Methods Employed by the Egyptian Physicians
I may mention in passing that, although the medical papyri which have come down to us are no doubt only an insignificant fraction of those possessed by the Egyptians, we, nevertheless, find in them abundant reference to medicine and surgery. In the Kahun papyrus obstetrics is dealt with. Gynaecology, also ophthalmology, materia medica, diseases of the ear, tongue, and nerves, also dentistry, are the subjects of others, and even veterinary medicine was treated of in a papyrus, a fragment of which was found by Professor Flinders Petrie.
According to Herodotus, Egyptian physicians specialized to a considerable extent, ‘Each physician applies himself to one disease only.’ ‘Some,’ he says, ‘are for the eyes alone, others for the head, others for the teeth, others for diseases of the abdomen, others again for special internal diseases.’[28] As to dentistry it may be remarked that the ancient Egyptians were probably the first to stop decayed teeth with gold. I may add that Ebers states that twenty distinct diseases of the eye are referred to in the papyri, and Dr. Grant Bey asserts that the operation for cataract was practised in ancient Egypt.[29]
As regards materia medica the Egyptians possessed the following drugs:—lactuca, various salts of lead, such as the sulphate, with the action of which in allaying local inflammation they were well acquainted; pomegranate and acanthus pith as vermifuges; peppermint, sulphate and acetate of copper, oxide of antimony, sulphide of mercury, petroleum, nitrate of potash, castor oil, opium, coriander, absinthe, juniper (much used as a diuretic), caraway, lotus, gentian, mustard, ox-gall, aloes, garlic, and various bitter infusions; mandragora, linseed, squills, saffron, resin, and various turpentine products; cassia, certain species of cucumis, cedar-oil, yeast, colchicum, nasturtium, myrrh, tamarisk, powdered lapis lazuli, vinegar, indigo; the oasis onion, mastic and various gums, mint, fennel, hebanon or hyoscyamus, magnesia, sebeste (a tonic and a cough medicine), lime, soda, iron, and a great number of other agents, the names of which no one can at present translate.
PLATE VI
Front of the temple of I-em-hotep, Island of Philae
PLATE VII
Eastern wall of courtyard of temple of I-em-hotep, Philae; showing door and apertures into narrow wall chamber
In reading this very imperfect list one does not wonder that Homer speaks of ‘the abundant herbs of Egypt, healing and baneful, used by men more skilled in medicine than any of human kind.’[30] The Berlin Medical papyrus alone mentions fifty medicines of vegetable origin. Some of the prescriptions in Ebers’ papyrus are stated to have come from the great medical temples of Sais and Heliopolis. The copy of Ebers’ papyrus has evidently been in use by the priest physicians, for various notes have been added on the margin by later hands in reference to the prescriptions—‘Good,’ ‘Very good,’ ‘Try this,’ etc.
It is an interesting fact that upon the walls of some of the ancient temples hieroglyphic records have been cut referring to medicine, and containing, in some instances, prescriptions; in other cases descriptions of various chemical processes; some of the temples seem to have had laboratories attached to them. The hieroglyphic name for the land of Egypt was Khami, whence are derived the words ‘Alchemy’ and ‘Chemistry.’[31]
Surgical instruments and the actual cautery were in use, also steam inhalations, massage, ointments, plasters, poultices, suppositories, injections, and emetics, and the importance of temperature in disease was to some extent recognized.
Prescriptions were written out in due form and sometimes at great length, fully equalling those of the most enthusiastic therapeutist of our own day. Some hundreds of prescriptions have come down to us in papyri. The longest prescription which I have read contained thirty-five ingredients. To read it was a formidable task; to take it I should think a much more formidable one. Some prescriptions are wise and rational, a few strange and repulsive, and some are associated with charms and spells.
Human nature is the same in all ages; hence one was not surprised to meet with hair invigorators, hair dyes, cosmetics, pain killers, insect powders, and a soothing syrup for small children containing opium in use three thousand five hundred years ago. It was rather interesting to find that the symbol for a half tenat often used in their prescriptions is identical with that indicating a drachm with us, though the amounts are not the same. I trust that the drachm will soon be as obsolete as the tenat.
The writings of Dr. Grant Bey contain the information that during the Hyksos period a law was enacted to the effect that if any physician adopted a method of treatment not authorized by the sacred books and in case the patient died under that treatment, the life of the physician should also be forfeited. It is to be hoped that a principle so absolutely fatal to all progress was not permitted long to remain in operation.[32]
II
A Suggestion in Regard to Preventive Treatment of Valvular Disease
I have referred to certain facts, mostly of recent discovery, bearing on the existence of our profession in the remote past and in reference to the partial knowledge to which the priests of I-em-hotep attained as to the circulation of the blood, a subject not without a certain interest, but the advances of that knowledge made subsequently, which have on more than one occasion been dealt with in this room, those now making, and those yet to be made in the future are of more practical importance to us.
The genius and the marvellous industry of Harvey first clearly unfolded the great secret of the course of the circulation, thus opening a wide door for the work of others, physiological and therapeutic. A recognition of the principles of blood pressure, and of the action of vasomotor nerves, and other advances have followed. We have attained to a larger, though I believe as yet only to a partial and provisional, hold of truth in these matters. As such we shall regard our knowledge if we are wise. The great mistake in all times has been that of believing that the truth already attained is the whole and that nothing remained behind.
Our Egyptian and our Greek predecessors seem to have believed that they had attained to absolute and final knowledge on these subjects. While we smile at their error, let us be humble in estimating our own position and ever remember that we ourselves may be yet barely on the threshold.
Our father, Harvey, has exhorted us ever to search and to study out the secrets of nature by the way of experiment. Will you pardon me if I devote the remainder of this paper to an account of a humble attempt to carry out his mandate, if I narrate briefly an experiment dealing with a yet unsolved problem in the pathology of the circulation, to which I have devoted twenty-five years of my life?
I may plead the usage of speakers and writers who follow a tale or narrative by a moral or practical application, and perhaps I may also be allowed to say that the discovery that ancient Egyptian physicians advocated rest in certain forms of heart disease suggested to me the propriety of supporting this doctrine by a brief narration of my own experience in the same direction.
As the Egyptians were probably ignorant as to the action of the valves of the heart, they can only have known the fact that rest was beneficial, but not the reason.
Valvular defect is one of the most important and perhaps the most common of circulatory diseases. It is one which probably we shall never be able to cure, and is thus likely to remain one of the opprobia of medicine. Is it possible to treat it by prevention? This is the problem upon which I wish to speak a few words. I am the more encouraged to do this because I know that various Fellows and Members of this College hold similar views to those which I desire to unfold.