symptoms withinthemedical
papyri.

27See,forexample,Pages36-7.
28Barnes,EarlyGreekPhilosophy, 15-16.Allthereferencesto EgyptcomefromGreekwriterswhoaresomewhat
confusedthemselves.Forexample, IsocrateshasPythagoras goingto Egyptto studyandwhichinfluenced his
laterpronouncements.Yet,Herodotus hashimfirmlyresidentin Samos but,nevertheless, thatPythagoras
implies
stoletheEgyptianideathatthesoulis immortal andentersintoanother animal when it is bom,Histories
11:
123.
Thebeliefinthetransmigration
of soulsseemsto havedeveloped inotherpartsoftheworld,seeA.
independently
B.Lloyd,HerodotusBook11Commentary, 99-182 (Leiden,
1988), 59.
29R.0. Steuer, Ancient
Egyptian andCnidian Medicine(Berkeley, 1959).Thisproposal because
is important it is
a constructiveone.Otherwisethe 'links'betweenGreekandEgyptian thoughtall comeunsubstantiated and
fromtheGreeksthemselves.
gratuitously Forexample, we are toldthat notonlydid Pythagoras visitEgypt to
studybutthathewasthefirstto bring(that)philosophy
to Greece 28-9).
Busiris
(Isocrates,
30K.S.KoltaandH.Tessenow, 'Schmerzen' Schmerzstoffeoder F5ulnisprinzip
zurBedeutung vonw, einem
Terminus
zentralen deralt5gypfischem Medizin',
ZAS127(2000), 38-52. -bdw,

6
 Anypreviousresearch in is
Egypt
on pain ancient lacking.
distinctly from
Apart one

shortarticleby Dawson withinhisseriesof studiesin themedicaltextsthere

on terminology

havebeenno directdiscussions 31 Theworkby Dawson

on thesubject. on terminology
and

medicinalplantidentification
oftenformsthe basisfor later Whilst
reviews. manyof his

identifications Hisworkin thisareahasbriefly

remainvalidothershavesincebeendiscounted.

the individual
in his discussionof the termstt and in considering
touchedon painterminology

Dawson
of certainplantsubstances.
properties stt to be a symptom
considered of painwhilst

othershaveproposed
it as pathological
factor,albeitwithdifferentfunctions,
onewhichwas
intrinsic
to anEgyptian 32Thus,
of thediseaseprocess.
concept likewhdwit is regarded
either

of disease
asa symptom factor,whichis onefundamentally
or aspathological in the
significant
interpretation
of diseaseandits treatment.

In comparison
therehasbeensubstantial studyon diseasein ancient
andcontinued

Egypt.However,
the largescaleappraisals
of Egyptiandiseaseare earlyones.Duringthe

period1890-1930
workonpaleopathology
wascarried
out by
mainly Ruffer, Smith,
Elliot Jones

andtheirteammembers. of fundingandbecause
33Thesestudieswerepossiblebecause of

workbeingcarriedoutin thesamegeographical
theassociated areas.Infact,theyaretheonly

of financeor discipline
of diseasesincelaterworkhas by necessity
realoverallappraisals

thespecificratherthantheholistic.Mostveryrecentworkhasbeenspecificin
veeredtowards

remit:forinstance, byMarotaet al,34of dental

thestudyof DNAdecayratesin humanremains

by KeitaandBoyce35
andcranialporosities agentsfromthe
anda reviewof contraceptive

31W.R.Dawson, 'StudiesintheEgyptian medicaltexts11',

JEA19(1933),133-7. 'StudiesintheEgyptian medical
textsIll',JEA20(1934), 41-6.'StudiesintheEgyptian medicaltextsIV, JEA20(1934), 185-8.
32Grundriss, VI1,814-5.T. Bardinet,
Lespapyrus m6dicaux deF8gyptepharaonique (Pads,1995).
33M.A. Ruffer,'Historical Studieson EgyptianMummies', M6moires Institutde Ftgypt6 (1911),3, 'Studiesin
Pathology, (Chicago),1921.G.ElliotSmith,'ReportontheHuman Remains', TheArchaeologicalSurveyofNubia.
Report for1907-8 (Cairo,1910).
341.Marotaet al.,'DNAdecayratein papyriandhumanremains fromEgyptian sites',American
archaeological
Journal ofPhysicalAnthropology117(2002),310-18.
35S. 0. Keitaand A. J. Boyce,'Diachronic pattersof dentalhyperplasias andvaultporosities duringthe
predynastic intheNaqada region,UpperEgypt' AmericanJournalof Human Biology 13,(2001),
733-43.
,

7
 36
papyri.
medical However
this for
concern the ignores
sometimes
unwittingly,
specific,albeit

the moreprosaicyet fundamental Egyptian

aspectsof ancient In
medicine. thisthesisI will

of disease(Chapter
thewideraspects
consider a listof thebroad
4).Thisis in orderto produce

of
categories diseasethat feature
were a common of life.
Egyptian The list shouldbe

if
representative it is to be instructive
towards the level
of overall
an understanding of disease

andtreatmentin ancientEgyptian.It is anticipatedthatpainwill be a prominentfeaturein most

of thedisease
categodes.

Intermsof thetreatment
of painin ancientEgypttherehavebeennoprevious
studies

andnooveralldiscussion.
Anyconsiderations in
havebeentheresultof research
of analgesics

specific
other for
situations, during
example, thediscussion
of a supposed
circumcision 37
ritual.

In termsof treatment workis basedon thefewshortreviewsof Dawson

mostof theprevious
Certainmedicinal
There have been no collectiveappraisals.
on medicinalsubstances.

havereceived
substances butnotdirectlyin consideration
attention of theirpain-killing
abilities.

In termsof narcoticsubstances
thishasbeenin respectof otheraspectsof theplantsrather

or hypnoticproperties.
thanon theiranalgesic Forexample, the
the opiumpoppyproduces

narcoticopiumresinwhichis a powerfulandimportant Its use leavessignificant

painkiller.

socialtracesonsociety.It wasknownbytheRomanS38 of introduction

butthetimeandmethod

intoEgyptis uncertain.
Theviewthatits usewaswidespread is based
in the NewKingdom

upontheworkof Merrillees.
39However,
thediscussion
of opiumby is
Merrillees notconcerned

withits pharmacological
implications
but ratherwiththe movement the
of goodsthroughout

Aegeanduringthe BronzeAge.Similarlythe lotushas receivedmuchattentionbut for its

supposed
eroticassociations
or psychedelic ratherthanits narcoticor analgesic
properties

(See,Chapters
properties. 5.2and6.4).

36J. Guiter, enýgypteancienne',

'Contraception BIFAO101(2001),
221-36.
37M. M. EI-Ansary,'Historyof Pain Reliefby AncientEgypfians',MiddleEastJoumalOf Anaesthesiology
10
(1989),99-105.
38Itsuse(andabuse)is reportedby PlinyandGalen.SeeChapter5.2on opium.
39R. S. Merrillees,
'Opiumtradein the BronzeAgeLevant'Antiquity36 (1962),292.
,

8
1.3 PlantSubstances
- Entdes
in the Medical
Papvd
- Problems
of Identification
- Current

Sources
Reference

TheEgyptian Asidefrommagical
for diseases.
medicalpapyrigivelistsof treatment

and surgicalapproaches involvethe administration

thesetreatments of a wide rangeof
These
substances. were invariably
used in combination.An eclecticrangeof productswas

utilised.This even includedthe use of animaland humanexcreta.In view of the supposed

between
connections theintestinal
contentsand whdw,I will,in theAppendix
to thisthesis,

entriesfor faeces(ps).
examinethe prescription

TheEgyptian treatments
prescription bedividedintodrugsof mineral,
canessentially

animalor plantorigin.Drugsof animalandmineralorigintendto appearequallyrecorded

is possible.Forexamplecommonsubstances
outsidethe medicalcontextandso identification

likenatron,ochre,beer,milk,honeyandbloodallappearwidelyoutsidethemedical
papyri.

In contrasttheactualidentification plantsis problematic.

of medicinal 40Thereareno

is madeby name
of plantswithinthe medicaltextsandreference
pictorialrepresentations

41Whilst
alone. thereis considerable for themeaning
agreement wordsfor
of theEgyptian

manyherbalsubstances,
othersare lesscertainandmanyunknown.
42.Someplantshave

beenfoundintactin tombsandplantremains
havebeenisolated
fromexcavation 43Other
sites.

plantsfeaturewidelyoutsidethe medicaltextsandso theiridentifications

are morecertain.
Outsidethesetextsthe pictorialrepresentations
of plantsare commonbut are sometimes

difficultto distinguish
beyondformandso allowfor misidentification. grapesin
Forinstance,

areindistinguishable
representations frommelonsunlessthe plantis shownprovidedwitha

40L. Manniche,AnAncientEgyptianHerbal(London, 1999),159-62.

41Thiscontrastswiththe 'rule'of laterherbalswhereproperidentification is consideredvital.E. g:
(byillustration)
OrtusSanitatis1491,DeHistoriaStirpium1542.
42Nunn,AncientEgyptianMedicine,153-5.
43Manniche,AncientEgyptianHerbal,40,147,149,151.

9
supportto implythevine.Theperseafruithasthesameoutlineandcolouras themandrake

fruitmakingidentification,
insomeinstances, 44
impossible.

Theformsof plantsin themedicaltextsaresometimes bydeterminatives

recognisable

sincethepharmacological
Thisis a problem
buttheactualpadof theplantis rarelyspecified.

of a plantcanoftenvaryacrossits parts.In otherwordsthechemical

contents of
constituents

the leavesmaybe differentto the roots.Thisis vitalto the assessment

of anypharmacological

For
activity. the
example, is
willowplant an important of
source These
salicylates. arepowerful

agents.Howeverit is onlythe barkthat contains

anti-pyreticandanti-inflammatory
analgesics,

45Alsotheotherwise
thesesalicylates. innocuous planthasleaveswhichcontainoxalic
rhubarb
46
acidwhichis toxic,butwhichis notpresentintheediblestalks.

thatthepartof a plantis rarelydefinedwithinthemedical

It is notwithoutsignificance

Thiscouldeitherbe
thatit wasnota relevantfactorfor the practitioner.
texts.Thissuggests

or becauseits properties
becausethe partto be usedwas alreadyunderstood werenot

It that
appreciated.seemsunlikely suchan important
aspectof a plant
wouldnot be stated

sinceselection the have

of correctpartwould been for
vital itsdesiredpharmacological
effects.

it seemsmorelikelythatthepharmacological
Therefore properties
werenot This
appreciated.
is not surprisingin view of the Egyptianpracticeof using multipleingredientsin a single

47It may evenbe that any

whichwouldhaveobscuredindividualproperties.
prescription

wereactuallyincidental
properties
pharmacological totheprocess
of treatment.

Theidentification fromtheirappearance
of substances in themedical
papyrirelieson a

combination lexicalconnectionS48
of matchingphysicalappearances, and pharmacological

againstknownreference
properties Oftenpharmacological
substances. canonlybe
properties

by reference
assumed to the indexmedicalcondition
of the that
prescription; is by matching

44Manniche AncientEgyptianHerbal,160.
45C. Newallet al.,HerbalMedicines (London,1996),268-9.
46Newall,HerbalMedicines, 228.
47Thisis discussedin detailin Chapter9.
48Therearesometmesusefulconnections withCoptic.

10
diseaseagainstthe knownpharmacological of reference
properties This
treatments. is often

since
problematic manymedical are
conditions themselves
not clear or are
symptoms

ambiguous.

to Egyptian
References plantnamesandtheirbotanical are
properties foundin the

illustrated a Greekphysician
herbalof Dioscorides, whoworkedas a militarysurgeonunder

49Hisworkcontains
Nero. over600plant
and The
entries.
substance into
translation English

century.Thebotanical
fromtheGreekdatesfromtheseventeenth andassociated
references

are generallysound.
pharmacology The plant namesare givenin Latin,Greek,Romanand

often However,
Egyptian. despitea few nameswith phonetic most
connections, of the Egyptian

namesseem and
erroneous offerliftlehelpin identification.
50

on ancientEgyptianbotanicalsourceswasthe
Thefirst modemmajorpublication

centurywork
nineteenth
considerable by Loretin whichthe first identifications
of many

Egyptian 51
plantspeciesweremade. Dawson
Following and VI
Volume of the der
Grundriss

MedizinderaltenAgypter52therehasbeenmoreworkin termsof botanical

studiesby and

54Themagnusopusof Charpentier
53andGermer.
Charpentier the
remains mostimportant

but
work,
reference its is
emphasis botanical than
rather Aufr&re
medicalor pharmacological.

a detailedlexicological
hassincepublished seriesof twenty-seven which
naturalsubstances

includessubstances 55Theworkof Bouloson medicinal

significance.
of medicinal plantsof

NorthAfricaprovides information
useful on distribution
current uses
andmedicinal in present

49Dioscorides,TheGreekHerbalOfDioscorides. TranslatedbyJ. Goodyer (ed.) (Oxford

(1655),R.T. Gunther
Reprinted
1934). NewYork,1959.
50TheEgyptian namesaresaidby Manniche to be a later2ndcenturyadditionandnotgivenby Dioscorides
Manniche,
himself, Egyptian
AnAncient Herbal,163.Thepointis notmadebyGoodyer orGunther.
51V.Loret,LaflorePharaonique
2ndEd.(Paris,1892).
52H. Grapow,et al., Grundrissder Medizinder AftenAgypter.9 volumes(Bedin,1954-1973), (hereafter,
Grundriss).
53G.Charpentier,Recueddematdriaux6pigraphiques 6
relatifs la botanique
de 118gypte
antique 1981).
(Paris,
54R. Germer, in AltenAgypten,PhDThesis(Hamburg,
OberArzneimiftelpflanzen
'Untersuchnung 1979).Flora
despharaonische Agypte(MainzamRhein,1985).
et d'histoirenaturelleIV-V[',BIFA084 (1984),1-21.'budes de lexicologie
55S. Aufr6re,'budes de lexicologie et
BIAFO86 (1986),1-32.'budes de lexicologieet d'histoirenaturelleXVIII-XXVI',
d'histoirenaturelleVIII-XV11',
BIFAO87 (1987),21-44.
day Egypt.56More recentlyBaum has publisheda work on ancientEgyptiantrees and shrubs.

The emphasisis on pictorialrepresentation

and but
distribution some have
specimens

significance57
pharmacological

OutsideEgypt a developedand recordedmedicalsystemwas used by the

andAssyrians.
Babylonians Thereis no evidence between
of anycross-influences themand

thattherewassomein termsof
in termsof medicaltheories.Butit is possible
theEgyptians

medicalknowledgeduringperiodsof intensecontact,such as the Amarnaperiod.58Many

medicinalplantsubstanceswereknownto the Babylonians

andAssyriansand their modeof

Workon theidentification
usemayparallelthatof theEgyptians. of theseandtheirusewithin

systemhasbeencarriedoutbyThompson.
themedical 591-lis HerbalandDictionary
Assyrian of

Botanystillremainthemainreferences
Assyrian in thisareaalthough
thesevolumes
arenow

dated.
rather These
arebased
oncuneiform lists texts date
plant andmedicinal which fromthe

to the first millennium

endof the secondmillennium is madeto these
BC.Crossreference

worksin thisthesiswhensimilarEgyptian
plantsarediscussed.

In termsof Egyptianprescriptions the collectedvolumesin

and their ingredients

andlatterlyWestendoff
Germanof the Grundfiss in thisarea.
60remainthemajorreferences

Theycollateinformation
fromall themedicalpapyri.VolumeVI of theGrundriss,
albeitprinted

in 1959,stillremains Egyptian
thecitedcomplete the Grundriss
Furthermore
pharmacopoeia.

collatesdiseaseintocategories intoGerman
andgivestranslations of Egyptian
medicalterms.

Manyhoweverstill remainuncertain
whichmakesdiagnosis
of somediseases The
difficult.

is furtherconfused
situation by theassumption to diseaserather
of sometermsas precursors

thanasdescription
of diseasesymptoms,
as discussed s latertwovolume
above.Westendorf
56L. Boulos,Medicinal
Rantsof NorthAfrica(AJgonac: Michigan,1983).Thetermmedicinal 'use'shouldbe
fromactualpharmacological
distinguished thatin manycasesheis merelydescribing
I consider
properties. 'folk-
lore'assumptions
astotheirproperties.
57N.Baum, ArbresetarbustesdeI'Egypteancienne(Leuven,1988).
58Seepage42below.
59R. Campbell Thompson, TheAssyrian Herbals(London,1924).A Dictionaryof AssyrianBotany(London,
1949).
60W.Westendorf,Handbuch derAltagyptischen
Medizin.2 volumes(Leiden, WestendoM.
(hereafter,
1999),

12
 is
work essentially
an abbreviated
versionof the Grundriss the
without benefits
of hieroglyphs

buthasupdates
ortransliteration, onsomeof theGrundriss
omissions.

in thattheycontain
in the Egyptianmedicalpapyriaredistinctive
Thepresc(iptions

ingredients.
multiple For Eb663
example, thirty-seven
contains ingredients
different andmany

otherscontainin excessof ten. Thisis unusualand differsfrommoderntreatmentsand even

61It contrasts,
fromancientherbals. Herbalwhich
withtheentriesin theAssyrian
in particular,

contains
generally singleitems.Despitethis in
'anomaly' Egyptian neither
medicine the

GrundfissnorWestendorf ingredientanalyses.In Chapter9 of this thesis

offeranyprescription

I havecollatedalltheinformation entriesforthesubstances
fromtheprescription in
discussed

theprevious
chapters. between
Thisis doneon thebasisof efficacyandof the relationships

ingredient In fact,therehavebeenno overallprescription

appearances. beforethis
analyses

thesis.I considerthatthis has beenan important

omissionin the consideration
of ancient

Egyptian I believethattheEgyptian
Thisis because
medicine. of formulation
method mayhave

limitedtheexploitation
of pharmacological Multiple
substances. musthavehindered
ingredients

the recognition
of the properties
of individual
pharmacological If
properties. this is
limitation

shownto be validthenit mustrenderthe efficacyof the individualprescriptions

in the medical

papyrisuspect.It mayalsocallintoquestionthefundamental
abilityof the ancientEgyptian

By this I meanthat treatments

physician. wouldhavebeenpart of the ritualratherthan

treatment
perse.

61TheOldEnglishHerbarium datesfromc.1OOOAD is
and an Anglo-Saxon from
translation a 5thcenturyLatintext.
Its entriesare oftenfor a singleingredientor if in combination
generallywitha solventor fixingagent.E.g. Water
lily (nym/aeaalba)for a swollenstomach;'for the sameusethe rootsandgiveto the patientto eat for ten days',
'For eye painand swellingtakethe plantcalledapiumor wild celerypoundedwellwith breadand lay it on the
eyes'.Englishtranslations from,A. vanArdsall,MedievalHerbalRemedies(NewYork,2002),178,201.

13
 Papyd- Descdotion
1.4TheMedical andProblems

Thefollowing in this
tableis a list of the mainmedicalpapyriwhichare mentioned

generalworksknownfromancientEgypt.As suchthey
thesis.Thesearethemostimportant

the bulkof writtenmedicalevidence.

represent listsof
62The medicalpapyriareessentially

undera nameddisease;
treatments scantdetail.Asidefrom
eachentryis terseandcontains

somesurgicalcasesthereis littleor no elaboration its cause-

on the disease,particularly

exceptin casesof demonic Theycontainlittle,or no,evidence

possession. of anyphysiology

or pathologybut ratherserveas prescription

lists.However,thisstylecannotbe takento reflect

anylackof medicalknowledge sincemodernformularies

or otherwise in the
are presented

and are takenfrom Nunnwithout

sameway.The datesof the copiesare approximate

63They
comment. arelistedinchronological thanorderofsizeorimportance.
orderrather

TABLE1.5
(i)

MedicalPapyri(mentioned
in thetext)

TITLE LOCATION APPROXIMATEDATE CONTENTS

OFCOPY

111,
Ramesseurn IV,V Oxford 170OBC gynaecological,

(Ram) paediatric
ophthalmic,
EdwinSmith(Sm) NewYork 1550BC surgical,trauma
Ebers(Eb) Leipzig 150OBC generalmedical
Hearst(H) UCLA,California 145OBC generalmedical
London(Lond) London(BM10059) 130OBC magical,medical
Berlin(Bin) Berlin 120OBC magical,medical

e Abbreviationsin parenthesesarethose used in the text.

62Otherthanmedical Thesewereremedies
ostraca. writtenona stoneor pottery
medium.Knownexamples date
fromthe Amamaperiodthroughto the Romanperiod.F. Jonckheere, Prescriptions
m6dicalesur ostraca
Wratiques(Brussels,
1954).
Egyptian
63Nunn,Ancient Medicine,
25.

14
 Thesepapyriweremostlyfoundwithinthe lastonehundredyearsandofferedfor

privatesale withinthe then vigorousantiquitiesmarket.They came with virtuallyno

Theyareconsequently
provenance. (apartfromtheRamesseum
Papyrus)
namedaftereithera

modernowneror theirultimaterestingplace.Theyareessentially formularies

medical laidout

in paragraphs, headedbya description

eachgenerally of themedical thetreatments
condition,
for whicharethendescribed.
Apartfromhumanremains,
thesepapyriiformthe basisupon

whichmostEgyptianmedicalstudiesrely. Likewisethis thesiswill rely on thesefor its

analyses.

Thetwomostimportant
medicalpapyriaretheEdwinSmithandtheEbers.TheEdwin
SmithPapyruswasfirsttranslated
by Breasted
in 1930andlatertranslated
intoGermanin

VolumeIV of the Grundriss

in 1958.64
A laterGerman
translation
wassubsequently
produced
1966.65
by Westendorf
in EdwinSmithcomprises
48 mainparagraphs,
withsome13 'sub-

cases'andis secondonlyin lengthto Ebers.It is primarilyconcerned

withsurgicalcases,

onesof severeinjuryor trauma.In viewof the potential

particularly for industrial
injuriesin

ancientEgyptit is possiblethatthe casesin EdwinSmithdescribe

just suchinjuries.
66The

injuriesdescribedin the latterare so numerous

that the sourceof its contentshas been

to comefromanindustrial
suggested (pyramid/ ) siteratherthana battlefield
quarry? situation.
Thisis because
in thelatterit wouldbedifficultto findadequate 67
timeto devoteto treatmentS.

However,
Ralstonin a morerecentevaluation
of 'CaseFour'in EdwinSmithconsiders
that

Breasted
waswrongin his diagnosis
becauseof the rarityof suchinjurieswithinhis limited

in civilianlife. The headinjuriescausedsinceby roadtrafficaccidentshave

experience

complexinjuriespresenting
produced parallelsfor comparison
to someof thosein Edwin

Smith.ThishasallowedRalstonto suggestthatthe injuriesin CaseFourmighthavebeen

64J. H Breasted,TheEdwinSmithPapyrus(Chicago,1930).
65W.Westendorf, EdwinSmithPapyrus(Bern,1966).
66B. L. Ralston,'MedicalReinterpretation
of CaseFourof the EdwinSmithSurgicalPapyrus',JEA62 (1976),116-
21.
67Ghaliounghui, MagicandMedicalScience,44.

15
 by
caused an Egyptian
battle by fracture
axeor evena sword,not accidental as previously

If
suggested. indeed
theinjuries then
wereasa resultof a sword it has for
implications thedate

of thetext; it it beyond
since puts well theOld by
implied
Kingdom 68
Breasted.

freeof themagical
EdwinSmithdiffersfromtheothertextsin thatit is virtually content

whichis a varyingfeatureof theothers.In thissenseit demonstrates andrational

anempirical

to
approach The
treatment. of
prognoses casesare stated
realistically at the such
outset that

are
some declared It
untreatable. also from
differs theother in
papyri thatmanymorecasesare

specificallydefined.This is done by the use of glosseswhichgive additionaland specific

information an
regarding injury.
Unfortunately,
suchglosses
are from
absent theotherpapyriso

thattheexactidentifications is difficult.TheEdwinSmithsurgical
of somemedicalconditions

is
papyrus a copy by
taken,
generally the styleof to
writing, datefrom 155013C.
about It has

sincebeen that features

suggested archaic havebeenaddedto giveit the appearance
of

69Breastedactuallyattributedit (somewhat
'reveredantiquity'. to the legendary
poetically)

Imhotep: Vizier
priest,architect, to Djoser
and(alleged) It
physician. is difficult
to believe
that

sucha repository
of surgicalexpertisecouldhavebeen written
personally by in
someone

Imhotep's
position.

TheEbersPapyrus
is thelargestandmostimportant This
papyrus.
medical is because

of itsgoodphysical itsclearwritingandthesizeandtherangeof medical

condition, conditions

whichit contains.Its importance

is stressedby thegravitasof its statedFirstDynastyorigin,

'-found in writingsunderthefeetof Anubisin Letopolis

andwas to
brought the of
majesty the

kingof UpperandLowerEgyptDen',(Eb856a). as to
Nodoubtthisgavesomereassurance

70It is by farthewidestrangingof themedicaltextsand

thequalityandso efficacyof theteXt.

68Thisis becausetheswordwasa laterintroduction,Ralston,JEA62,119.However,it is notunreasonable to

supposethatsurgicaltextswereup-datedafter'new'caseswereencountered.
69Nunn,AncientEgyptianMedicine,27.
70Similarly,endorsements withthe endorsement
of medicaltextsaregivenin otherforms.Eb468is a hair-restorer
thatit wasmadefor the 'motherof a king. Theremedyin Lond25is statedto have'camedownfromthe sky'and
weretakenintothesafecustodyof (thelearned)kingKhufu.

16
consists 8T7
of some paragraphs include
which fourteen However,
magicspells. Edwin
unlike
frommanydifferentsources.
Smith,its orderis notlogicalandit appearsto be a compendium

because
However, its its it
completeness,
of widecontentand physical is morelikelyto be

This
medicallyrepresentative. presumesthat were
all medicalconditions presentedfor

treatment,or recordedas such. It is possiblethat sometypesof medicalconditionswere

excludedfromthe 'official'or recordedtreatmentsof the medicalpapyri.Thiswas,perhaps,

because
of ineffectual theavailability
remedies, or becauseof the use
andcostof practitioners

of treatmentsoutsidethe papyri.This possibility- the use of homenostrumsand their

ontherecorded
significance evidence laterin Chapter9.
willbediscussed

However,thereis somesemblanceof orderin Ebersin that manyconditionsare

groupedtogether.Butmanyremediesare simplylistedunderthe title 'anotherremedy'.This

alsoallowsforthepossibility
thatthesemayhavebeencopiedoutof order.

TheEbersPapyrusis importantin thatit containsa Widerangeof medicalconditions.

However,
notall areclearandthishas for
allowed someliberal
interpretation
of thetext.Thisis

71 wherebyan enthusiasticattemptto match

particularlyso with the Ebbelltranslation,

Unfortunately
conditionsto knownmedicalconditionshas resultedin spuriousconclusions.

theseare oftenperpetuated
into othersourcesandofferedas evidenceof modemmedical

common suchasanginaanddiabetes-72
conditions

Theothermedicalpapyriarelessimportant
generallyandin termsof for
reference this

thesis.TheHearstPapyrusis a generalmedicalwork.It differsfromEbersin thatit is arranged

in diseasesections.In thissenseit is usefulas an aidto categorise

andcomparetreatments.

Forexample,H59-70concem'urinaryirregularities'
suchthatthe associated
remediesmust

alsoconcerntheseconditions.
Suchclearassociation
of remedywith is
disease not always

71B.Ebbell,ThePapyrusEbers(Oxford,1937).
72Nunn,AncientEgyptianMedicine,30. Anginaand maturity-onset diseasesandso
diabetesare age-related
lessprominent
proportionally in highearlymortality
societies.

17
foundin the more randomEbers.The HearstPapyrushas only 260 prescriptionentries

to
compared 877in theEbersbut 100
almost of thesearefoundas direct in
equivalents Ebers.

The BerlinPapyrushas some204 medicalentriesmanyof whichare identicalto

withthefunctionof
Ebers.In particularBln163duplicatesEb856,the longsectionsconcerned

the mtw TheLondonPapyrusis in poorphysicalconditionconsisting

of 60 prescriptions
the

in Ebers.
majorityof whicharemagical.Some23entrieshavedirectequivalents

TheRamesseurn is known.It wasdiscovered

Papyrusis uniquein thatits provenance

in 1896by Quibellin a tombshaftin the Ramesseurn whofirstpublished

at Thebes.Gardiner,

73 The
the hieratictext, suggestedthat this tomb belongedto a medicalpractitioner.

Ramesseurn anddiseasesof
Papyrusis in threeparts:RamIII coversthe eyes,gynaecology

children.RamIV is mainlyconcernedwith diseasesof womenand childrenand RamV is

principallyconcernedwith remediesfor the mttv In no partsare thereany corresponding

withsectionsof Ebersor theotherpapyrus.

parallels

TheKahunPapyrusis a shortgynaecological
textof whichthereareno parallels
within

by Griffithsin 1899.It is of an
by Petrieandfirsttranslated
theothertexts.It wasdiscovered

earlierdatethanthe othertextsandis actuallydatedfromthe MiddleKngdom.It is in poor

withmanylacunae.
physicalcondition

In termsof translation,
the mostimportantmedicalpapyrus,the Eberspapyruswas

first publishedin facsimileby EberS74 translatedinto Germanin

in 1875and subsequently

1890.Thereare twopublished of the textintoEnglish.Thefirstwasby Bryanin

translations

1930andfollowedby Ebbellin 1937.75 Theyareessentially

Neitheris satisfactory. translations

of theGermanoriginal.Theformerversionby Bryanhasa gratuitous to translation

approach

whichhas possiblyunwittingly the

sown seedsof confusion some
amongst English
readers.

Themostscholarlyanddefinitivetranslations
are the volumesof the but
Grundriss
German

73k H.Gardiner,
TheRamesseurn Papyri(oxford,1955).
74G.M.Ebers,PapyrusEbers,2 volumes
(Leipzig,1875).
75Ebbell,ThePapyrus
Ebers.Bryan,ThePapyrus Ebers.

18
eventheseparticular
translations
arenowapproaching Thefactthat
50 yearsold (Vol.1,1954).

from1954to 1973illustrates
thisserieswascompleted theenormous
amountof effortrequired

to evaluateEgyptianmedicine. the lengthof timemayalsoserveto illustratea

But,conversely

caveatwhichmightbelikenedto 'thepaintingof theForthBridge'.

Thediscovery
of themedicalpapyriallowedforthestudyof ancientEgyptian
medicine.

Initially,the situationregarding 'in the Eberspapyrusappearsas a

Egyptianmedicine,

contradictory of magicandof someimportant

mixture of anatomy,
elements pharmacology
and
76It is fairto saythattheviewof Egyptian
pathology. medicine following
wasre-evaluated the

byBreasted
translation intoEnglish
of theEdwinSmithpapyrus in 1930.Ghalioungui
suggests
thatthishascreated
twoviewsof Egyptian one'pre-Breasted'
medicine: andtheother'post-
Breasted'.
77TheEdwinSmithtextdemonstrates to medicalproblems,
a rationalapproach
in the fieldof surgery,
particularly whichis basedon acuteandempirical of
observations

practice Forinstance,
andprocedures. 'accessories'
varioustherapeutic which
arementioned
to modem
equate use:flaxplacedinwounds
surgical flaxdrainsforwounds,
asanabsorbent,

sutures, andtheuseofsplints!8
cautery
Paradoxically, theEdwinSmith
in termsof translation,
whilstno doubta watershed
Papyrusmayhaveunwittinglypushedthe presumption too far. The
of empiricalapplication

expertiseshownin EdwinSmithdoesnot necessarily

extendacrossall the medicalpapyri.
Simplystatedthe EdwinSmithPapyrusis a surgicaltreatise.The natureof the injuriesis

andso anytreatment
apparent, mustbeempirical
- fractures be
cannot setby So,
incantations.

whilstthe approachto injuriesand physicalproblemsappearsto havebeenbasedon fairly

thiswasnotnecessarily
soundmethods thecasewithdisease.

Breasted's
translation Thelay-outof the papyrusis well
wasnotwithoutits problems.
butthetextis unfinished.
organised Severalof thetermsfoundin EdwinSmithappearfor the
76Ghalioungui,
Magicand MedicalScience.58.
77Ghalioungui,Magicand MedicalScience,58.
73Ghalioungui,Magicand MedicalScience,64.

19
 theonlytime.Hehimselflackedprofessional
firstandcurrently knowledge,
anatomical which

he neverdoubtedthatthediseases
79Moresignificantly,
he acknowledged. by the
described

ancientphysician
wereknown
to modernmedicine
andthat translation
givenproper couldbe

defined.Whilstthis approach Ralstonhassincere-evaluated

mightsoundreasonable, two

caseswhichshowBreasted's
diagnoses
to befaultybecause 80
of thispresumption.
It maybethattheaccident
of discovery of themedical
of translation
andthesequence

papyrihaveprovedto beadouble-edged in respect

sword'.Thepresentsituation of theoverall

appreciationof Egyptianmedicineis still far from satisfactory.The first translationsof the

date
papyd
medical backto a pedod
whenknowledge
of theEgyptian
language
wasstillbeing

is thatearlylanguage
Anotherproblem
developed. pioneers by lexicographers
were necessity

scientists.
notmedical

All themedicaltextsarein hieratic,exceptthe Ramesseum from

V. Thetranscription

difficultbecauseof problemsin actuallyreadingthe text itself.Also,

hieraticis sometimes

anotherproblemis thatsomemedicalpapyriwerediscovered or incomplete.

eitherdamaged

Plates1.5(ii) (iii),showexamples
of the incomplete
natureof the BerlinandLondonpapyri

of damage.
because

of the Londonand Hearstpapydweremadeinto Germanby

Thefirst translations

Wreszinski
in 1909and 1912respectively.
81Subsequent appearin the
Germantranslations

volumesof Grundfissand Westendorf.

Leakeproduceda shortEnglishtranslation
of the

Hearstin 1952.82
It lackstransliteration lists,butis usefulin termsof disease
andfullingredient

Whilstthe Grundfiss
classification. andWestendorf
translations commendably
aresometimes

79Breasted,TheEdwinSmithSurgicalPapyrus,xix,
80Ralston,JEA62,116-21.
81W. Wreszinki.,Der GrosseMedizinischePapyrusdes BerlinerMuseums(Leipzig,1909),Der Londoner
MedizinischePapyrus(BritishMuseumNo. 1005)Hearstin Transkription,
Obersetzung, (Leipzig,
undKommentar
1912).
82C. D. Leake,TheOldEgyptianMedicalPapyri(Chicago,1952).

20
 this
cautious however,
can, allowforthepossibility byothersin some
interpretation
of spurious

areas.
uncertain
Whilstthereis considerable between
repetition someof the between
notably
papyri,

the Ebers,Hearstand Berlin,it is not unreasonable

to believethat we are still only in

of a verysmallfractionof theoriginalnumbers.
possession of time,destruction
Thepassage of
duringtombrobberies
property andthefiresin thelibraryof Alexandria
areperhapsamongst
the reasonsfor this.

Also we can only speculateon how these texts were actuallyused: possiblyas

83Sincethe medicalpapyriare only

teachingaids or as part of an academicrepository.

formularies
withoutanymedicalinformation
it mightbe presumed medicaltexts
thatseparate

perse existedasteaching
aids.Consequently if in factthere
maybe instructive
theirabsence

wasno medicaltheorybeyondthatof empirical It is perhapspossible

treatments. thatmaster

textswouldhavebeenpresentin oneof thepr cnb84or 'Houses

copiesof themedical of Life'

whichwereattached Thesewereprobably
to thetemples. scribe-based
centresandalsomay

haveservedas 'book'repositories
or centresof documentation
with facilities.
teaching 85 We

have no idea how many papyriwere producedand more importantlyno idea how

arethosewhicharein our possession.

representative Forexample,
Leakesuggests
thatthe

HearstPapyrusmayhavebeenusedas a 'hands-on'formulary.
86It has little systematic

beingplacedwithoutanylogicalsequence.
groupsof prescriptions
organisation, As such,it

thatthiswasan individually
seemsprobable requested drawnfrom
collationof prescriptions

othersources.However,
the veryfact of repetition
acrossthe medicalpapyridoesperhaps
implythatwearein possession
of thecoreof prescription
knowledge.

83Perhaps theyweresimplycarriedby thephysician,

althoughthismighthavebeenphysically The
restrictive.
'magical'
papyri,whichoftenfeatureincantations,
wouldpresumablyneedtobepresent aspartof theritual.
84Nunn,AncientEgyptianMedicine, 131.
85Ghalioungui,
MagicandMedical Science,28.A. H.Gardiner,
'TheHouseof Life,JEA24(1938),157-179.
86Leake,TheOldEgyptian MedicalPapyn).

21
 Theproblems
withthe translation
andinterpretation
of the medicalpapyri fall
broadly

intotwoareas:firstly,whereit is impossible diseaseor pharmaceutical

to identifysymptoms,

ingredients wherecertaintermshavepossible
andsecondly connotations.
widerpathological

frequently
Problems arisewith the identification
of manyof the drug and will
substances

in the absenceof moreevidence.

probablyremainunresolved Thecombination
of multiple

to
substances produce
a single for
remedy, often conditions,
uncertain identification.
hinders

The inabilityto producean accurateand completeEgyptianpharmacopoeia

will always

of drugtreatment.Theproblemswithsubstanceidentification
precludea completeassessment

havecreatedconfusion in respectof identification

wherebymanyassumptions havebeen

perpetuated
erroneously Lichtheim,
intoothersources.As an example, scholar,
a respected

translatesan itemin a literarytextfromthe MiddleKingdomas laudanum,whichshe perhaps

confuseswith 'poppy'.87Laudanumresults from the macerationof opium in pure alcohol and

neitheringredient
wasknownto the Egyptians
at this period.Thus,whatappearsa simple,

erroris reallymoreinsidious
gratuitous in thisarea.
andis typicalof thecreationof confusion

term
Ebbelltotallyconfusedthe word9ndt in Eb732.He translatedit as the anatomical

88 This resultedin his

'prepuce'rather than the generallyacceptedword acacia (thorn).

of Eb732as thetreatment
interpretation froma circumcision,
of complications ratherthanan
injuryarisingfrom 'acacia'thoms.89This was then given as evidencethat circumcisionwas

in ancientEgypt.90
practiced

EI-Ansary
in a paperpromisingly
entitled'Historyof PainReliefbyAncientEgyptians'

theEgyptians
describes usingmandragora (mandrake)
officinalis somniferum
andpapaverum

(opiumpoppy)as analgesics
andstatesthatthey'weremixedwithotherdrugsto be usedas

87Eitherthisor sheintendsandmisspellstheword'ladanum,
' butthe 'damage'is stilldone.M. Lichtheim,Ancient
EgyptianLiteratureVol.1:TheOldandMiddleI(ingdom(Berkeley,1975),214.
88R. Hannig,GrossesHandw6iferbuchAgyptisch-Deutsch(Mainz,1995),(hereafter, Hannig),831.
89Westendorf, 670.
90Ebbell,ThePapyrusEbers,103.

22
localanalgesicsfor stiff or painfuljoints'.91This is despitethe absenceof mandrakefromthe

papyriandtheexistence
medical of onlyone(disputed) to opium(App,opium,poppy
reference

)
seeds? in an internal for
remedy a child(Eb782). in
Merrillees, thecourse
of hisclassicwork

ontheimportation jugsfromCyprusduringtheNewKingdom,
of poppyshaped that:
concludes
'opiumplayeda vital part in everydaylife and must have been as indispensablein the

as aspirinis today'.
household 92Thisis despitea totallackof evidence
forsucha statement.

(SeebelowChapter
5-2).Consequently,
manygeneralworkson Egyptian areflawed
medicine
becauseof the repetitionof errors.It maybe that theseare overlookedbecauseof the cross

disciplines
of scienceand history.I believethat the failureto fully appreciate
scientific

andto drawon otherdisciplines

implications thatreflecton
mayactuallyproduceproblems

matterswithhistorical Forinstance,
significance. fromthe so called'Munich
the revelations

Mummies'by Balabanova
and her team still remainunresolved
despitethe enormous

forOldandNewWorldlinks.93
implications

In conclusion,
someof thetermswithinthe medicalpapyriareuncertain
andothers

Somehaveimplications
confusing. of widerpathological andthereis a minefield
connotations,

of problems.Someof thesetermswere probablyso fundamental

as to be obviously
by theodginalreaderso thattheyappearwithoutfurtherelaboration
understood in thetexts.

Theabsenceof suchelaboration
mightimplythatwe maybe missingancillaryexplanatory

theorytexts.It maysimplybethatthemedicalpapyriwerejustformularies
medical withoutany

or pathological
physiological However,I am concerned
associations. that someanalyses

regardinq havebeenexaggerated,
theirsignificance resultingin erroneous about
conclusions

the Egyptians'
knowledge of diseaseandlinkswithlaterGreek
the aetiology
of physiology,

thought.Onesuchtermis whdw.It is usedon severaloccasions

in the medicalpapyribut

91M. M. EI-Ansary, 'A Historyof PainReliefby AncientEgyptians,MiddleEastJournalOf Anaesthesiology

10
(1989),99-105.
92R. S. Merrillees,
'Opiumtradein theBronzeAgeLevant',Antiquity36 (1962),292.
93SeeChapter5.4.

23
unlikesometermsis neverdefinedin gloss.It appears
to derivefromtheverbwbd-'to suffer.

hasformedthe basisof extensive

Itssignificance 94Gardiner
initiallyby Steuer.
consideration

andFaulkner
simplygivethedefinition it seemsto be eithera
95Basically,
of wbdwas 'pain'.

termfor painor a factorintrinsically of painanddiseaseand

linkedwith the transmission

fundamentally
significant of disease.It hasalsobeenallegedto be thefactor
in theaetiology

forms
which linkbetween
thecommon Egyptian Forthisreasonthisand
andGreekmedicine.

otherwordsforpainwillbefullyconsidered
in thechapteronterminology.

94Steuer,Bulletinof Historyof Medicine10(11948).

95A. Gardiner,EgyptianGrammar3rded. (oxford, 1957).Reprinted1973,562. R. 0. Faulkner,A Concise
of MiddleEgyptian(Oxford,1962).Reprinted1991,68.
Dictionary

24
 PLATE 1.5 (ii)

*--WNW&

iv !ý 01 .01
-t4,
1ý i, %-t\
ý.. IA
. ýpl .
",

.1
7-To 1-1 look)
e,. 1.
.'o
jo ,, k-!, " --U4.

Aw

Zjcz,

4ý1'i A AA. A
JK
sic
VP

0ý-

,,

*... %,
641, Z-24

I
I..
- #4ktll tv
QL)
1"Z

- I
too.

BERLINPAPYRUS
Paoe2 -shovAnatypical darnaae
(TakenfromWreszinskiEdWon,1909)
 PLATE1.5(iii)

"Lana,

clap
-Z-Al
.

t. J

VI)

LONDON
PAPRUS
Paae2- showinaextensivedamaas
(rakenfromWreszinski
Edrdon,1912)
1.6AimsandMethod

Theoriginalintention
behindthisthesiswasan aimto produce of
anoverallappraisal

the standardof ancientEgyptianmedicineand the effectiveness

of the Egyptian
ancient

Theintrinsicproblemto achievetheseendsis of timerestraints

physician. becauseof the

potentialscopeand volumeof the subjectarea.Therefore,in an attemptto circumventthis

hurdle,it wasnecessary
to isolatethoseaspectsof diseaseandtreatments
thatwouldbeboth

intrinsicandrepresentative
of thewhole.Thus,theconsideration
of painwascarefully
chosen
for this thesis.I believethat an appraisalstartingwith a singleaspect,'pain', may help to

widerconclusions.
expedite

'Painmakesusconscious
of ourbodiesandsignalizes thatbelongs
thatsomething to

us is threatened'.
96Pain,to the patient,is an importantaspectof disease.An 'effective'

to paincontrolshouldfollowtheempirical
approach of injuriesfound
to thetreatment
approach

in theEdwinSmithpapyrus. in dealingwithpain
andtheabilityof theEgyptians
Therationale

should,therefore,
reflectthegeneraleffectiveness
of theirmedical andabilities.
organisation

Painis the first indicatorof diseasefor the patient.In this respectit is a common

denominator
of disease.Notonlyis paintheindexsymptom
withindisease
butimportantly
its

can be effectively
treatment by the patient.In thisthesisthe abilityof the ancient
assessed

Egyptianphysicians
to treatpainwill be assessedby theirabilityto effectively
utilisethe

medical
available foranalgesia.
substaoces I willbasically thisin twoways.Firstly:by
approach

thoseanalgesic
selecting andthento lookfor their
knownto havebeenavailable
substances

appearance of the medicaltexts.Thereasonsfor theirselectionwill be

withinprescriptions

givenin detailwithinthe relevantdiscussion(Chapters to examinethose

5-8).Secondly,

in whichthesesubstances
prescriptions appearandto consider they
whether arein factbeing

usedto treatpain.

96H.E.Sigerist, Medicine',
'Primitive History
ofMedicine.
2 volumes
(1951),1:116.

27
 Medicinal for whichthey
fromthediseases
cannotbe viewedin isolation
substances

wereintended.
Also,I appreciate It canonlybeviewed
thatpaincannotbeviewedin isolation.

as a holisticindicatorif it is considered the disease

within associated Therefore
state. this

thesiswill alsoconsiderdiseasein ancientEgyptin Chapter4 of thisthesis.I will notonly

considerthe type and extentof diseasebut importantlythe degreeof pain as a factorwithin

thosediseases.
Theactualmethods arediscussed
of approach indetailwithinthechapter.
The

aimis to produce
anoverallandrepresentative Thisdeliberately
listof disease. contrasts
with

currentspecialistresearch.Thiswill be achievedby selectingthe maincategoriesof diseasein

an attemptto producea list of categories the majorityof recorded

whichshouldrepresent

diseasein ancientEgypt.Fromthislisttheextentof painas a featurewillbe considered

by

referenceto the individualdiseases.If painis the predominant

symptomwithindiseasethenit

shouldequallyidentifya dynamic
fortreatment
- analgesics.

In respect
of thetreatment
of pain,manycompounds to havebeenusedbythe
alleged

Egyptians
as hypnotics; andstudy.These
havebeenthe sourceof discussion
or painkillers

includeopium,cocaineandthe lotus.It is important

substances to considertheiravailability

anduse.Thisis because of theirusegoesfar beyondthepharmaceutical

thesignificance and

mayhaveimportant
historicalimplications.
Theseandother'painkilling' will be
substances
fullyin laterChapters
considered 5-8.Theselection andthereasonsfor
of thesesubstances

willbediscussed
theirselection laterundertherelevant
sections.

Beforethetreatment
of paincanbediscussed, to lookfirstly
it is necessary
I consider

at its terminology.
Thisis essential
for tworeasons.Firstly,paincannotbe viewedoutsidea

socialframework.
BythisI meanthatthelevelsof painwhichareacceptable
astolerable
within

diseasearesociallycontrolled
andso equallycanbe sociallydefined.In thissenseobjective

painis moreoftendefinedbysocialreference
thanbysubjective In
reference. someconditions

sufferingmaybe considered
a normalor inevitable
condition
anddifferent
to due
suffering to

28
 Thiscanoccurevenif painlevelsareidentical
disease. notbeing
despitetheformercondition

described
as a 'disease'.
Thisis important
sinceit affectstheterminology
of painwhichmay

the
actuallyalter actualclassification
of conditions
as disease This
or otherwise. is a valid

forboththeancientandmodernmodels.
analysis Oneexample
of painbeing by
defined social

referenceis the processof childbirth.In modemWesternsocietythe painsof childbirthare

considered
generally 97Indeedthispainis
to betheworsttypeof painthatwomencansuffer.

charts.98Accordingly,
oftenusedas an upperlimitcomparatorin paincomparison the painof

is notconsidered
childbirth acceptable hasbecome
todayandso its treatment a mainpartof

the birthprocess.However,
thishasnot alwaysbeenthecasesincepainwasconsidered
a
$normal'part of the processfor differentreasons. sincepain was normal,it
99Consequently,

to bedefinedaspainandimportantly
ceasesnecessarily doesnotrequiretreatment.

Thetreatment withina societymustbeviewedagainstsucha

of painwithanalgesics

framework Thus,it is important

of socialacceptability. theEgyptian
to consider for
terminology

pain.Thisis because
theterminology of sucha socialframework
maybereflective andmayaid

its understanding.
Secondly, it is necessary
andmoreimportantly theextentand
to quantitate

degreeof painwithindisease.
Withoutanunderstanding thisquantification
of painterminology

is notpossible.
Tothisendthethesiswillconsider forpain,since
in somedetailtheterminology

definitions
extended maywellprovidefor painto be a largerfeaturewithinsomediseasesin

the medicalpapyri.If this is indeedthe casethenthe abilityto treatpainor otherwiseis

instructive
towards theabilityof theancientEgyptian
understanding physician.

97B.Sjorgren, foranxiety
'Reasons in 100pregnant
aboutchildbirth women', of Psychosomatic
Journal Obstetrics
andGynaecology4 (1997),
266-72.
Thefearof painfeatures listof anxieties
veryhighlyinthesewomen's pending
childbirth.
98The unit of painmeasurement is givenas a dol. Thisis unit of measurement
fromthe machinethat produces
and measurespainlevels.Mostcancerpainsrateas 0-2 dols.Theaveragepersonseldomgets past5.5 dols
throughouttheir lifetime.Yet, somelabourpainsrate at 9- 10.5dols whichis equivalentto a burningcigarette
beingheldagainsttheskin.M. Farley,TheConquest of Pain(London,1978),80-1.
99If not normalin termsof functionor chauvinistically
consideredas beingthe Iof of womanthenby punishment
from God duringthe Creation.'I will increaseyour sorrowin childbearing; with sorrowyou will give birth to
children',Genesis3,16.
b,

29
 Finallyanalgesics
themselves
will be Several
considered. have
substances been

andtheseformthebasisforChapters
selected 5-8.Theconsideration
of thesesubstances
will

in severalways.Thepharmacological
be approached of
properties eachindividual
medicinal

will
substance be in
appraised, its
particular ability
actual as an Its
analgesic. appearance

textswillbeconsidered
withinthemedical withitssuitability
together in respectof
forinclusion

the statedintentionsof the prescriptions. of its appearance

Lastly,any significance in

withothercompounds
combination thefrequency
Thatis to consider
will be considered. and

appearance
withothercompounds effects.This
andto consideranycombinedpharmacological

willtaketheformof a prescription
latterexercise References
analysis. to thepharmacologically

suitability
of substances knowledge
willbe madeagainstcurrentpharmacological andagainst

inclusion
ingredient important
in classicalandmodemherbals.Thelatteris particularly since

willfeaturemodempharmacologically
modempharmacopoeias ratherthannatural
engineered

products.

to directlyassesstheextentof painfromtheEgyptian
It willnotbe possible sources.

to diseaseandthe extentof thatdiseaseshownto be

Thiscanonlybe doneby reference

present.The levelsof painwill be assessedby modernreferences

to painwithinthese

thatactualpainin ancientEgyptwillbe thesame

In otherwordsit willbe assumed
diseases.

thatwereusedto treatthis painin

for the samemedicalconditiontoday.Any substances

ancientEgyptwill be assessedeffectiveor otherwiseby referenceto currentreference

It is that
pharmacopoeias. appreciated this may
approach ignore
the of
socialcontext disease.

However,
the efficacies still remainconstantandthusI believesuchan
of the substances

approach forthepurpose
is sufficient Infact,thenatureof ancientEgyptian
of thecomparison.

formulations This is fully

may be suchthat they may negateany individualcomparison.

intheconclusion
explained to thethesis.

30
 I believethatthediscussion in sucha fashionshould
of pain,diseaseandanalgesics

a representative
expedite of Egyptian
appraisal medicine byother
whichwouldnotbepossible

means.

31
 CHAPTER2: PAIN
2.1 Concepts

Nunnin hisbriefdiscussion it as'painmatteror morbid

describes
of thetermwhdwsuccinctly

thatthereareat leastfiveotherwordsforpain,butdoesnottellus
Healsosuggests
principle'.

whatthese 100
are. (Theterminology
of painandits implications
will be fully in
discussed the

'Ol
nextchapter).

Theconfused
situationin respectof manymedicaltermsis notjust a problemwith
fromthe Egyptianbut is alsobecauseof intrinsicomissions
directtranslation and lackof

withinthemedicalpapyri.Theseareperhaps
elaboration because,
omissions nodoubt,many

termswouldhavebeenobviousandunderstood
to the originalreader.Thisis perhapsnot

sincethemainmedicalpapy(iareessentially
surpfising lists.As suchtheywould
prescription

ratherthandiagnoses
serveto provideremedies or theories.

Someof the termsusedin the medicalpapydare expanded

uponin a footnoteor

gloss.Butthesegenerally
applyto termsof a technicalsurgicalnature.Forexample,
Edwin

Smith(4) refersto the treatment

of a gapingwound.In it glossA explainsthe meaningof

'splittinghis skull':as for 'splittinghis skullit meansseparating

shellfromshellof the skull

whilefragments 102However,
remainstickingin thefleshof his headanddo notcomeaway'.

thesetypesof seriousinjuriesarenotlikelyto represent generalpracticemedicine.

common

Theadditionof detailedexplanations
hereandtheirabsencein generaltextsis perhapsnot

surp(ising.

Anothermajorproblemis the difficultyin understanding

the socialattitudesof the

Egyptianstowardspain and, consequently, for treatment.This has

its appropriateness

implications
in translationand in treatment.For example,in modemEnglisha situation

described
as 'painful'couldvaryanywhere
froma situationof acutesocialembarrassment
to

100
Nunn,Ancient EgyptianMedicine,62.
101 in thethesisaremine,exceptwhenstated.
Alltranslations
102
Translation
takenfromRalston, JEA62,118,9.

32
oneof injury.
physical
actual A distinction
similar to
seems applyin for
Egyptian: example,

whilst,Faulkner
Hanniggivesthe word3,bw as 'Schmerz'(pain)but also'Leiden'(trouble),

103
trouble,illnessandeveninjury'.
definesthewordas'pain,misery,

Thewordmr'04is literallytheverb'to be ill' (kranksein)butit is generally

translated

so that it to
applies the degree
of suffering
withinthat state
particular of Thus
illness. the

widerto includepain,forexample:
canbecome
definition

mr id. 1, 'anillness
whichI will (a
treat', common in
phrase themedical
prescriptions).
fromthe knee',
to driveout illness/pain
kt nt dr mr (t) m pd, 'another(prescription)

(Eb605).

However,
complete of the
analysisof the textsis onlypossiblewhenthe symptoms

condition Thisis rarelythecase.Thefirstimpression

or illnessarefullyunderstood. onegets

the
whenreading Egyptian texts
medical is of theirterseness of
andpaucity It
detail. be
must

that
remembered this to
paucityalsoserves illustrate
that we maywell be missingserious

implications
withintheoriginal.

Painis unlikeothersymptoms
of a in
disease that it is also an human
essential

like
emotion fearor hate.
Equally,
painis difficult
to assess
sinceits is
perception subjective.

Conversely definedby reference

paincanbe objectively to socialsituations
andstereotypes.

thatpainhasbeensubjected
As suchit is notsurprising However,
to muchanalysis. mostof

thishasbeenin respectof Greekmedicine. worksonthetheory

Whilstwehavemanyhistorical

of disease
and pain in Greek,
105
we havenonein Egyptian.
In fact, we havevery little

103Hannig,10. Faulkner,A ConciseDictionaryof Middle Egyptian,3.

104Hannig,344.
105Thereare many.For example:Plutarch,On the ScientificBeliefsof the Philosophers911A (balancesand
disease),Aristotle,OnRespiration
473bl-474a5,
Philolausin AnonymusLondinensis, MedicalWritingsXVII8-XIX
(onthecauseof disease),translations
fromBarnes,EarlyGreekPhilosophy. AristotleandGalen,seebelowpage
35 (reasonsfor pain).

33
theoretical fromEgyptandsocautionmustbeexercised
reflection in presuming or
anyreliance

between
relationship thesetwomodels.

Theconcept aspectin thehistoryof medicine.

is an important
of painanditstreatment

I wouldsuggestthattherearetwodistinctdivisionsto thediscussion
of painas a concept:

firstly,therationales thereasonforpainandsuffering
of thecauseof painperseandsecondly,

in thewider'human
condition'.

Chomme la douleurestsonmaTtre.
estunapprenti, EtnulestconnaittantquWna pas
106
souffert.

It is arguable
thatinquiryintothecauseandeventheperception
of painis intrinsicto

thehumancondition.
It is partof thelargerattemptof a societyto explaintheillsanddisasters

thatbefallit withintheirparticular
state.Indeed,thereasonforunnecessary
painandsuffering

stilloccupies
a primary intheological
position debatetoday.

Inthissense,paincanbedividedbroadlyintotwotypes:painthatresultsfromoutside

influences fromwithin.Manyprimitive
andpainwhichemanates believed
societies thatallpain

camefromoutsidethebody.It couldbe caused'notonlyby thorns,arrows,clubsor fire but

alsoby evilSpi(ItS'.
107 Thisprimitive,
externalviewof painlater'seemsto developintosome

concept thatpainandphysical
whichrecognised wereharmful
experiences 108
to thebody'.

Keeleevensuggests
thattheideaof painbeingdueto anoutsideobjectenteringthe

bodywas 'prepotent'in all primitivesocieties.Pain inflictedfrom withoutthen becomes

withthe termdisease.He continues

synonymous manydiseasesin
to saythataccordingly

primitive areheldto be produced

communities by theintrusion
intothebodyof objectsrealor

106
Musset,quotedin H.Merksey,'SomeFunctions oftheIdeaofPain,Pain9 (1980),
oftheHistory 3-8.
107
Fairley,
TheConcept ofPain,19.
108
K.D.Keele,Histofical
Concepts ofPain(London,
1962),4.

34
 'whether
imaginary: objectis as obviousas anarrowor aselusiveastheshotof
thisintrusion

an elf,the painwhichresultsis as equallyhardto bear'.109

TheMesopotamians
believed inflictedbythe
thatpainanddiseasewasa punishment

godsuponmenfortheirsins.110

Significant in theideasconcerning
changes at thetimeof Aristotleand
painoccurred

Aristotlemadedistinction
his contemporaries. andemotion.However,
betweensensation he

didnotregardpainas sensation it as oneof the'passions

butinsteadclassified of thesoul'.

Theintensive of touch,sightor hearingmightgiveriseto painbutonlybecause

experience of

"' ClearlyAristotledid
tookplacein the heart.
its internaleffectswhichAristotlepostulated

realisetheimportance
of peripheral in causingpainandit wouldbehardto suppose
stimulation

cause.Both
fromhis writingsthathe thoughtthatpaincouldarisewithoutsomeperipheral

Aristotleandthe Egyptians
wereclearly in
mistaken thattheyplaced
no valueon the brain

withinthe painprocess.It wascompletely by the Egyptians

discarded duringthe embalming

jars.112
anddidnotwarranta placein thecanopic
process

Galenin the secondcenturyAD,however, thatthe brainandthe senses

concluded

werelinkedto differentpartsof thebodyby a networkof nerves.Thesewere'hard'and'soft'

nerves:thehardnervesbeingmotornerves(movement) sensation.
andsoftnervesconveying

109
Keele,HistoricalConceptsof Pain,4.
110
G. Roux,AncientIraq3rdEd.(London,1992),336.Illnesswas,therefore,a moralcondemnation callingfor a
moralcure.Treatmentwasoftenreligiousor magical.
M Aristotle,Partsof Animals11647al, 14-20.From, The CompleteWorksof Aristotle.The RevisedOxford
Translation, J. Barnes(ed.), (Princeton,
1984).
112The Greekview was that the brain had no sensationwhen touched.In this sense,it was like 'bloodor
excrement'.It was presumably considereda discreteorganbut couldhaveno rolein a systemwherepassions
werefelt in theheart;ratherit hada placeconcernedwiththe processof sleep- AristotlePartsof Animals11652b,
3-6.

35
InDeUsuPartium:

of nerves:shewishesto give
'Naturehasindeeda tripleendin viewin thedistribution

to organsof perfection,
sensibility movement andto all the
to organsof locomotion,

othersthefacultyof recognising of injury.Thethirdaimof Naturein the

theexperience

distribution
of nervesis theperceptionof thatwhichcancauseharm'.' 13

In otherwordsGalenis attempting
to definepain.Heclearlyrecognised
the needfor

pain.Forhimpainwasnecessary in the body

to makeus awareof the noxioussubstances

whichthenneededto be expelledbeforetheycoulddo damage.However,therewasno further

workor developments
onGalen'sideas.
114Thetheoryof theGreekphilosophers
thatpainwas

a passionof thesoulremained for sometwothousand

widelyaccepted yearsandwasonly

withtheadventof scienceandtheunderstanding
replaced in thelateeighteenth
of physiology

andearlynineteenth
century.

TheEgyptian
'theoryof whdW withits implications
on thetransmission
of painand

diseasefroma distinctsourcewithinthebodyis a fundamental If correct,it would

hypothesis.

bothpre-dateandsupersede of whdw as a conceptin

Greekthought.The understanding

Egyptianmedicine factorswithinthe
of diseaseandpathological
to explainthe transmission

bodyhasbeengenerally 115It accordswiththeideaof thevesselsof thebody,the

accepted.

thevariousorgansandterminating
mtw connecting aroundtheanus,a conceptof anatomy

brieflyexplained
inthesocalledVesselBook.
116 'to
Estesstatesthatthemtwwereconsidered

be indispensable
to normalbodilyfunction'to the extentthattheirimportance
'is implicitin

ancientwishes:'mayhis mtw be comfortable'

everyday 'mayyourmtw be
or in greetings:

113
Fairley,
Concept ofPain,21.
114Hisrefusalto acceptthatthe soulwasimmortal led to the suppressionof his workby the fathersof the
Christian
Church intowhosehands, forthemostpart,thepractice of medicinehadpassed.
115
Fortwoexamples, whereit is accepted as a pathological factor,seeK. R. Weeks,'Medicine, Surgery and
PublicHealthin AncientEgypt'in J. M.Sasson (ed.), Civilizations
of the Near
Ancient East111,(1995),1787-98
,
andR.K.Ritner,TheMechanics ofAncient EgyptianMagical Practice(Chicago,1993),82.
116
Thenumber of themtw,theiranatomy andfunction is describedin Eb854/856,Bln163,(TheVesselBook).

36
 117
sound'. The connection
of wbdw with the mtw allowsfor further For
presumptions.

the the
example, practiceof shaving body(generally to
thought be because
of hygienic
or

is
demands)'18
religious because
probably the
shavingpermitted freeexitof wbdwfromthe

mtw that in
terminated theskinor '
hair. 19
Theabilityof iKhdwto travel the
through mtw and

resulf.Suchthatthere
in a clotis 'thefinaldestructive
to changethebloodandto culminate

a
wasconsidered needto the
remove scabfromthebody.
Worth the
connects destructive
'final

bdwwith
element'of w-, the presenceof the 'BloodEater'and the "Eaterof Intestines'
in the

a relatedfearof
Hallof Judgement.In that,he statesthattheirpresence'probablyrepresented

120
corruption'.
corporeal

it seemsthatEstesis merelyaddinghis ownsuppositions

However, to the original

of
proposals Steuer.
It is difficultto imaginethe ancientEgyptian
notto perceive
a scabbing

bloodclotas theimmediate otherthantheexternalsourcethatcausedthe

resultof anything

In
wound. fact,the for
evidence such is
treatment welldocumented
anddoesnot implyan

urgencyto removescabbing
- rather
one of bandaging
or application
of (Sm9a,
emollients

Eb482-509).

uponby
with healthanddiseasehaveremarked
Food,diet andtheirassociations

in food anddrinkmaywell havebeenconsidered

and Greeks.Overindulgence
Egyptians

or self indulgent,but Estessuggeststhat it was actuallyconsidered

immodest unhealthy

tractthatwouldfacilitatethe
residuesleft in the gastro-intestinal
becauseof the excessive

of whdw.121
development

Herodotus that
alsowrites theEgyptians disease
connected withfood 122
eaten.

J. W. Estes,TheMedicalSkillsof AncientEgypt(NewYork,1989),80.
117
of Religionand Ethics10
118See,A. M. Blackman,'Purification(Egyptian)',in J. Hastings(ed.), Encyclopaedia
(Edinburgh,1918).
119
Estes,TheMedicalSkillsof AncientEgypt,85.
120
Estes,TheMedicalSkillsof AncientEgypt,80,83.
Estes,TheMedicalSkillsof AncientEgypt,83.
121
122
Discussed in Chapter3.2,below.Healsoblamesdiseaseon changesin theweather.

37
 The perilsof suchoverindulgence to
appear be in
contained a instruction
dernotic

teXt: 123

thefoodharmshim.
Illnessbefallsa manbecause

Hewhoeatstoomuchbreadwillsufferillness.

He whodrinkstoomuchwineliesdownin a stupor.

Allkindsofailments
arein thelimbsbecause
of overeating.

in hismannerof life,hisfleshis notdisturbed.

Hewhois moderate

in food.124
Illnessdoesnotbumhimwhois moderate

Thetaboossurrounding in thattheymightoffendthe
somekindsof foodareexplained

god with whom they are associatedand 'prompthim to retaliateagainstthe offenderby

producing
%ýW. 125
The I
however,
connection, is
believe I
spurious.canfind of
noevidence

foodbeingassociated
withnbdw.1261n
fact,theideaof tfýbdwbeing withfoodis not
connected

by Steuerin his originalproposals.

evenpresented is presumably
This connection made

because
of theassociation
of foodandtheintestinal The
system. believed
Greeks thatdiet
was

127
factorin goodhealth.Butthiswasviewedas beingpartof a goodlifestyle.
an important

Eitherthis or it was associated

with imbalances
in the 'forces'of the body.In that,those

diseases canbecuredbydepletion.
byrepletion
thataregenerated 128

intoFrenchby Bardinetof somemedicaltermsshouldhopefully

A recenttranslation

haveofferedclarification
of whdwasa medicalterm.Bardinet themainkeytexts
re-translates

123Aristotleseessleepas partof thedigestive process. Thebrainis involved with the sleepprocessbut it is

concerned withdissipatng theheatcausedbytheintakeandprocessing of food.A personawakesfromsleep
whendigestion is completed.Aristotle,
OnSleep458a,10-15.Thus,deepsleepfollows overindulgence.
124Papyrus Insinger'TheEighthInstruction',
in Lichtheim,Ancient Egyptian Volume
Literature TheLatePeriod,
1/1:
190.Thistextdatesfromthe4thcenturyandso couldbe a Greekidea.Thepointis madeby Lloydbuthe
considersit unlikelyandratherseemsto support theconcept of foodandwýhdw, Lloyd,HerodutusBook// 1-98,
331-2.
125Estes,TheMedical SkillsofAncient Egypt,84.
126ActuallyAristotledoes'connect'foodwithcertainillness:fevers.Thelinkis notwithfoodperse,butwithfever.
Infeverthebodyactslikedigestion producingsleepto assuage theheatofthefever,OnSleep4571a,1.
127Sarton,GalenofPergamon, 61.
128E.Cralk, Diaita,inJ. Wilkins
'Hippokratic et al (eds.
), FoodinAntiquity(Exeter,1996),347.

38
 and fails to
from severalof the medicalpapyri,yet for ipýhdwhe givesno translation

factor,ratherviewingit as havingnodirectequivalent
it asthemainpathological
acknowledge

in contemporary 129
medicalpractice. He the of
wiselywarns reader the dangers
of making

facile interpretations on Egyptianmedicinebasedon currentmedical

and conclusions

Hisreluctance
knowledge. somedifficulttermsmightbe applauded
in translating butfor his

He lists wbdw as oneof the four major

failureto fullyexplainsomeof his assumptions.

factorsalongwith ri-r,stt and blood.He seesstt and whdw as of externalorigin

pathological

comparedwithbloodand ciewhichhe considerselements'normallypresentin the bodyor on

the surfacebutableto becomepathogenic 130Heviewswbdwas the

in certaincircumstances'.

factor
opposing to theblood. is
Blood the factor
principal whichis vitalto the Opposing
body.

thisis whdwwhichbecomes
joinedto anyoffereddecomposing
material.ndw, amongst

(la douleur).The bodyis

otherthings,is involvedin the Egyptianideaof 'suffering/pain'

in thefleshor evenpiercedby substances

'gnawedat' (grignot6) in the mtw. He
immersed

of whdwwiththebloodin histranslation
makestheconnection buttherehe
of Eb193,202,

thesignIZ 131
actuallytranslates Thisis otherthanits accepted
as wbdw.132 asPs
rendering

(faeces)and where Eb193,202 are generallythoughtto relate to the treatmentof

133
constipation.

Steuerin hislaterstudyon Egyptian

andCnidianmedicine thattheconcept
suggests

is actuallyseminalto thelaterGreekphilosophies
of whdwas a morbidprinciple on painand

1341-lowever,
illness. I consider forthisandI willfullydiscuss
thatheoffersnoactualevidence

hisconclusions
in thenextchapter.Evenif it is accepted theotherit is
thatoneideapreceded

129
Bardinet,Lespapyrusm6dicauxdeI'8gyptepharaonique131.
130 ,
Bardinet,Lespapyrusm6dicauxde I'8gyptepharaonique, fromtheFrenchintoEnglish.
121.Mytranslation
Thesign/Z appearsfrequentlyaloneandin conjunction
131 the ps,
with word where faecesmust be meant.See
Chapter9 below.
132
Bardinet,LesPapyrusm6dicauxde I'tgyptepharaonique,131,134.
133Westendort,
842.GrundrissVII:6311,2.
134
Steuer,AncientEgyptianandCnidianMedicine.

39
important thatthereis noevidence
to appreciate thattheEgyptians about
wereascircumspect

astheGreeks.
thehumancondition

2.2PainRelief

of painmustbe prefacedwith the caveatthat a 'conceptof pain'

Any considerations

Thisis an importantpointin respectof

reliefmayactuallyprecludethe use of painkillers

Egyptianmedicine;one that can only be speculatedupon againsta presumedsocial

135Equally
framework. Painreliefin any
of diseaseis definedbysocialreference.
thedefinition

societyis promoted
onlyif thatsocietyfindsthe treatment
of painacceptable
andmaynot

be in proportion
necessarily withthe availability Forexample,
of analgesics. 'thealmosttotal

absenceof painin documentation

from 1000to 1200ADin the westernworldreflectsthe male

136Evenin late
dominatedmilitaristicideologythat viewedpain as weakand ferninine'.

Europeheadachewas still regardedas a weakness,a

eighteenthand early-nineteenth

trait.137
feminine

mayhavebeensimilarbutwasprobably
viewof painon thebattlefield
TheEgyptian

138
differentto theirviewof painin a domesticsituationat homein Thebesor Memphis.

in termsof the battlefield

However, it wouldseemlogicalto lookafterone'stroopsandso

protectthe efficiencyof the army.This protectionwouldpresumably

extendto medical

if timeallowed.
treatment Theuseof analgesics
wouldhavebeenimportant
to placateandso

135Whatis normalandwhatis disease? Forexample, 'a patientmayfeelill andin painwithoutnecessarily

suchphenomena
explaining in termsof a disease model',from,H.T. Engelhart,'Conceptof HealthandDisease',
inA.Caplan (ed.), TheConcept ofHealthandDisease (Massachuseus, 1987),37.
136F.A. Djit6-Bruce, ThePuzzleof Pain(EastRoseville, 1994),126.Equally, havebeen
the'pains'of childbirth
viewedas'normal' andonlyrecently havebeenconsidered forpainrelief.
suitable
137Quoted byMerksey, Pain,3.
138'Battlefield
analgesia'in whichsoldiersfeellittlepainappearsto be causedby thephysiological effectsof
adrenalinandthepsychological overlayof reliefthattheywerenotkilled.Equally, painappears to be 'gated'or
modulated bypastexperience. J. Blenkinsopp,'Analgesics',ThePharmaceutical Journal268(2002), 252.

40
to facilitate 139Modernsurgeryhas only developed
treatment. sincethe properuse of

andanaesthetics.
analgesics

Injuriesrequiring
surgicalattentionmusthavebeencommon of
as a result industrial

The
accidents. tomb lpy
of at Deir
el Medina full
showsa relief of injuries
occupational suchas

dislocatedshoulders,footinjuriesandthe removalof foreignbodiesfromthe eyes.140

2.3 Physicians

Anothermajorproblem
withEgyptian is
medicine thatwe do notknowhowphysicians

operated It seemsprobable
or howtheyweredistributed. thatsomemedicalactivityoperated

of Life'attached
aroundthepr cAhor'House(s) whichwerethemselves
to thetemples, partof

The importanceof the 'Houseof Life' is mentionedby

infrastructure.
the overallorganisational

thehighofficialUdjahorresnet
sincehe is int
charged al withtheir furnishing
restoration; them

withstaffand to
equipment carryouttheir 141
dutieS. It seems that
unlikely anyformal
training

was operatedrather
programme being 'centresof documentation'
or for
repositories

142
information.
Bylooking
at later
historical the
models presumption be
must thatphysicians

for
operated the i.
elite e. those to
able availthemselves
of those This
services. is also

important
in theconsideration
of theavailability
of pain-killing Weretheyreserved
substances.

justfortheelite?Thismayexplaintheapparent
absence whichonemight
of somesubstances

143Certainly
predictto be presentin the medicalpapyri. the veryfactthatprescriptions
were

139 Yetfor Greco-Roman timesSalazarsuggests that'analgesiawasnotto be expected'. C. F. Salazar,

'The
treatment of warwoundsin Greco-Roman in I Scarborough
antiquity', (ed.), Studiesin AncientMedicine 21
(Leiden, 2000),65.
140 in R. L. Miller,'Paleopathology,
Illustrated Literacy,andMedical Treatment amongst Necropolis Workmen in
NewKingdom Egypt'Medical 35(1991),
History 7.
, Lichtheim,Ancient
141 Page43.Also,thistaskwasclaimed bytheSaiteofficialPeftuaneithin his'autobiography',
Egyptian Literature- Volume /11,35.
142 Thereis ampleevidence to connect'TheHouseof Life'withmedicine, thisis discussed byA. Gardiner,'The
Houseof Life, JEA 24 (1938),157-9.He firmlytakesthe viewthat therewerenot 'trainingcollegesor
universities'.However, thisviewis notaccepted byotherswhoconsider it toonarrow a viewof the'Houseof Life',
see,forexample Lichtheim, AncientEgyptianLiterature-
Volume /1/,36,41.1 agree with Gardinerand taketheview
thata morelikelysystemof medical training
operated likeothertradesor professions - on theapprentice/
master
relationship.
143
SeeChapter 5.2onopium.

41
writtenandcopiedimpliesusageby an elite.It seemslikelythatmedicine on
waspracticed

differentlevelsbutwithina framework
wherethedefinition wasfar wider.The
of a physician

is modernconcept.
controlof entryto a medicalprofession Themedicalpractitioner
of ancient

Egyptcouldbedrawnfromthe'wellborn,
no lowbom theM'144
among of the 'House
of Life'
or

fromtheworkmen's
villageat Deirel Medina.
145

Someof the communications

writtenduringthe Amarnaperiodillustratethe elitist

Thevalueplacedon theEgyptian
natureof medicine. is shownbytheHittiterequest
physician
for a palaceattendant'thatis also a physician.Herethereis no physician'and a requestthat

'the kingsendan archerandmyrrhfor medication'.

146However,
it is oneparticular
counter

requestby Amenhotep He is recorded(on morethanone

III that is far moresignificant.

sendingto theMitanniking,Tushratta,
occasion) 147This
a requestfor 'OurLadyof Nineveh'.

was a statueof the goddessIshtarsent in an attemptto relieveAmenhotep

of his pain.

Donadoniin attemptingto justifythe studyof apparentlyisolatedand trivial detailsin

Egyptology of Amenhotep's
citesthisveryexample 'detailsthe likeof whichmay
toothache:

indeedlaterproveto havegreatersignificance'.
148

Thefactthattheservices werenotusedwasnotalwaysdueto economic

of physicians

Thechoicebetweenpainfultreatment,
or elitistconsiderations. withuncertain by a
outcome,

anddeliberate
physician neglectwasoftena preferredchoiceof a patientevenin recent

history.Jacksondiscusses
howin GreeceandRomepatientssoughtthe helpof thegodsin

to theuseof doctorsforsuchreasons.
preference 149InEgypttheinvoking
of godsthatwereso

integralto thedailywayof lifemayalsohaveoftenbeenthefirstchoice.Certainly,

aswithall

144
Lichtheim, Ancient EgyptianLiterature-Volume 1/1,40.
145Afthough Ghaliounghui believed
'fromthestricthierarchy of theirtitles'that'somekindof controlmusthave
beenexerted ontheirentry.OnthishequotesDiodorus (1,82)Ghaliounghui, MagicandMedical Science,
64-5.
However, I thinkthisis an example of Diodorus supposing andapplying thetypeof 'Greekorder'alludedto by
Lloyd,seefootnote, 187.
146
W.L.Moran(ed.), TheAmama Letters,(London, 1992),120EA49,316 EA69.
147M.Roaf,A Cultural AtlasofMesopotamia andtheNearEast(NewYork,1990),132-40.
148S. Donadon! (ed.), TheEgyptians (Chicago, 1997),A. Thesignificance is thateffective
painreliefappears
not
tohavebeenavailable toAmenhotep in Egypt.Please,seeChapter 5.2onopiumforfurthercomment.
149
J.Jackson, Doctors andDiseases in theRoman Empire(London, 1988),20.

