Ancient Egyptian Medicine

Abstract

Ancient Egyptian Medicine, James F. Nunn. Norman, OK: University of Oklahoma Press, 1996, ISBN 0-8061-2831-3, 236 pp, $39.95. What is going on here? A review in an anesthesia journal of a book about medicine in a country some 5000 years ago, with not a word about anesthesia? Your reviewer found this to be a fascinating book, however, and thought it might be of interest to other anesthesiologists also, not the least because of who the author is. John Nunn, for the benefit of those of recent entry into our specialty, is a British anaesthetist internationally recognized and respected, a giant in anesthesia for more than 3 decades. He co-authored, for example, no less than three editions of the widely popular classic General Anaesthesia, an early example of the encyclopedic all-in-one books so popular today. A pioneer in studies of pulmonary physiology, Dr. Nunn also authored yet another classic: Applied Physiology with Special Reference to Anaesthesia, a book as useful today as when it first appeared in 1968. Some 20 years ago, his anesthetic interest not being enough, Dr. Nunn began his study of Egyptian hieroglyphs and pursued it with such dedication and intensity that today he is recognized as a member of the Egyptian Exploration Society and an expert Egyptologist. Few, indeed, today are those expert in specialties as widely disparate as medicine and Egyptology. Dr. Nunn starts the present book with insights in a variety of areas. One of these areas deals with a necessary, for most of us, discussion of how the unique geographical features of Egypt played an important role in determining the history and development of this ancient country. Basically, Egypt is a long sliver of land with one of Earth's largest rivers, the Nile, running the length of it from south to north and with deserts on both sides so vast as to defy significant penetration over the millennia. With the Nile as a source of water and its annual inundation providing silting of rich soil throughout much of the country, Egypt has remained until recently totally self-sufficient, needing no appreciable imports of foods, materials, or ideas, and immune from invasion from outside. In no other continental land has there been isolation greater in degree and duration. A consequence of this level of isolation over a period of a millennia was, as Dr. Nunn points out, the development of a national conservatism that created a remarkable level of stability, both governmental and cultural. The arts and written language that the ancient Egyptians developed remained static for many centuries but generated exceptionally high levels of literacy for this period in the development of humankind, as testified to by the ubiquity of hierographs and surviving papyri. As hydrologists, ancient Egyptians were able to irrigate every bit of cultivatable land using water from the Nile. As accomplished mathematicians and engineers, they were able to build pyramids of a magnitude and grandeur so great as to still boggle the mind. As anatomists, they became expert in the postmortem handling of the human body in such a way as to preserve bodies for thousands of years. As healers of the ill and diseased, ancient Egyptians were, however, not adept. How the ancient Egyptians lived and died starts with a detailed and lengthy discussion of the information derived from studies of mummies, stelas, carving on walls and in tombs, artifacts in tombs, papyri, and hieroglyphs. Anthropologically, for example, the average Egyptian was shorter in stature than modern Westerners: about 5 prime 1 double prime for males and 4 prime 10 double prime for females. Average lifespans were about 35 years for royalty but were likely shorter for commoners because of increased disease and malnutrition, but since commoners were rarely mummified, embalmed, or entombed, data to prove this are scarce. Ancient Egyptians had little sense of human physiology: functions of the brain, the lungs, the heart, and the arteries were not known. On the other hand, Dr. Nunn can list in 33 pages the not inconsiderable numbers and types of diseases with which the early Egyptians were afflicted. All cannot be listed, but the parasitic diseases that were especially present included malaria, schistosomiasis, and dracunculiasis. Bacterial infections included tuberculosis, both pulmonary and spinal, leprosy, and tetanus. Viral diseases may have been present but are difficult to diagnose from sources available. Ancient Egyptian healers, devoid of our modern understanding of physiology, pathology, and etiology, could only direct their treatment of diseases to the management of symptoms, not causes. To this end, considerable reliance was placed on a wide variety of botanical preparations. Apparently, morphine and opium were not used. On the other hand, magic and religion were also relied upon extensively, perhaps even more so than botanical therapies. In the absence of anesthesia, elective surgery in ancient Egypt was restricted almost entirely to circumcisions. Surgical management of trauma, including fractures and lacerations, of which there appears to have been an abundance, was imaginative and often effective, as shown by the many illustrations Dr. Nunn provides. There is no evidence that trephination was used in ancient Egypt as it was in ancient France and South American countries. This book is enlightening. It is interesting. Most of all, it is fun, a book not easy to put down once one starts reading it. This book also stands as compelling evidence that, for changes and advances in human societies and cultures, including medicine, interaction among different peoples with different backgrounds and ideas is a sine qua non. Spontaneous or evolutionary changes in society and culture were rare or absent in the presence of isolation as complete as that seen in ancient Egypt after a certain stable and relatively low level of cultural advance had been achieved. Multiculturism would seem to be a necessary catalyst for the advance of human societies. Nicholas M. Greene, MD Department of Anesthesiology; Yale University School of Medicine; New Haven, CT 06510