Edwin Smith Papyrus - Procedure

Procedure

The rational and practical nature of the papyrus is illustrated in 48 case histories, which are listed according to each organ. Presented cases are typical, not individual. The papyrus begins by addressing injuries to the head, and continues with treatments for injuries to neck, arms and torso, detailing injuries in descending anatomical order like a modern anatomical exposition. The title of each case details the nature of trauma, such as “Practices for a gaping wound in his head, which has penetrated to the bone and split the skull”. The objective examination process included visual and olfactory clues, palpation and taking of the pulse. Following the examination are the diagnosis and prognosis, where the physician judges the patient’s chances of survival and makes one of three diagnoses: “An ailment which I will treat,” “An ailment with which I will contend,” or “An ailment not to be treated”. Last, treatment options are offered. In many of the cases, explanations of trauma are included to provide further clarity.

Among the treatments are closing wounds with sutures (for wounds of the lip, throat, and shoulder), bandaging, splints, poultices, preventing and curing infection with honey, and stopping bleeding with raw meat. Immobilization is advised for head and spinal cord injuries, as well as other lower body fractures. The papyrus also describes realistic anatomical, physiological and pathological observations. It contains the first known descriptions of the cranial structures, the meninges, the external surface of the brain, the cerebrospinal fluid, and the intracranial pulsations. Here, the word ‘brain’ appears for the first time in any language. The procedures of this papyrus demonstrate an Egyptian level of knowledge of medicines that surpassed that of Hippocrates, who lived 1000 years later. The influence of brain injuries on parts of the body is recognized, such as paralysis. The relationship between the location of a cranial injury and the side of the body affected is also recorded, while crushing injuries of vertebrae were noted to impair motor and sensory functions. Due to its practical nature and the types of trauma investigated, it is believed that the papyrus served as a textbook for the trauma that resulted from military battles.