42
 TheEbers
otheraspectsof lifetherewereno definitedividesbetweenmagicandmedicine.

at thebeginning
Papyrus thispoint.It givesspellsthatareto be recitedwhenthe
illustrates

('traditional') is
remedy being 'words
used, to be spokenwhenthe is
medicine drunk,
'really

times,
a million
excellent; (Eb3).
A votivestelato Amen-Re int
records al thanks
givenfor the

in savingthelifeof a son,'I madeforhimpraisesto hisname,on behalfof

latter'sintervention

Nakhtamun,
thedraftsman justified, 150
wholaysickuntodeath'.
151
The Egyptianwordfor doctorappearsto havebeenstmw: m. var. 0 .

The presenceof the 'arrow'may havearisenwith the development

of the doctoras the one

who arrows
removed on the 152Any
baftlefield. understanding
of the distribution
of doctors
is

because
confused
somewhat of the useof the wordswnw withinhierarchical 153
titles. For

thevizierMereruka,
example, son-in-law V1,ranksamongst
to Tetiof Dynasty histitlesthatof

of thetwosidesof theboatof thedoctorof thegreathouse'.Whether

'overseer thistitlewas

realor merelyanhonorary
title kudos
bestowing byacademic is
prowess difficult
to But
know. it

is equallydifficultto imaginethe son-inlaw of a king actuallypractisingmedicine.The

statue
naophorous of from
Udjahorresnet the Twenty-seventh
Dynasty gives an

154He heldverymany
accountof hisworkfor the PersiankingCambyses.
autobiographical

offices,included
important theseis thetitle uTswnw.Thistitlewasclearlyof great
amongst

fromDeirel Medinarecords
to him.At theotherendof thesocialscaleanostracon
importance

the dailygrainrationspaidto the varioustypesof workers(Cairo,Ostracon 155The

51518).

150
Lichtheim,
AncientEgyptianLiterature- Volume2,106.
Hannig,677.
151
152Nunn,Ancient Egyptian Medicine,115.Orit couldsimplybephonetic
153A fulllistof suchfitlesis givenbyJonckheere. Theyinclude, int al, 'chiefdoctor,doctorof theroyalpalace,
doctorof thestomach andeyes'.Thelasttitleimpliesspecialisation. F. Jonckheere, LesM6decins de ltgypte
Pharaonique (Bruxelles, 1958).
154A. Kuhrt,TheAncient NearEast.2 volumes (London,1995),663.
155Thesearerecords forthenecropolis workmen of theRamesside period,albeittheymaynotberepresentative
of Egyptasa whole.Thephysician (swnw)forthework-crew seemsto havebeenpoorlypaid:I kharof wheat
and%kharof barleypermonth(Ostracon Cairo,25608)compared to thenormal workman's rationof 4 kharand
1Y2kharrespectively. It maybe thatthesewagesmerelysupplemented thebasicwage,butthisis notstated
(whereas, detailsof daysoff for sicknessetc.are).Thiscontrasts the
with payment made by one workman for
'private'(outside)medical treatmentto an un-named doctorof 22debenof copper(P.Turin1880,vs 5.2),(22

43
rationpaidto the is
doctor at the bottomof the list, belowthatof female and
servant boy.

thisis reflective
Whether the
of statusor typical the of
of workingpractices a it
doctor is difficult

to say. But it seemsunlikelythat theywerefull time 'professional' It is

physicians. more

that
probable theywereemployed the
aspartof general and
work-force performed in
medicine

156
capacity.
a secondary As to the'costs' treatment
of medical the
again is
situation notclear.

Somelimitedevidence for
of payments is
treatments from
available theDeir
el Medina
records

for
above theRamesside Diodorus
Conversely
period. that
mentions in Egypt had
people
some
157
freecarewhichhasbeendesc(ibedby someas a sortof 'NationalHealthService'.

2.4UseofAnalgesics

In respect
of thetreatment thehistorical
of paintoday,Jaros,in considering concept
of

painandits treatment
decidesthatevenuntilveryrecentlypaincontrolremained
somewhat

and
empirical ineffective.
Evenwithinthe last two decades...
'the therapeutic and
modalities

drugswereavailablebut not properlyappliedbecausestudentswerenot taughtthe basic

158Equally
of painmanagement'.
p(inciples is
pain a subjective that
sensation be
must accepted

thesufferersaysit is. Oneindividual's

byothersasbeingwhatever senseof pain be
might felt

as mildandeasily by
tolerated 159A
another. thesamestimulus
personcanexperience of pain

on different but
occasions feelthatthe intensity
of painis different
on Likewise
each. activity

(awareness)
oftenreduces of pain.

debenofcopper= 11debenof grain=2 months ThefiguresquotedaretakenfromMiller,Medical

salary). History
35,16-17.
156See
abovefootnote.
157Diodorus (1,62).Thedescription
ofa 'National
HealthService'is madebyPahorandmust,inthelackof
evidence, beassumption. Hefurtheralleges
thatmanyphysicians weresalariedbythestate.Thewealthof
'private'
physicianscanbeevidenced bythesplendourof theirtombs,J. L Pahor,'Ear,NoseandThroatinAncient
Egypt,Journal ofLaryngology andOtology 106(1992),678.However, thisreliesonthetombtitlesbeingactual
nothonorary ones.
158J.A.Jaros,'Historyof Pain:Concepts andTherapy',
MountSinaiJournal of Medicine 58,(1991), 194.
159 Painthresholds havebeenshownto varybetween menandwomenand between those of different
socio-
economic groupsandoccupations. Froma reportin theLancet(1971),reported in Fairley,TheConcept of Pain,
63.

44
 Theavailability
of drugs
does directly
notnecessarily to
equate theiruse.It is perhaps

difficultto imagine
thatanysocietythatpossessed wouldnotusethem.Butit cannot
painkillers

thatjust because
be assumed an ancientsocietyhadaccessto certainmedicalcompounds

thattheirusemusthavebeenwidespread.
Thepointis thatmedical areonlyused
compounds

For a modernexample,in Europeandthe USA,over

withinthe prevailingsocialbackground.

thelasttenyears,painin terminal is nowregarded

conditions
medical Thisis
asunacceptable.

due to a socialshiftin the perception

of pain.Previously
the painassociated
with certain
terminalconditionswas regardedmerelyas partof the illnessi.e. naturalandso somethingto

with. Consequently,
be contended the currentpolicyof givingever increasing
dosesof

makesthedosageregimes
to dyingpatients
morphine in earlierformularies
notonlyredundant

buttotallyinadequate.
160Equally,narcotics
havebeenfreelyavailable
for somecenturies
yet

pandernicof drug addictionhas only been possiblebecauseof the

the post-1960's

predisposing factorswithinthecurrentsocialclimate.
sociological

It mustbeappreciated
thata lackof knowledge
of thesocialcontextof drugusewillto

someextenthindera greateranalysisof the use of analgesicsin ancientEgypt.In

of this, I fell one methodof approachmightbe to lookat the actualuse of

consideration

todayandattemptto find paralleluseswithinancientEgypt.Themodemuseof

analgesics

andsedatives
analgesics intothreebroadareas:the reliefof acute,minor
canbe classified

discomfort, of painin chronicandincurable

thetreatment diseaseandthe treatment
of pain

injury.
following

Thevolumeuseof analgesics
todayis for minordiscomfort.
It is partof the social

withintoday'ssocietythatpharmacy
expectation willprovidea 'pillforall ills.' Thirtyyearsago

for anxietyand'related'conditions
theuseof sedatives Today
wasenormous. thisis a mere
fractionandindeedmanyof thesecompounds
havebeenwithdrawn theyarenotnow
because

160Thisis illustrated
byofficialmedical Thedosefor (oral)morphine
monographs. sulphateto controlpainwas
givenas 10-20mg in 1970.In 2000thedosewasgivenas upto 500mg(if required).
BritishNational
Formulary
(London)1970,2000.

45
economical 161
to produce. Thisis an exampleof socialattitudes controlling
andexpectations

the useof drugswithina government framework.

prescriptive to imaginethat
It is impossible

treatment
thisvolume of painoperated Egypt.
onthesamelevelin ancient 162

todayis in the
At thechroniclevelof painthe highestuseof opiatesandnarcotics

Cancersarenotwelldocumented
treatmentof carcinomas. in Egyptandthereis goodcauseto

thattheywerenotwidespread
consider in geneticprofiles,livingconditions
dueto differences

anda shorterlifeexpectancy.
It is the shorterlife expectancy manyof these
thatprecludes

diseasesof middleandold age.

conditionswhichareessentially

Injurywasa problemin Egypt163bothat the militarylevelandthe inclustrial

level,

duringstoneworking.Thereappearslittleevidence
particularly thatanalgesics
wereusedat

weredealtwithandthe painseemsto havebeenrelievedby the actual

thislevel.Fractures

settingor immobilisation
of thelimb'64
or in thecaseof facial
fractures notreatment
received at

all. 165

166
of suchinjuries.
TheEdwinSmithpapyrusrecordsanddisplaysan understanding

Whilsttheirtreatment to
appeared be there
systematic is being
no recordof anyanalgesics

administered.

The understanding in ancientEgypton the useof

of any possiblesocialrestraints

is limited.Knowledge
analgesics be limitedby
mustby necessity
of the useof analgesics

reference in themedicalpapyri.Whether
to theirappearance thisis actuallyrepresentative
of

161Thevolumeof usageforsucha widerangeof alleged'psychosomatic' andthesubsequent

complaints social
consequences cannotbe overstated. See,M. C. Smith,A SocialHistoryof theMinorTranquilizers (NewYork,
1985). Rochepharmaceuticals finallydiscontinued productionof Valium inJanuary 2002.
162Themaindifference between themodels is in theircomplexity. Thesociologist Parsons proposed a 'sickrole'to
allowpeoplein modern, societyto temporally
stressful opt out to recoverandreintegrate. The'sickactor'is
excused workwithoutblameor stigma.Theuseof medicines servesto justifythisrolein, P. Bates,'Is the'sick
today?,ThePharmaceutical
role'stillrelevant Joumal269(2002), 246.
163Theexcavation intheareaofthefirstAswandamin 1907produced 6000bodies thatshowed a highincidence
offractures, totheforearm
particularly andcollar-bone - possiblya resultof from
blows F.
sticks. W. Jones, 'Some
lessons fromancient fractures'
BritishMedicalJournal (1908),
455-8.
164EI-Ansary, MiddleEastJournalOfAnaesthesiology 10,99-105.
165V.S.Femades andM.Andrade, 'Thetreatment of fracturesof the face',
Acta Medicine Portugal11, (1998),
119-126.
166Forexample: Sm4,6,7(skull),Sm12(nose),Sm35(clavicle) andSm36(humerus).

46
theirusecannevertrulybe known.However, of the medical
in viewof theeclecticcontents

papyrionemightexpecttofindanalgesics
in proportion
to theirneed.

for this thesisis to predictthe needfor analgesics

I feelthatthe bestapproach by

lookingat thetypeandincidence
of diseaseandtheimportance
of painas a symptom
within

that disease.The incidenceof diseasewill be consideredin Chapter4. On this basis,it is

demandmayemergewhichcanthenbe gaugedagainstthe actual

hopedthata quantitative

number If theneedof analgesics

of specificremedies. in thisway,thentheir
canbepredicted,

actualquantitative in the medicalpapyriishouldbe significant.

appearance

47
 CHAPTER3: EGYPTIANTERMINOLOGY

3.1WordsforPain

for 'pain'.Whilstthis might

In this sectionI proposeto dealwiththe Egyptianterminology

it is important
initiallyseempedantic to evaluate of someoftheseterms.
thewidersignificance

ListedbelowaresixwordS167
in Egyptian
thatareusedfor 'pain'.Thenumberis not

the rangeof meaningof 'pain'.168

surprisingconsidering
141'ft (Eb,H, Berlin,Kahun,London36, Ram111,
% IV,Ostr.Cairo.)
mr

mn'-"I'ft (Eb,Berlin,Ram111)

i,bw1r'3-11'ft (Eb37)

iffir §11:
ý, (Eb,Sm22,1)

whdw (seetextbelow)

Stt (seetextbelow)

mr (t ) is a wordthatcommonly both
appears insideand the
outside medical It
papyri. is a

generictermfor 'illness'andits useis extended

to mean'pain'.169It occursas bothverband

noun.Forexample,
in EIJ30
1: nut m cýt nb.t 'suffering/pain
in everylimb, P,,t nut a 'severe

disease', mrftp'headache?', (Eb258).

mrt'pains'(Ebl2,13,16,21),

Mn (t) similarly frequently

appears bothinthemedical
andothertexts.It canbebothverband

It
noun. is to mean'suffering'and'pain'.170For example,tnn.f lb (u)
generallyaccepted

(Kahun,5), nw.f Iýtnb.t'he suffersin all hislimbs/body',mnt m mwit'pain in

'toothache'

theOne (onudnating)',
(Eb267).

1671donotsuggest thatthislistis complete

butofferit asa starting Otherwordsexist,for
pointto thediscussion.
ý
example §n]in Eb252,369 (see,Grundriss V11:
856).Thewordnkm with is usedto meanboth'affliction' and
depending
'painful' oncontext, seeA.H.Gardiner, 'A NewLetterto theDead',JEA16(1930), 21.
168Fora modern comparison therearealsosixlistedin German, Cassell'sGerman & English
Dictionary
12tIEd.
(London, 1975),349.
169Hannig,344.
170Hannig,335,Grundriss V11:365.

48
 t is
Irillp. by Hannig Leiden',
'Schmerzen, 'pain, 171
trouble'. Faulkner
Mw given as givesIhw

as 'sufferer.
'172Thewordappears
most in
frequently the literary
texts it
where

to to but
appearsnot apply physicalpain moreto in
'trouble' the senseof Such
'deprivation'.

173In The
to Merikareit appearsas: Mw m mw 'shortof water'.
that in the Instructions

thewordis translated
of Khakheperre-Sonb
Complaints as 'futile',suchas:'it is
by Lichtheirn

174In the sametext tfýhdappearssomefour timesand is

futileto answerthe ignorant'.

of Ptahhotepit appears
translatedvaryinglyas 'painful,sufferandendure'.175In the Instructions

with a causative's' as sihw and is translatedby Lichtheimas 'deprived'such that, 'one

deprivedbecomesanopponent'.
176

1ý1 is takenin the medicaltexts

dPr'.: => thiswordgenerallymeans'bitteror bittemess'177but

to mean'pain'whenthe symptoms by
arecaused some'bitter For
source. in
example, the

caseof a patientsufferingfroma (tumour?

), d,ýrs m jwff 'it is bitter(pain)in his body',

(Eb868a).

In thecaseof a Anc(a 'stoppage'), in: S'ncn.fr-lb. -gmm.k sw Ar r

in thestomach

'bitter'(pain)fromthestoppage,
elt wrt thepatientexperiences (possibly
because
of gastric

of
reflux thestomach
causing
severe (Eb201).
heartburn),

However,thelasttwowordsfrom'thelistof six,' w, andsu, are moreimportant

_hdw
thansimplywordsfor pain,andtheyhavebeenthe sourceof somediscussion. Theyare

since
significant theyhavebeenproposed
as terms far
with wider in
implications thatthey

to
appearseminal theEgyptian
conceptof physiology the
and aetiology
of As
disease. I
such,

to dealwiththesein somedetailbelow.
it necessary
consider
171Hannig,10.
172 A Concise
Faulkner, Dictionaty
ofMiddleEgyptian,4.
173 Ancient
M.Lichtheim, EgyptianLiterature 1975),104.
Vol.L TheOldandMiddleKngdom(Berkeley,
174 Ancient
Lichtheim, EgyptianLiterature,
148.
175
Lichtheim,AncientEgyptianLiterature,149
176
Lichtheim,AncientEgyptianLiterature,
72
Biftersein',Hannig,985.
177

49
 3.2 whdwU'aViliýi

ndwis a wordthatappears
generally
onlyin the 178
papyri.
medical Its is
appearance

notfrequent
anditssignificance
musthavebeenunderstood
bythecontemporary
practitioners.

Sometermsandconditions
in the medicalpapyriaredefinedin moredetail,as footnotes
or

as a resultof later copyingor perhapsas an aid to teaching.

glosses,presumably

Unfortunately,
thereis nosuchglossfor whdw.It hassincebeenvariously
definedas 'pain'or

as a termto explainthe Egyptian

moresignificantly of disease.Nunn
viewof the aetiology
brieflydescribesthe problemsassociatedwith the understanding
of the term whdw. He

the differentviewson its meaningas lyingbetween'painmatteror

summarises
succinctly

179
'morbidprinciple'. thisto bewellputandwillusethetermmorbidprinciple
I consider whereI
discussiqhdwas a pathological
factor.

ndwis generally
accepted fromtheverbjiýbd'tosuffer.180
asoriginating It appears

in themedicalpapyrias: whdw, u,-bdwt(apparently

a feminine
form)and whdwy(?).181
1

includethelatterforcompleteness
because fromwhdwis
Nunnstatesthata personsuffering

referredto as a wbdwywithýy' added.Thisis presumably form.However,

a participle this

formis notgivenintheGrundriss,
norhaveI yetfoundthisin anyof themedicalpapyri.It does
however
appearas a singleentryin Admonitions
of an Egyptian (discussed
Sageby Gardiner

182Gardinergives tfýbdas bothverb:'to suffer,bearpatiently'andas a noun,'pain'.183

below).

Faulkner
givestfýbdas theverb'to be painful;suffer,endure;be patientwithsomeone'
whilst

bothivýhdwand 184
whdalare givenasthenoun'pain'.

Except,see3.2(iv)below,howeverstillin a medicalcontext.
178
Nunn,AncientEgyptianMedicine,61.
179
180Hannig,214.
181
Hanniggivesthewordas w_,bdy, 214.
A. H. Gardiner,TheAdmonitions
182 of an EgyptianSagefroma HieraticPapyrusin Leiden(Leipzig,1909),10,12
Gardiner,EgyptianGrammar,
183 562.
Faulkner,
184 A ConciseDictionary
of MiddleEgyptian,68.

50
 It is notwithoutsignificance fz
thatthepustuledeterminative is seenbothin
- . wbdand

bdw.
w, Gardiner this
attributes signto 'bodily kind'.
of a morbid
growthsor conditions For

it
example, is found
in:

R'ZZ,.
Psfaeces
ez
(Eb,H,RamIV),%%%(Eb,Bin,H,RamIV).
EEO FE; a

gftv'to swell'-. - '1ý3

(Eb871
c), -- "ý3(Eb561,767,
Sm)

ý! J,
dd)'fat' ý z (H,BIM62).

However,in the Old Kingdomit seemsto havebeenusedwithoutany morbid

It
connections.wasinstead
of the 'ý'
sign bothas ideogram It is seenin
anddeterminative.

lbw'Elephantine'and 185
Vw'be narrow'.

Themorbidprinciple bdwis basedon theideathat wbdwis notpain.It

theoryof tfý,,

throughthevesselsin thebody,the
painbutis actuallyan agentwhichspreads
mayproduce

mtw. The is
concept claimed
asbeing to
seminal later
Greek
ideas
on 186
medicine. Thetheory

of wbdwas a morbidprinciple
emanates of the bodyduringthe
fromthecloseobservation

mummification Thedutyof theembalmer

process. the bodyin an attemptto
wasto preserve

achieveimmortality.
It is not surprising wouldhavebeenawareof the
that the embalmers

immediacy
of theputrefaction Theywouldhavenoticedthatit was
duringpreservation.
process

vitalto quicklyremovetheintestinal from

contents thebodyin to
order prevent
rapiddecay
of

thecadaver.Intestinal
spillageandfaecalmatterwouldbecomeassociated
withputrefaction.

Thisideaisthentransposed
fromthedeadandextended to theliving.
eventually

185 Egyptian
Gardiner, Grammar,539.
186
Saunders, fromAncient
TheTransition Egyptian
to GreekMedicine,
20-33.

51
 Herodotus
tellsus thatthe Egyptians three
practised levelsof 187
embalming. Each

gearedto the incomeof the client,yet in eachlevelhe still emphasises

presumably the

importance the
of removal to the
of,andneed clean, intestinal They
cavity: takefirsta crooked

pieceof ironandwithit drawoutthebrainthrough

thenostrils they
next make
a cut andtake
... ...
outthewholecontents whichtheycleanse,washingit thoroughly
of the abdomen, withpalm

wine and again frequentlywith an infusionof powdered 188

aromatics.

Theremoval
of the intestines
wasvitalto the embalming both
process pathologically

and Steuer
cosmetically. that
suggests the embalmer
andthe both
physician the
performed

physicaldecayafterdeaththeotherpreventing
role:onepreventing
sameessential physical

bythewordsrwhmeaning
decayduringlife.Thishesaysis confirmed butalsoin
to 'embalm'

in general.However,
a medicalcontextto expresstreatment HannigandFaulknergivethe

as
wordsduýh 'to embalm'
and 189
'treat'. Certainly
srKb is well in
attested the to
papyri
medical

meantreatin the it
medicalsenseandpresumably couldbe to
extended meantreatin the

a bodyduringtheembalming
senseof preparing 190
process. SteuerstatesthattheEgyptians

sawbothprocesses of thecorpseat deathandpathological

as linked:thatis decomposition

decayof the livingbodyin disease.Both'as apparentidenticalmanifestations

of organic

destruction':

'Justas thephysician
couldby appropriate thedestructive
therapypostpone powerof

wbdwduringlife,so the by
embalmer itselfa therapeutic
mummification, procedure

althoughtranscendentally couldpreventphysicaldecayof the bodyafter

conceived,
death'.191

187
Lloydthinksthatthisis merelyan example of 'theorderlyGreekmindimposing a rigidsystemwherenone
appearedtohaveexisted',fromLloyd,HerodotusBook11,356.
188
Herodotus,
Histories 86.
11:
189
Hannig,788.AJso,Wb4:368.Giventhesimilarity of thewordsandtherarityof sdwbthelettermaybeanerror
byconfusion
caused in copyingfromthehieratic and
Hannig,
190 729.AJsoseeGrundriss V11:
775-8.
191
Steuer, Egyptian
Ancient andCnidian
Medicine, 4.

52
 Wewillseelaterthattherearedifficulties
withSteuer's However,
views. theycontinue

in thattheyproposean Egyptian'conceptof disease'

to be quoted.Theyarefundamental

to be Equally
whichequallycontinues cited. importantly,
wbdwas a pathological limits
factor

forpainfuldisease
thepotential the texts
within medical and so the
affects It
analysis.
overall is,

therefore,importantto reviewtheseviewsandalsothe proposedparallelsandlinkswithGreek

medicine.

thatis carriedbythevehicleof the

Steuerseeswhdwasa noxiousagent,something

faecesand, Whichhadthe potentialon absorptionof causinga greatvarietyof diseasemainly

'In theprodromal
supperative'. stagesof diseaseeveryattention wasdirected
of thephysician

of whdw togetherwith the faecesthroughthe use of purgatives

to the elimination and

192
enemas'.
IndeedHerodotus the
stresses importance
of the
purging body:

daysthey(theEgyptians)
'Everymonthforthreesuccessive fortheir
purgethemselves

health'ssake,withemetics, in
andcysters, thebelief
thatall disease from
comes the

foodthata maneats.193

This seemsto be supportedby the Eberspapyruswhereabouta quarterof all

areintended
remedies forthegastro-intestinal
system.

of the anatomicalsystemand its

The so called'VesselBook',a 'description'

to the variousconnecting
relationship ductsor mtw seemsto reinforcethe conceptof

194
Itappears
transmission. thattheheartandtheother(mentioned) to
thought
were
organs be
to themtw all unitingat theanus.Thisis important
connected because
sucha systemwould

192The connectionof ifýhdwwith the faeceshas even beenusedexplainthe presenceof a latrinein an Old
Kingdomtomb(2302)at Saqqara,not simplyfor defecationbut ratherto rid the bodyof tghdw,in Estes,The
MedicalSkillsof AncientEgypt,95.
193Herodotus,Histories11:77. Therectalrouteof drugadministration waspopular.ThepapyrusChesterBeattyVI
is solelyconcernedwithrectalconditions, seethe briefdiscussionin Lloyd,HerodotusBookl/, 331.However,his
implicationherethat the rectalroutewas recognisedas a meansof 'systemic'treatmentcannotbe correct.The
volumeof prescriptionsdealingwiththeanusratherreflectsthedegreeof sufferingin thatareaof thebody.
194To be calleda 'Book'is an overstatement, as it is little morethan a few collectedheadings,althoughit may
haveformedpart of a largertext. It is the only Egyptianequivalentwe have,albeitfar moreskimpy,to Grays
Anatomy.

53
not restrictthe flow of faecalmatterwithin the intestinal
tract but would allowfor the wider

195
spreadof wbdw. Thus, are
prescriptions found'to both
refresh' the heartandthe anusand

to expelfever(Pap.ChesterBeattyV1,13a).

'The Egyptianconceptthat mostinternaland infectiousdiseaseswererelatedto the

the in
of organicmatter
of corruptibility
observation this to
seems
manner havewonacceptance

in the medicineand biologicalscienceof classicalGreece'.'Whilstthe humoraldoctrine

in
expressed the Hippocratic
workOn the Natureof Mancouldbe saidto Greek
dominate

Galen
medicine, to
seems fusethe viewof humoral
theory
withthe Egyptian in
concept: De

'whoever
methodomedendi, to
attempts cure a fever must prevent 196
putrefaction'. The

conceptof disease in
originating the is
bowels alsoseenin Cnidian There
medicine. was

believedto be a normalstateof the faeces- koprosand its pathological

counterpart

197
peritoma.

betweenifýhdwandputrefaction
Whilsttheconnection via thefaeces
maybe logical

be in that
cautionmust applied suggesting this laterhadan influence
on Greektheories
of

disease.Certainly
contactandfamiliarity
between
the two but
culturesareundeniable'98 it is

to connectfirmEgyptian
impossible disease.AlsoI
beliefsto laterGreektheoriesregarding

thinkit shouldberemembered
thatto associate in the'normality'
anychanges of theprocess
of

is morefundamental
defecation'99 just
and cannot be claimedas an Egyptian
or Greek

There
concept. is an essential
andnormal
needto regularly body
expel that
substances are

if In
certainlyas unpleasant. manysocieties
perceived,notas noxious, any irregularity
simple

this suchasconstipation
with process, in
or a change appearance
of thefaecal has
stool, been

195
Yoyotte modifiesthetheory in thatwlidwin the faecesactuallylocalisesin theanus. It spreads from hereand
sofrequent bowelevacuation is necessaryto preventdisease.
J. Yoyotte, 'Une Th6oriebologique des M6decins
tgyptiens',
Kemi18(1968), 79-84.
196SteuerandSaunders, TheTransitionfromAncient EgyptianToGreekMedicine, 31-2.
197Steuer,AncientEgyptianandCnidian Medicine,21.
198C.A La'da,'Encounters withAncient Egypt:TheHellenisticGreekExperience', in R.Mathews andC.Roemer
), Ancient
(eds. PerspectivesonEgypt(London, 2003),71-94.
199Regular defecationis alsoquitesimplypartof a patternof regularhygiene. Thepresence of latrinesand
bathrooms homes
in Egyptian werevitalaspartof theprocess of secularpurification.This involved
purification all
aspects shaving,
ofcleanliness: bathing,
washing offeet,depilationetc.Blackman, (Egyptan)',
'Purification 4-8.

54
viewedasabnormal
andso associated irrespective
withillness.Thisis a validassociation of a

society.Forexample,
particular in eighteenth England
andnineteenth-century theexamination

of faecesandurineforanychanges
in colouror consistency withphysiological
wasassociated

changesthat werenot themselves 200Remedies

understood. for laxativesand
abounded
Indeedtheword'physic'wassynonymous
aperients. 201TheGreeks
withtheword'laxative'.

alsousedlaxatives,
butnotto ridthebodyof putrefaction.
Ratherit appears
thattheirusewas

intendedto addressthe 'imbalances

specifically of forces'withinthe body.202

However,we will see laterthatfaecalmatterwasactuallyusedby the Egyptiansas a

ingredient.
prescription Thisapparent
paradoxto whdwas a diseasetransmission
agentis

fullydiscussed
in theAppendix.

SteueralsostatesthattheancientEgyptian viewedthepassage
physician of w-hdwas

intrinsic
to theageingprocess
itself.Thepassage themtwwhenactingupon
of wbdwthrough

the bloodunderwent intopus(ryt ).203It is actuallythisassertion

transformation thatSteuer

usesasthebasisto connect
Egyptian
andGreekthought.(I consider forthis
thathisevidence

isflawedandwilldiscussthislater.
) Hesuggests to becausedbythe
thatoldagewasbelieved

inevitable of wbdwleadingthento the physicaldestruction

absorption of the body.In facta

similarparallelis foundin Hippocratic wherethe humours

literature mixwiththe bloodin old

age.204Even
if it is accepted
thatEgyptian
theoryinfluenced
Greekit is important
to realisethat

thereis noevidence
thattheEgyptians aboutthehumancondition
wereascircumspect asthe

Greeks.It is unlikelythatthe Egyptians

tooksucha philosophical to painandit is
approach

probableto assumethat they simplyregardedit as connectedwith diseaseand, thus,

200
Inthesamesense, onecouldclaima linkbetween ancientEgyptandthenineteenthcenturyEnglish model.
201Thewordis recorded from1589,OxfordShorterEnglishDictionary, 1575Thefortunesof manyexisting
companies
pharmaceutical originateintheproductionof laxatives
fromthisperiod.
z
Cralk,inWilkins
202 etal (eds. ), FoodinAntiquity,
348.
203
Steuer andSaunders, Ancient Egyptian
andCnidian Medicine, 31.
204De Morb.,1,24. It is merelya pgrallel.Thedifference theoryregardsthe humours
is thatHippocratic as
It is theirimbalance
occurring.
naturally thatis problematic.
ndwis nevera natural substancethatis in balance.
alsoseesoldageas an imbalance.
Aristotle Thesourceof lifeis lostwhenthesourceof heat,withwhichit is
boundupisnolongertempered bycooling,
4is consumed byftself- OnYouth,OldAge479a,8-10.

55
 that be
something should in
treated itself.
For blood
example, letting
was in
practised Europe

the
until earlynineteenth it
Whilst
century. was beneficial
believed thelogic it
behind waspoorly

by
understood its 205
practitioners.

I believethatSteueris possiblyrightin associating

However, of the
the experiences

the
with process
embalmer of bodily But,
decay. thebelief
that the
whdwwas to
agent
specific

aid this I
transmission is
believe This
uncertain. is in part by
supported a recentreviewof

tfýhdwby Koltaand Whilst

Tessenow. theytakethe viewthatit is a factor
pathological they

dismissits connectionwith faeces. This is becausethere is 'no connectionor parallel

(as be
appearance should expected) faeces
between andwbdwinthemedical 206
texts'.

of ubdwwithpainandthepathological
Alsothecloseconnection wouldseem
process

thisviewmightbe one
to makeit too widea termfor a specificmedicalcontext.However,

is
which by
conditioned themodern
viewof science
withexact
and terminologies.
specific

in respectof whdw is not entirelyclear.They

Theexactpositionof the Grundfiss

207
dw as 'Schmerzstoffe.
translatetfýb, morethanmere
Sowhilsttheyallowthatit is something

paintheir
viewdoesnotnecessarily to
subscribe theideathat whdwisintrinsic
to theaetiology

Whilstthismightbe'fencesitting'it maybetheonlyandmostsensible
of thediseaseprocess.

to takeinviewof actualevidence.
position
it is necessary
In orderto evaluateifýhdwas a termof morbidprincipleI consider to

eachin turn.Essentially,
dividethetheoryintotwopartsandthenconsider thetwoaspectsof

thetheoryarefirstly,oneof observed
putrefaction from
resulting intestinal
disturbed contents

the
andsecondly, belief
that from
a specificagentevolved that then
which
situation travelled
to

otherpartsof thebodywithpathological
consequences.

205As late as 1840a prominentmemberof the RoyalCollegeof Physiciansstronglyadvocatedblood-letting for

theprevention andcureof disease.Itseffectsareso strikingandimmediateit is hardlypossibleto over-estimate
...
if. Despitethispraisehe admitsthatthereasonsfor its effectsarevaguebutsuggests(aswellhe mightin an age
of mechanical achievement)thatit is connectedwiththe mechanicalactionof the bloodon the bloodvessels.M.
Clutterbuck, OntheProperAdministration of Blood-letting
andthe Cureof Disease(London, 1840).
206 KoltaandTessenow, ZAS127,38-52.TheEnglishhereis mytranslation.
207Grundriss VII:207.

56
 In respectof the first situation,it seemsperfectlylogicalandquitelikelythat the

of therapiddecayof thebodywasassociated
observation spillageandwiththe
withintestinal

natureof
unpleasant theintestinal However,
contents. the
whilst Egyptians
mayhavebelieved

thatsomeagentwasinvolved
in theinternaltransmission
of it
disease, doesnotfollowthatany

beliefwaseitherpromulgated
or usedas the basisfor medical In
treatment. to
words,
other

by Steuerit is necessary
fully acceptthe theorypostulated to acceptthatthis agentwas

andgivena name.
specified
actually
Equally,
thetheoryis convenient andGreekthought.It fitsboth
in thatit joinsEgyptian

andin termsof thelatter'spraisefor theformerssupposed

chronologically medicalprowess.

ButI believea passivebeliefis stillpossiblewithoutspecifyingwbdwas a morbidprinciple.

of the term wbdw andwhetherit was

The theory,therefore,hingesaroundthe interpretation

wehaveis theinterpretation
Theproblem
to bea namedmorbidprinciple.
believed of thisterm

the
within medicalpapyriandto decide to it or as
whether accept asa morbidprinciple 208
pain.

If wbdwis a termfora morbidprinciple

thenit is somewhat it alsoto mean
difficultto reconcile

to meanboth.Thewordsnm andmr are

unlessthetermcanbeextended
painor suffering,

in termsof thelatterbeinga degree

bothusedfor'illness'and'pain'butthiscanbeexplained

or a conditionof the former.To this extentit is a questionof extendingthe definition

It is difficultto envisagew-hdwin the sameterms,withoutconfusion,

semantically. where

wbdw is both a term with fundamental

pathological and a symptomof
significance

pain. Equally,
'straightforward' humanfaeceswereactuallyusedas prescription It
ingredients.

seemsdifficultto reconcile
thisfactif whdwwasa pathological
factor.Theuseof excrement

papydis discussed
withinthemedical laterin theAppendix.

208 of wbdwbeinga specific

Thepossibility symptom (pain)is dismissed byKoltaandTessenow. Thisis because
theyseetheconnectionof w, withotherwordsin certainphrases as to thatpossibility
incongruous e.g. s§n
-bdw
(pain?). I disagree
wbdw a pool
of wbdw withtheirconclusion in thisrespect, astheydiscussand
particularly
admitthemetaphorical
significance of (medical)
termsin theliterarytexts,ZAS127,39.

57
 Inmyattempt
to re-assess I
tvýhdw foundit that
apparent all the developments
later or

to itssignificance
furtherattributes originaldeliberations.
derivedfromSteuer's
arethemselves

1,therefore, it is necessary
consider thatSteuerputsforward.
to lookin detailat theevidence

Themorbidprincipletheoryof whdw is essentially

dependent
on the of
movement faecal

matter(withwbdu) aroundthebody,suchthatanyblockage
willleadto problems.
Heclaims

thatBerlin154illustrates
thisandso is seminalto thetheory.Plate3.2(i) givesthecomplete

intoEnglishaspresented
translation below.Following
by Steuerandthisis thendiscussed the

discussionon Steuer'sproposalsI will offer other examplesof the appearanceof ivýhdw.

ThesearetakenfromtheLeidenPapyrus,
Admonitions
of an Egyptian
Sageandthemedical

texts.

58
 PLATE3.2 (i)

BERLINPAPYRUS154(XIII,3-7)

TheEnglish is fromSteuer209
Translation

Another(prescription) fever,(1)
againsta pool(of wbdl+)generating
his(thepatient's)
bodyis heavy,hisr?lb (cardia? ) is sick,
Pylorus?
hisheartis hot,it pulsates;
hiscoversareheavyonhim,
hecannotstandmanycovers;
hesufferthirstatnight
andhetastes(feels)hisheartoppressed
like(thatoo a manwhohaseatenfruitsof thesycamore
(?) tree;
hisfleshis weaklike(thatooa manwhomtheroadhasfound.
If hecrouches
in orderto evacuate
(then)hisintestines
areunderpressure
(but)heis notgettingalongwiththeevacuation.
Thoushouldst saytohim(i.e.concerningsucha case);(2)
Thisis onewhois undera poolof wb-dwin hisbody;
hetastes(feels)hisheart,,
heis sick(and)I shallact(onhisbehalo.
Shouldit arisein himandbecome (3)
anocclusion
youwillhavetoapply(tohim)
remediesagainstwhdw,together to
withremedies
destroytqhdw.

209 Ancient
Steuer, Egyptian
andCnidian
Medicine,
37-8.

59
 is headed:
Theprescription

(1) kt SS'Mbaw

againsta poolof (vtýhdw

Thisis'translatedby Steuer:'as another(prescription)

fever.
generating However,
the is from
wordwhdw absent thisline.The of
assumption the

of is
presence whdwhere from
drawn (2)later:
dd! n.krYbrySS'ifýhdwmPtf, 'thenyouwill

say(concerning
it),thisis is it
onewho undera poolof wbdwshould arisein hisbody'.

whichdemonstrates
Berlin154is givenas theexample tKbdwas a morbidprinciple.
the 'rising'of whdw which causesa blockagethat subsequently
One whichdemonstrates

needsto be The
treated. 'risingof a pool' of wbdw (s§ n ivýhdu)is indicatedby Steueras

'beingthegeneralcauseof fever- thisbeingtheearliestexample

of sucha causalassociation

andfeverin thehistoryof medicine'.

of putrefaction 210

At (1)thewords§ 1`ý,is translated

as 'pool'andSteuerseesthisas an additional

reinforcement
metaphorical Hecompares
of hisargument. thesimilarity poolsand
of stagnant

theirdisagreeable
natureandodourwiththestagnation 211
of faecalmatter. TheGrundriss
give

thetranslation
of ss'as (German
'Nest' andEnglish)
whichaccords
withGardiner
andFaulkner
r-=-

ýý
whogivess§,! as'bird than
pool'ornest' rather asa 'pool'u 1.212
Thesymbol
s§ ýý at (1)

birds to r-.
-,1.
clearlyshows asopposed ss' 3m

Thewordss' ýý appearsin theLeidenmagicalpapyrus(6R6)whereit is suggested

to referto the'takingoverof thebodybya demon;thedemonthoughtto havemadeits 'nest'

in thepatient's body.213

210 Ancient
Steuer, EgyptianandCnidian Medicine,
51.Thisis hisconclusion buta
butit isdifficultto seeanything
slimmetaphoricallink.A betterpossible
linkbetweenEgyptianandGreekmedicine intermsofthecauseof 'fever'
mightbe theviewof opposites. TheEgyptians sawtheworldin termsof opposites andthe balanceof those
forces.Thisviewis alsoseenin Pythagorean medicinewhere'Opposition'hadmedicalapplication. Thisis
demonstratedby Plutarch in thatwhilstfevercomesaboutfroma surfeitor deficiency of nutriment,thecauseof
thiswasstillan imbalance between theheatandcoldin the body- Plutarch, Onthe Scientific Beliefsof the
991A.
Philosophers,
Steuer,Bulletinof theHistoryof Medicine10,16.Steuer,AncientEgyptianandCnidianMedicine,39.
211
Hanniggivesint al both'nesfand'swamp','Nest,Sumpf,761.
212
VII:778,9.
213Grundriss

60
 I wouldsuggest wouldfit in withssas nestand
a betterwordmightbe 'cluster'which

withtheideaof 'pool'asin 'pooling'or a 'conglomeration'.

alsoaccords

h3btlw

i
rill ý If
**,il
144
failsto translatethisterm,the Grundfiss
Wreszinski (fOr)ein
gives:'Einanderes(Heilmittel)

NestdesUmherziehens
(b!jb vonaw- Hitze,whichNunntranslates
as 'another for)
(remedy

of heat.214Thistranslation
a nestof wandering andthedirecttranslation
is mostenigmatic

from Germanto Englishis not helpful.I would suggestthat the absenceof an acceptable

forthislinehasmerelyaddedto the'enigma'
translation of wbdw.

TheGrundfiss
failsto lookat thesymptoms
of thepatient.Thesymptoms by
exhibited

includes
thepatientcertainly oneof 'heat';his'bodyis heavy,hisheartis hot,hiscoversare

by a high
heavyon him'.The patientseemsclearlyto be in somedistressoccasioned

'Fever'seemsto fit the symptoms:

temperature. thirst,quickening and
pulse,constipation

frombedclothes.
discomfort this line as 'fever'.I see no
215Steueris correctin considering

as 'fever'.Thecautious
reasonwhy'heat'shouldnotbeconstrued conservative
andsomewhat

approachof the Grundfissof sw as heat is reallybecauseof their commitment

to the

of W as'Umherziehens'
rendering (seelaterat3.3,in respectof stt).

SteuerhasIvb (1)as 'send'whichis problematic.

hib hereis shownwiththeplough

symbd'ý (alsoat H69)whichis morein linewithFaulknersrendering

of 'tread'ratherthan

216
'send'. In H69,H70it appears
asb3bandis translated undertheheading
in theGrundfiss

'Umherziehen'
- 'wanderings'
(noun).
217The interpretation
Grundriss of (1) depends
on Mb

beinga nounin directgenitivewith aw, andin H70we actuallysee Wband aw in indirect

genitivalform: dr Mb n aw. The Grundrisswouldhavethis as 'the drivingout of the

214 VIA04,Nunn,Ancient
Grundtiss EgyptianMedicine, 85
215
Theconditionin Bln154isdescribedintheGrundfiss asa 'blockage
ofthestomach, bymovements
occasioned
I wouldsuggest
ofdiscomforf. thatperitonitis
is a condition
whichmightfit inwellwiththesesymptoms.
216Faulkner,A ConciseDictionafyof MiddleEgyptian,157.
211GnindrissV11:
563.

61
 of
wanderings 218
heat'. This to Ub
seems support as a nounformandthrows
moredoubt
on

In factthe onlyexampleof the word'send'usedin the medicalpapyri

Steuer'srendering.

seemsto bein a spellintheLondonPapyrus

(Lond4).

In verbformA?b appearsin EIJ767

and Cairo,
Ostr. in both the
examples Grundriss

seem to concurwith Faulknerand give the translationas 219

'tread'.

In Eb767it appearsas ft (in sdm.f form)in whichcontextthe Grundfiss

giveas:

dasin das Ohrendringt- thatwhichtreads(pierces*)the ear.(Thisis possiblyinflammation,

or

an inner
ear infection),
*my in
translation brackets.
In Cairo (ODM
Ostracon it
1062) appears

as:vonKrankheit,
die dieAuge (of
betriff anillness, (pierces*)
treads
which the 220
eye).

I wouldsuggestthatin thesecasesA?b is meantin a moreforcefulsensethanthe

word 'tread'conveys.Particularly with ear disorders

as the main symptomsassociated

221
areof acute,sharppain.
generally I
Therefore, that
wouldsuggest the word is
'pierce' a

translation.
moreappropriate

(1) is shaky.Ignoringthe presumed

OverallI thinkSteuer'stranslation omissionof

hdw
w, his depends
translation on Yb being form
a participle of the verbto 'send'of which

thereappears
noothermedical
example, text.Hisassumption
butone,in a magicalmedical of

s§as metaphorical
evidence
of whdwis too The
convenient. Grundriss
translation
of kt ss'n
(remedy)
Mb uw. 'Another fora nestof wandering
of heat'(Grundriss)
is non-committal,
which

for
commendable
although its cautionmaysupporta spurious Inthat,froma 'nest'or
analysis.

thespillageandsubsequent
anaccumulation of wbdwmayjustbeimplied.
'wandering'

TheGrunddss maybe technically

translation to describe
correctbutis too restrained

It is (1) a headingto the prescription

the symptoms. andas suchit shouldbe expectedto

the
encapsulate body I thinkthe word'nest'shouldbe a poolor 'cluster'of
of symptoms.

218GrundrissIV:1144.
VA06,Faulkner,A ConciseDictionaryof MiddleEgyptian,157.
219Grundriss
220GrundfissIV:60.
221Murtagh,GeneralPractice,463-5.

62
 (whichin factarelaterdescribed).
symptoms, Theword'heat',I seenoreasonwhythisshould

not be fever,thus'wandering' couldconveythe riseandfall associated

(if appropriate) with

feveror thespasms
of painasanaccompanying Also,if h;b is takento meantread,
symptom.

anditsmeaning to'pierce'(Eb767),
extended thena betterEnglish mightbe:
translation

kt s§n Mb aw

(remedy
'another a clusterof thespasms(of)fever.
against)

(2) ddin. kr. fhrXsgn whdwmhtf

Steuergivesthislineas:'thenyoushouldsayto him(concerning
it) thisis onewhois

undera poolof whdwin hisbody'.Herewecerl:

ainlyhavess'n wbdwwhichwasimpliedby

Steuerat (1)TheGrundriss
hasthislineas: thenyouwillsayto him(concerning
it)thisis one

whois undera nestof 'Schmerzstoffe'

in hisbody'.222

The Grundfissuses 'Schmerzstoffe'

for the translationof wpdw. WhilstSteuer

describes
wbdwbutdoesnotprovide
anEnglish theGrundriss
translation, theterm
translates

but vaguelyenoughto allowfor the possibilityof wider connotations.

In manyways

is a goodword.It is non-committal
Schmerzstoffe andit allowsfor a middlepositionbetween

dw
wb, as either
morbid
principle
or 'Schmerzstoffe'
pain. is difficult
to put into English
direct

'painmatteror'painsubstance'.
otherthanperhaps Inthissenseit is betterforit allowsforthe

butdoesnotnecessarily
theoryof whdwasa morbidprinciple, accepttheideaof tKhdwasa

transmitter It merelyallowsfortheconnection
substance. or association.

Steuer
seesSS'asimportant
in s§n wbdwandindicative of
of a poolor collection
However,
ifýbdw. I as 'painor suffering'
seeno reasonwhy %ýbdw not
should be appropriate

in thisline.Thelinecomesaftera longlistof specificsymptoms.

it wouldbe logicalfor ss'n

222GrundrissIV:104.

63
 hdw
w, to generically that
encapsulate list, suchthat:'thenyouwill say him
concerning he is

froma nesUcollection
suffering '
in hisbody.
of pain/sufferings

Alsohisrendition
of r.f to 'to
mean him'is highly It
irregular. for
allows theaddition
of

thewords'concerning
if andsoimpliesanunintended
degreeof gravitas
tothecondition.

ir ts.n. f im. fhpr n (fl m gn

'Shouldit arisein himandbecome

anocclusion.
irbr. kr. fspwnw ný,
bdw...

Pncspwnwsdt tvýhdwmbt.f

Thisline(3) is important.
Steuertranslates
andgivesthis as an exampleof whdw

risingin the bodyto become at a point,therebycausingillness,withthesubsequent

occluded

needto driveit out.Thispassage,

at firstsightis quiteconvincing in respectof the
particularly

factthatit is necessary
to both'apply'spw'remedies'
againstuýbdwandto 'breakup' sdt;

thatyoumustfirsttreattheimmediate
suggesting andthendriveit outto complete
symptoms

the cure.Thus,to substitute in that'a

the word'pain'for wbdwwouldseemto repetitive,

remedyagainstpainanddrivingout pain. ButSteuer,in histranslation

intoEnglish,ignores

the fact thatthe verb ts is actuallyin the sLd-m.

n.f formandso in the pasttense,an unfulfilled

It shouldstrictlybetranslated
condition. as'if it hadarisenin himandbecome
occluded'.

However,
the word ts (u) Steuertranslates
needsmoreattention. this as

'rising'in thesenseof upwardmovement.

It is certainlybasedupontheverbts to 'raiselift',

I.
withthe determinative However,
hereit appearswiththe determinative
-'I suggestive
of

motion.Hanniggivesvariousmeanings
for the verb ts! withdeterminative
including'rising,

liftingup'whichimplies'raise'in thesenseof erectratherthanmovement.

223In thissenseits

is extended
meaning to mean'stiffor stiffness'As a nounit appears
in Sm3theGrundriss
so

223Hannig,
962.

64
thatfor ts foundin Sm3the Grundfiss the
gives word'stifFin 'stiffneck.As a nountsw it is

giveas:'erleidetan
seenin Sm3in thephrase,mn-f-tswn ntbt. f ThisphrasetheGrundriss

Versteifung
an seinemNacken',
('he is from
suffering in
'stiffness' his 224
neck) in
However,

Eb262itsmeaning different
appears andseemsmoresimilarto its
in thatit cannotbe'stiffness'

use at (3) as 'rising',kt nt rd.t wgsshrd tsw n mwit m MY, 'anotherto causea childto

(one
urinate from)
suffering theaccumulation
of urinein the This
body'. has
example tsw in a

formof 'rising'as 'accumulation

participle to aid
Thisis clearlya prescription
or massing'.
It is thatthe urineis notvoided,it risesor accumulates.
micturition. an observation

Sm3and Eb262are usefulin that seemto offeran explanation

betweenthe two

contradictory
apparently meanings
of ts (w) - 'stiffness
andaccumulation'. Eb262
Whilst is

obviously connectedwithurine,whichif notvoidedsuccessfully InSm3 (w)

willaccumulate.
-ts
is a 'rising'whichbecomes(perceived (of discomfort)
as) an accumulation to a pointthat

becomes
erect,stiff.Thiswouldaccordwithall meanings
of ts (w) as 'stiffness,
accumulation

andto beerect'.TheformthatSteuersuggests
as a 'rising'certainly
impliesaccumulation
and

I seenoreasonwhy'pain'could
(1). However,
wouldseemto accordwiththerisingof týýbdw

for wbdw. If whdw is takenas 'pain',thenin termsof 'accumulation'

not be substituted it

as:'If it shouldaccumulate
mightberendered in him(i.e. thelocalisation
of pain)andbecome
a

Thisaccords
blockage'. wellwiththepossibility
of thiscondition fever,spasmodic
asperitonitis:

painandsuddenlocalisation asa blockage.

perceived

224Grundfiss
IV:173.

65
3.2(ii)TheVesselBook(Eb854/6,
Bin163)

throughthemtw
reliesonitstransmission
Thetheoryof whdwasa 'morbidprinciple'

ofthebody,soit is necessary
thevessels to givethissomeconsideration.

BothClement
of Alexandria
andManetho to
allude theEgyptians somesix
possessing

booksconcernedwith medicalmattersone of whichwas concernedwith the anatomyof the

corpusof knowledge.
humanbody.Nobookis knownto havesurvivedwithinthissupposed

However, tantalising
whether or distracting,
partsof the Berlinand Ebers do
Papyri indeed

descriptions
contain which have
might beenfragments
of sucha book.
As such 854/856
Ebers

and 163
Berlin havebeen to
referred as 'TheVessel 225
Book'.

Thetermmt 226is obviously has

a wideoneandprobably nosingle English
direct

the
although
equivalent; word'vessel'
wouldseemappropdate as
enough, it is equallya

term
generic
somewhat in English.
It in
appears Egyptian
to include
muscles, blood
tendons,

and
vessels other long,
various thinducts
of thebody.

TheVesselBookessentially the
assigns of
number mtwto a part
specific of thebody

andmayalsodefine
thefunction the
or contents
of the It nt at it is
mtw. is interesting
relative

oftenspecificasto whatis transported

bytherelevantmtw.- blood,air,mucous,
semen,water

'to hisrightearthebreathof lifeenters'

andair,breathof lifeandbreathof death.Forexample,

Bin163g).
(2mtw)...'to hisleftearthebreathof deathenters'(2 mto, (Eb854f/856g,

betweenthe texts.Bln163b
As to the actualnumberof mtw thereis a difference

227All are saidto cometo the heart,'they

whereasEb856liststwelve.
recordstwenty-two,

to hisnoseandall uniteat hisanus'(Eb163h).

distribute Eb854listssomefifty-two
However,

mtw allof which

seemto represent
a systemof distribution
independent
of Eb856
andBin163.

Also,it is notclearin Eb854thatall the mtw connectto theheartandunitearoundtheanus.

225
Nunn,AncientEgyptianMedicine,44.
226
Hannig, 373.
'Hohlgefflss',
227 it maybethatthelatteris a scribalerrorfortheformer.
Adthough

66
 thatEb854mayin fact represent
Nunnhassuggested an independent
view; it
although, is

difficultto imagine
diversity have
onwhatshould beenaccepted 228
fundamentals.

Theanatomical laid
scheme outat is
Eb163h includes
onewhich themain It
organs. is

that be to be Egyptian
a scheme might predicted partof anoverall One
system.
anatomical in

whichallthe'main' are
organs i.
listed, e. those by
perceived theEgyptians
as important:
being

andthe anusis
to receivelife;the heartis the seatof the emotions
Thenoseis important

to
necessary expelall noxious However,
matter. whilstthereis somelogicin partsof the

hadnoclearconceptof thecirculatory
clearthattheEgyptians
VesselBook,it is immediately

Equally,
system. this that
means theycouldhave concept
nooverall of human For
physiology.

those
example, mtw that to to the
seem appropriate arteries
werethought
notto blood
contain

but to containair.229Also, it is difficult to imaginethat with all the practicalanatomical

knowledge processthattheycouldbelievethatall the mtw

throughtheembalming
obtained

couldleadto theheart
andyetstillunitein the One
anus. for
explanation this be
might dueto

the dual of
with possible meaning
confusion the wordpbWylt 230
bothas 'anus'
and 'end'.

Thereis insufficient to
evidence investigate
thisfurther,
butthe be
should
uncertainty notedas

Steuer'stransmission is
of wbdw partlydependent
on the of
relationship the mtw to the

231
anus.
TheEgyptian knowledge
lackof anatomical in thatfromthetwenty-
is furtherillustrated

destinations
sevenalleged of the fifty (thirteen)
mtw, nearly percent of contents
or functions

Thoseareasof the bodywherethe functionsarespecifiedarethosethat

are notspecified.

(duringembalming)
wouldbevisuallyapparent andbladderthey
e.g. in thecaseof thetesticles

228 Egyptian
Nunn,Ancient Medicine,
48.
229
Thisis possiblybecauseafterdeaththeyappearto deflateandarevoidedof blood.
Hannig,288.
230
231Thewordapparently changedspellingto include
aT fromthelate19thDynasty. in Blnl63aspPWY
It appears
andin Eb856cas ppww. Thesituationis furtherconfused in thatWalkerconsiders bothmaybe different
anatomical terms.Theformerequates to thatgeneralregionofthebodyi.e.thepelvicareagenerally, the
whereas
a 'ratherspecialised
latteris specifically termdesignating withwhichonlypersonshaving
an internalstructure
specialknowledge wouldknow,(or usedfor rectum)'. Walker,Studiesin AncientEgyptianAnatomical Terms
,
227,223-4.

67
 Herethemtw wouldseemto
wererightlysaidto containor passsemenor urinerespectively.

to thetwospermatic
correspond cordsandtheureters.

The lackof a statedfunction/destination

for the othermtw mightsuggestsome

intellectual However,
reserve. is
a magicalelement seenin the the
conceptof ears(andless

obviouslyexplainedfor the shoulders)wherethe breathof life is said to enterthe (ight side

(ear/shoulder)
andthe breathof deathto enterthe left. Thisright/leftaspectmayhavea

withtheEgyptian
parallel concept 232
of opposites.

Eb856a

beginswiththefollowing
Thisprescription prefaceor heading. is nodoubt
Itspresence

intendedto aid its efficacythroughthe gravitasof its divineimplication.

Anfangvon

demBuchdes Umherziehens
der Schmerzstoffe desMannes,
in allenKörperstellen

alsetwas,dasgefunden unterdenFüssen(einerStatue)desAnubisin
istin Schriften

Letopolis:zur Majestätdes Königsvon Ober-und Unterägypten

Usaphals,dem

Gerechfertigten, 233
wurdeesgebracht.

Beginning
of theBookof Wanderings in
of iKbdw all thelimbsof a manas wasfound

in writingsunderthetwofeetof Anubisin Letopolis,

underthemajestyof theKingof
UpperandLowerEgyptetc.,(mytranslation
fromtheGrundfiss).

In respectof theaboveSteuerstates,'it is notwithoutsignificance

thatthetreatiseon

found
allegedly
tKhdwwas the
under feetof Anubis; andthe
a godwithmedicalassociations

232Therearemanyexamples. E.g. deities:HorusandSeth(goodandevil),ShuandTefnut(dryandwet),J. G.

TheConflict
Griffiths, of HonisandSeth(Liverpool, 1960),1-22.'Cosmic andthebattleforequilibrium',
entities in
D.MeeksandC.Favard-Meeks, DailyLifeof theGods(London, 1997),19-23.
233
Grundfiss
IV

68
godof 234However
mummification'. Eb856a
whilst could be
hardly described
as a '
'treatise,the

heading, atfirstsight,doesseemsignificant.
nevertheless

appearsin the Grundriss

the vagueword 'wanderings'
As in Bln163previously,

Thistimefromthephrase:hbbb i+ý,
translation. bdw Heretheword

bbbb originatesfromthe verb hb 'to tread,to travel'235

with bbbb as the compoundversion

'traverse'
- in thesense
of 'tread/tread'.

Faulkner
Incontrast, to EMMA) givesa different
(inreference of theword
translation

bb,hb (withthe stickdeterminativei)as, 'to driveout (pain)'.236Thusif Faulkneris correctin

,
of thisword,Eb856wouldbe a prefaceto the bookfor 'thedrivingout of
his interpretation

(pain)
ifýbdw in allthelimbs
of a man'.

of whdw: fir das

for the 'destruction'
In Ebl03 at 25,8-11we seea prescription

(tqbdu)in BauchunddasMen derWurzeldes

Men derSchmerzstoffe 1237Herethe
.....
Theuseof thisphrasemakesit morelikely
(death)of wbdwis clearlyindicated.
'destruction'

for tfýh_dw Thisis because

to be painratherthana morbidprinciple. whenactingas a morbid

physically
agenttiýbdw in
accumulates thebody.
It subsequently to
needs be 'ledoff fromthe

paincouldbestopped
body.Incontrast (killed)in situ.

TheGrundriss
givesbothwordsIVbandbbbbas 'Umherziehen' translated
generally

Similarly,
intoEnglishas'wanderings'. aswithBerlin154, hasthedanger
theword'wanderings'

of implying
something
more
esoteric
whenperhaps
a more translation
prosaic be
might better.

In the contextof Eb563the Grundrisstranslatesthe word bbbb as 'betreten,

(pierce,
endfingen' 238
tread). The word hbhb is also listedin the Grundriss
glossaryas

234Steuer,AncientEgyptianandCnidianMedicine,4.
490.
235Hannig,
A ConciseDictionary
236Faulkner, of MiddleEgyptian,158
237Westendorf,564.
238GrundrissIV:235

69
'Durchziehen'
- 'to
specifically crossor pull 239
through'. I see no reasonwhy the latter

couldnot similarlybe appliedto E856a.Theuseof the stickdeterminativei

interpretation

a
suggests morevigorous
actionthan is
'wandering' beingimplied.Thusthereis a 'pulling

through'or fromwbdw.ThiswouldalsoagreewithFaulkner's
a release to'driveout'.

As suchit is possibleto havea'book'whichis concernedwiththe 'expulsion'of w-bdw

notthe'wanderings'of
wbdw.In thiscase pain
iiýbdwas seems
quiteappropriate
-'a bookto

onefrompain/suffering'.
release or heading.
I thinkthisis morelikelysinceE856ais a preface

Onlyoncedoes wbdw appearin E856and in this preface.It maythen representa generic

a
panacea, 'universal
cureall', by
endorsed Anubis the
andunder reignof a mentioned I
king.

seenoparticular to reinforcetiýhdwasa morbidprinciple.

connection

3.2(Iii)TheLeidenPapyrus
1,348- Spell13240

Themagicaltextsof theLeidenPapyrus spells.Theseareeither

consistof thirty-nine

incantations with cursoryphysicalremediesfor various

of incantations
or a combination

Theword tvbdwappearsin Spell13 (butnowhereelse).Spell13 is

medicalcomplaints.

demonintothe body.Theremedyfor whichis

intendedto preventthe entryof a malicious

recitedovera 'figureof Redrawnin fish bloodon a pieceof king'slinen'.Thespellis in a

commonformatwhichincludesan addressto the demonlistingall its evil intentions

to the

Thedemondesiresto forciblyenterthe personthroughthe head,'youaresaying

individual.

thatyouwillstrikewoundsin thishisheadof hisin orderto forceyourentryintothisbrowof

his,to smashin thesetemplesof his',(R6,5-7).

241Oncehavinggainedentryto thebodythe

demonintendsto unleash listof evil.242

a comprehensive Thespellwillhopefully
counterthese.

239Also the Grundrissgivespýr as 'twist,turn' and umherziehen (in respectof stt ) also as
and bt and LpLht
umherziehen, GrundrissVI 1:283,574,673.
240 aretakenfromJ. F.Borghouts,
Thetranslations TheMagicalTextsofthePapyrusLeiden(Leiden,
1971).
241 TheMagical
Borghouts, TextsofthePapyrus Leiden,21.
242Inthispassagethelistof afflictions in thesecondpersonsingular
aresuffixed V, suchthattheyaredemon's
whichwillbetransferred
afflictions tothevictim.

70
 'Backwards
enemy,fiendetc...Retire It willwardoff yourstrikingpower,it willdispel
...
yourseeds,yourharms,yourdigestion-products,
yourejaculations, youroppressions,

yourinflammations
yourtorments,
yourwrongdoings, heat
(ivýhdu),yourafflictions,

andfire,all the badthingsof whichyouhavesaid:'he shallsufferfromthem!

' - and

accordingto whichyouhavedone(indeed)l(R6,7-8).

Borghouts
translates
wbdwas inflammationS.
243This
is quitea good in
rendering that

it takes accountof the Grundfissview of wbdw as Schmerzstoffe

since the word

'inflammations' thepathological
embraces significance alsoimpliessuffering.
of w-bdwand

of Spell 13 is in the 'type'of afflictionsthat are listedin

I thinkthe importance

in thatit appearsto includenotonly'physical'

with nýhdw.Thelist is significant
conjunction

harms but also harmsconnectedwith 'biologicalimpregnations',

for example,'your

Suchthatit seemsthat wbdw mightbe

yourseeds,yourdigestiveproducts'.
ejaculations,

biological to add to the 244

JiSt.
another substance

However,the 'biological'wordsin Spell 13 needcloserexamination

sincetheir

has the word cic (with') from line R6,6as

meaningsare far from specific.Borghouts

Thiswordis oftentakenas'seed,semen'butalsoas'illness'.
'ejaculations'. 245

The Grundriss
givesthe wordas 'poison'.
246Dawsonalsotakesthisview,suchan

'impregnation andmagic'suchthat,'it
withsemen'is 'thepointof contactbetweenmedicine

thatsomeevilsecretion
wasenvisaged wasinjectedintothebodyof thepatientbya godor a

demon,anditseffectwasto causesuffering'.
247This intothe
whenintroduced
toxicsubstance

243Borghouts, TheMagical TextsofthePapyrus Leiden,100.

244Bodilyfluidsfigurein magicalmedicaltexts.For instance, thereare severalexamples wheregodsare
confronted by theirbodilyfluids.In PapyrusLeiden1,343(R25,1,x and2.26)theyareinvoked: 'Thisis your
blood(sni) Horus!Thisis yourefflux(pus? -rji) Seth! These are your (Pwia)
putrefactions Seth!... '
etc. Inother
casesthefluidsofthegodarequotedasthreats. e.g. the'fluid(mwm),poisons (mm) andbitterstuffs(4w4 of
Seth,Shu,Wepwawet'. FromBorghouts, TheMagical Textsof thePapyrus Leiden,99.
245 Wb1:168,167.Theintrinsic natureof thewordas'semen'maybetherootof themeaning
or seminal forother
wordssuchthatthewordciet(withappropriate determinatives ) is connected for irrigation,
withreservoirs I. e.
essentialtogivelife(Wb1:166).
246 129-133.
VI11:
Grundriss
247 JEA21,39-30.
Dawson,

71
 It required
to bethecauseof a varietyof diseases.
bodywasconsidered bothwith
treatment

'traditional' andwithincantations.
remedies

It maywellbethattheintroduction toxin
of some by is
impregnation in
envisaged Spell

13. Butequallythe term c3ccan be usedwherethereappearsto be no external(malign)

forceS. 248

upona victimcanbeseen
thattheactof impregnation
Alsoit shouldberemembered

as anactof humiliation.
Thisis in
witnessed thebattle Seth
between and in
Parkinson,
Horus.

in ancientEgypt,discussesthe act of malesexual

of homosexuality
his considerations

in termsof degradation
penetration 249
ratherthansexualgratification. I aminclined
to thinkthat

in a widelist of general
Spell13 mightbe just suchan exampleof physicalhumiliation

degradations.

'yourseeds'appearat R6,7butthesameis seenlaterat R6,8butthis

Theexpression

bythewordmm- inthephrase,cic- mtwtsuchthattheword'poison'maybe

timefollowed

of 'seed'(alsoBedin58).
hereinstead
appropdate

(Pwi) is aninteresting
hereasdigestion-products
Thewordtranslated It also
proposal.

appears whereit is takento mean'decay'(verfaulen)

in Eb296,858f priorto theproduction
of
worms. 250

In summary, in Spell13is notentirelyclear.

I wouldsuggestthatthelistof afflictions

Theiruseseemsto be in termsof abuseor threatratherthanof 'actualbiological

assault'.

218 Bln58is a casewhereric is drivenfroman alreadydeadbody. (unlessperhaps thiswasthecauseof the

death).To addmoreconfusion to the meaning, Steuerviews1*3c as the mainsymptom of schistosomiasis,
haematuria (bloodin theurine) that'comes fromthe(infecting) 1VT"'(worm).Theconnection of thiswormwith
thesymptoms andcondition is 'remarkableconsidering thesizeof theinfecting parasite',Steuer,Ancient Egyptian
andCnidian Medicine, 2. Remarkable indeedconsidering to thenakedeyeandthatthelifecycle
thatit is invisible
of theparasite wasnotdemonstrated untilthelatenineteenth century.In contrast, Bardinetconsiders cleto be
oneof themajorpathological factorsbutconsiders it asa factor'normally present'in thebody. It is thefactor
that
actuallygivesriseto w-bdw.Buthegivesno evidence for thisotherthanin Eb99,'another (remedy) forkilling
whdwanddrivingoutof ciefromthebodyof a manor a woman'Bardinet, Lespapyrus m6dicaux doI'8gypte
pharoanique, 113.
249 R.B.Parkinson, 'Homosexual 'DesireandMiddleKingdom Ulterature',JEA81(1995), 56-76.
250 GnindrissVI:108.I thinkthattheallusion to wormsmayindicate thefinality(seriousness)
of a condition. See
mydiscussion laterin thetext.A translation withthisin mindmight'fit'thelist:yourharms, yourseverit(ofintent),
youroppressions.

72
ndw appearstowardstheendof a list whichis associated or
shortcomings
withpersonal

e.
afflictions
spiritual g. yourwrongdoings,
your The
torments. translation
of as
tvýh-dw 'pain'

inthetextto makesensein context,

couldstillbesubstituted suchthat:

I youroppressions, yourtorments,
yourwrongdoing, yourpLins,hate
yoursufferings,

andfire andall the badthings...

'

3.2 (iv) Admonitions

of an EgyptianSage

In Admonitions
of an EgyptianSagetranslatedby Gardiner251we are presentedwith

of wbdwwhichseemto supportitsuseas'pain'or'forbearance'.
twoclearexamples

formof wbdw
It appearsin theformof wbdwywhichNunnstatesto be a participle

i.e. onesufferingfrom wbdW252

I do not thinkNunnhassufficientlyconsideredhis inclusionof

this term.It is the only exampleand also contradicts givenby

the completetranslation

Gardiner.

hdýVW253
sA?thb ........... týý, rnm. f, hcw,f

to immerse himwhois in pain(?) whenheis ill in hislimbsI

'remember
......
thb is takenby Gardinerto mean'soak,immerse,dip, irrigate.
254It is obviously

relevantto the medicaltreatmentof the patienthere,the onewhois in pain.

The word thb is commonly

foundwith this sense(i.e. soaketc.) in the medical

(Eb,H, Kah,Bin).Itsuseis typicallyillustrated

literature in Eb32wherea liquid(drugremedy)

reliefbyirrigation
is appliedto produce (qbb)of theaffected
pad.

Steueradmitsthat whdyw in Admonitions To overcomethis he

is 'problematic'.

that'if the lacunaaftert, is ignored'thenit wouldbecomea participleto read,

suggests
-hb

251 TheAdmonitions
A. H.Gardiner, ofanEgyptian
Sagefroma Hieratic (Leipzig,
inLeiden,
Papyrus 1909).
Egyptian
Nunn,Ancient
252 Medicine,
61.
Gardinergiveswbday as thesingularparticiplefromtheverb wbdto suffer singularto accordwithmn.f
253
-
AlsoHannig,939.
254

73
 bdwY. 2551 think it is more likely that the lacuna
'those (the one) immersedare called ivý,

(like
obscures otherexamples
of tbb) the nameof the that
substance is by
applied
actually

to relievethe'onewhois in pain'-the wbdwy.

soaking

bdw as painin the sense'to bearor endure'.It is difficult

In lines13-14(105)we see uý,

hdwas Schmerzstoffe
hereto envisagew-, In thefollowingvvýbdw
or otherwise. asan
appears

formfollowing
infinitive týh:
tgndjbjýh tfýbdw

k?iry. 1stn ZT. f

Itp.1swmdwtnt (mcir)

drindmal

'WouldthatI hada heartableto suffer

Then/ wouldrestuponit

I wouldloadit withwordsof (misery?

)

I 256
wouldwardofffromit mymalady'.

Entriesfor "dw.
3.2 (v) OtherPrescHption

intowhichit is difficultto fit the morbidprinciplemodelof

Theseare prescriptions

bdw
w, andin whichI the
consider useof theword'pain' be
would as(ormore)appropriate.

Ebl3l

Eb131is interesting
in thatit is an 'incantation' §nt The
againstabdw,, oýhdw. 'spell'

whenandif: in whdwprm bkn

is to berepeated

255
Steuer, Egyptian
Ancient andCnidian
Medicine,
40.
256
Gardiner, ofanEgyptian
Admonitions Sage,105.

74
 in respectof theterm
If the 'm'here is takenas a 'stateof being',or is concomitant

) 257
bý-n,(swelling? it thenmightimplysomelocalised infection.
(painful) Thenwbdwas'pain'
2

wouldseemto fit, suchthat:'it is painwhichcomesfrom/duflng

theswelling
.

Eb336,741

Theseareheaded:
krtrrdt'-"'r ntwhdwmsnfmlrw4, is
'what to be donefor

rdtnt whdwwith bloodin (both)eyes'.

258-a tumourof
The Grundrisstranslatesthis phraseas G5wachvon Schmerzstoffe

In theirrecentappraisalof wbdwKolta andTessenowcitethis as an example

Schmerzstoffe.

of wbdwasa morbidfactor.Theymaintain
thatthewordis associated
withinthephrasesuch

that it preludesthe meaningof tqbdwas a specificsymptom(pain).Theyarguethatthe

noun
preceding rdt be
must in lexical
combination
with whdw.Thusthe be
must
condition a

result of iiýbdwitself. 259

However, is thattheyaccepttheGrundriss
theproblem translation I
withoutcomment.

of the wordrdt needsfurtherattention.It appearsonlyin this

thinkthatthe interpretation

in
prescription a medical Nunn
context. the
gives meaning the but
of wordasgrowth not(one)

'synonymous tUMOUr. 260The to derivefromthecommonly

with wordappears usedverbrdl'to

261Inthissense,its useequatesmetaphodcally
grow'. andin English.
thesamein Egyptian As

suchit meansto 'flourish,

to prosper(financially) 262
andevento overgrowwithweeds'. Onlyif

its meaningis viewedin a medicalcontextcanit be supposed

to meana (tissue)growthor

tumour.Butthereis no evidence to suggestthatit is a turnour.In fact,it

in thisprescription

seemsdifficultto envisage Theonlyactual

as a turnoursinceno exactlocationis specified.

257 568,Bardinet'foyer
Westendorf, Lespapyrus
putride', m6dicaux 262.
deI'tgyptepharoanique,
258 V:79,Westendorf,
Grundriss 609.
ZAS,127,44.
KoltaandTessenow,
259
260Nunn,AncientEgyptianMedicine,224.
261Hannig,462.
262 A Concise
Faulkner, Dictionary
ofMiddleEgyptian,
154.

75
 is
symptom an indication
of bloodin both This
eyes. is morelikelyto be the of
result a head

Importantly,
injuryor eyecondition. these
anyinternaltumourof theheadwhichmightproduce

be be
couldnot seenandsonot
symptoms The
identifiable. viewof a tumour
as a is
'growth' a

concept
modern only from
experienced postmottem I
analysis. that
suggest it wasa concept

263
beviewedsimilarlyby the ancientEgyptians.
thatwouldnot necessarily

It is easierto see rdt in termsof 'non medical'growthand ratherto viewit in a more

way
conventional in whichcasewbdwcouldbe a The
symptom. phraserdtn ifýhdwwould

thenimplya growthof w, thatis 'thegrowth(increaselgetting

worse)of painresultingwith
-hdw,
bloodin theeyes'.

Eb858

is headed:a remedy(§s3tofor btihnt bprt br wdt

The prescription QTX
264 n

w, '
bdw, an that
abscess has because
occurred of the of ivýhdw
movement -.
l! 266
Mcer/abscess/boil
of
Here,theimportant
phraseis, hnhntl! Z'Snt
wbdW265

iqbdw'.

Heretheboilor abscess or displacement

arisendueto themovement
hasapparently

of whdw.Thisphrase,
onthefaceof it implies
that whdwis a fluid that
agent has the
caused

However,
abscess. the here
phraseonlyappears at E858,
but the wordwdt is alsousedin

with'puttingback'a joint
is clearer.Sm43is concerned
Sm43,whereits useas 'movemenf

thathasbeendisplaced a 'jolting'or 'movement'

andin thiscontextthewordseemsto indicate

to this 267
required achieve effect. Thismightalsoapplyto the of bdw
symptom n,, in termsof

263Theword'growth'to meana morbidformation onlyseems to have been usedfrom1847 in England.

The
Shorter Oxford English Dictionary
onHistorical Pfinciples3rded.2 volumes. 1972).Revised
(London, 1978,897
264Grundfiss VI:234,Vertagerung
-'displacement, shifting'.
265Thisis another exampleoftheappearance of wbdwina relatedphrasethatKoltaandTessenow see
precluding itsuseasa symptom ofdisease, ZAS127,49.
266Grundriss VII:609
267It is a recognised for settinga dislocated
technique shoulder,illustrated
in Nunn,Ancient
Egyptian
Medicine,
179.

76
1..ngpain'.However,I do concedethatthe indirectgenitiverelationship
1016 of wdtwith w,
-hdw
couldbe problematic
to thisproposal.Butthelinkcouldstillbeoneof descriptionor causeto

describe
theprodromal
symptoms from
of the boil,'a boilcausedby pain'or 'a boilresulting

pain'

Bin75

Theinterpretation
of thisprescription difficulties.
presents It concerns
thetreatment
of

a patientwhois saidto be:bry Pn i+,-bdw.

HereP appears 1" TheGrundriss

translates
this 269
ZahnsmerZ
asl 1.268 wordas

suchthatthephrasebecomes
'toothache' because
'toothache Westendorf
of Schmerntoffe'.
translatesthe worddifferentlyas the somewhatvaguetermKaumuskelkraMpf
270'crampof the

Thisphraseis problematic
smallmuscles'? in thatit seemsthatthe
to wbdwas a symptom

is a resultof the wbdw.It seemsunlikelythe toothache

toothache (pain)is a resultof the

itself.
bdw(pain)
w,

However, at Kahun5. Itsentryhereis

in theKahunPapyrus
theworddi alsoappears

puzzlingand so throwssomedoubton its meaningat Bln 75. The KahunPapyrusis a

treatise.It hasa commonformatwhichgenerally

gynaecological startswiththe expression:
fora womanwhosuffersfrom'followed
'instructions bya description
of.thesymptoms
affecting

thefemalereproductive
organs.Yetin Kahun5 surprisingly
the'teeth'and'gums'areclearly

usingthe termtA Kahun5 is headed,'a prescription

mentioned for a womanwhosuffers

(mn.s ) in her teeth and gums and cannotopen her mouth'.This is followedwith a

uponthecondition,
pronouncement ddbrkr. s arpwpmt2T'thenyouwillsayconcerning

her/it,'it is 0 of thewomb'.Clearlythiscannotbe'toothache the Nunn

of womb'. translates
this

\-jj 1.
268 to bea falserendering
It appears of to. Westendorf,
168.
269GrundrissIV:67
270Westendorf,168.

