my internal monologue when Ancient Egypt is mentioned: [don't talk about imhotep and the first codified diagnostic manual. the fact you know so much about it is deeply weird and nobody cares about medicine that much]
That sounds fascinating and I want to know. Please.
I have been enabled, and By Jove I Will Deliver.
The year is 1862, and antiquities dealer (and forger) and self-made Egyptologist Edwin Smith steals a papyrus from an antiquities seller in Luxor. I could go on a whole separate rant about European colonialists treating culturally significant artifacts like grab 'n go bags and have done so here.
Anyway, Edwin's pilfered scroll gets translated in 1930, and it turns out have been a transcript from about the 17th century BCE of a papyrus written by a man named Imhotep, a vizier in the court of King Djozer who practiced neurosurgery, and made forays into astronomy and architecture too.
Now, Imhotep was wicked smart. As in "when the Greeks met him they incorporated him into the pantheon as a magician of Ascelpius because they couldn't figure out how he had such a comprehensive understanding of the human body and treating it's ills" smart. His scroll was a record of treatment of 48 cases, ranging from fractures of the hand to open abscessed wounds to trauma injuries to the skull. Side note: a lot of medicine during this period was considered to be the work of occult phenomena, and so a lot of treatments involved charms to ward off malignant spirits and incantations to aid in curing them.
What's remarkable about the Edwin scroll is that it is the first recorded account of medicine without the attachment of spiritual or occult phenomena as the root cause or a means of treatment; it's a purely scientific endeavour, complete with an anatomical glossary, diagnosis, summary, method of treatment and prognosis for each injury and illness.
It's the first evidence-based, scientific diagnostic manual.
The most significant case is Case 45, concerning a patient with “bulging masses — they may be compared to the unripe hemat fruit which is cool, and hard to the touch” in the breast. These masses are malignant tumours, the manifestation of breast cancer, and provide us with the first ever recorded case of cancer.
Imhotep knew that a tumour that has hot to the touch was a sign of infection (the inflammatory immune response produces tumor (swelling), rubor (redness), dolor (pain), and significantly to this calor, or heat). Infected abscesses could be treated with draining and a topical poultice. In the section for therapy for Case 45, though, there's one single, haunting line:
“There is none.”
In 2500BCE, well before germ theory, aseptic technique, chemotherapy and antibiotics, a surgeon picked up a scroll of fresh papyrus and provided us with the first ever codified, scientific diagnostic manual for injury and illness, and the first written record of the emperor of all maladies that we call cancer.
That's pretty fucking dope.
(If the cancer aspect is something you're interested in, I highly recommend The Emperor Of All Maladies: A Biography of Cancer by Siddhartha Mukherjee. It's a record of the diagnosis and treatment of cancer from the days of Imhotep to the present day, and it's a fascinating read)
