The Edwin Smith Surgical Papyrus
"Practices for a fracture in the pillar of his nose. If you treat a man for a fracture in the pillar of his
nose, and his nose is flattened and his face is flattened out, while the swelling that is on it is high,
and he has bled from his nostrils, then you say about him: 'One who has a fracture in the pillar of his
nose: an ailment I will handle.' You have to wipe it for him with two plugs of cloth. You have to push two
plugs of cloth wet with oil inside his nostrils. You have to put him on his bed in order to reduce his swelling. You have to set for him
stiff rolls of cloth so that his nose is restricted from moving, and treat him afterward with an oil and honey
dressing every day until he gets well. As for 'the pillar of his nose', it is the bridge and side of his nose,
inside his nose in the middle of his nostrils. As for 'his nostrils', they are the two sides of his nose,
penetrating to his cheek, starting at the end of his nose and exiting the top of his nose."*
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This is an excerpt from The Edwin Smith Surgical Papyrus (papyri are named for their discovers or first purchasers of note; Edwin Smith
purchased the papyrus in Luxor in 1862, but did not write it!). The Edwin Smith Surgical Papyrus is a medical papyrus, and the text
shown above discusses the treatment for a broken nose.
The Smith Papyrus consists of 22 columns of text on two sides of a 4.68m x 33cm strip of papyrus, containing in all 469 lines of text.
The text is written in hieratic, and is read from right-to-left. I have not changed that orientation in the photograph of the papyrus, although I have flipped the hieroglyphic transcription to read from left-to-right. There is a one-to-one correspondence between the hieratic and hieroglyphic signs, although the frequent use of ligatures (linking two or more signs together in a single brush-stoke) tends to obscure that relationship.
Evidence from grammar and vocabulary indicate that the text of the Smith Papyrus is very old, and probably dates from the Old Kingdom, ca. 3000 – 2500 B.C.E. Over time, as the text was
copied and re-copied, language change rendered obscure some of the terms used by the author, and eventually someone took it upon himself
to add glosses in the form of explanations for these obsolete words. Even these glosses are ancient, dating probably to around 2500 B.C.E. The
copy of the papyrus purchased by Smith was probably written in Thebes sometime in the Middle Kingdom, around 1600 B.C.E.
There are several medical papyri known from Ancient Egypt, in addition to Papyrus Smith, such as Papyrus Ebers and the Berlin Medical
Papyrus. However, Papyrus Smith is very different from the others. All the other medical papyri are essentially collections of recipes
(or prescriptions) for a wide variety of illnesses, in which the recipes are fundamentally folk remedies and in which illness is viewed
primarily as an assault by demonic forces upon the person.
Invocations and spells are as integral to the prescriptions as the ingredients of the remedies.
Papyrus Smith, however, is a systematic discussion of how to treat specific physical injuries, hence the name Surgical Papyrus. The
injuries under discussion appear to be the kind likely to be suffered by construction workers (crushed body parts, fractures) or by
soldiers (punctures, slashes), and it is probable that the author of the papyrus had experience in both areas. The text systematically
considers the human body from injuries to the head on downward (but unfortunately is not complete, ending at the thorax and
upper spine), and for each body part considers injuries on a spectrum from less serious to more serious. For each injury, diagnostic criteria are given, a prognosis is suggested, and then the appropriate treatment is described. Following this are the glosses that define obscure words.
The Smith Surgical Papyrus is unique among Egyptian medical texts, and in fact unique in the ancient world until the anatomical studies
of the Greeks 2000 years later. The author of the text was clearly working from personal experience, and appears in many cases to be coining for the first time, or adapting to new meanings, the words he uses to describe the injuries or treatments he is considering (which may be another reason that glosses for these terms were later needed). The author could clearly see that the injuries he was treating had physical causes and physical treatments, and there is no recourse to incantations, spells or useless remedies in fixing them. He even describes many cases for which he concludes there is no treatment, so systematic and completely practical is his approach. He was, beyond that, skilled at his craft, within the limitations of knowledge and medical technology of his age, and many of his treatments could be successfully applied today.
Discussion of the text
The cases discussed in the Smith Papyrus begin with a description of the major symptoms of the injury, usually in red ink, followed by tips for refining the diagnosis. After that comes the prognosis, also in red, then the treatment regimen, and finally any glosses on the terms used. The text takes the form of a series of instructions (maybe modeled on a textbook), and addresses the reader in the second person ("If you examine...", "Then you should say..."). The text tends to build on itself, so a term glossed early in the text will probably not be glossed if encountered later. Some of the treatments assume a basic knowledge of medicine, so there is no description in the text of how to make a honey and oil ointment, for example.NOTES
- Despite the scribe's careful explanations, there is some debate among modern scholars about exactly what part of the nose is indicated by the "pillar". It may refer to the bridge of the nose, the septum (the fleshy wall dividing the nostrils from each other) or the entire nose excepting the nasal bone. For this reason, most translations simply refer to the "pillar of the nose" and don't try to get more specific.
- The text uses a lot of abbreviations, for example
for 
Hsb 'fracture', and
for 
fnd (also spelled
fnD) 'nose'. For the most part, these words are spelled out elsewhere in the text
(as in Hsb at phrase 6 and
fnd at phrase 13); moreover, they mostly remained common Egyptian words, and so
we can be confident that we are reading correctly both their spelling and meaning.
- The word
mnyt 'mooring-posts' is not spelled out anywhere in the
Smith Papyrus. It does appear in other texts, however, and it is from there that we get its spelling and general meaning. The odd
phrase 'put him at his mooring-posts' was equally odd to the ancient Egyptians, and perhaps was coined by the original author of the
papyrus. The scribe who added the glosses to the text defined its
meaning in another case: it means to give no medications and let
nature take its course.