77
 271Westendoff
as 'acutepain'. to the
whichis appropriate
use the wordKaumuskelkrampf

Icramp'type of painexperienced It may be that the word tR is

with uterineconditions.

to describe
attempting in Kahun5 the
However,
thetypeof painas beingsimilarto toothache.

is reconciling
problem thismetaphorical withthewombandwiththeprefacewhich
connection
describesa womanwho 'suffersin her teeth',(the word jbpw clearlybeingused).It makes

littlesenseof whdwtobea pathological

agentasfarasteethareconcerned
sinceit is difficult
272
itsaccumulation
to visualise inthisarea.

H4,26,29,30,41-7

Thetermiiýbdwappears
in allof theaboveprescriptions
fromtheHearstPapyrus.

1-14: for the expulsionof whdw from

pbrtpt drrlmw" nw whdwppwy. Thisis a prescription
J the term
ZJ,
the anus. There is some uncertaintyover the meaningof rlmwe ra 01

proceeding
wpdw.TheGrunddss
failsto translatethisterm.Leakehasthislineas:'to expel

gripingpainfromtheanUS'.
273Westendorf of theStOtzen
hasit as 'theexpulsion )
(base/basis?

fromthe 274I thinkit is important

to H4is for local
of whdw anUS'. that
remember a prescription

(direct)application
to theanus.Inthecircumstances,
it wouldseemlikelyto bea preparation
to

soothepainratherthanexpelsomemorbidprinciple.In thiscase,the translation

by Leake

wherethe termrlmw-ris takenas describing Theincidence

the painseemsappropriate. of

painandanaldiscomfort
in particular
willbeconsidered
in Chapter
4.

271 Egyptian
Nunn,Ancient Medicine,
34.It appearsalsoin Sm7where(dental)painseemsto bea clearerfeature.
aninjurytotheskullwhichisfollowsbyfeverand63whichaffectsthemouth.
Thisinvolves
272KoltaandTessenow usethewordLeidensmacher It is quiteappropriate
for wlidwratherthanSchmerzstoffe.
forBIn75.Howevertheyalsosubscribeto wbdwasa transitory ZAS
feature,
pathological 127,45-8.
273Leake,TheOldEgyptianMedicalPapyri,62.
338.
274Westendorf,

78
H26:

pb,tt nt sd uýhdwmht
H29:
pba nt sd whdwm ht
Boththeaboveprescriptions 'to breakup' wbdwfromthe bodywhich
aredesigned

Leakegivesasto 'breakuppainsinthebody'.
275

H30

dr ifbdwm gnbt

Thisis morespecificin thatit is to 'expel',or'breakup' wbdwintheAnbt-LY'.

BothWreszinski
andLeaketranslatethiswordas 'skin',276whilstWestendorf
translates
the

277
wordas'breast'.

herebecauseit wouldbe difficultto conceive

Theword'skin'wouldbe significant

dw
uýh, as being
ableto 'accumulate'
in the There
skin. is nodirect of
connection the mtwwith

the skin.Also,anydisturbance andso likelyto be

of the skinwouldbe a localdisturbance

painful.

via the skin.Leake,in fact,

The overallnon specificpainof arthritisis perceived

thisrangeof Hearstprescriptions
considers arefor the treatment
for arthritis.If so, thenas

otherpartsof thebodyarepreviously at H30to complete

skinmightbe predicted
mentioned

sucha list.Thisis a logicalassumption,

buttheprescription
ingredients
arenotspecificenough

andat H30the wordappearsas an intemalremedy.Also,the word§nbtas breastis well

I
attested. thinkthatWreszinski
waswrongandthatLeakeperpetuated
theerror.It appearsin

Eb187asanalmostexactcopyof H30:ktntbsAvýhdWms'nbt,'another
to driveaway(repel)

in
vvýhdw thebreast'.
However,
wbdwaspainis stillappropriate.

275Leake,TheOldEgyptianMedicalPapyri,80.
276 DerGrosseMedizinische
W.Wreszinski, PapyrusdesBerlinerMuseums(Leipiig,1909),7. Leake,above.
552.AJsoWalker,Studiesin EgyptianAnatomicalTerminology,
2" Westendorf, 276.

79
H41.42,46,47

H41(E584):
pba nt dr i+,
bdw nhpm I'tnbt nt s

H42:pbrtntsm? whdwm ctnbt

H46:spwnwsn2iwbdwm rtnbt

H47:pbdntsni? wbdwmht

All the aboveareto 'expelor deaden'ifýhdwin anypart(limb)of the body.Leake

(42-46)'todeadenpainsin anylimb'.278
theseasa groupof prescriptions
translates
- 11.
H41is interestingsinceit has wbdw qualifiedby nhp roA The Grundrissgivesthis

279Leakegives it as 'throbbing'.Thus, we have a 'throbbingof

as, 'schneiden,springen'.

dw.
mh, ' It is difficult
not to agreewith Leakeandto have iKhdwas pain:'throbbing
pain'.

it is difficultto envisage
Conversely, a throbbing' Leake's
morbidprinciple. viewof thisrangeof

as
prescriptions arthritis does
treatment seem particularly to
appropriate E41 sincethe

pain'is treatedbyanexternalapplication
'throbbing to theaffectedlimb.Again,this
bandaged

forremoval
is inappropriate of an'internal'
element.

278Leake,TheOldEgyptianMedicalPapyti,81.
279GnindrissV11:
409.

80
3.2(vi)TheConnections
of whdwwithGreekMedicine

I believethis to have
Sincethe theoryof uýhdwhas generallywon acceptance,

to
provided, some
extent, to
support theideaof Egyptian
andGreek in
connections theareaof

bySteuerandSaunders.
asproposed
medicine

Thelink betweenthe EgyptianandGreekmodelsis describedin the following:'wbdw

althoughof greatimportance
represents schoolof thoughtbasedon the
onlyoneparticular

formation of theblood.Thecommon
ofpusandthecorruption element to
is theabilityof ivýh_dw

convettthebloodintopusto CoagUlate.
280

'Asto thecoagulation
effectof wbdwupontheblood- theconversion into
of itýh_dw
/
of pusin theblood)as the
pus Iryy wasbelievedto producea stateof pyaemia(presence
---A

281
stageofbloodcoagulation'.
preliminary

Accordingto Steuerand Saundersit is 'pus' that linksthe two models.Aristotle

the
associates idea the
of sepsiswith processof 282
digestion. In the Egyptian
model hdw
tvý,

the
produces pus that (sepsis)
coagulates, in the Greek the
model of
coagulation sepsisis

byabnormalities
produced inthedigestion 283
process.

However, is that thereare no textsthat

the seriousproblemwith theseproposals

of theblood.In factthereappears
connectwbdwto thecoagulation to be noconnection
with

whdwandthe bloodat all. In respect

of this Bardinet
point 'plus
writes: grave,on chercherait

en vainunpassagedecrivait
de manlerenonequivoque du
cettecoagulation sangpar le pus

repandu 284InfactSteuerhimselfseemto concede

danslesvassauxl. theabsence
of evidence

280It is interestingto notethatare nowtoldthat w, Irepresents onlyoneschool'of thoughtwithoutbeing

informed the be.Steuer,
Ancient -hdw
Egyptian
of othersmight andCnidian Medicine, 7,26.
281Steuer, oftheHistory
Bulletin ofMedicine
10,26.
282kistotle,Meteorology 381b,12-13.
283Heeithermisquotes or misunderstandsAristotleon thispoint.kistotleis writingin Meteorology aboutthe
effectsof differenttypesof heatonthedryingprocess. Hegivesdigestion as an example of thegraduallossof
surfacemoisture - so thatlower downtheintestine
the drying is
effect such that'excretion (381b,
putrefies' I
13).
thinkthisisto explain theunpleasant changeofthenatureoffoodintoexcreta. it is notpus.
284Bardinet, Lespapyrus m6dicaux de1'8gypte
pharoanique, 130.

81
in hisoriginalwork'concerning (sic)
particularments of the of hdw
specificaction týý, uponthe

information
blood,nodidactic is offeredby themedical 285
papyril.

However,
he latertriesto supplywhatis missingby histranslation
of thewordts as

286
'coagulation'.Thewordts'ýIlu appearsin themedicaltextsandseemsto bea derivative
r. =

of the verb ts -"ý to knot.287Steuerstatesthat 'the specialmeaningin medicaltermsof ts

(is)usedto designate
bloodcoagulation the
and solidification 288He
tissues'.
of cartilaginous

offersnoexamples.

Withinthe medicaltexts the word appearsin a few examplesonly. The examples

concernsomespecific
surgical
cases(Sm)andsome'internal'
cases(Eb,H), the
albeit latter

allrepresent to bethesamecase.In Sm5,1weseea casewiththeinstructions:

whatappears

'youmustlift (thebandage)
afterthe thirdday and notewhat ts (is allached/bound,
<my

translation>,recoII6)289 totheshellofhisskull'.
In Sm5,19w6have:'youmustcleantheinteriorof histwonostrilswithtwolinenstrips

soasto removeallof thebloodwhichts (isattached/li6) Gloss

in theinteriorof histwonostrils'.

12 for the aboveexplainswhatis meantby the expression

'all the bloodwhichis ts to the

interiorof thetwonostrils,'it is bloodwhichis tfh (baked)in theinteriorof thetwonostrils'.

Theseareclearlycaseswherebloodis 'boundin thesenseof being(attached,

fixed)'clotted'

ona wound.Thereis noimpliedmorbidpathology.

285Steuer,Bulletinof the Historyof Medicine10,15.

286Steuer,Ancient Egyptianand CnidianMedicine,47.
287Wb 5:396.
288Steuer,AncientEgyptianandCnidianMedicine,47.
Lespapyrusm6dicauxde 1'8gypte
289Bardinet'recolW, 130.
pharoanique,

82
 Theothercasesarelessclearsincetheyareinternal'caseswhichconcerna 'poolof

is unableto ts (bind):
blood'which

snfpwSS'n tstf (Ebl98a),

s§n snfn tst.f (H143)

s9n snfn ts.n.f (Eb593)

All are prefacedwiththe description
of a 'blockage tautnessof the
of the stomach,

skin',withthe subsequent of 'a poolof bloodwhichcannotbind'.It is very

pronouncement

difficultto envisage
whatis meanthere.A blockageoccurring
becauseof this 'pool'would

evenblood,wasin factlodgedorfixedratherthantheopposite.
thatsomething,
suggest

Bardinet
in a reviewof Steuer'sproposals He
forthesepassages.
makessuggestions

takesthis as illustrative /6
of the powerof bloodas the mainlife force.71fautcomprendre

encorequele r6ledu sang,quiestde fierlessubstances

se trouvant6 soncontact,ne peut

290
Bardinet's
s'exercee. of bloodbeingbound
suggestion of its lifegiving
andsodeprived
is plausible,
capability butthesepassages offered.Also,he givesno
are the onlyevidence

indication thebloodwasthoughtto reactwith.

of whatsubstances

If thewordts in Ebl98aetc.is takento mean'coagulate' bySteuer(i.e. a

asproposed

reactionwith wbdu), then we would have a blockagecaused by the blood unable to

coagulate, becoming
yetstillpresumably pusin orderto produceillness.Thisis notthesame

Steuer's
'coagulation'of unobservable
pathological
process.

I thinktheconnection
of Egyptian
andGreekmedicine bdwis unproven.
theorywithuý,

Whilstinfluence
between
GreeceandEgyptcannotbedenieditsextentin thisrespectis oneof

In the absenceof specificEgyptianphilosophical

assumption. texts,anysuchlinksbetween

Greekand Egyptianthoughtmustremainsupposition.
The situationhas beenexacerbated

because
of theassumption
of theGreeksthemselves wasbasedon
thattheirownphilosophy

290Bardinet,131,above.

83
Egyptianthought.However,
the provenparallelsare veryfew andon analysissurprisingly

It is impossible
imprecise. tofinda singlecaseof influence 291
inthisarea.

3.2(vii)Conclusions
on Mdw.
On balancethe ideaof ivý,
bdwas a morbidprincipleis unproven.

Steuer'sworkis basedon his interpretation is unsound

of Berlin154.Histranslation

andhe to
appears usethisto makeit fit his assumed I
model. thinkit likelythatthe ideaof

substance
noxious duringtheembalming
observed wasin somewayassociated
process with

diseasein the living.However,

I thinkany link is moresupposed It is not
thanschematic.

to believein someconnection
necessary factor.
andalsoto needa namedpathological

Equally,
theuseof humanandanimalexcrement is difficult
ingredients
as prescription

withitsbeinga carrieror generator

to reconcile factor.
of a pathological

KoltaandTessenow
haverecentlylistedand appraised
the possiblemeanings
of

TheydismissSteuer'sviewthatit is a pathological
tvýhdw. processor specificagent,butstill

suggestit to be a causeof illnessor a pathological way'.They

agencyin a 'ratherunspecified

rendera definition
as: Leidensmacher
292(causeof suffering- mytranslation).
In thissense

theyseeit as a possible
causeof diseaseanddismissthe possibility
of it meaning
a specific
(pain).However,
symptom of themedicaltextsis basedupontheinterpretation
theirreasoning

of theGrundriss.
Whilsttheypresenta validsummary
of thepossible
meanings
of whdwtheir

donotfullyconsider
conclusions thefactthatwbdwcanbeunderstood
as'pain'.

I thinkthatanattemptto seeka singlespecificmoderndefinition

of uýhdwforthesake

ofsatisfying isa mistake.

terminology Whilstconvenient
it restricts
thepossibilities
of meaning;

suchthatthe termLeidensmacher
restrictsthe possibility its
of use as a In
symptom. this

291Barnes,TheEariyGreekPhilosophers,
15,38.
292KoltaandTessenow,ZAS117,52.

84
 Schmetzstoffe
respect is a better
term it for
since allows a wider It
definition. is perhaps
wiseto

leavethetermun-translated.

I amnotproposing thatthewordpaincan
that whdwjustmeant'pain',noradvocate

I havegiven.WhatI dosuggestis thatin manycases

intotheexamples
simplybesubstituted

theword'pain'fits as easilyas otherinterpretations. juxtaposition

Themetaphorical of words

Also,in manycasesthereis a
betweenliteraryand medicalcontextsis underestimated.

to cometo themedical
tendency textswithmodernanalogies 293
of meaning.

animportant
It wasobviously mayhavehadsignificance
termwhichin someinstances

per se.Thefactthatit appearsonlyin the medicaltextsseemsto support

beyondsuffering

ButI thinkSteuer's
this.294 arewrongandhavebeenseminalto erroneous
conclusions pursuit

of theterm.

I thinktheproblem
is probably ndw maywellhavehadmore
justoneof semantics.

in thatit mightbe a generictermfor illness(evenfrommorbidassociation)

thanonemeaning

yetstill the
retain specificity
of Such
'pain'. an in
example, is
English, thatonecanbe (ill)
'sick'

yet to be 'sick' to
alsomeansspecifically 'vomit.In the the
absenceof context is
difference

to detect.Themedicalpapyriarenotdetailedenoughto providedefinitive
impossible evidence

and the cautious

view of the Grundriss
in this has
respect createdan additional,and perhaps

illusion
unnecessary, of Overall
mystery. there where
appearmoreexamples the word'pain'

wouldbeasappropriate for ifýhdw.

a translation

Asfaras I cansee,therearenoexamples
where'pain'is nota possible and
rendering

noneedto lookfurther.
therefore

isonesuchword,seediscussion
m Theword'growth' onEb336,aboveChapter 3.2(v),page73.
m Compare the 16thCenturyuseof the Englishword'possession'in differing
contexts.In legaldocumentsit
wouldmeanactualor legalownership thesewouldmeannotonlydomination
yetoutside byanevilforcebutto be
in'possession e. anillness,ShorterOxford
ofa condition'i. English
Dictionaryon Historicalftciples,1635.

85
 2,
3.3sttT, %"%3%

Thistermlike whdwhasbeenthe subjectof discussion. firstsuggested

Wreszinski

295Later,it wasdescribed
thatthetermstt appliedto 'swelling(boil)or tumour'. by Dawson
to

mean 'shootingor acute pain' and has since been translatedby the Grundrissas

296Thelatterinterpretation
'Schleimstoffe'. is important
becauseit impliesa conceptual
term,

partof the Egyptianviewof the aetiologyof disease.Thismakesit necessaryto reviewit in this

thesiscn pain.

The derivation ý"? '

of stt as 'shootingpain'comesfromthe verb st! 'to shoot,

(arrow/person),
to impregnate
a female(ejaculate?
) and to stare (to shoota stare?-

)'.297However,
glare? it alsoappearsin phoneticform,unrelated
to the abovein stt 'ground'

and styw'Asiatics'.Withthe waterdeterminative the verb st! meansto 'pouror flow'.As

suchit appears
at Eb9l,768,207d.

The W6rterbuch whenit givesstt as: 'swelling,

all thesetranslations
summarises

featureof disease
turnour, ofthehead,neck,chest,bodyandotherwise'.
298

There are essentiallytwo positionson the meaningof the word stt.- firstly,

Schleimstoffe factorand
therathervague'featureof disease'or pathological
whichembraces

theviewof Dawson
secondly wherestt is regarded
aspainof an'acuteshooting
type'.

TheGrundriss bythewater
fromtheverbstj to 'flow',evidenced
seesstt asoriginating

determinative' 'Es sindalsoStoffe,die in K6rperumherziehen'.

'It is alsoa substance

whichtravels,wandersthroughthe body'.
299Thisideathatstt is a substance
thatwanders

throughthebodyderivesfromTheVesselBookat Eb856fwherethereis briefmention

of stt in

withthe mtw. Thus,we haveanothertermthatwasoriginallyconsidered

connection to be

295Wreszinski,
DerGrosse
Medizinische
Papyrus
desBerliner
Museums,
131.
296Dawson,JEA20,185. GrundnssVI:813,for bothformsof stt with bothpustulefZ andwatercleterminatives

297
Hannig,778.Wb4:330.
298
Wb4:333.
2wWestendorf,
343.

86
'pain'butlater,like w, is presented
as a featurewithpathological andwhich
significance
-hdw,
travelsthebodyviathecirculatorysystem.

If whdwis a featurethatunderlies it seemsdifficult

thecauseandspreadof diseases

to imagine
theneedfora secondfeaturewhichmayoperateinsimilarfashion.
Steuerdoesnot

considerstt in his considerations process.Likewise,the

of wbdw and the embalming
Grundrissis non-committal
as to anysignificance
of sawithinthe pathological
process.

It maybethateach'factor'wasthoughtresponsible
fordifferent of disease
categories

or withindifferentpartsof thebody.At firstsightstt seemsto be orientedaroundthe upper

body,particularly
as Schleimstoffe
seemsconnected 300
withcoughandcatarrh. However,
with

systemall thoughtto interconnect

an anatomical it is difficultto imaginewhytwo different

andwhythereis nointeraction
agentsarerequired
pathological between
them.

In fact, Bardinetconsiderssuch interactions

as part of the diseaseprocess.He

includesstt (alongwith whdw) asoneof the'fourmajorpathological

factors'andof extemal

origin.However,
he failsto explainits 'externalorigin'andgiveslittleevidence
to supporthis

Hemerelysuggests
conclusions. thatEb296givestheevidence
for stt as a 'livingsubstance'.

Hereasons
that,sincestt is derivedfromtheverbsti'to flow,pour',thena connection
withstt
'flowing'throughthe mtwis made.301

It is necessary
to lookcloselyat the examples
of stt as theyappearin the medical

papyri.

300Eb52,298.

301 Lespapyrus
Bardinet, deI'89yPte
m6dicaux 121,125.
pharaonique,

87
(1)E296

k hr
ir n231. y stt m nk w(t) Abth t.Jýbr.s

HereDawsonseesstt as a symptomof 'somestomachtrouble,whichmakesthe

rigid'.Hestatesthat'themeaning
abdomen of (theword)ný-w(t) A (whichfollowsstt)

is unknownto me'.302The Grundrissalso suggeststhat thesesymptomsarisefrom'tightness'

of thestomach

translatesthe wordntw (t ) as 'Schneiden

The Grundriss It
(alsoSchmerzen).

hereandBerlin94,alsoat Eb`102
appears is givenas,
(var.ný-w). Thetranslation

'Wenndueienen(Mann)betrachtest
mitSchleiffistoffe Schmerzen',
undschneidenden

i.e. 'if youexamine fromSchlebstoffe

(aman)whois suffefing 303
anbcuttingpain'....

However,
the Grundfiss seemsto ignorethe W betweenstt andn*w andso
translation

separatesstt from the symptomof 'cuttingpain. If the W is treatedas an W of

concomitance,
it wouldthen 'stt In
pain'.
read: withcutting thissense is a
stt notnecessarily
disease
feature,but,couldbe'shooting
painwithcuttingpain'.

laterwesee:tum stt.fm ht.fn gm n.s witntprtn grt witpny-SIM.f

However,

it cannotfinda wayout,alsothereis nowaythatit couldgoout'.

1sttis in hisstomach

'if it putrefies
It continues, in hisstomach, worms.It will
it cannotescapeand(finally)becomes

wormsif it dies.Then,it separates

notbecome better.
outandhequicklybecomes

Thispassageis curiousandat first sightmightimplythe presence

of someactive

factor.It differsfrom vKbdwin that it appearsto be a factorthatcannotbe

(pathological)

butseemsto haveto 'separate 304

expelled oUt'. It is this thatBardinet
passage givesas
for stt as a pathological
evidence factor.Thefollowing
is mytranslation
of therelevantsection

(fromtheFrench):
of Bardinet

302Dawson,
JEA20,185.
303 Westendorf,
602.
see131043,
However,
304 discussed
later,wheresucanbedrivenoutandexpelled
intheurine.

88
 Wnnsttmht. fngmn. s witntprtngrt witpny. s im. f_phw.;
ihnrsm hnti.
if'

'If youexamine fromstt withpainin theinteriorof hisbody

a manwhois suffering

the stt whichis thecausecannotfinda wayout.Thereis no wayfor it to leavehim

withoutbeingableto leave'.
Then,it mustdecayintheinteriorof hisbody(always)

The importantpart is that underlinedabove.Bardinettranslatesthis specificallyas it must

decaynotmaydecay:'Alors,ils devront(--nepourront
que)se dans
d6composer de
lint6rieur

soncorps(toujours)'.
He that
reasons because
stt mustdecay decay
not might thenit is a

(whichby definition
'livingsubstance' mustdie anddecay)andwhichwhendeadtransforms
305
into worms.He statesthat Eb296showsthe urgentneedto avoidits accumulation.

However, is hypothetical.
theanalysisby Bardinet between
It relieson theconnection stt and

However,
'worms'andthatthelatteris actuallypartof thediseaseprocess. stt andwormscan

occurseparately.

Theconditionin Eb296seemsto be concerned in thatthe stt

withan 'obstruction'

fromthestomach.
cannotbe relieved However,
I thinkthattheimplication may
of putrefaction

wellbe allegorical
andintended
to conveytheseriousness In otherwordsthe
of thecondition.

mightbefatalunlessthesymptoms
condition pass.In thiscaseit allowsfor stt applyingas a

i.e. 'pain'.
symptom

Thewordusedhereat Eb296forwormis bsbt Thereareseveralotherwordswiththe

worm I
determinative foundin themedicaltextsfor example,ILtw(B205), si, sp (Eb671)

andAt (H196).However,
in viewof thesupposed
highincidence worminfections
of parasitic is

306It is
thereare onlytwo thatcan be actuallyrelatedto someknowncondition.
surprising

logicalto assume
therewouldhavebeenrecognition
(andso possibly connection)
a perceived

betweenthe apparentspontaneous
appearanteof maggotsafterdeathanddufingcertain

305 Lespapyrus
Bardinet, deltgypte,125,6.
m6dicaux
306
ThetwowordsareLiVelandpndwhichappearto correspond
to roundwormandtapewormrespectively,
see
Nunn,Ancient
Egyptian
Medicine,
72.

89
(infected) of maggotsin gangrenous
For instancethe actualpresence
medicalconditions.

woundsis an almostcertainpreludeto fatalsepticaemia. in Eb296

described
If thecondition

to be a seriousor fataloneunlesstreatedthenthemention
wasequallyconsidered of worms

mightbeincluded
assuchanindicator.

(2)Eb297(52,7-10),Bin 136

Eb297

ktntdrsttm, ht

'another
(prescription)
to driveoutstt fromthestomach'.

Berlin136

pbd nt dr stt mht m ctnbt

'a prescription andallpartsof thebody.

to driveoutsttfromthestomach

Essentially
thesearevariantson Eb296buttheydifferin thattheyshowthatstt can

indeedbedrivenoutof thestomach
andall (other)partsof thebody.

In BIn136suis notlocalised, asbeingm ctnbt'in allpartsof thebody'.

it is desc(ibed

Thisseemsto correspond
betterwithit meaning
'pain'asopposed feature
to somepathological

thatneedsto 'collect'andthenturnto worms.Eb297,'another(prescription)

to driveout stt

fromthestomach'.
Eb300is similarbutaddsto thetitle'of a manor a woman',kt nt dr stt m

ht nt s st r-pw.

Dawsonseesthe aboveconditions
as 'colicor someotherformof acutestomach-

307However,
ache'. if the mentionof wormsis an allusionto theseriousness
of thecasethen

'colic'is hardlyappropriate.
Butsome'formof stomachache'(dueto constipation?
) is implied

to an extentby theformulaof theremedyin Eb297.Thisconsistsof an internaldoseof figs,

whichwouldhaveanaperient
curninandcarminatives effect.

307Dawson,
JEA20,185.

90
(3)Eb294(51,15-19).
(H35)

ý
In H35,stt is shownas,withboltV 'and a 'woman'determinative,in Eb294as

sttwitha 'z
pustule.

In theseprescriptions
the lowerbodyis affected.
Thisexcludes
the possibility
of stt

being a factor confinedsolely to the upper body. pAtt nt sW (yt) At m npPw. It is a

308
to causeto godownstt fromthe'pelvis'or 'groin'.
'prescription Aftertreatment is
stt saidto

'godownimmediately'
(subside)ep-ýsA?.t! Pr -rwy.It is thisprescription the
whichprompted

of sttas a 'swelling'.
translation thegroinareacouldbea boilor a hernia,and
Sucha swelling

rd!,U to'cause
to down'(the
come wouldseemto appropriate.
swelling)

Leakeagreeswiththisreasoning
andgivesH35asa prescription
'tocauseanabscess

or swellingin the pubicareato subside'.

309However, butthe most
thismightbe convincing,

wordfor 'swelling'
common is wellattestedin themedicaltextsas Owt A It doesnot

occurhere.It appearsat It
Eb556,553,558-560,562,563,583-5,589-91.is alsofound

frequentlyas a verb gfw in Eb871c,561,767, Sm4l etc. It frequentlyappearsin

dr,§fwtm hff (Eb556).

withtheverbdr'to driveout',forexample,
accompaniment Dawson

pain'i.e. releasefrom(shooting)
rd! 19stt as,'tocauseto comedownof (shooting)
translates

310
pain'.
I thinkit important theareaof thebodyin whichthepainoccurs,thegroin
to consider

or pelvis.Dawson
describes
stt as'shooting
or acutepain' he
because that
reasons thegroinis

areafor rheumatictype (dull?

not an appropriate ) pain.However,I think that Dawson's

is flawed.A painin thegroinis morelikelyto be theresultof an abscess

reasoning or evena

hernia(thelatterbeingparticularly
welldocumented). for a hernia
Thetypeof painexpected

wouldbe dullpaingenerally
felton movement,
whilstthe painof an abscesswouldbe acute

308GrundrissIV:140,Dawson,JEA20,185.Walkergivesthe word'groin,inguinallymphnodes',AncientEgyptian
AnatomicalTerminology,
270.
309Leake,TheOldEgyptianMedicalPapyri,80,
310Dawson,JEA20,186.

91
 onlyfeltoncontact.
but,generally Whist'pain'mightbeanappropriate of stt in this
translation

I amlesssurethat'shooting'
example, If the
in viewof thelikelycondition.
painis convincing

pelvisis involved
thenpelvicpainmightsuggestarthriticpainof thehip.Also,suchpainwould

tendto bedullratherthansharpor shooting. to have

thereseemsto benoevidence
Equally,

sttas 'Schleimstoffe',
a pathological
agent.

(4)Eb295(51,12-19)

Inthisprescription
the'neck'is clearlyaffected:

k s stt m Wt. f
ir n2i3.

Jw.fmn. f "ty n npbt.f

iw. fmn. f tp.f

iwlswnnhbtfn, ht
iwnpbtf wdn.tin bpr.n n.fdgtn btf

iw tsn r.f

dd M'.kbrysttmntbt. f

a manwithstt in hisneck,hesuffersin thebase?aoint)311

'If youexamine of hisneck,

hisheadhurts,thevertebrae
of hisneckarestiff,hisneckfeelsheavy,he is unableto turnit

(lookat hisbody),it is painfullawkward,

youmustsayit is onewithsit in hisneck.'

Thesymptoms
in thisexampleareclearerthanthosein (1).Thepatientis suffering

from stt of his neck,312which is desc(ibedas painfulwhen an attemptis madeto inclineit

towardsthebody.Dawson
describes
thiscondition
as a caseof 'fibrositis 313He
or stiffneck'.

butit seemsreasonable
doesnotelaborate to suggestthatthestt is 'shooting
pain'produced

byanyattempt
atmovement.

stt as boil
or does
swelling nordoesstt asa pathological
notseemappropriate agent.
311 Studies
Walker, inAncient
Egyptian
Anatomical
Terminology,
266.
TheVesselBookdescribestwospecificmtw to theneckalthoughtheircontentsarenotspecified.
312
313Dawson,JEA20,186-7.

92
(5)Eb298(52,10-13)

(prescription),
ktirftn smn.fhntm tp.fsttmnPbt. f, 'another whatis to bedonefor

his
suffersbntin
a manwho head
and his
sttin neck'.
HereDawson thisaspain(stt) in 'thefrontof theheadandtheneck',which
translates

diagnosesas 'neuralgiaor similar'.(The symptomsmightsuggest

he not unreasonably

which
migraine is certainlya 'shootingpain' but, migraineseemsto appearelsewhereas gs

---1314

boththe Grundfiss
However, and Westendorf
differin that theytake bnt 315
not to

but
'front'
mean instead
to 'catarrh'.
mean
6.
in theoriginalwiththenosedeterminative 'Wenner anSnupfen/kattarh
It appears

an seinemKopfleidet,
indem in
Schleimstoffe seinemNacken 316
sind'.

Theconnecting'm 'impliesthatLmtis in theheadandthatstt is in theneck.That

-bnt
to
seems be something in
actually the headas opposed to the 'front'
of the headis shownin

Eb391:ktDt drbDt m tp m msdrwyanotherto driveout hntfromtheheadandears'and

Sm22,8,drbntpwmtpwherebnt is drivenoutof thehead.In Eb36:ktntdrbntmjrly,

'todriveouthnt in theeyes'.Andin Eb4l8:ktntdrLmtm fnd, 'to driveoutbnt in thenose'.

6
Sincebnt affectsthe head,noseandeyesandappearswiththedeterminative it seems

likelyto becatarrh.

in Eb298bnt m tp.fstt m nbbt.f if Pntis catarrh,thenwehavecatarrhin

However,

theheadwhichcouldsuggestthepresence
of stt in the neckas the But
cause. thisdoesnot

precludeit beinganothersymptomand 'shootingpain'or 'pain'wouldseemappropriate

SeeEb250andPap.BeattyVRs.
314 4,1-9wherethesymptoms ofgs-tpasmigraineareclearer.
Walker
315 gives'frontofface,head',Ancient
Egyptian Anatomical
Terminology,
272.
316Westendorf,602.Thespecialcharacter Schleim(slime,mucous, which
viscosity) is appendedto Stoffe
for
completenessis 'reservedfortherelationship
of to
stt catarrhandcoughandnot Such
otherwise'. thatfollowing
Berlin48weseea coughremedy, Westendorf,
344.

93
 suchthat'hesuffersfromcatarrhin theheadandpainin hisneck'.If notthenstt must
enough;

betakentoqualifythecauseof bntthecatarrh,suggestive factor.

of somepathological

(6)Eb856f(103,11-12)

iwmtw2 jm. fnVb. firmn. f*1j2. fd? dcbw.f

in.kr. s sttpw
-dd
'Thereare2 vesselsin theupperarm.If hisshoulder
suffersandhisfingerstremble

thenyouwillsayit is sti.

The aboveprescription
is from the 'VesselBook'whichwas discussedearlierin

Chapter3.2 (ii).In thisprescription

we aretoldthatthereare'twovesselsto the upperarm'

(gib)andthatthesymptoms
arecollectively to stt.Asthemtw areviewedasvessels
ascribed

Eb856fsuggests
of transmission sttas a factor bythesemtw.
transmitted

Here(6) Dawsonhasstt'shootingor acutepain'as the collective

description
of the

'painin the arm and tremblingof the fingers'.He suggeststhat this maybe
symptoms:

paralysis 317Wreszinski
agitans. thislineas,'if hisarmssufferandhisfingersare
translates

sore,thenyouwillsayit is the(stt) condition.Westendorf 'if hisshoulder

andthe Grundfiss:

suffersandhisfingerstremblethenyouwillsay:it is Schleimstoffel.
318

Thesymptoms
aredescribed
(rnn) in the shoulders
andfingerswhichthengetsthe

response (stt). To havesuas shooting

of thecondition havebeen
painswhenthesymptoms

described
previously In thiscasestt mightbe thoughta
as painfulmayappearas duplication.

termof widersignificance.

Howeverthereis no reasonthat stt shouldnot be 'shootingpain'.Thesufferingin

and
shoulder fingers
is described as stt'shootingpain'.Suchrepetition
andsummarised is not

in themedical
uncommon texts.

317 JEA20,185.
Dawson,
318 DerGrosse
Wreszinski, Medizinische
Papyrus
desBerliner 698.Grundriss
134.Westendorf,
Museums, IVA

94
 forthecondition
Theremedy is givenin:

iInt r.s sbR.fmt7n w Pr M-t PrLYs

i wf(w) r-pw Im cdb cý

w.fpr bddw-k3
wr snb.
f

it by
to vomit- Erbrechen)
'Whatis to bedoneforit. Hewillbecausedto expel(caused

meansof fishwithbeerwith(plant?
) or meatetc.,in orderto be 319
well'.

It is atfirstsightdifficult
Thisline'causedto expelit or causedto vomit'is problematic.

Thewordsb,§(t)
to explain. *as 'tovomit'seems
well It
attested. in
appears Eb85,16b

and Eb696as sb§yUEýO*1'O'jA and with an additional,clearer It

determinative. suggests

needto removesttfromthebodyandseemsdifficultto reconcile

thephysical withthestopping

However,
of pain. this be in
might explained thatverb be
sb9could usedto indicate
the'action'

of the i.
remedy,e. like a (from
release
vomiting, quickandviolent pain- stt ). I see no
M
to its meaningandthatof theverbdr'
betweenthisapproach
difference whichis well

to meanbothphysically'drive
attested out'andto'd(iveout pain.

of thevessels(rntO
It is Eb856fwhichhasbeenputforwardto implythatthecontents

to theuppershoulder
weresa. Butthis is it
connection notactuallystated, is that
merely the

It alsomakestheassociation
twotermsappeartogether. difficultif the
withcatarrhsomewhat

are
shoulders involved.

of catarrhonlyif stt is generally

It is possibleto equatestt witha definitesymptom

to mean'mucousor fluid'.In thissensestt couldbe bothcatarrhand

morewidelyconstrued

the rathervaguer'fluid'passingthroughthe mtw withpathological

significance. it
However,

to bespecificto thedestination
seemsunusual (upperarm).

319Westendorf,
699.

95
(7)Berlin48

abitnt drsttm gw(t)y.fy

I
hisbody
forthe'drivingoutof stt inthetwosidesof
Hereweseea prescription
.
Thiscontradicts at (6)thatthemtw to theshoulder
thesuggestion containstt.

(8)Berlin138

pbit nt rdit, &y stt nbt mvw ftt m iwfn s

to causeto bringdownall the sawhichcomesandgoes?(bLht)in the

'Prescription

bodyof a man'.Dawson thisas a remedyfor'sttwhichcomesandgoesin a man's

translates

flesh.' It is an internalremedyfor 'shooting pains'.TheGrunddss

or intermittent seesthisasa

'to
prescription causeto bringdownall the stt, which'wanders'
in the bodyof a 320
man'. This

impliesthatstt mustbephysically
'brought down
down'.Or,it couldequallyimply:the'bringing

of allpainswhichwanderin thebodyof a man'.

or removal

(9)Berlin139

Dh,ttntdrsttmnt. smS'Mwmprtm rtnb

.
Thisis a prescription andwinterin all
in summer
to 'driveoutsUwhichcausessuffering

thepartsof thebody'.Themention sinceit suggests

is significant
of winterandsummer thatstt

is notseasonally
affected. pain.In fact,Berlin140hasthe
Thisseemsto implya permanent

same but
heading differsin that stt is for
specified the (rheumatics,
winter ).
sciatica? Under

it easierto viewstt as 'pain'.It is difficultto imaginea 'pathological

thesecircumstances factor'

fluctuation.
to seasonal
beingsubjected

320Dawson,JEA20,187.GrundrissIV:159.

96
(10)Berlin142

pb,rtntdrsttm mnt(y).sprbrymnd wnmyilbyr-pw

'A prescription
to driveoutstt whichcauses the or
under right
suffering leftbreast.

Dawson
translates for stt whichgives'painundertherightor leftbreast'
thisas a prescription

The Grundfissgivesthis a prescription

for the 'drivingout of sawhichcausesdiscomfortin the

(ightor leftbreast'.
321

to
appropriate
sttseems painhere,
thereis to
nothing suggest
sttas Schleimstoffe.

(11)Berlin143

kt nt,§dstt m WSS'

'Another(prescription)
to removestt in/from(m ) the urine'.This prescriptionDawson

hasas a remedyfor 'shootingpain'in the bladderor urethra(painfulmicturition),

'perhaps

someinflammation gland'.However,
of theprostate theGrundriss
givesit asanexample
of the

needto expelstt via theurine:fOrdasFoifnehmen

vonSchleimstoffe 322
durchAusscheiden.

'fortheremoval
of sttby/through
excretion'.
- r-ID
Thedifference
between hingesaroundthewordws.§
thetwotranslations I,.. I

is mistaken
thinkDawson herein takingthiswordto mean'bladder.
323Thus,histranslation
as

'painin the bladder.The Grundfiss

translatesthis as 'urine',hencethe drivingout of stt

theAne. Therearemanyexamples
(through) of ws.§ as One (Eb24,26,262,Bin154,1871

195etc.).

DespiteDawson's in histranslation
mistake I believeit is logicalthatsushouldbepain.

It is necessary
to consider
thepossible to be someproblem
Thereappears
medicalcondition.

A prostateproblemor a urinaryinfectionwouldproduceshootingpainwhilst
withmicturition.

321Dawson,JEA20,187.GrundfissIV:159.
322GrundrissIV:159.
323
Walkerdoesnotcitethiswordin hisextensive listsbutrathergivesthewordspw for bladder,
anatomical
Ancient Anatomical
Egyptian Terminology,
276.

97
 to urinate.Thefactthatstt is expelledthroughthe urineor duringurination
attempting goes

is
Equally,the routeof transmission
againstthe conceptof stt 'pooling'or 'wandering'.

intheVesselBook.
withthemtwas suggested
unconnected

(12)Berlin201

ktpbrt nt stt m msdr my

for stt intheears'.It wouldappearto referto 'earache'.

'Thisis anotherprescription

(13)EdwinSmithPapyrus

WhilsttheEbersandHearstpapyrimayappearto bedisorganised, andan

repetitive

andmagictheEdwinSmithpapyrus,
eclecticmixof medicine in contrast, orderedand
appears

It is primarilya surgicaltreatisedevoidof theoriesandmagic(exceptin a single

pragmatic.
SM9). 324The
case, tendto bea logical
treatments toinjurywithanequally
approach candid
injury.In fourteenof the fifty-twocasesno
of the abilityto treatthatparticular
assessment

is recommended
treatment dueto theseverity andtheinability
of theconditions to treatthem.

For example,a case of a splinteredbreakof the shoulderwhichis ominously

by bloodfrom the nostrils,ears and mouth,is statedas 'an illnesswhichone

accompanied

cannottreat' (Sm17,7
1-7).Whilsta'hole'in theshoulder illnesswhichI willtreat'
becomes'an

14-17).
(Sm15,6

betweeninjuryanddiseaseis that in injurythe causeis

difference
Thesignificant

usuallyknown.In thissensethereis no needfor a systemof explanatory factors.

pathological

As a surgicaltext EdwinSmithconcentrates
on first-aidtreatment
designedto stabilisethe

324Thiscaseinvolvesa seriouswoundto theskull.The'primary'treatmentis surgicalwitha charmfor the

'additional'protectionof Isis.

98
injury.If stt is a pathological 325
factorit is unlikelyto appearin EdwinSmith. wefindit
However,

in at leasttwoexamples:

Sm43(14,22-15,6)

to haveproduced
a chestinjurywhichappears
Thiscaseconcerns somestrainonthe

centreof the rib cage. It is headed: for

'Treatment a imh of the ribs if the chest'. 'If you

a manwitha umbin theribsof hischestandyoufindtheribsof hischestraised?

examine

flushedin hisfaceQp) andalsohesufferssttin bothhissides'.

326.
The word wnh is definedin GlossA and takento mean'dislocation/separation'.

Thetypeof injuryis furtherdefined(in GlossB) in thatthe injuryhascausedthe patientto

hereis that'both'sidesare
'sufferstt in bothhissides',jrmn. fsttm§wty. fy. Theimportance

from
affected a injury.
central Thegloss to
seems be to
necessary confirmthe diagnosis
of

pulledor strained
chestmuscles. sharppainbeihgfelton both
Thiswouldresultin a 'referred',

in ratherthanfromthe centralinjuryitself.In thiscaseit

sidesof the chestwhenbreathing

'pain'.stt as Schleimstoffe
otherthanreferred(shooting)
seemsthatstt cannotbe anything

seemsinappropriate.

Sm47(16,1817.1-2)

Thisis headed:'Treatment (,*) woundto hisshoulder(ktt4'.

for a gaping/spewing?

Thiscaseinvolvesa woundto theshoulder

whichappearsto be causinga problemwiththe

shoulderbone,thescapula.Mn.f stt (m ) mgc4ct.

underlying f, he suffersstt in his scapula

to explaintheseverityof thewound.It has

Hereagainstt as 'pain'seemsmostappropriate

gonedeeplyenoughto affectthe lowerboneand so mightproducea radiating(sharp,

pain.
shooting)

325Theideathatinjurycouldbe complicated I thinkit unlikelyin Edwin

by pathologycannotbe totallydiscounted.
Smithsincethe treatmentsare first-lineones directedtowardsphysicalinjury.Complications or prognosis(of
treatable)casesarenotdiscussed
326In Sm3l GlossA, Westendorf,
731.

99
 In briefsummary,
I believethatthe evidence factoris not
for stt as a pathological

proven.Themedicalpapyrimightimplythisbutdo notsupplyanyfirmevidence.
Theconcept

of stt as a pathological
agentarisesfromthe of
spuriousassociation the mtw and stt in

Eb856f.Whilstthe Gnindriss
in Eb52rightlytranslateshnt as catarrh,theythenassumea

directconnection attributeit (in othersituations)withsimilar

withthisandstt andunnecessarily

propertiesi.e. Schleim.Theremay well be some connectionbut on balancethere appears

to translate
equalopportunity stt as 'shooting
or sharp in
pain' most
of theexamples
whereit

appears.Thosein the EdwinSmithpapyrusI considerare clearexamplesof this. The

withwormsin termsof stt is a widerallusion.

connection
problematic It canbeexplained
as a

to thesedousness
allusion
metaphorical of thecondition.

Terminology
3.4Adaptive

in thischapterI havediscussed
Previously medicaltermswhichhave
someEgyptian

beenclaimedto be integralto the aetiologyof disease.I havehopefully

demonstrated
that

thesecanassimplybeexplained
bytheirrelationship of pain.327
to thesymptom

Thesetermshavederivedfromtheadaptation
of theoriginalword(adjective)
usedto

describethe typeof pain.I intendto call this adaptiveterminology. is

Adaptiveterminology

usefulsinceit providesbothfor a description To

of the diseaseandfor its nomenclature.

a diseasein termsof painis logical;sincethetypeandextentof painis important

consider to

thepatientin termsof sufferingandto theclinicianin termsof diagnosis.

In somecasesthe

originaldescription
of the type of pain may then havebecomeadaptedto describethe

itself.Thismethodwouldprovidefor a systemof nomenclature

condition for painfuldiseases,

to be lacking.I do notproposethisto be a regulated

onethatappears systembutmerelyone

that may have developedon an ad hoc basis in some circumstances.

The 'adaptive

327"dw, stt etc.Invernacular

English
examples e.g. the'gripes'-symptom,
arecommon The
andcondition.
$pox'-
symptomanda (cursed)
condition.

100
terminology' mayhelpto explainsomeof themany'unknown'
approach that
conditions
medical

appearacrossthemedical
papyri.

To this end, I havemadea selectionof someof the morefrequentlyappearing

'unknown'
medical
conditions to classiýthoseunder(therespective)
andhaveattempted parts

of the body.I do notproposeto evaluatetheirtreatmentsbut ratherto considerthe nameof the

fromthe typeof pain.I do not suggestthatthe list is

conditionas a possibleadaptation

butmerelyrepresentative.
complete

(1)TheEve

Thefollowingareconditions
whichaffectthe eye.Theyareall listedby Nunn328as

'unidentified'
conditions:ným,Chn,bid pdst, Prw

(a)Atfl
Thistermappears np andits variants.Itsmeaning
to derivefromtheadjective varies

between
'wild,neglected, dangerous
terrible329,
restless, 330
andinfected'.

AsthewordnM -t-IJ3 to described

it is usedasanadjective
(withvariants) a type

of wound(Sm4,23-4)- presumably ) or
) or with'rough'(wild?
onethatwas'severe'(terrible?

unevenedges?In Eb874ait describes Thismayreferto the'rough'feelof

a typeof swelling.

(restless)
the skinor movement In Eb197bit describesa
of the swellingon examination.

stomach
condition, onewithpainfuland'restless'
presumably symptoms.

It appearsas an eye conditionin Eb346,350,383.All of theseprescriptions

are

to theeyesdesigned
externalapplications to 'ddveout'nlvt. It hasbeensuggested
thatthese

328Nunn,Ancient EgyptianMedicine,Appendix13:217
329Wb 2:290
330
L. H. LeskoandB. SwitalskiLesko(eds.), A Dictionaryof LateEgyptian.5 Volumes(Providence,
RI, 1982-
1990),ii:25.

101
 to
corresponds the trachomatis
conditionchlamydia 331
trachoma. Thisis a disease
that is
-
throughhumancontactand flies and is especiallyrife in crowdeddomestic
transmitted

conditions
associated hygiene.
withpoor It in
results themost form
common of blindness
in the

world It
today. was presumably
alsoa largescale in
problem ancient The
Egypt. untreated

conditionis by
characterised scarringof the eye lid, in-turnedlashes,cornealulcersand

blindness.332

Inviewof thefactthatthecondition
wouldhavebeen in
widespread Egypt
ancient it is

333Thewordnlytwould seemappropriate:
logicalto expectthe conditionto havebeennamed.

being'thetroubled ) eye'andalsoimplying
(terrible? (neglected)
widespread disruption
physical

to theeye.

, -
2,
(b)tbnEDm.

Thiscondition in Eb349,381,337
appears Nunngivesthecondition
andRam111. as a

doesin factsuggestan
'thn injury'of theeye.334In Eb337(kt nt r t1mm irt) thetreatment

injuryto theeye.Westendoff its to

considers nature be a (split,
'Ritzung' )
etc.
scratch caused

bya foreignbody.335

A21the verb'driveout' (dr) is usedsuchthatthe remedyis

in Ram111,
However,

'todriveoutthfif dr thnpw. Thisimpliesthatthnis actuallyan'external'

intended attachment,
,
ratherthanan injury.Eb349seemsto confirmthissincethe condition as being
is described

331Thiswasoriginally proposed byEbbell,seeGrundfiss VIA72.

332J. 2nd
Murtagh, General Practice Ed.,(Roseville, NSW,1998), 471.
333It is stillhyper-endemic in theNileDeltatoday.Overhalfof pre-school children haveactivetrachoma. Some
90%of residents, over25 yearsof age,havebeenshownto displaysubstantial scarring.
conjunctival See,P.
Courtright et al.,'Trachoma andblindness in theNileDelta:currentpatterns forthefuturein the
andprojections
ruralEgyptianpopulation', BritishJournalof Ophthalmology 73 (1989),536-40.The problemseemsto be
connected withcloselyclustered familygroupsandtheabsence Theseconditions
of properlatrines. musthave
alwaysexistedin this region,P. Courtright et. al., 'Latrineownership as a factor
protective in inflammatory
trachoma in Egypt',BritishJournal of Ophthalmology 75(1991), 321.
334Nunn,AncientEgyptianMedicine,225.
609.
335Westendorf,

102
tsw.f i.e. whichis bound/attachedto the eye.Againin Eb381the problemseemsto be

causesinceis described
orwithanexternal
external asbeingPr(upon)theeye.

Faulkner the tbn to

gives word as a verbmeaning 'injurethe 336
eye'. Butit appears

it is morelikelya nouni.e. theinjuryitself,asa resultof something

fromtheevidence actually

the
entering eye.Although
the strikingarmdeterminative
sometimes with
appears the wordit is

todirectlyrelatethecondition
notpossible to anyknowncausative
verb.

blAtZ

Thistermappears Eb368is to 'driveout(dr) bid in (m) theeyes'.As

in Eb368,385.

for the same

it is unlikelyto be an injury.Eb385is an incantation
botheyesare mentioned

butmentions
condition: 'watering'
of theeyes.

(d)p dst "- Ko"

Thistermappears withtheeye.Theverbmeansto 'stamp

in connection
in Eb355,430

orflatten'337and toderive
appears inconnection
fromthewordfor'foot'pd It alsoappears

withthecompounding
of drugs(mortar
and ).
pestle? The of
meaning thetermis givenby the

Grundriss 338
asa 'smallpellet'. Inthissensetheytakeit to referto a 'sty'.However,
thereis no

for thisotherthana commitment

evidence in respectof
aspectof its meaning
to a particular

drugpreparation I thinkit as probable

(pelleting), thatthetermis referring in
to thesymptoms

termsof 'stamp,flattenetc.' Inthiscase,it couldreferto thetypeof pain(flattening,

beating)
or

thestateof theeye,flattened,
perhaps closed.Thelattersymptom
wouldbea typicalsymptom

(infected,
of blepharitis closedeyelid).

3x Faulkner,A ConciseDictionatyof MiddleEgyptian,301.

337Hannig,299.
302. The reasoningseemsto basedon the fact that grounddrugs,in their preparation,are
3n GrundrissV11:
reducedto a smallpellet.

103
(e),ýirtv
for ',§inv in both eyes'.The
This conditionappearsin Eb351as a prescription

hereincludes
treatment thelocalapplication ox
of roasted liver
to the Fresh
eyes. liver
contains

a highsourceof fat solublevitamins

including of vitaminA canresult
vitaminA. Thedeficiency
in the impairmentof visionin dim light or night blindness.It is this fact that has led to the

betweenthe treatment
association in that93,
withliverin Eb351andnightblindness, rw has

339However,
beentakento meannightblindness. nightvision(orindeednight)is not
impaired

mentionedin Eb351.340
Thestorageof fat solublevitaminsin the liveris a comparatively
recent

andit wouldbewrongto ascribethisknowledge

discovery to theancientEgyptians.
Also,any

contentin theliverwouldberemoved
vitamins bycooking.
Equallyabsorption
throughtheskin

wouldbeseverely
limited.

Whilstthiscondition appliesto theeyesit cannotbeconsidered

obviously a treatment

fornightblindness. nolexicalconnection
AlsoI cansuggest withpain.

(2)TheSkin

lkw4 Pw3w,Psk

(a)lkwt

Thisconditionis described
by Nunnas an 'unidentified
diseaseor manifestation
of

341
disease'. I consider
However, it to morespecifically of theskin.It appears
referto a condition

Thesearepartof a runof prescriptions

in Eb543,544,545. fromEb537whichareintended
to

339Both Ebbelland Westendorfhave committedthemselvesto this conclusion;see Nunn,AncientEgyptian

Medicine,200.Thisconnectionis oftenquotedas an exampleof Egyptianmedicalprowessin the recognition of
vitamin See,
treatment. for example,G. Wolf, 'A historicalnoteon the modeof the administration
of vitaminA in
nightblindness',AmericanJournalof ClinicalNutrition31, (1978),290-2.
340It appearsas an incantationfor Prwof theeyesin BMEA 10059,22-24.
341Nunn,AncientEgyptianMedicine,217.As doesthe GrundrissVII(l):13

104
treat skin wounds.Westendorf the to
considers condition be (eczema,
Hautblase skin

342
vesicles).
Thecondition
is likelyto havebeenonewithsymptoms anditching'.
of 'irritation

(b)Pwlw WMýi

Thiscondition
onlyappearsin Eb123.It is an externalpreparation
designed
to drive

outpainfromthepatientwitha 'skincondition 343

andwithitt andhWIW. Westendorf
considers

thatalsocauses'trembling
thisasa skincondition 344
andshivering'. Cerl:
ainly,some'motion'of

thebodyis impliedsincetheprescription to cometo a

tellsus thatit willcausethecondition

'halt'.It is difficultto envisage

a skincondition withallthesesymptoms.
complete both
However

thelattertermsarelikelyto bevariations of theindexcondition.

onthesymptoms

ThewordPwiw appearsto derivefromPwc meaning'foul,offensive,

putrefaction'

etC.345 InLateEgyptian tohavebeenextended

theuseofthewordseems 'worry
tomean or
itt 347 to
346
vexation'. fromtheverb
toderive
At seems 'flyup'.Thecombination
of
theseseemsto implya foul skin condition(infected)that is 'flared-up'(sore,inflamed?
),

andrestless(itching?
agitated ).

1M 0ýý;
(3)Psk '-*-,

348
cutting)'. It clearly
Nunngivesthis wordto meana 'diseasedemon(especially

derivesfromtheverb'to cutoff,clip,deprive'etc.349It appears

to beactingasthenameof the

342 641.Eb546usedthetermkikal similarly

Westendorf, translated.
343Westendorfgivesthetranslation
asZittem?
SchOttelfrost?
- trembling, 567.
Westendorf,
shivering.
34Thereis nomention offeverorheatwhichmighthavemadea diagnosis easier.
345
Wb3:50-1
346LeskoandLesko,Dictionary ofLateEgyptian,
ii:104.
347 Wb3:50,5GrundfissVI1:111
348 Egyptian
Nunn,Ancient Medicine,221.
349
Wb3:168

105
demon,in thatit is 'theonewhodepriveS1350(of inflictsdisease.It is
health)andconsequently

bothdescriptive It appears
andaetiological. in Eb854e the'capture'
whereit explains of theair

whichis ordinarily to theearsviatheconnecting

supplied vessels. in Eb360
Thetermappears

in an incantation
for an eye condition.
351The conditionmay be one wherethe sightis

'cutoff or 'deprived'
temporarily i.e. a condition impairment
withthetemporary
associated of
thevision.

(4)Mgpnt

Thiscondition
mgpnt in
appears the Hearst
Papyrus
at H160-6
andin 9,10,
London

16,and25 (in demonicform).Leakeconsiders for the

thattheseareexternalpreparations

of 'bone,jointor muscledisorders'.
treatment 352This
is because
theyall includemild,alkaline,

astringentagentsincorporated
in a fatty basewhichare obviouslyintendedfor external

353However,
massage. Westendorf as does
thisto be an actualskincondition
considers
Bardinet it asan'eczema'
whospecifies and'eruptive' 354
condition.

(5)NsytandpW

Boththe Grundfiss
andNunnconsiderthetermnsyt'ý'W6P-appliesto an unknown

diseasethatis causedby a 'disease-demon'.

355
Thisis essentially
because
of theappearance

of the termin London5 andLondon25 bothof whichare spellsintendedto exorcisethe

condition.

350 VI1:635
Grundriss
351Lefebvrethought thewordbskapplied to migraine.
Hegavenoreason, butpresumably
thoughtit appropriate
tothesymptom of'cutting'
painThetermnowgenerally believedto haveappliedisgs-tp, GnindissVII:
636.
352Leake,TheOldEgyptian MedicalPapyri,
322.
m Theskinseemsto beinvolved in BMEA10059,6.'...WhichcomesupfromHeliopolis whichpenetrates and
emerges from Isisstands,laments, aftershe has raisedup (?) the '
skin! from
Translation C. Leitz,Magicaland
...
MedicalPapyrioftheNewKingdom (London, 2000).
354Westendorf,239.T. Bardinet,
'Remarques surlesmaladies dela peau'Rdt 39(1988), 21-3.Inthisarticlehe
showsthatthereareclosesimilaritieswithCopticterms.
355GrundfissVII:480.Nunn,AncientEgyptian Medicine,223.

106
 sntntnsyt (Lond5)

InLondon
25it appears withtheunknown
additionally tmyt,
condition
'm A 25). 356
gntntnsyt tmy0-M (Lond

In London5 and London25 both of the aboveconditionsare clearlyintendedto be

curedby magic,but this doesnot automatically are causedby

meanthat the conditions

demonicpossession. in conventional
Boththetermsappearelsewhere Theterm
treatments.

nsyt in
appears H206-11
wherethe Grundfiss the
considers termnsj4 to be a diseaseof some

'internal Leake
organ'. thinks
these to
mightrefer 'fever,
although 357
givesnoreason. However,

thismakesit difficultto reconcile in connection

withits usein Eb751whereit appears withthe

eyes,to 'driveoutnsjlfrom botheyes'.

contextin H168,
thetermtmytis seenin a 'traditional'
Equally,

pbit nt dr tmyt, a 'prescription

to driveouttmyt.

it
in somecasesmayinvolvedemonicinfluence
Thus,whilstboththeseconditions

doesnotpreclude
theirappearance
elsewhere.

Boththesetermsmightbe explainedif theywereconsidered

in termsof adaptive

Forinstance:
terminology. nsyt derive
might fromnsr = bum,flameetc.or nsywt = javelin

(?sharp,quick,stabbing), 358
hiUifrorntheverbtmtto beat,powderetc.

Thus,whatstartsout to describethe typeof paineventually

becomesadaptedto

describe so thatnsyt couldbe a diseaseor condition

thecondition, by eithera
characterised

'burning'(fever,Leake?
) or 'stabbing'
pain.ThetermhW wouldbe anotherpainfulcondition

beinga painsimilarto 'beating'

themainsymptom ).
(palpitations?
or'pummelling'

39Thistermis alsoanunknownmedical whichis similarly

condition described illness,Wb5:306,
asa 'demonic
V11:
Grundriss, 952.
Leake,TheOldEgyptian
357 Medical
Papyri,
58
W Wb2:335-6fornsr etc.,Faulkner,
A ConciseDictionary
of Middle 139
Egyptian, for ns Grundriss
VI:954
andWb5:09for tmt

107
 Suchconditions as such.This
wouldbe by definitionpainfulandrequiretreatment

wouldbeanalgesics.
wouldfit inwithH209andEb751,inwhichcasetheremedies
explanation

It wouldalsoallowforthecondition suchasin Lond5and

influences
to becausedbydemonic

Lond25.

(6)VerbsandPain

In thissectionI havetakena smallselectionof commonly Egyptian

occurring verbs

whichdescribe pain.I havethenlooked

actionswhichcouldbeusedto relateto or to describe

at theiroccurrence the texts

within medical in to if
order see anyare into
'adapted' termsfor

painfulmedical
conditions.

Thefollowingverbswereselected:

cý 'fa X
Q9 ----j 359
to 'crush,beat,pound,pulvedse.
TI xi
ng m x, var. k-j to 'break,force.
' 360

Ill'i
ppd x, oll"I 361
var. x to'break,smash,sevee.

Adr to 'grip, grasp, seize'.362

ýx-W-- 363.
sd to 'break,
smash'.

ýO-Ul
sPm to 'crush,
pinch, 364
bruisel.

Hannig,940.
359'Zerstossen',
M'Aufbrechen',Hannig,438.Grundriss VII:487.
361 Hannig,290.Grundriss
'Trennen,aufschneiden', VI1:962.
362'Zimmern',Hannig,450.GrundissVII:499.
363'Brechen',Hannig,787.Grundriss
VI1:827.
3"'Zerstosssen,zerquetschen,
zerstampfen', Hannig,736.

108
 NO
365It onlyappearsto be usedin
Thisverbmeansto 'crush,beat,pound,bruise,etC.

connection the
with preparation
of drUgS.
366

ng

It is usedin thecontextof
Theverbmeansto 'break,force,reduce,anddisintegrate.

stonebreaking.
It is alsoin the drugs
contextof reducing
medical to a state
manageable in the

ofdispensing
process It is notseenin connection
medicines. withmedical
conditions.

(C)pPd (pAd

This verb meansto 'beat, sever split, crack etc'.367This is also only seen in the

of drugsin themedical
preparation context,(Eb875c,
Bin26).

(d)ndr

Thisverbmeansto'grasp,seize'.Thewordis usedin thecontextof wounds.It is used

as a verbin Sml4 (6,8), 26 (8). Hereinstructions

are givento (4dr) i. 'to (draw
e. grasp'

together) it is alsousedas a nounwhichis descriptive

thewoundpriorto closure.However, of

a disease
or disease
state,e.g. in Sm22,11
the is
condition described (mn
as a suffering ) of

n&-u4in (m) the This

anus. to
appears beanadaptation
of thetype seizing.
of pain:grasping,

to describeanalpainwhichwouldproducean involuntary
Thisseemsappropriate seizingor

(pain)
grasping in theanus.

GrundrissVII:785.
A ConciseDictionary
365Faulkner, of MiddleEgyptian,300,GrundfissVil: 962,'Verstossen'.
W As is the verb bbk'to beatup, grind'(EbI1,21).But it appearsonly as nounoutsidethe medicaltexts,for
example,'the thud(bbk) of thy shaft (spear),in A. M. Blackmanand H. W. Fairman'Mythof Horusat Edfu11',
JEA29 (1943),6.
367GrundrissVII:2811

109
(e) sd (sLd)

Thisverbmeansto 'break,smash.It is useda verbin thesenseto 'breakup'(dispel)

disease (eliminate)
or paine.g. sd wbdwtosmash pain,or to 'break'
up in
pains thebodyi.e.

(Eb,BIn,H). In PapyrusSmiththe wordis usedin

to get rid of, to act as an analgesic,

withfractures
connection of thebone(a break).Suchthatin Sm5(glossA) it appears
as a sd

fracture'.In Sm34it is usedin connection

of theskull.Herethewordmeansa 'smashed with

of a woundsuchthatit is usedadjectivally
thedescription sid(wbnw) Pr s i.e. a 'fractured
or

wound'.It alsoappears
smashed in connection of boneswhichhave
withthe'knitting'together

(broken)
beensmashed sidf (H13,15).

MSPM

' Thewordalsoappears
Thismeansto 'crush,pinch,pound. in themedicaltextsas a

thetypeof (crushing)
Thetermcouldbe describing
medicalcondition. in
pain.Forexample,

teeth(gums)areinvolved.
Eb553ulcerated is intended
Suchthattheprescription to 'driveout

spm (the ing/pounding

crush pain)of teeth'
ulcerated (stm nw jbPw). Beatty
Chester 2 is

withsbm n (anus?
concerned ),368'a crushing(sensation)
of the anus'.Sm33concerns
the

(sensation)
neck:spmm is n 4bt, 'a crushing in thevertebrae
of theneck.

3w 213.
Westendorf,

110
 CHAPTER
4: DISEASE

4.1Back-qround
- Sources
- Studies
Previous

Thepurpose
of this is to the
chapter examine patternof in
disease ancient in
Egypt anattempt

to identify of illness.
themajorcategories

Earlytwentieth diseaseinvolved
centurystudieson ancientEgyptian theexamination

of humanspecimens
of largenumbers whichshouldhaveprovided
valuablerepresentative

369
evidence. However,
in respectof bone
degenerative disease, of
some theinitial
conclusions

from thesestudieshavebeenre-appraised of later scientific

becauseof the availability

Laterstudieshavemostlybeenon a muchsmallerscaleandhavetendedtowards
techniques.
370Forinstance, debateasto whether
therehasbeenconsiderable
thespecificor theesotedC.

a separate existedin ancientEgypt.Suchwasthepreoccupation

dentalprofession thatwhena

that
in a tooth,it wassuggested
femaleskullwasfoundat TellDuwair,witha metalfragment

thisprovided It
suchevidence.wasinitially to
thought bea filing
dental had
which beeninserted

surfaceof a lowermolartooth.However,
intotheocclusal a laterdetailed showed
examination

fragment
tobea smallmetallic
thismerely deathandwhichhad
thathadbeenbittenonbefore
itself.
failedto displace 371

As for examples
of the esotericthereis a continuum the
regarding
of publications

body
unusual shapeof the NewKingdom
king In
Akhenaten. the latest
of theseBurddge

Marfan's
suggests 372
syndrome andCattaino thatAkhenaten
suggests frommyotonic
suffered

369The principalworkwas carriedout by the anatomists ElliotSmith,WoodJonesand Derryworkingin

conjunctionwiththe extensive excavations carriedout by Reisnerbetween1907-10. Fora biography of the
'players'andtheirrelationships
withReisner see,A. Waldron, 'TheStudyof HumanRemains fromNubia:The
Contributionof Grafton
ElliotSmithandhisColleagues to Paleopathology,MedicalHistory44(2000),363-388.
370Notsurprisinglysubjectschosenfordiscussion aredictatedbythebackground of theresearchers asopposed
tothemoregeneral earlieroverallstudies.
371P.Ghaliounghui,'Dida dentalprofession existin ancientEgypt?Medical Histoty15(1971),92-4.F. F. Leek,
'Reputed EarlyEgyptianDentalOperation, anAppraisal', in D. Brothwell
andA. T. Sandison(eds.), Diseasesin
Antiquity 1967),
(Springfield, 702-9.
372A. L. Burridge,Warfansyndrome andthe 18thdynastyroyalfamilyof ancientEgypt.Preliminary research
News111(2000),
reporf, Paleopathology 8-11.
 373Abretson
dystrophy. diagnoses fromwhichresultedin
disorder,thedisability
an endocrine

coupledwitha lackof 'maternalaffection'is

fromthe family.Thisexclusion,
his exclusion

arguedto be the explanation 374I mentionthesewithout

for his later'turn'to monotheism.

but,I wouldpointoutthattheseareall fairlyrare

on thevalidityof anyconclusions
comment

Suchspecificattentioncandistractandgivea falseperspective
medicalconditions. on the

overalllevelandtypeof disease.Manypublications
on diseasein Egyptdrawfromthesame

popularpictorialsourcessuchthatthe readermightbe leftwiththeimpression,

for example,

that dwarfism was common or that blindness was a prerequisitefor a musician.375Equally,

thereis a presentand.sometimes tendency

misleading of knownmedical
to matchexamples

withancientpictorial
conditions Forexample,
representations. diseases
anarticleonendocrine

bytwowellrespected
in antiquity researchers Theypresentan illustration
strainscredibility. of

a potteryvasefromthe Mochicaperiodof Peru.Theysuggestthatthe staringeyesof the

humanfigureonthevase'werepossible
intended 376
to portraythyrotoxicosis'.
Thesamearticle

of Cleopatra
claimsthattherepresentations at Dendera
showsher'witha full neckthatcould

begoitrous.However, potsshowthatthestareis presentonthem

of Mochica
anexamination

eitherthewholepopulation
all whichsuggests fromthyroidproblems;
wassuffering or, more

wasjustanexample
obviously Asto Cleopatra's
of artisticstylisation! 'goitre',thesameshaped

neckis presenton thegoddessIsisandotherfemaleson templesat KomOmboandPhilae

simplythePtolemaic
andis I suggest ratherthangoitre.
styleof representation

I believeit is necessary to disease.In this respect

to takea moreprosaicapproach

willbedrawntowardsthemoregeneralconditions
attention thatafflictedthewiderpopulation.

Fromsucha list the relevance in an

will be considered
andextentof painas a symptom

attemptto drawconclusions
asto theneedforpainkillers.
A recentLondonsymposium
on pain

373
G.Cattaino andL.Vicario,
'MyotonicdystrophyinAncient
Egypt,European 41(1999),
Neurology 59-63.
374C.SAbretson &C.Abretson,'Akhenaten-pharaohand heretic', Nor
Tidsskr. 119(1999),
Laege/bran, 1115-8.
375 ( London,
J. Filer,Disease 1995)53-66.
376
C. Sandison andA. T. Wells,'Endocrine
diseases',
in Brothwell andSandison ),
(eds. Diseases
in Antiquily,
522.

112
 thatthosesocieties
concluded thatpromoted theeffectivetreatment
and'demanded' of pain
377
hada bettersystemof medicine
(paincontrol) thanthosethatdidnot.

'Patients for The

onlyconsultphysicians painor anxiety. reliefof painis a duty
prime of

378
a doctoe.

Thus,if thelevelof painfuldiseaseis highit shouldprovidean impetusto treatment.

to theoverallabilityof theEgyptian
Theabilityto treatandcontrolpainshouldbe proportional

physician.
Onthefaceof it, theevidence
fordiseasein ancientEgyptcompared
withotherearly

societiesis wide and abundant.Evidenceis availablefrom threemainsources:human

of disease(bothpictoriallyand withinthe literarytexts)and the

remains,representations

But naturally,thereare problemswith the interpretation

medicaltextsthemselves. of the

in theirremitsufferedfromthe lackof modern

Manyearlystudieswhilstambitious
evidence.

scientific It mustalsobe remembered

andtechniques.
equipment thatevenareasof scientific

studyaredrivenandinfluenced
by the historical
current or
perspective fashion.
Forexample,

the originsof venerealdiseaseandin particularsyphilishavelongbeenthe subjectof a

379
Newor OldWorlddebate.
continuing of thelastcenturysyphiliswasa
Aroundthebeginning

majorincurabledisease.Consequently,
most physicians with its
were well experienced

Thisalsoappliedto tuberculosis
symptoms. whichwasalsoa verycommon So,
condition. it is

thatFouquet
notsurprising in a studyof humanremains of bothsyphilis
thepresence
reported

377
Reported
in TheTimes, July7 2000.
378
P.McCarthy,Arthritis
andAlliedConditionsIstEd.(Philadelphia 40.
1985),
379 at theUniversity
Researchers of Bradfordreportedthatbonydeformities of syphilishadbeen
characteristic
foundonremainsin Hullandwhichdatedbackto 1300-1450; priortothediscoveryof theNewWorld.However, it
nowappearsthatthosedatesaresuspect sinceit hasbeendiscovered thathighfishdiets(oftheHullresidents)
mayproducespuriousradiocarbon determinationofage,reportin ThePharmaceutical 266(2001),
Journal 768.

113
 380However,
andtuberculosis. as dueto the post
the bonecondition
Smithlaterattributed

motlemeffectsof burrowing 381

beetles.

Evennowtheidentification
of thedisease and
process its withpostmortem
confusion

382Pseudo-pathology
aftefactsremainsproblemafiC. Thisis the effectthatthe
is a problem.

surroundingenvironmentcan have on humanremains.A numberof factorscan produce

changesto thoseremainswhichovertimecan mimicthe signsof disease.Forexample,the

sheerweightof soil abovea samplecan producepost mortemskull defectsthat mimic

383Mouldscan form that simulateleucocyteswhich can give rise to the false

disease.

impression
of inflammatory
lesions.Problemscan arisefromthe physicalchangesoccurring

dueto the natureof the embalming

processitself.Forexample,
an initialdiagnosis
of an
in an elderlyfemalemummywaslatershownon closerexamination
arterialaneurysm to bethe

384
resultof a tearduringmummification. for the
it wasnotuncommon
Alsoto addconfusion,

to includepartsof differentbodiesor animalremains

embalmers in the mummy 385As
pack.
importantly,
it mustbe remembered factorscanproduce
thatpostmortem thatmight
changes

obscurethe presence In this respectthe incidence

of 'true'pathology. of diseaseactually

perceivedin humanremainscouldbe lowerthatthat recordedandso neverfullyquantifiable.

However,at the sub-physical

levelidentifiabletissuechangesare lesssusceptible
to artefact

changes.A recentpapersuggeststhatan arteriallesionis stillidentifiable

in remainsafter3000

yearsandalsoillustrates At a chemicalleveltissue
today.386
a typeof diseasestillencountered

380D. Fouquet,'Observationspathologiques',in I de Morgan,Recherches sur les ofiginesde I'tgytpe (Pads,

1904),350-373.
381G. ElliotSmith,'Reporton the HumanRemains',TheArchaeological Surveyof Nubia.Reportfor 1907-8,
(Cairo,1910).
MIE. Buikstraet al,'WhatdiseasesplaguedtheancientEgyptians', in W.V. DaviesandR.Walker(eds.),
Biological
AnthropologyandtheStudyof AncientEgypt(London1993),27.
383
P. H. K Gray,'Calcinosis
Invertebralis
withSpecialReference to SimilarChanges Foundin Mummies of
AncientEgyprin BrothwellandSandison, Diseases in Antiquity,
2
384
H.Hankeet al.,'Thediscovery of thepaleo-physiologicalaspectof athersclerosis revied, Acta ChirBeIg
-a
101(2001),162.
3n El MahdyC., Mummies,Mythsand Magicin AncientEgypt(London,1995).96. lkrarnand Dodson,'The
Mummyin AncientEgypt,118-129.
386
R. Magee,'ArterialDiseasesin Antiquity,MedicalJoumalof Australia169(1998),663-6.

114
phenolicacidand inositols
havestill beenisolatedfromthe tanninusedin the mummification

387
processes. Equally,
identifiable
DNAhas been from
recovered bone
Egyptian fragments

some5400 388
yearsold. However, to the
a morerecentstudy measure DNA in
half-lives

is higherthanpreviously
remainshasshownthatresidualDNAregression
ancientEgyptian
believed.Thisprovidesan indirectargumentagainstthe reliabilityof claimsaboutthe recovery

of activeDNAfromEgyptianmummies 389
andboneremains.

in privatetombscenesand
of diseaseare foundmoregenerally
Representations

They
statuary. to
appear be to
candidandcontrastparticularly formal
royal 390
stylisation. The

(JE51281).
statueof Senebthedwaffandhisfamilyis a famouspiecein theCairoMuseum
His physicalstatureseemsnot to havebeenregardedas sociallyunacceptable
or even

'abnormal'and may have representedan elementof noveltyor enterl: 391

ainment. The

Autobiography
of Harkhufillustrates albeitof a youngboy,shown
the evidentfascination,

392A woodenfigurinefromthe FifthDynastyappearswith a humpedback

towardspygmies.

deformityof the chestwhichmightbe a possiblecaseof Pott'sdisease

and corresponding

(CairoMuseum,
JE 52081).
393A scenefromthetombof Mehuof the SixthDynastyat Saqqara

five
shows fishermen
eitherwithenlargedumbilicusand/orenlargedscrotumswhichhavebeen

387P. Mejanelleet al., 'Identification of phenolicacidsand inositolsin balmsand tissuesfrom an Egyptian

mummy,Journalof Chromatography 767(1997),177-86.
388E. Crubezyet al, 'Identification
of Mycobacterium DNAin an EgyptianPott'sdiseaseof 5,400yearsold, CR
Academy Science1//321(1998),941-51.
3891.Morotaet al.,' DNAdecayratesin papyriandhumanremainsfromEgyptian archaeologicalsites',American
Journalof Anthropology 117(2002),310-8.
3wAkhenaten is theexception if we areto believethathe wasaccurately Otherwise
presented. signsof disease
wereexcludedfromroyal'portraits'.Forexample,the conditiontalipes(clubfoot)wascommonly represented in
non-royals.(SeeNunn,AncientEgyptianMedicine,79).Yet the NewKngdompharaohSiptahescapessuch
representationdespitesharingthisobviousdefect Rowlingsuggeststhatthe reasonfor suchexclusions maybe
foundin the sixty-ninthchapterof the Bookof the Dead:1 havebecomea spirit I havebeenjudged...I have
destroyedthe sicknessand sufferingwhichwas there! This passageimpliesthat the diseasefromwhichthe
deceased diedwasnotreproduced Thecareto restorethemummyto perfection
in thehereafter. is demonstrated
by thefactthatthebedsores of Nesi-Tet-Nab-Taris werecoveredby gazelleskinat mummification, J. T. Rowling,
'HemiaIn Egypt!in Brothwell and Sandison, Diseasesin Antiquity;35-6.
,
391Theyappearto havehada specificplace.Theywereregarded as Tullhumansor perhapslife-longchildrenas
themanifestation of thesungodReandof Horus',V. Dasen,Dwarfsin AncientEgyptandGreece(Oxford,1993),
51.
392Lichtheim,AncientEgyptian LiteratureVolume1,23-7.
m Filer,Disease, 70.

