Trauma in Ancient Egypt

 

5th Dynasty Egypt (2465-2323 BC)
First Splinting of Fractures.
First Successful Amputations
The tombs of the pyramid builders at Giza were discovered in 1990.

A mummy from this period has a splint, applied to a (partially-healed) fracture of the radius and ulna. Simple and multiple limb fractures were found in skeletons from both the lower and upper burials. The most frequent were fractures of the ulna and radius, the bones of the upper arm, and of the fibula, the more delicate of the two lower leg bones. Most of the fractures had healed completely, with good realignment of the bone, indicating that the fractures had been set with a splint.

Two cases, both male, that suggested amputation, of a left leg and a right arm. The healed ends of the bones indicate that the amputations were successful. Few other cases of amputation have been recorded in Egyptian archaeology. Depressed fractures of the frontal or parietal skull bones were found in skulls of both males and females. The parietal lesions tended to be left-sided, which may indicate that the injuries resulted from face to face assault by right-handed attackers.

contributor: Barry Armstrong

Splint applied to radius & ulna
in mummy from work tombs at Giza

c1600 BC
Edwin Smith Papyrus
Wounds of the head, neck, shoulders and chest were described in the "Edwin Smith Papyrus", held at the New York Academy of Sciences. The Edwin Smith Papyrus is the oldest known text referring to treatments of injuries. The papyrus is 5 meters long, and is chiefly concerned with surgery. It described 48 surgical cases of wounds of the head, neck, shoulders, breast and chest. Unfortunately, the scribe who copied it did not proceed further from the thorax, and it ended abruptly in the middle of a sentence. The papyrus listed the manifestations, followed by prescriptions to every individual case. It included a vast experience in fractures that can only be acquired at a site where accidents were extremely numerous, as during the building of the pyramids.

Wounds were sutured with needle and thread or treated with adhesive plasters:

From 'Case 10', describing a deep laceration above the eyebrow:
EXAMINATION : If thou examinest a man having a wound in the top of his eyebrow , penetrating to the bone, shouldst palpate his wound , (and) draw together for him the gash with stitching.
DIAGNOSIS : Thou shouldst say concerning him : "One having a wound in his eyebrow . An ailment which I will treat."
TREATMENT : Now after thou hast stitched it , thou shouldst bind fresh meat upon it the first day . If thou findest that the stitching of this wound is loose , thou shouldst draw (it) together for him with two strips (of plaster) , and thou shouldst treat it with grease and honey every day until he recovers .

The ancient Egyptians used topical applications of meat as a hemostatic agent

Compare this with modern hemostatic agents such as tissue factor, topical fibrinogen & thrombin). The Egyptians used honey when applying dressings to wounds (the hyperosmolar and hygroscopic character of honey aid in host defences against infection). Their bandages were made of linen.

From 'Case 2', describing a deep scalp wound :
DIAGNOSIS: Thou shouldst say regarding him : "One having a gaping wound in his head . An ailment which I will treat."
TREATMENT: Thou shouldst bind fresh meat upon it the first day thou shouldst apply for him two strips of linen ; and treat afterward with grease , honey , (and) lint every day until he recovers.

Closed reduction of a nasal fracture ('Case 12') :

EXAMINATION: If thou examinest a man having a break in the chamber of his nose, (and) thou findest nose bent, while his face is disfigured, (and) the swelling which is over it is protruding .
DIAGNOSIS: Thou shouldst say concerning him : "One having a break in the chamber of his nose . An ailment which I will treat ."
TREATMENT: Thou shouldst force it to fall in , so that it is lying in its place , (and) clean out for him the interior of both his nostrils with two swabs of linen until every worm of blood which coagulates in the inside of his two nostrils comes forth. Now afterward thou shouldst place two plugs of linen saturated with greases and put into his two nostrils . Thou shouldst place for him two stiff rolls of linen , bound on . Thou shouldst treat him afterward with grease , honey , (and) hint every day until he recovers .


The ancient Egyptians recognized the futility of treating dislocated cervical vertebrae with associated quadriplegia:

EXAMINATION: If thou examinest a man having a dislocation in a vertebra of his neck, shouldst thou find him unconscious of his two arms (and) his two legs on account of it , while his phallus is erected on account of it, (and) urine drop from his member without his knowing it; his flesh has receives wind ; his two eyes are blood-shot ; it is a dislocation of a vertebra of his neck extending to his back-bone which causes him to be unconscious of his two arms (and) his two legs. If , however , the middle vertebra of his neck is dislocated , it is an emissio seminis which befalls his phallus .

DIAGNOSIS: Thou shouldst say concerning him : "One having a dislocation in a vertebra of his neck , while he is unconscious of his two legs and his two arms, and his urine dribbles. An ailment not to be treated..

Atta HM. Edwin Smith Surgical Papyrus: the oldest known surgical treatise. Am Surg. 1999 Dec;65(12):1190-2

A description of the Edwin Smith papyrus' contents is on-line at www.eoa.org.eg/oldest.htm
Information on other Egyptian medical texts can be found here: www.crystalinks.com/egyptmedicine.html

contributor: Barry Armstrong

c1300 BC
First description of shoulder reduction
In a painting in the tomb of Ipuy, the sculptor of Ramses II depicts a physician reducing a dislocated shoulder, using a similar technique Kocher described in 1870, some 3200 years later.

contributor: Barry Armstrong