115
variously to hernia,signsof gynaecomastia
ascribed 394Scenes
andschistosomiasis. of blind

appearfrequently;
harpists forexample, the of
on wallrelief thetombof from
Paatenhemheb

the Eighteenth
Dynasty(Rijksmuseuem,
Leiden,AMT 1-35).The stelaof Romaof the

Dynastyshowshim with a severelywastedright lower leg (Copenhagen

Eighteenth

AE.I.N.13Y).Theproblemis to understand
howrepresentative
thesedepictionsactuallywere.

In the casesof RomaandSenebtheir'deformities'

wereobviouslyimportantfeaturesof their

persona.In other casessuch featuresmay have beendeliberatelyselectedto add some

variationandcontrastto otherwise
repetitivestylisation.

Other sourcesof the evidencefor diseaseare the medicalpapyri themselves.

However, butdefinitive.
theseareanything Thereareproblems
withtheactualidentification
of

medicalconditionswhichwerediscussedin Chapter3 on terminology. itselfcan

Terminology

alsochange theGreekwordTE1TCTCI
withtime.Forinstance, iscommonly as'leprosy',
translated

butintheclassical
periodincluded
skindisease
suchaspsoriasis,
eczema never
andprobably
trueleprosy.
In medieval to includeleprosyandmayhavealso
usageitsrangewasextended
395 for
to
referred syphiliS. ofthestudyof Egyptian
Inrespect textstherehasbeenmoreconcern

specificsto the extentthat it has effectivelylimitedprogresson an holisticand an effective

analysis.Also, there is 'an underlyingfascinationwith and delightin demonstrating

the

of Egyptiancivilisation...
precociousness thesebiasesarein partdueto thenatureof available

data,but are ultimatelysymptomatic

of the historicalandefite-centred of traditional
emphases
Egyptology'.
396

However,settingasidethe problemsof identification,

it is difficultto ascertainthe

actualincidenceof specificdiseasesfromthe medicaltexts.Fora modemanalogy,fromthe

of thecontents
examination it wouldbe difficultto picturethe
of anycurrentpharmacopoeia

394
C. Reeves,Egyptian
Medicine (PrincesRisborough,
1992),34
395
P. H.K Gray,Pseudopathology, in Brothwell
andSandison, Diseasesin Antiquil)ý17.
3%G.J. ArmelagosandJ. Mills,'Paleopathology in Daviesand
of Egyptology,
as Science:thecontributions
Walker,Biological
Anthropology, 5

116
 level
overall of health
andmedical
sufferings that For
community.
within particular instance,
at

in
present the UKthe prescribing
of analgesics for
accounts some12%of all 397
prescriptionS.

Thisfiguretellsusthatpainfeatures
highin eitherpatients' prioritybutdoesnot
or prescribers'

whichdiseases
indicate intheHearstPapyrus
thatpain.Ofthe260prescriptions
areproducing

ten (H144-149,155-158) some4%of thetotalnumber,yet

areto 'improve'the hairrepresenting

onlytwo (H8,9)
prescriptions to
appear to
relate dental lessthanonepercentof the
problems,
total. 398.Statistically thandental
thistellsusthathair'problems' fivetimesgreater
werealmost
thatlogicandexperience
Yet,it is a conclusion
disease. fromothermodelstellsuscannotbe

possible.

Thefundamentals for life are generallyacceptedto be food,waterand

necessary

shelter.In thisrespectthe Nilevalleyseemsto haveamplyprovidedall. Barleyandemmer

wheatwerereadilycultivated
andsupplemented Shelterwas
by fowl,fish andvegetables.

throughtheuseof mudbricks.All of thiswassupplemented

available bya favourable
climate.

Underthesecircumstances
it is notsurprising
thatthe PapyrusInsinger,
albeitoptimistically,

tellsus thattheideallifespanwas100years. in respectof modalityhave

399Actualstatistics

centuryand then oftenonly for European

only beenavailablesincethe mid-nineteenth

The
countries. lowlife duringthisperiodin Europewasdirectlydueto thespreadof
expectancy

diseases
infectious withindustrialised
associated livingconditions.
Incontrast
onemightexpect

of ancientEgyptto haveprovideda healthierlivingenvironment.

the non-industrialisation

averagelifeexpectancy
However, for pharaonic
Egyptappearsnotto havebeenhigh.It has

beenestimatedas 39 yearsfor men and some34-36yearsfor women.

400It shouldbe

397Department of Health,
'Theuseoforalanalgesics in primarycare',MeReC Bulletin11(2000),1.
398Leake,TheOldEgyptian Medical
Papyd, 63
399 Ancient
Lichtheim, Egyptian
LiteratureVolume/, 199.
400W.B. Harer'Healthin PharaonicEgypt,in DaviesandWalker,Biological Anthology andtheStudyofAncient
Egypt,20.Thesefigurescanonlybe estimates. Theyarebasedon actual,modemfiguresfor maternal-related
andneonatal lossin ThirdWorldcountries.
Similarfigureswereobtained fromtheexamination of actualremains
fromtheTurincemetery (709skullsshowedanaverage
collections, age at death of 36years).B. Chiarelli
et al.,
'Ricerchesullecollezione
antropologicheegizianedell'Instituto
di Antropologia di Torino',Rivdi Antroplogia,
53,
(1996),61-9.Theaverage ageat deathincreases aftertheinitialperiodof childhood diseases.In RomanEgypt

117
 that
remembered thesefigures
whether
correct
or notareonlyan and
average should
not be

in
viewed isolation.
Thelife expectancy
of womensince1900in has
England increased
and

that 401
nowexceeds of men. Thisis notbecause
of some or
reversal in
change disease
pattern

butsimplybecause
of the reduction
of maternity It
mortality.
related is to
reasonable expect

thatwomenin Egyptwhoescapedmedicalincidentduringtheirchild-bearing
ageweremore

likelyto liveaslong,or perhaps,

longerthanmen.

that it will be impossible

Thischapteris writtenwith the awareness to completely

thetypeandincidence
conclude is
of diseasein ancientEgypt.WhatI hopeto demonstrate

thatthereis evidencethatthereweresufficienttypesof commondiseasesthat presented

suchasto requiretreatment.
painfulsymptoms

diseasewasdoneearlyduringthefirstthirtyor
Mostof theworkon ancientEgyptian

of X raysin 1895allowedthe non-destructive

so yearsof the lastcentury.Thedevelopment

of mummies.
examination to examineEgyptianremainsas earlyas
Petrieusedradiography

1898.It is the technique

of X-rays
and its initial that the
novelty probablyspawned birthof

Muchearlyworkwasdoneby Rufferwhoundertook
paleopathology. histological
considerable

402
tissue.
of mummified
analysis of diseaseallcomefromthisearlyperiod
Theinitialdiagnoses

andhavebeencollatedin Table4.2.Thislist, althoughearly,still includesall of the main

of diseases
categories Inthissenseit is a representative
isolatedto datefromhumanremains.

it hasto be assumed
list.However, thattheremainsthemselves This
arealsorepresentative.

be But,
cannot statedwithcertainty. it is that
probable they the
aresince remainscomefrom

different
regionsandacrossmosttimeperiods.

Thereareproblems
identifying
infectious
diseasefromevidential Certainly
remains. in

recenthistoryinfectious
diseases of youngdeathswhich
forthelargenumber
wereresponsible

from300census lifeexpectancy
returns, (maleandfemale)
wascalculated at23.9yearsyet,increasedin 10year
oldfemales to 34.5-37.5years.R. S. BagnallandB. W. Frier,TheDemography of RomanEgypt(Cambridge,
1994).
401 Statistics
Central OfficeEnglishLifeTableNo7-PopulationTrends99Spring 2000
402M.A.Ruffer,'Histological onEgyptian
studies mummies, M6moires deI'tgypt 6 (1911),
Institute 3

118
drastically
reduced lifeexpectancy values.Inpre-antibiotic
Western societiesinfectious
disease
I
accounted for the baselineof illness;today,withits eradication
this positionis occupiedby

degenerative
diseases.
Thedifficulty
withits is
diagnosis that do
pathogens not leave
always
lesionsontheskinor bones.Somecancausechanges
distinctive to theouterlayerof bonebut

maybe no morethanjustan indicator

of infection
or inflammation.
However,
someinfectious

at laterstagescausedegenerative
diseases changesto theskeletonmakingthisan indicator
Forexample
of theirpresence thisis oftenthecasewithleprosy,
tuberculosis
andsyphilis.
Since these early diagnosesscientifictechniquesand methodshave radically

improved
suchthatin thosecasesthathavebeenre-evaluated
initialspecificdiagnoses
have

often been challenged.

403Often later work has been to correlateskeletalevidenceof

anddiseasein themedicalpapyribut,onlyto verifyor refutethetextsratherthan

pathologies

in a widersocialcontext.
to putdisease

However,
the evidenceof diseasesfoundpresentis still evidencethat that those

diseases Table4.2liststhosediseases
wereactuallypresent. forwhichscientific has
evidence

beenfoundfromhumanremains.It is presently
in roughlyhistorical
orderandwithoutinitial

as to its veracity.Thelist still represents

comment of diseasethathave
the maincategodes

fromhumanremains
beenisolated to date.Table4.2willbetakenasa startingpointto discuss

someof the actualdiseasesin detail.Thelist accordswiththegeneralacceptedpatternof

diseasefor ancientEgyptas described

by Nunn,DavidandMiller.
404FromTable4.2,1would

suggestthatit is possibleto placeall thechronicconditions

intobroad,genericheadings
for

detailed
discussion.
Thisexcludes
infectious because
conditions of identification
of theproblem

andbecause
of theirunsuitability
for analgesic
treatment. is excluded
Arteriosclerosis for the

samereasons.Thesebroadcategories
wouldthenbe carcinomas,
arthritisandotherbone

403See,Buikastra,
in DaviesandWalker(eds.), Biological 24-53.Otherexamples
Anthropology, arediscussed
belowinthetext.
404Nunn,AncientEgyptian
Medicine,64-95.A. R. David,'Disease
in Egyptianmummies:thecontribution
of new
Lancet349(1997),1760-1763.
technologies', Miller,MedicalHistory35,1-24.

119
 anddentaldisease.
conditions TothelistI wouldaddparasitic
worminfections
andrespiratory

disease inthetextbelow.
withanexplanation

120
 TABLE4.2

MedicalConditionsandFirstIdentifications

MedicalCondition FirstIdentification

cancer(ovarian) Granville
1825
rectalandvaginalprolapse Jones1908
osteoarthritis Smith& Jones1908,Ruffer& Rietti1912,Ruffer
1918,Smith& Dawson
1924
infection
mastoid Smith& Jones1908,Derry1909,Smith& Dawson
1924
arteriosclerosis Shattock
1909,Ruffer1910
carcinomas(others) Derry1909,Smith& Dawson
1910
(Pott'sdisease)
tuberculosis Smith& Ruffer1910
schistosomiasis Ruffer1910
pneumonia Ruffer1910
leprosy Smith& Derry1910,Smith& Dawson
1924
smallpox Ruffer& Ferguson
1911,Smith1912,Ruffer1914
scrotalhernia Smith1912
tuberculosis Smith& Jones1918
dentalcaries,abscesses Ruffer1918,
gallstones Smith& Dawson
1924
gout Smith& Dawson
1924

Referencesfor table: B. Granville,'An essayon EgyptianMummieswith observations on the art of embalming

amongtheancientEgyptians', Philosophical
Transactions of the RoyalSociety115(1825),269-319.F. W. Jones,
'The Pathological Report',ArchaeologicalSurveyof Nubia,Bulletin2 (1908).G. E. Smith& F. W. Jones,The
Archaeological Surveyof Nubia:Reportfor 1907-1908, (Cairo,1910).M.A. Ruffer& A. Rietti,'Onosseouslesions
in ancientEgyptians',Journalof PathologyandBacteriology 26,(1912),439.A. M.Ruffer,'Arthritisdeformansand
spondylitisin AncientEgypt',Journalof Pathologyand Bacteriology22 (1918),335-82.G. E. Smith,W. R.
Dawson,EgyptianMummies(London1924).D. E. Derry,'AnatomicalReporf,Archaeological Surveyof Nubia,
Bulletin3 (1909).G. E. Smith& W. R. Dawson,EgyptianMummies(London,1924).G. S. Shattock,'A reportupon
the pathologicalconditionsof the aorta of King Memeptah',Proceedingsof the Royal Societyof Medicine
(PathologicalSection)2 (1909),122-7.M. A. Ruffer,Remarkson the histologyand pathologyof Egyptian
mummies',Cairo ScientificJournal4, (1910). G. E. Smith & D. E. Derry, 'Pott'scheKrankheitan einer
AegyptischenMumie aus der Zeit der 21 Dynastie,in K. Sudhoff (ed.), Zur historischenBiologie der
Krankheitseffeger,Heft3, (Leipzig,1910).G. E. Smith& D. E. Derry,'Anatomicalreport', Archaeological Survey
of Nubia.Bulletin6 (Cairo,1910).M.A. Ruffer& A. R. Ferguson,'Aneruptionresembling thatof variolain the skin
of a mummyof theTwentiethDynasty(1200-10BC)',Journalof PathologyandBactedology 26 (1911),1-3.G. E.
Smith,The RoyalMummies(Cairo,1912).G. E. Smith& F. W. Jones,TheArchaeological Reportfor Nubia:
Reportfor 1907-8,(Cairo,1910).

121
4.3Carcinomas
Surprisingly
the situationregardingthe presenceof cancersin ancientEgyptian

remainsis notclear.It is notunreasonable

to assumethatthosechronicmedicalconditions

for
todaycouldalsohavebeenpresentin ancientEgypt.However,
generallyencountered

manyof thecausalfactorsarenotcomparable.
carcinomas Theriskof cancerincreases
with

age such that in populationswith low life expectancylower levels of cancerswould be

But thoseenteringold agewouldprobablybe at equalrisk.Alsomanyof the

anticipated.

moderncancersarethe resultof industrialisation changesin livingand

andthe subsequent

ecological 405
patterns. Theincrease
in presentdaymalignant hasbeenascribed
turnours to an

increasein life expectancy

and the enhancedinfluenceof environmental
factorse.g. air

pollutionand the nutritionalintakeof potentialcarcinogens.

A recentstudyshowedthat

inherited
geneticfactorshaveonlya minorrolein causingcancerbutthattheenvironment
is

the maincontributor 406Lungcancer,untilrecentlya majorcauseof

to the majorityof cases.

maledeath,is nowlowerin Western

societybecause in smoking.
of thereduction Conversely,

skincancersare increasing
dueto the fashionof sun bathingandthe increasein radiation

due to ozonedepletion.
exposure A highincidence for
of skincancersmightbe predicted

ancientEgyptbecause 407
of theclimate.

Certaintypesof cancersif untreated

are insidiousby natureandcan producelarge

tumoursbeforedeath.Thechangesthatthesecausedirectlyto associated
boneandtissue

canoftenbe seenin skeletal

remains
andso provide of
evidence 408
disease. Evidence
of

405By moderncancersI meanthosecausedby industrial chemicals cancerfromsoot,bladder

e.g. testicular
cancers fromorgano-chemicals.
406N.Spector, 'Cancergenesandtheenvironment, NewEngland Journal ofMedicine 343(2000),1494.
407Thereis highfrequency of skincancersin Egypttodaycompared to Western Europe. Some60%of theseare
directlyattributable
to exposure to thesun.J. E. Cleaveret al., 'Xeroderma pigmentosurn patientsfromEgypt:
Preliminary correlations
of epidemiology,clinicalsymptoms and molecular biology,Journalof Investigative
Dermatology 77(1981),96-101. F.el Khwskyet al.,'Riskfactorsfornon-melanomatous skincancerinAlexandria,
Egypf,International Journalof Cancer56 (1994),375-8.A. S Pappo,'Melanoma in childrenandadolescents',
European Journalof Cancer18(2003),2651-61. Thesymptoms of skincancers aresuchthattheyaredifficultto
identify
intheancient medicaltexts.
408Nunn,Ancient EgyptianMedicine, 81.

122
 in
cancers human
remains
was in
reported early 409
studies. However,
thesehavesincebeen

putintoquestionby Brothwell
in 1967andMicozziin 1991whosuggestthattheserepresent

410Equally,Rowling(1961)dismissesSmithand
benigngrowthnot malignanttumours.

(1924)diagnosis
Dawson's (malignant
of osteosarcoma from
growth) the of
examination a left

411Thedistinction
(benigngrowth).
femur,ratherconcludingit to be a caseof osteochondroma

is important
because formof benignbonetumours.It is
is themostcommon
osteochondroma

andoccursprimarilyin youngerpatients(between
oftenasymptomatic 412
theagesof 10-25).

in termsof lifeexpectancy
Statistically, thisgroupis morelikelyto be represented
andthus

between
misdiagnoses willleadto anomalies
thetwoconditions of frequency.

Thelargestinvestigation wascarriedout by the Nubian

of diseasein humanremains

Surveyin 1907priorto the buildingof the firstAswandam.Morethan6000

Archaeological

bodieswereexamined; havingaccounted
soil andclimaticconditions for exceptionally
well

preserved Those
remains. withexternalsignsof pathology
werethen for
retained museum

It is that
collection. unfortunate this its were
and records
collection subsequently by
disrupted

in 1941,whilstattheRoyalCollegeof Surgeons.
bombdamage A re-appraisal
of thecollection

wouldhavebeenof enormous workwascarriedout by Smith

value.Theoriginalanatomical

whosurprisingly exceptforonepossible
notumours
reported fromCemetery
metastasis 7.413

of tumoursin skeletal
For ancientEgyptgenerallyNunnreportsthatthe incidence

remains'seemsfew'.Thosehe citesarea skeletalreactionto meningiomata

(tumourof the

of the brain)reportedby Hussein(1949-50),

membrane of
an osteo-chondroma the femur

repofted in 1962andcarcinomas
by Rowling the by
of naso-pharynx in
Wells 1961
andby
409Table 4.2.
410D. Brothwell,in Brothwelland Sandison(eds.), Diseasesin Antiquity,430.M. S. Micoz;
ei,'Diseasein antiquity,
thecaseof cancer',Archivesof Pathology of Laboratory. Medicine115(1991),838-44.
411T. J. Rowling,Proceedings of theRoyalSocietyof Medicine54 (1961),409-14.
412R.T. Steinbock, PaleopathologicalDiagnosisandInterpretation. BoneDiseasesin AncientHumanPopulations
1976),319.
(Springfield,
413T. Molleson,'TheNubianPathological Collectionin the NaturalHistoryMuseum,London',in Daviesand
Walker(eds.), Biological
Anthropology, 141.

123
 Ghaliounghui
in 1980.414
Sandison that
reports for all the caseever only
studied twenty-six

knowncasesof tumourareknownin total,whichhesuggests 415

harvest'.
'is a meagre Strouhal

improves
onthisfigure
by that
suggesting thetotal is
number in fact to 416
nearer sixtycases.

Ina studyof thefragments (25adults)onlyonetumourwas

fromsomethirtymummies

foundon the heelof a separatedfoot.417Strouhalin 1976reporteda caseof naso-pharyngeal

in
carcinoma a middleagedwomanof the SixthDynasty by
overlooked
whichwasapparently

418
SmithandJonesin their1910excavation.

in the TurinMuseum
A studyof somethreemummies bothradiologically
examined

andexternallyshowedno bone 419

or otherpathology. Equally
the of
collection in
mummies the

Museum
Manchester 420
of cancers.
showsa notableabsence

so far, doesnot seemto supporta strongcasefor the presence

Theevidence, of

in Egypt.
carcinoma ancient in
However, study
a morerecent of some415 (325
individuals

adults)fromthewestern somefourcasesof malignant

Thebannecropolis tumours the
affecting

were
skeleton identified.
In two (a
cases male20-5 and
agedyears a female
aged4045 years)

thereweremixedbonelesionssuggesting from
metastases
multiple These
carcinomas. were

the
possibly resultof testicular
andbreast In
cancersrespectively.thetwo (40-50
cases
others

yearsof agesexunknown
anda male50-60 of
years there
age) weresignsof that
symptoms

thevertebra,
hadaffected pelvisandskull of 421
suggestive myeloma. Fromthistheresearchers

that
concluded theirfindings
indicated
that factors
important tumourswere
malignant
affecting

effectiveevenin historic Statistically

populations. thesefigures for
adjusted age and sex

414Nunn,Ancient EgyptianMedicine,81.
415Reported byNunn,Ancient EgyptianMedicine,81.
416E.Strouhal,'TumorsinAncient Egypt,Paleopathology
Newsletter
85(1994),1-6.
417M.Zimmerman, histiocytoma
'A possible in a anEgyptian
mummy', Archives 117(1981),
of Dermatology 364-
5.
418E.Strouhal,'Tumorsintheremains ofanEgyptian',American
Journal Anthropology
ofPhysical 45(1976),
613-
20.
419M.GallinoandSantmaria E.,'Radiological
andskeletal-anatomical of
study mummies in theTurinMuseum',
Minerva Medicine.18(1995),11,503-6
420David,Lancet349,1761. Nosample sizegiven.
421 Tumors
J. Zinketal.'Malignant inAncientEgyptianPopulations',
Anticancer 19(1999),
Research. 4273-8.

124
indicated tumourwithboneinfectionhigherthanthatof England
a rateof malignant between

1901and1905.Thatis an expected
frequency
of 0.95-1.74, lowerthanthe present
although

frequency
day- expected 13.57-16.68.422
Thefactthatmanyof theskeletons
wereincomplete

thatcomplete
suggests mayhaveproduced
samples higherresults.

Entdes
Prescription

Thereappearsto be no directevidenceof cancerin the medicalpapyri.However,

Ebbell423hassuggestedthatEb8l3 is a caseof uterinecancer:

andin
for a womanwhosewombis eaten/consumed
Eb8l3 'Another(prescription)

whosevulva(9ds) ulcersarepresent'(mytranslation).

canceris wnm (t) fromthefirstline:kt nt

indicates
ThewordthatEbbellsuggests

wvmtm idt. Thewordimm is wellattested

as theverb'to 424
eat'. TheGrundriss
translates

this as fressen'to consume, 425

corrodeandgnaw'. It appearsin participle
formas immo

'devourer',
meaning asin 'devouring
flame'.
426

However, appearsto be a good

Theword'eating'427
Eb813is buta singleexample.

(modem) of a cancerandin thiscasethewombjdt is clearlymentioned.

description However,

it is unlikelythatthisinternaleffect(of cancer)wouldhavebeenappreciated
by the ancient

Egyptians.
The actualcancerwouldbe occult.It is morelikelyto referto the symptom

by patient.Theideathatmany'specific'anatomical
perceived termsareintended
to describe

thatareaof thebodynottheorganitselfis discussed 428Therefore,

by Walker. it seemsmore

likelythat imm wouldapplyto thesymptoms

of a gnawing, eatingtypeof painor
consuming,

422
A.Waldron, biomarkers
'Editorial: ofdisease',
Intemational 6 (1996)324-5.
Joumalof Osteoarchaeology
423Ebbell,ThePapyrus Ebers,130.
Faulkner,A ConciseDictionary
424 of MiddleEgyptian,81.
425Grundriss
VI1:185.
426 A Concise
Faulkner, Dictionary
of MiddleEgyptian,
62.
427
Theword'consume(d)' haslongbeenusedin theEnglishlanguagetomeanbothto'eat'andto be'consumed
Oxford
(eatenup)withdisease'. Shorter
English
Dictionary
onHistorical 409-10.
Principles,
J. H.Walker,
428 Studies
inAncientEgyptianAnatomicalTerminology,
(Warminster1996).

125
 in the areaof the lowerabdomen.
discomfort Thus,it is as likely,for exampleto simplybe

describing
dysmenorrhoea infection:
or a candidal discharge,
vaginal and
ulceration 429
irritation.

Eb874,877refersto citntbnsw 'swelling Thishasbeentakento mean

of Khonsu'.
leprosyby Ebbellin 1937andby Lecain 1988.430.
tubercular Millerhasan entirelydifferent

viewof c3t
nt pnsw in Eb875.Herehe seesthe swellingof Khonsuto referto thatswelling

by the presence
produced guineawormunderthesurfaceof theskin:'it is a
of the parasitic
knownswelling aboutit'.431However,
do notdo anything thefulltranslation
of thesepassages

isdifficultandit mayrelatetocancer,bubonic 432

plagueor evenneurofibomatosis.

4.4BoneandJointDiseases

Thisheading
is notintended butrathera genericheading
to bea specificclassification

includearthritis,rheumatism
to collectively spinaltuberculosis
and othermuscular-skeletal

Specificindividualisation
problems. of diseasewasnotconsidered forthepurposes
necessary

of thischapterandbecause
it is appreciated withspecificidentifications
thatthereareproblems

Rather,it is considered
withinthiscategory. at thispointto acceptthatthesetypesof
sufficient

diseasewerea problem
andsopresented forpainrelief.Forexample,
a potential in theHearst

Papyrus, thatcanbeclassified
of thoseconditions forthetreatment
of bone,jointor muscular

veryfewareactually
disorders specific- apartfromfractures.
433

Withlow life expectancy

in ancientEgyptthosethatsurvivedintoold agemightbe

to sufferthesamemaladies
expected thatafflictmodemman.Thehieroglyphic
determinative

foroldisdepicted
bya hunched M
manleaningona staff.

429
P.J. ReesandD.G.Williams (eds.
), Principles
of Clinical
Medicine(London 717.
1995),
Ebbell,ThePapyrus
430 Ebers,127.A. P.Leca,LaM6decine tgyptienneau des
Temps (Paris,
Pharaons, 1938).
431
R.L.Miller,'Dqr,Spinning
andthetreatmentof theguineawormin P.Ebers875',JEA75(1989),
251.
432
Nunn,Ancient Egyptian
Medicine,75.
Leake,TheOldEgyptian
433 Medical
Papyri,62.

126
 IntheInstruction
ofPtahhotep
wearetoldthat:

Age is here, old age arrived eyes are dim; ears deaLthe bones ache
..
throughoutpainfularestanding
and 434
sitting.
..

Tuberculosis
is statedby Nunn as beingwell documented.
435The remainsof

Nesparehan,
priestof theTwenty-first
Dynasty
clearlyshowsa deformity
of thespinewhichis

of Pott'sdisease(spinaltuberculosis).
characteristic 436Derryreportson somenineknown

cases of tuberculosisfrom remainsexcavatedprior to 1938.437

Zimmerman
considersthe socialconditionsthat wouldfavoursuchconditionsas
438A largefamilywas consideredprestigious.Householdsseemto have been
tuberculoSiS.

of large,multi-generational
composed families.In turntheseresultedin crowdedhousingand

periodicepisodesof undernutritionand in the rudimentary 439.

disposalof wastes. Such

wereidealto sustaintuberculosis
conditions Zimmerman
andotherconditions. reportsonsuch

casefromthetombof Nebwennef.
a childhood 440

The clinical diagnosisof skeletal tuberculosisis not simple. Single dried,

bonespecimens
archaeological cancompound Onlyif thespineis involved
anyconfusion. will
be morecertain.
a diagnosis 441Many canbeconfused
otherconditions withtuberculosis
such
arthritiS. 442
astraumatic crushfractureandrheumatoid
arthritis,

Buikstrain an extensive
studyof tuberculosis thattuberculosis
andsyphilissuggests

wasnotextensive diagnoses
andthatprevious arenotconclusive beingother
moreprobably

434 Ancient
Lichtheim, Egyptian
Literature
Volume 1,62-3.
435
Nunn,AncientEgyptian
Medicine,73.
436
Nunn,AncientEgyptian
Medicine,73-4.
437
D.E.Derry,'PotfsDisease
inAncient Egypt',Medical
PressandCircular
197(1938),196-9.
438
Zimmerman, JARCE 14,33-6

439J Dixon,'TheDisposal
of CertainPersonal,
House-holdandTownwastesin AncientEgypt,in PJ Ucko,et al
(eds.), ManSettlement
andUrbanism, (London,1972),647-50.
440Zimmerman, JARCE 14,34.
441B.Morse, 'Tuberculosis',
in BrothwellandSandison(eds.
), Diseases 249.
inAntiquity,
442Steinbock,Paleopathological
DiagnosisandInterpretation. inAncient
BoneDiseases Human
Populations,
321.

127
 443
boneconditionS.
degenerative However,
morerecentstudies DNA
involving havesuggested

in ancientEgypt444andof Pott'sdiseasein a pre-dynastic

findingsof tuberculosis
thepositive

445
skeleton. Most
recently
a newDNA has
technique tuberculosis
shown in
present 25of some

85humanmummy 446
tested.
samples

Arthritishasbeenfoundin a largenumberof casesfromancientEgypt.Ofsomeeight

in
mummies the British
Museum,
examined in
radiologically 1961, degeneration
arthritic was
four. 447 from Late Ptolemaic
foundin RemainsfoundnearAlexandria
of soldiers the and

have
periods shown bone
degenerative disease,
particularly of
arthriticcondition the feet

due
presumably to thestress
of 448
marching. in
Miller a study
on necropolis
workmen the
noted

injudesand work practicesthat led to extensivearthritisand chronicskeleto-muscular

449A computertomography(CT) scan of a Twenty-secondDynastymummy

deformities.

it
showed to have from
suffered Schmod's
nodes(herniation
on the of
surfaces
articular the

This the
vertebrae). waspossibly resultof liftingheavy 450
A
objects. studyof 64 from
mummies

This
to the Romanperiodsshowedsome18 casesof disc calcification.
the pre-dynastic

28.12%
represents the
of sample, is
which far higher
thanthat from
expected modernstatistical

occurTence- 0.0001%. 451

in thefossilised
Infactit hasevenbeendiagnosed
Jointdiseaseis a veryoldproblem.

remainsof a 452This
dinosaur. that
suggests the disease to
assumed
whilst be a hazard
of

modern is
lifestyle in fact a mucholderproblem. is
Osteo-arthritis the most joint
common

443 in Brothwell
Buikstra, BiologicalAnthropology,45-6.
444 et al.,Differental
A. Nerlich, diagnosisof tumourus ERES(Arqueologia)
lesionsin historictissues',
skeletal 7,
(1997),87-100.
445E.Crubezy et al.,'Identification
of mycobacteriurnDNAin an Egyptian PottsDisease of 5,400yearsold',CR
Acedemy. Sciience.1I (1998),941-51.
446A. R.Zinket al,'Characterization of Mycobacteriurntuberculosis
complex DNA'sfromEgyptian mummies by
Journal
Spoligotyping', of Clinical
Microbiology 41(2002),359-67.
447Reeves, Egyptian Medicine, 41.
448C.Wells,Bones, Bodies andDisease: Evidence of DiseaseandAbnormality in EarlyMan(London, 1964),65.
449Miller,Medical History35,21.
450Filer,Disease, 50.
451Gray,in Brothwell andSandison (eds.
), Diseasesin Antiquity,
22.However, thiswaslatershownto bedueto
thepostmortem absorption of natronusedin theembalming process (absent in thepre-Dynasticsampleaswere
thepresence of 'degeneration').
452B.Rothschild etal.,'Spondyloarthropathy intheJurassic',
Lancet360(2002), 1454.

128
diseaseseenin archaeolog
icallyhumangroUpS. at Meir(Twelfth
453Thetombof Ukhhotep

showsa nakedpotbelliedmantalkingto a shipwright.

Dynasty) leaningon a
Heis depicted

himself
stickandsupporting on the bowof the ship.Hisknees to
appear be swollenandthe

of thelowerlegseemto beemaciated.
muscles to bea representation
It appears of arthritis.

Rheumatoid
arthritiswasreportedin the handof mummyfromtheThirdDynastyby
1960.455
Rufferin 1918,454also in
exampleby KarshandMcCarthy
in a FifthDynasty In 1975

degenerative
Weizshowed osteo-arthritisthe
of spineandjointsin anOldKingdom 456
MUMMy.

In 1999Rothschild thepresence
reported of spondylarthopathy 457
inearlyNubianpopulations.

fromthe'Tombsof theNobles'
A morerecentstudyof theremainsof 273individuals

at Luxorshowedint al the presence in up to 60%of examined

of spondylosis The
vertebra.

in oneof themainnecropoles
thatthelivingconditions
concluded
researchers was'quitepoor

andin contrastto the'usuallyassumed of thesociallyhigherpopulation

highstandard of the
458
Egypf.
capitalof

Feldtkeller
in reviewingthe availableradiological
evidencefrom pharaohsof the

Eighteenthand NineteenthDynastiesconcludedthat at least three had ankylosing

459
spondylitis.

A recentmajorstudyexamined and273
the humanremainsof 211MiddleKingdom

to LatePeriodindividuals
NewKingdom fromtheThebanNecropolis.
Bothgroupsshoweda

highlevelof tuberculosis
anddegenerative
boneconditions.
Thoseof the MiddleKingdom

453
Rothschild,above.
454
Ruffer,Journal ofPathology andBacteriology.
22,152-196.
R.S.Karsch
455 andJ. D.McCarthy, Wchaeology andArthritis',
Archiveof IntemalMedicine
105 (1960), 640-664.
W.Wenzet al.,'Viewofthepast:Roentgenography
456 ofanEgyptian mummy', 15(1975),
' Radiologie 45-9.
457B. M. Rothschild, et al.,'Spondylarthropathy
identified American
as theetiologyof Nubianerosivearthritis',
JoumalofPhysical Anthropology 109(1990)259-67.
458A. Nerlichet al.,'Anthropological
andpaleopathologicall
analysisof thehumanremains fromthree'Tombsof
theNobles'of thenecropolis ofThebes-west,
upperEgypt,Anthropol. Anz.58(2000), 321-43.
459E. Feldtkeler et al., 'Ankylosing in pharaohs
spondylitis of ancientEgypt',RheurnatologyInterriational
23
(2003),1-5.Theyinclude Amenhotep11,
Ramesses 11andMerenptah.

129
 showed
particularly evidence
of disorders
metabolic with manifestations,
osseous the
typically

resultof scurvy
and 460
anaemia.

Jointdiseaseis a majorreportedproblemtoday.Some25%of peoplein theUKvisit

theirdoctorbecause
of joint 461
disease. In a Spanish
studysome51% aged
of patients 65

arthritic
yearsor morereported or rheumatic andof thesesome82%reported
symptoms pain,

some23%asfrequent 462
andmoderate.
in the
of 'painsandsicknessin the limbs'as described
Therathervagueconditions

Hearstpapyrusmaybe textualevidenceto supportthe presenceof joint conditionsin ancient

thatat least69 prescriptions

463Leakeconsiders
Egypt. of joint,
(27%)mayindicateconditions

is givencredencein that the majorityof these

boneor muscledisease.His suggestion

are
preparations non-quantitative
external designed
preparations as 'rubbing or
compounds' to

be appliedby bandages. that H33,34,37,41-6,125-130mayall represent

He considers

withH123,124actuallyaddressed
of arthdtictypeconditions
treatment 464
to arthriticdeformity.

But,whilstthis maywellbe the casethe symptoms

are vagueandthe actualprescription

ingredients
arenotallrecognisable.

460A.Nedichetal.,'PaleopathologyofancientEgyptian mummies Investigations

andskeletons. ontheoccurrence
andfrequencyof specificdiseases duringvarioustimeperiodin thenecropolis
of Thebes-West, Pathologie 23
379-85.
(2002),
461Roberts1999:
100
462M.Espalliaques at al.,'Osteoarticular
disorders
in theelderly:anapproach impact',Clinical
to theirpopulation
Medicine(Barcelona.) 106(1996),601-16.
463Leake,TheOldEgyptian Medical
Papyri,
61.
464Leake,TheOldEgyptian Medical
Papyri,62.

130
 Entries
Prescription

Manyof theseprescriptions intheEberspapyrus.

appearasequivalents

H33(Eb3Ol)kt pbrt nt srw mrwt m I'ivt nbt n s, 'anotherprescription

to

remove/banish fromthe limbsof a man'(mytranslation).

sickness/pains
C,
A-A
H34dr stem -rwtnbtto driveout ste (aneffect)fromall the limbsof the

body'(mytranslation).

H33is vagueenoughto applyto arthritictypepaini.e. 'to driveout painfromthe

4651n
limbs'. bothH33,34thesame,astheyfollow
H34thewordsteis difficult.Leaketranslates

eachother.TheGrundfiss an effect466such
of thewordst-ras Einwirkung
givesthemeaning

thatH34is to 'driveout the effectsof the condition' Westendorf,

or to curethe symptoms.

however, forces.
thatthe'effect'is dueto demonic
considers thiscanonlybe an
467However,

to explainan otherwiseopen term. It seemsunlikelysince the preceding

assumption

H33mentions
presc(iption in thelimbs,notdemonic
suffering possession.

H37 irrt r nhp m cwt 'whatis doneagainst'nhp / jumping'in the limbs(my

translation')(nbp = schneiden,springen).
468.Westendorfgives this as an exampleof the

(of Schmetzstoffe)'
'Umherschnellen i.e. 'the rapidmovement
(of Schmerzstoffe)
aroundthe

469
limbS'. Butthisis because
of hiscommitment
to tvýhdw factor(seeChapter
asa pathological

3 ). I thinkit farsimplerandmorelikelythatLeakeis rightin givingnhpto meanjumpingin the

470
limbs. wouldbea bettertranslation
'Throbbing' of nhpsuchthatH37becomes
a prescription

465Leake,TheOldEgyptianMedicalPapyri,80.
466GrundrissIV:264.
467 Westendorf,
367.
GrundrissVI 1:469,Westendorf,
468 319.
319.
469Westendorf,
Leake,TheOldEgyptian
470 Medical
Papyri,
81.

131
 in thelimbs.In thiscasearthritisor rheumatics
to curethrobbing wouldseeman appropriate

forH37.
explanation

H41,(EME drtKhdwnhpm cainbtnts'to driveoutpainandthrobbing

fromany

limbof a man'.

H42(Bln
161)pbrt sm?wbdwm lul nbta prescription painfromanylimb'.
to remove

H43-5'anothee.

H41is anexternal
application appliedbybandage.
of excrements thatfollow:
Theprescriptions

differinthattheyareinternalpreparations.
H42-45

H123 (Eb654).H124(H655)'another(prescription) N-RA )a

to causeto soften/relax(sgnn

jointin anylimb'

H123is a remedy
forrubbingin whilstH124is appliedbybandages.
Leakehasthisas

forarthriticdeformity.
a treatment 471 Whilstthiscanonlybe assumed,
I nevertheless
thinkthat

thisrepresents of anarthritictypecondition.
goodevidence

H160-6,
H168,169
Leakesuggests is for'muscular
thatthissequence or subcutaneous

soreness'sincethey are localapplications in a fatty base.

of mild alkalineastringents 472
r--" -

hefailsto translate
However, theconditions herems'pnt-1 on c3(H160-6)and
thatappears .u

-w%cl. TheGrundfiss
tmYrz. andWestendort
givems'pntasHaufflechte473 it to
suggesting

besomekindof skincondition
butoffernotranslation
for tMyt. 474

Therearealsoprescriptions
H94-122
andH228-238, deal
which withvariousafflictions

to themtw. Theseinclude'cooling'of themtw (1-195),

to give'reliefto themtw (H96,Eb627),

Leake,TheOldEgyptian
471 MedicalPapyri,
62.
Leake,TheOldEgyptian
472 MedicalPapyri,
63.
VI: 398.Westendorf,
Grundriss
473 839.
474
Theyappeartobeskinconditions,
seepages71-2.

132
 'stiff'(H110,
for a mtw which'throbs'in any limb(H99,Eb644),for a mtw thatbecomes

in
Eb694)andto 'soften'a mtw (H114,Eb659,Bln49).Thewordmtw hasbeendiscussed

somelength
aboveat 3.2 (ii).Whilst
it is takento the
represent internal of
vessels the body

an
within framework
anatomical it canalsobe in
taken its to
sense
generic include and
muscles

475In thisrunof prescriptions

tendonS. thelattermeaning to
of mtw seems be implied.
In this

caseit seem
would that
appropriate someof these could
presc(iptions be
well designed
to give

typeconditions.
reliefto arthritic
Inaddition,
I wouldsuggest
thatthereareotherinstances mightbe
whereprescriptions
for the treatmentof arthriticconditions.I offer a few examples:Eb603-5
appropriate

(ointments)
applications for the nvst'the knee,
or region
of the 476
knee' and for
EIJ295,298

'painin the neck.'

4.5DentalDisease

to otherpartsof thehumanbody,aremorelikelyto disintegrate

Theteeth,compared

duringlifeyetafterdeathhavegreattenacityagainstdecay.Because
of thisfactwehavebeen

fromwhichto assessthelevelof dentaldiseasein ancient

dentalevidence
leftwithabundant

Egypt.It is generally thatthe levelof dentalhealthwaspoor.

accepted 477Ruffer
notedthat

dentalabscesses in everyskeletalcollection
appeared fromEgyptandNubia.Healsoreported

478He
of thoseteethexamined.
severeattritionin themajority thisto thetypeof food
attributed

to breadbutalsoto the consumption

eaten,principally lentils,artichokes,
of rawvegetables:

andcabbage.In an extensivestudyof some3000dry ancientEgyptian

beans,asparagus

skullsLeekfoundthat,although bygoodcalcification
mostof theteethwerecharactefised and

enamel,mostexhibiteda greatvarietyof non-pathological These

abnormalities. included

475Nunn,AncientEgyptianMedicine,222.Westendorf, 839.
Westendorf,
476, 224.
477Filer,Disease,94-102.Reeves,AncientEgyptianMedicine,16.
478M. Ruffer,Studiesin Pathology
of Egypt(Chicago,1921),228.

133
 of oneor moreteeth,varieties
absence cystsandimpacted
of non-pathological andun-erupted

werefoundto be the resultof attritionto the cuspsof the teethwith

teeth.Theseproblems

damage
to thesurrounding in infection
softgumtissueresulting 479
abscesses.
andsubsequent

thatthecauseof thisdentalattritionwasdueto contaminates

It appears in bread,theprincipal

food.An analysisof ancientsamplesof breadhasrevealedthe presence

of extensive
and

damaging 480Theseparticlesappearto havederivedfromwindblownsand

mineralparticles.

and fromthe surface

of the mudbricksilos.Thesecontaminates
wouldhavecausedboth

dentalattritionanddirectdamageto the gums.Thisis supportedin anotherextensivestudyon

fromAbydoswhichshoweda highincidence
humanremains andseveredental
of abscesses

in
present
attrition theolder 481
adUltS. Extensive
dental
wear in
results of thepulp
theexposure

of thetoothto infection
chamber andsubsequent 482Roseandhisteamfoundthat
abscessing.

of over50%of allsamples
onaverage examined sitesin Nubiashowedextreme
fromcemetery

4831n1999Lovellreported
dentalwear. of dentalenameldefectsin allof some88
highpatterns

fromMencles.
individuals, Theserangefromthe OldKingdom,
FirstIntermediate
andGreco-

484
Romanperiods.

Modemnon-invasive havenow allowedmummiesin museum

medicaltechniques

to be withoutdamage.
collections examined A CTscanof thecollection at Leipzig
of mummies

dentalattrition.
extensive
showed 485AnotherCTscanof anancientEgyptian showedit
mummy

to exhibitseveredentaldisease.
Ofthe28 teethpresentin themouthsome24wereshownto

haveextensive of the dentalpulp,'thiswouldhaveresultedin considerable

exposure pain,

479F. F. Leek,'TeethandBreadin AncientEgypt'JEA58(1972),126-32.

,
480Leek,JEA58,130.
of Biological
481B. J. Baker,'Contributions Anthropology of AncientEgyptian
to theUnderstanding andNubian
Anthropology
Societies', andEgypt(1995),111.
482J. C.Roseet al.,'DentalAnthropology of theNileValley',in DaviesandWalker(eds.), Biological
Anthropology
andtheStudyofAncient Egypt,64.
483Rose,
above,63.
484N.C.Lovelland1.Whyte,'Patterns of dentalenameldefectsat ancientMendes in Egypt,American Journalof
Physical Anthropology. 110(1999),
69-80.
485T. Nickol,et al.,'Anexaminationof thedentalstateof anEgyptian mummyby means of CT: to
a contribution
Journal
dentistry', oftheHistory
of Dentistry
43(1995),105-12.

134
 distress
personal 486A CT the of
remains
andmalaise'. recent scanof mummified theLadyUdja

lower
attritionandextracted
alsoshowedextensive 487
molars. in
Nerlich a recentstudyof

humanremains
Egyptian dental
reports as
conditions being with
poor a highdegree
of dental

and
abrasion 488
abscesses.
debateof
incidenceof dentaldiseasehasleadto the yet unresolved
Theconsiderable

dental
a separate
whether profession in
existed Egypt.
ancient is
There no to
evidence support

anydental
workon the large of
numbers human from
remains Egypt
and 489
Nubia. However,

to
thereappears be to dental
someevidence supporta separate in
profession that in several

dental
cases titles the
accompany For
ones.
medical example, has
Niankhsekhmet thetitlesuT

Physician),
stmw(Chief (Chief
wrs%nwpr-c3 of the Palace
Physicians),
andRTjbPypr-c3

(Chiefof theDentists
of the In
Palace). addition is
Khouy alsogiventhetitle Wriry ! bp (Chief

of 4901t
Dentists). is this
outside to
thesis discuss
thisfurther.
However, the
whilst highincidence

of disease
dental mightsupposea dental some
profession, cautionmust be appliedin

this
suggesting is by
demonstrated such There
titles. areother where
examples these'dental

thattheymightmerelyrefer
medicaltitlessuggesting
titles'appearwithoutanyaccompanying

491
to someofficeof stateor markof prestige.

or dental
of dentaltreatment
Theredoesnotappearto be anyknownrepresentation

At firstsight,thisis perhaps
disease. in the high
surprising viewof apparent incidence
of dental

486A. H. Melcheret al., 'Non-invasive

computer tomography andthe three-dimensional of the
reconstruction
dentitionof a 2,800-year-old Egyptianmummyexhibitingextremedentaldisease',Journalof Physical
Anthropology103(1997), 329-40.
et al., 'Dentalandskeletalfindingsin an Egyptian
487J. K. Thekkaniyil mummy',Journal
of AmericanOrtho-
Orthopology
Dentotacial 117(1)(2000),10-14.
Nerlich,
488 AnthropologyAriz58,340.
Nunn,Ancient
489 Egyptian Medicine,
202
Ghaliounghui,
490 Medical History15,171.
491Leek,MedicalHistory16,404.Udjahorresnet andformernavalcommander
a highofficialof the27thDynasty
wasawarded theobviously titleof 'chiefphysician'
administrative bythePersianking.

135
 492By contrastin nineteenth
disease. England
century whenthe level
of disease
dental was

high,
equally painandtoothache in
represented
wereprominently 493
caricatures.

Evidence
Presdiption

Prescription
evidence typically
although is is
surprisingly
vague present,although not

The
extensive. Hearst has
papyrus only two possible only
references, 0.78%of the total

H8
Prescription
numberof prescriptions. is a remedyof gumanddumbpalm
to 'makefirm'

to 'treatbloodin
(smn)a tooththatis aboutto fallout.H9is lessclearin thatit is a mouthwash

'494This
the (mouth)? to a dentalproblemas it followsH8 andits
is a possiblya reference

formulais thatof Eb742where'teeth'arementioned.

In theEberspapyrus
thepossible arealsolessthanonepercentof
dentaltreatments

drshm bnulJ RIS

Eb553/4
thetotalnumber. to to
appear refer teeth
ulcerated or gums:

m lbp P
srdt -rw'todriveout )
(*abscesses?in thetooth to the
and strengthen flesh )',
(gums?

(Eb554).

or the 'affixing'of a toothPct--rm pbrt nt smn

E739-41referto the 'strengthening'

jbp, 'thebeginning to
of a prescription affixa (Eb739).
tooth' is
Eb742 to treata tooththatis

being'eatenaway'.Kt nt srwhlbp ws'cwrrP -rw,'anotherto treata tooththatis beingeaten

in
away thefleshof themouth'. is
Eb749 to treat
a bleeding
toothktpbrt nt srwb !my snfm

to treatbloodin thetooth/ableeding
jbp'anotherprescription ' Eb122(Bln3Qis to 'drive
tooth?

out ;ýbdw in
(pain) the(r) '
mouth/teeth?andis a possible for
remedy toothache.

beargued
Itcouldequally
492 thatdentaldisease is difficulttodepictanddifficultto imagineinwhatcontextit might
appear.Thepointemphasises theinadequacy of pictorialevidence as a guide to health.
493M.knold-Foster,Imagesof Pharmacy andMedicine (London,1989).Thesecaricatures wereby definition
of
exaggerations Equally,
features. many of the Egyptian representations are those 'odd' features
medical perhaps
(and
selected for
exaggerated) their
novelty value.
Theformula
494 of mulberry,
consists aniseed andotherherbs.Suchherbalformulas havebeenshowneffective as
an mouthwash.
antimicrobial J. M. Kaim et al.,'An in vitro investigation
of the activity
antimicrobial of an herbal
mouthwash',Journal
of Clinical Dentistry
9 (1998), 46-8.

136
 Dentaldiseaseseemswellevidenced to
andappears havebeenwidely 495
present.

in ancientEgyptcanbesurnmadsed:
Thestateandextentof dentaldisease

Ofthemanycollections andNubianskeletalandmummified
of Egyptian there
remains

496
of dentalabsCeSS.
doesnotappeartobeanywithoutat leastoneexample

Painofvaryingdegreemusthavebeena continual
presence.

Worms
4.6Parasitic

The terrestrialhabitatandthe changeto an omnivorousdiet exposedearlymanto a

highdegreeof helminthic
infection. bythedomestication
Thiswouldhavebeenexacerbated of

which
animals wouldhave infection
encouraged by The
contact. elimination worm
of parasitic

in modernWestern
infections WorldWardevelopment.
societyhasonlybeena post-Second

Thishasbeendueto a combination
of the of
understanding the biological
life of
cycles the

in
improvement
parasites, living and
conditions importantly
the availabilityof effective

Therefore,
treatments. the presence in ancientEgyptshouldbe
of parasiticworminfections

Indeed
theearlyclassical thern. 497
obvious.,
considered writersreporton

The Nilewasa focalpointin Egyptianlife whichprovideddrinkingwater,washing

for parasiticinfection.
facilities,the meansof travel and transportand an opportunity

infection
seemsto havebeena common
Schistosomiasis 498Indeed,parasitic
in ancientEgypt.

worminfections
are still a problemin Egypttoday.Rowling some
estimated 50% of the

495It hasrecentlybeenshownthatpoororalhealthis linkedto increased lungdisease. Lungfunction wasshown

to diminishastheamount of gum-aftachment lossincreased.F. Scannapiecoet al.,'PoorOralHealthandLung
Disease', Joumalof Periodontology 72 (2001),50. Thiswouldhaveexacerbated the healthproblems of the
ancient Egyptians.
496Filer,Disease,98.
497Plinyreportsonthefrequency of tapeworm andLucretiusCarus(11 BC)describes
stcentury elephantiasisasa
common disease.Reportedby A.T. Sandison,'Parasitic
Diseases',
in Brothwell
and Sandison (eds.), Diseasesin
Antiquity,180.
498A. Cockburn, 'AncientParasites on theWestBankof theNile'Lancet(1981), 938.J. T. Rowling, 'Urologyin
Egypt,in BrothwellandSandison, Diseases in Antiquity,
530.

137
 in
populationwere affectedwith schistosomiasis In
1963.499 1993 the World Health

Organisation
estimated to beaffected
some12%of theworldpopulation withschistosomiasis.

is causedbya parasitic
Thecondition between
wormwhichhasa lifecyclealternating

itshumanhostanda particular
species The worms
of watersnail. adult pairin theportalveinof

in
thehumanhostandthenceto theveinsof thebladderandrectum.Theeggsaredeposited

andthepassingof bloodin theurine(alongwiththe

thebladderwheretheycauseulceration

eggs).Thepassingof bloodin theurineis the characteristic This

of thecondition.
symptom

was by
noticed the troops
occupying of Napoleon's
armywhodubbed
Egypt
as 'the landof

menstruating 500
men'.

Theparasitein the courseof its cycletravelsalongthe portalsystemto the liver.

Because of interference
of this,thereis a possibility withliverfunction. from
Thecomplications

It is becauseof this that Ghaliounghui

this can give rise to gynaecomastia. suggested

for the strangeshapeof Akhenaten.

infectionas a possiblediagnosis
schistosomiasis Loebl

asa diagnosis
thispossibility
alsoconsiders forBak,Akhenaten's 501
chiefsculptor.

It is doubtful
if theEgyptians TheBookof
wereawareof thecauseof schistosomiasis.

theDeadincludes
thenegative 'I havenotwadedin thewater.Nunncitestheview
confession:

thatpenilesheathsmayhavebeenusedto preventschistosomiasis
in themistaken
beliefthat

entryof theparasite
wasviathe i.
penis e. thesamerouteas thesymptom
of infection.
502But,

in viewof theextensive
andsomewhat
vaguerangeof negative in theBookof The
statements

Deadandthefactthatmanysocieties
usepenilesheaths seemsdoubtful.
anyconnection Also,

as the wormis too smallto be viewedby the nakedeye we mustassumethattheywere

ofthecause.
unaware

499Rowling,'Urologyin Egypfin BrothwellandSandison(eds.), Diseasesin Antiquity,534.

500Nunn,AncientEgyptianMedicine,69.
501Citedby Nunnin AncientEgyptianMedicine,82.
502Nunn,AncientEgyptianDisease,69.

138
 Thepresence hasbeenconfirmed
of schistosomiasis ovaby
bythefindingof calcified

Rufferandin the remainsof Nahktby Miller.

503El Mahdysuggests
thatthiswasa problem

by
shared many
ordinary but
mummies notdiscernible
so far in royal 504
mummies. It is logical

'higherorder'.Theyarenot
maynothavebeenpresentin the Egyptian
thatschistosomiasis

likely to have the samedirect level of contactwith Nile water as ordinarypeople.Reeves

however, of Ramesses
reportstheremains scrotalsacimplying
VI havinga largeeviscerated

fromlivercomplications
thatthisresulted secondary 505However,
to schistosomiasis. I consider

this conclusionsomewhatsuspect.Thesymptomsare too remotefromthe indexdisease.The

is thatit wassimplya caseof aninguinal

likelihood hernia.

Otherparasitic
wormhavealsobeenidentified
anddocumented.
Theguineawormor

dracunculus appearsto havebeenanothercommoninfection.

medinensis Calcifiedremains

havebeenfoundin Mummy
1770at Manchester. itselfin theankleregion
Thiswormmanifests

of its humanhosts.Removalthroughthe skin,althoughdangerous,

can be performed
by

excisingthe wormthenwindingit carefularounda stick.Millersuggeststhatthis

surgically

is
method in
proposed Ebers
875.506
Other
parasitic
worm to
appear
conditions havebeenvery

Amongst
common. arefilariasis(TappandWildsmith
thoserecorded in theLeedsMUMMy),
507

(Tapp
strongyloidiasis in theManchester tapeworM508
mummies), 509
androundworms.

is a parasiticwormthatblocksthe lymphatic
Filariasis systemcausingcharacteristic

and
swelling thickening
of the skin(elephantiasis).
Strongyloidiasis
is a wormthatentersthe

humanbodyviathefeetandthenceto thelungsviathevascular
systemproducing
symptoms

Tapeworms
of cough. areintestinal of greatlengthbutpresentfewoutward
worms,sometimes

otherthanlossofweight.
symptoms
503CitedbyNunninAncientEgyptian Disease,69.
504C.el Mahdy,MummiesMythandMagicinAncientEgypt(London, 1995),.
505Reeves, Medicine,
Egyptian 34.
506Miller,
JEA75,249-54.
507CitedbyNunninAncientEgyptian Disease, 71.
w8E.Tapp,inA. R.David(ed.), Diseasein theManchesterMummies (Manchester,
andEgyptology
in Science
1979).
509A.CockburnandE.Cockburn (eds.
), Mummies, Disease 1981).
(Cambridge,
andAncientCultures

139
 Theoldestparasite
forwhichthereis evidence
is enterobius or pinworm.
vemicularis

Recently,faecalsamplesfrom RomanEgypthaveshownthe presenceof pinworms.

510

today.Theyareverycommonin
arestill a problemevenin the UnitedKingdom
Pinworms

childrenandinfection
is spreadfromfingerscontaminated in theanus)to
witheggs(hatched

otherhumansorally.It is a fairlyinnocuous
conditionbut is characterised
by intenseanal

irritation, thatthrivesincramped
at nightwhentheeggshatch.It is a condition
particularly living

conditionsandmusthaveverycommonin ancientEgypt.511

There are several pictorialrepresentationsthat are alleged to show individuals

from
suffering They are mentioned
parasiticconditions. here for completeness
but such

arefarfromclearandremainspeculative.
diagnoses Thecuriousfigureof theQueenof Punt

fromthetempleof Hatshepsut
is represented severalfoldsof skinonherlimbs.
withapparently

This has beensuggested include

but otherexplanations
as an exampleof elephantiasis,

dystrophy,
muscular andDercrum's
achondroplasia disease.
512Theretention fluid
of abdominal

is a common
symptom shownin a groupof fishermen
andthisapparently
of schistosomiasis

in the tombsceneof Mehuat Saqqara.

represented 513Thisswellingresultsfromhepatic

andis a symptom
impairment of Symmers'
syndrome.

Entries
Prescription

References
to wormsdo appearin the medicaltexts but their identification
and
is
significance The
obscure. ideathattheirmentionmaybesymbolic
andrepresents
a concern

asto theseriousness is considered

of a condition in theabovechapteron Terminology.
Ebbell
0ý
1ý -1
the CC
considered word I _u - r----to meanhaematuria
- (blood
in the the
urine) mainsymptom

510P. D. Horne,'Firstevidencefor in ancientEgypt',Journalof Parasitology

88 (2002),1019-21.
511Zimmerman JARCE24,33-36.Therearemanyprescriptions designedto'cooltheanus',e.g. Ebl 38-64.
512K. R. Weeks,'Theanatomical knowledge of the ancientEgyptiansandtherepresentationof the humanfigure
in Egyptianarf, Ph.D. Thesis(Yale,1970).
513Reeves,EgyptianMedicine, 33.

140
 Thisviewis alsoacceptedby Steuer.
of schistosomiasis. 514However,the problemis thatthere

areno textsthatconnectc?cwiththe bladder.Dawsonviewedell'as a typeof pathological

factorrepresenting
anevilinfluence
whichwasbelieved 515Sothatin Berlin
to causedisease.

58:pbrt nt dr c1cn ntr nftt'a prescription

to driveout cicof a godand/orgoddess'.
The

Grundfisstaketheviewthatthewordmeanssemenor Giftstoffe-'poisonoussubstance'.
516In

theimpregnation
thissensew represents of a victim,generally byanevilspirit
whilstsleeping,

withits poisonoussemen,theconsequence
of whichcausesdisease.

Berlin'165,1-118,
Eb49, Bln187 are possiblecandidatesfor prescriptionsagainst

They of bloodintheurine:pbrtnts wsgfmsnf c93,

schistosomiasis. referto theelimination a

for a manwho'voids'muchblood'.Theverb wss'ý='

'prescription is generally
takento

meanto 'expel,to eliminate, 517It is non-specific

ausscheiden'. suchthatit maymeaneither

or defecation.
urination thatin thiscaseit maybe describing
Nunnsuggests the passingof

bloodin thefaecesandsomaybea caseof bleeding

haemorrhoidS.
518However, I
on balance

thinkit morelikelyto be descdbing

the passingof bloodin the urine.Haernorrhoids
can

heavybleeding
produce justspotsof blood.Thewordc,§iis usedto indicate
or morecommonly

thevolumeof bloodandwouldseemto implya largevolumeof bloodyurine.

Eb875is givenaspossible to dracunculiasis

reference (guinea-worm).
519
Thisrefersto

which
swelling 'comesand goes'whichwouldbe consistent
with the femalewormbeing
2'
presentunderthe skin.Reference
is madeto treatment
witha knife.Theworddýr is

usedin connection
withthetreatment
whichthe Grundfiss
givesas 'to cling,press'.
520Miller

thealternative
suggests 'to spin'.521Thisaccordswithits surgicalremovalby cutting
meaning

514Steuer,AncientEgyptianandCnidianMedicine,3.
515Dawson,JEA21,39.
516Grundriss
VI1:129.
837.Grundriss
517Westendorf, VII:2119.
518Nunn,AncientEgyptianMedicine,91.
519Nunn,AncientEgyptianMedicine,70.
520 VI 1,991.
Grundriss
521Miller,
JEA75,249-51.

141
 it arounda stick.
windingit outor 'spinning'
theskinto releasethewormandthengradually

to be a resultof
havebeensuggested
Themissinglowerlegsof Mummy1770at Manchester

breakingoff of the wormresultingin

havinggonewrongwiththe premature
thistechnique

522
infection.
secondary

Disease
4.7Respiratory

In TheInstructions we areinformed
of Ptahhotep thatold agebrings,amongst
other

of
shortness
problems, breath:

whatoldagedoestopeopleis badin everyrespect

cannotbreathe,
Thenose,clogged,
523
Painfularestanding
andsitting.

A limestone from
ostracon Deirel Medina
shows
an elderly with
workman his mouth

openin a manner
which laboured
suggests 524
breathing.

Duringthe embalming the

process lungs in
wereremovedandplaced a jar
canopic

the
under careof Hapi,
theape figure
headed oneof the Children
'Four of Most
Horus'. of the

found
specimens and
parcels
aresmall were dried
clearly and before
collapsed 525
wrapping.

Mostare,therefore, In manycaseshoweverre-hydration
in a poorstateof preservation. and

histological
subsequent has
examination been Ruffer
possible. two
examined suchcasesof

Dynasty
Twentieth origin:onewithhepatisation
of thelung the 526
and otherwithpneumonia. In

1938Shawexamined
themummy thelungsshowing
of anelderlyman,a singer,yetreported

(carbon
anthracosis
extreme deposits)
and The
pneumonia. former
condition have
must beena

Filer,Disease,12.
522
AncientEgyptianLiteratureVolume1,63.
Lichtheirn,
523
J. JanssenandR.Janssen,Gettingoldin AncientEgypt(London,1996).
524
Diseasein Egypt,in BrothwellandSandison(eds.), Diseasesin Antiquity,489.
J. T. Rowling,'Respiratory
525
Ruffer;Memoires
526 surItgypte: InstitutdEgypte6,3.

142
 of livingconditions,
product fromoil lampsandopenfires.Infact
smokeinhalation
presumably

disease
suchrespiratory seemsto havebeenfairlycommon.
527

Studieson town planningshowcramped,intimatelypackedhousing.

528Evenat

Amarna,a 'greenfield' site, the workmen'svillageseemedto havefollowedthe same

529Largefamilieswereprestigious
pattern. andhouseholds
tendedto be multi-generation
with

of housingandcrampedconditions.
subdivision
consequential Thisenvironmental
pollution
fromclosecontactin cramped overopenfiresandoil lampsmusthaveproduced
conditions

The presence
problems.
respiratory of carbonpigmentsin lungtissuehas beenfoundby

530
Zimmerman.

Whilstsandcontamination
in breadcausedone problem,sandinhalation
seemsto

another.In 1910Murrayfoundevidence
havepresented in a male
of sandpneumoconiosis

531A malemummyKharyexaminedas pad of the Manchester

MUMMy. MummyProject

exhibited
pulmonary causedby sandpneumoconiosis
adhesion whichwasso severethatthe

chestcavitywasdividedinto threesections.Davidreportsthatsandpneumoconiosis
and

problemsfromenvironmental
associated 532An investigation
pollutionwerewidespread. of
datingfromtheMiddleKingdom
humanremains to theRomanperiodat Abydosshowedhigh

levelsof nutritional 533Thisseemsto havebeena resultof irondeficient

stressandanaemia.

grain,insufficient
childhood dueto parasites
nutrition,malabsorption or a combination
of all

thesefactors.All thiscombined
withthe latereffectsof respiratory
diseasewouldsuggesta

stateof health.
witha marginal
population

527 in Brothwell
Rowling, andSandison(eds.
), Diseases inAntiquity,
492.
Zimmerman,
528 JARCE 24,34.
B.J. Kemp,'TheAmarna
529 Workmen'sVillagein retrospect',
JEA73(1987),
21-50.
Zimmerman,
530 JARCE 24,35.
CitedbyReeves,
531 Egyptian
Medicine,33.
David,Lancet349,1761.
532
Baker,
533 andEgypt,111.
Anthropology

143
 In Papyrus
Westcar
theprince,on meeting
theonehundred
andtenyearoldmagician

Djedi,compliments
him:

Yourcondition
is likethatof onewholivesaboveage- for ageis thetimeof death,

andburial- onewhosleepstilldaytime
enwrapping, andfreeof illness,withouthackin
gpUqh.534

Thephrase'withouthacking
cough'is givenbythephrasenn kWt sryt.It is notinsignificant

thatthewordfor 'cough'is linkedlinguistically the k I&h 535 'to be old'. 536

with word meaning
This impliesthat a hackingcoughmightbe an inevitableproductof old age. Blackmanstates

that'eventoday'thissymptom
was'typicalandsymptomatic
of the congestion
amongstold

menofthepeasant 537
class'.

Certainly disorderis welldocumented

coughas a resultof respiratory in the medical

papyd

Eb305t3t--rm pba nt dr sryt I U19 'startof the prescriptions

to stop(driveout)

cough'.

EW06-320
ktanother

Eb321ktbrwcndrsrytmht, 'another
to instantly
driveoutcoughin thebody'.

Eb322-5
kt'another.

H61,pbrt nt dr sryt withBin29pPft nt dr sryt m brd'a remedyto stop

Bln29,31,

coughin a child'.

534 Ancient
Lichtheim, Egyptian
Literature
Volume 1,218.
535Thelinkissurelyalsoonomatopoeic.
536Hannig,888.
537A. M.Blackman,'SomePhilological
Notes',JEA13(1927),187-91

144
 andIniuries
4.8Accidents

In additionto the abovecategodes

of I
disease thinkit important
to considerother

that
conditions mightpresentsymptoms I
of pain. do notintend
anysuchlistto be exhaustive

but ratherto illustratethat suchconditionswere common.TheseadditionalcategoriesI

to
consider be from
trauma accident
or industrial
injury,
bumsandinsect
and bites.
snake

Intermsof surgicaltreatment foranything

to be noevidence
thereappears otherthan

'surgical'
verysimple Of
procedures. all the so
remains far noneshowanysignsof
examined

538AIso,
scars.
operation there
whilst is an abundance
of surgical from
instruments the Greco-

RomanperiodstherearenoneknownfromearlierEgypt.539

of fracturesin Egyptianhumanremains.Jonesin 1908

Thereis a highincidence

that 6000
reported of some bodies at
examined Aswan a
showed high
surprisingly incidence
of

of fracturesto the forearmwere31.25%andto the collar

Therecordednumbers
fractures.

of thetotal.540It seemsthatmanyof theseinjurieswerepossiblytheresultof a

bone13.75%

by Bakerfromthe investigation
blowfroma stick.541A similarscenariois laterdescribed of

542She reportsa high incidenceof,

humanremainsacrossseveralperiodsfromAbydos.

(amongst
otherinjuries),
fractures
to the forearmlikelyto havebeen by
caused blunt
small,

objects.TheAbydossamplealsoshowedmanyinjuriesthat appearto havebeenactivity

Osteoarthritis
induced. wascommon withwearto thejointsbyrepetitive
andaccorded trauma.

Thispatternof wearaccords
withthetypicaltombscenesthatshowservants foodand
carrying

538J.T. Rowling,'Theriseanddeclineof surgery in dynastic 63(1989),

Egypt,Antiquity 312-9.
539Nunn,AncientEgyptian Medicine,163.Therearerepresentations of manydifferentsurgicalinstruments
and
otheraccoutrements on theoutertemplewallat KomOmbo.Theseappearto includehooks,probes,forceps,
sawsand catheters. (Adthough,Ghaliounghui disagreesand ratherconsiders themto be toolsand other
appliances, Ghaliounghui,MagicandMedicalScience,101-3).No surgicalinstruments featurein the earlier
medical texts.Eb866-877 containreferencesto whatpresumably mustbea simplesurgical procedure.Herethe
X
ýý' isusedwhichtheGrundriss
wordjweL: translates Grundriss
as'knife-treatment, 1000.Eb866involves
V11:
a swellingoftherntwwhichistodealtwithby'knife-treatment.
540F.W.Jones,'SomeLessons fromancient fractures',BritishMedical
Joumal 455-8.
(1908),
541CitedbyNunn,Ancient EgyptianMedicine, 177.
542Baker, AnthropologyandEgypt,111.

145
 on polesthataresupported
suspended
offerings or carriedin baskets
acrosstheshoulders on

topof thehead.Therewereseveralexamples fractures

of compound due
of thewristpossible

to falls.Manyothershadmultipleinjurieswhichsuggests or
accidents
ordinary fromhazards

Onefemaleaged30-35yearstypically
withanoccupation.
associated showedmultiplehealed

anda laterwoundacrosstheP and6thribsthatwasthelikelycauseof death.

fractures

Miller1991in a studyon necropolis

workmenof the NewKingdomreportsa high

of failureto reportto workdueto sickness.

incidence 543However,
the evidenceof carein

providingfor the welfareof these workmenis high. There would appearto have been a

to losethis workingpopulation
reluctance
pragmatic at higherratesthannecessary.
The

in Egyptaretheproductof Greekauthors.
of neglectandharshworkingconditions
suggestion

Thetombsceneof lpy fromThebesillustrates

an activeindustrialbuildingsite.It showsa

rangeof industrial including

accidents thedroppingof malletsandinjuriesto theeye.It also

showswhatappears to removea foreignbodyfromtheeyeof a worker.

to beanattempt 544

A recentstudyshowedthatwork-related
bonedamagewasfoundin all the human

fromtheMiddleKingdom,
examined
remains andtheLatePeriod.Surprisingly,
NewKingdom

fromtheLatePeriodshoweda considerably
thoseremains higherlevelof damageconsistent

with levels
greater of This
work. withwhatmightbe expected,
contrasts sincethe
particularly

NewKingdom buildingperiod.
periodwasanextensive 545

Thedomestic of ancientEgyptian
arrangements homesandtheircrowding
musthave

for accidental
opportunity
adequate
presented scaldingandburningof individuals.
A studyon

healthanddiseasein contemporary
primitivesocietiesshowsthatthe incidentof accidental

burnsis highdueto domesticarrangements

andthe closeproximity
of sleepingnearopen

Miller,MedicalHistory.35,60.
543
P4Miller,MedicalHistory35,7.
Nerlich,Pathologie
545 23,380.

146
 546Nunn
fires. bums
that
reports andscaldsmust been
have common. today,
547Even without

openfires,
thenumberof burns
to is
youngchildren very In
high. theUSAburns, fire,
through

for
account the deaths
of 17.3%of all in
deaths those 5
aged yearsor The
less. numberof

bums
childrensuffering increases
by a factor
of six foldin thosefamilies
withmorethanone

child. 548 It is, however, to that burns

reasonable assume accidental to have
must
children been

highin ancientEgypt.

EntHes
Prescription

In termsof medicalpapyri,the EdwinSmithPapyrusprovidesa textfor the surgical

treatmentof vadoustraumasto the upper body.549Eb863-77concernthe treatmentsof

turnours
or possible
swellings cit, somewithsurgical Eb51O-41
intervention. are concerned

the treatment
with non-surgical from
of woundsresulting blows
to thebody.

e.g. Eb482hit-c m
for burnsappearat Eb482-509
Themedicalpapyriprescriptions

pbrtnt wbd4Istart for

of prescriptions a Lond
burn', 15-21,
Lond46-61,
Ram111,
B5,Ram-11,1

N11andpossibly
at H39-40 'a
(Eb537,538) weeping '
wound/burn?

Insectandsnakebitesmusthavebeena commonproblemin ancientEgypt.These

in
result an intense in
painand some
andspreading cases
could proved
eventually The
fatal.

withsnakebites.It namesanddescribes
BrooklynPapyrusis concerned sometwenty-one

the
snakes, severityof theirbites treatment;
andappropriate local,
either herbal or
products by

550
incantations.
magical

5461.V.Polnin, 'HealthandDisease in Primitive

Societies',
in Brothwell
andSandison, in
Diseases Antiquity,
69-
98.
547Nunn,Ancient EgyptianMedicine, 182.
548R.Scholer et al.,'Burnsinchildren',
Pediatrics101(1998),El 2.
549R.P.Feldmen andJ. L.Goodrich, 'TheEdwinSmithSurgical System
Papyrus,ChildsNervous 15(1999),281-
4.
550In fact,it alsodealswiththetreatment of humanandanimalbites- crocodile, hippopotamus,pig,dogetc.
Manyofthetreatments haveexactequivalents 249-78.
in theEbersandHearstpapyri.Westendorf,

147
 Scorpion
stingsmustalsohavebeena painfulproblem in
yetthereareno remedies

theBrooklyn
Papyri.In termsof painEb200compares froma stomach
thesuffering condition

551Bin78 alonegivesa remedyfor a scorpionbite,

withthatlikeonebittenby a scorpion.

usingthelessusualwordpYmryforscorpion.
although 552

Its form
The cippusof Horuswas a formof stelapopularin the first millennium.

Horusas childstanding
featured andotherdangerous
whilstholdingscorpions
on a crocodile

and
animals so forces.
their
assuaging TheMetternich
stelais a particularly
excellent
example

whichis engraved
with the storyof Isis, Horusand the sevenscorpions
and texts
magical for

againstthebitesof poisonous
protection canbe recitedfor
animals.Itstextsandincantations

bothprevention 553 Protection

and relief. againstbiteswas alsoprovidedby the wearingof

amulets.
protective

4.9Summarv

In summary of diseasethatappeared
themaincategories to haveafflictedtheancient

Egyptiansare: boneand joint disease,parasiticworminfections,dentaland respiratory

disease.Withinthe categoryof 'boneandjoint'diseaseshouldbe includedinjuriesto the

bonesandjointsnotresultant
fromdiseasebutfromindustrial In addition
andsocialsituations.

to thislistshouldbe addednon-diseased
butpainfulconditions
suchas burnsandinsectand

snakebites.I havepreviously but

stressedthat I do not considerthis list to be exhaustive

it to berepresentative
ratherto consider of thebulkof possible 554
episodes.
medical Astheaim

551Westendorf,
582.
552 Westendorf, 278.Nunn,Ancient Egyptian Medicine,
190.
553Metropolitan Museum of Art, NewYork(MMA50.85).Othersmallerversionscan be seenin the British
Museum (EA36250). Nunn,Ancient Egyptian Medicine,108.
554 1acceptthatanylistwillbelimited.Forinstance fevermusthavebeena problem asa symptom of infection.
It
is excluded heresinceI amdealing withpainandalsobecause leavesnorecordon humanremains.
it generally
However it is nowpossible to testfor malariafromsuitabledesiccated/ mummified remains. R. L Milleret al,
'Diagnosis of Plasmodium falciparum infectionsin mummiesusingthe rapidmanualParasight -F test',
Transactions of theRoyalSociety of TropicalMedicine andHygiene 88(1994),31-2.Thereis 'surprisingly
a total
absence of febrifuges' for the Greco-Roman period,C. F. Salazar,'TheTreatment of WarWoundsin Greco-
Roman Antiquity', inJ. Scarborough (ed.), Studies
inAncient Medicine 59.
21(2000),

148
 thatpainwaswidelypresentin ancientEgyptit is necessary
is todemonstrate
of thischapter to

brieflylookatthelevelsof painwithinthesemedical
categories.

the disabilitythatpainbringsis
Painis complexandwithmanymedicalconditions

moreimportant
sometimes thepainis
withboneconditions
thanthepainperse.Forinstance,

to localtissueandbecomes
oftenradiated These
referredpainor causesnervecompression.
from
canrange ache
conditions to deepoppressive hot pain
painor evenred stabbing whichis

on
accentuated movement
or bearing.
weight 555Therearedifferences levels
between of pain

in differentenvironmental
perceived Thosewherea patientis forcedto workand
situations.

thosewhererestis allowable.
Presumably familyunitof ancient
the largemulti-generational

In fact,it
Egyptwouldallowelderlypatientsin painrespitefromworkandso reducesuffering.

seemsthatchronicpainin onememberof a familygroupnotonlymakesan impression

on

of
othermembers that but
group thatinter-relationships the
affect painlevel
itself. has
Richards

that
shown familyprocesses
cantrigger
or accentuate 556
pain.
chronic In fact,it seemsthat

worsepainwerethosein experiencing
thosesuffering difficultlivingconditions.
557The
cramped

of theancientEgyptians
livingconditions irrespective musthaveaddedto
of anyfamilybonding

thelevelsof paininchronicconditions.

Boneandjointdiseasecanbepainfulto theextentthatit caninterfere

withthenormal

processof living.Evenin contemporary wherephysicallabouris no longerthe norm

England

of GPsis reported
of theworkload
themajority to befrom'backpain'.
558In arthriticconditions

themainsymptoms however,
of jointswithlimitedmovement
areswellingandstiffness painis

themostfrequentsymptom 559It seems

andthe onefor whichpatientsconsulttheirdoctors.

C. S. B. Galasko,SkeletalMetastases
555 (London,1986),100.
M.B. Richardset al., Psycho-social
556 Aspectsof pain,Pain8, (1979),355-66.
M.Humphrey,
557 BackPain(London,1989)
W DSSReport,Sicknessandlorincapacitybenefit. HMSO(London,1990).
- Spellsof CertifiedIncapacity
559Reesand Williams,Pfinciplesof ClinicalMedicine,557. P. Macarthy,Arthritisand Allied ConditionsIst Ed.,
1985),40.
(Philadelphia,

149
thatboneandjointdiseasehasalwaysbeena problem.
Thisis bomoutby a comparison
of

earlierfiguresfromEngland
whichshowa similarlevelof suffering 560
today.

Painassociated
withdentalconditions
canbe This
severe. have
must beenparticularly

Thesemayalsohave
so in Egyptwheredentalattritionresultedin painfulgumabscesses.

interfered of eatingandspeech.Onthe 'dol'painscale(1-10)the

withthe normalfunctions

painof toothache andbackache.

rateswithcancers Equallyit is thelevelof painthateventually

patientto finallysuccumb.
causesa 'dentistresistant' 561

Painis alsothemajorfeatures insectandsnakebitesseemto have

of burns.Equally,

beenparticularly andwouldalsohaveprovided
common scopeforanalgesic
treatment.

The remaining on the 'list' are parasiticworminfections

conditions and respiratory

Schistosomiasis
conditions. of fourtypes:acute(Katayana
is generally fever),urinary,colonic

andhepatic fever
Katayana
schistosomiasis. startswith itchy
localised ('swimmers
dermatitis

itch')aftercontactwith the waterand leadsto fever,bronchospasm

and gastrointestinal

Theotherformsaffecttheu(inarysystem(haematuria
symptoms. thecolon
andproteinuda),

(withbloodyand intermitted
diahorrea)
and hepatic
system(Symmers' 562
syndrome). The

of theseconditions
symptoms inappropriate
areconsidered for analgesic However,
treatment.

worm(pinworm)
certaintypesof parasitic willresultin analirritation
whichmightberelievedby

of localanalgesics.
theapplication

Respiratory
diseaseagainis not consideredappropriate
for analgesictreatment.

is characterised
Tuberculosis by symptoms
of weightloss,feverandnightsweats.
563SiliCoSiS

will resultin a reduction

andanthracosis of respiratory leadingto breathlessness,
efficiency

560Figuresfrom 1921showthat 'lumbagoand arthritis'(87.6cases/1000) weresecondonly to 'bronchitisand

bronchialcatarrh'(231/1000).Onthe Stateof PublicHealth;AnnualReportof the ChiefMedicalOfficer,HIVISO
(London,1990).
W Fairley,TheConquest of Pain,16.
A. Cook,ParasiticDiseasesin ClinicalPractice(London,1990),127-8.
562
ReesandWilliams,Principlesof ClinicalMedicine,302.
563

150
tiredness
and However,
cough. I that
consider thesymptom
of is
cough in
important respectof

of opium(acoughsuppressant).
theavailability 5.2.
inChapter
Thiswillbeconsidered

Painmusthavebeeneverpresentin ancientEgyptian Thiscoupled

society. withthose

diseases in thischaptermusthaveproduced
discussed a situation healthinthe
of marginalised

generalpopulation.

151
 CHAPTER
5: MEDICINAL
PAINKILLING
SUBSTANCES

5.1Introduction

Following anddisease,I nowproposeto lookin detailat

thechapterson pain,terminology

thathavebeenallegedto havebeenusedas analgesics

substances in ancient
or sedatives

Egypt.I usethewordallegedsinceI believethatin somecasesexamination

of theevidence

mightactuallyrefuteeithertheir presenceor the exploitation

of their pharmacological

properties.
I haveselectedthe substancesthat appearin the followingchapterson the following

basis:

(i) By an examination that appearin the medicaltextsand by

of the substances

selectingthosethat appearin prescriptions

whichare eitherspecificallystatedto be for pain

or
control for thatdealwithconditions
thoseprescriptions painful.HereI
whichareobviously

includechronicarthritic-type
typically conditions.

(ii)To selectothersubstances
thatappearin themedicaltextsandwhichhavebeen

bymodemauthors
proposed to havebeenusedaspainkillers.
Here,I includesubstances
such

asopiumandthelotusflower.
(iii)InadditionI includealcoholandsurfaceanalgesics
bothof whichwerepresentand

canbeusedto controlpainalthough inthemedical

theyarenotrecorded texts.

The aboveare broadreasonsfor inclusion;specificdetailsfor inclusionare given

texts.It wasnotpossible
withintheappropriate to producethelistby matching to
prescription

ratherit wasdoneby matchingsubstance

substance; Thisis becausethe
to prescription.

wouldhave involvedthe collationof all thoseprescriptions

alternative intendedfor the

of pain,thenextracting
treatment the'active'substances MostEgyptian
fromeachprescription.

prescriptionscontain multipleingredientswhich often have confusingor conflicting

152
 (Thisalsoignoresthe fact that manyplantsubstances
properties.
pharmacological remain

In
unrecognised).other it
words, is difficult
(andperhaps impossible)
sometimes to recognise

theindexingredient of thisis notmerelyin termsof ex

Thesignificance
withina prescription.

post facto identification

but that it must also have presentedproblemsto the original

It may well have hinderedthe recognitionof individualpharmacological

practitioners.
If, in fact,thiswasthesituation
properties. it wouldactas a 'brake'to anydynamic
of effective

Thisaspectof treatment
treatment.
medical hasnotbeenconsidered
by previous
researchers

butwill be considered
by mein Chapter9. Thiswill be achieved 'prescription
by pefforming

fromthosesubstances
analyses' Withthisendin mind,I thinkit less
in mylistof painkillers.

thatthe list mightbe incomplete

important Thisis oneof the
ratherthatit is representative.

reasonswhy 'pain'was deliberately

chosenas the basisof this thesis.Painis the most

important in disease,
symptom theonethatprompts by the
whichcanbe assessed
treatment

Thusanylistof analgesics,
patient. albeitincomplete,
shouldstillbemorerepresentative
of the

thana listof othertypesof medicines.

overallsystemof treatment

It is appropriate
to brieflymention thathavebeenusedbyothersto
herethemethods

identifymedicinal fromthe Egyptianmedicaltexts.Identification

substances hasessentially

beenbythefollowing by linguistic (demotic,

Greek,andCoptiC564), from
methods: association,

andby matching
Dioscorides theeffectsof knownsubstances
to symptoms
withinthemedical

texts.
The GreekHerbalof Dioscorides
has beenthe majorsourcein Egyptianplant

565It givesfull descriptions

identification. of the physicaland pharmacological
properties
of

herbs
roots,
plants, alongwithvines,wines,dairyproducts
etc.acrossfiveBooks.Mostof the

plantdescriptions as aretheirmedicinal
areaccurate It quotesRoman,Greekand
properties.

5u Copticmedicinewas essentiallyGreek,althoughsome Egyptianremedieswere used, W. C. Till, Die

Arzneikunde derKopter(Berlin,1951).
565The Englishtranslationby J. Goodyeardatesfrom 1655.Dioscorideswas a Greekworkingfor the Romans
(c.60-8BC).Theoriginaltextdatesfromthe secondcenturyandso thatthe Egyptiannamesmightwellhavebeen
lateradditions.

153
(often)Egyptian thelatterarenotreallyhelpful.
namesalthough 566Muchof theearlyworkon

identification
plant by Dawson
reliesoncrossreferencing
of between
descriptions theEgyptian

textsandDioscorides.
567

In termsof moderntexts, the GrundrissVolumeVI (1959)providesthe only

(1981)568
(Egyptian/German)
'pharmacopoeia'
whereasthe magnumopusof Charpentier

a wider(Egyptian/French)
provides 'dictionary' sourcesand
givescomplete
whichadditionally

historyof identification.

Aufr6rehas morerecentlypublisheda seriesof reviewson Egyptianplantsubstances

(1984-7).
Theseare concerned on the basisof
of theiridentifications
withthe re-appraisal

lexicalconnections 569Most recentlyMannichehas

with Dioscorides.
and reconciliation
Herbal(1999). 570
herAncientEgyptian
published

Thelistof obviouspossible from

painkillers thepagesof the is
Grundriss small.Thelist

of candidates larger.Thisis becauseI haveincluded

I havechosenis somewhat substances

thathavebeenmorerecently
shownto possess
analgesic
activity.

My list includes:opium,cocaine,cannabisand tobacco,wild lettuce,celeryfruit,

lotus,dill, juniper,willow,henbane,myrrh,alcoholand surfaceanalgesics.

mandrake, I

thatthislistis representative
consider forthepurposes
of a laterprescription In terms
analysis.

of identification
therehasbeennonewlexicographical beyondthatwhichI givein the
analysis

text. I do not intendthat my discussions of identification

will be re-appraisals but rather

appraisals fortheirpainkilling
of thesubstances Thisis donein anoverallattemptto
properties.

effective
whether
consider to theancientEgyptians.
painreliefwasavailable

566
Forexample,theEgyptianwordforcoriander isgenerally
accepted to bePw (Manniche, AnAncientEgyptian
Herbal, 516.Whilstthisis wellattested
94,Westendorf, in Egyptian sourcesDioscorides givestheEgyptian
word
asochion(Book111:
71)
Forexample,
567 seehisdiscussion
oftheplant1ft,in Chapter 6.1.
568 Recueil
Charpentier, Mat6daux8pigraphiques Relatifs
Ala Botanique Antique.
de1'tgypte
569 BIFAO
Aufr6re, 84(1984),1-21,BIFAO 86(1986),1-32,BIFAO87(1987), 21-44.
570Manniche,An AncientEgyptianHerbal.The detailof othersis lackingand she doesnot attemptany
independent Itdoes,however,
re-appraisal. generallyrepresenta summary ofthelatestviews.

154
 5.2Opium

Manyof the modemmedicaland historicaltexts presume,often withoutany

anduseof opiumin ancientEgypt.

thepresence
elaboration, 571 is notat asclear
Thesituation

asthese imply.
writers Whilst
opium to
appears be known
well fromearly history
Greek thereis

fromEgypt.
a distinctlackof evidence
572The Greeks
Homerrefersto it as the drugthat 'quietsall painsand quarrels'.

opiumto havederivedfroma plantthatgrewin Egypt.

believed 573However, to be
thisappears

andonewhichhasfuelledthe anecdotalstatusof Egyptian

an exampleof Greekmisperception

knowledge
medical 574
andprowess.

Theexactoriginof theopiumpoppyandthebeginnings
of theactualuseof opiumasa
575The
arenotclear.
narcotic opium is nowthought
poppy toAsia
to havebeenindigenous
Mesopotamia.
Minorandnorthern theopiumpoppythenspreadfromAsiaMinor
It is probable

intotheGreekworld.It hasbeensuggested foropiumuse

thattheopiumpoppywascultivated

on theGreekmainland of the lateBronzeAge.576At somelatertimeopium

bythe beginning

seemsto havespreadfromthe Greekworldintothe restof the Mediterranean.

It haseven

thatthissituation
beenproposed timeswhentheLuxor
in Greco-Roman
wasactuallyreversed

571Bern6thin a extensivestudyof opiumstatesthat the opiumpoppywas knownto the ancientEgyptianswell

beforeRomantimes.However,his referencesto this are the findingsfromthe tombof Khaandthe allegedentry
of opiumin Eb782.J. Bern6th,Poppy:The GenusPapaver(London,1998),2. This is similarlyaffirmedby L.
Kapoor,OpiumPoppy,Botany,Chemistryand Pharmacology, (New York, 1995),2. Boothalso quotesthe
referenceto Khaandadditionally informsus that opiumis includedin some700 remediesin the EbersPapyrus,
M. Booth,Opium,A History,(London,1996),16. This is remarkablesincethere are only 877 prescriptions
recordedin total!
572Odysseyiv: 220,230
573Thiswasalsobelievedby the Romansin thatGalen(c 130-200AD)tellsus thatThothtaughtthe mortalsabout
thepreparation of opium.
574'Madein Egypt'carriedmuchmedicinalweightin Homersday.R. PorterandM.Teich,(eds.), Drugsand
Narcoticsin History,(Cambridge, 1995),4.
575W. C. Evans,Treaseand EvansPharmacognosy 4thEd. (hereafter,Trease& Evans)(London,1998),368.
Somewritersreportthatopiumwasfirstusedby the Sumerians.Forinstance,see Kapoor,OpiumPoppy,2 and
Bern6th,Poppy,TheGenusPapaver,2, but,whoofferno evidence.Thompsonappearsto identifyboththe poppy
and opiumfrom the Assyrianmedicaltexts. However,identificationis far from clear since there are many
synonyms andbye-names in the textswhichpresenta confusedpicture.Themedicalconditionsthat he matches
withthe useof opiumare tenuousin the extreme.For example:ýarriýamumarru,the bitterdrug...a narcoticor
poison,gama-a-ba SA, enemyof the muscles may refer to the narcoticpowersof the opium.J. Thompson,A
...
Dictionaryof AssyrianMedicine(London,1949),224-9.Moreimportantlythereis no mentionof the hypnoticor
sedativepropertiesof opiumwhichis emphasised by the Greekwriters.
576R.knott, 'DiseaseandHealingin theAegeanBronzeAge, in Studiesin AncientMedicine(Leiden,1988),41.

155
areabecame for opium
an area growingpoppiesand exporting to the Greekislands
and

theMediterranean.
throughout 577

its usewas.
in Egyptandhowwidespread
It is notclearwhenopiumfirstappeared

centredaroundthe
is essentially
Theideathatit waswidelyusedduringthe NewKingdom

workof based
Merrillees on his the
assertionsregarding tradeof opium Greece
between and

Egypt.578

Opiumis a powedulanalgesic, hypnotic

sedative, and cough It
suppressant. also

powerful
possesses It
activity.
anti-diarrhoeal is perhaps
one of the mostimportant
drugsin the

historyof medicine.It is importantnotonlyin termsof its efficacyandwidemedicalapplications

579
itsusehaswidersocialsignificance.
butbecause

Sincethe patternof diseasein ancientEgyptshowsa highlevelof chronicpainful

dental
medical, the of
properties
conditions pharmacological
andrespiratory opiumwouldhave

impacton the levelof suffering.

hada tremendous andthe abilityto
580Bothits availability

and
appreciate to its
exploit properties
are,therefore, to
significant Egyptian
ancient medicine

andsociety.

fromtheopiumpoppypapaversomniferum
Opiumis produced of whichtherearefour

Theredor cornpoppypapaverrhoeas,although
varieties.
cultivated a numberof
containing

has 581
alkaloids, no narcoticactivity. I believethat therehas beensome in
confusion the

577A.Sigerest, 'Paraceisus intheLightof FourHundred Years'in MarchofMedicine (NewYork,1941),117.

578R. S. Merrillees, 'Opiumtradein the BronzeAge Levant, ' Antiquity36 (1962),287-92;'Opiumagainin
Levant
antiquity', 68(1971),167-71.
579Notjustin termsof addiction, crimelevelsandsocialdependence butevengovernment economic for
policies,
example theOpium Warsofthe1840's. Seearticlein,ThePharmaceutical Joumal, 267(2000), 926.
580Opiumis alsoa highlyeffective treatment for diarrhoea dueto thecodeinecontent).I havenot
(principally
discussed theincidence of diarrhoea in mychapter ondisease, butpresume it wasa considerableproblem dueto
infected
waterandparasitic worminfections. Again,onemightexpectto seesomemention of theuseof opiumfor
thiscondition.In fact,it is difficultto evenfinda wordfordiarrhoea. Nunnbrieflydiscusses thewordwsg,which
appears in Eb44-8, as a possible candidate. Nunn,AncientEgyptian Medicine, 90.Theverbws§is usedmore
oftenastheverbto 'urinate'. (Bothversions appearwiththedischarging phallus Hannig,
determinative), 217.The
Grundriss givesthewidertranslation as 'ausscheiden',i.e. 'evacuations'thereby, allowingfor the possibility
of
Eb44-8beingfor the treatment of diarrhoea. i.e. remedies to 'stop ws§,.However, the formulationscontain
variouslyfruits,dates,resins,and honey.Theydo not particularly suggestthemselves as anti-diarrhoeal
formulations.
581TreaseandEvans, Pharmacognosy, 368.

156
inability
of somewritersto appreciate between
thetypeof poppyflowersandto distinguish the

useof poppyseedsandopiumitself.

in severalnewKingdomtombsceneswhereit is
The poppyfloweris represented

in
shown combination
generally flowers,
withother the and
principally cornflower 582
mandrake.

to distinguish
It is impossible Sincethe poppy
betweenthe speciesin suchrepresentations.

arecommon,
andcornflower field
wild, it
flowers likely
seems thattheyweresimply for
picked

ratherthananyotherproperties.
theircolourcombinations

The opiumpoppyis currentlyfound growingwild throughoutEuropeand the Near

East.583opium is the white juice or latex that is naturallyexudedfrom the plant pod. In

cultivated it
species is by
produced incising
careful 584
the unripepoppycapsuleof papaver

Thelatexobtained
somnifenim. is thendriedbya combination and
evaporation
of spontaneous

of the morphine
by artificialheat.The correctdryingprocessis vital to the conservation

585It to
content. needs be driedandthen out
stored of with
contact air in orderto prevent
loss.
morphine In modem the
production latex is into
moulded 'cakes'or 'bricks'
each

of
characteristictheplace
of odginandthen in
wrapped leaves
poppy for It
export. is fromthis

driedstatethatotherformsof preparation
aremade.

The opiumso producedis a complexof somethirtyalkaloids,the six principal

being:
constituents 586
morphine, thebaine,
codeine, noscapine,
narceineand 587
papavefine.

Sucha scenefroma Theban

582 tombis illustrated
in Manniche,Ancient EgyptianMedicine, 130.
583TreaseandEvans,Pharmacognosy, 367-8.Itspresent in Egyptis prohibited
cultivation by law,although it is
reportednaturalisedinsomeregions from'oldgardenplants',Boulos,MedicinalPlantsof NorthAfdca,140.
584It needsto bedonein theafternoon andtheexudates arethenscraped offin themorning. Rainwindanddew
willspoilit.T. E.Wallis,A Textbook ofPharmacognosy 4thEd.,(London, 1960),439.
585Theactivealkaloids in thelatexareonlypresent forabouttendays.If notharvested theywillbreakdowninto
inactivecompounds.
586Thelastentryformorphine in theBritishPharmacopoeia statestheminimum morphine contentin opiumto be
10%.
587Thesealkaloids appearto beof nousetheplant.Onerecentsuggestion is thattheirpresence wasa random
mutation producedbytheplantschemical processes. Oncetheywerefoundusefulto humans theyevolved for
thepoppy'ssurvivalby virtueof thefactthatmanthereafter plantedandnurtured it. R. Sturgess, 'Christmas
Miscellany', Pharmaceutical Journal267(2001), 927.

157
 opiumhasthesameeffectsas morphine,
Essentially its principal albeittheonsetof
ingredient,

theformeris slower.

Dioscorides
wroteextensively aboutopiumandwasclearlycognisant
andaccurately

of theimportance its
of correctpreparation
sincehe between
distinguished thelatexoposand

588The
thewholeplantmekonion. of hiswritingson opiumis thattheimportance
significance
in termsof its potencywere
of the poppyspeciesandthe needfor its carefulpreparation

589The
clearlyrealised. dangers
associated
withopiumpoisoning
werealso by
noted himin his

to
referencesearlier 590
writers. is
There nosimilar in
mention any Egyptian
known 591
texts. It is

thatlendsitselfto ritualyetnoneis recorded

of preparation
a method 592
or illustrated.

Certainlyopiumwaswellknownto the Romansandso its use mustbe assumed

of Egypt.
duringtheiroccupation thesetwoeventsi.e. opiumin the
593It is theperiodbetween

thatis lessclear.594
in EgyptduringtheRomanoccupation
Greekworldandits presence This

'gap'hasbeenfilledby Merdllees
whosuggests of opiumintoEgypt
thattheimportation

fromtheAegeanduringthe NewKingdom.
occurred wasimportedin Cypriote
595This Base-

Ringjugletswhichweremodelledon the shapeof a poppyhead.This was in orderto

the contents(seePlate5.2 (i), overleaý.Thesejugletsthenreducedin number

'advertise'

duringtheXVIlthDynastywhichhe stateswasbecausetheopiumpoppythenbeganto be
itself. 596
grownin Egypt To furtherdemonstrate of opiumin the NewKingdom
a presence

588Dioscorides
IV:64,6.
589Yet,hereports thesameEgyptian nameforboththewildandopiumpoppy, nanti.DioscoridesIV:64,65.
590HerefersspecificallytoDiagoras (c.40013C)andAndreas (21713C).
591It is interesting
that scenesof vomitingand prostration (seemingly
-due to an excess of wine) are not
infrequentlyincludedin banquet scenes. SeeMu-Chou Poo,WineandWineOffelingin theReligion of Ancient
Egypt(London, 1995).
592Scenes ofagricultureandtending ofgrapesarecommon tombscenes.Perhaps sucha'ritualin respectofa
cropofbrightlycoloured opiumpoppies mightbepredictedif theywerepresent?
593It ismentionedbyGalenandPliny.Thelattermentions thatit wasknowntotheEgyptians.
5941do notimplythattherewasa complete voidbetween thetwoevents.Thepresence of Greeksduringthe
Greekruleof Egyptpre-supposes theirknowledgeanduseof opium.
595Thischaracteristicshapehasbeenfoundin Egypt,Gaza,UgaritandSyria.K. Koschel, 'OpiumAlkaloids in a
Cypriote BaseRing1Vessel of theMiddleBronze Age',AgypteundLevante 6 (1996),159.
596Merrillees,Antiquity36,290.Later'disruption'in theareamightequallyprovidea reason.AftertheAmarna
periodtherewas a diminution of tradein general.Onecausemaybe seenin the ArnarnaLettersin the

158
Merrillees
suggests at thistimein handicrafts
thatthepoppyshapedmotiffirstappeared and

beads.
necklace It be
can seen in
typically piecesfromTell el Amama
of the Eighteenth

597
Dynasty. It is allegedthatthesedemonstrate
thepre-occupation
withopiumin thattheywent

beyond and'symbolised
mereornaments thepowerful
andprotective of opium'.
properties
Fromthishe concludesthatopiumplayed:

'a vi.talpartin everyday in households

lifeandmusthavebeenindispensable asaspirin
jS today'.598

hasalsostudiedthedistribution
Karageorghis shapedjugsandjuglets
of distinctively

theLevantandshownthatsomeappearto havecontained
throughout liquid.The
anexclusive

Cypriotoneshavingthe widestcirculation 599This networkof

throughthe Mediterranean.

seemsto havebrokendownafterthe Hyksosperiod.Thesewereeitherthe Red

distribution

Lustrous
Wheelmade BaseRingJuglettype.It is theformerthathaveusually
wareor Cypriote

beenfoundin tombsin Egypt.The deceasedin thesetombswereusually,althoughnot

female
exclusively, and the jars haveusuallybeenfoundnearthe 600
head. Certainly
the

in
products thesecontainers
musthavebeen to
exclusive Cyprus.
He statesthat the long

narrowneckservedas'a tradeidentification ' However,

of theproduct. I thinkit aslikelythatthe

correspondence of thekingofAlasiatoAmenhotep IIIwhentheformercomplains of theattacks onhiscountryby

andthatit wasravaged
pirates byepidemics. W.L. Moran,TheAmama Letters (London, 1992),17-21.
'poppy'shaped
597SiMilarly objectshaveallegedly beenfoundin Mycenae. Buttheyhavemorerecently beenre-
assessedas partsof a 'pomegranate'. M. D. Merlin,OntheTrailof theAncientPoppy(Rutherford, 1984),199-
201.Equally, thevariform beadpendants froma necklace foundat Amarna andstatedbyAldredto represent a
'poppy'havealsobeenre-assessed as a 'pomegranate',G. T. Martin,TheRoyalTombat el Amama1; The
Objects(London, 1974).1wouldagreethatit is difficultto visualise manyof theseAmarnaitemsas poppies.
However,oneparticular necklace,madeupof concentric rowsofcoloured faience fruits,doesshowwhatappears
tobepoppyflowers. However, theyarepresent fortheircolouraspartoftheoveralldecorative effect- notfortheir
symbolism. See,Fig111, page64in J. Samson, Amama- KeyPiecesfromthePetrieCollection (London1974).
,
598 Antiquity,
Merrillees, 36,292.Thisfactseemsto haveescaped Amenhotep IIIperhaps themostunhealthiest of
thepharaohs. Hesuffered fromobesity,appallingteethwithabscesses thatmusthavegivenhimconstant pain.
Yetdespitesupposedly havingreliefonhand,in theformof opium,heis recorded assending (onmorethanone
occasion)to theMitanni kingTushrattafor OurLadyof Nineveh -a statueof the goddess Ishtar.
Roaf, A Cultural
AtlasofMesopotamia andtheNearEast,132-140.
599V.Karageorghis, 'Relationsbetween Cyprus andEgypt.Second Intermediate PeriodandXV111th Dynasty',
Agypte undLevante 5 (1995),74.
600Karageorghis,AgypteundLevante 5,75.

159
shapewasindicative the i. andsorequiring
of producte. expensive 601
use.
controlled Such,
that

be to the to their
or prevent
theshapemightsimply either aidpouringof contents 602
wastage.

that the
by Merrillees,
The contentswerecertainlyexclusivebut the assumption,

opium
contained
contents on
relies theoriginal of
analysis
chemical an copy
alabaster of such

a jar fromthe tombof Khaat Deirel Kha

Medina. wasdirector
of of
several
under
works the

Dynastykingsand is believedto havediedabout1405BC.603His tombwas

Eighteenth

intactcomplete
discovered by an Italianteamworkingunder
withits funeraryaccoutrements

in
Schiaparelli 1903.
All the to
wereremoved
contents the in
Museum
Egyptian Part
Turin. of

the funeraryequipment
of Khaand his wife Meritwas a of
provision oils in somethirteen

vasesof
alabaster different (Plate
capacities 5.2 (ii), Some
overleaf). wereclosedandsealed

andhadbeen in
placed a finelymadecedar
wood which
casket wasfully Another
sealed. six

whichwerealsomoreor lesshermetically were

sealed the
about
scattered tomb.

Samplesof thesejars were sent to the Universityof Genoafor analysisin 1925.A

chemicalanalysiswas then performedon one of the intact jars

alabaster by Muzioat the

Instituteof ExperimentalPharmacology.Her report concludedthat the contentswere a

604
vegetableoil: 'probably
a mixtureof thosethat were by
recognised the Egyptians
ancient -

castor,sesame,linseed 605
and palmoilS'. In additionthe mixturewas found to containa

considerable amount of 606

iron. This substance was then subjected to standard

601Oilor perfume perhaps? Ormaybea combination of both?Perfumes needed to be'fixed'in oilsat thisperiod
duetotheabsence ofdistilled
alcohol.
602Bothmodem perfume bottlesandproprietary bottlesof opiumtincture aresimilarin thisrespect. Botharesmall
andgenerally less than50ml and have a restrictive
neck or capfor controlledpouring. Such that there mightbe
indistinguishing
difficulty between thetwowithout labels.
603H.R.Hall,'Tombof Kha',JEA14(1928), 203.
604Oilsandfatswereimportant cosmetics in thehot,dryclimateof Egypt.Theremains of sucharefrequently
foundin tombs.Oftenperfumed additiveswereincludedto givethema morepleasing fragrance. A. Lucas,
'Cosmetics,Perfumes andIncense inAncient Egypt',JEA16,(1930), 44-7.
6051.Muzio,'Sudi unoliomedicato dellatombdi Cha',AttideflaSociet& di Scienze
Lingustica, e Lettere4 (1925),
249-53. English translationisfromtheoriginalItalian,in Bissett,Journal ofEthnopharmacology 41,Appendix.
606Thisis difficultto explainsinceit cannothavebeenabsorbed fromthecontainer. It musthavebeenaddedat
source. Ferrous salts were notuncommon as constituents of paintsand kohl.(Lucas & Harris,Ancient Egyptian
Materials andIndustries, 235).Buta separate basketcontaining (all)of Merit'scosmetics werefoundin thetomb.
Whyironsaltsshouldbeincluded withopiumis puzzling. Surprisingly,Bissettdidnotreporton thepresence of
iron!

160
 tests.
pharmacological involved
These theinjection the into
of substance laboratory in
animals

to any
order observe physiological The
changes. substance
when into
injected a froganda

to
mousewasalleged haveproduced i. followed
withmorphinee. excitation
resultsconsistent

bydeath- sleepbeingproduced
in lowerdoses.Muzioreported:
'fromthepsychological
effects

exhibitedby both the frog and the it

mouse was easy to infer that the alkaloidisolatedwas
607
morphine'.

positivefor morphinewith Fr6hdesReagent,copper

This then testedchemically

andwithferrouschlodde.
sulphatein ammonia 608In summary,
the samplewasreportedas

conferToe conoppio'.
oil also'medicato
a vegetable
containing 609

Since1925theresultsof thisanalysis
haseffectively of the
theonlyevidence
provided

of opiumin ancientEgypt.However,in 1994samplesfromthe tombwerere-

presence
tested
by Bissettat KingsCollegeLondon.Theseincludednotonlythe previously
analysed

Turinsamplebutanotherfivefromtheoriginalcache.Thesewereanalysed
notby chemical

as
reagents in the tests,
original but by using modemspecific of
methods thin layer

(TLC),
chromatography gas layered (GLC)
chromatography and 610
immunoassay. These

methodsare veryaccurateand unlikethe chemicalmethodsof analysisare specificand

Theresultsfoundthatnoneof thesamples
quantitative. 611
showedanytracesof morphine.

607A morespecifictestis the Straubreaction.Thissensitivetestis the observation of an erecttail on injectionwith

morphine.It wasnotreportedby Muzio.
608Thesetestsare not specificto a substancebut merelyrelyon colouror otherchangesbroughtaboutby the
reactionof the chemicalsto that substance.In this sense,anothersubstance(unrelatedto opium)mightprove
positivewiththesametest.
w9Muzio,AttidellaSociet6Lingusticadi Scienzee Lettere4,253. Onemustaskwhyopium,whichis a sedative,
wouldbe includedin the goodsrequiredfor the afterlife.Oilsare generallyusedto revitaliseor awakethe dead.
The Openingof theMouthCeremony setsoutthis rite.Koschelseesopiumhereas providinga euphoriceffector
for its 'problemsolving'action,AgypteundLevante6,162. However,I thinkthishis commentmoreappropriate to
modern therapythanancient history!
610Thesensitivityof thismethodis high.It candetectvaluesas low as 0.024ngof morphinein a 0.1ml sample,J.
D. Milleret al., 'The dispositionof cocaineand opiatesin hair and fingernailsof humans',Journalof Analytical
Toxicology 24,(2000),496-508.
611N. Bissettet al, 'Wasopiumknownin 18thdynastyancientEgypt?An examination of the materialsfromthe
tombof the chiefroyalarchitectKha',Journalof Ethnopharmacology 41, (1996),196.It mightbe due to the fact
that some sixty-sevenyears have elapsedsince the analysisby MuAo.However,the originalanalysiswas
conductedsome twenty-fouryears after the removalfrom the tomb and storageconditionswere museum
controlledbetweentheseperiods,such that any chemicaldegradationis unlikely(EgyptianMuseum,Turin-

161
 It shouldbesaidthatthefindingsby Bissettdo notpreclude thatopium
thepossibility

may formed
have the the time.
of vaseat some
partof originalcontents it
However, doesmean

thatopiumwasknownat
fromthetombof Khacannotbegivenasevidence
thatthecontents

thispedod.

However,
a later
analysis to
alleged havefound
the of
presence opiumin a type
similar

by Koschel
jar.It wasreported of opiumin a Base
in 1996thathehadfoundpositiveevidence

RingjugletfromtheEgyptian
collection of WOrzburg.
at theUniversity Thepresence
of opium

was by
demonstrated theuseof TLC,
GLC,
mass and
spectrograph radio This
immunoassay.

wouldhavebeenan important had

discovery not the of
provenance the been
vessel worthless.

It is reported
as been
having 'a
purchased longtimeagofroman antiquities in
dealer Egypt

as partof a lot of thirteenpiecesof Telel Yehudiyah

froma privatecollector mostly
ceramics,

Egyptian
of genuine 612
types'. Alsothe Yet,
vesselwasnotsealed. despite
thisandthelackof

the
properprovenance, contents
werereported
as beingsome3500yearsold. If this is the

casethen the
mostof sample have
would degraded through
andoxidised with
contact theair.It

that
suggests anyopiumpresent be
must a latter
addition
andcouldnothavebeentheoriginal

613
contents.

temperatureand humiditycontrolled).'Factorsin the storagedeteriorationof drugs' in Trease and Evans,

1004.
Phartnacognosy,
AgypteundLevante,
Koschel,
612 161.
in an analysisof severalmummiesdeliberatelylookingfor the presenceof drugsdoesnot report
613Balabanova
the presenceof opium. B. S. Balabanova,et al., 'First identificationof drugs in Egyptianmummies',
79 (1992).
Naturwissenschaften

162
 PLATE5.2(i)

CYPRIOTEBASERINGJUGLET
shownalonqsidean invertedseedpod
of Papaverum
somniferum for comparison

(Takenfrom Nunn,AncientEgypfianMedicine,1996)
 PLATE5.2(ii)

"AX

"Fff

b-1- A

VESSELSand STANDSfrom the TOMB of KHA

Thevaseon the right is sfill sealed.

Exhibitsat theEgyptianMuseum
Turin

(Takenfroma museumphotograph Egizio,Torino1996)

in Roved,Museo,
 Entries
Prescription

to applyto
In termsof the medicaltextsthereis onewordthathasbeenforwarded

"; ý.. 614It for internal

opiumThisis thewordApn o entry
onceas a single
onlyappears an

this
preparation, beingat Opium
Eb782. has been to
suggested applyhere Eb782
because

to
appears bea intended
remedy to actas or
sedative hypnotic
to pacifya cryingchild.

Eb782:

"'I i
pbrtntdrcg3wt

the is in to
where meaningof e9m elaboratedupon a gloss explainthat it a
means, 'childwho

SothatEb782is a presdiption:
is screaming.

crying)in a child'.
(excessive
'forthedrivingoutof screaming

Theprescription of
consistsof a combination §pnnnw, §pn the of
and excrement flies (fromthe

in
wall),make onething(mix), and
mash useforfourdays.
It stopsatonce%

Fly'excreta'is specifically in
mentioned theformula to
asopposed just'fly'.It is difficult

to envisage is It
here.
exactlywhat meant maybe thatit is for
a colloquialism a fly.
'dead' That

is one'swatted'on thewall.Thespeedof its despatch

maythenbe intended
to the
parallel

the 615
speedof efficacyof remedy. One the of
mustalsoquestion wisdom flies
ingesting withits

health
associated 616
(isks.

11111 11-1 has beentakento meanpoppyseeds.617This

spnn nw spn 0 -0

hesitantly
is somewhat by
reported the 618
Grundriss. Where9pnnis givenas Mohnk6rmer?

(poppyseeds)andApnasMohn?(the'opium'plant).

614 La Botanique
Charpentier, de ltgypte, 1094.
615SeeChapter9, page
616It wouldnothavebeensafeandwouldhaveintroduced
thepossibility Onepresumes
of allsortsof infections.
thatthiswouldhaveknownsincefliescongregate aroundfaecalwaste.Yet,it is strangethatfly excretais
considered here(Eb782)
innocuous sincew, andfaeceshavebeensuggested as associated pathological
indicators. -bdw
G. Lef6bvre,Essaisurla m6decine6gyptienne
617 de 116poque (Paris1956).
pharaonique,
618GrundfissIV:292.

165
 Thereis littledoubtthatopiumwouldprovidean excellentsedativefor a cryingor

child.Theuseof laudanum
distressed (tincture base)provided
of opiumin an alcoholic such

in nineteenth
to mothers
reliefandemancipation 619
centuryEngland.

albeitin decorative
Sincethepoppyappears, andhorticultural it nevertheless,
context,

have
must hada nameands'pncouldindeed
be this However,
name. thisdoesnot it
specify

as the 620
poppy.
gpýUM The importance
of the correct of
species poppyis vital in orderto

One
effect. mightexpecta gloss
achievea sedative to this in
effect but
Eb782 it is notfound.

Theheadingto Eb782impliesthatthe prescriptionis intendedto achievea sedativeeffect,i.e.

of a child (to pacify).Whereas,the instructions

to driveout the screaming are actually

if
since opiumwas
ambiguous in
included the its be
would
remedy effect This
immediate. is not

the the
with wordsof prescription
consistent tell
which us thatit the
after
willcease is
treatment

usedforfourdaysrk-w4tmýT ewy(r= extending Whilst

over). I that
accept theuseof 'four

formulaic
days'is somewhat that 'it willstopafterfourdays'is nota good
theannouncement

nor
remedy consistent
withthe effects
of More
opium. importantly,
poppyseedsof whatever

no
contain
variety morphine
andsohavenosedative 621
effect.

9pnis alsoseenat Eb440,443

asaningredient foranexternalapplication
in a remedy

andin Eb445(Sm4114,6,Sm4616,12)in a powder

forexternal
application.

gpnis combined
In Eb440/3 andmadeintoanointment
withvariousothersubstances

to beappliedto theskin.It is listedundera 'run'of remedies forthe'removal'

intended of (the

619Itsusewasaccelerated by thedomestic overcrowding of therapidurbanisation Revolution.

of theIndustrial
Theavailabilityof opiumemancipated themotherandreleased herforotherroleswithintheindustrialised
social
framework. Thenumber of proprietaryproducts for children
waslargeandwidelyavailable V
withoutrestriction,
Berridge andJ. Evans,OpiumandthePeople(London, 1996),24.in ancientEgypttheworkinfrastructurealso
reliedon the by
participation allthemembers of thefamily.This'abilityof opiumwouldsurelyhavebeenin great
demand.
620Theonlywildpoppyreported asgrowing in Egypttodayis thepricklypoppyor argemone mexicana,L. Boulas
etal.,TheWeedFloraofEgypt(Cairo,1984),137.
621Poppyseedscontainsome50-55% of paleyellowfixedoil.Thisis usedtodayfor culinarypurposes andby
artistsforfixingpaintpigments. Theabsence of anyrecords of thisin Egyptandindeedfromlaterpaintanalyses
might also be of
reflective its A.
non-availability.Lucas and J. R. Harris,
AncientEgyptianMaterials
andIndustries
4thEd.,(London, 1962),351.

166
 term)
vague
somewhat 'bnsit(illness)
in the head'.
Eb440 in
contains, equal
parts, Mr-
App,

spdw ),
(mineral? date honey,
syrup, gnft (fruit)
whicharethenmadeintoa massandapplied

to thehead.Thisremedyrelieson anypotential
effectsof Apnandinr-spdw into
incorporated

an inert
baseof honey
anddate It be the
remedy;
syrup. wouldessentially a sticky honey
and

to holdtheactiveingredients
designed
datesyruppresumably and(unlikeanointment
together

for massaging
base)unsuitable intotheskin.622Thisis important
forthereleaseof anyactive

ingredients andefficacyof thesgpn

andsoto thesignificance Theeffectof massaging
present.

into
an ointment the skinwill favour
release
of anycontained
active In
ingredient. this case

the
without benefit
of massage,
any narcotic
or othereffectsof 9p.
Sn wouldbe, at best,

via
released
marginally the skin,suchthat any effectsof §pnwouldbe Eb443
minimal.

gpn,
contains )623,
carob?
LWt(colocynth, skin (burnt?
) of hippopotamus
andfat in equalparts.

Anytherapeutic of
effects Eb430/3
couldonlybe fromthe 'soothing'
effectsof theapplication

viaitsemollient
properties.

InEb445s9pnn withotheringredients
is usedincombination forexternal
andpowdered

The
application. ingredients
are: inr-spdw,
Apnn, (mineral),
cntyw(myrrh)
andArt (mineral,

fossilised
resin,gUM? Boththemyrrhandthesktseem to havebeenusedhereto aidthe
)624.

theformer
is antiseptiC. 625 It is difficultto ascribeanyparticular
although
pulverisation, alsoan

effectsof thispowderbeyondthatof its form.It wouldno doubtbe soothingand

therapeutic

and
antiseptic maywellhaveaidedthedrying
of some However,
wounds. anynarcoticeffects

of §pn be
should discounted.

622A remedy roseoilandopiumlatexis described

containing byDioscorides IV:64,forthetreatmentof headache.
A liniment opiumwaslistedin theBritishPharmacopoeia
containing until1949,althoughtheabsorptiveeffectof
theopiumis nowdiscounted. See,ExtraPharmacopoeia,Martindale25thEd,(London, 1967),802.
623Nunn,AncientEgyptianMedicine,154.
624 VI:458,Hannig,
Grundriss 733.
6251amnotsurethatthe Egyptians wereactuallyawareof all the medicinal
propertiesof myrrhsinceits use
does
generally notseem to imply
this.Thiswillbeconsidered
later.

167
Summary
In summary, fortheuseof opiumin ancient
I wouldsuggestthatthereis noevidence

Egypt.The'negative is in the
evidence' significant viewof valuethatopium have
would hadin

usewhichwouldhaveleft
Egypt.I believethatthiswouldhaveledto widespread
pain-ridden

Otherwise,
someevidence. it is a glaringomission
fromthemedical
texts.

being
It is a drugthat is uniquein that its effectsgo beyondthe pharmaceutical

detectable the fabric

within social of a Again
society. there to
appears be no suchevidence

aboutits effectsandsocial
fromancientEgypt.TheGreeksand Romanswrotefrequently

consequences, the
particulady pedIs
of 626
addiction.

to considerthe formsof opium,i.e. the actualfinalpreparation

It is important of the

of opiumfrom Greeceto Egyptmighthavealso

of the importation
product.Proponents

this The
considered aspect. modem of
method is
export in the formof a blockof This
latex.

allowsit to then madeinto otherformse.g.

allowsfor easeof handlingand importantly

tinctures,lozenges,
mixtures
etc.627 If the Greekformwassupposedly in
dissolved oil for

a Greekdesireto
it wouldrestrictitsabilityto beusedin otherforms.Thismightsuggest
exporl:

disguiseor protecttheirsource.Butit seemsunlikelythateventheywouldwishto restrictits

itsformin thisway.
useandsalebyrestricting

626Dioscorides IV:64.Diagoras, Andreas, Mnesidimus andNicander of Colophon,

theseauthors arereported and
discussed byJ. Scarborough, 'TheOpiumPoppyin Hellenistic andRoman Medicine', in PorterandTeich(eds.),
DrugsandNarcotics in AncientHistory,4-22.Marcus Aureliuswasgiventhedubious honourby Galenof being
oneof history's firstrecorded drugaddicts.Yet,thedosestakenwereactuallylowerthannecessary to cause
addictionin the propersensei.e. a needto keepincreasing the dosagelevelto maintain the samelevelof
euphoria.Thereis a needto cautiously viewandto separate historicalmodelsintostatesof euphoria andactual
evidenceof opiumaddiction. Thisis because of thelackof a full appreciation
of thecapabilities of opium.This
viewis supported by Hamarneh whocitesthe misuseof bothopiumandcannabis occurringaftersometwo
hundred yearsof theirintroduction to pre-IslamicArabia.S. Hamarneh, 'Pharmacy in Medieval Islamandthe
of DrugAddiction',
History Medical History16(1972), 226-237.
Throughout Englishhistory,fromat leastthesixteenth century,therehasbeendiscussion of opiumaddiction,
although, notalwayscondemnation. It appearsto haveeitherbeentreatedas a subjectof interestas in The
ofAleppoorasa subject
History ofamusement e.g.thebehaviour of theRestorationdramatist andaddictThomas
Standwell waswellreported. Indeed thecontrolof opiumwasonlyfirstrestricted bythePharmacy Act1868,(and
thenfordebateable reasons).
627TheRomans werewellacquainted withnumerous formsof opiumincluding tinctures,mixtures, lozenges,
ointments etc.,Scarborough, in PorterandTeich(eds. ), DrugsandNarcotics inAncient 4-22.
History,

168
 It mightbearguedthatthenon-appearance
of opiumin the texts
medical is because
of

someexclusive eitherto aneliteor forreligious

restriction 628
purposes. Thisseemsunlikelyif it

amongstan elite,outsidethe
Greekproduct.As to its restriction
werealreadyan exclusive

texts,I thinkthatthedemands
medical wouldhavemadeit difficultto
on its medicalproperties

keepsecret.

Also,it is necessary of opiumfromthe poppyflowerand

to considerthe preparation

theextentof its cultivation.

Thecollection is an art whichtends
of the latexandpreparation
itselfto ritualisation.FromEgyptiansocietysomeremnantsof this ritualisationmightwell be

Whilstagricultural
yetwehavenoevidence.
recorded featuredon tomb
scenesarefrequently

of the poppybeyondits appearance

wallswe seeno evidence 629Thepoppy
as decoration.

fieldis distinctive
andwouldsurelyhavemeritedsomeattention yetthereareno
or comments,

630
textsor representationS.

If indeedthe useof opiumin Egyptwasas commonas aspirinis today631thenthe

presenceof cultivatedopiumpoppieswouldnot havebeeninsignificant.

In an attemptto

demonstrate
howsignificant
thatpresence
wouldhavebeenI have some
collated figures
to

showthe landrequirements Table5.2 (i) showsthesefigures.I producethis

for cultivation:

tablefullyawareof itscaveats. forEngland

I amawarethatthefigureswhilstaccurate canonly

for Egypt,nordo I propose

be estimates usagemodels.I do
thatthetwoareinterchangeable

thesebeingtotallycorrector scientifically
notadvocate themto illustrate
validbutproduce that

a poppycropwouldnothavebeeninsignificant.
Thetableshowsthataccording
to estimated

levelfor the NewKingdomsome11,523acresof poppyfieldswouldhaveto be

population

628Onecanfindseveralreferences to this,butall appearto be anecdotal andwithoutreference.E.g. 'Theearly

useof opiumwascloselyrelatedto religious cuffs...theknowledge of thedrugwastheexclusive privilege of
magicians
priests, orwarTiors'cited fromB.Dai,'OpiumAddiction in Chicago',PhDThesis(Shanghai, 1937).
Anylargescaleproduction
6-19 of opiumrequires cultivationin fields.Vinesareshownin Egypt.Compare those
regionswherewineproduction is prominent, it becomes partof therecorded socialfabricandthefolkloree.g. the
FrenchAquitaine wherethegrapeishighlyprominent in medieval tapestries.
630Therehavebeenmanyliteraryandsymbolic connections the
with poppyover the ages,forexample itsuseto
representthose'fallen'during'theGreatWar.
631 Antiquity,
Merrillees, 36,292.

169
 to
cultivated satisfy
a demand to
comparable thatof century
mid-nineteenth These
England.

largeonthetotallandusageof Egyptarelargeenoughnotto go
figures,whilstnotnecessarily

in
unnoticed the infrastructure
agricultural of The
Egypt. for
records land within
usage, the

structure,
economic
overall are fairly well for
recorded the New Kingdomperiodat the

workmen'svillageat Deir el Medinaat westernThebes.

There are recordsfor int a/ crops,

oils,
vegetables, water
anddung(fuel)
but no mention
of opiumor 632As
poppies. importantly,

633
basiswithinsmallvillages.
theholdingof landevenat laterperiodswason a smallholding

foodin thefirstinstance
Thislandwasvitalto provide to otheremployment.
or asa supplement
in verysmallparcelsandthese
Themajorityof landseemsto havebeenheldby individuals

have
smallplotswould fully
been for
utilised basicitems.

thereseemsto be a glaringabsence
In summary, of opiumfromthe medical In
texts.

additionanycircumstantial its is
of presence also
evidence lacking.
As to the importation
of

opiumfromGreece
during
the NewKingdom I
period,whilst do not this
consider impossible

the
given level
of trade that
anysuggestion its be
must
usewaswidespread discounted.

632 Commodity
J. J.Janssen, PricesfortheRamesside Period(Leiden,
1989).Thecommodities andlistsareso
wideasto vergeonthemundane. Theomission of an'important'
cropistherefore
significant.
633FortheRamesside periodsome48%of all thesmallholdings were between3-5auroras (2-3.33 acres),S.
Katary, LandTenurein theRamesside Period,(London, 1989),309.Thesamepatterndoesnotalterwithtime.
LaterfortheHermopolitenome,albeitin theRomanPeriodsome50%of allthelandwasownedbyonly3.36%of
thetotalowners,
whereas themajorityof theowners(almost50%)heldonly9 arouras (c.6 acres)of landor less,
LandOwners
J. Rowlandson, andTenants in RomanEgypt(Oxford, 1996).

170
 TABLE5.2 (iii)
COMPARISON
OFOPIUMUSAGEIN ENGLANDANDANCIENTEGYPTANDTHEAMOUNT
OF GROWING
LANDREQUIRED

aretakenfromHomeOfficestatistics.
ThefiguresforEngland Anaverageperannumconsumptionwas
takenforthetenyearperiodbetween1849-1859,
whichis considered
to berepresentative
of thetotal
figuresavailable.

Theaverageconsumption of opiumfor thatperiodwasfoundto be 59,180lb. / p.a.634

This figure was then adjustedfor populationto give a consumptionof 3.421b.per 1000
population

If the sameconsumptionfigureis assumed635for ancientEgyptthen for differingpopulation

following
estimates636the tablecanbeproduced:

The Cakulated Opium use in Ancient Eqvpt and Land Required for that Volume

Population Size Amount consumed p.a. Land required in acres

5 million 001b.
17,11 19,214
3 million 10,2601b. 11,528
1.5million 5,1301b. 5,765

Thefigurefor land requiredwas obtainedas follows.The modemproduction figureof 8-15kg/

wasused.Thisfigureisformodem,
hectare637 intensive farminginidealgrowing andwithfull
conditions
Thefigurefor ancientEgyptwouldbe far lower.Thesoilconditions
useof pesticides. are notideal,
over-wateringcandestroya cropandthe controlof irrigation wasa realproblem.Equallymodem
techniques
collection ensureoptimum collection andlookingat figuresfor
levels.All thisconsidered
othercropsI wouldestimate at best,to benohigherthan1kg/hectare
production, or 0.89lb/acre.

634
During thisperiodopiumimportation intoEngland wasat itsheight. Yet,thepercentage imported fromEgypt,at
thattime,stillonlyaveraged 4.46%of thistotal.i.e.some2639lbs. p.a.
635Thisis notideal.However, although thoughtheseconsumption figuresarehigherthanpresentday,thisis
because of nonrestriction andbecause of thecurrentavailabilityof morespecifictreatments. InthissenseI think
thetwomodels arecomparable forthisexercise.
636Thesecanbenomorethananestimate sincethefirstpopulation census wasnot 1815.
until These figuresare
takenfromButzerwhogives1.5MfortheOldKingdom, 3MfortheNewKingdom and5MfortheIstcentury. They
aregenerally in linewithotherwriters,(although methods ofcalculation vary)andI consider themsufficientforthe
purpose of thisexercise. K.W.Butzer, Eailyhydraulic in Egypta studyin culturalecology,
civilization (Chicago,
1976).J. C.Russell, 'Thepopulationof medieval Egypt,' JARCE5 (1966), 69-82.BagnallandFriergivea slightly
lesslowerestimate, forRoman Egypt,(basedoncensusreturns) of 4.5M.Bagnall andFrier,TheDemography of
Roman Egypt,91.
637TheseweretakenfromV. Burridge andG. Edwards, OpiumandthePeople, (London 1991),13.andBooth,
opium,a History(1996), 6.

171
5.3Cannabisin Egypt

In this sectionI haveincludedcannabis,cocaineand tobaccoundera collective

Thisis because
heading. is
cannabis evidenced
as being in
available Egypt
ancient andthis

withcocaine
and is
tobacco reported
as having
beenfound in
together ancient human
Egyptian

byBalabanova
remains andherteam.
638

Cannabis sativaor hempis a tall,annualshrubandis usedfor its oil,seed

cannabis

andfibrewhichis madeintorope.Thedriedflowering plant,from

andfruitytopsof thepistolate
is usedto produce
whichtheresinhasnotbeenremoved, thewellknownnarcotic
component.

The Egyptianwordfor hempappearsto havebeenS'MS'Mt

to havebeenfoundin thetombofAkhenaten
Piecesof hemparereported atAmamaandplant
11.640
Ramesses
pollenonthemummy
of

Hempis actuallythefibrouspartof the plantandhasno narcoticvalue.Hempwas

butthisfactdoessupportany
usedas rope,mattingandforwovenfabricsW bytheEgyptians

knowledge
of thenarcotic of theplant.
properties

Therearetwovarieties
of cannabis: fibreandtheotherbothfibreand
oneproduces

thenarcoticresin.It appears in whichtheplantlivesdictatesits abilityto

thattheenvironment

narcotic
produce 642
resin. Thenaturalnorth fibre-producing
European is
variety not but
narcotic

to
willrevert theresin-producing
varietyaftera fewyears
when in
grown Egypt
andconversely

Naturwissenschaften,
6a Balabanova, 9.
639
Charpentier, La Botaniquede ItgypteAntique,1114.In Arabic,thecloselysounding, kn.§mis thewordfor
sesame. However, theuseof sesame in ancientEgyptis wellattestedbutforinternalusewhereasftgmt only
appears in non-oral See,W. R. Dawson,
preparations. 'Studiesin theke--dical
Texts',JEA20 (1934),44-5.The
wordappears in thePyramid Texts(514)andis described as a plantfromwhichropeis made.Itscommercial
valuein thisrespectis demonstratedfroma loannotein whichhempis usedas theinterestrepayment of a
monetary loan.A.C.JohnsonandL.C.West,Byzantine Egypt.Economic Studies 1949),190.
(Princeton,
640
Manniche, AncientEgyptianMedicine,82.
641
Manniche, AncientEgyptianMedicine, 82.LucasandHarris,AncientEgyptian andIndustries,
Materials 136,
149.
642Thishas madeif difficultto producea realisticlegaldefinitionof the drug,
narcotic Trease and Evans,
Pharmacognosy, 527.

172
 to
whenremoved temperate
climates
willfail to 643
produceresin. This that
means thehemp
of

Egypt
ancient have
wouldcertainly been the This
resin.
of producing narcotic
capable resinis a

brown, amorphoussemi-solidcomplex containingsome sixty alkaloid compounds

Thesecompounds
(cannabinoids). orally644
areeffective andwhensmoked.

in earlyHinduandChineseworks.It is thoughtto have

As a drugit is mentioned

from
spread China Persia
through andintothe Arab 645
world. It is as
reported been
having

usedbytheHashishan into
sectwhocame conflictwiththe during
Crusaders theHolyWars
of

Equally,it attracted
theeleventhandtwelfthcenturies. of the Europeans
the attention at the

Egyptian
timeof Napoleon's expedition.

name.Hedescribes
whogivesno Egyptian
by Dioscorides
It is brieflymentioned the
646
'juiced'seedasgoodfor'painsof theear.

Themedicinal of cannabisare wide.

properties In the pastit has beenusedas an

hypnotic,
analgesic, and
anxioylitic
anti-convulsant, 647
anti-tussive. It is not as therapeutically

versatileas opiumand has beensomewhat in

displaced Western because
medicine of its

abuse.
recreational

is important
Correctstorageof thesubstance during
since ordinary it
conditions rapidly

648Since,the fresh drug is importantone mightexpecta glossto t is

losesnarcoticactivity.

effectin the Egyptian texts.

medicinal This implies
absence this was not appreciated
and

an
suggests intrinsic
lackof in
knowledge of
respect thedrug.

E.Pittsetal., THC,THCAincannabis
6A3J. (1992),
sativa',Joumalof Pharmacology44 947.
1923givessomefiveoralpreparations.
w TheBritishPharmacopoeia,
TreaseandEvans,Pharmacognosy,
645 527.
646
Dioscorides 165
111:
647Although, mostwidelyknownnowasa 'recreational' albeitControlled beenusedto control
Drug,it hasrecently
nausea in cancerpatients andto stimulate
appetite in AIDS patents.P. Robson, Effects
'Therapeutic of Cannabis
and Cannabinoids', British
Joumal of Psychiatry
178(2001), 98.
rA8Yetanalysis of somedriedsamples fromthePittRiversMuseum at oxford(1896-1903) appeared to showthat
most of the originalcannabinoidcontent wasstillpresent, D.J. Harvey,'Stability
of in
cannabinoids driedsamples
ofcannabis dating from around1896-1905',Journal of Ethnopharmacology 28(1990), 117.

173
 Entdes
Prescdotion

gmgmtappearsin the medicaltextsat Eb618,Eb821,BIn59,Bln8l, RamIII A26

. r-=
are either oral or inhaled
ChesterBeatty13b. However,none of these formulations

thatthemedicinal
whichsuggest
preparations of theplantwerenotappreciated.
properties

Eb6l8

Thisis partof a 'run'of presc(iptions to beappliedbybandage

whichareintended to a

toenail.Theyvaryslightlyin ingredients formula

butEb618containshemp.It is a quantitative

withAdw(resin),
! bw (plant),
yellowochreandhoney.
However,
evenif thehempin thiswas

in theformof resinanynarcotic wouldbe minimalbythisroute.Thisis because

absorption of

for
of theskinandthesmallsurfacearea.It is unusualto seeseveralremedies
thethickness

an
appears
what apparently
obscure It
condition. is that
possible this might
condition to
refer a

or stubbedtoe (lossof toe nail?), presumably

damaged sinceshoes
a commonoccurrence

werenot It
worn. maybe thatthe here
medication is intended
to actas a for
perhaps
poultice

an from
infection a (or
damaged ingrown)
toenail.

Eb821

Thisis a gynaecological
preparation intended
ratherobscurely 'to the Its
cool womb'.

groundwithhoneyandis administered
formulaconsistsof Ams'mt Theeffectis
per vaginum.

'thisis I'N 11313649

as:
stated a contraction', .

It is difficultto speculate
ontheintended in thisprescription,
condition otherthanto say

thatthewombis 'thought'to be involved.

650As to anynarcoticeffectof thehempwe arenot

649Grundriss V:484.
650Thewordidt is usedherefor 'womb'.Medicalterminology namedpartof the body
in respectof a 'specifically'
sometimes intendsto referthe generalarea.See,Walker,Studiesin AncientEgyptianAnatomicalTerminology,
259-60.In this casethe conditionmightactuallybe one affectingthe lowerstomachi.e. painin the 'area'of the
womb.It is unlikelythat the ancientEgyptianscoulddiagnosean occultuterinecondition.Nevertheless, they
appearto'think'the uterusis concernedsincethe remedyis per vaginum.

174
toldwhichpadof theplantis used:fibreor resin.In theabsence onemight
of anyelaboration

assumethe formerand henceno narcoticactivitycouldhavebeenderivedfrom Eb821.

if theresinhadbeenusedthenabsorption
However, fromthevagina
of anyactiveingredient

wouldbeeffective 651
thantheoralroute.
andquicker

Bln59

Thisis 'another(remedy) from

dueto impregnation
to driveoutdemonicpossession

the'semen(?)' and'poison'of a god.It featureswithsomeotherfivecompounds

andunlike

is designedto be usedby fumigation.

the previouspreparations it is difficultto
However,

thattheingredients
imagine foranynarcotic
wereselected activityunlesstheywereintended
to

sedatethedemon.It is morelikelythatthe inclusion

of hempwasto aidthe burningof the

otheringredients to theprocess
andasanancillary of exorcism.

Bln8l,

This is a prescriptionfor the driving out of fever or inflammationk2mt

-1ý11141 652
.

It is anointment
consisting leaf(kBw n gmftt) contained
of s'ms'mt in a fattybase.It

is intended
seemsthattheointment fever,sinceno particular
to treata generalised partof the

However,absorption
bodyis mentioned. of any activeingredient
throughthe skin will be

to otherroutesof administration.
compared
minimal thinksthereasonfortheinclusion
Dawson

in thisprescription is becauseit punswiththeword§M§M.

of S'MS'Mt 6531thinkthisdoubtful

sinceBln81seemsmerelyan inclusion
in a runof prescriptions (Bln80-88
againstS'MS'M and

R303,304).

651Boththe vaginaland rectalroutesproviderapidabsorptionof activecompoundsand also avoidmanyside

effectsassociatedwiththeoralroute.It is routepreferredin continentalEuropefor manysystemicproducts.
652GnindrissVII:854.Thewordappearsto be usedfor bothfeverand 'Jocalised' heatsincethe latteris seenin
connectionwithwounds,e.g. Sm4l.
653Dawson,JE4 20,44.

175
 A26
Ram111,

to 'cool/refresh'theeyes.It consistsof celerynvtt andhemp

Thisis a preparation

is in
and usedas an eyewash the The offers
morning. prescription no moreinformation
than

it is significant
this.However, foranalgesic
thatit is clearlynotintended relief.

Btl3b

of severalitemsincluding
Thisis a combination emmer(mymy), and*bw
Amgmt,

asmwnw... andhencetheyappearto betheresultof the

(plant).Theseitemsaredescribed

'active'ingredients in water.In additionthe formulacontainspulp(date?

dissolved ), Lim of

lotusandgoosefat.Theresulting is
mixture thenusedperrectum, intended
presumably either

of the bowels,(sincewe are told

to soothethe rectumor morelikelyto aid evacuation

at
previously 13athat:dnspw n pPyff, 'it is a blockage
of his rectum' ).
(constipation? No

to
actionseems
analgesic be from
expected this nor
prescription wouldit be likelysincehemp

resinis not in
soluble water.

thattheEgyptians
thatthereis noevidence
I wouldsuggest wereawareof thenarcotic

of
properties The
hemp. above fail
prescriptions to demonstrate No
otherwise. of
part theplant

is specifiedandall are for externalpreparations.

The inhalation
of hemp- the mostusual

of
method is
administration notspecified
- saveforonecaseof demonic 654
fumigation.

654Manniche recordsthattheAssyrians usedit in fumigationto 'dispelsorrowor grier,AncientEgyptian Herbal,

82.1thinksheis misled.It seemsto havebeenknownto theAssyrians, butcarefulattention to theentriesfor
hempsuggests thatthattheyhavelessknowledge thanis supposed. Fordepression of spiritswe see'eatand
drinkwitha meal',KAR203 i,59.Butin thecaseof fumigation it is intendedfor'thepoisonof allfimbeAM91,1,10
andfor the'Handof Ghost,AM.99,3r. 4. Herodotus describes thefumigation of hempseedsby the Scythians.
Thompson wronglydescribes theresultanteffectsto intoxication becausetransported by thevapourtheyshout
Thompson,
aloud'. A Dictionary of AssyrianBotany, 220. However, theyonly shoutaloud because thisvapour
servesthem insteadas water bath;forthey neverby anychancewash bodies
their withwater,HistoriesIV:74-5.

176
 Cocaine
5.4Cannabis, andTobacco
-The Mummies
Munich

thattheuseof drugswithina societycanbe reflective

I havestatedpreviously of that

societyand their studymaygive a valuable into

insight social With
behaviour. this same

in
sentiment mind,an investigation
into the use of hallucinogenic in
substances ancient

was
societies caniedout by Balabanova
andteamin 1992.
Thisinvolved from
analyses the

remainsof some in
mummies the museum
at Munich
to determine
the possiblepresence
of

655These
drugsubstances. dated
remains frombetween
theThirdIntermediate (c.
Period 1070

BC)andthe Ptolemaic/RomanPeflod(endingc.395AD).Thesamplestestedweretakenfrom

to analysisby radio-immunoassay
bone,softtissueandhair.Theywerethensubjected and

(GC/MS).
massspectrometry
gaschromatography/

Theresultsproduced in thatthepresence
wereastonishing and
of cocaine,cannabis

was
nicotine foundin all thetested As
samples. surprising
wasthefactthattheconcentrations

of thesesubstances very
weregenerally In
high. fact,high to
enough be to
comparable levels

individuals
foundin addicted in modern 656
societieS.

arecorrectthenthreeimmediate
If theresultsfromthesesocalled,'MunichMummies'

seem
consequences to flowfromthis Firstly,
discovery. that the of
presence drugscan be

periodof time,in thisinstancealmostsome

detectedin ancientremainsaftera considerable

thatthelevelsof drugsdetectedsuggests
3000years.Secondly, to
a levelof useamounting

Thirdly,
addiction. thatcocaine
andtobacco,
whichare believed
to be NewWorldproducts,

appearto havebeenavailable
to theancientEgyptians.

Whatis surprising
andperhaps in
ominous
somewhat the by
report is
Balabanova that

was expressed
no astonishment If true, it wouldopenup the
aboutthis last implication.

possibilityof trade routesbetweenthe Americasand the Old Worldand consequently

655
Balabanova wasworking asa forensic
toxicologist
attheInstitute
of ForensicMedicineat Ulm.
E.J. Coneet al.,'Theoccurrence
656 andheroinandmetabolites
of cocaine in thehairof drugabusers',
Forensic
Science 63(1993),
International 55-68.

177
 the
re-writing
necessitate history
of the 657
period. Balabanova
andteam to
appear havefound

that
evidence primafacierepresents find,
historical
a major yetseemto ignore
thismerelyto

comment discovery
their
that is important
in thatit that
shows drugusecanbedetected
evenin

658
societieS.
ancient
teaM659
In 1993thesame similarfindingsfromsome72 Peruvian
reported mummies,

twoSudanese
mummies
andfromsometen southGerman
BellCulture
human (see
remains

Table5.4(i).660
Whatis surprising wasnowshownto be
fromthe 1993resultsis thatcannabis

in
present the Peruvian Whilst
mummies. the coca plant(the sourceof cocaine)and tobacco

are nativeAmerican
products;
cannabis
sativais generally to
accepted be a plantof Asian

originhence
an OldWorld in
productandnotpresent South
America
at this This
period. find

to the
appears reinforce possibility
of tradelinks.
The of
presence cannabis
would be
indeed

logicalif suchlinkswerepresentbetweenEgyptand SouthAmericabut this significance,

again,seemsto beignored
byBalabanova.

Surprisingly
therehasbeenno-follow
upor connected to
attempts reproduce
or directly

resultsfromtheMunichmummies.
Balabanova's
compare

I considerthis 'situation'to be one of scientificinputinto an historicalmodelthe

by many
implicationsof which are consideredtoo remotefor further consideration

However,
Egyptologists. it is important
thatthiswholemattershouldbe properlyresolved
and

or dismissed.
eitherexplained beingleft
It is an exampleof 'external'inputinto Egyptology

It canonlyberesolved
unanswered. byfurtherscientific
analysis.

657Silkhasbeenfoundpresent as a hairribbonon a NewKingdom femalemummy fromDeirel Medina. China

wastheonlysourceat thistimeandsosuggests tradethroughPersia.
Theearliestprevious example wasfound
at Quastal, southof AbuSimbelanddatedto aboutthefourthcentury A.D.J. Lubecet al.,'Useof Silkin Ancient
Egypt', Nature,362(1993),25.
658Balabanova, Naturwissenschaften, 358Theystatethatcluesto ancientsocialbehaviour areexpectewith
'regardto childcare'Theythenreportthat'ourresultsarein excellent agreement withrecommendations from
Pap.Ebers(Eb782)whichshouldcalmcryingbabies'I wouldsaywithcare'generallynotnecessarily justin
respectof children.Anyhow,I fail to see any connection betweenthis andtheirresults.Seemy previous
discussion of Eb782.
659F.Parsche etal.,'DrugsinAncient Societies,Lancet432(1993),503.
660 tonotethattheircomparative
It isinteresting figuresnowshowthattheMunich mummies number elevennot
theninepreviously reported intheirpaperfrom1992.

178
 remainsdifficultto
thefindingsof cocaineandtobaccoin ancientEgyptian
I consider

The
accept. useof in
drugs societies
oftengoesfar beyond
the Narcotics
medicinal. affectand

a
within
arereflected leaving
society, their beyond
mark the It
patient. inconceivable
seems that

a traderoutein suchproducts
or, moreimportantly,
those themselves
products couldhave

leaving
existedwithout If
anyevidence. indeed
theyhad Egyptian
escaped then
records it is

almostimpossible theGreeksandRomans.
thattheyalsoescaped

foundaddto thedifficultyof beingableto accept

Thehighlevelsof drugsreportedly

thesefindings.Thismightbe explainedif thereweresomefaultsat the scientificlevel.Possible

for
reasons spurious
resultsat the level
scientific be
might faulty
contamination, methods,

or some
withsimilarcompounds
confusion fault the
with remains (e.
themselves g. possible

fakes).
modern Manyof these seem
arguments inapplicable
sincesimilar have
results been

by Balabanovain other samplesfrom other situations.Any possible

demonstrated

is in
contaminationeliminated the 661
technique. Thewhole of
point drug in
presence hairand

Anydrug
tissueis thatanydrugcontactpostmortemwouldnotresultin intratissuepresence.

have
must
sorecorded beeningested
during
thelifetime
of theindividual.

of cocainein hairwasreportedby Balabanova

Theoriginalmethodof thedetection

herselfusingGC/MC.662It hassincebeenreportedon by manyotherworkersas a reliable

663It usedto detectand quantifythe presenceof simultaneous

method. opiates,cocaine,

in hair. 664
andothernarcotics postmortem
cannabinoids

661Samples of hairfor example arewashedpriorto testto removed anypossible (Pipe

contamination.
external
smoking Egyptologistswerenotinfrequent in thepast!) Washing reducethelevelsof detectable
canhowever
drugs.Inthecaseof cocaine -5% and THC(activeingredient -36%wasrecorded
of cannabis) againstunwashed
hairsample. R.J. Zortlein,
'Effects
of theshampoo in humanhair,International
UltraCleanondrugconcentrations
Joumalof LegalMedicine, 113(2000),102-6.ThismeansthattheMunich examplesmayhavehadevenNghe
initiallevels
662 S. Balabanova and J. Homoki, 'Detection of cocaine in human hair by gas chromatography/ mass
spectrometry',ZeitschriftRechstnedizin,98 (1987), 235-40.
663Y. Nakaharaet al, 'Hair analysisfor drugs of abuse', Archive of Toxicology66 (1992),659-74.
664Dependingon hair length it can provide a quantitativehistory of the narcoticingestion of an individual from
twelve months prior to death. A. M. Tsatsakis et al., 'Evaluation of the addictionhistory of a dead woman after
exhumationand sectionalhair testing',AmericanJournal of ForensicMedicalPathology22 (2001), 73-7.

179
 Alsorecentstudieshaveshownthatnicotineis evenpresentin thehairof neonates
of

who
mothers areknown
smokers
whilst in
negative those
of 665
non-smokers.

of hair:'provides
In 1995Kintzstatedthattheuseof GC/MSfor the analysis a wide

windowof detection from

ranging to
months yearsand information
provides the
concerning

druguse.' Indeed,theGC/MCmethodis nowgenerally

severityandpatternof an individual's

acceptedas being to between

accurateenough providecorrelation the amount
of drug

detected
andthatknown
to be It
ingested. is a methodwidelyusedin drug in
centres
addiction

theUnitedStates.Suchtestsareregularly
usedasscientific before
evidence the 666
courts.

thefindingsby Balabanova
In othercircumstances wouldcauseno The
controversy.

methodusedby Balabanova,
therefore, to
appears be soundandwell Substances
attested.

testedcanbeaccurately is specific
theprofileproduced
recognised, tothatcompound.

Thechanceof otherplantsin ancientEgyptcontaining

thesamealkaloids
as cocaine

and is
tobacco botanically 667
remote. Also,if did
similarplants they
exist wouldhaveto have

beenplantsthatwereusedextensively, profilesto cocaineandtobacco,

withexactchemical

theirusenotrecorded
andthento This
disappear. doesnotseemat allfeasible.

The breakdown by
of abusivesubstances the body and the ultimatelevelsof

will varybetweenindividuals
deposition on age,stateof healthandother
andis dependent

ingested.
substances 668Howevdr,
over a long periodof time some breakdown
of drug

to
substance their is
metabolites 669
probable. Thus,this wouldimplythat the drug levels

discovered mayhavebeenhigherat the timeof deathsuggesting

by Balabanova almost

in
addiction
certain theEgyptian
specimens.

665P. Kintzet al.,'Nicofine

analysisin neonates' hairfor measuring
exposure Journalof Forensic
to tobacco',
Science 38,(1995),119-123.
W It hasbeenusedin Italyto checkthatformerdrugaddictsare'clean'priorto re-issue M.C
of drivinglicences.
Ricossa et al.,'HairAnalysis
forDrivingLicence in Cocaine andHeroinUsers.AnEpidemiologicalstudy,Forensic
Science International107(2000),
301-8.
667
Knapp, TheMystery
citedin 'Equinox, of theCocaine Mummies', Channel
Equinox),
(hereafter, FourTelevision
Script(London, 1996),8.
G.G.Gibson
668 andP.Skett,AnIntroduction to DnigMetabolism 1994).
(Glasgow,
R.J. GreenandN.D.Harris,Pathology
669 andTherapeutics (London,
forPharmacists 1994).

180
 No information of the mummieswas
regardingthe socialstatusor provenance

supplied(orstatedas unavailable);
an important in an anthropological
omission 670It is
study.

extremelydifficultto envisagethat any drug addictionat this apparentlevel couldgo

andwouldnotbenotedor reported
undetected in anycontemporary
documentation
or medical

671
papyri. Thepresence dueto thepossibility
of thesesubstances or necro-
of necro-chemical
biological is highlyunlikely.
changes Asdiscussed
GC/MCanalysis
is easilyableto distinguish

betweenparentdrugand metabolite wouldhavebeenpreviously

and alsoany anomalies
by
witnessed forensic
toxicologists.

Oneotherinitialexplanation mayhave
of the resultswasthatthe Munichmummies

beenlatefakes,something
thatwasnotuncommon wereanxiousto establish
whenmuseums

in thenineteenth
collections 672David
century. hasexamined theprovenance
andpronounced

as 'probably
of the mummies 673Sincethe 'Munich'and1993analysesthere
the realthing'.

havebeenlaterfindsof similarsubstances
in othermummies.
In 1996Balabanova
reported

findsof nicotine
in prehistoric
Chinese 674
remains.

as findingnicotinein 'twoof thetissuesamplesandoneof thehair

Davidis reported

fromManchester;
samples' It is, again,interesting
to notethatneithercocainenorcannabis

wasfound.Shedoesnot sayhowor howmanysamplesweretestedandher resultsappearto

675
beunpublished.

670Thenine'mummies' aremerelydescribed as:sevenheads,onecomplete femaleandoneincomplete male

Balabanova, Naturwissenschaften, 358.However, the femaleis allegedby Davidto be fromthe Twenty-first
Dynastysarcophagus of the'Ladyof theTwoLands'segarately in possessionof themuseum. David,Equinox,8.
However, theprovenance is notfroma knownexcavation butbypurchase froma'privatecollector'
in 1845
671Please seemyearliercomments in respectof addiction.
672Thedesirefor mummies by European collectors andmuseums duringthe earlynineteenth centurywas
Consequently
insatiable. it wasnotunusual forrecently deadbodiesto bemummified tosatisfythisdemand.T. G.
Wakeling, ForgedEgyptian Antiquities(London, 1912),H. Pringle,TheMummyCongress. Science, Obsession,
andtheEverlastingDead(London, 2001),171-8,190-2.
673ThisI wouldventureis stillonlyanopinionsinceall werepurchased or acquired dealers.
throughantiquities
Her'examination'
appears tohavebeencircumstantial sincetheactualremains werenotmadeavailable.
674S. Balabanovaet al.,'Detection of nicotinein prehistorical
skeletalremains of SouthChinese', Anthropology
Anz54(1996), 341-352.
675 in Equinox,
David,reported 8. Unpublished to date.

181
 Balabanova's for
results herPeruvian also
samples seem 1993
Springfield
high. using

GC/MSon samplesof Peruvianhairfrom 1000ADreportslevelsof cocainebelowthat of

(<
modemcocaineabusers 800ng/g).
His figures
are far belowthosefoundby Balabanova

Table5.4(i).Thisis verysurprising thepresence

considering natureof cocaine
andendemic

hedoesnotreportthepresence
usein Peru.Interestingly A recent
or cannabinoids.
of nicotine

studyof hair from

samples from
somenineteenancientspecimens sites
archaeological in

Chile
northern anddeliberately
tested no
revealed traces or
of cocaine,opiates 676
cannabis.

Themainscientific the
with resultsof
problem Balabanova's
teamis thattheylackany
677
controlgroupS. Control
groupsshouldhave to
attempted includeother humanremainsof

origin
non-Egyptian from the same This
museum. would have testedfor any possible

from
or mix-uparising
contamination, museum It
storage. is that
surprising the teamdid not

seekto examine from

material youngchildren
and These
animals. aretwogroups to
unlikely

haveingested
thedrugsinquestion.

andherteamin Table5.4(i). Theresults

I havecollatedthefindingsof Balabanova

fromherteamareshownfortheEgyptian,
Sudanese, andBellCultures
Peruvian together
with

bymeformodern
figuresprovided drugabusers.

basisit is difficultto justifythefindingsfor theEgyptianmummies.

Ona comparative

FortheEgyptian thevaluesshownforcocainearewellwithintherangefor modern

mummies

livingdrugaddicts.Thefiguresfor nicotinein the Egyptian arewithinthe rangefor

mummies

H.Baezet al.,'Drugsin Prehistory:

676 ChemicalAnalysis
of AncientHuman Hair,
' ForensicScienceInternational
108,(2000),173-9.
6T7 arevitalin scientific
Controls Theyserveto highlight
experimentation. possible problemswithinthescientific
methodandalsoto showupanypossible Thisis donebyselecting
contamination. whichwilltest
neutralsamples
andby selecting
negative samples fromthesamestorageenvironment. of drugsin hair
M. Uhl,'Determination
usingGC/MS',ForensicScience International
84(1997).
281-94.

182
modemliving The data
cigarettesmokers. comparative for shows
cannabis the Egyptian

to
samples
mummies beof a higher thanthemodemsamples
concentration

Thehighpresence
of these in
substances the Egyptian is
samples evenmoredifficult

to explainin viewof theprobability

of a breakdown of thesesubstances
nota potentiation post

mortem.
methodand from an
In summary,we are left with resultsvia an established

and
experienced distinguished It
team. is difficult
to their
contradict and
results as difficult
to

imaginethatthesehavebeendeliberately
faked.However,
despitetheapparent of
accuracy

thescientific I consider
methods, cautionuntilthere
thattheresultsmustbeviewedwith'some

is someindependent andsimilarindependent
re-testing resultsonotherEgyptian
mummies.

findingswithouthaving
theirapparentlackof surpriseat theircontinued
However,

on
somecontrolexperiments
attempted thefirstsamplespromotes 678
scepticism. Thereis no

or cocaineby theancientEgyptians.
asto theuseof tobacco
evidence Thesearesubstances

whichgo beyond
mere to
palliatives
chemical become
partof the social In
structure. Peru

is
cocaine integral
with it
lifestyle, is depicted
in its art. In NorthAmerica
tobacco
smoking

a ritualwithinindigenous
became unlikelythatit wouldnothavehada
society.It is extremely

similarimpactwithinEgyptian recordin artandiconography.

societyandalsoescaped

A possible is thatsuchsubstances
explanation forspecialor exclusive
werereserved

theirapparentblanketappearance
use.However, whatmustbe a random
in presumably

in theMunichMuseum this. 679

of mummies
collection precludes

678It mightbe arguedthatthis is just scientificignoranceof history.However,the historicalsignificance

wassoon
pointed out: 'I got a pile of letters that were almost threatening,insuffingletters saying that it was
nonsense becauseit wasprovedthat beforeColumbusthesePlantswerenot foundanywherein the world
......
outside the Americas, personalquoteby Balabanova from,Equinox,2.
679Seemyearliercomments in respectof the supposedexclusivityof opium.

183
 TABLE5.4 M
Summaryof the concentrations
(nq/q)of the alkaloidsreportedby Balabanova
et al.

Belowthesefiguresfor comparison
are showntypicalvaluesfor moderndrugabusersandsmokers(summarised
fromCone(1993),Kintz(1993)andJurado(1995)680
(Thenumberof samplestakenis shownin parenthesis).

COCAINE NICOTINE CANNABIS

Egyptian
mummies(Munich)

Hair 24-200(4) 140-900(4) 800-4100(4)

softtissue 70-442(8) 125-1045(10) 59-2875(10)
Bone 25-110(6) 45-1050(11) 36-2800(10)

Peruvian
Mummies

Hair 220-13900(12) 28-1400(12) 50-1700(17)

softtissue 43-1371(10) 57-1997(6) 49-2795(8)
Bone 26-326(16) 39-557(26) 14-276(20)

Bell culture

Bone 0(10) 56-142(8) 0(10)

Sudan

Bone 0(2) 87-93(2) 0(2)

Modern drug
abusers

Hair 4-760(1W), (17) nottested 0.06-3.87 (100),

(17)

Modernsmokers

Hair nottested 0.37-63.50 (100), nottested

(40)

BellCulture
- datestated
as250OBC.
Sudan- datesstatedas5000-400OBC
and400-1400AD.

680Cone,ForensicScienceInternational,
55-68.lKintz,Journalof Forensic 119-123.
Science, C. Juradoet al.,
'Simultaneous
quantification
of opiates,cocaineandcannabinoids ScienceInternational
in haie,Forensic 70
(1995),165-174.

184
 CHAPTER
6: LETTUCE,
CELERY LOTUS
FRUIT,MANDRAKE,

6.1Lettuce

1'4
sativaebw?
Lactuca

Lactuca cB 681
virosaeft,var.

Thereare two speciesof lettucebothof whichwerenativeto ancientEgypt.Theseare L.

which
sativa is known
commonly
most as thedomestic
lettuce
andwhichis widelyeatenas a

and
saladvegetable682 thelesser
known L.
variety
rarer virusa
or thewildleffuce.

lettucewaswellknownto the ancientEgyptians;

Thedomestic canbe
its cultivation

seen in
illustrated tomb 683
scenes. It wasalso to
considered be to
sacred thegod 684
Min.

TherearetwoEgyptian that
words havebeen to
offered meanleffuce:
theseare cbw

and eft, which Manniche to

suggestscorrespond the domesticand the wild lettuce

685The
respectively. word bwis
, accepted
generally as the(domestic) 686
lettuce. It likely
seems

wellknownin domesticandmythological
thatsincethe nameof the lettucewasobviously

then
contexts someother
name
wouldbe to
reserved it
distinguish fromits wildandmedically

Only
variety.
useful thewordeftonly in
appears the medical Dawson
However,
texts. reasons

thatsincethewordforthe(domestic)
lettucewaswellknownthenthewordeftmustrepresent

681 BIFAO
Aufr6re, 86,(1986), 6.
682Egyptseemsto havebeenamongst the earliestareasof domestic D. Breweret al.,
lettucecultivation,
Domestic PlantsandAnimals - TheEgyptian Ofigins
(Warminster,1995), 74.
683 of wildlettuceis shownin theOldKingdom
Thecultivation tombof Niankhkhum andKhumhotep at Saqqara,
Manniche, AnAncientEgyptian Herbal,113.Thechapelof Senusret I at Karnakshowshimofferingmilkto the
godMinbehind whoareshownthreelettuceplants.VVb 1:176,'anofferingtotheithyphallicgodMinandAmun.
684 seemsto havearisenfromthesimilarity
Thisassociation between themilkyjuiceof thelettuceandthesemen
ofthegodsTheconnection alsoexistswithotherdeities.InonemythSethissaidto become pregnant
aftereating
lettucethathasbeenimpregnated withthe semenof Horus.J. G. Griffiths,TheConflictof HonisandSeth
1960),
(Liverpool, 41-6.
685Manniche,AnAncient Egyptian Egypt,113.
686TheWorterbUch givesebwas 'lettuce'whilsteB var. eft is merelyreferred to as a 'plant,Wb1:176,Wb
1:182.

185
 plant. 687 This he takesto applyto mefflot(mefflotus
someother or the sweet
officinalis)

688
clover. The is
connection because
made of the properties to
ascribed the by
melilot
with the usesof eft in the
whichDawsonsees as directlycorresponding
DioscorideS689

Egyptian texts.Dioscorides
medical wordsforboththeseplants,butneither
givestheEgyptian

any
provides lexical Mefflot
connections. hegivesasheamith
andforL sativahegivesembrosi.

Thewildlettuceisdescribed
butnotgivenanEgyptian 690
name.

In the Egyptian
medicaltextsthe plant cft seemsto havebeenintended
to combat

usesthisfactto makethissameconnection
pain.Dawson between
mefilotandeft.
Itsuseasa painkiller
is principally
in externalpreparations internally
whereas it is also

usedint al to treatcoughandto actas a vermifuge.

Theuseas a coughremedyre-enforces

viewthatsomesoothingtypeof herbmusthavebeenintended,
Dawson's 'melilota kindof

691
muchhoney'.
cloverwhichsecretes

Theviewof Dawson
thattheplanteftwasthemefflothasbeenwidelyaccepted.
692BUt

forthepharmacological
thisrelieson theclaimsgivenby Dioscorides of thernefflot.
properties

I thinkthe choiceis somewhat

However, randomandthatthe minorityviewof Aufr6reand

Manniche thewildleffucedeserves
that -rftrepresents furtherconsideration.

687 failstoconsider
He,however, (orwasprobablynotawareof)thewildlettuceasa possibility.
6NW.R.Dawson, in theMedical
'Studies Texts',JEA20(1934), 41.
689Didscotides
111:
48.
690
Dioscorides 166.Hedescribesit as being'soporificandfor theeasingof pain.'
11:
691Dawson,JEA19,41.
692Thisviewhas beenaccepted by mostfromDawsonto Charpentier. Charpentier,Receuddo mat6daux
relatifs6 la botanique
6pigraphiques deI'8gyPteantique,240.TheyelaboratenofurtherthanDawson. However,
Aufr6retakestheviewthatthissubstance is the'wildlettuce'.Hisargument
is basedon thereasoning thatthe
sincedomesticlettucedoesnot appearin the medicaltextsandconsidering the significance
of lettucean
appearancewouldbepredicted. Aufr6re,
BIFAO86,1-32.

186
6.1 (i) PrescOption
entdesof cft in the EgyptianMedicalTexts

EMO

ktntdrmrtmgsn, bt

(prescription)
'another in thesideof thebelly'
to driveoutillness/pain

(tostoppainin theabdomen
- Dawson).

Theremedyfor thiscondition
consistsof cft withdatejuice,boiledin fat or oil. It is

andassuchis intended
a poultice
essentially to beapplieddirectlyto theskin.

Thewordmrt is usedandI agreewithDawsonthat'pain'is a morelikelytranslation

than'illness'.The sideof the bellyis clearlyindicatedand morelikelyto be describing

a

whichmustbe pain.In the absence

'symptom' of moredetailsit is difficultto speculate
as to

is likelyto be.
whattheactualcondition
However,
it is significant
thattheremedyintended thepainis an external
to assuage

ratherthananinternalone.Thisis oddbecauseeft(eitheras mefflotor wildleffuce)wouldbe

minimallyabsorbedfrom a poulticecomparedto its oral administration,

so reducingany

benefit.Thisimpliesthattheproperties
painkilling or that cft
of cftwereeithernotappreciated

otherthanleffuceor melilot.
wassomesubstance

H42

bdwm ITnbt
pbrt nt smi ivý,

'a prescription
todeadenpainin allthelimbs',

forthedeathof Schmerzstoffe
'a prescription in allthelimbs',693

'tostoppainin anypart'(Dawson).
694

Thisremedyconsistsof a complexmixtureof ingredients

whichincludeseft in beer

and is
which intended
to bedrunkovera periodof fourdays.UnlikeEb40thisprescription
is for

internaluse, but the combination

of "A with severalother unknownplantsmakesa

693Grundfiss
IV:11.
694 hasthiswrongly
Dawson listedasanexternal
preparation!

187
 impossible.
prognosis
pharmacological If cftwas to
thought bean per
painkiller
effective sethe

This
seemssuperfluous: might
presenceof othercompounds be if
explained it was not

ingredient.
to betheprimary
considered

However,
it seemsfairlycertainthatthisprescription to combatpain.It is
wasintended

partof a 'run' in
of prescriptions the Hearst
Papyrus
(H33,34,37,41-46,125-30)
whichLeake

695
areto treatarthritis.
considers

Eb608

kt nt sgnnml ct

(prescription)
'another theknees',
to soften/soothe

'tostoppainin thelegs'(Dawson).

Thisan externalpreparation of eftwithhoney,datesandfat whichis madeintoa

consisting

'mass'andthenappliedto theknees.Thisis presumably in

a remedy combatstiffness the
to

jointsandpresumably theknees.
wouldaffordsomereliefasanaidto massage

Eb86

pbd nt sd uýhdwmht

to breakuppainin/fromthebelly',
'a prescription

to breakupSchmerzstoffe
'a prescription 696
in thestomach'.

Theformulaconsistsof eft, cRh(cowfiesh), juniperberries,fresh

697sktr (incense),

breadandsweetbeerwhichis strainedanddrunkfor fourdays.Dawson thisis for

considers

thattheformulais laxative,nota painkiller,

'purging'suggesting whichratherrunscontraryto

The pain may indeedbe from constipation

his argument. but, any laxativeactionis not

bytheformula.
supported
695Leake,TheOldEgyptianMedicalPapyri,62.
696GrundrissIV:104.
697GrundfissIV:104.

188
 Eb751dr nsyt m irly'to driveout nsyt in the eyes'.Its formulaconsistsof Ift, bsbs

(plant/fruit),
LYs (plant),
jPw (fruit) beer.
andsweet It is intended
to bedrunk.

Dawson these
quotes but
prescriptions doesnot on
elaborate their I
significance.think

is intendedto
hereis somesortof painfulillnessandthatthisprescription
thatthecondition

relief.
giveanalgesic

Eb640

'anothee(presdiption)-from Eb637nwdtntsgnnbtnbt, 'ointmentto soften/soothe

anypart/all '
things,'for stiffjointsandmuscles' (Eb656
(Dawson). has 'all
Abu nbt stiffness,

intended
perhaps )
here.

This is an externalpreparationcontainingsome 15 differentingredients:eft, w.§bt

), pm (plant),698red ochre,copperoxide,sludge?(apt s-dr),

(mineral),ssk; (fruit/mineral?

ibex
natron, fat, donkey drrt
excreta, )699,
(colocynth? psýd(pod/husk),
enb tp3w(freshpartof

),
plant? bone
700 andwhitefat. This is all madeinto a massand then applied. has
Dawson this

for'stiff
as remedy joints I
andmuscles whichis not an However,
assumption.
unreasonable the

formulais odd sincethe additionof donkeyexcretadosesnot fit with the usualsoothing,

formulas
aromatic of This
agents.
rubbing that
suggests it as a
wasusedmorespecifically

for
poultice localised than
rather
application a 'universal for
rub' joints
stiff or muscles.

to notethatlikefly excretain Eb782,the additionof donkey'excreta'

It is interesting

Thatis stubbornand persistent

heremaywell be allegoricto the natureof the condition.

(donkey-like) (pain).
symptoms 701

698Acacia?,Westendorf, 656
699Nunn,AncientEgyptianMedicine,164.
700Juniper?,Westendorf, 656.
701Thecharacteristics of animalsare frequentlyusedin Egyptianliteratureto describehumantraits.In 'Warnings
to an idlescribe'fromthe PapyrusKoller:'Thyear is deaf,thouart likean assin takingbeatings(stubbom).Thou
art like an antelopein fleeing',translationfrom A. H. Gardiner,EgyptianHieraticTexts1, (1964),39. In 'Be a
scribe,for a soldierslot is a hardone'fromPapyrusAnastasiV: I... areyouan ass?Onewillmasteryou!Thereis
sensein your body',translationfrom R. A. Caminos,Late EgyptianMiscellanies, (1954),235.Thereare many

189
Bln20l.

kt pbrt nt stt m msdr wy

'another for'shooting
prescription in
pains' both
ears',

'another for
prescription in
Schleimstoffeboth 702
ears',

(Dawson).
'forearache'
...
Theformulaof thisprescription
consistsof cficombined
with1br )
(ointment?whichis usedin

forthetreatment
theears.It seemsthatthiswasintended of earache. hadsome
It presumably

soothingeffectin the by
ear virtueof the base.
ointment
emollient However,
any active

ingredient wouldbelimited.
release

Bln36

kt nt sgr R sryt

'another(prescription)
to soothea cough'.

Thisconsists
of several including
ingredients eft, beer,
sweet fat
oil and andis to betakenfor

fourdays.It is presumably to havea soothing

intended cough.
effectona non-productive

Eb64

ktdrpftmbt

to driveoutPt1wormin/fromthebelly'.
'another(prescription)

Thisconsists
of eft, cm(plant),
Psi(fermented juice)
plant together
combined andthen'eaten'.

is designed
Thisprescription asa vermifuge, thetypeof wormis unknown.
although 703

moreexamples in the Texts',

'Instruction for example:in PapyrusInsinger
and The Instructions
of Ankhsheshonq,
in Uchtheim,AncientEgyptianLiterature111,159-217.
702GrundrissIV:63.
703Despitethe severityandthe highincidenceof parasiticinfectionsin ancientEgyptthereappearto be onlytwo
worms
specific mentioned by name in the medicaltexts.Ebbell
suggeststhatthese correspondto the roundworm
and tapeworm respectively, tft being the former.
Ebbell,ThePapyrusEbers,130.

190
 ingredients
Inviewof theunknown it is impossible
in thisprescription its
to saywhether

However,
formulawouldbe effective. therearesomeseventeen
other for
treatments the Pi?

wormin Ebersalone!

Eb530
704
bt
ssnb nbt mnt sm Sa

better,whena mansuffersa sore'.

'tomakeeverything

of eft,andsaltmixedin oil or fat whichis thenapplied.It is presumably

Thisremedyconsists

to heala soreor perhaps

designed sometypeof difficult
healing The
wound. ingredient
active

to be have
presumably
appears saltwhichwould afforded benefit.
antiseptic
some

WOW

705Its formulais an external

is intendedto preventhair JOSS.
This prescription

'chopped'
containing
preparation eft. It is difficult
to imagine
that this formula
wouldwork.

Sufficeto say that supposed'hair restorers'havebeenon offer acrossmedicalhistory.

Effective are a
ones essentiallyproduct
of verymodern 706
times.

Takingalltheaboveprescriptions a farwiderrange
as a wholetheyactuallyrepresent

of than
conditions are implied
actually by Dawson.
The presenta
essentially
prescriptions

that
substance is capable
of curingpainby bothexternal
andinternal
means,curingcough,

actingas a soothing
vermifuge, soresandactingas a hair An
restorer. to
attempt matchany

to be impossible
substance sucha widevarietyof useswould almost evenwith modern

Dawson
Insuchcircumstances,
medicines. (eitherconsciously
or not)hasconcentrated
onthe

704TheGrundrissgivesthisasSAM (eineWunde), GrundrissVII:820.

Aninteresting
705 alternative is Eb465.Itsformulais rathereclecticandtheingredients musthavebeendifficultto
of
consisting
obtain: lionfat,hippopotamus fat,catfat,snakefatandibexfat!
fat,crocodile
Hairlossanditstreatment
706 hasbeenaneternalproblem. (butlimited)products
In the1980'sthe'first'effective
weremarketedfollowing the observed sideeffectsof minoxidd a productoriginallyintendedfor thetreatmentof
hypertension.

191
 for approach.
broadusesof cft painandcoughs,perhapsnotan unreasonable his
However

viewthat fits
mefflot theuses to
ascribed 'R of
examination
closer
needs the properties
actual

of theformer than
rather a reliance
on Dioscorides.

6.1(ii) Melilot

Thereis no published
scientific for mefflothavinganypainkilling
evidence properties.

Itsmainconstituents
are aromatic
coumarinS707and oil.It does alkaloidS708which
notcontain
It
mightprovideanalgesicor sedativeproperties. doesfeaturein some herbal
European

but
medicines its useis limited
asanaromatic, nota painkiller.
andcarminative
emollient

to combatpainandstiffnessof swollenjointswas
Its useas an externalpreparation,

by
reported Galen it
and useasa for
poultice by
swelling the monk
medieval 709
Gerard. Butthis

is becauseof its aromaticratherthan any pharmacological The fact that the

properties.

is its
wouldpromote
substance sweet-smelling in
inclusion soothing to
particularly
applications,

ingredients
counterother by its However,
properties.
aromatic the releaseof anyspecificpain

fromtheplantshouldbediscounted.
killingsubstance

6.1(iii)WildLettuce

Thisplantcontainsmorepharmacologically thanthemefflotandso
activesubstances

seemsa morelikely for

candidate theusesof eftin themedical The
texts. wildlettuce
contains

flavenoids,
citricacid,oxalicacid,cournarins, terpeniods is
and alsosaidto contain It
alkaloids.

is saidto possessmildsedativeandanalgesic andhas beenusedfor insomnia,

properties

and
cough,muscular afticular 710
pain.

Thesepossessbloodanticoagulant
707 properties.
TreaseandEvans,Pharmacognosy,
708 167.
Reportedin M. Grieve,A ModemHerbal,www.botanical.
709 com.,(March,2003).
710Whilstthe chemistryof wild lettuceis well documented representthe active
it is not clearwhichconstituents
component. Early reportssuggest the presence of hyoscyamine. This has been disputedby J. Huang et al.,

192
 Whilstthereis no published
information herbalusesedative
to supportits traditional

in animalstudies.It hasalsobeennotedto produce

effectshavebeenreported and
mydriasis

in animalstudies.
of motorcapacity
a reduction 711

It seemsthatthewildlettuceratherthanthemefflotwouldmoreappropriately
accord

with the medicalconditionsdescribedfor the eft plant. However,I do not state this as a

certaintybut ratheras a choicebetweenthe two substances as 'candidates.

suggested

I am concerned
However, of eft in combination
thatthe appearance withothersubstances

mightmeanthatit wasnottheintended
primaryingredient. a problemin
Thisaspectpresents

termsof identification. inclusion

Random impliesthatanymedicinal werenotactually
properties

If -rftwasconsidered
recognised. to be an effectivepainkiller
onemustquestionthe needto

addotheringredients.
Egyptian andits implications
polypharmacy in more
willbe considered

detailin theconcluding of thisthesis.

chapters

on HerbalRemedies',
'Studies Joumalof Pharmaceutical Sciences71 (1982),270-1.C.A. Newellet al.,Herbal
a GuideforHealthcare
Medicines, Professionals,
(London,1996),266.(Hereafter,
HerbalRemedies).
711Butthissuggests somealkaloidactivity,F GonzAlex-Lima
et al., 'Depressant
pharmacological
effectsof a
component fromlettuce',
isolated International
Joumalof CrudeDrugResearch 24(1986),154-6.

193
6.2(i) CeleryFruit

Mgt712

ApfiFructus

Celeryfruits are the dried ripe fruits of the cultivatedplant Apium graveolenswhich are

currently into
imported Europe,
Western mainlyfrom Europe
southern andthe The
Levant.

to
plantappears havebeen in
present ancient 713
Egypt.

Theplantstemappearsnotto possesspharmacological
activitywhilstthe fruit contains

two to threeper cent of volatileoil, fixed 714

oil, proteinand mucilage. It has in
featured

traditional
medicineuntilfairly timeS715
recently and has muchlonger
beenwidelyusedin

and
alternative folk It
medicine. hasbeenusedas a tonic,
sedative, andasa
u(inaryantiseptic

716Indeed,it stillfeaturesin the currentBritishHerbal

for arthritisandrheumatism.
domestic

Pharmacopoeia This feature

asananti-rheumatic. particular of theactive in
constituents celery

fruitfor paincontrolin muscular disease

skeletal wouldhave it
made a in
compound
useful

Egyptian
ancient In
medicine. view of the high incidence one might
of such complaints

in
entries
corresponding
appropriately
anticipate themedical 717
papy(I.

Theplantnamedm?tt hasbeentakento meancelery(celeryfruit).Thiswasoriginally

by
proposed Loretaftersomedetailed 718
consideration.Thisis nowthe generallyaccepted

712Aufr6re, 86,9.
BIFAO
R.Germer,
713 Floradespharaonischen Agypten,(MainzamRheinj985),137.
Thephthalate
714 contentof theoil hasbeenshownto havesedative andantispasmodic propertiesanditsother
have
extracts demonstrated ant-inflammatory in
activity animal Newall,
tests. HerbalMedicines,65.
Itwasusedforitsanti-arthritic
715 properties
andappeared in theBPCuntil1949.Martindale 28thEd.,1015.
716
Itspain-killing,
anfi-inflammatory havebeendemonstrated
properties A. H.AdaandA.
inin vivoanimalstudies,
'Anti-nociceptive
AJkofahi, andanti-inflammatoryeffectsof someJordanian medicalplantextracts',Jourrialof
Ethnopharmacology 60(1998),117-124.
Discussed
717 intheChapter onDisease, pages126,132.
Loret,LaFiorePharaonique,
718 16.

194
viewandis supported
by Manniche, andthe Grundriss.
Nunn,Charpentier, 719Dioscorides

the
gives Egyptian for
name withtheCopticwordMIT.720
celeryasmithwhichalsoaccords

6.2(ii) Dawson
andM3tt

Thedissenting
voicefor thetranslation
of the plantnvtt as celerywasDawsonwho

an alternative
proposed namelythemandrake
meaning, plant. 721 SinceDawson
stillcontinues

to be quotedin the areaof EgyptianmedicineI considerit necessary

to lookat Dawson's

beforeattempting
proposals to evaluate
themedicalpapyri.(Themandrake
willbedealtwithin

a latersection).
Dawson'sreasoning
is, at first sight,quiteconvincing
andfor that alonedeserves

furtherconsideration.

Hisasseaion
is basedonananatomical withintheLeidenMagicalPapyrus
connection

(1,348lines5.8,6.1)
whichstate:

hisphallusis Bebo,

histesticles
arethefruits
ofn2; tt

(Inswy.fy m prt mitt)

histhighsareIsisandNepthys
etc.

TheLeidenMagicalPapytusis an exampleof a commonformof 'anatomical

list' in

whichpartsof thehumanbodyarerelatedto a deity.Dawsonstatesthatthe nameof a fruit

'shouldrankas equalto a divinityonewithoutstanding 722He presumably

magicalstructure'.

wasthinkingof the supposed He alsotakesthe word

of the mandrake.
magicalproperties

719Manniche,An AncientEgyptianHerbal,76. Nunn,AncientEgyptianMedicine,154.GrundrissVI:214.These

authorsconcordwithoutcomment.Charpentierlists all the referencesin support,Charpentier,Receuilde
matbriaux6pigraphiquesrelatifs6 la botaniquede ltgypte antique,501.
720Dioscorides, 75.
111:
721Dawson,JEA19,133-5.
722Dawson,JEA 19,134. But I think he is supposingmagical'structure'becauseof his belief that it is the
mandrake -a plantwith(M-U-ChlateLr)mysticalassociation.

195
 to to
mandrake equate n9tt because
he the
associates of
shape thetesticles
withtheshapeof

flowers.TothisendhequotesBudgein sayingthat,aftertheflowersof thisroot

themandrake
0
havedriedthereremain:'two littleballswhichare like the testiclesof a man
(mandrake)
.
as'thedevil'stesticles'.
hecitestheArabnameforthemandrake
Equally

in themedicalpapyri:a
thereseemsto betwospeciesof nvtt mentioned
Additionally,

equateto the indigenous

deltaanda foreignvarietywhichDawsonmaintains plantandthat

fromtheLevant.
imported
presumably

plantin the
I agreethatthe allusionto the shapeof the testicleswiththe mandrake
723
thanceleryfruitin thesame
Leidentextis initiallytemptingandmoreappropriate conteXt.

However of thenameof a plantin theLeiden(andDendera)

I thinkthatthemention anatomical

listsis glaringly
outof place.

entriesof bodilyparts(although
In the LeidenMagicalPapynistherearetwenty-five

threeareunclearin termsof theactualpartsof thebody)andeachis identified

witha i.
deity: e.

directly
either witha deitye.
g. 'mybellyis Nutwho up
raises thegods'
or withthedeityacting

as Lordor Protector
of thatbodily
parte.g. 'myrighteyeis theeyeof Atummy/efteyeis the

eye of In
Horus'. the Dendera lists
anatomical thereare thirtyrelationships
againmosty in

witha deity.The'basicrule'of theseanatomical

directassociation listsis thattheyarewritten

in a 'form'or patternof alliancebetween

thebodilypartandthedeity.If othersuchanatomical

thenthe samepatternis found:in papyrusGenevaMAH15274,'your

listsare considered

of Seth'.
testiclesaretheprotection 724In Litanyof the Sun,'histesticlesarethe TwoHidden

(InMWy), 725in theBook

Ones' oftheDead,
Ch172,'histesticle
areNephthyS!
726and
inThe
CoffinTextsSp.945,'histesticles
aresp3'(Sepa?
).

Dawson
723 appears to havemisseda similarentrythatmightwellhavestrengthened
thiscase.Thesameentry
in
appears the'anatomicallists'at
Dendera,
i.e. 1nswy.
fymprtmjtt.
Walker,
724 StudiesinAncient Egyptian
Anatomical Ter7ninlogy,
325.
Walker,
725 StudiesinAncient Egyptian
Anatomical Terminology,
314.
WalkerStudies
726 inAncient Egyptian
Anatomical Terminology,
311.

196
 Infact,thereareat leasttwenty-six listsin whichall of thebodilypartsare
anatomical

directlyrelatedto or indirectly to
related some or
attribute the of
protection a deity.
Nowhere
is

brokennoris thereanyinclusion
that'pattern' of a plantalliedto the body.
human This'rule'
is

in respectof thetesticles.
givenbyDawson
brokenonlybytheexample

Thelineinswy.fy m prt mitt is givenby Dawson:as:

'N
,\

thenthiscouldbeprovided
in thesequence
thata deityshouldbeexpected
If oneassumes by

the
making line:
C4 W.
-- n
LJ 'm -. 57 Z3

female ý
determinative by
the
wherenytt carries and
<--* 0 min,
that
assuming prt m. \ iii mayhavebeena latermiscopying
of prt .. A (since
prt canbe

deity).
takento meanritualcomingin respectof a particular 727Sothatthelinewouldthenread:

his'testicles
arelikethe of
coming/risinginmPso the
providing anticipated This
sequence. fits

wellwithDawson's from
examples
ownquoted the Text
Pyramid anda Middle
Kingdom
coffin
Mi0aý111
728In boththesethereis mentionof a goddess,-"42, Invu
fromBeniHasan.

daughterof the gods',who is describedas 'burstinginto leaf, perhapsher ritual or

(prt?
coming/dsing ).

but he alsomisleadshimselfon the

analysisflawed729
Thus,not onlyis Dawson's

Thefolkloresurrounding
of the mandrake.
'magicalsignificance' is becauseof
the mandrake

of its rootsandstemto the outlineshapeof the humanfigure.Thefolklore

the resemblance

example,the Risingof Sothis-Sirius,

727For Faulkner,A ConciseDictionaryof AncientEgyptian,91
Dawson,JEA19,133.
728
729 Heappears to havemissedanothersignificantentryof mitt fromDendera: 'itsperfume is stronger(than)that
of theSummer lotusand than
stronger thatof mitt withitsseed',(mytranslation of theFrench from)Charpentier,
Receuil demat6daux 6pigraphiques
relatifs6 la botanique deltgypte antique,321.Thesignificance is obviously
inthescentofinittwhichmustcompare (orbeassociated) withthelotus.Theceleryfruitleavesandflowershave
a distinctive odour
aromatic comparedto the mandrake whichhasanapplelikescentbutonlywhenthefruitis cut.
Equally thelotusandcelerywereusedin combination in flowergarlands.Suchgarlands havebeenfoundon New
Kingdom mummies, Manniche,AnAncient Egyptian Herbal,76.

197
 is
andmythology a European from
creation the MiddleAges There
onwards. is no similar

for
evidence Egypt.
ancient

6.2 (iii) Mittin the MedicalTexts

in the medicalpapyri;it appearsin the Ebers,Hearst,ChesterBeatty,

It appearsfrequently

IIIandIVpapyriforaneclecticrangeof conditions.
Berlinpapyriandin Ramesseum

Possession
Demonic

In Eb226,227,228,236 237 nvtt (celery)is foundin combination

with other

to
substances cure illness from
resulting demonic Most
possession. are oral preparations.

is 'anotheroralremedy'to driveout Ic of a godwhichis in thestomach

Eb226,forexample,

It
of a man'. consistsof mm with
variously
combined 1bw (plant),
honey,
holly berries,

and
coriander is to betakenat (the
bedtime timeof ).
possession? Eb227,228
are'to driveout

cicfromthe (ib)
heart' int
combined
of celery
andconsists al withfig,ochrein a beer
or water

Bln94areexternalpreparations
base.Eb236,237and amongstotheringredients,
containing,

to
celery wardoff demonic Eb236
possession. is a formula
quantitated of jbw
celery, (plant)

andsweet Eb237
beer. jbw(plant),
celery,
contains tow(pea?) and beer.
sweet

Alltheseprescriptions
areforconditions to
thought be demonic
either or an
possession

Eitherwayit is not possibleto speculate

illnessresultingfromdemonicpossession. on the

for
reason
pharmacological theinclusion
of 730
celery.

730Magicanddemonic possession arefundamental to Egyptian beliefsandsothe'remedies' arenumerous and

varied. There is noother evidence that celerywas ever associated
particularly with I
mysticism. thinkany link here
iscoincidental anditsinclusionrandom.
However, themandrake hasbeensurrounded by mysticism butonlyin Europe. TheHerbatium of Apuleids an
early English herbal mentionsit for 'devil
sickness or demonic In
possession'. Genesis(30,14-15) Leah is made
fertilethrough theuseofthemandrake or'loveapples'.Thesignificance andthepowerof thesebeliefsis thatthey
appear to need onlyto contain
mandrake to This
work. is in completecontrastwith Egyptian
ancient formulations
whichare based on (and
multiple often un-related)ingredients. SeeChapter 10 on analysis
prescription for a full
discussion onEgyptian polypharmacy.

198
 Wheeze
Asthma/

Eb334followsin a runof sometwentyprescriptions

whichareintendedto dealwith

The
cough. wordfor 'cough'
as sryt is well 731
attested. However
the to
condition be in
treated

Eb334is not coughbut gPw a conditionwhich appearsonly in this context.The

doesnot translatethiswordbut considersits possiblemeaningas 'asthma'or a

Grundriss

'description
of thesymptom' 7321thinkthatsomerespiratory
e.g. wheeze. is likelyhere
disorder

since follows
Eb334 a lineof cough(respiratory) Wheeze
remedies. is indicative
of reduced

This
capacity.
respiratory have
must beena in
problem Egypt
ancient dueto sandanddust

fromthesmokeandsootof industrial
inhalation domestic
andcramped situations.

of Eb334arenotclear.It is quantitated
Theexactingredients andcontainsint al m?tt

with Ank; (tiger ),

nuts? bread, wine,
grapes, beerandotherunknown The
plants. resulting

is
mixture thentaken for
internally fourdays.
It is difficult
to comment
on itsefficacyotherthan

of celerywouldseemto be of limitedusein asthmatic

to saythattheinclusion wheeze.The

to
seems
mixture beintended
to tastepleasant
andto actasa demulcent.

Bloodin the Eyes.

for the removal(&) of bloodin (Pr upon?

Eb352is a prescription ) botheyes.It is

actuallyis. It is temptingto thinkthatit mayreferto the

difficultto knowwhatthiscondition

of the eyesresultingfroman eye infection,suchas conjunctivitis.

bloodshotappearance

in Eb387we actuallyfind a prescription.

However, to remove'vesselsof bloodin the eyes'

(mtwn snfm irty). Thelatterseemsto bea betterdescription

of bloodshot
eyesasopposed

of bloodin theeyesat Eb352.Therefore,

to bloodor theappearance Eb352seemslikelyto be

a for
remedy a in
condition both
which eyesarerendered
completely
red.

731Grundriss 773.
V11:
923.Possiblyonomatopoeic.
732GrundfissV11:

199
 seemsto discount
Thefactthatbotheyesareaffected of a foreignbody
thepresence

or trauma, from
common industrial
injuries.
733In thiscasea likelydiagnosis be
might keratitis,

734
uveitisacuteglaucoma.

Theingredients
of Eb352
consistof (SW)
incense 735
with to
celery be to
applied the

eyes.It is difficult
to imagine
thatthis couldhaveany beneficial
effect.No suspendingagentor

baseis specified have

whichmight some
provided effect
soothing onthe 736
eyes. In factcelery

compounds
containsphototoxic whichmay causephotosensitive in
reactions susceptible

It canprecipitate
individuals. allergicreaction 737As
to thosewithexistingplantpollenallergies.

this reactioncan occurevenon handlingthe celeryfruit, application

to the eyes seems

738
unwise.

To treata tonquethatis painful(mt:f)

to treata tonguethatis painful'.

EFOOktntsnfýhnsmrf 'another(prescription)

Thephrasegivenis mr f 'suffers,is painful.I think'pain'mustbe

Eb701kPanother'.

indicatedheresinceit is the mostlikelysymptomif the tongueis diseased.

Thetreatment

consistsof a most mix

unusual of ingredients
whichare designed
to be taken Eb701
orally.

of
consists celery,
msdmt,(lead ),
ore? 739
ochre(Stj ),
740
Ps bil and honey.
It is difficult
to

effectwiththisformulaandtheinclusionof celerymust
therapeutic
imagineanyconstructive

justbea random Lead

choice. oreandochre741
aretoxicin sufficient
quantity
andtheinclusion

733SeeEb337,338. Theseactually a twodaytreatment

specify fora splitor damageOnto theeye,Westendorf,
609.
734Murtagh,General 475.
Practice,
735TheGrundriss frankincense
specifies here.GnindrissIVA8.
736Eb363actually thattheceleryis pounded
specifies in coolwaterforapplicationto thetempleAW certainly
a
cooling but
effect, the is
condition unknown. TheGrundrisshas thisunder eyetreatments, this
although is not
clear,GnindrissVI:2115-
737Newall,HerbalMedicines,66.
738It maybe thatcelerystemsarebeingusedin whichcaseno reactionis likely.
739Grundriss VI:289.
IV:68.
740Gnindriss

741Ochrewasa commonly occurring

andemployed
substance.It seemsprobable thatthe morecommonly
yellow
occurring ochreis being here
recommended whichis either ironor based.
arsenic Lucasand Harris,

200
of Ps bi; The Ps
moresuspect. phrase bi; is literally
'faeces
of copper' 742
(Kupferschlacke).

thisstate'assoftorslushyfaeces.
describes
Westendorf '743

in thatit mustreferto the 'dullshiny'(likecopper)

The'coppercolouris significant

andcolourof
appearance the faecesitself.Either
way,it is intended
to be a markerof an

stateof
abnormal the faeces.
The of
significance thisis thatthe is
faeces morelikelyto be

bound
pathogen andso likelyto causeinfections
on The
ingestion. in
treatment Eb701is,

therefore,
notonlyirrational
(froma but
perspective)
modem dangerous.

statedtheadditionof faecalmatteris paradoxical

Also,as previously becauseof the

supposed belief
Egyptian of the of
connection
close faeces
withtqbdw. is,
That if it wasindeed

factor.Again,the reasonfor its inclusionhere may be an

believedto be a pathological

the Here
with symptoms.
association
allegorical thecolour
of thefaeces
is important
andmay

of thetongueor evenan allusionto 'metallic

or discoloration
be takento reflectanydullness

withthecondition.
taste'associated

To ddveout heaviness(pressure?dns) in the ear.

Bln200contains
celery, )
innk(thyme? andincense
whicharemixedtogether,
moulded

andthen into
inserted the ear.It maybe thatthe mention
of 'pressure'
refersto the typeof

experienced
symptom ).
(earache?

j 744theteethandto treatthem
To fix (strengthenLrW

intendedto affix teeththat are loosethroughdecay,

Eb748.This is presumably

or
abscess disease.
periodontal In viewof thehighincidence
of disease
periodontal thiswould

AncientEgyptian andIndustries,
Materials 348.Eitherwayanysignificant couldbe fatal.Indeedthe
absorption
absorption of anysubstance directlyfromthemouthis morerapidandeffective
comparedto theswallowed oral
route.Itsaddition hereis probablydesigned to thickentheproduct.
Theremedy wouldbequitestiffandstickyto
itsretention
facilitate onthetongue.
742Grundriss IV:68.
743Westendorf, 666.
744Eb739,743 usetheverbsnw 'to makefirmetc.'

201
 thanlooseness
seemto bemoreprobable dueto dentalcades.Theremedyconsistsof celery

andthe dwit in
plant sweetbeer.Theformulais somewhat in 'fixing'the toothbut
optimistic

somelimitedantiseptic
mighthaveafforded reliefandservedasa refreshing
mouthwash.

Eb555is alsoa prescription

designed 745Inthiscasedr bnwt
to curedentalproblems.

m jbpwsrdtpcw'to driveout (sores)

abscesses aroundthe teethandto strengthenthe flesh'

of ingredients
(gums).It is a complexcombination includingcelery,innk (thyme?
), drrt

), tirm (plant),inst (plant,aniseed?

(colocynth? ),746ernmerwheat,incenseand water.It is

to bechewed(bpe).Inrespect
intended it is unlikely
of gumabscesses to havebeeneffective.

werelikelyto be 'on-going'anddueto regularattritionto the

Equally,anydentalproblems

gumscausedbydamaging
foodcontaminates.

Burns

Eb847is 'totreata woundfroma bumin anypartof thebodyof a man'.Thisis partof

a 'run'
of to
prescriptions treat Burns
bums. have
must been sincefireswereusedin
common

in
closeconfines domestic and
situations fora of
variety industrial Consequently
processes. the

of
number Eb482-509
remedies seemsto this.
reflect

The 'run' is headedby Eb482whichinterestingly

consistsof a seriesof different

to
remedies be applied
overfive days.
consecutive Bumsactuallyundergoa progressof

over
change a time
similar These
period. changesarepartof the naturalreactiveprocessof

the bodyand are demonstrated

in a perceivedor visiblecycle:pain,oedema,redness,

itching
crusting, etc.It maybe thattheobservation
of theuntreated
burnmayhaveledto the

of differentdailytreatments
development to counterandtreatthe progressive
stagesof the

burn.

745Thefactthatmyrrh(a compound wellknownat this time)anduseduntilrecentlyin the treatmentof oral pain

and infectionwas not used here (and Eb701)is surprising.I think this is significantand will be more fully
consideredin a laterchapter.
746Grunddss, VI:44-5.

202
 thissaid,it is difficultto seemuchlogicin theformof theactualtreatment.
However,

Painis the first symptomof a burn.The treatmenton 'day one' treatmentencouragingly

involves
theapplication
of black Whilst
mud. this an
provide
might initial of
cooling thebumand

the
sorelieve painit is liable
to introduce
infection,
themain after
problem
secondary Day
pain.

two involvesthe applicationof animalexcreta747whichwouldcertainlycarry a high risk of

infection
introduced to traurnatised
skin.

Eb482is followedby severalother remediesto treat bums none of which specify

ona particular
application Eb487
day.. a
contains of
mixture ingredients
including
celery,conifer

oiland*bw (plant)
whichareto be together
mixed and to
applied the by
wound bandage.
This

wouldhavehada 'cooling' to
effect the burnandmay have
possibly hadsomebactericidal

benefit. 748

It
forcelerywhichis pulpedandappliedto a burnby bandage.
Eb503is a prescription

is described intended
as a prescription to (?
'darken' ) a bumslcmtwbdt.TheGrundriss
gives

themeaning black,
of skmtasto make to 749
darken.

Theintention
of the seems
prescription but
obscure
somewhat is to
presumably heal

the bum.It maybe thatthisis a differenttypeof bumto thoseabove(lesssevereor a different

).
cause? Another be
might
explanation a result
of theobservation
of the bumhealing
process

i.e. thosebumsthatresultin a discoloration

- darkening
of the skin,on It
healing. mayhave

'early'it wouldby-pass
beenthoughtthatit if thisstatecouldbeachieved theearlierpainfuland

to indicatethe
stages.In thiscasethenskmt wbdt mightwellbe an expression
infectious

to 'heala burn'.
state'i.e. a prescription
'brown(healed)

fora smallanimalis given.Westendorf

Thedeterminative
747 Westendorf,
givesit as Weinviel,'smalllivestock',
632.
748A recentscientificpaperhas shownceleryfruit to exhibitnot only antisepticand anti-fugalactivitybut also
and
mosquitocidal nematicidal(parasitic
worms),R. A. MominandM. G. Nair,'Mosquitocidal, nernaticidalandant-
fungalcompounds fromApiumgraveolens,Journalof Agricultural FoodChemistry 49 (2001),142-5.
749GrundrissVII:808 This is because of its use in connectionwith the treatmentof greying hair. It appears to
derivefrom the verb, Am, 'to make complete,' Hannig,714. So that the reversalof greyinghair was consideredto
be a restorativemeasure?This might apply to the treatmentof bums.

203
 to predicttheresultof theapplication
It is impossible to
of celery burnssincethereis

nopublished it
Presumably
data. have
would somecoolingeffect allergic
although is
sensitivity

possible.

of bumsseemssomewhat
Thewholetreatment usingan arrayof eclectic
confused,

Of
ingredients. all the Eb492
treatments is the most involving
logical, the use of honey.Honey

for othercomplaintssuch that its inclusionhere may just be

is used in manyprescriptions

It be
random. may appliedbecause its 'soothing'
of general Eb492
nature. consistsof binding

the bum with honey.This is in fact an excellent for

treatment burnssince it is bactericidal

becauseof the 'protective of

membrane' honey the
whichreduces risksfrom infection
external

in
contactwithoxygen
whilstallowing the air (for Such
healing). is
treatment by
mimicked the
buMS. 750
type dressings
modern of alginate the
now standard for
treatments

Mtw-'to softena mtu) orto'treata mtwthatthrobs'

Eb634is a preparation of
consisting salt,
celery, fat, incense,
bnct3(plant),
btm

(mineral), It
natron,onionandcaraway. is designed
to 'soften/ (sgnn
soothe' ) the mtw of the

to giverelieveto stiffor painfuljointssuchas

knees(mist). Thisis likelyto be a preparation

fromrheumatics artWiS. 751

or

Eb682is anotherapplication intended

probably to combat It
condition.
somearthritic is

'whatto do againsta mtw whichthrobsin any pad of the body'.It is a complexof a

of
combination Lvsji
celery, (bryony),
cyperus Ad
grass, (fruiUmineral?
), and
resin turpentine

oil.

750Thetreatment of burnsuntilcomparatively recentlywasby the application (typically

of antiseptics chlorine
basedsuchas Eusol) followed bydrydressings. Now,sincetheunderstanding of thehealingprocess, wounds
arekeptwetwhilst excludingairbornebacteria.
751Therearesomethirty-eight in theHearstPapyrus
preparations (H94-122,228-238) whichsimilarlypurportto
lease,cool,or to givereliefto themtw.' Leakecategorises theseundertheheading of 'bone,jointandmuscle
Leake,
disorder, The OldEgyptian Medical
Papyrus, 62.

204
OtherConditions

for an assortment
Theinclusionof celeryis foundin severalotherprescriptions of

E291
conditions. is to the E822
stimulate appetite, to the E145
cool uterus, for a prolapsed

rectumandBlnl92 as a contraceptive.

intended
Eb291is in a 'run'of prescriptions theappetite(E284-293).
to stimulate This

is interesting food
since wasa basic
andimportant and
commodity notto be Anorexia
wasted.

canbe discounted it likely

so seems thatit must
referto thetreatment
of a debilitating
illness,

E291
somecancer.
perhaps fatty
celery,
contains meat, raisins
wine, and beer
sweet andis to

designedto add some

be drunkovera periodof fourdays.Thefattymeatis presumably

its
elementof nutrition, tastebeing by
masked the of
addition and
raisins sweet
wine.Celery

as a tonic.In additionto Eb291therearesomenineother

fruithasindeedbeenrecognised

ingredients.
withotherdifferent
tonicremedies 752

E822is somewhat designed

vaguely to 'cool
the It
uterus'. is a remedyconsisting
of

incense
celery, andcow'smilkwhichare together,
ground and
strained into
administered the

vagina.
intendedfor a prolapsedrectumkt nt jMh 753M
E145.Thisis a (another)prescription

ppwy. The remedyconsistsof celery,myrrh,resin,incense,

cyperusgrass,mhtt (fat),

This
andsalt.
codander is into
made a mass
and into
inserted therectum. its
Presumable effect

and
wassoothing the process
mechanical of was
application designed
to the
replace prolapse.

of 'contraception'.
Bln192.Thisis a rathercurioustwostagemethod 754It consists
of an

initialfumigation ).755
of thevulvawithwheat(seedcom/emmer? Thenit is followedby a four

752Eb284-290, Eb292-3.
753WAhis definedin a glossat Sm3l, glossA whereit is describedas 'separation'of thevertebra.Sinceit hasa
physical it
significance is likelyto be a in
prolapse termsof therectum.
754other bizarremethodsincludecrocodileexcrementin milk(Kah215,6 RamIV C 2,3)or honeywith natron
,
(Kah22,317)both usedper vaginum.The latter may have possessedsomespermicidalactivitywhereasthe
formerprobablyactedas a barrieror absorbent.Presumably theexcretawaswrappedin a clothandformedintoa
tampon.
755 MyMy
j,
Westendorf, 426.

205
dayoralcourseof celerywithoil/fat,in sweetbeer.Whilstothermethods were
of contraception

intended
clearly to act as a spermicidal Bln192
barrier, mayhavebeenintended
to act as an

fruit
Celery
abortifacient. is to the cycle
reputed affect menstrual andto bean 756
arbortifacient.

Ebl98(cj is an applicationcontainingcelery, myrrh, PwIt (plant),fat and resins

to
designed 'driveout a nestof bloodthathasnotyet This
clotted'. maybe description
of a

bruise.

6.2(iv)Summary

Theuseof nvtt in themedicalpapyrishowsit to be usedfora widerangeof eclectic

Of
conditions. its twenty-three there
appearances are some fourteenseparatemedical

There
conditions. to
appears be very little between
correlation the of
properties
medicinal

celeryand the However,

above.
prescriptions it is very to
difficult suggestany one single

that be
compound might in
useful
equally morethana fewof theaboveconditions.

Theactualknownproperties
of celeryare in
relevant onlythree as
cases: a tonic,
as

for type
and arthritic
an abortifacient However,
conditions. thesemustbe for
qualified two

Firstly,
reasons. onlythe fruit is activeyet the partof the plantis not specified
and the
secondly

for ones.
treatments arthritisare external In the latterinstance
therewouldbe little,if any

the to
compared
of activecompound
release, oral This
route. that
suggests the Egyptian
were

the of
properties
anti-rheumatic
notawareof pain-killing fruit.
celery

flowfromtheseresults:eitherthatm?tt wasnotcelery;thatit was

Severalpossibilities

its were
and properties notknown;
757thatits inclusion
wasmerely (or
random anycombination

of thethree).

Y.
756S. Mills, The Dictionary of Modem Herbalism (Wellingborough,
1985).Uterine has been
stimulation
documented for the oiland so itsuseis in pregnancy
contraindicated
757Thiswouldbea significant omissionon thepartof theEgyptian's thepresumed
considering demandfor the
of
treatment pain in type
arthritic conditions.

206
6.3.Mandrake
= ol
Mandragora rMt ? 758 I
officinarium _Ulýj

in
speciesand was present ancientEgypt.759It is
The mandrakeis a commonMediterranean

to the
similarpharmacologically belladonna in
plant thatit contains and
atropine, hyoscyamine.

haveshownit to containothersolanaceous
Recentinvestigations 760It has never
alkaloidS.

featuredin Englishtraditionalmedicinebut the leaf and roots were included in official

in
pharmacopoeiasparts
of Europe
continental until1883.

Itssedative characteristic
pharmacological
andanalgesic wouldhaveproved
of usein

ancient However,
Egypt. is
itsappearance notseenin themedical 761
texts.

andManniche
Thewordrrmt is givenby Charpentier It appears
to meanmandrake.

that the plantwaswell knownto the Greeks

and to
appears be descriibed by
accurately

Dioscorides
who givesthe Egyptian
wordsas being 762
apemum. Dawson the
considered

to
mandrake havebeen
widelyusedin Egypt
ancient sincehe the
considered Egyptian
wordto

thisviewis notnowaccepted
benva. However, intheformersection.
andhasbeendiscussed

Manniche that
maintains the first
mandrake in
appeared theNewKingdom. it
Certainly

in
appears tomb from
scenes the Ramesside and
period is frequently on objects
represented

763If it did appearthislatethenit mayexplainits

fromtheAmamaandpostAmamaperiods.

in
non-appearancethe texts
medical andso an
reinforce for
argument later
introduction.

758Manniche, An AncientEgyptian Egypt,117.Charpentier, Receuilde mat6fiaux 6pigraphiques relatifs6 la

botanique deItgypteantique, 689.Ift 2:439givesa'smallfruit.
759Germer, Floradespharaonischen Agypte, 169.
760Trease andEvans, Pharmacognosy, 358.
761Nunnreports thatthe,'London andLeidenpapyrus ADcontains
of thethirdcentury thewordmantraguru (sic)
,
indemotic, clearlya formof Mandragora',Ancient Egyptian Medicine,156-7.
762Dioscorides IV:76
763Seethegardening sceneof Thebantomb#217,(illustrated in Manniche,AncientEgyptianHerbal,117).Also
an ivorylid formthe Petriecollection showTutankhamen andhis wifewithher (presumably) sisterspicking
mandrake in an elaborate garden scene (illustrated
in Samson, Amama, CityOf Akhenatenand Nefertiti:Key
PiecesfromthePetrieCollection, 71).Thestyleof tombdecoration changed in theNewKingdom, 'therewasa
feelingfor naturecompared to theOldKingdom', H. Sch5fer, Principles
of EgyptianArt.Translated
byJ. Baines
(ed.). (oxford,1974), 44.

207
 It hasa distinctive
shape.Itsrootsaresupposed to thehuman
to beara resemblance

formsincetheytendto forkintotwoandshooton eachside.Thishascausedtheplantto be

bysuperstition
surrounded Suchlegendsappearto datefrom
andallegedmysticalproperties.

andlaterwhenits usewasbasedon the 'cloctrine

earlyGreektimes'64 of signatures'
- the

beliefthattheshapeof a plantrelatesto itsactualproperties.

765

It is surprising imported
thattheapparently plantdidnotcarrywithit sucha reputation

surely
which have
would been in
exploited a highly
ritualised
society.

On balanceit hasto be assumed waspresentin Egypt

thatalthoughthe mandrake

thereappears thatit wasusedforanysedative

to benoevidence or analgesic
use.

764W. C Bowman, 'DrugsAncientandModem',ScottishMedical Journal24 (1979),135-6.V. A. Peduto,'The

mandrake rootandthe Viiennes Dioscorides',
Minerva 67(2001),
Anestesiology 751-66.
765J. Cule,'Thedevil'sapples',Vesafius
3 (1997),95-105,E.Lev,'Thedoctrine in themedieval
of signatures and
ottomanLevant,Vesalius 8 (2002),13-22,F. Panese,The'doctrine andgraphical
of signatures' technologies
at
thedawnof modernity; Gesnerus 60(2003),6-24.It hasevenbeenusedin modem homeopathy, C.Richardson-
Boedler,'Thedoctrine a historical,
of signatures: philosophical, BritishJournalOfHomeopathy
view(11)',
scientific
89,26-8.

208
6.4Lotus

766
ssn-

Lotus,WaterLily,nymphaea
Egyptian (blue)
carula lotus
nymphaea (white)

andmythologybeingone
Thesymbolof the lotusfloweris embeddedin Egyptianiconography

of the most motifs

occurring
commonly in Egyptian
art. The lotusis depicted
beingcarded,

in
displayed
wornas an ornament, bouquets, in
presented offerings
andis oneof the most

frequently 'structural'
employed elements. theuseof the 'lotiform'capitaldates
In architecture

seen. 767
andcanbewidely
fromtheOldKingdom

The lotuswas importantto the ancientEgyptiansto the extentthat it couldbe

described 'one to
symbol, whichreferred
as a national the power
of life the
existing, fecundate

powerof the 768

Nile'. Its is
importance shownby the fact that it formedan integral
partof

being
observation
religious to
presented the godsin formal
bouquets
or shown
as partof the

inventory 769
of offeringscenes.

holdingthe lotusto theirnoses('sniffingthe lotue)are

Scenesshowingindividuals

and
numerous from
feature theOldKingdom to
through theLatePeriod.
770

766 Wb3:485.Charpentier, Receuil demat6daux 6pigraphiques relatifs6 la botaniquedeltgypte antique, 1003.

767 Anearlyexample is themortuary templeof Sahureat Abusir(FifthDynasty). A laterandperhaps themost
famousNewKingdom example is theSunCourtof Amenhotep III at LuxorTemple. Thesedemonstrate thatthe
lotuswaspurelysymbolic and decorative sinceits stemis limpandcouldneverhaveprovided anysupport. D.
Arnold(ed.), TheEncyclopaedia ofAncient Egyptian Architecture(London, 2003).
768A. M.ElKhachab, 'Some Amulets Depicting Harpocrates Seated ona Lotus,JEA57(1972),133-145.
769 It alsofeaturesin oneof theCreation Myths.Horusshutsupthesun'sdiskinsidea lotuswhosepetalsprovide
protection. Onthemorning of thefirstdaythefloweropensandthegodburstforthasa childwearing thesolar
diskonhishead.Thus,thelotusemerging became symbolic of thesunbursting forthat dawn.It alsofeaturesin
theBookoftheDead,Spell81A.
770Emboden seesthe appearance of the lotusin Egyptian art becauseof its psychedelic pharmacological
properties. It wasusedto developed a formof 'shamanistic' tranceusedas partof thehealingritual(1981,40
1989,66).'Theanalysis of ritualandsacrediconography indicate thatthepeoplepossessed profound knowledge
ofplantloreandalteredstateof consciousness ,
(1989,72). W.Emboden, 'Transcendentaluse of narcoticplants
in ancientEgyptandMayaduringrituals, ' Journalof Ethnopharmacology 39-83.'Thesacredjourneyin
3 (1981),
Dynastic Egypt:A shamanistic trancein the contextof the narcoticwaterlily',Journalof Psychoactive Drugs
21(1989), 61-75.Infact,upto theFifthDynasty flowersoccurrarelyasdecoration in Egyptianart,fromthenon
,scarcely anyone attabledoesnotholda lotusto hisnose,Sch5fer, PrinciplesofEgyptian Art,21.

209
 it wasformerlycommon
Todaythebluelotusis onlyfoundin theDeltaregionwhereas

intotropicalAfrica.Thewhitelotus
in ditches,poolsandsidewatersof the Nile,southwards

deeper
somewhat
requires is in
waterand rarer Egypt
today,
mainly in
distributed thesouthof

flowersandprobably
771In ancientEgyptthesewerebothcommon
thecountry. theonlylarge

and flowers
'showy' thatwere and
regularly widely This
available. to
compares otherflowers

in
shown such
scenes asthe or
poppy cornflower
whichwerewildand It
seasonal. is probably

thatmadethe lotusfeatureso highlyin Egyptianlife. The

thissimplereasonof availability

beautyof the flowermusthaveprovidedaestheticpleasureandits widespread

appearance

alsoreflected
probably smellsthatmusthaveconstantly
an attemptto countertheunpleasant
life. 772
Egyptian
permeated

Thelotusplantdiffersfrommanyof theotherplantsusedin medicine

in thatit hada

high profileoutsidemedicine.Becauseof this it was widelyrecognised

and its lexical

identification, the of
unlike majority medicinal little
presents
plants, The
problem. word is
'lotus'

nameandtheancientEgyptian
a genericbotanical canila(blue
speciesareeithernymphaea

lotus(thewhiteEgyptianwaterlily).They.are actuallya
waterlily) or nymphaea
Egyptian

vadetyof waterlily and shouldst(ictlybe to

referred as 773
such. Thereappearsto be no

771 F.Hepper, Pharaoh's Flowers: Botanical

Treasures of Tutankhamen (London, 1990),16.
772 Scenes thelotus'haveledto thesuggestion
of 'sniffing thatthelotuswasalsousedasanaphrodisiac, W.B.
Harer,'Pharmacology andBiological Propertiesof theEgyptian Lotus',JARCE12(1985),49-54. Thissuggestion
essentiallycentres on scenes in theTurinEroticPapyrus 55001.Herea youngwomanis seen'sniffingthelotus'
duringsexualactivitywithan elderlymalecompanion (whoappearsnot to needchemical The
assistance).
conclusion of an aphrodisiacis surelysuspect sinceit appears to bea sceneof courtesan andclient(whereany
encouragement wouldbereserved fortheclient!
). Shein factappearsto beusingthelotusasa hairadornment to
complement herheavymake-up. Moreimportantly no releaseandabsorption of anyactiveconstituentcouldbe
achieved byinhalation alone.
ý
773 Theconfusion startedearly.Thecommon hieroglyph indicating
theplant Champollion described asa Iotus-
lily'a plantrepresentative of thesouthof Egypt.butwithoutevidence andon hisownopinion(in Grammaire
tgyptienne, (Paris,1836),161.Thisis nowaccepted as representing thefloweringscirpus-reedor 'sedge',a
common emblem of Upper Egypt Gardiner,Egyptian Grammar, 73.
Formisleading medical properties,seeforinstance theproperties describedbyTennyson in hispoem'TheLotos
Eaters' whichprobably havebeenunwittingly associated withtheEgyptian waterlily.

210
Egyptian
wordto between
distinguish thetwo I
species. will usetheword in
'lotus' the textto

to
apply eitherof these
species
of Egyptian lily
water sincethiswordis usedbytheGrunddss.

to meanthe 'lotus',albeitin its 'genefic'form.Wilkinson

Thewordss'nis accepted

the specifically
gives wordss'72to mean'lotusblossoms',
as from
separate giptas the budand
leaf. 774
k& as the

Thelotusis reputedto containalcoholsoluble(butwaterinsoluble),

narcoticalkaloids

whichare in
concentrated theflower
and but
rhizome whichare from
absent the seeds,stem
leaf. 775
and thereis no reportedscientificdatafor the in vivoeffectsof these
However,

In
alkaloids. fact,in those of
species that
nymphaea havebeenusedin modemEuropean

it is the seedsratherthantheflowersthatare
(n. albaandn. pubescens)
herbalmedicines

used. They are not used as a narcoticbut rather as a diaphoretic

and cardiotonic

776
respectively.

forLotus.
EntHes
6.4(i).Prescdption

Considering
the ubiquitous
natureof the lotus and its supposed it
narcoticproperties is
few. 777
that
surprising
somewhat its in
entries the medicalpapyriare relatively It appearsin

(H82),258,475,479
Eb209,224 andChester 13b.
Beafty

Eb209is somewhat in
obscure thatthe to
condition
medical be treatedis It
uncertain. is a

intended
(prescription)
$another blockage
to treat(smýh)a stoppage/ (s'nc) in therightside

TheGarden
A. VVilkinson,
774 inAncient Egypt(London, 1998),54.
775 byNunnwhoappears
Thisis reported to bequotingfromHarer(1985:
53),Nunn,AncientEgyptian
Medicine,
157.Thesefouralkaloidsarestatedasnymphaeine, nupharidine
nuciferine, Thisstatement
anda-nupafidine. of
to Emboden
Hareris thenreferenced whoin turnoffersnoreference. W.A. Emboden, Plants2ndEd.,
Narcotic
(NewYork1979).
Trease
776 andEvans,Pharmacognosy, 499.
m Thefailuretoseeanexpected highincidence maybedueto 'twosystems' treatment
of medical One
operating.
levelmightbe a documented 'official'systemwhereasanothermightbe a non-documentedsystemof 'home
nostrums'.

211
(gS)778
whichis a of
result implantation'.
demonic779 The remedyconsistsof a complexmixture

of several including
ingredients LYw bryony,
n s9n, myrrh, juniper
celery, (fruit),
si?(conifer
oil),

coppersalts ),
(malachite? bt-ds (myrtle?
), §nft (fruit), bt
!ý, (barley:
whiteand green),jim

(plant),honeyandgoosefat in a beerbasewhichis to be takenovera periodof fourdays.

to it is notunreasonable
is referred
Sincea 'blockage' thatperhaps
somepurgative
effectmay

havebeenanticipated.

demonic
Eb224,(H82).Thisis a caseinvolving It is eitherpossession
possession. perseor an

illnesswhichhasbeencausedbyit. Theremedyis intended

to driveout(dr) the clc780
in the

belly(bt ) and heart(W ). It consistsof an internalremedycontaining

amongstother

fruitin a waterbase.Eb258is also

h3wn An, freshbread,datesandsycamore
ingredients

It
vague. is (kt)
'another (prescription)
to the
well
make head'
-from Eb255
ktntssnb f
tpn2r.

to makewell the headwhichis painful/suffering'.

'another(prescription) The methodof

is but
applicationnotspecific is by
either
presumably bandage
or in (rd! r tp) The
anointment .
can
condition onlybe at.
guessed The of
consists
remedy lotus(SS'A
blossom?
), cumin,gsfn

(resin),tntm (seeds),myrrh,&ý- (moringaoil) and juniper(pit seeds).Presumablyit would

haveafforded
somesoothing by
relief virtueof itsapplication.

designed
Eb475is clearerin its intent.It is a prescription to preventhairloss.It consistsof

lotusleavesboiledandplacedin oil or fat. It is thento be put on the 'headof a despised

(msddt
woman' st). Thislatter to
seems
reference implyanelement
of blackmagic,designed

778The Grundrisssuggestthis is the 'stomach'(Grundriss,IV:101).Mannichecallsthis a 'demonicconstipation,'

Manniche, An AncientEgyptianHerbal,127.1thinkit unlikelyto be constipation
sincethe 'ýghf sideis clearlyan
importantfeature.It is morelikelyto be a symptomof right-sidedpain:possibly,bilarycolicor appendicitisfor
example, see Murtagh, GeneralPractice,252.
779&n nsA Grundriss V:176.
GrundrissIV:147.
780'Gifistoffes',

212
 Perhapsit was intendedto transferthe conditiononto another
to aid its effectiveness.

(unworthy)
person.

(prescription)
Eb479Thisa 'anothee - fromEb477
whichis intended
'to (snfý,
treat b) the liver
Tx CA
(mist) 11 It
%. consistsof b; iv n s9nwith wine, dýx n nbs (fruitof Christ-thom
tree),figs,

sjW, juniper
milk, berries
and 781
beer.
sweet It is to be drunkfor fourdays.

to the liveris clearbut not the actualcondition

Thereference Nunn
or symptoms.

suggestthat this may be a treatmentfor jaundice.I think this is unlikely.782

ChesterBeatty13bThis is clearlyfor rectalapplication(enema).It containsamongstother

itemsfreshbread,waterof the *btvpiant, fat andbiwn s9n.It is to be madeintoa massand

theninsertedintotherectumoverfourdays.

6.4(ii) Summary Entdes

of Prescription

thatcontainthelotusas an ingredient
Takenen blocthoseprescriptions appearto
haveno pharmacological
patternor logicto Significantly
them. noneof themsuggestthatthey

werebeingusedto exploitanynamoticactivity.

Btl3b certainly,andEb209probablywereintendedto achievesomepurgativeaction.

A narcoticalkaloidwouldmostlikelyproducetheoppositeeffectby reducingthe motilityof the

the condition.Equallyin Eb475,evenwitha magical

tractandso exacerbate
gastro-intestinal

element, doesnotseemtobeappropdate.
anynarcotic
The typesof diseasesthat wouldbenefitfrom any narcoticpropertiesof the lotus

wouldbe thosedisplayingsymptoms
of pain, those
typically that havebeen in
discussed the

781 It is specified
thatthemixtureis to beallowedto standovernightNunnconsider thatthisis possiblyto facilitate
the alkaloidreleasefrom the lotus,Nunn,AncientEgyptianMedicine,158. However,beer was a common
pharmaceutical vehicle.It wasprimarilywaterbasedandsowouldnotreleasewaterinsoluble alkaloids!
782 Nunn,AncientEgyptian Medicine,158.Theliveris thelargestorganin thebodyandwasobviously recognised.
It is mostunlikelythatits physiology wasunderstood. Thus,it difficultto imaginethattheancientEgyptians could
associate jaundicewitha conditionof theliver.

213
chapteron disease.
Eb258mightpossibly to treatthehead
qualifyfor thisi.e. a prescription
(pain? featureof the lotuswouldbe lost heresincethe methodof
). But any painkilling

of the activeingredient
is externaland wouldaffordlittle,if any, absorption
application

comparedto the oralroute.Theimplication is thatif the Egyptianlotus

fromthe prescriptions

didcontainpainkilling thenit waseithernotknownor notexploited.

narcoticsubstances 783

6.4(iii) Conclusions
on theLotus

Becauseof themysticism withits iconography

associated
andsymbolism the lotushas

suffereda similarfatein termsof its supposed properties.

pharmacological

Asa general do
rulemostwaterplants not The
alkaloids.
contain lotus
Egyptian differs

in thatit does.784However,the ideathatit containsfouralkaloidsandthat it has narcoticand

possiblyhallucinogenic proposalsby Emboben.This

propertiesis basedon unsubstantiated

idea seemsto emanatefrom his experiencesagainstthe backgroundof the Californian

drugcultureof the 1960s,in whichhe worked.Thereappearsto be no published

psychedelic

dataor otherreferences
scientific thepsychedelic
to substantiate of theEgyptian
properties
lotUS.785

As to the 'namotic'propertiesof the lotus it has beensuggestedthat thesewere

exploitedby dissolvingthe lotusin wine,the idea beingthat the alcoholin the wine would

releasethe otherwise alkaloids.Harersuggeststhatthe lotuswasfrequently

water-immiscible

usedfor its narcoticand soporificeffectsby this method.Indeedmanybanquetand 'party'

drinkingscenesdoshowthelotuspresent(oftenaroundthewinevesselitselo.

m Thelatterwouldbesurprising consideringtheubiquitousnatureof thelotus.

M ThegenusNupharbelongsto the Nyphaceae familyof whichthereare someonehundredspeciesknown,
whichincludethe Egyptianlotus.Therehasbeenmuchworkdoneon the alkaloidsof theseplantsthe nuphar
butprimarily
alkaloids in termsof chemicalsynthesisandchemical structures.
In 1967someelevennupharalkaloidswereknownandby 1989anothereighteenwereaddedto the list.At the
dateof wTitingnonehavebeenadded.The list includesthe threealkaloids* by Embodenbut not
mentioned
(*however,
nucifefine notin respectof thelotus).A. S. HowardandJ. P. Michael,TheAlkaloids.TheChemistry
andPharmacology 35(hereafter, TheAlkaloids),
(SanDiego,1989),215-256.
ns See,HowardandMichael,TheAlkaloids9,441464, TheAlkaloids16,181-213;TheAlkaloids28,246-262,
TheAlkaloids35,215-256.

214
 Thesuggestion of thelotusin thewinewasby accident.
is thattheinitialimmersion

The 'straws'oftenshownwithdrinkingvesselswouldallowfor the liquidto be extractedand

drunkfromaroundthe lotusflower.'Theassociation
of wineandthe lotusis particularly

duringtheNewKingdom
common in Egypt'.
786This
is interesting it impliesthatthe
because

use.If indeedit wassuchan important'socialdrug'then

lotuswasbeingusedfor 'recreational'

it mightexplainits sparseappearance
in themedicaltexts.

However,I havestrongreservations
aboutHarer'ssuggestions.
787Also,thereis no

scientificdataon thepharmacological
published of the lotus.Thoseplantsthatare
constituents

closelychemically withthe lotusandfor whichdatais availabledo notsupportthe

associated

ideathatits alkaloidsarenarcotic.Thenatureof medicalresearchhaslimitedtheproduction

of

anydataon nupharalkaloidsto in vitrostudiesonly.788Theseresultshaveshownsomeof the

and anti-fungaleffectsrather than narcotic

nupharalkaloidsto exhibitantibacterial
789
properties.

In briefsummary, in the medicalpapyrithatcontain

it appearsthatthoseprescriptions

Untilthereis firm
the lotusdo not suggestthatit was beingusedfor anynarcoticproperties.

786Harer,JARCE12,54.
787Hissuggestions arepurelyspeculative. Equally,his ideathatthe alkaloidwasextractedby thismethodis too
glib.The extractionof alkaloidsfromplantsis not as simpleand requirescontrolledand optimumconditions.
Activeingredient releaseis achievedby absorption intoa appropriate solventwhichis accelerated by stirring,
beatingand/ortemperature control.To illustrated thepointI offertheexample of belladonna for whichdataexists,
(BPC1963).It is similarto the lotusin thatboththe leafandflowerare used.Extraction is achievedby forced
percolation of thedriedandfinelypowdered plantfor somethreehoursin 70%alcohol.Highconcentration alcohol
is vitalto achievethis alkaloidrelease(hyoscyamine). Hyoscyamine is freelysolublein alcoholyet onlysoluble
1:280partsin water,suchthata3 gramleafwouldrequirealmostonelitreof water.
Thealcoholcontentof Egyptian wineis thoughtto begenerally lowerthantoday.In fact,fermentation above14%
is self limitingso that wineswereunlikelyto be above10%of alcohol.In this situationabsorption of water
insolublealkaloidfrom the lotus into 10% alcoholwouldbe very minimalat best See, J. H. Richards,
'Pharmaceutics Solubility
andDissolution Rates',in Aulton,Pharmaceutics, 62-89.
788Thisis because of costsbutalsobecause of therestrictiveprotocolsonhumantesting.
789Thesetestsinvolvedspeciesof N Luteaand Njaponicabothof whichcontainseveralchemicalvarietiesof
nuphaddine (allegedby Emboden to be in thelotus).Whilstantibacterial activitywasdemonstrated againstsome
organisma veryWideanti-fungal activitywasshown.Thiswasequatedto be similarto the licensedanti-fungal
compound amphoteracin B. In factsomeof the rhizomes of nymphaea andnupharspeciesappearto havebeen
usedin folkmedicine fortheirantibactrial tannins,Trease& Evans,Pharmacognosy, 38.

215
scientific the
on actualpharmacological
evidence of
properties those in
alkaloids thelotus
then

be
must
reservation in
applied terms
of its narcotic
supposed 790
activity.

M Andcertainlyits supposed psychedelic Theattemptto producepopularinterestin thisareanotonly

properties.
strainsbut sometimesdistortsthe historicalperspective. A televisionserieson plantsin ancientsocieties
pronounced the EgyptianbluelotuspsydWelic aftera (non-controlled) Theywere
'test on two 'volunteers'.
partnersandhadbeenpreviously uses'in ancientEgypt.Aftertakingthe
fullybriefedon the plants'psychedelic
lotus dissolvedin wine they announcedthat they left strange'.The programme's presenter(an Oxford
thenconcluded
archaeologist) that followingtheproofof thepowerof thelotus..the wholeof Egyptianhistory
needsto bere-written.Scriptfrom,'AncientPlants',Channel FourTelevision August
transmitted 28 1998.
-

216
 7: DILL,JUNIPER,WILLOW,HENBANE,
CHAPTER MYRRH

7.1Dill

graveolens
anethum
Coptic:emice

jMSt791

Thisplantis
Dillconsistsof the driedripefruitsof the smallannualplantanethumgraveolens.

to southernEuropeandis stillcultivatedin Egypttoday.792

indigenous

andhasbeenusedin EuropesinceAnglo-Saxon
It wasknownto DioscorideS793 times

formedicinal
purposes.
It is
beingcarvoneandfimonene.
Itsfruitcontainsa volatileoil the principalingredients

chemicallysimilarto oil of carawayboth of which have been used as a flavouringand

794
carminativeagents. Dill has beenvery widely used as the activeingredient
in gripe watersto

treat infant colic.795Its taste is aromaticand distinctive.It has also been widely used as a

flavouring in
agent medicines for
particularly It
children. is reported
as having
antispasmodic
aCfiVity.796

TheWidespread andhomemedicines
useof dillin traditional to treatinfantcolicand

dyspepsia withinthe Egyptianmedicaltexts.However,this

mightbe expectedto be replicated

is notthecaseandthefewappearances
withinthe medicaltextsseemto be for the treatment

of pain.

791
Grundriss
VI:34.Charpenter,
Receud
demat6daux6pigraphiques deltgypte antique,
relatifs6 la botanique
134.
792
Trease& Evans,PharmaoDgnosy,
264.
m, HegivestheEgyptian of whichhegivesas carminative
namesasArachutheproperties andfor'wombgriefs',
Dioscorldes,67.
111:
m Treaseand Evans,Pharmacognosy,
264.
795Martindale2P Ed.,854.
7%C.W.Fetrow,andJ. R.Avila, Complementary Medicines
andAlternative 1999),224.
(Springhouse,

217
 Entdesfor Dill
7.1(i) Prescdption

to
fromH42-pAdntsn2?ifýbdwm Itnbt'a prescription
H44Thisis'another(kt) prescription

formula
kill pain(nýhdu)in all partsof the body!It is an oralremedy.It is a quantitative797

consisting
of dill,dates,
raisins,wineall of whichareheated, and
strained thendrunk
overa

periodof fourdays.

Eb249(H77)

)-
to treat someproblemwith the head(headache/migraine?
This is 'another(prescription)'

to driveoutskt798in thehead'.
fromEb248'a prescription

It consists
of a complex of
mixture dill bryony
fruit),
(seed/dried (seed/berry), (seed),
coriander

)799and bt-ds (myrtle?

donkeyfat, b7nk(thyme? are madeinto a mass
).800The ingredients

whichis thenappliedto theheadforfourdays.

Eb650

to ease(sg&) themtwof theshoulder

Thisis a prescription

dill
It perhapsrefersto sometypeof arthriticpain.Its formulais a complexmixturecontaining

(seed/fruit),
entyw jzdm (sweetmyrrh),s4r, sc?m (plant,Chaste-shrub?
)801,
prt jbw (plant

Ps.;
seeds), py('manly'?plantgruel),wstnt c9(firshavings),
ssla (?), cyperusgrass,nstyn

b.§.?andsycamorefruit.It is madeintoa massandappliedto the shoulder.Sometemporary

have
reliefmaypossibly been by
achieved the of
effect in
massaging theapplication.

797
It is presentin theratio1:169of thefinalvolume.But aswithallprescriptions,
nodosageis given.
798
Grundriss IV:35.It appearsto havea demonic origin.
7%Nunn,AncientEgyptian Medicine, 154.
800
Nunn,AncientEgyptian Medicine, 154.
801
Hannig,668.

218
 (Blnl63.
Eb856e e)

Ir mn.f 4btf tgr ir. fy dd.Ark r.s n?pw n mtw n npbt.f gsp.n.sn mrt'if his neck is

both (Igr)802
and eyesareglazed?
painful/suffers 'then
you say
should thisindicates
that
the

(mtto
vessels of the neckhave (gsp)
received an (mrt).
illness' Thisis intended
perhaps to

theadditional
treata 'stiff neckalthough reference It maybethatthisis
to theeyesis obscure.

to
referring a fixed be
starewhichmight if
present it were to
painful turnthe head.
BIn163e

intrfmpba'what
reads is to bedone,
bythe It
prescription. to
refers theindex as
condition
) gimyt nt rbtw
Eb856e.The two formulationsdiffer but both containint al bt-ds (myrtle?

(waterfromwashing)
andhoney
andboth to
areapplied theneck
and in
smeared forfourdays.

hasdill(seed/fruit)
OnlyBln163ein addition prt imswt.

forDill
onEntHes
7.1(ii) Conclusion

thedillcontentwithintheaboveprescriptions
In summary wouldhave little,
offered if

from
any,relief pain.It only
appears oncein an oralpreparation, as a painkiller
specifically

butitsformula
(1-144), ratherthananalgesic
anaperient
suggests action.

Theotherentriesalsoseemintended Yet,beyondanyphysical
to beanalgesics. relief

by
afforded the they to little
of massage wouldseem contribute
actualprocess 803
effect.
actual

It is surprising to
not seedill beingusedto infant
treat This
colic. is a that
condition is

to
painful theinfant
and disruptive
equally to the and
mother family
other 804
members. It is also

not
surprising to seethis usealso to
extended treatadult flatulence
indigestion, andgastric

It
spasm. maybethatthe in the texts
non-appearance medical fortheseusesimplies
its usein

in the 'officialtexts'mightwellbe for conditions

In thiscaseits appearance
homenostrums.

to
unrelated its 'proper
or nostrum This
use. of
aspect home mightexplainsomeof
nostrums

IV:8.
802Grundfiss

803Thepresenceofothersubstances, makeit difficult

manyunknown, to predictpharmacological
effects.
my earliersectionon opiumdiscusses
804Similarly, its widespread usefor placating
infantsin crowdedand
domestic
stressful to
situations the
emancipate mother.

219
the pharmacological withinthe medicaltextsandwill be considerlaterin more
anomalies

detail.

agentwouldhavebeenan excellentpalliativeadditionto those

Dillas a flavouring

with
medicines badlytastingingredients.
In fact,its as
absence a flavouring
agentandthe

of
absence
apparent flavouring in
agents in
general Egyptian
medicine
maybe It
significant.

mayimplya with
parallel lateVictorian
andearly Century
Twentieth patent Often
medicines.

leftun-masked
tastesweredeliberately
distinctive to retainthetaste.Thisserved
withadditives

'medicinal'
andcreatedistinctly
to separate Thiswasin partdueto the'beliefthatbe
flavours.

beneficial shouldnot
medicines tastegood805
i.e. 'theworsethetastethebettertheeffects'!It

that
seems the use
widespread of 'offensive' in
substances Egyptian
ancient medicine
andthe

failureto masktheirtasteor smellis intrinsicto muchof their'pharmacopoeia'.

It is possible

forsomemedicalproducts
thatthismightwellevenbea prerequisite andperhapsconnected

witha perceived of
system By
treatment. thisI the
mean concept
of usingone item
noxious to

the
counter effects
of a (noxious) an
condition, This
illness. particularly to
seems be the case

withtheuseof human as
excrement a ingredient.
prescription Thisis discussed
in in
detail the

Appenix.

AJso,oftendonein termsof safetyto preventexcessiveuse.Comparetheoriginal'colour-coding'

805 of pharmacy
betweenoral,eternalpreparations
bottlesto distinguish andpoisons.

220
7.2Juniper

Juniperus
phoenicia

drupacea
Juniperus

806
wcn

neverwasindigenous
Juniperis shruborsmalltreeswhichcanattaingreatage.It probably to

Egyptandwasthus,animported 807
species.
Theberries
It is the berriesof thejuniperthathavemedicinalandflavouringproperties.

mayalsohavehad 808
significance.
symbolic However, the
recently natural
oilsin thewood

havebeenshownto possess 809

properties.
antiseptic

juniperoil. Theconstituents
Theberrieswhencrushedproduce of the oil arevaried

tannins,
acids,
andcomplexcontaining: volatileoils, resinsand 810
sugars.

Juniperoil hasdiuretic,antiseptic, andanti-rheumatic

carminative 811The.
properties.

berriesalsopossessarbortifacient
properties. it
Traditionally has beenusedas an internal

to
medicine treat for
externally
cystitisandcolicand applied rheumatic
painsin jointsand

806GrundrissVIA30,Charpentier,Receuil demat6riaux 6pigraphiquesrelatifs6 la botaniquedeltgypte antique,

317.
807Manniche,AncientEgyptianHerbal, 110.
808Theyhavebeenfoundassociated with burialsfrompre-dynastic timesthroughto the Late Period.In
Tutankhamen's tombsomefourbaskets of berrieswerefound.Lucassuggests thatjuniperoilwasactuallyadded
oilaspartof theembalming
to ordinary' process (presumably to 'augmentit).Alsothearomatic sawdustusedfor
packingsometimes appearsto havecontained juniperoil. LucasandHarris,AncientEgyptianMaterials and
309,325.Perhaps
industries, because of theuseof bothin theembalming process,Herodotus seemsto have
confused cedaroil withjuniperoil (cedarwoodwasusedfor coffinsandshrines), Herodotus, Histories 87.
11:
Discussed inA. Lucas,"Cedar-Tree Products in Mummification',JEA17(1931),13-21.
N9K. A. GrossandE. Ezerietis, 'Juniperwoodas a possible implantmaterial', Journalof Biomedical
Material
Research 64(2002), 672-83.
810FeltrowandAvila,Complementary andAlternative Medicine, 367.
OilNewall,HerbalMedicines,176.

221
 812These
muscles. medicinal
effects
canalsobe by
obtained the
eating fruit
whole itself.
The

dose
oralmedicinal of fruitis givenas3-6gbutit is toxicin higher 813
doses.

surprisingin viewof its

this is somewhat
Juniperis not recordedby Dioscorides;

and
symbolic medical in
significance Egypt.
ancient

It appearsvery frequentlyas an ingredientin the Egyptianmedicalprescriptionsthe

to beforpainfulconditions.
atfirstsight,appeafing
largestproportion,

7.2 (i) Juniperin the EgyptianMedicalTexts

Eb86,87.89

in thestomach'.
to (sd) 'breakup/repulsepain(wýh_du)
Theseareprescriptions

Eb86is a quantitated of
mixture juniper, (flesh
'ýnh - of ),
ox? incense,
lettuce,
freshbreadand

beer.
sweet Theformula
of Eb89consistsof juniper
with fruit,
sycamore
notched 19d
grapes,

figs,sjztr,curnin,goosefat andsweetbeer.It is to be takenoverfourdays.

(fruit)814,

815The Grundrisstranslatestfbdw as
Mannichestatesthis to be a laxative.

816
Schmerzstoffe they
which taketo bea 'pain than
rather
producer' a description
of pain.

H59(Eb23,31)

Itsformulaconsists
statedto bea laxative.
Thisis specifically ofjuniper,honey,sweetbeerand

isto betakenorallyforfourdays.

812
Itsanti-infiammatory is high.Thishasbeenshowntobe60%(incontrolled
activity conditions)compared to
45%forindomethacin (apatented anti-inflammatory HerbalMedicines,
agent),Newall, 176.
813Althoughthiswouldrequiremuchhigherdoses,2.5g/kgover7 dayshasbeengivento animals in controlled
testswithoutsideeffects.N. Mascolo et al.,'Biological plantsfor anti-inflammatory
of Italianmedicinal
Screening
Phytotherapy
activity', Research 1 (11987),
28-31.
Egyptian
814 Hannig,
Balanites?, 106.
Manniche,
815 AncientEgyptian Herbal,I 10.
SeeChapter3.2
$16 whereI propose thatpainis mostlikelymeant.

222
EblOl

of pain(uýbdioin the stomach.

Thisis for'the destruction

It is a complex includejuniperberries,cyperusgrass,beer,sni
Theingredients
oralremedy.

(fruit),goosefat,honeyandwater.

B1020

'Tocldveout inivt andshootingpains(stt) in bothlegs'.

juniper,fat,wine,datesyrup,incenseandfreshbread.It is takenoverfour
Itsformulaincludes

days.

Blnl38

Thisis similarto Bln120butis to 'treat(intermittent)

shooting
pains.

juniper,&rt (colocynth?
It is a complexmixturewhichincludes ), sem(plant,wormwood?
)817,

(plant),S'n](fruits)andresins.
cc3m

Bin154

of pain'(gsn whda).
Thisis to 'treata nest/cluster

Itsoralformulaincludes grass,datewine,honeyandRd(fruit).
juniper,cyperus

Bln153

of pain'(%ýhda).
Forthe'wanderings'

juniper,meat,innk (thyme?
Itsformulaincludes ), celery,sV andfreshbread.It is to betaken

forfourdays.

AncientEgyptianHerbal,80.
817Manniche,

223
Ebl22 (Bin35)

forthe'driving(dr) outof tfýhdw.

is listedundera generalheading:
Thisprescription

'pain(wbdw) in themouth
forcombating I
Eb122is specifically
.
Its formulais a complexmixtureof juniper,bryony,incense,sem(plant),tPrm(plant),ee?
m

), notched
(plant),igd(persea? fruit,ochreandcress.Theremedyis intended
sycamore to be

bV) overthe usualfourdays-818

'sipped'(sý,

Eb254

'forthe headwhenit hurts(mr.f ) andto 'hurryaway'(SSW)819

Thisis prescription the pain'.
,?
Its formulaconsistsof equalpartsof juniper(fruit),sjW andtpnn (cumin)in goosefat. It is

into
made anointment
andthen to
applied thehead.

Ebl38

Thisis a complex
oralremedycontaining for
juniper the 'destruction
of in
c3c a manandthe

deathof wbdwandthecoolingof theanus.Itsformulaincludes

sem(plant),
honeyandsweet

beer.It is takenoverfourdays.

Ebl85

to treat the chest/sternum(§nbt ) and to drive out all

This is 'another(prescription)

in
pains/illness the bodyandto the
treat lung'
(snv). Theoralformula
includes
int al juniper,

figs,j9d(fruit)sjztr,jut (colocynth?
), beer,cress,sweetbeeranddates.

Fourdaysseesto be'formulaic'
$18 fortreatments in theEgyptianmedical texts.I canfindnoreasons
forthis.It
chosenongrounds
wasprobably of pragmatism. It is sensible Alsomany
periodin termsof costandtreatment.
will
conditions
medical improve withinthisperiod.
naturally
754.
Hannig,
819

224
 a

Eb209

causedbya demon'(nsyt).
intherightside(ofthestomach)
Thisis to 'treata stoppage

It is a complex
mixturewhichincludes lotus,
juniper, bt-ds
myrrh, (myrtle)
tvm (plant),
conifer

oil, beer
honey, andfat.It is intended
to be for
taken fourdays.

Ebl37(EbJ52)

(prescription)
Thisis to another andtheanus'.
to treatthestomach

ofjuniper,ki-t; (fruit),sweetbeer,honey,sjztr,raisons,"k,
Itsformulaconsists andfigs.It

isto bedrunkeveryday.

Eb327

for (from Eb236)the 'destruction/eradication

This is 'another(prescription) of asthma?

820
1-U).
WIP It consistsof figs,
juniper, Rd (fruit),
grapes, fruits,
sycamore
notched sktr, cumin,

fat
wine,goose, and beer
sweet are
which into
made a strained
mass, and for
drunk fourdays.

E85

). It consistsof equalpartsof juniperoil and whiteoil

This is to 'treatpnd worm'(tapeworm?

andis to betaken for

orally fourdays.

Eb263

(prescription)
'Another /correct(snvj theurine.
to regulate

juniperberries,date,bryonyandhoneyin water.It is to betakenoverfour

Itsformulaincludes

days.

607.
820 Westendort,

225
Eb266

(prescription)
'Another theurinewhenit is not'.
to regulate

Itsformulaincludes
juniper,RP (fruit/plant), fat,
goose honey
and It
dates. is to be takenover

fourdays.

Eb278(H63)

(prescription)
'Another - (fromEb227)
to driveouturinewhenit is excessive.

It containsjuniperberries,kdt (creeping?plant),honeyand beer. It is to be takenfor four

days.

Eb282(H68)

'Tostopurination'.

It is a complex of
mixture juniper
berries, lbw
celery, (plants),
wim (plant),
dwit (?
sb3t plant),

datesandfruits.It is to betakenforfourdays.

Eb479

'(prescription)
Another - (fromEb477)
to treat
theliver'.

wine,milkandsweetbeer.It is to be takenover
juniper(fruit),figs,lotus,incense,
It contains

fourdays.

Eb585

inthestomach'.
To'driveouta swelling

juniper,cow'smilk,beerandkW (plant).
Itsformulaincludes

Theingredients
aresievedandthentakenforfourdays.

226
Eb758

Another(prescription)
- (fromEb757)
beginning
of the to
prescription treat
the half
right (ofthe

body)during/with ' (m rW). 821It is a complex

theillness/discharge? application,
a mixtureof

juniper,incense,!bw (plant),lettuce(fromLowerEgypt),ps'nt (plant),Hem(plant),bbw

(plant)822,
(plant),Avt rimt! cornseed(whiteandgreen),mineral,git(plant),psýd(husk)myrtle

andhoney.

Eb652,(HIOI)

to 'refreshthe mtw.' Its formulaconsistsof severalingredients:

Thisis a treatment juniper,

coniferoil,incense,
myrrh,mineral, andpigfat. However,
coriander thejuniperhereis in the

to be usedas a bulkingagentfor thefat basedformula.It is

formof (saw)dustandappears

appliedasa poultice.

Eb752(H206)
)823in I
Totreata'demonic (n*l
possession a man.
It containsamongst juniper,9nft (fruit),beerandb;slt (plant).It is an oral
otheringredients

preparation.

Eb833,Eb8O6

Thesearebothgynaecological Eb833is for'a womenwhohasnotmenstruated

treatments. for

824It is a infusionof juniper,cumin,sjW, wcPandbonemarrowin milk.It is to

severalyears'.

bedrunkforfourdays.

821Westendorf,
674.
822Westendorf,
506.
823Westendorf,
673.
824 to bedescribing
Thisappears themenopause.

227
Eb806is 'another(prescdption)
intended
-(from Eb800)
'to induce (sth-
childbirth' to loosen).

Itsformula andfir resin.It is usedpervaginum

ofjuniper,nid?(plant)825
consists in a pessary.

Eb298

(?) in the headandshootingpains(stt) in the neck'.

Thisis to treat'cold/catarrh

Herethetreatment of junipertwigs,ladanum,hsit (balsam),

consists ochre,leadore
incense,

aremadeintoa 'bandage'
andanimalfat.Theseingredients andthenapplied.

ChesterBeattyV1,6

This is a remedyintendedto dealwith rectalbleedingfollowinga previoustreatmentby

containsjuniperin a fat andwheatbase.This maywell have

The treatment
suppository.

andsoothing
someantiseptic
provided relief.

7.2(iii) Conclusions forJunipe

onEntHes

in the medicalpapyriin someeighty-sixentries.Those

Juniperappearsfrequently

included
entries illustrate
above therange
of different conditions.
medical

Ofthetotalnumber forpainfulconditions:
of entriesover50%areindicated wbdwand

stt some
appear times
seventeen (19.7%of the total),12.7% difficult
concern or painful

11.6%
u(ination, the
concern and
stomach anusand those the mtw probably
concerning

painfulmuscleorjointconditions.
indicate

of juniperare comparedto the prescription

If the actualproperties entriesa fair

canbe demonstrated.
correlation Juniperhasbeenusedto treatcolicandurineinfections.
826

the stomachandit maybe thatsomeareintendedto dealwith

Eb86.87,89,101concerns

501.
825Mint?,Westendorf,
826 176.
HerbalMedicines,

228
colictype Some
conditions. ten Onary
concern
presc(iptions Eb263,278
irreguladties. in

appearto refertocystitis.
particular

Juniperpossesses propertiesand so would

anti-rheumatic have been a useful

in
product ancient
medicinal This
Egypt. to
appears be the casesince is
Bln120 for 'shooting

painsin the for'wanderings'

Bln153
legs', of painand for
Bln138 'intermittent
shootingpains'

or
rheumatic
whichsuggests type
arthritic Importantly,
conditions. theyarealloralpreparations

imply
which in and
confidenceefficacy in thesafetyof thepreparation.

however,
Someremedies, appearnotto be to
related the of
properties juniper.
Eb883,

treatments
886aregynaecological for theactual
andit is doubtfulif juniperwouldbeeffective

Although,
indications. withits associated
it mayhavebeenusedheremaybe in connection

Eb479
properties.
arbortifacient areto 'treat
the liver andaretoo It
vague. is that
certain the

Egyptians
ancient of
werenotaware thefunction
of the 827
liver.

Unfortunately
thecomplexpolypharmacy andthe
natureof manyof the prescriptions

inclusion ingredients
of unknown the difficult
effects
make pharmacological to However,
predict.

the frequent of
appearance in
juniper the texts
medical does to
equate
generally its known

Its
properties. being
inclusion however,
random, be
cannot but
discounted withthis caveata

does
generalcorrelation exist its
between and
appearance its actual
medicinal It
properties.

to
seemsreasonable propose juniper
that wasusedto treat
painfulmedical
conditions.

Itsfunctions
827 areconcernedwithdeto)(ification
andthemetabolic processes of thebody.Davidson's
Plinciples
andPracticeof 326-331.
Medicine, It is, thelargestorganin thebodyandsotheEgyptians
however, wouldhave
beenawareofitspresence.It maybethattheseprescriptions
referred ).
to painintheareaoftheliver(back?

229
7.3Willow

salixsubserrata

salixsafsaf
0
ftj 828

to havebeenan indigenous
Thewillowtreeappears 829Remains
speciesin ancientEgypt. of

willow have
leaves been found
reportedly in thetombof 830
Tutankhamen.

andvariouschemicalformsof
Thebarkof thewillowcontainsphenoliccompounds

831
salicylates. Salicylates important
are extremely and medicinal
versatile They
products.

anti-pyretic,
possessanti-inflammatory, and
anti-rheumatic analgesic 832
properties. Salicylic

is
acid also bacteriostic
and fungicidal
and has beenuse for the treatment
of eczema,

dandruff
psoriasis, and 833
warts.

Theuseof willowbarkandtheexploitation is
ingredients
of salicylate well in
known

folklorebutdoesnotappearto havebeensimilarly
European exploited 834It is
in ancientEgypt.

byDioscorides.
notmentioned
is wide
It doesappearin a fewentriesin themedicaltextsbuttherangeof conditions

andit is difficult
to these
equate withits known
properties.

Grundriss
828 VI:564.Charpentier,Receuildernat6riaux relatits6 /abotanique
6pigraphiques deI'tgypteantique,
1388.Baum, ArbresatArbustes deI'Egypte 196-7.
ancienne,
LucasandHarris,
8-29 Ancient EgyptianIndustries 439.
andMaterials,
830
Manniche, Ancient Egyptian Herbal,147.
831
Between 0.5-9.0% depending onthespecies, HerbalMedicines,
268.
832
Acetylsaliclicacidis betterknownasaspirinandprobablywasthemostwidelyused(andversatile) medicineof
thetwentieth century.
&13Ithasbeenusedtotreatfungalconditions oftheskinandears.Martindale 25m Edj 261.
834It isusedin present-dayNorthAfricaforfeverandrheumatism,Boulos,Medicinal RantsofNorthAfrica,158.

gin
 Entriesfor Willowin the MedicalTexts.
7.3 (i) Presedption

Eb766(c)

to 'treattheearwhenit iswet'.
intended
Thisis a prescription

of willowfruit,acacialeavesandcuminwhicharepowdered
Theformulaconsists and

totheear.
thenapplied

andwhichimpliesan
impliesthattheearis discharging
Heretheterm'wet'presumably

ear infection.
The fact that the ingredients
are seems
powdered intended
to act as an

for thedischarge.
absorbent

Eb293

Thisis 'another(prescription)
- (fromEb284)
intended
'to causethe heart
to receive

bread'(nourishment).

(?) of willow,dates,wet (tigernuts?

Itsformulaincludes ), siza;fat andsweetbeer.It

is intendedto be drunkfor four days.The Grundfisshas this prescription

as an appetite

835
It is that
stimulant. possible this used
was asan to
adjunct therapy.
other is
This because
lossof appetite
wouldseemto imply
somesortof associated
medical
condition.

doesnotspecifywhatpartof thewillowis to beused.

Theprescription

Eb582

Thisis 'another(prescription)
-(from to
Eb565) driveout a in
swelling anypartof the

body'

Thisis lastbutonein a 'run'of nineteenprescriptions

underthesameheading.It is

animportant
andobviously
obviously or frequently
occurring Swelling
condition. in 'anypart'of

VI:97.
835Grundriss

231
 a nonlocalisedswelling.Thismayin fact be referringto somearthritic
the bodysuggests

than due
rather swelling
condition to infection
or injury.
836

Itsformulaincludes
willowfruit,dbn (earth/mortar?
), fruit,
sycamore and10 (fruit).
It

is appliedby bandage, because

presumably of the 'slushy' of
nature the formula.
Whilst
the

somepainrelief,thefruitwhichis specifiedhere
barkof thewillowmaywellhaveprovided

wouldnot.

Bln75

fortoothache
Thisis a fumigation

It containswillow,grass,gims (plant).Therewouldbe no salicylatereleaseor

by
absorption the burning
of Possibly
willow. the is
smoke intended
to driveout the pain/or

causeof thepain.

Bln87

(ointment)
Thisis 'another (fromBIn8O)
to driveoutS'mml 837
(fever).
-
The formulaincludesfruit of the willow,celery,hippopotamus
It is a complexapplication.
faeceS838,
w3m(plant),
scm(plant),
An ew(plant)
and The
honey. ingredients
are by
mixed
heatingandstillappliedto the skinwhilstwarm.Thismaybe intendedto 'counter'the heat

fromthefever.

Someof thesecrossreferto entriesin HearstwhereLeakeconsidersthemto be for'boneandjoint'conditions.

836
Leake,TheOldMedicalPapyri,62.
837Westendorf, 319-20.Grundriss, VII:854.
838Hereonesearchesfor a possibleallegoricalconnectionbetweenthe hippopotamus andthe symptoms.It may
be in the distinctivenatureof the animalwhichcontinuallyentersand exitsthe waterin orderto cool down.It is
perhapsappropriate heresinceEb87is intendedto driveout heat/fever.

232
H234

Thisis to be appliedto a limbaftera bonehasbeenset.It consistsof willowleaves,

acacialeaves,sycamore
leaves,wheat,gumandwater.It is appliedas a bandagefor four

days.It is essentially
a practicalremedy.The'gummy'constituents act to
wouldpresumably

stiffentheleavesandsoactasa castto supportthelimbduringthehealingprocess.

Noneof theprescriptions thatthepainkilling

offeranyevidence of thewillow
properties

wereknownto theancientEgyptians.
In H234andBln75it appears
to bepresentmerelyforits

as a baseto set a boneandto aid burningin fumigation.

physicalproperties: Elsewhere,
its

inclusion
apartfromitsphysical
properties to bepurelyrandom.
appears

233
7.4Henbane

hyoscyamus
niger
Unknown
Egyptian:

species.It currently
is a smallplantof whichthereare someelevenhyoscyamus
Henbane

growsover North
Europe, Africaand Asia and is indigenous
to Egypt
Upper and India.
839

in recenttimeshasbeencultivated
Henbane muticusor Egyptian
in Egyptas hyoscyamus

henbane has
which ýeenthe for
areaof growthandexport
principal 840
hyoscyamus.

foundamongstancientEgyptian
hasbeenreportedly
Henbane 841
remainS. In viewof

it seemslikelythat henbanewas availableto the ancient

this and its currentdistribution

thenameof theplantandanyentriesin themedicaltextshasyetto be

However,
Egyptians.

842
identified.

All thedifferentspeciesof henbane withsimilarchemicalproperties.

containalkaloids

843Theseare principally
The alkaloidsare presentin the stem,leaves,flowersandseedS.

hyoscyamine
and hyoscyine
which have similar effects
pharmacological to speciesof

belladonna.

Henbane beenuseas a sedativeandmorerecentlyto treaturinary

hastraditionally

tract
spasMS. 844 In home it
remedies has beenusedas a to
poultice relievelocalpains,to treat

for pain. 845

toothache
andasa suppository rectal

839TreaseandEvans, Phannacognosy, 353.

840Wallace,Textbook of Phannacognosy,333.
841It wasreportedly foundin remains of an ancientrubbishdumpat Saqqara, Manniche, An AncientEgyptian
Herbal,20.
842Ebbellproposed thewordpsdto meanhenbane, basedonthefactthatit is usedin H42,46,Eb1OO, BIn48,
120and162to treatpain,Ebbell,Papyrus Ebers,132.Thisis discussed
andsupported byGermer, PhDThesis,
271-5.Thereis littleothersupportfor this,andthewordis generally accepted to be somesortof seedpod,
Westendorf,838.
843Theseedsalsocontain a smallamount ofatropine,TreaseandEvans,Pharmacognosy, 352
P4Itsderivativeswere comparatively
until recently
used in combination
with morphine to induce 'twilight (a
sleep'
partialanaesthesia)forlabour.A. J. Carter,
'Narcosisand British
Nightshade', Medical Joumal 313 (1996), 1630-
2.
845It wasusedto treattoothachebyfumigation, thesmokefromtheseedsbeingdirected to thetoothbya funnel.
Henbane seemsto havebeenusedin this mannerto smokeout the 'tooth-worm' a wormthoughtto be
responsiblefor dentalcariesandother'evils',W. E. Gerabek 'Thetooth-worm: historical aspectsof a popular
OralInvestigation
belief,Clinical 3 (1999),1-6

234
 useof henbane
Themedicinal byCelsus
datesfromtheearliesttimes.It wasrecorded

and Dioscorides
Dioscorides. henbane
prescribed to 'procuresleepandto ally pain'andto

nameforhenbane
treat'allgfiefs'.HetellsusthatthattheEgyptian 846Hisphysical
wassaptho.

description the
of plantotherwise It
seemsaccurate. also in
appears the Oxyrhynchus
Papyrus

foritsmedicinal 847
properties.

to havebeenknownandusedmedically
It appears It figuresin the
by theAssyrians.

herbalsbuttheprescribed
Assyrian arenotentirelyclear.It appearsthere
medicalconditions

(for to
condition),
as a poultice an unknown decaying
treat teeth,
swelling
andfor thestomach
lungS. 848
and

Entriesfor Henbane
7.4 (i) PossiblePrescription

of henbanein ancientEgypt,its properties

Withregardsthe identification shouldbe

with
considered a viewof linking
themwith uses
similar in themedical This
texts. that
assumes

whilst henbane that

was present its properties
pharmacological were also known.It is

to the
necessary predict 'prime' for
property
medicinal whichit was likely
most to havebeen

In
used. thecaseof henbane
this have
would beenits sedative
andhypnotic These
effects. are

thatarerecorded
theproperties sourcesandso mostlikelyto havealsobeen
bytheclassical

bytheancientEgyptians.
exploited

However,in the medicaltextsthereappearsto be only entrythat couldreferto

andtheactualentriesfor'sleep'arefew.Theseare:RHO, Eb363/4
'sedation' andEb782.

forthe'headandforsleep'.Itsformulaconsists
Eb260Thisis a prescription of resins,incense,

It is groundandappliedto produce
andmineral.
malachite sleep.

846 IV:69.
Dioscorides
847Lucas,JEA24,198-9.
848TheAssyriannameis givenas takiru Thompson, 230.
A Dictionaryof AssyrianMedicine,

235
 celeryinwaterwhichis saidto 'quicklyproduce
Eb363contains sleep'.Eb363contains

assestoothandwater.Clearlynoneof thesepreparations
couldbe applicable
to henbane

sincetheingredients
areallclearlystatedandrecognised.

Eb782is a prescription child'.Theformulacontains9pnn(fruit)

to 'placatea screaming

of gpn(plant)mixedwithfly excretafromthewall,madeintoa masswithwaterstrainedand

thendrunk.It is theheadingto thisprescription

thathasledto thesuggestion
of 9pnas the

of s'pnand I wouldventurethan
849Thisis the onlyentryfor an oral preparation
opiumpoppy.

henbanemightbe argueda moreappropriate

translation on the basisof this single
of sgpn

It
entry. wouldworkas a and
sedative the wordgpn is not dissimilar to the
phonetically

wordandthatgivenbyDioscorides.
Assyrian

Howeverthe problemwithgpnas an hypnoticis thatit alsoappearsIn Eb440,443and

to treatbnsit (anillness)of
in externalpreparations
Eb445.Here,it appearsas an ingredient

the head.Whilstthe conditionis not certainit almostcertainrefersto somekindof wet

850
in thehairof thescalp.
discharge It doesnotappearto beconcerned
withsedation.

7.4 (il) HenbaneToxicity

Theabsence
of plantswithsedativeor painkilling fromthemedicaltextsis
properties

Some
puzzling. substances
areso in
powerful terms
of theirpharmacological
andsocialeffects

in thattheyareunlikelyto escapesomerecord.Henbane
is a substance
thatappearsto have

beenwellknownin classicalandAssyriansourcesyet appearsto haveescapedrecorded

in

ancientEgypt.Thismightbeexplained to homenostnimsandso excluded

if it wererestricted

fromtheofficialtexts.

SeeChapter5.2,page167.
849
625.Alsotheseedsarespecifiedherewhichwouldbe equallyappropriate
850Westendorf, to henbane.

236
 However,theremaybe anotherreason.The seedsof the henbaneplantare toxic.851

Thisfactmightbethereasonwhythereis nomention
of henbane.
Manyclassical
writerswere

plants.In particular,
awareof thetoxiceffectsofcommon thereareseveralclassical
references

to thedangers
ofeatingg2aýil 852
whichhavebeenfeedoncertaintoxicplants.

'Somefruitsareunitfor us to eat,butfit for others,likethe henbane

andhellebore,

to menbutgoodforquails'.Aristotle,
whicharepoisonous OnPlants820.b 6-7.

Thereis similarconnection in theBiblewhenduringtheExodussucha fate

mentioned

appearsto havebefallenthe Israelites:'Theygatheredthe quails...andwhilethe fleshwasyet

theirteeth,ereit waschewed,thewrathof the Lordwaskindledagainstthe people

between

andtheLord the
smote peoplewitha verygreat Numbers
plague'. 11,234.

Thisapparently betweenquailand henbanesimilarlymayhave

obtuseconnection

in Egypt.Yet,quailwasanimportant
(orevenodginated)
beenbelieved foodproductin ancient

853
Egypt. featurein agricultural
Thecaptureof quailusingnetis a common 854
tombscenes. A

between
connection quail and
consumption henbane
poisoning difficult
seems to explain.

seedsretainedin thequailcropwouldbe toxicbuttheywould

In practice(henbane)

bediscarded
almostcertainly Anyalkaloids
on preparation. by theactivebirdwould
absorbed

bebrokendownintoexcretable It seemsunlikely
metabolites. thatquailcouldhavebeena very

likelysourceof poisoningsince quail appearto have been so popular.

855I considerthat a

could
connection be if
explained theassociation butintended
wasmerelyapocryphal to actas

an illustration
or aide to
memoire the dangers
of henbane
toxicity.
Thiswouldhaveservedto

851Themaximumdoesof henbaneis statedas 3g daily(of leaves).Theseedcontainsome0.5%of alkaloidsand

fatalitieshave been recordedwith as little as 20 seeds.Casesof lethal poisoningand drug abuse is not
uncommon in the presentnearEast, M. Kukcuoglu, 'Henbanepoisoningin thevicinityof Erzurum',TurkishJournal
of Pediatrics 12 (1970).48-56.J. Urkinet al.,'Henbanepoisoningin childrenin the Negrev',HareFuah120(1999),
714-6.
852Therearemanyreferences e.g. by Didymusof Alexandria,Geoponics, 14,24andPliny(10,33).
853Herodotus,11: 77. He reportsthat quailwereeatenuncooked,just merelysalted.Brewerstatesthat evidence
showsthemto havebeena 'relishedfood'.Brewer,DomesticPlantsandAnimals,124.Theyweremigratorybirds
andmanyfell to thegroundexhausted thento be caughtin largenets,Lloyd,Herodotus Book111-98,335.
854Darbyet al.,Food;TheGiftof Osiris,311.
855it has been variouslydescribedas an exampleof food poisoning,the result of desert heat or due to
psychological effects,
reportedin Darby et al, Food.,TheGiftof Osiris,314.

237
 of itstoxicity,andsomostlikelyhaverestricted
actasa warning themedicinal
useof theplant.

thatit wouldhavebeenusedforinternalmedicinal
If thiswasindeedthecaseit is unlikely use.

238
7.5 Myrrh

III
-

entyw

Commiphora

The Egyptianword cntvtvis generallytranslatedto meanmyrrh. 856It is a wordclosely

I
857
in
associated Egyptian
andotherearly texts with the wordSnIr generallytranslated
as

frankincense Bothmyrrhandfrankincense
(Boswellia). are natural,resinproductsobtained

fromtheirrespective
shrubspecies.

Theywereveryimportant
materials beingusedas incensein
fortheancientEgyptians

858
religiousrites. They as
wereconsidered in
elements
purifying all Egyptian
observancesand

wereusedto honour
bestow uponthose They
worshipped. werealsousedas in
ingredients the

and
proceSS859
embalming figure in
widely the texts.
medical

asthelandof Punt.Itsexact
textsputthesourceof boththeseproducts
EarlyEgyptian

butit probably
locationis uncertain to
referred theareaof Sudan
eastern to
adjacent the Red

860
Sea. Thetreesbrought to Puntaredepicted
backfromtheexpedition on thewallsof
Hatshepsut's temple
mortuary at Deir
el Bahri, they
although are in
depicted a stylisedmanner
diffiCUlt. 861
makinga positive identification

Theimportance in theliterarytextswhereit represents

of myrrhis illustrated oneof the

benefactions:
ultimate

856Wb1:206.Grundfiss VI:99.Westendorf,497.But it hasalsobeensuggested to meanfrankincensebysome

andasa generic foraromatic by
resins Lucas
others, and Ancient
Harris, EgyptianMaterials
and 93.
Industries,
857 WbIVA80,18-181.17

858 Incenseandincense burnersarementioned in recordsandfoundin graves.

Theoffering fromthe
of incense,
BookoftheDead,is a common templescene,LucasandHarris, Ancient
EgyptianMaterials 90.
andIndustries,
859 S. A. BuckleyandR. P. Evershed,'Organicchemistryof embalming andGreco-Roman
agentsin Pharaonic
mummies', Nature 413 8374
(2001), 1.
8wK.A. Ktchen,'TheLandOfPunt', in T. Shawet al.(eds. ofAfrica:Food,MetalsandTowns
), TheArchaeology
(London, 587-608.
1993),
861 However thelargeredlumpsof entywshownin thereliefscertainly myrrh,A. Lucas,'NotesonMyrrh
suggest
and JEA
Stacte', 23 (1937),
29.

239
 'Youarenot richin myrrhandall kindsof incense.But I am the Lordof Punt,and

is myveryown'. 862
myrTh

it is notentirelycertainthatPuntwasthe onlysourceof myrrhandother

However,

funerary In
resins. fact,
NewKingdom
textsstatethatlarge of sittrwere
quantities brought
from

Syriaand Palestine in
a region whichfrankincense
doesnot 863
grow. This has led to the

that
suggestion sntr wasnot but
frankincense a
rather resinfromPistacia,
a specieswhich

todaycanbefoundin IraqandAfghanistan.

Recentwork suggeststhat incenseresinswere in fact importedfrom wider afield

duringthe New Kingdomand so has revivedconfusionregardingthe identityof these

864
products. ResinfromPistacia
specieswasfoundin the cargoof a wreckoff the southern

coastof Turkeyand datedby to

chemicalanalysis the postAmarna Equally
period. resin

coated bowls
incense from have
Amama been to
shown contain
not but
Boswellia Pistacia.
It

that
possible
seems the increased for
demand during
incense the NewKingdom a
promoted

brisktradeinthisresinfromwiderareasof production.

wasobtainedfrom
Thishasraisedsomedoubtas to whethersntr (asfrankincense)

Boswelfia
theplantspecies from
or wasactually a different that
species, of Aside
Pistacia. from

thesignificance
of thisin termsof tradeit mayalsopresent
a in
problem termsof theactual

identification
of cntyw'. 'If sntr is Pistacia
resinthenis cntywfrankincense
or Or
myrrh? was

thereinfacta confusion 865

of species'.

However, because
whilst of costsanddemands incense'
'generic was likelyto have

beenusedit doesnotautomatically that and

mean myrrh frankincense species.
wereconfused

862 From'TheShipwreckedSailor'in Uichtheim,

AncientEgyptian Vol.1,214.Thephrasehereallkinds
Literature
of incense that
suggests sjztr is beingusedasa generic.
863Lucas,JEA16,30.
V M.Serpico andR.White,'Thebotanical identityandtransport
of incense NewKingdom',
duringtheEgyptian
884-97.
74(2000),
Antiquity
865 andWhite,Antiquity,
Serpico 895.

240
 866 It
If entywwas thenit couldnot alsobe Commiphora
Boswellia whichwasnot the case.

seemslogicalthatthedemand withthemassivebuilding
forincenseresinswouldcorrespond

of
programme the NewKingdom.
It presumably be the
without
couldnot satisfied introduction

But
of widerspecies. thisdoesnot that
mean linguistic would
confusion be a necessary
result.

wouldhaverestricted
Theexpenseandscarcityof myrrh(andfrankincense) theirusedto

867
occasions.
special The introduction
of paralleland moreabundantspecieswouldsurely

serveto increase of theformer.

theexclusivity

Importantly,there are distinctivephysicaldifferencesbetweenthe resinsthat would

makethemstand Frankincense
apart. and myrrhare bothfragrant
gumresinsbut differin

frankincense
colour; beinga light, colour
yellow-brown to
compared the moredistinctive

These
reddishcolourof myrrh. were
colours to
unlikely be confused
at the level
medical

both be
whereas mightwell included the
under heading
generic of used
sntrwhen as incense.

7.5(ii) Charactedstics
of Myrrh

Myrrhis an oleo-gum is from

resinwhich obtained the stemsof variousspeciesof

today
andwhich
commiphora in Africa
grows north-east andArabia.
Much
of the from
secretion

theplantstemis obtained
byspontaneous fromcracksandfissureswhichcommonly
extraction

viscousfluidsoonhardensinto a reddish-brown
formin the bark.Theyellowish-white tear

868
shapedmass. Thisfractures
andpowders It
easily. hasanaromatic
odourwithanaromatic,

some7-17%of volatileoils,2540%resin,57-61
bitter,acridtaste.It contains %of 'gum'and3-

869
impudties.
4%of

866Therehavebeenmanypositiveidentifications of myrrhas Commiphora fromthe NewKingdom, Lucasand

Ancient
Harris, EgyptianMatedals andIndustries,93.
LucasandHarris,
867 Ancient Egyptian
Materials andIndusides, 329.
8mOilof myrrhor stacteis described
byDioscorides 1:73,although hismethod is unlikely.
of extraction Theword
mdt (oil)describedas being expressedfrom fresh -ntyw seem to correspond to stacte.G. A. Wainwright,
of Recent
'Notices JEA21(1935).
Publication', 254-5.
869
Trease andEvans,Pharmacognosy, 289.It is soluble (c.50%)in bothwaterandalcohol.

241
 Myrrhhasbeenusedin modemmedicine recently.It featuredin the
untilcomparatively

BritishPharmacopoeia
until1973 tincture
as an alcoholic and in
appeared the in the British

HerbalPharmacopoeia
of It
1990. is stillusedin Europe
continental asanoral 870
preparation.

It is statedto possessanti-microbial,
astringent,expectorantand carminative

871
properties. it hasbeenusedforwounds,abrasions,
Traditionally coldsoresandspecifically

872
formouthulcersandgingivitis. Thetraditional
treatments andmouthulcers,with
of gingivitis

the
tinctureof myrrh,relynotonly antiseptic but
of myrrh,
properties as importantly
on the

layer
protective it formsover the dentalmucosato allow healing.More recentlyit has been

to andpain-killing
anti-inflammatory
shown possess 873
activity.

Theseproperties its to
of myrrh: ability a
produce on
effect
soothing infected
tissueof

themouthandthroat
anditsintrinsic
painkilling
effects
were by
reported 874
Dioscorides.

incidence
In viewof thewidespread of dental
and'bone' in
disease Egypt
ancient the

useof for
myrrh thetreatment
of disease
dental andas an anti-inflammatory
painkillershould

However,
bepredictable. thisprediction texts.
is notfulfilledwithinthemedical

Texts
7.5(iii) MyrrhintheMedical

Myrrhfeatures in
widely the texts
medical andfor a widerangeof medicalconditions.

However,
someof these are
conditions difficult
to reconcile
with its knownpharmacological

It in
properties.appears Papyrus Hearst,
Ebers, Cheater
Smith, Beatty,
Kahun, V-
Ramesseurn

andin the In
Papyrus.
Berlin the Hearst
Papyrus both and
myrrh frankincense in
appears over

25%of thetotalnumber myrrh

of presdiptions for
apcounts
alone 7.45%
some of the 875
total.

870M.Blumenthal, et al.,TheComplete Commission E monographs:TheTherapeutic

Guideto HerbalMedicines
(Boston,1988),174-2.
871HerbalMedicines, 199.
872Fetrow andAvila,Complementary andAlternative 448-9.
Medicines,
873Report in,ThePharmaceutical Joumal265(2000), 427.
874Dioscorides1:71.
075Thisis highcompared to theinclusion
of beer,wineandmilk(asprescription for
whichonlyaccounts
vehicles)
I 1%,4.7%and4.4%ofthetotalsrespectively.

242
 thefollowing
I produce listof prescriptions
all of whichcontainmyrrh.Thelist is nota

butdemonstrates
complete therangeof medical
conditions:

Thisis a (prescription)
H31(Eb708) to'removebad(body)odourintheSummer.
intended

It consistsof equalpartsof myrrh,frankincense, It is madeintoa

jbw (plant)andS-nif(fruit).

massandthenappliedto theskin.It is presumably to actas a deodorant

intended to counter

bodyodour.

Thisis a fumigation
Eb852. smells-'to makesweet(sAdm)homeandclothes'.
to counter

(sktr), Am(fruit),inktwn (mineral?

myrrh,frankincense
Itsformulaincludes ), dmtn (mineral),

melonandstorax.

Boththeaboveprescriptions, withotheringredients,
albeitcombined clearlyexploitthe

fragrant876and effectofmyrrh.
pu(ifying

appearsto usethe astringent

Thefollowingprescription andantiseptic
properties
of

myrrhinthetreatment
ofwounds.

Eb529'Whatisto bedonefora woundintheneck'.

of myrrhwithdbit (powdered
Thisconsists 877These
flax/plant). aremadeintoa massandthen

appliedby bandage.The formulawouldpresumably

offer some antiseptic,dryingand

relief.
protective

These'another'remedies- (fromEb437),'to driveout bnsit

Eb444,445,447
878in
(illness) thehead'.

8761say'fragrant'
sincepresumably theassociatedsmellof myrrhwouldhavebeenfamiliar(andpleasant?) to the
ancientEgyptian whilstnotnecessarily suitingcontemporary'tastes'.Theuseof fragrantsubstancesandthe
problemof 'fixing'perfumesin fatsis welldiscussed
byLucas.Heis of theopinionthatmyrrhshouldbe'included
in anydescriptionof ancientEgyptian A. Lucas,'Cosmetics,
perfumes', andIncense
Perfumes in AncientEgypt,
JEA16(1930), 44-7.
877Westendorf, 639.

243
 Eb444is a complex
remedy of 3bw(fruit/mineral?
consisting ), -rntyw, (colocynth?
)
-Ort
t;
and -msp(crocodilefaeces?
). Theingredients
arethenpowdered priorto application.

Eb445is anotherpowderfor the sameconditionbuttheformuladiffersconsisting

of

myrrhwithinr-spdw(mineral)
andApnn(poppy?
). The here
condition
medical is but
vague,

to bea suppurating
appears in whichcasethepowderwouldhavedryingand
scalpcondition,

benefit.
antiseptic

Eb447Thisis forthesamemedical butdiffersin thatit is to beappliedas an

condition
It
ointment. contains
myrrhwith fat
hippopotamus (nv,
ýbt),lbsi (plant
)879,
gsfn (gumresin)and

si
uT(resin).

to makegooda woundwhichis painful'.It containsint al

Eb130Thisis 'another(prescription)

irlyw
myrrh, (plant), and
emmer, beer.It wouldhavepresumably
affordedsomesoothing,

effect.
antiseptic

880
to (fromEb543)driveoutlknl (illness).
Eb545is 'another(prescription)

Theformulaconsists
fora skincondition.
to beintended
Thisappears of mid (mineral,

)881 is
pumice? which groundup in myrrhand then applied(rd r.s ). However,
any protective

and effect
antiseptic of the seem
would
myrrh to by
negated the natureof thepumice.
abrasive

Thisis a complex
Eb91is to 'driveout(dr) wtWw(skindisease)'. application
whichconsists
of

(sktr
frankincense
myrrh, ), 3-m-a(plant),
inr-spdw (mineral),
leadore, sl-tvr (resin),
jnb

dut (colocynth?
(plant),ochre,sc3m(plant), ) andhoney.

Affectingthehairon thehead,an oozingeruptionaroundthehairfollicle,seeGrundriss

878 VII:6611
Wildmint?,Hannig,42.
879
880GrundrissIV:251.Westendorf
givesHautblasen, eczema,Westendorf, 641.
881Westendorf,641.

244
 to driveout wtgw in (on?) the belly'.It is anotherapplication
Eb95is 'another(prescription)

including andhoney.
myrrh,a %T(resin)

in thesepresc(iptions
Whilstthe skinconditions somesoothingeffect
are unknown,

fromtheirformulas.
mayhavebeenderived

Eb209,299

in thattheyareintemalremedies
Thesearesignificant myrrh.In Eb209themedical
containing

is
condition It
vague. is intended
to 'treat
a (Anc)
stoppage of the side
right (stomach?
)' which

hasbeencausedbydemonic
influence 882.
(nsitdemon).

It is a complexmixturecontainingmyrrh,9nft, com, bryony,celery,lotus,bt-ds

honey,beerandgoosefat. It is to be drunkoverfourdays.Myrrhas a
), malachite,
(myrtle?

singleingredient,
in the dose,
correct wouldhaveafforded
somepain This
relief. is presuming

it is difficultto predictthepharmacological
thatpainwasa featureof the'stoppage'.However

the due
actionsof mixture to the of
complications
unknown the ingredients.
additional

whatto dofora manwhenhesuffershnt(catarrh?

(prescription),
Eb299is 'another ) in

pain)in hisneck'.
hisheadandstt (shooting

includingint al myrrh,cd
severalingredients
It is a complexoralmixturecontaining

), fat,ladanum,
(resin? npdtand beer.
sweet It is to betaken four
over days.

Eb564(H126)

(prescription)
Thisis 'another anditchingin anylimbof the
(fromEb563)to driveoutswelling

myrrh,datesyrup,salt,beerandfrankincense
body'.It contains andis appliedbybandage.

forarthritis.
thisto bea treatment
Leakeconsiders 883

IV:101.
882Grundriss,

883Leake,TheOldMedicalPapyti,62.

245
Eb637(1-194)
Theseareointments
to alleviate and'to
'anything'(bt nbt Eb637)or mtw (1-194)

the
soften mtW. They to
arepartof runof prescriptions 'treat
themtW. Theformulas
consist

beer,
of myrrh,gum, fat
ochreand whichare by
applied H94-122
bandage. maybe a seriesof

for
prescriptions boneandjoint In
disease. whichcase,the here
treatment to
appears be

designedto treatsomearthritictypecondition.

(fromEb257)to treattheheadwhenit hurts.It is either

Eb258Thisis 'another(prescription)

as
applied anapplication
or by (rd!
bandage ). Thisis myrrh,gsfn,
mixturecontaining
complex

tntm (plant),
tpnn(curnin?
), lotusandbeer
whichis to
applied thehead.
It is difficult
to know

the is
condition
what medical butthe may
prescription affordsomelimited
reliefas a soothing

poultice.

Eb140,145,155

is a run of prescriptions
Eb`140-145 the anus'and are for rectal
all designedto 'treat/cool

(bysuppository).
application

myrrh,bpr-gT
Eb140containsmyrrh.Theremedyis a complexmixturecontaining

), ochreandhoney.Someastringent
(sjztr), tpnn(cumin?
(plant),pr Am(fruit),frankincense

effect
andcooling wouldbe from
obtained the However,
ingredients. it maybe thatthe resinis

presentmerelytogivethemixture to assistrectalretention.
somestiffness

(awb) rectum.It containsmyrrh,frankincense,

for a prolapsed?
Eb145is specifically

fat
cyperusgrass,celery,coriander, and salt. The ingredients
are madeinto a massand

intotherectum.
inserted

to driveout'heat(aw-irritation?
(prescription)
Ebl55is 'another ) in theanus'.Thisis a

beans,
mashed
remedyof myrrh, dut
mashed (colocynth?
), Ibmt (resin)
andmsdmt (lead

ore)whichis madeintoa massandinserted

intotheanus.As withEbl40,it maybe thatthe

246
leadsalt and resinsare presentto stiffenan otherwise'sloppy'formulato facilitaterectal

application.

Theremaining
prescriptions forwhichit is difficultto seeanylogicor
areforconditions

benefits
particular totheirprescribed
treatments:

treatment(from Eb789).It is designedto 'make the

Eb792This is 'another'gynaecological

uterusgo (M)
down/descend to its place(a prolapsed ).
uterus? It contains
ochrein fresh

myrrhwhichis 'applied
to the and
navel' then with
moistened more It
myrrh. is difficult
to see

anylogicinthistreatment.

to treattheeyes'whenthereis ubdw (pain)withbloodin the

Thisis a prescription
Eb336(b)

It
eyes'. contains frankincense,
myrrh, tntm,ochreandwater.

Eb391is 'to driveout catarrhin the head'.It is a quantitated,

externalapplication
of resins

myrrhandIntl(plant).

Theuseof myrrhandotherresinsin the embalming

processwouldhaveprovided

to the
ampleopportunity appreciate protective
and strengthening
properties
of Not
resins.

forthetreatment
theprescriptions
surprisingly seemto suggest
of woundsandskincomplaints

of theprotective
knowledge andastringent of myrrh.However,
properties theinclusion
of other

withintheformulas
ingredients this.Thepresumption
seemsto contradict thatmyrrhwasthe

active
primary ingredient be
cannot because
certain of its inclusion
withotheringredients.
Its

be
might
addition, to assistthe consistency
of the product(Eb14O,
145,155b),or be merely

247
 The
random. of
significance 'active'ingredients
and their role in the ancientEgyptian

will
prescriptions befully in
considered 9.
Chapter

The majorityof myrrhcontaining is

prescriptions for This
preparations.
external is

It in
significant. appears onlytwo neitherof
oralpreparations which to
appear involvepain

This
relief. is further by
reinforced thefactthat type
arthritic are
conditions treated
withmyrrhby

so
methods,
external any
negating benefit.

a parallelusein medicine
Sincemyrrhwaswidelyusedin religiouspurification might

884However,
bepredicted. onlyEb582
uses in
myrrh fumigation,
butfor its fragrance
andnotto

internally
purify(heal) to demonic
or expel This
possession. to
seems implythatthe disease

forces.
herewasthoughtto be dueto internalbodilyfactorsratherthanexternal,malevolent

Thisis notto denytheparticipation forcesin diseasebutratherto suggestthat

of supernatural

thelattermightwellbe a secondlineof approach

whena traditional had
treatment not been

885
successful.
hasbeenin thetreatment
Themainuseof myrrhin othersocieties of dentaldisease.I

it is 886
think a glaringomission thatit doesnot in
feature theEgyptian texts
medical forthisuse

of dentalproblems.
inviewof thehighincidence

884it mayseemlogical(to a modernmind)to thinkthatincensewasthoughtto 'purify'theair. However, this

supposes thatairwas thought to be some sort
of 'transmitter.Pinch maintainsthat the Egyptians thought that'bad
air'causedepidemics, Magic in Ancient Egypt, 133.1 can findno evidence for this and I think she is confusingit
with the 1811
century derivation of the word malaria from malaria- 'bad air'. I think it as important thatthe
andsmokeaddedto theritual.Waterwasthemostusualpurification
'fragrance' mediumandfoodanddrink
(secondary ones),since all provided lifeand vigour.A. Blackman, 'Purification(Egyptian)', in J. Hastings(ed.),
Encyclopaedia of ReligionandEthics10(Edinburgh, 1918),476-82. Theideathatgrainsof incense werethought
to be theexudations of a divinityarediscussed by Blackman. Theincense'restores thelossof vitallifefluids'.
From,theRitualOfAmonin A. M.Blackman, 'TheSignificance of Incense andUbations in Funerary andTemple
ZAS50(1912),
Ritual', 69-75.
885 Thoseconditionsin themedicaltextsthatarecausedbydemonic possession arevagueandneverspecify
symptoms. This,perhaps, implies conditions beyond thephysician whicharerelegated to secondlinetreatments
bymagic.
N6If theprotectiveproperties of myrrhwereexploited in wounds andskintreatments it seemsoddthatit wasnot
alsousedorally.

248
 8: ALCOHOL,SURFACEANAGELSICS
CHAPTER

8.Alcohol

Theabsence
of essential
painkillers, the inability
with apparent
coupled of the Egyptian
ancient

to exploitotheravailable
physician products limitedthecontrolof suffering
musthaveseverely

in chronicpainfulconditions.Becauseof this one must considerwhetherpain controlwas

and
attempted if sobywhatothermeans.

Oneavailable thatcouldhavebeenusedto controlbothpainandother

substance

sufferingswasalcohol.Alcoholis an effectivepainkiller,it wasavailablewidelyin ancientEgypt

is thatit wasusedin controlpain.

in theformof beerandwinesandthelikelihood

However, is complex,
the'role'of alcoholwithinsocieties its useandabusegenerally

the
reflects degree
of social and
problems Whilst
complexity. we haveno information
detailed

the
on useof in
alcohol Egypt
ancient thereis use
abundant for modern For
societies. instance,

theuseof alcoholin nineteenth England

century was discussed
widely anddocumented
both

887
at thetimeandsince.

But,theessential the
with use
problem of and
alcohol any between
comparison social

is
models the difficulty
of the
separating useof in
alcohol the overall
social from
context its

distinctroleaspainkiller. of this,theroleof alcoholin medicine

Because is oftenanecdotal
and

difficultto separatefrom alcoholabusedue to dire socialconditions.Paradoxically,

its

from
exclusion traditional is
medicine because
probably of its consequences
andeffectson

It
behaviour.
social is difficult
to establish
a distinct of rolessinceits acceptance
separation

the
within 'official system'
medical might
alsoimply of thesocialconsequences
endorsement of

alcohol.

B. Harrison,Dfinkandthe Victofians,
887 (Frome,1971).

249
 Certainlyalcoholand its effects,particularlythe adverseeffects of excessive

have
consumption longbeen in
documented ancient 888
societies. In Egypt
ancient the useof

is
alcohol also in
documented literature
andis in
shown tomb Its
scenes. usewasessentialto

to life
secularand religious being
anessential
part
of religious 889
ceremonies.

of beerin theearliest
Alcoholin Egyptgoesbackto theearliesttimes:'theinvention

timeswasso deeplylostin theabyssof irretdevable

Egyptian its makinganduse
memodes,

wereso knit
inextricably in the fabricof daily 890
life'.

also start from the earliesttimes.It is integralto

of it properties
The appreciation

Egyptian for
mythology: instance,
the Ra
creator used'red' beerto dull the excesses
of the

891
Sekhmet.
goddess

Herodotus
reportswidelyon in
alcohol Egypt, somewhat
although He
inconsistently.

reportsonthefeast
of Hathor
at 'more
Bubastis: gMe-wineis consumed
at thefestival
thanin

all the rest of the 892

year combined'. Later, he appearsto this
contradict since (the

888its adverse effectsareoftenreported within the Egyptian 'Wisdom' texts: 'Do not getdrunk lest, yougo mad',
from,'TheInstructions of Ankhshenshonq' in Lichtheim, Ancient Egyptian Literature Vol.Ifl, 168. It alsofeatures
widely in Biblical Prophecy; see, V. M. Matthew, 'Alcoholism in BiblicalProphecy', Alcohol and Alcoholism (1992),
89-90.
However, the supposed awareness of some of the effects of alcohol in ancientsocietiesis misplaced. For
example, many Greek and Roman philosophers are quoted expressing an awareness of harm to the foetus
caused by alcohol during pregnancy. However, this was because of their belief of the effectof alcohol on themale
at ejaculation. Alcohol produced a 'cold'body which enhanced the likelihood of conceiving a female which
according to the Greeks and Romans was a 'deformity. E. Abel, 'Was the fetalalcohol syndrome recognized by
theGreeks and Romans?, Alcohol and Alcoholism 34 (1999), 868-72.
889Ramesses III is reported to havegivensome22,566jarsof wineto varioustemplesat Thebes,10,355to
Heliopolis andsome25,978to temples at Memphis, figuresfromthePapyrus Harrisin J. H. Breasted, Ancient
Records of Egypt. 5 volumes. (Chicago, 1906), Reprinted London, 1988, iv: 168.
890Darbyetal.,Food.TheGiftof Osiris,529.
891 Shewasmadedrunkby7000jugsof beermadeto looklikeblood(bytheaddition of fruits)andso mankind
was saved. J. ternk, Ancient Egyptian Religion (Westport, 1952).
Thedrinking of wineappears to bea heavenly occupation sinceUtterance 440of thePyramid Textstellsusthat
god's nobles in heaven: 'lean on their
staffs,clad in red linen, living on figs, drinkingwine, anointed in unguent' in
Egyptian Literature Vol.1,45. ,
Lichtheim, Ancient
892Histories 11:60.'Festival daysaresometimes described as Daysof Drinking. Drunkenness is evenfoundin
Festivalsof the Dead', in Lloyd, Herodotus Book//,276.

250
 'theirdrinkis Vinealthough
Egyptians)... theyobtainit frombarleysincetheyhaveno vinesin

893
theircountry'.

Beerwas presumably
popularbecauseof the stateof sanitationin ancientEgypt,

894It wasalsoa morepopulardrinkthanwineon economic

beingsaferto drinkthanwater.

sincethe abundance
grounds, of beercontrasted
of grainandtheeaseof production to the

moreintensive
andexpensive
cultivation 895
of grapes.

of beerandwinehas alwaysprovidedfor socialdistinctions.

The consumption The

socialdiscrimination
supposed wineandbeerin Egyptis probably
between dueto reportsof

the Greekwriterswho themselvestendedto associatebeerwith poverty.

896Any distinctions

dueto thefactthatbeerwasa staplepartof thedietwhereas

aremorepossibly winewasnot.

Equally,winemakingfacilitiestendedto be privatelyownedby the kingwith little private

ownership (despitethe representations

of vineyards in privatetombscenes).
897Theoffering

listsin thefunerary
textsincludebothwineand beer. 898

8.1(i)AlcoholAbuse

with alcoholwerewidelydocumented
The abuseandthe perilsassociated in ancient

Egypt.Socialstatusseemsto haveprovidedno exceptionto alcoholicexcess.Herodotus899

tellsus thatkingAmasisof theLatePeriod(because

of drink)was'averseto engaging
in any

seriousemployment '
heroamedaboutandrobbedpeople.
...

893
Histories11:77.LloyddoesnotViewthisasa contradiction sincehemaintains
thatHerodotusis referring
to
UpperEgyptandthesouthern DeltaandmusthaveknownofthevinesintheDelta,Lloyd,Herodotus 11,334.
Darby,Food.TheGiftof Osiris,
894 533.
895
Beercouldbesimplymadeat homebysoaking graininwater.SeeDarby,Food.,TheGiftof Osiris,534-8.
896
Darbyet al.,Food:TheGiftof Osiris,529-32. Winein Egyptwasthemostexpensive drinkandsorestricted
to
the upperechelons of society.Privatewinecellarswouldindicateprestige',
Mu-Chou Poo,Wineand Wine
in theReligion
Offering ofAncientEgypt,(London,1995),28.
897M.A. Murray, 'Vificulture
andWineProduction', in P. Nicholsonand1.Shaw(eds.
), AncientEgyptianMaterials
andTechnology (Cambridge, 2000),578.
898
Darby, Food:TheGiftof Osiris,532.
899
Historiesii:174.Adthough, Amasis appearsnotto havebeenhighlyregardedbyHerodotus! Seeother
comments in Lloyd,Herodotus /1,214.

251
 of drink.
ThescribeANgivessageadviceaboutthesocialdangers

beer
'Donlindulgein drinking

lestyouutterevilspeech

if youfallandhurtyourbody

onefinds
youlyingontheground.

As if you werea lifflechild'.900

Perhapsthe mostinteresting recordsare the illustrations

and informative of alcohol

Tomb
abuse. scenes
oftenprovide of
portrayals
candid the of
effects For
alcohol. instance,
one

NewKingdom
banquet lady
sceneshowsa seated holding
guest herheadto onesidein order

drink901Equally,a wall scenefromBeniHassanshowsparty

to vomitthroughexcessive

guestsbeing through
carriedawayprostrate excess 902
drink. Plate8.1(ii).
Suchscenesare

in ancient
importantbecausetheyhavebeengivenas examplesof the socialdecadence

I thinkit is unwiseto cometo suchconclusions.

Egypt.However, in an articleon
Forexample,

Egypt
alcoholabusein ancient that
suggests
el-Guebay abuse in
began the Kingdom
Middle

androseto a in
peak theNewKingdom:

by a widegroupof peopleleadingto a rejecting

'a threatis perceived attitudetowards

abuseand as
measures
moralistic the Empire its
reaches The
apogee. LatePeriod

seesdecadence
of theEmpire
andin its drinking
structure
social is witha
acculturated

903
lifestylein allsocialstratas'.
toleranthedonistic

900Lichtheim, AncientEgyptianLiteratureVol.1,135.
901See Plate 8.1(ii). Most observersacceptthat this is due to wine excessratherthan say generalover-
indulgences, seeMu-ChouPoo,Wineand WineOffering,28 andSigerist,Historyof Medicine1, plate64.
in Darby,Food.TheGiftof Osiris,658.
902Illustrated
903N. el-Guebaly,WcoholAbusein AncientEgypt:the RecordedEvidence',International
Journalof theAddictions
16(1981),1207-1221.

252
 PLATE8.1 (ii

r1

GUESTSCARRIEDAWAY AT BANQUETS
Froma tomb sceneat Beni Hassan

SICKLADYAT BANQUET
-Museum
Froma scenein the Brussefs- of Art andHistory,E2877
(Both imaaesare takenfrom Darbyet al., Food:the Gift of Osifis. 1977)
 Anysuchconclusions 904It is likelythatrepresentations
aretotallyspeculative. of social

artisticfashion.Also,if alcoholwasbeingusedto
drinkingare madebecauseof prevailing

controlpainit is unlikelythat this use wouldbe reducedor variedbecauseof the moral

decadence histodcal
of a particular The
period. factthatthescenesof excesswerereproduced

in tombsappearsto indicatethat therewas no particularantagonism

towardsexcessive

905
drinking.Rather,it appearsto havebeenviewedas a sourceof amusement.

8.1 (iii) TheMedicinalUseof Alcohol

Alcoholin the form of wine and beer featuredprominentlyas ingredientsin the

its useonlyappearsto be as a dilutionvehicle,flavouring

Egyptianmedicaltexts.However

or
agent to aid for
dissolution theother
main ingredients.
prescription is
There that
noevidence

or for its owneffectsper se.Thesynergistic

it wasusedsynergistically effectof alcoholwith

906Incontrast
featurein paincontrol.
otherdrugsis animportant alcoholin theformof winewas

usedby the for

Greeks medicinal
use per 907.
Se. It was also mixedwith otherdrugsto

andto enhance
accelerate by the Greeksas a diuretic
theireffects.Alcoholwasrecognised

andso believed
to be in bilious
effective removing 908
humour.

904Thisis beingdiplomatic sincethe lackof evidence strainshis conclusions.

Theexampleis onlygivento
illustrate
themisunderstanding of thesocialusesof alcohol.
Hirschonlyseestheriseof alcohol anditsassociated
problems beginningwiththeabilityto concentratealcohol.Whilsthe is discussing
gin andspiritsin eighteenth
centuryEngland, I makethe pointsincedistillation andspiritswerenotavailable in ancientEgypt,J. Hirsch,
'Adcoholism',JournaloftheHistory of Medicine
4 (1949),236.
905 Mu-Chou Pooquotes, thatin somereligious
festivalsdrunkenness 'brokethebarrierbetween lifeanddeath'so
thatcelebrations 'in the tombcouldbringtogetherrelativeswiththeirdeceased kinsfolk',in Wineand Wine
Offering, 37.
906Theadditionof (pure)alcoholto narcoticsin the treatmentof terminalpainis one of the only'official'usesof
alcoholfor pain relief in modernmedicine:BromptonCocktailfrom The BromptonHospital,Londonrecipein
Martindale25ThEd.,785.
907SeeH.vonStaden, Herophilus
- The Artof Medicine
in Early
Alexandria,
(Cambridge, 1989),
1-20.It wasalso
recommended (somewhat as an antidoteto hemlockby Nikandios
optimistically) in Alexipharrnaka186-206,
fromG.L. Irby-Massie
translation andP.T. Keyser, GreekSources Era(London,
oftheHellenistic 2002),305.
w8Reported in Darby,Food:TheGiftof Osiris,577.

254
 Wine was expensive909
and this seems to be reflected by the fact that some

only
prescriptions specify'dregs'
of wine, as for in
instance Ebers82. Interestingly,
this

with
contrasts the Papyrus
Berlin which dregs,
specifies
never rather
wine 910
itself.
q r--* 6

Bothwinejrp 11,1, andbeerjmý-tJA

.1 appear
veryfrequently all
across the medical

But,
papyri. theyare used
merely as prescription in
vehicles the samewaythatpurifiedwater

or syrup be
might usedtodayin medicines 911
today.

that use beeras a

In the HearstPapyrusthereare some27 (10.5%)prescriptions

wine
vehicle, in
appears 12 (4.7%)
and water912and milk in 24 (9.4%)and 11(4.3%)

But,
respectively. in noneof theseis the alcoholcontentsufficientor significant
enoughto

the
exploit effectsof alcoholas a hypnotic 913
andpainkiller. However,
it is that
possible large

quantities
of a remedy
weretaken may
which have 'mollification'
produced of thecondition.

H26is aninternalpreparation
Forexample, to 'breakuppainsin thebody'.It
intended

ofjuniperandyeastin beer.
consists
dissolved
H27is to'expelpnewofthelegs'.It is aninternalmixture inwater.

to 'deadenpainsin anylimb'- headingfromH42.Its

H44is 'another(prescription)'

in beer.This'run'showsthatbeeris merelybeingusedto
dilldissolved
formulais essentially

dissolve
theotherprimary In H44theratioof ingredients
ingredients. to diluentis asfollows:

dill1/32r, date118r,"h (?) 1/8randwine5r(wherer=c.14ml)

909Mu-ChouPoo,Wineand WineOffering,35.
Thisis because,'thepatronwhocommissioned
910' the Berlinwaswealthierthanthesponsorof the Ebers',quoted
by Darbyin, Food: The Gift of Osiris,577. However,manyof the other prescriptioningredientswere more
expensiveor moredifficultto obtain.Mu-ChouPoostatesthatwinedoesnotappearat all in the HearstPapyrus.
Heis wrong,it appearsin H44.
911Mu-ChouPooreportsthat theywereinter-changeable. Theymighthavebeenbut this is not specifiedin the
texts.Mu-ChouPoo,WineandWineOffering,30.
912Sinceit presumedthat beerwassaferthanwaterits inclusionis somewhatstrange.It mayhavebeenboiled
priorto use(notstated)or takenfroma considered
'safe'source.
913Alcoholcontentin winewaslowerthantoday.PureAlcoholis obtainedby theprocessof distillationwhichwas
almostcertainlyunknownin Egypt.LucasandHarris,AncientEgyptianMaterialandIndustries,24.

255
 Thus,thetotalwinecontentis onlyabout60ml.In viewof thefactthatEgyptian
wine
be weakerthantoday'scontrolled
wouldprobably wine(12%alcohol)andbeerevenweaker

verylittlealcoholic
effectwouldbeafforded
bytheseprescriptions.

Eb291andEb287areprescriptions
intended
to 'stimulate
theappetite' from
-heading
Eb286.Eb291containsfattymeat,raisins,figs,celerybeerandsweetbeer.Eb287contains

winewithwheatgruel.Theinclusion
of wineandbeermaybe 'activeingredients'.
Thealcohol

maywellactto stimulate
appetite.

8.1 (iv) Dioscoddes

andAlcohol

Whenstalewineis leftin contactwithairthealcoholcontentis reduced

to aceticacid

Thisis a process
whichturnsthewineintovinegar. thattheancientEgyptians
musthavebeen

fullyawareof. It is, therefore,

interesting
to notethattheEgyptians
appearto havecompletely

texts.Thisis particularly
ignoredvinegarin theirmedical interestingly
sinceit featuresin Greek

andRomanmedicine.

TheEgyptian ingredients.
utiliseda vastandeclecticarrayof potential
physician The

processis a frequenttombsubject.
of thevineandthewine-making
cultivation 914Yet,despite

featurein themedical
thisonlywineandnoothervineproducts texts.

Thiscontrasts devoteda complete

withDioscorides book(BookV) to coverall aspects

of thevine,wineandvinegars(some83 entriesin all).Forexamplein BookV: 1 vineleaves

intalforheadache
arerecommended andinflammation
andburning
of thestomach.

Dioscorides in addition
recommends to winethevine,grapes,raisins,fruit,oldwine,and

Wine
vinegars. wasgenerally
considered kidney,stomach,
goodfor bladder, ulcersetc.(Book

V:2).

Thetombof Nakhtat Thebeshasmanysuchillustrations.

914 See,A. G. ShedidandM. Seidel,TheTombof
1996),Figs.43-45,56.
Nakht,(Mainz,

256
 He reportsthat vinegaris goodfor the 'stomach,for bleedingwounds(keepsfrom

for itchingandcough'.In fact,vinegaris an expectorant

inflammation), andhasbeenusedin

for this purpose.When,appliedto the skinit is bactericidal

homeremedies to manymicro-

to
andactsasa coolingagentwhenapplied
organisms theskinin 915
fever.

8.1 (v) TheUseof AlcoholOutsidethe MedicalTexts

In viewof the availability in Egypt

of alcohol ancient andthat shows
evidence that it

be to one
could used excess, it
assume
might wasalsoused 'medicine'
outside to copewith

However,
painfulmedicalconditions. thiscanonlybe an assumption
sincewe haveno actual

the
outside
evidence texts
medical Certainly,
themselves. onecanonly as
guess to theextent

for
of alcohol this but
use; in all its
likelihood usewould
expected be its
Although
high. usesin

textsshowsnoregardforitshypnotic
themedical 916
properties.
andanalgesic

mightbe made
In termsof theuseof alcoholoutsideofficialmedicaltextscomparison

withlaterhistorical for is
models whichactualevidence Nineteenth
available. England
century

providessucha modelwheredrinkwaswidely within

available domestic
crowded situations

diseases
andwherechronicpainful wererife. In this situationalcoholwascertainlyusedas

painkiller.

Inthissituation, was
alcohol a 'if
painkiller, onlybecause
thepoortended
to regardpain

of
notas a symptom but
disease ratheras the itself.
disease Equally,
'917 whilst,alcoholwas

beingusedto assuage
chronicpainin the domestic
situation
no evidence
canbe foundin the

texts.
medical
official

915Martindale 25thEd.,4.
9161wouldsuggestthatthe exclusionof alcoholfrommedicalpharmacopoeias in moderntimesis partlybecause
of the socialimplications of alcohol.SeeF. Cartwrightand M. Biddiss,DiseaseandHistory,127-30whodiscuss
alcohol and legislation.I do not offer the same suggestionfor ancient Egypt but would suggestthat paid
physicians would not recommend something thatwas being
already usedin socialanddomestic situations.
917Harrison,Drinkandthe Victorians, 41.

257
 domestic
Similarly, crowding
appeared 918However,
to haveexistedin ancientEgypt. I

sincein nineteenth
do not wishto implyanythingotherthana slightcomparison century

Englandmuchof the alcoholabusewas a resultof socialpressuresbroughtaboutby

919
industrialisation.

life:it
But,alcoholin theformof beerandwinewasanintegralpartof ancientEgyptian

the infrastructure
partof agricultural
wasa partof nutrition, andpartof religious 920
ceremonies.

Whistthe excessconsumption
of alcoholmayhavebeenfrowned
uponif it interfered
with

'normal'life it seemsprobablythat socialover-indulgence

wasmerelyregardedwithsome

humour.Sinceits use was so integralto society,it must have featuredlargelyoutsidethe

framework
officialmedical to pain
control andto make
chronic
painmore 921
tolerable.

8.2 SurfaceAnalqesics

Theapplication directly
remedies
of prescription to the skinby direct by
application,

rubbingor by local with

application the aid of a bandage
werecommonmethodsof ancient

'drugdelivery'.
Egyptian

arefor externalpreparations
In theEbersPapyrussome60%of all theprescriptions

to
compared those intended
medicines for internal
use.In the Hearst
Papyrus
this figureis

evenhigheratover70%.

Sincemanypreparations
werefor topical
use it is temptingto thinkthatsomemay

havebeenan attemptto controltopicalpainby producing at the pointof

surfaceanalgesia

918The physicaleffectsof crowdedand crampedliving conditionswhich are reflectedin humanremainsis

discussedby M. Zimmerman in 'A Paleopathological
andArchaeologicalInvestigationof the HumanRemainsof
DraAbuel-Nagasite,Egypt,PhDThesis(University 1976),136-7.
of Pennsylvania,
919Between1830to 1880the gross consumptionof spiritsin Englandand Walesincreasedby over 140%.
Harrison,Drinkandthe Victorians, 67.Thiscannotreflecta corresponding
increasein painor paincontrol
920It appearsto havefeaturedin personalnames,implyingthatdrunkenness wasnotan unworthysentiment.Mu-
Chougivesexampleswhichrangefrom Old to New Kingdoms:0, iby, tbyt, ibic, sn-tb, 'The Drunkard'and
'Daughterof the Drunkard'respectively,Mu-ChouPoo,Wineand WineOffering,36.
921The use of alcohol,prior to surgery,has long featured,anecdotallybut never formedan entry in any
pharmacopoeia. J. Kirkup,'Surgerybefore generalanaesthesia',in R. D. Mann (ed.), The Historyof the
Management of Pain,(Camforth,1988),16.

258
pain.Forexample, usefulfor commonly
thesewouldbe particularly arthritictype
encountered

conditions.
herein itswidermeaning
I usethetermsurfaceanalgesia sincetruesurfaceanalgesia

is blockageof the sensoryreceptorsin the skin by the effectson the peripheral

nervous

922In realitythiscanonlybe achievedby the modernlocalanaesthetic

system. categoryof
923
drugsthatmimictheeffectsof cocaine.

intended
In thoseprescriptions in previous
to treatpainwhichhavebeenconsidered

to exhibitany realbenefitat eithertopicalor systemiclevel.

chaptersnonehaveappeared

wereformulated
Manyof theexternalpreparations in fattybasesandso wouldhaveoffered

effector actedas a suitablebaseto aid massage.

someemollient Thismayhaveproduced

sometemporary from
relief the effects
of itself.
massage However,
it be
should remembered

ignoresandrenders
thisanalysis of anyactiveingredients.
theaddition
superfluous

By surfaceanalgesiain the contextof EgyptianmedicineI meanit to be those

which
compounds are to
applied the skinto pain
relieve but work different
through methods

thanthoseof themodernlocalanaesthetic Forexample,

compounds. of 'heat
theapplication

directly
substances
producing' to the skineitheras a poultice
or by bandage
haslongbeen

Themethodof actionis complexin

usedto assuagepainin chronicarthritictypeconditions.

thatlocalpaincanbe temporarily of a 'counterirritant'substance

reducedby the application

area
overa wider thanthat This
affected. works
essentially by dilating
localbloodvesselsto

thebloodsupplycanbeimproved
of heat.Equally,
a sensation
produce in an affectedlimbby

relieffrompain.On a 'psychological'
this methodandso producesometemporary levelit

to
serves
probably distract from
attention thepainandaffordssomedegreeof relaxation.

922Thesensoryreceptors(nerves)in the dermis(lowerskinlayer)are chemically

blockedand the skinis
H.R.RangandM.M.Dale,PhaiTnacology
desensitised. 2nded.,(1991,London),
751-4.
Thefirstrecorded
923 medical
useofcocaine wasin 1884.RangandDale,Pharmacology, 751.

259
 counterirritantis mustard.Whitemustardsinapisis nativeto western
Oneexcellent

Asiaandwasavailable 924Mustardis usedas a flavouring

in ancientEgypt. agentandas a

and
medicine hasbeenwidely
usedovertimeasa irritant
counter to pain
achieve Its
relief. use

withvinegar
irritant
asa counter by
wasrecommended 925It
Hippocrates. wasalsomentioned
(11:
by Dioscorides its medicinal
142)whodescribed properties
andgaveits Egyptian
nameas

Herbals.
in theAssyrian
It is alsomentioned
'euthmoe'. 926

In modemtimes,it hasbeenusedwidelybothin homenostrums

andofficiallyas an

irritant,
emetic,a counter bath
a poulticeandas a mustard andliniment.
927Despite
thisit does

in
notappear the Egyptian
medical This
texts. is surprising
in viewof its in
presence ancient

in twoways.Firstly,it maynot havebeen

thisabsencemightbe explained
Egypt.However,

used;this is if
possible its were
properties not or
recognised if someperceivedaetiology

dictated of 'likewithlike'.928
againsttheapplication Thiswouldaccordwiththepractice
o using

faecesbecause its
of noxiousandso repellentnature. its
Secondly, maynot
properties have

thatit wasusedin home

butthisseemsmostunlikely.It is moreprobable
beenrecognised,

and
nostrums sodidnot in
appear the'official'
records.

924It appears to havebeencultivated fromtheearliest timessinceseedshavebeenfoundfromprehistoric siteson

theNubian border,seeBrewer, Domestic PlantsandAnimals, 6. TherearetwoEgyptian words(blackandwhite
mustard? ) thathave been applied to mustard: sn (n)w-pt and bftm (var. bltm, b1th),neither appear in the
medical texts,Charpentier,Receuil de mat6daux 6pigraphiques relatifsA la botanique de ltgypte antique, 855,
966andAufr6re, BIFAO 87,42.
925Hippocrates, OnRegimen in AcuteDisease, in FetramandAvila,Complementary andAlternative Medicines,
446.It is alsoreported bythemashavinganti-microbial activity.
926Manniche, AncientEgyptianHerbal,148.
927It featuresin theBritishPharmaceutical Codex1934in severalexternalpreparations: ointments,liniments,
plasters andbaths.Theointment is listedtotreatpleurisy,pneumonia anddeep-seated pain.
928 Theuseof counterirritants camefromtheobservation thattheywere'hot wheneaten.Equallyit wasfound
thattheapplication of heatwasbeneficial to 'bone'typepain.Thesesubstances werethenusedto mimicthe
effectsof heatandwarmth. H.King,'Theearlyanodynes: pain in theancient world',in Mann (ed.
), TheHistory of
theManagement of Pain,56-7.

260
 andtheTombof Ankhmahor
8.2(i) SuffaceAnalgesia

Malecircumcision
was in
practised Egypt.
ancient However,
theextentof thispractice

andmoreimportantly
the for are
reasons circumcision not at all clear.In many it
societies

from beliefs
stems religious the has
and practice become
anintegral
part
of religious 929
history.

Inmanymodern it integral
societiesstillremains
primitive to theprocess
of male 930
initiation.

Theprocess
of circumcision in theEgyptmedical
is notmentioned textsandwhilstthe

or ritualisticprocessthisis by no meanscertain.
is to considerit as a 'cleansing'
temptation

tellsus thatthe Egyptians

Herodotus fromwhomthe
werethe firstto practicecircumcision,

Hebrews the custom.Whilstthisimpliesthe widespread

acquired in
practiceof circumcision

ancientEgyptthe evidencefrommummiesand othersourcesby no meansprovidesany

931
pattem.
consistent

Therearetwoscenesdepicting in Egypt
circumcisionancient whichareknown:
oneis

in theuppersection)
(albeitdamaged Thissceneshowsa kneeling
in Templeof Mutat Karnak.

) standingfigurewhilstholdinga 'circumcision'
'operator'holdingthe penisof a (young?
932
whichis shapedin theformof a
instrument bevelled
rod.

929In theJewishreligionit symbolisesthecovenantmadebetweenGodandAbraham.

9301wouldsuggestthat the real reasonsfor circumcision are still obscureand complex.In a detailedstudyof
moderntribesthoseinterviewed did not knowwhy it was donein respectof initiation,merelythat it had always
beenso, see M. Bloch,FromBlessingto Violence.Historyand Ideologyof Circumcision (Cambridge,1986),48-
50. In anotherstudy,of femalecircumcisionthe reasonsfoundwerenestedin a 'complexof beliefsaboutidentity,
religion,moralbehaviourand the workingof the femalebody, K. P. Ericksen,'FemaleCircumcisionamong
EgyptianWomen,Women's Health4, (1995),309-28.
Eventhe practicein twentiethcenturyEngland,ostensiblyfor medicalreasons,hasshownextremefluctuationdue
to changein thefashionof medicalviews.
931HerodutusHistoriesii:104.See,alsocommentsin Lloyd,HerodotusCommentary Book11,224.ElliotSmith
reportedthatall the malesfoundexcavatedin the HearstExpedition of 1908werecircumcised (in Nunn,Ancient
EgyptianMedicine,162).Yet,othermummiesexaminedshownoconsistency.
The VictoryStelaof Pi containsan obliquereferenceto circumcision: it statesthat threeof the four 'kings'of
Egypt,in surrender,werenotallowedto enterthe palacesincetheywere'uncircumcised andeatersof fish',from
Lichtheim,AncientEgyptianLiteratureVol. 1//,80. Thereis perhapssomeelementof racialdiscrimination or
denigration here.
in Ghaliounghui,
932Illustrated MagicandMedicalScience,97

261
 Thesecondis in Room1 (eastside,northdoorway)
of thewellpreserved
mastaba
of

the 6th DynastyvizierAnkhmahor

at Saqqara(see,Plate8.2 (ii)).Thisreliefconsistsof two

sceneswhichappearto represent
adjacent twostagesof a circumcision
'ceremony'.
Theright

uponby a seatedfigurewitha knife.

handsideshowsa nakedstandingmanbeing'operated'

Thelefthandsceneis thescenepriorto theoperation,

it showsthefigurebeingrestrained
bya

thirdmanwhois shownholdingthe'patient's'
wristsin anupwardfashion.

262
 PLATE8.2(ii)

1. ""'"

TOMBOFANKMAHOR
at Saggara- Circumcision
Scene
(TakenfromNunn,AncientEgypfianMedicine,
1996)
 in theupperregisters
Thehieroglyphs read:

/ shallactforyourpraise.

Holdhimfastlsecure!

Donotlethimfall!

Rub(it)well

(/)willmakeit sweet1comfortable.

Thelowerregisterreadssbtbm-Kc'theHemKapriestis circumcising'
(?).933
Thiswill

laterinthetext.
beconsidered

The other scenesin Room1 are also of a medicalnature.

934The sceneabovethe

circumcision
showsa patientreceiving to hisleg.It is difficultto makeoutthe
medicalattention

natureof the It
treatment. hasbeeninterpreted between
variously actual incision
surgical and

bymassage.
treatment

Anotherscenein RoomI (westsideof northdoor)showstwosittingpatientsreceiving

individual oneto a thumbandthe otherto a toe.Rooms2 and3 showthe more

treatment:

traditional
expected, femaledancersanda procession
scenesof agriculture, of dignitaries
and

935
moumers.
Theuniquescenesin Room1 haveled this mastaba
to be calledthe 'Tombof the

936
Physician'. But,Ankhmahor underTetiandthereis noevidence
actedasvizierandoverseer

thathe waseithera physician

norevenheldanyhonorarymedicaltitles.937It is, therefore,

difficultto explainthe presence

of thesescenes,if he werenot exhibitinghis ownmedical

or actuallypartof them.It is alsodifficultto imagine

prowess thatthesceneactuallyshowsthe

ofAnkhmahor
circumcision himself.

933
Ghaliounghuihasthisas'circumcising Science,
priest,MagicandMedical 95.
J. P.Lauer,Saqqara.
934 TheRoyalCemetery ofMemphis 1976).
(London,
935above
TheSixthDynasty
936 tombof Khentikaat Saqqarashowsa manicure perhaps
andpedicure, in respect
grooming
Shown,
ofsomeinitiation. in Nunn,Ancient
EgyptianMedicine,
133.
937
Ghaliounghui inMagicandMedicalScience,98.

264
 that this mightbe explainedif the sceneis takento
has suggested
Ghaliounghui

a
represent tokenof This
justification. be
might the caseif he hadbeena foreigner
or bornof

938However,
lowlybirth. thisdoesnotexplainthepresence the scenes.
of othermedical if
Also,

that
wasa ritual
circumcision it
Egyptianisation
bestowed is oddthatwe have
should onlyone

939
example.
recorded
in a differentway. It has been
Morerecentlythe scenehas beenre-appraised

that
assumed
generally the was
operator an bm-K.; The
priest. different has
interpretation the

between
rolesreversed and
patient priest
suchthat the is
operator actinguponthe Pm-Ki

prieSt. 940 This theinitiation

of thetombscenein thatit couldrepresent
thepresence of
explains

oneof Ankhmahor's
sonsintothe In
priesthood. the lower the
register verb (to
sb circumcise)

to
appears haveanextralt (sbt).
'941 If sbtis takenaseitheraninfinitive the form
or as passive

the
of verb(sý&.tw.f) thenbm-Ki becomes
the to
object, 'circumcising
mean: - thebm-K?

the
priestor circumcising I=-KI priest.I aminclined
to agree
withthis analysis.
grammatical

However, thatthescenerepresents
Rothgoesfurther,sinceshesuggests nota circumcision

942Theimplement
withan initiationintothe priesthood.
but rathera ritualshavingassociated
fa 943
knil..
shownbeinga razornota

I do not agreesinceit missesthe pointof the scenes.I thinkanotherinterpretation

be
might There
offered. are clearlytwo to
aspects the reliefand I thinktheseneedfurther

944Theleftsceneshowsthe patientbeingrestrained
consideration. yetthe rightsceneshows

938Thisis suggested byGhaliounghui, MagicandMedical Science, 98.

939It is clearlya ceremony associated withcircumcision sinceanothersceneshowsa procession of priests
bringing clothin boxessupported oncarrying poles.(sýApt) nwb t (r?
) 19brs ebtr tp.
mr in bm-10,'(bri
ng)n*t
clothto thefestivalfor thecircumcising of the tp.mr by thek?priest,A. M. Roth,Egyptian Phylesin the Old
Kngdorn (Chicago, 1991),66andfig.41.1,63.
940A. M.Rothin Egyptian Phyles in TheOldi(ingdom, (Chicago, 1991).
941Thisseemsanunlikely addition in anOldKingdom text.
942Shetranslates sin wwt as 'ruboff excellently' so implyingthe rubbingoff of shavedhair.Roth,Ancient
Egyptian Phyles, 66.
943Theshaving of pubichairappears intwootherOldKingdom tombscenes. Reported byNunn,Ancient Egyptian
Medicine, 171.
94Theyaredifficultto explain if it is simplya ritualshaving. It alsoexcludes anyjointsignificance
withthescenes
intherestof Room1.

265
himrelaxeddespitetheoperator a
performing It
circumcision. is difficult
to explainthepurpose

restraint
of physical sincethehandof the
in a shavingritual.It alsoappearsto a circumcision

is
operator behind
thepenisandthe is
instrument clearly in
shown theareaof a markedglans

945
peniS. In theleft the
scene to
appears
operator be applying to
something or the
around penis

for the actualincision.Only this interpretation

in preparation wouldmakesenseof the

'rub
expression well, (1)will makeit Either
comfortable'. this is someformof ritualapplication,

or aslikelysomeattemptat suffaceanalgesia
cleansing priorto thecircumcision.

EI-Ansary thatthe itemheldby the operatorin the leftsceneis a pieceof

suggests

If mixedwithvinegar946it wouldresultin thereleaseof carbon

stone'or limestone.
'Memphis

overthatareato becut..theequivalent
gaswhichwouldthen:'resultin anaesthesia
monoxide

'947
ofmodemctyoanalgesia.
by reducing
Carbondioxidegascanproducesurfaceanalgesia of the
thetemperature

in suchcircumstances
skinbut,it seemsdoubtfulthatsufficientgas couldbe produced to

Whilstthe analgesic
produceeffectiveanalgesia. stonecannotbe taken
effectsof Memphis

948I stillthinkthatthesescenes
seriouSly, at sufface
showanattempt priorto the
analgesia

of
operation Either
circumcision. the device was
shown usedto applythe or
pre-medication it

in orderto allayapprehension.
actedas partof theprocess Thiswouldplacatethepatientand

duringtheprocedure.
soaidtheoperator

945Morerecently another explanation hasbeenspeculated. It hasbeensuggested to representthetreatment of a

caseofparaphimosis, a conditioninvolving a swollenandinfected foreskin,
liableto become gangrenous, andso
potentiallyfatal.If so'recording nota simpleprocedure butrathera lifesavingoperation. N.Kanawati, TheTomb
andSeyond. ýBurialCustoms of Egyptian Officials
(Warminster, 2001),101.
946Butvinegar seemsnotto havebeenusedin (medically) in ancientEgypt.Seetheearliercomments onalcohol.
947M. M. el-Ansary, 'TheHistoryof PainReliefin AncientEgypt,MiddleEastJournalof Anaesthesiology 10
(1989),99-105.Theeffectsof theMemphis stoneis recorded by Dioscoddes (V:158)whorecommends it to be
crushed on 'theplacesthatshallbe cutor bumfproducing 'senselessness withoutdanger.Butit is Plinywho
specifies theaddition of vinegarforthesamepurpose (XXXVI: 11,2).
948Theanalgesic anddestructive effectsareonlyachieved topicallybyveryhighconcentrations or theuseof 'dry
ice'i.e. frozencarbondioxide,Martindale 25thEd.,877.It is usedas subcutaneous insufflations
as an adjunct
therapyin backpain,T. Brockow et al.,'Analgesic
effectiveness of subcutaneous carbondioxideas an adjunct
treatment in neckorlowbackpain',Complementary Therapeutic 9,(2001),
Medicine 68-76.

266
 surfaceanalgesiait would
I suggestthat if this sceneis intendedto demonstrate

the the but

of scene
explain significance moreimportantly
the for
reason its inclusion the
within

tomb.Thecircumcision the in
shown
scenes
sceneand other RoomI aresurgicalnotmedical.

They are particularlyconcernedwith pain and the circumcisiondemonstratesthe abilityto

controlpain. In this senseRoom1 becomes

a demonstration,
not of
necessarily the medical

prowessconnectedwith Ankhmahorbut of his symbolicpowerto assuageandcontrolone of

thegreatest'forces 949
of nature':pain.

9491thinkthisis possible.However, theconceptappearsnotto havebeenan overtonesincethisexample

appears to be unique.Although,Roththinksthata similarsceneis theonemissingfromtheadjacent tombof
&I-1a. Roth,Egyptian Phylesin theOldKingdom, 69.Capartarguesthatthereareillusions in
to circumcision
severalothertombs.Suchscenesshowyoung(pre-pubescent) boysplaying'games.' These,he suggestare
$some sortof ritualdramatisation,
connected 'Notesurunfragment
J. Capart,
withcircumcision', de bas-relief
au
BritishMuseum', BIFAO(1931),14-15.

267
 CHAPTER9: PRESCRIPTION
ANALYSIS
9.1Introduction

Inthepreparation
of this I
section have all
extracted thoseprescriptions were
which discussed

the in
compounds
medicinal
under respective the previous Their
chapters. have
details been

collatedandthese in
arerepresented form
tabular (Tables
1-9).
This illustrates
collation certain

trendswithintheprescriptions:
common
formulascontainmultipleingredients,
(i) mostof the prescription

(ii)manyformulations to
appear beof doubtful benefit,
therapeutic

(iii)therearebothglaringomissions fromthemedicaltextsanda
of somesubstances

failureto utiliseobviouspharmacological
properties
of othersubstances.

takenfromthechapters
Asstatedabove,thoseprescriptions compounds
on medicinal

that
clearlyshow allof theformulations
consistof several ingredients.
active
pharmacologically

sinceit appliesto ancientEgyptian

This fact is not solelyclaimedfor theseformulations

in general.
medicine

of multipleingredients
I will referto this phenomenon as 'ingredient
polypharmacy.

Theterm'polypharmacy' definition
some
needs further
before discussion.

are usedto treatone

It is generallya situationwherebyseveraldifferentmedicines

950
approach.
medicalcondition;a multi4reatment The concept
can be to
extended include

formulations
prescription so that the term'ingredient is
polypharmacy' the
essentially same

but
approach one the
where actual formulation
prescription contains
morethanoneprimaryor

ingredient.
active These
arenotanexactseparation. Egyptian
Whilst be
might
medicine based

uponEgyptian it
polypharmacy,alsodoes the
not preclude useof different for
remedies a

singlestatedcondition.

950This mightbe, for example,the useof two antibiotics,ineffectivealone,but ableto treatresistantinfectionin

combination.However,with patent medicinesthe differencesare often subtle differencesin formulationto
otherwiseidenticalactiveingredients,
for marketingstrategy.

268
 to activeingredients
In addition formulations
prescdption ingredients
contain whichare

That is thoseinert ingredients

presentas excipients. whichare presentnot to produce

but
effect
pharmacological to aidthe preparation
actual of the For
remedy. theyare
example,

usedto dissolution,
facilitate as flavouring
agents
or to aid of
application the overallproduct

951Primaryingredients
(e.g. the use of fatty productsto producean ointmentbase). are

the
essentially active in
ingredients a formulation
prescription i.e. those ingredients
which

producethe desired effect

pharmacological of the The
prescription. definitionneeds

since
qualification, in the Egyptian
ancient I
context havetakenit as even
applicable if the

compound or intended
doesnothavethateffectbutis believed forthateffect.

Whilsttheoverallnatureof Egyptian
medicine as beingsomewhat
mightbedescribed

then
randomor eclectic at least
theconcept
of ingredient
polypharmacy some
provides degree

In
of consistency. this I
respect believe
it to be of fundamental
importance
to Egyptian
ancient

medicine
andonethathasnot been
previously considered.

It is important
sinceit has implications
several whichare notonlyfundamental
to the

interpretation
of the actualprescriptions but
themselves, in
might partexplainsomeof the

and
anomalies
apparentpharmacological It
absences. mayalso be
actually of
reflective the

of disease.
aetiology
perceived

makesidentification
In ancientEgyptianmedicine,ingredientpolypharmacy of the

intended
activeingredient sincewithoutthisknowledge
difficult.Thisis a seriousproblem it is

impossible withits actualefficacy.Thisis particularly

to matchthe intentionof prescription

difficultwithformulations
thatcontainseveraldifferent activeingredients.
pharmacologically

Theotherproblem withEgyptian
associated is oneof druginteractions.
polypharmacy

Thisis thepossibility
thatdifferentsubstances canreacttogetherto produce
in a preparation

TheScienceof DosageForms,162.
Aulton,Pharmaceuticals;
951

269
effectsdifferent
to their intended 952
singleeffect. More is
problematic that the interactive

compounds
are difficultto prediCt. 953 Any
effects
pharmacological of several
combined

predictionsare complicated
since some Egyptian plant
medicinal in
substances, these

are
combinations, still 954
unidentified.

In modemmedicine is
polypharmacy usedto exploit interactive
synergistic i.
effects e.

thecumulative
effectsof ingredients
to a
produce more than
substance
effective is by
produced

a single In
ingredient. this each
case,essentially ingredient
is a selective for
compound
active

to be treated.However,
thatmedicalcondition seemsto
in practiceEgyptianpolypharmacy

divergefromthisprinciple
sincemanyof the ingredients
seemto be of an If
nature.
unrelated

thisis indeedthe casethenit impliesthatthe selectionof ingredients

is purelyrandomand

basis.
without any pharmacological It also implies a spuriousknowledge
of their

pharmacological
properties.

existedas a fundamental
However,the very fact that Egyptianpolypharmacy

feature
prescription that
maysuggest somerationalewas intended.
But the is
importance

oriented.It maybe that the use of several

whetherany rationalewas pharmacologically

in was
compoundspreparations thought
to be more by
beneficial increasing
theeffectsof each

individualcompound- synergism.Such a systemwouldnot necessarily

requireactual

knowledge
pharmacological of thosesubstances rather
used, a belief
in a logicthat'moreis

of Egyptian
955Anotherexplanation
better'. mightbe as a resultof an extension
polypharmacy

of by
treatment magicor an association
with'medical By
mystique'. thisI meanthattheuseof

952Depending onthesubstances theeffectcouldbetheenhancement of a singlepharmacological effector even

negation.
953Thisstillremainsa majorproblem todayevenwhenthepharmacological effectsof individualsubstances are
known.C. M Hohlet al., 'Polypharmacy, adversedrugrelatedeventsandpotential adversedrugreactions in
elderlypatents',AnnalsofEmergency Medicine38(2001), 666-71.
954See,for example, in Nunnwhereout of 27 Egyptian drugsusedas aperients of 6 are
the identifications
uncertainandanother 6 unknown, AncientEgyptian Medicine,159.
955Thisviewhasoftenbeenfashionable in thehistoryof medical
treatments.Bickeldiscusses in somedetailthe
problems associatedwithdevelopment of modernpharmacology andconcludes, 'amongst otherthings,thatan
increasein thenumber ofdrugsis oftenmistakenforanincrease in knowledge. M.H.Bickel,'TheDevelopment of
Experimental Pharmacology 1790-1850', Gesnerus Supplement 46(2000), 7-158.

270
 956 it is
severalcompounds andmightwelljustifythe
wouldaddto the fitualof treatment CoSt.

that
evenpossible this'medical some
produced
mystique' by
results
positive a placebo It
effect.

maybe thatthiseffect
wasinitially discovered
accidentally through
the useof polypharmacy

andthen developed.
further

As importantly Egyptian
perhaps, would
polypharmacy be different
to homenostrums

957This wouldprovidean explanation

whichwouldprobablybe singleitem remedies. of

if it is to
polypharmacy useswererestricted the 'official'
medical This
system. aspect
will be

discussedin morelengthlater.

9.2,Collation
of Matedal

morefullyI have
In an attemptto considertheseaspectsof Egyptianpolypharmacy

the
collated from
information the in
prescriptions thechapters
onmedicinal andput
compounds

it intotabulated
form.Inorderto evaluate
anypatternor consistency I have
in theprescriptions

the of
position
shown numerical the indexingredient
withinthe otheringredients.
I havealso

beingeitherforintemalor forextemalusein orderto consider

listedprescriptions anypossible

between
relationship this the ingredients.
and numberof prescription

thattheimportance
As a startingpointI haveassumed of theactiveingredients
would

958The
in thepresc(iptions.
bytheirorderof appearance
bereflected information for
is tabulated

eachmedicinal forwhichprescriptions
compound in thetablesbelow.
existandis reproduced

thenfollowsthetables.
A discussion

956Thissupposes thatthepreparationof medicines wasperformed in frontof thepatient;otherwisethisaspect

wouldbelost.
9571 thinkit not unreasonable to presumethat homenostrums wouldprimarilybe singleactiveingredient
preparations.Thisis because andactualdemonstrable
of cost,no needfor ritualassociation valuebyempirical
experience. It is a common formulafollowedby manyof the herbals,manyof whichdeveloped fromhome
nostrums, seevan Ardsall,Medieval HerbalRemedies, 119-230. 'EarlyGreektextsshowthat woundsand
ailmentsweretreatedwithsimples(notcompounds)', Irby-MassieandKeyser,GreekScience of theHellenistic
Era,290.
9581acceptthatthisis an assumption butstillremainsa fairlyprobable one.It is the'necessary'
formatfor all
ancientandmodem pharmaoopoeiasandindeedcookery recipes.

271
 TABLES9.3

ENTRIES
PRESCRIPTION INTHEMEDICAL COMPOUNDS
TEXTSFORTHEMEDICINAL

TOTHETABLES:
NOTES

" PRESCRIPTION.This is the number

prescription in whichtheindexingredient These
appears. are in
listed the
sameorderinwhichtheyarediscussed 5-7,although
inchapters theactualingredients
arenot.
" TREATMENT. Thisis a brief
summaryof themedical condition the
which it
states
prescription is to A
treat.
discussion
detailed isgivenin withintherespective
oftheactualcondition chapters.
" NUMBER OFINGREDIENTS. Thisis thetotalnumberof ingredients Whereitems
aslistedin theprescription.
suchaswater,beeretc.aregivenwithout theyarepresumed
quantification to beprescription
vehicles
andso
Theysameappliesto fats etc. in externalpreparations
are excluded. to be
whichare alsoconsidered
prescription
vehicles.
" POSITION OF ACTIVE This
INGREDIENT. is thenumerical in
order the
which mainindex
ingredient
appears
in thelistofprescription
items.
" INTERNAL / EXTERNAL. All that
prescriptions areto be by
taken mouth
areclassified
asinternal
preparation.
Allothermethods asexternal.
of useareclassified
" VALIDITY. This the of
rates suitability index ingredient
for thestatedintendedmedical
condition.The is
rating
scaled1-5where1 is takenasunsuitable and5 mostsuitable.It doesnot(norcould)takeintoaccountany
interaction It is nothingotherthana directcomparison
withothersubstances. between indexeditemand
medical Also,it is purelya subjective
condition. anyratingfordemonic
rating.I haveignored for
possession
obvious
reasons.

272
 TABLE9.3 (1)

PRESCRIPTION
ENTRIES
INTHEMEDICAL
TEXTS:
POPPY

PrescHption Treatment Number of Position of Internal/ Validity

lnqredients active External
lnqredient

Eb782 sedative(child) 2 1 1

Eb440 bnsitof thehead 6 3 E 1

Eb445 Imsitof thehead 4 2 E 2

Eb443 Lmsitofthehead 4 3 E 1

Sm4l woundto thechest 5 1 E 2

Sm46 swelling/woundto thechest 4 1 E 2

TABLE9.301)

ENTRIESIN THEMEDICALTEXTS:HEMP
PRESCRIPTION

Prescription Treatment Number of Position of Internal/ Validity

Inciredients, active External
Inciredient

Eb821 cooltheuterus 1 E 2

Eb618 toenail 6 3 E 2

Bt13b rectal 7 3 E 2

Bln81 fever 3 2 E 2

Ram111,
A26 refresheyes 1 1 E 2

Bln59 demonicpossession 7 6 1

273
 TABLE9.3(M)

INTHEMEDICAL
ENTRIES
PRESCRIPTION TEXTS: LETTUCE
WILD
Prescription Treatment Numberof Position Internal/ Validity
lnqredien of active External
s Ingredient

Eb4O painin thebelly 2 1 E 2

H42 painin thelimbs 8 3 1 3

H608 stiffnessin thejoints 12 11 E 3

Eb86 painin thebelly 6 3 1 2

Eb751 to treatnsyt 5 2 1 2

Eb640 to soften/soothe 15 6 E 3

Bln201 painin theears 2 1 E 2

Bln36 cough 5/6 1 1 4

Eb64 PAworm 3 1 1 1

Eb530 sores 3 2 E I

Eb467(b) hairloss 1 1 E I

TABLE9.3(iv)
INTHEMEDICAL
ENTRIES
PRESCRIPTION LOTUS
TEXTS: FLOWER

Prescription Treatment Numberof Positionof Internal/ Validitv

Inqredienstactive External
Inqredien

Eb209 intherightside
stoppage 16 7 1 2

Eb258 treatthehead 7 7 E I

Eb224 demonic
possession 6 5 1

Eb475 hairloss 2 1 E

Eb479 treattheliver 7 1 E I

13b
131: enema 7 6 E 3

274
 TABLE9.3 M
ENTRIES
PRESCRIPTION INTHEMEDICAL CaERYFRUIT
TEXTS:

Prescription Treatment Numberof Positionof Internal/ Validity

lnqredientsactive External
lnqredient

EIJ226 demonic
possession 10 3 1

Eb227 demonic
possession 7 3 1

Eb334 cough/
wheeze 11 5 1 2

Eb352 blood
intheeyes 2 1 E 1

Eb701 tongue
painful 5 2 E 1

Bln200 intheears
pressure 5 3 E 1

Bln748 fix/strengthen
teeth 3 1 1 2

Eb555 infected
(?) gums/
teeth 10 6 1 2

Eb487 bums 4 2 E 2

Eb503 'darkenbums 1 1 E 2

Eb634 mtwoftheknees
soften 14 6 E 2

Eb291 stimulate
appetite 6 5 1 3

Eb822 cooluterus 3 2 E I

Eb145 prolapsed
rectum 8 5 E 2

Bln192 abortifacient 3 2 1 3

Eb198(c) 'nestofblood 9 9 E I

TABLE9.3(A

PRESCRIPTION INTHEMEDICAL
ENTRIES TEXTSDILL
Prescription Treatment Numberof Position
of Internall Validity
Inqredients
active External
Inqredlent
H44 painkilling 4 1 1 2

Eb249 headache 6 1 E 2

Eb650 mtwinshoulder
ease 11 5 E 2

Eb856e mtwintheneck 4 2 E 2

275
 TABLE9.3 LvDfl
ENTRIES
PRESCRIPTION INTHEMEDICAL
TEXTS'MYRRH

PrescriDtion Treatment Numberof Positionof Internal/ Validity

In-qredientsactive External
Ingredient

H31 bodyodour 4 4 E 4

Eb852 tocounter
smells 8 1 E 4

Eb529 intheneck
wound 2 1 E 3
Ebl30 painful
wound 2 1 E 1
Eb444 Imsitofthehead 5 2 E 1

Eb445 thehead
Lmsitof 4 3 E 3
Eb447 thehead
Lmsitof 5 3 E 2

Eb545 ?kwi 2 1 E I

Eb9l Wtow 14 1 E 2

Eb95 UW
ff%, 4 1 E 2
Eb209 ofthestomach
stoppage 16 7 1 2

Eb564 itching
swelling, 6 6 E 2

Eb637 alleviate/
soothe
mtw 5 2 E 2

Eb258 head
painful 7 4 E 2

Bln14O cooltheanus 10 9 E 3

Eb145 prolapsed
rectum 8 1 E 2
Eb155 heatintheanus 5 3 E 2
Eb792 (?) uterus
prolapsed 2 1 E I
Eb336b pain/blood
intheeyes 3 1 E I

Eb391 catarrh 7 6 E 2

276
 TABLE9.3(viiij
INTHEMEDICAL
ENTRIES
PRESCRIPTION TEXTS:
JUNIPER
Prescription Treatment Number Active Inq. Int./Ext. Validity
Eb88 painin the stomach 7 6 1 2

Eb89 painin thestomach 10 8 1 2

H59 laxative 4 2 1 2

Eb1O1 painin thestomach 8 4 1 1

Bln120 in" shootingpainsin thelegs 10 5 1 2

Bln138 shootingpains 9 5 1 2

Bln154 'nest of pain 10 5 1 2

BlnI53 'wanderings'of
pain 13 4 1 2

Eb122 painfulmouth 13 5 1 2

Eb254 headache 4 3 E 2

Eb138 c;epain,coolingof theanus 4 2 1 1

Eb185 pain/heatin thechest 8 4 1 2

Eb209 stoppageof thestomach 16 5 1 2

Eb137 stomach,anus 8 5 1 1

Eb327 asthma 9 6

Eb85 worms 2 1

Eb263 regulatetheurine 6 5 1 3

Eb266 regulatetheurine 7 1 1 3

Eb278 expelurine 5 4 1 4

Eb282 stopurination 10 4 1 1

Eb479 liver 5 3 1

Eb585 swellingin thestomach 3 2 1

Eb758 treatrightside 12 6 2

Eb752 demonicpossession 4 3 1

Eb833 amenorrhea 5 1 E 2

Eb806 inductionof childbirth 3 1 1 4

Eb298 cold/catarrh 7 3 E I

Eb652 refreshmtw 10 6 E 2

277
 TABLE9.3 (ix)

ENTRIESINTHE MEDICALTEXTS:WILLOW
PRESCRIPTION

Prescription Treatment Numberof Positionof Internal/ Validitv

Inciredients active External
lnqredient

Eb766c $wet'
ear 4 3 E 2

Eb293 appetite
stimulant 8 8 1 2

Eb582 swelling 7 6 E 2

BIn75 toothache 4 1 E 1

Bln87 fever? 7 7 E 2

H234 seta limb 5 2 E 3

9.4Discussion.

In orderto analysethe information tablesandto lookfor

in the preceding
contained

for overallconsideration:
patternsI haveselectedthe followingrelationships
anyconsistent

the positionof the indexingredient

internal/externalpreparations; in the ingredient
order;

numberof ingredients/complexity of theindexingredient

of diseaseandtheappearance asthe

prime ingredient/validity.
I considerthese relationships and
providea comprehensive

representative of thepossible
analysis factorswithintheprescriptions.
variable

Internal/Extemal
preparations.

Of the total numberof prescriptionsin the tables (103)forty-fivewere intendedfor

internaluse.This representssome44%of the total,whilstthe greaterproportionwasintended

for externaluse,56%.

This ratio is not surprisingsince it agreeswith the overallratio of all prescriptions

acrossthe medicaltextsgenerally.Table9.5 belowshowstheseratiosfor the Ebers,Hearst

andBerlinpapyri.

278
 TABLE9.5

Rafiosfor Internal/ExternalPreparations
Percentaqe

Forall Prescdptions:

Intemal Extemal Totals

Ebers41% 59% (877)

Hearst26% 74% (260)

Berlin50% 50% (204)

The abovefiguresclearlyillustratethe fact that the most popularmethodof drug

notonlyin respect
deliverywasbytheexternalratherthantheinternalroute.Thisis important

of the treatment
of pain,but in the of
overallconsideration Egyptian
ancient The
medicine.

than
externalrather delivery
internal of drugs
has implications.
several It implies
an awareness

the noxiousnatureof
of potential some when
substances givenbytheoral However,
route. this

is somewhat by
countered the factthatmostquantitative as
areonlyexpressed
prescriptions

ratios of the other ingredients,

actualdoses are not 959
given. Therefore,
unlessthe overall

is
volumeof a medicament knownno safetyis by
afforded the ingredient
prescription ratio

960
directions.

Thusthefactthattheexternalapplication wasthe favouredroutedoes

of medicines

notimply The
caution. limited knowledge
physiological of the Egyptian
ancient would
physician

restrictknowledge
of the systemiceffectsof Without
medicine. such logical
knowledge

959 theratiosin manyprescriptions

Equally, to besuspect.
I consider BythisI meanthat- evenignoringthefinal
'doses'-someamounts seemtoosmallto bemeasurable.I give2 examples:H103totalvolume= 503116 r(=c.
702cc)comparedto a honeycontent
of only0.875cc.Eb749totalvolume576cc,yetamount of onlyequals
0.21cc. jOrt
960Leakelookedbrieflyat the aspectof quantification in Egyptianmedicineandwhetherit impliesa knowledge
betweendosage/ effectanddosage/ safetyanderredtowardsthe possibilitythatit did.Leake,TheOldEgyptian
MedicalPapyri,28-33.Although,this is onlyreallya generalised assumption.Thatthey'probablyknewthatthere
was relationshipbetweendose and effect and that 'some substancesby mouthhad a generalisedeffect
comparedto thoseappliedto the skin' is little morethan expectedempiricalrecognition.It does not implyany
systemor rationale.Moreimportantly,it is notreallyquantification provideratiosratherthan
sincetheprescriptions
actualquantifies.Furthermore,
whilst72%of the prescriptions in Ebersare so quantifiedonly47%are in Hearst
andnonein theLondonPapyrus.

279
 wouldbeby externalapplication
treatment siteof paincouldbe
so thattheactualor apparent

However,
directlytargeted. suchan approach
alsorestrictsexperimentation
withoralsystemic

effects.Thisimpliesthatthesystemic
effectsof manycompounds notknown.
wereprobably

Moreover of drugsrestrictstheirabsorption
theexternalapplication to
whencompared

961Thus,the abilityto recogniseindividualpharmacological

the oral route. effectswouldbe

severely Theinteractions
hindered. between wouldhaveexacerbated
variouscompounds this

problem. thattheindividual
I believeit possible effectsof manyindividual werenot
substances

because
recognised of this.It mayexplainwhythereappearsto be an illogicaluseof many

activeingredients.

However,
Table9.3(viii)showsan anomalyin respectofjuniper.It standsoutas an

to the'rule'of external
exception application of itsentriesareforinternaluse.
sincethemajority

Infact,if thefiguresfromTable9.3(viii)areexcluded
fromthetabletotalsthenthepercentage

of external
preparations to 72%of thetotal.
is increased

arefor internaluseis interesting.

Thefactthatalmostall the preparations Fromthis

one mightassumethat its effectswererecognised andso couldbe used

and understood

internally However,
withconfidence. showsits actualuseto be somewhat
closerexamination

illogical. andhaslongbeenusedas suchin traditional

Juniperis a diureticandanti-rheumatic

folk medicine.But, in Egyptianmedicinewhen it appearsfor theseconditionsit is in

withseveralotheringredients
combination andonlyonceas the primaryingredient.
It is also

usedfor sucha widerangeof othermedicalconditions

thatits inclusion
for theseconditions

(withactualknowledge)
isjustaslikelyto bea chanceinclusion.

961For detailson the problemsandvariablefactorsthatinfluence throughthe skinsee,Aulton,

absorption
*TheScience
Pharmaceuticals, of Dosage
Forms,381411.

280
Orderof IndexInqredients

is thatprescription
Thebasicrubricof pharmacopoeias arelistedin their
ingredients

orderof importance
withinthe However,
prescription. the tables
showthatindex 962
ingredient

in
appears the primary of
position the ingredient
prescription list in lessthanonethirdof all

cases(32%).
ingredients
Thisimpliesthateitherthe preceding moreimportant
wereconsidered or

was attachedto ingredientorder.The veryfact of the large

that no particularimportance

numberof ingredients
suggests
a of
principle based
polypharmacy on sheernumberrather

thanby selectionof individual,

sympathetic This is particularly
properties.
pharmacological

shownby Eb209wherejuniperappearsfor a 'stoppage butis in combination

of thestomach'

withfifteenother In
ingredients. suchan it
example is verydifficult
to envisagea common

theme.
pharmacological

plexityof disease.
Numberof ingredients/com

the ideathattheremightbe somecorrelation

I considered betweenthe numberof

ingredients
in a prescription of the disease.Thatis the morecomplexa
andthe complexity

the
condition
medical more the
complex in
treatment termsof ingredient If
numbers. thiswas

of treatment.
shownto becorrectthenit mightprovidea rationale

the averagenumberof ingredients

In an attemptto considerthispossibility fromthe

Onthisbasisanyprescription
tableswastaken.Thiswasfoundto be 5.62items/prescription.

oversix itemswasconsidered
containing to seeif thespecifiedmedicalcondition
wasmore

962It is perhapsworthreminding thatthe indexingredients wereoriginally selectedbecause of theirpossible

application Assuch,in termsof an'Egyptian
aspainkillers. Pharmacopoeia' I haveassumed thattheywouldhave
represented (Please
a majorposition. seeChapter 2 ontheimportance of pain).Thispointis madeto ensurethat
theconclusions froma sample, althoughlimitedin number Anydeficitin samplenumber
is stillrepresentative. is
alsocountered by the numberandwiderangeof the medicalconditions withinthe prescriptionsfor those
substances.

281
 thanthosebelowthisfigure.Thisessentially
complex intotwo
dividesthe medicalconditions

list'anda 'minorlist'.
groups:a 'complex

TABLE9.6

Complexconditions MinorConditions
ingredients)
(morethansixprescription (lessthansixprescription
ingredients)

Lmsitof the head,to treata toe nail,rectalcondition, sedative (child), Linsit of the head, wound to the
painin the limbs,stiffnessin the chest,cool the uterus,fever,refresheyes,painin the
demonicpossession,
joints, pain in the belly, to soften/soothe,cough, belly,to treatnsy4 pain in the ears,PR worm,sores,
.
infectedgums/teeth,soften mtw of the knees, to hairloss,bloodin the eyes,painfultongue,pressurein
stimulateappetite,prolapsedrectum,'nest of blood', the ears,fix teeth,bums,'darken'burns,abortifacient,
stoppagein therightside,to treatthehead,to treatthe hair loss, body odour, woundsin the neck, ikwt,
liver,enema,to countersmells,wtyw, stoppageof the %ýMw,soothethe mm heat in the anus, prolapsed
painfulhead,coolthe anus, uterus,pain/bloodin the eyes,pain,mtwin the neck,
stomach,swellingritching,
easemtwin the headache,cie, pain, coolingof the anus, worms,to
prolapsedrectum,catarrh,headache,
shoulder,pain in the stomach,lnw4 shootingpains, expelurine,to treatthe liver,swellingin the stomach,
of pain,painfulmouth, .ic, ammenorhea,induction of childbirth, 'wet' ear,
'nestof pain','wanderings'

pain/heatin the chest asthma,to regulatethe urine,to toothache,

seta limb.
stop urination,treat right side, cold/ catarrh,refresh
fever.
mtw,swelling,

Thelistsshowthatbothgroupscontainequallydiversemedicalconditions.
Also,they

can appearin bothlists.'Demonicpossession'

showthatthe sameconditions four
appears

timesin thecomplexlist.This'condition' to be a complexone,butit also

mightbe predicted

appears int al,cough(twice),catarrh/cold

on the'minor'list.Thecomplexlistcontains (twice),

in thejointslmtw(threetimes)and'stimulation'
stiffness Thesearecertainly
of theappetite. not

complexconditionsand it unlikelythat the Egyptians themso. The minorlist

considered

containsint al, sedation(child),'cooling'of the uterus,hair loss,'darkening'

of bumsand

swellingin thestomach.
Theseconditions to
appear be no lesscomplexthantheformerlist.

Fromthesefindingsthereappearsto be no demonstrable betweencomplexity

relationship of

formulaandcomplexity
of condition.

282
 Also,in termsof ingredient thatTable9.3 only
numbersit shouldbe remembered

includesthosesubstances
thathavebeenspecifically in Chapters
mentioned 5-7.Thereare

manyothermulti-item Forexample,
prescriptions. in
Eb663,whichI discussin theAppendix,

respectof Ps,contains
a total
of ingredients.
thirty-seven In this I
case, wouldarguethatit is

impossible
to claimanyactiveingredient;
ratherI wouldsuggest is dictated
thatitsformulation

bytheritualof itspreparation.

of activeinqredientas p(maryin-qredient
Appearance / to validity.

It is usualfor pharmacopoeias
to list prescriptioningredientsin orderof importance.

Thisbeingso, thosecaseswherethe indexingredientappeared

in primarypositionwere

Thiswasin orderto see if the ingredient

extracted. for the statedmedical
wasappropriate

Thus,in thosecaseswherethe indexingredient

condition. appearsin primarypositionone

mightexpectit moreappropriately
suitedforthestatedmedical Thisis important
condition. not

justto provethe'usualrule'or otherwise it shouldalsodemonstrate

butbecause theabilityto

thepharmacological
appreciate of theindexingredient.
properties

However, to be no relationship
thetablesshowthatthereappears between
thesetwo
I
Inthosefewcaseswhereanindexingredient
parameters. mightbewellsuitedto thecondition

of otheringredients
theaddition in Bln36(Table9.3)wildlettuceseems
Forexample
confuses.

wellsuitedforthetreatment withsixotheringredients.
of coughyetit is included

Theseresultsseemto reinforcethe fact that polypharmacy

is integralto overall

rationalebut,alsoraisesseriousdoubtas to whethertheindividual
treatment pharmaceutical

effectsof substances
werereallyappreciated.

283
9.7Conclusions

Egyptianpolypharmacy
seemsto be havebeenfirmlyrootedin ancientEgyptian

medicine.But, it also must have producedconstraintson the exploitation

of medicinal

Essentially,
substances. it is nota dynamicsystem.It wouldhavehadthemajordrawback
of

therecognition
confusing effectsof individual
of thepharmaceutical Thiswouldin
substances.

partexplaintheeclecticrangeof treatmentsassociatedwithindividualsubstances.

Egyptian maywellhavearisenfroma beliefthatmultiple

polypharmacy additions
aided

963although
theefficacyof a medicine, in practiceactualusemusthavesuggested
otherwise.
However,
in the scientificanalysisof any historicalmodelonemustbe carefulto discount

currentknowledge.For example,an examinationof early twentiethcenturyEnglish

pharmacopoeias fundamental
illustrates differences
in approaches
andthinkingin comparison

to today'sknowledge.
Theircontents
wouldscarcelybeenrecognised
by modernpractitioners.

Theessential
difference
between
theseearlyandmodemmodelsis thelackof powerful
and

With this in mindthe ancientEgyptianapproachseemsmore

effectivepharmaceuticals.

rationalwithinthe confinesof a limitedknowledge

of physiologyand limitedmedicinal

However,
compounds. I consider in thedevelopment
thatanyprogress of drugtreatments
was

essentially oncea systemof ingredient

restricted wasadopted.
polypharmacy
The absenceof certainsubstances
fromthe medicaltexts;or the failureto exploit

someof the obviousproperties withinthe medicaltextsis at firstsight

of othercompounds

Onereasonis thatEgyptian
puzzling. wouldmaskthepharmaceutical
polypharmacy properties
buttheremayalsohavebeenotherreasons.
of somesubstances, I takeasexamples
someof
discussed
thosesubstances in myprevious
chapter:alcohol,henbane
andtheuseof myrrhin

dentaldisease.It is difficultto imaginethatthesesubstances

werenotused,yettheydo not

Forinstance,
963 thiscontrasts
withtheapproach inAssyrian
medicine. Theformulasarefarsimpler,
Forexample,
whilstfor thesamemedicalcondition oftenovera dozenremedies wereofferedtheyat leastprovided
some
empirical feedback.
pharmacological Theprocedure seemsto havebeento tryoneremedy afteranotheruntilthe
patientimproved (orperhaps
died!
). It was'empirical
butdevoidof science',
M.Jastrow,'BabylonianandAssyrian
Medicine', AnnalsofMedical
History1 (11917),
240.

284
 mightbe explainedif these
appearin the medicaltexts.I considerthat theseanomalies

wereactuallyusedbut outsidethe 'official'medicalsystemand so werenot

substances

in the
recorded medical Whilst
texts. because
alcohol of itscloseassociation
withdomestic
and

documentation
mightwellescape
socialsituations the failureto usemyrrhin dental
disease

thiswouldnotbethecaseif it werealreadybeingusedin
However,
seemsa glaringomission.

the domesticsituationand so might be excludedfrom the 'officialsystem'of the medical

964
texts.
I consider to assumethathometreatments
it reasonable wouldrepresent
or nostrums

in respectof ancientEgyptian
the majoritysituation Theofficialsystemas
medicaltreatment.

throughthe medicaltextswouldbe of limitedavailability

represented onlyto thoseplacedto

affordit.965
A strongsystemof homenostrums theEgyptian
wouldnecessitate having
physician

or differenttreatments.
to beableto offereithermoreeffective Intheabsence
of a widerange

of effective thiswouldfavourthelattersituation.
substances Thismaywellhavebeenseminal

to thesystemof ingredient in thatit wouldservetojustifytheartandmystique

polypharmacy of

It wouldalsohaveprovideda levelof attentionthatitselfmayhave

the officialpractitioner.

to a 'placebo
servedto assurethepatientandsohavecontributed 966
ritual'.

964Plinyattempted to explain themedical profession's

shortcomings withinternal
in dealing disease byreference
to homenostrums. Hesuggested thatnaturescureswereavailable but(only)to thosepeasants wholivedwhere
theherbsgrew.Wethered, TheMindoftheAncientWorld. -A Consideration ofPliny'sNatural History,33.
w Acrosshistorydoctorshavealwaysbeenthe'lastportof callfor mostfamiliesconfronting everyday illness,
eitherbecause of cost,availability in thelightof limitation
or preference of medical diagnosis andtreatmenf, S.
KingandA.Weaver, 'Livesin manyhands', Medical History45(2000), 173.
1believethatthesituation is furthercomplicatedbythefactthattheviewofwhatis 'normal'andwhatis a disease
variesbetween historicalmodels.KingandWeavergivean example of medical referralin theearlyeighteenth
centuryEngland: in thesamefamilya doctorwascalledoutto accidents involvingservants yetthechildren were
onlytreatedwithhomenostrums formeasles, whooping coughandother'serious' childhood in Medical
illnesses,
History45,197-8.
The highincidence of dentaldiseasein ancientEgyptmaywell similarlyhaveproduced a similarattitude
considering it a 'normal' stateinstead ofa diseaserequiringtreatment.
966A recentstudyhasexpressed doubtsontheplacebo effectin someclinicaltrials.Itwas,however, stillshownto
be effectivein thetreatment of pain,A. HrobjartsonandP. Gotzscne, 'Placebo Effectsin ClinicalTrials',New
EnglandJournalOfMedicine 344(2001),159.

285
 CHAPTER10: GENERALCONCLUSIONS

Therearemanyanecdotal
or presumed to
references theabilities
andinfluences
of theancient

Egyptian
'medicalsystem'.Thesereferences
varybetween of
examples knowledge
medical

in
exhibited the texts
medical and the influence
Egyptian on concerned
concepts with the

aetiologyof disease.
There where
are manyexamples the modemanalysis
of disease
is

appliedadhocto Egyptian by
examples the linking
spurious of to
symptoms the 967
texts.

The Egyptianview of the aetiologyof diseaseis claimedto emanatefrom the

of
observation thedecay during
process drawing
mummification, with
parallels thelivingbody.

intoa concept
Thisis saidto havedeveloped of thedisease This
process. is based
principally

aroundthe'substance' is agentor precursor

claimedas a pathological
whdwwhich variously

to painor disease. 'aetiological

Thisconceptof whdwas partof an ancientEgyptian model'

968Additionally,it has beenclaimedthat this conceptwas seminalto

continuesto be quoted.

because
laterGreekthought.Thisis important dominated
Greekideassubsequently muchof

thought
medicaland scientific until the adventof modem in
science century
seventeenth

Europe.

thathasbeenappliedto this'system'of medicine,

In respectof theterminology these

Theterseandoftenimprecise
andothertermsremainuncertain. natureof the medicaltexts

hasallowedforgratuitous in interpretation
assumptions
or spurious Thewording
andmeaning.

withinsomeof the medicaltextsis enigmatic mightbe

to the extentthatsuchconclusions

drawn.However,
I consider
thatsuchconclusions and
arespeculative thata simpler
andless

conditioned mightbetaken.
approach

967For example,the connection of VitaminA in liverwith nightblindness;unseenparasiticwormsbeing

responsiblefor the manifestation
of franksymptoms; andthe linkingof externalsymptoms
withunobservable
internalcauses(cancers).Modemconnections areequallymadewithliterarytexts;'hecameto hishouseand
foundhiswifelyingdownandmadecruellysick andthereshelayandvomited'-thisis givenasanexample of
Pahor,Journal ...
bulimia, ofLaryngology andOtology,871.
968S.Wafts,Disease andMedicine in WorldHistory(NewYork,2003),17-8.

286
 in respectof.nomenclature
Someof thesetermsmightbe moresimplyexplained -

someterms have
might from
arisen of
an adaptation the word used
originally to describe
the

Thiswouldserveto explainsomeof theterms

terminology.
typeof pain-I callthisadaptive

andwouldprovidea basisof disease lacking.

otherwise
nomenclature, for
Likewise other

for in disease
conditions; example, a caseof occult thereis to
reference 'decaying
anddying

Rather
worms'. thanbeing to I
aetiology
a reference morbid thinkit aslikely
to beanallegorical

intended
reference to describe
theseverity
of the of
prognosis the 969
disease.

of anyEgyptian
Infact,thereis verylittleactualevidence letalone
'system'of disease,

had
later
onewhich influence
on Greek Any
thought. between
'link' thetwo rests
models onthe

that
premise some of
process decay
internal wasbelieved for
responsible disease,
andthat

thisprocess
wasincluded
within of
part Egyptian
terminology the
within medical However
texts.

to demonstrate
of thetextsproffered
I thinktheexamples thisandthereasoning
areessentially

flawed.Theassumption
thata nominated refersdirectlyto a perceived
terminology systemof

is I
aetiology spurious.have in
demonstrated this that
thesis termslike and
iKbdw stt canbe

in
explained terms
of painindicators than
rather the Also
latter. the useof faecal
matteras a

does
ingredient
prescription not the
support connection decay
between andthe aetiological

of
concept disease.
Rather
theuseof faeces
animal a
suggests system
of based
treatment on

between
connections
allegodcal speciesandsymptoms.

of diseasein ancientEgyptseemsto havebeenhigh.Thereis ample

Theincidence

evidencefrom skeletal from

remains, literary and
references graphic illustrations
to

this.Domestic
demonstrate crowding,
cramped and
arrangements
cooking dangerous
working

have
would
conditions created health
other problems exacerbated
andadditionally anyexisting

conditions.
medical
969Therearemanyothersuchallegorical connections.Pinch,in discussingthese,givestheexampleof thewoman
in labourmadeto squaton a baleof clothfor'breath'.Theclothis associatedwiththeweaverwhotypicallycannot
'breathe'(in TheSatireof the Trades),Magicin AncientEgypt,174.

287
 Manyof thediseases thepatientwithvaryingdegreesof chronic
wouldhaveprovided

The
pain. for
demand treatment for
and analgesics
shouldhave been
correspondingly high.

that,asidefromthe availability
it shouldbe remembered
However, treatments
of medicines,

mightalsohavebeeninfluenced
by any'view'
takenon disease.
By this I meanwhatwas

or
normal
considered for
appropriate It
treatment. may be that certainconditions
wereso

(for
endemic dental
example, that
problems) they mayhavebeen as
regarded the 'normal'

fortreatment.
stateandsonotappropriate

In this thesisseveralmedicinalsubstances for their painkilling

were considered

Apartfromopium(thepresence
properties. textsis suspect)
of whichat thetimeof themedical

nonewouldhavebeen Moreover,
effective.
particularly thepartsof medicinal
plantsarerarely

in
specified the medical This
texts. is an important
omission
sinceactiveingredients
canvary

the form.
across plant Thisimplies
thatthisaspect
wasnot to
relevant the If
treatment. sothen

it
again that
suggests inclusion
ingredient wasrandom.

Thequantification970of
prescription withinthetextsdoesnotalwaysoccur.
ingredients

Whereit doesthereis no indication

of dosage
but just
rather Equally
proportions.
relative no

frequency
of doseis beyond
specified the four
'formulaic'
general daytreatment Unless
period.

couldbe affordedto the patientin the caseof

volumewasknownno protection
a standard

toxicdrugs.Thisagainindicates
potentially systemof treatment.
a random

The properties
of othermedicinal do not appearto havebeenproperly
substances

By
exploited. this,I meanthattheirinclusion
withinthe medicaltextsgenerallyseemsto be

unrelated effects.Theirinclusion
to theirknownpharmacological to be randomwhich
appears

werenotknown.Withsomesubstances
impliesthattheeffectsof somesubstances thisseems

970Measurement wasby volumenotweight.Thiswasgenerally indicatedby reference to theunitmeasure ro

(approx.14cc.). However"" is alsousedto meanthefractional part-a fractionline.Thisallowsforpossible
confusionsince we cannotbe certainthat measureor fractionwas actuallymeant.The latteris generally
translated havesomereservations
butI personally sincemanyvolumes seemsuspiciously low,e.g. Eb327where
statedat 1/64ro(O.218cc)in a totalvolume
theingredient'cumin'is of approx7.5ro (105cc).

288
hardto explain,but I believethat theremaybe two reasonsfor this: Egyptianingredient

and
polypharmacy home 971
nostnims.

The Egyptianprescriptionmodel is firmly rooted in a systemof ingredient

In
polypharmacy.other all
words (unlike
prescriptions containseveraland
mostothermodels)

ingredients.
(oftenconflicting) of the
This,I believe,wouldhavehinderedthe recognition

individual Also
effectsof manysubstances. it wouldhaveimpeded
any in
progress drugregime

the It
within medicalsystem. contrastswith the restraintshownby the Greeks
and Roman

in the of
physicians number formulation
their 972
ingredients.

may have been pursuedbecausethe actualprocessof

Egyptianpolypharmacy

involved
preparation, with formed
substances,
several an important of
part thetreatment
ritual.

andwouldserveto justifythe
the'official'systemfromhometreatments
Thiswouldseparate

in themedicaltexts
appearnotto havebeenexploited
former.Thefactthatsomesubstances

be by
could explained a systemof home i.
nostrums e. a of
system home
treatments the
outside

That
officialsystem. is thattheywere being
already usedin thedomestic This
situation. might

their from
explain absence thelatter
andso the
re-enforce ritualof polypharmacy

I consider
Insummary, thatthetreatment
of bothpainandinternal in
diseases ancient

Egyptwaslimited.Thisis particularly by
reflected the in
differences to treatments
approach

thosein theEdwinSmithsurgicalpapyrus
between andthegeneral
medical In
papyri. thelatter

by the largernumberof ext6mal

the ineffectualnatureof internalcures is highlighted

which
preparations could at best providetemporary This
mollification. is not altogether

since
surprising Greek
andRoman had
medicine such Whilst
limitations. theyhad in
skill
great

971Plinystatedthatnatureprovideda curefor all ills. Butthatknowledgewasdeniedthe 'betterclasses'andwas

restrictedto those peasantswho lived where the herbs grew. Wethered,
The Mind of the AncientWorld:A
Consideration of Pfin)esNaturalHistory,33.
972Sarton,Galenof Pergamon, 64.

289
treatingwounds,internalmedicalconditions 973Thisis not unexpected
remaineda problem.

sinceneithertheynortheEgyptians
hada significant
understanding
of physiology.

In conclusion
I believethis thesishas shownthat the treatments
discussedwere

ineffective.
pharmacologically Theimportance by anymodem
of thisshouldnotbedismissed

However
references. therecording
of elaborate
methods
of preparation
of aneclecticrangeof

multipleingredientsindicatesa methodology.
Treatmentsin the medicaltexts likely

any larger'rite of treatment'ratherthan havebeena completeor discrete

complimented

methodon theirown.Sinceritualwasso integralto Egyptianlifewe shouldperhapsnotbe

thatit appearsto haveplayeda moreprominent

surprised rolein the recorded
treatment
of
internal
disease
thanpreviously
thought.

973H. King,GreekandRomanMedicine, (Bristol,2001),44-5.J. Barnes,'Galen'sLogicandTherapy,in F.

KudleinandR.I Durling(eds.
), Galen's
Methodof Healing,(Leiden,1991),50-103.
Singer,GalenonAnatomical
61-2.Wafts,Disease
Procedures, andMedicine
in WorldHistory,34-7.

290
 11.APPENDIX:
THEUSEOFEXCREMENT
INPRESRIPTION
FORMULATIONS

11.1Inthecourseof examination medicaltextsit became

of theEgyptian thatfaeces
apparent

ingredient.
wasoftenusedasa prescription Inviewof itscloseassociation bdw,lackof
withtf,ý,

benefitand possibledetrimenteffect I considered

therapeutic it necessary
to give such

inclusion
moreconsideration.

Bothanimalandhumanfaeces(ps ) wereusedas ingredients

in bothinternaland

formulas.
externalprescription Thisis a somewhat
puzzlingadditionin viewof its supposed

connectionwith whdw974and in spiteof the moregeneralviewthat in embalmingthe latter

wasseenastheantithesis
to preservation.

In orderto considerits usesI havelistedits appearances

in the medicaltextsbelow.

Thelistis nota totalonebutis representative

of thetypesof faecesusedandof themedical

thattheywereusedto treat.Equally,I do notgivealltheaccompanying

conditions ingredients

butratherdiscussthosewhichI consider
to berelevant.

11.2HumanFaeces

Humanfaecesarementioned
in the medicaltextsas follows.It appearsbothas an

andasanindicator
ingredient of themedical heading.
undera prescription
condition

It appearsin Eb30as Ps mr, in 'to driveout Ps mr in the stomachof a man'.The

Gnindrisstranslatesthis phraseas 'KrankerKof whilstWestenclorf

gives'Schmerzhaftem
Kot'975.
In Ebl96it is seenin the strangeexpression,
ummwnwts, 'eatingof faeces'.The
hasthis phraseas the literal,Xot-Essen'whilstWestenclorf
Grundriss usesthe expression

whichis moresuggestive
'Kotenbrechen', of someinternalproblem.
976It is unlikelythatthe

974SeeChapter
3.2
975 V11:
Grundriss 631,Westendorf,
552.
Grundfiss
976 633,Westendorf,
V11: 581.

291
phraseis referring
to the actualeatingof faeces.Thephrasemaybe an attemptto explain

somesodof internalblockage 'breakdown'

withsubsequent orcomplications.

H85is a magicspellthatis intended

to driveoutdemonic It is in twoparts
possession.

the
and secondpartconsists to
of a magicspeech 'thedead'.
Mck in. 1Ps
n. n wvm, I
'behold,

havebroughtfaecesfor eating'.Herethe repulsivenatureof faecesseemsto be directed

theevilin anallemptto repelor deterit.

towards

IntheBookof theDeadthehumiliation of eatingfaecesis shownbySpell

and'offence'

53,6:

'I detestwhatis detestable;

I willnoteatfaeces,

I willnotdrinkurine,

977
I willnotwalkheaddownwardS.

Spell189showsthatit shouldnotevenbeallowed
Inaddition to touchthebody:

I whatI detestis faeces,I willnoteatit; excrement,

I willnotconsume
it. It shallnot

fallfrommybelly,it shallnotcomenearmyfingers,andI willnottouchit withmytoes.

it shallnotenterintomybody,I willnotapproach
it withmyhands,I will nottread
...
uponit withmysandals.
'978

Yetas aningredient
it appearsin threeprescriptions.
In thefirsttwoit is described
as

Psn mg (humanfaeces).In Eb531it is in a runof treatments

for differenttypesof wounds.

Thisis specifically
a remedyintendedfor 'all weepingwounds'.
979Here,it is combined
with

or pig faecesandappliedto the wound.Eb541is anothersimilarapplication

crocodile to a

wound.

977R. 0 Faulkner,TheAncientEgyptianBookof theDead(NewYork,1972).RevisedEditionLondon,1985.

978Faulkner,TheAncientEgyptianBookof theDead,185.
639.
Westendorf,
979'Wundsekret',

292
 Eb349is to treatan eyeconditiondM (Split?
).980In E349it is specified
as from'the

of a child'it is mixedwithhoneyandappliedto botheyes.

stomach

11.3AnimalFaeces

Thereareeighteen
different
typesof animalfaecesthatareutilisedwithinthemedical

texts.

faeces(Ps-u).It appears
Donkey in H208(Eb756),
BIn64,Eb640,670
and691.
H208is faecesdissolved
in wineandwhichis thento be drunkforoneday.It is usedto treat

nsyt (demonic
illness).
981Bln64
is for
equally demonic
possession, Eb640is
'todriveout cjcý982

to 'sootheallthings'(fromEb637).
anapplication Eb670,691
areintended 983
to 'soothe'.

Smallcaffle(Ps cwt). It appearsin Eb482as a 'day2' application

in a complexfive day

forburns.
treatment

Fly (Ps(n ) cff). It appearsin severalprescriptions.

In Eb782it is used(fromthewallof a

house)in a formulation
with poppy(?) to 'instantly'placatea screaming
infant.In Eb800

it is usedto facilitatea birth,'to causea childto be released

(13107) (sibt, loosen)fromthe

bodyof a woman'.Here,it is usedpervaginum.

It appearsin anothergynaecological in Eb8l0, 'for the

or postpartumpreparation

whenit/ theyhurf, (mrf). In H136it is usedto treata 'swelling'.Eb877(e)

breast(s) is a

611.
980'Ritzung',Westendorf,
981GnindrissIV:154.
982GnindissIV:151.
983Westendorf,661.

293
 stage
complex to
remedy treata 'swelling
of Khonsu'.
In it
Eb429 is usedfor obscureeye

984
condition. is todryupa wound.
Eb521.

Lion.(Psng! ). Thiswaspresumably
a item
difficult to It
obtain. is usedin This
BIn68. a magic

demonic
remedyagainst possession.

(Psibjj. It appears
Panther in BIn68asabove.

in Bln68.
Ibex(PsnBu).Thisagainappears

andEb231allof whichdealwithcases
in BIn64,BIn,68,BIn7O
Cat(Ps(n ) m1w). It appears

of demonic
possession. is
Bln70 for
specifically the (unknown) hhyt
condition andusesint al

driveout c3cofa god...'

faeces.Eb231is to'immediately
bothcatandcrocodile

It appears
alsoat Eb488
to treat
a from
resulting
wound a burn.

Dovelswallow in BIn7O,
(Ps(n) mnt). It appears asabove.

Crocodile(Ps(n ) msp ). Thisalsoappearsin Bln70.In Eb344it is usedfor an eye condition,

onewhichis to be to
applied the 'outside
of both Ram
eyes'. IV (C,2-3)/ Kahun
21 areboth

985
agents:'to stopa womenbecomingpregnant'.
intendedas contraception

It is combination
Ostrich(Psnlw.). Thisappearsin Bln68for demonicpossession. int al with

ibexandgazellefaeces
lion,panther,

984'Toreleasea hair?', GrundrissIV:58.

985Nunnsuggestthatthismaybe to deterthe man,Nunn,AncientEgyptianMedicine,196.1thinkit is morelikely
to be an allegorical Thecrocodileis associated
connection. withSeth who is himself'connectedwith J.
abortions',
Womenat Deir-el-Medina
Toivari-Viitala, (Leiden,2001),169.Also see, R. K. Ritner,'A UterineAmuletin the
OrientalInstitute',JNES43 (1984),209-21.

294
Pelican(psjmt). Thisis seenin Eb365whereit is usedto 'driveoutMOMin theeye'.

Lizard(ps Im8sw ). Thisis seenin Eb370whichis essentially for the same

a treatment

asin Eb365above.
condition

Pig(Ps.01.). Thisis seenin Bln64whichis a fumigation Itsformula

for demonicpossession.

includesint al honey,donkey,andpig faecesandthe urineof a youngwoman( eM et ). 987

Eb663is for 'thesoothing(gnn) of the mtw. Its formulation

containsa totalof thirty-seven

of whichpigfaecesis approximately
ingredients halfwaydownthe list.

in BIn68.It features
(bsgbs). Thisalsoappears
Gazelle in Eb471whereit is usedto'treatthe

hair. Its formulais gazellefaecesmixedwith honeyand appliedto the head.Eb849is a

kkt(? )988It is
against
remedy usedin a 'roasted'
form.

(ps (n ) Ism ).989Eb578is for a 'swellingin any partof the body'.It is the
HoundlGreyhound

last in a run of fourteenprescriptions

for the samecondition.It containsint a/ cat and

faeces.It is appliedbybandage.
greyhound

(Ps dh). It appearsin Bln87and Bln195.The latteris a magicformulation

Hippopotamus

to aida'womanwhocannotconceive.
designed

Goose(Ps) It appearsin BIn69as fumigation

to 'driveout'a demon'fromthebodyof a

man'.Itsformulaconsistinta/of hairof donkey, faeces.

gooseandswallow

986
'WOtens', 614.Raging,
Westendorf, inflamed?
364.
Westendorf,
987
A geckoor'worm-like',
988 Westendorf,
690.
989 965.
Hannig,

295
 for the 'destruction
Bird(ps idw), ldw bird.Thisappearsin Eb326.It is intended of gPW

). It is usewithotheringredients,
(cough/wheeze? into and
made a mass,pressed for
drunk four

days

11.4Summa!
y
bythefact
is at firstsightstrange.It mightbeexplained
Theuseof faecesin medicine
990Thathumanfaeces
thatsucha diverserangeof productsare utilisedin Egyptianmedicine.

is mentioned in be in
can part explained that its is to
use restricted descdbing of
symptoms

diseaseor to deterdemons.This seemsto be the case in H85 whereits repulsivenature

to
seems beturned the
against demon.

whilstanimalfaeceswas.However,
Humanfaeceswasnotusedin internalmedicine

with wbdw. Its clearuse to treateye

this fact doesnot discountthe latter'sassociation

andwoundsseem
conditions to ignoreanyfurther arisingwith ifýhdw
problems
pathological

contamination.
Thewideruseof someeighteenvarietiesof animalfaecesfor medicalinclusionis

It
instructive.
equally is doubtful
that implications
anypathological of faecal could
contamination

I statethissincetheprocess
fortheanimalkingdom.
havebeenthoughtto havebeendifferent

of accelerated from
decay faecal have
equally
must
contamination been for
observed animals.

if therewerepathological
Equally, connotations
withfaeces
thensomeotherpartsof theanimal

be to any
might used achieve desired
allegorical 991
effect.

9wPinchmaintainsthat the use of excrementis a caseof 'treatinglike with like', sincethe digestionof food is
associated of the corpse,Pinch,Magicin AncientEgypt,134.1thinkshe is wrongon this
with the putrefaction
pointas there is no for
evidence it; also she importantly
fails to consider
any See,
connections.
allegorical J. G.
Griffiths,'Allegoryin GreeceandEgypt,JEA53 (1967),79-102.
Thecollectionof facesmusthavebeeneasierandsafercomparedto thewholeor partsof the animal
991

296
 ingredient
Theuseof excretaas a prescription must,I propose,have
in medicines

beenmadeforoneor moreof thefollowing

essentially reasons:

benefit.
1.Thatit hadsomeactualobserved

2.Thatitsaddition
wasmerelyrandom.

to havebeenbeneficial.
3.Thatit wasthought

Whilstmostof the faecescollected

Thefirst reasoncan obviouslybe discounted.

would
presumably havebeenin driedform,
its to woundsandoraladministration
application

muststillhavebeena strongsourceof furtherinfection

or complications.

Its additionmayhavebeenrandombutthisseemsunlikelysinceits useis carefully

I
specified.thinkthemorelikely is
reason thatit wasthought
to havesomebenefit.
I this
mean

in manymagicformulations
in a broadsense.Its appearance thatits inclusionmay
suggests

besymbolic to
or evenallegorical the I
treatment.do not this
advocate as a hardandfastrule

but stateit as a possibility of the animalmaymatchthe

wherethe physicalcharacteristics

intentions Onthefaceof it thisis notsurprising

of theremedy. whenthepowersof animalsare

oftenusedasallegodcal What
assuagers. is is
difficult to match
all theexamples
on thisbasis.

I believethatit is possible andthattheseformedthe matchthat

to explainsomeconnections

wasthendeveloped
on a broadformulaic It
basis. is beyond
thescopeof thisthesisto fully

expandtheargument reasonforvariabons
otherthanto profferit as a possible on treatments.

thatarisewithinthethesisI morefullydiscussthepoint.I merelygivesome

Inthoseexamples

here
possibilities as illustration.
For the
example, donkey
maywellhavebeenforstubborn
and

Eb640,670and691areto 'soothe'andso possiblyreferto somelong-

conditions.
persistent

In respectof thefly, it wouldhavebeenimpossible

standingarthritictypecondition. to seeor

evencollectitsfaeces.Therefore,
I thinkthatPs(n ) cff mostprobably to the
wasa reference

'deadfly'. Thus,theemphasis
hereis on its speedof despatch
- swatted
on a wall.Eb682

297
 faeces'froma housewall'.I thinkit mightbe an analogyto thespeedof
specifies
specifically

theintended
prescription; The1dwbirdmaywellhavehada soundlike
it willwork'instantly'.

that of the conditionin Eb682gpw cough,wheezeand thus providean onomatopoeic

The
connection. othersmainly in
appear casesof demonic Their
possession. use is in

ibex,ostrichandgazellefaeces.In BIn7O
In BIn68weseeintal lion,cat,panther,
combination.

Thus,it appearsthatthecombined
we havedove,catandcrocodile. of these
powers/abilities

maybeusedagainstthoseof thedemon.
animals

Importantly, of faecesis an important

theinclusion of thestrongunderlying
reminder

magicalnatureto treatmentsevenwithinthe 'traditional'medicaltexts.This mustquestionthe

actualabilitytotreatwithconventional
substances.

298
 GLOSSARY
OFMEDICAL
TERMS

achondroplasia
- inherited in
disorder the
which mainbones
failto growto normalsize
(dwarfism)

activeingredients
- those ingredients
prescription effect
a pharmacological
whichproduce

analgesic-a substanceto reducepain(withoutlossof consciousness)

anti-bacterial
-a to
substance killor the
reduce growth
of bacteria

to reducefever
anti-pyretic-a substance

anti-tussive
-a to
substance cough
suppress

to reduceanxiety
anxiolytic-a substance

flavouring
aromatic-a distinctive agent

arteriosclerosis
- damage
or thickening
of an artery due
generally to age or high blood
pressure

thatcausesshrinkage
astringent-a substance of theskin

atherosclerosis
- fattydeposition
in theartefies

of thetooth.
caries- decayandcrumblingof thesubstance

cardiotonic-a that
substance the
affects heart

carminative
-a to
substance flatulence/antacid
relief

thatactsasa powerful
cathartic-a substance purgative

CTscan- (computed
tomography)
a non-invasive layersof thebody
methodof examining
(mummy)

demulcent
-a that
substance soothes
or protects

thatpromotes
diaphoretic-a substance sweating

thatpromotes
diuretic-a substance urination

elephantiasis
- distinctive
gross enlargement
of theskin by
caused filarial
parasitic worms

thatsoothesandsoftenstheskin
emollient-a substance
 ingredients
excipients- inertprescription (otherthanactiveingredients)

to of
-a substance aidexpulsion
expectorant bronchial (cough)
secretions

frank- observable of disease(cf.occult)

symptoms

gaschromatography -a methodof drug and

separation by
identification the
reducing
to a gasunderpressure
substance

goitre- swellingof the neckdueto thyroidinsufficiency

gynaecomastia
- of
enlargement themalebreasts

studyof stainedtissues
histology- themicroscopic

hypnotic-a substanceto producesleep

lipids- intemalbodyfats

disorder
Marfan'ssyndrome- inherited byexcessive
characterised height

- chemical
metabolites by
produced
products thebreakdown
of in
substances thebody

metastases
- the of
movement morbid from
matter one of
part thebodyto another

dystrophy
myotonic lossof tone
muscle in
resulting laboured
andlossof mobility
-

- worms
nematodes

of
symptoms
occult- non-observable (cf.
disease frank)

osteochondroma
- boneturnour,
usually long
affecting
painless bones

osteosarcoma
- bone
malignant turnour

periodontal
- the
conceming mouth

Poft'sDisease- tuberculosis leadingto hunchback

of thebackbone deformity

polypharmacy
- theuseof different
several, (or
medicines ingredients)
to treat
a single
condition

vehicle
prescription - aninert that
substance actsa for
solvent ingredients
prescription

pseudo-pathology
- falsesignsof disease
in by
caused
remains external,
non-pathological
factors

pneumoconiosis
- lungdisease by
caused inhalation
of (or
dust sand)
 heatwhenappliedto theskin
thatproduces
rubifacient-a substance

thatcalmsthebody
sedative-a substance

(bilharziasis)
schistosomiasis - disease by
caused parasitic fluke,
liver especially in
common
Egypt

of thejointsof thebackbone
spondylitis- inflation

strongyloidiasis-a parasiticworminfectionof the smallintestine

Symmer'ssyndrome-a complication
of theliverarisingfromschistosomiasis

thatworktogether
synergistic- substances anincreased
to produce drugeffect

systemic-a that
substance actsin thebody,asopposed
to topicalapplication

to theskin(cf.systemic)
topical- application

usedto expelwormsfromthebody
vermifuge-a substance
 BIBLIOGRAPHY

Abbreviations:

BIFA delInstitutfrangais
0- Bulletin darcheologie duCaire(Cairio)
orientale
BP- BritishPharmacopoeia
(London)

BPC- BritishPharmaceutical
Codex(London)

Grundriss H.,
Grapow et al, Grundfiss
derMedizin
deraltenÄgypter.
9 (Berlin)
volumes
-
Hannig Hannig
R.,Grosses Agyptisch-Deutsch
Handw6rterbuch (Mainz)
-
JEA- Journalof EgyptianArchaeology
(London)

JARCE
- Journal
of theAmerican
Research in
Center Egypt
(Boston)

JNES- Joumalof NearEastemStudies(Chicago)

(Paris)
RdE- Revued6gyptologie

Westendorf
Westendorf
- W, der
Handbuch Medizin.
Altägyptischen 2 (Leiden)
volumes

H.,W6rterbuch
Wb- ErmanA andGrapow Sprache.
deraegyptischen 7 volumes
(Berlin)

fürÄgyptische
ZÄS- Zeitschüft Sprache (Leipzig
undAltertumskunde andBerlin)
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