Certain of the contents of the medical papyri are at present almost
incomprehensible, partly on account of the difficulty of translating
technical terms; these parts I shall not refer to at all; those portions
which are more easily understood still present difficulties, and
translations must necessarily be free and at times vague. It must be
remembered that the hieratic script was not a good medium for the clear
and definite statement of facts, also that the modes of thought and
forms of expression of the time were far removed from our own, even far
remote from those of the Hellenes. We enter a different world when we
try to comprehend the beliefs and conceptions of the ancient Egyptian,
the platform of thought on which he built is imperfectly known to us.
Furthermore, the philosophic conceptions which the Greeks gave to
mankind and their lucidity of expression had not then come into
existence.
In addition to these negative aspects of difference there are positive
ones. The Egyptian believed himself to dwell in a universe peopled by
spirits and demons, good and evil, whose influence must be propitiated
or averted by charms and spells. It will, therefore, be understood that
a hieratic papyrus is vastly more difficult to interpret than a Greek
manuscript.
The references in various papyri to the circulation, though somewhat
vague, are not without interest. Where the sense is important I have had
the help of one or two learned living Egyptologists, and here I must
express my acknowledgments to Dr. Budge, Professor Kurt Sethe, Dr.
Brugsch, Dr. Joachim, Dr. Leemans, Dr. Withington, Dr. Grant Bey, Dr.
Sandwich, Mr. Garstang, Professor Carrington Bolton, Professor Flinders
Petrie, Mr. Percy E. Newberry, and others, for help orally, or from
their writings, without which, in my ignorance, I should have done
little. I am especially indebted to Professor Kurt Sethe’s work on
‘Imhotep’ and to Dr. H. Joachim’s ‘Papyros Ebers.’
Let me read you one or two extracts from the work of the Pharaoh
Usaphais quoted in Ebers’ papyrus[15]: ‘Man hath twelve vessels
proceeding from his heart which extend to his body and limbs; two
vessels go to the contents of his chest, two vessels go to each leg, two
to each arm, two vessels go to the back of the head, two to the front of
the head, two branches go to the eyes, two to the nose, two vessels go
to the right ear, the breath of life goes through them, two go to the
left ear, and through them passes the breath of death; they all proceed
from the heart.’ The concluding sentence is the earliest example I know
of the ancient superstition that the left side of the body is sinister
and evil. This is very early anatomy, professing to be at least six
thousand years old; we must not expect it to be quite accurate.
Turning to a comparatively recent period, I shall quote from other parts
of Ebers’ papyrus; the only existing copy of this papyrus (found in a
tomb at Thebes) was written in or before the sixteenth century B.C. No
doubt most, if not all, its contents are much older than that date.[16]
The extracts which I am about to read commence thus: ‘From the secret
book of the physician, a description of the action of the heart and of
the heart itself. From the heart arise the vessels which go to the whole
body ... if the physician lays his finger on the head, on the neck, on
the hand, on the epigastrium, on the arm or the leg, everywhere the
motion of the heart touches him, coursing through the vessels to all the
members’ [the reference is clearly to the pulse]; ‘thus the heart is
known as the centre of all the vessels. Four vessels go to the nasal
chambers, of which two convey mucus and two convey blood. There are four
vessels within the temples or skull, from these the eyes obtain their
blood.... The four vessels divide inside the head and spread towards the
hinder part.’ The Berlin papyrus speaks of the division into thirty-two
vessels within the skull, and implies that air traverses, at any rate,
some of them.
Returning to Ebers’ papyrus[17]—‘When the breath enters the nostrils it
penetrates to the heart and to the internal organs, and supplies the
whole body abundantly.’ This idea that certain of the vessels convey
air, you will observe, is identical with the Greek conception and
probably was its source. ‘Three vessels traverse the arms and extend to
the fingers, three vessels also pass down the leg and are distributed to
the sole of the foot, a vessel goes to each testis and one to each
kidney. Four vessels enter the liver, conveying fluid and air; these may
be the seat of various diseases as they are mixed with the blood; four
vessels convey fluid and air to the intestine and spleen; two go to the
bladder and from them the renal secretion is produced. Four vessels
convey fluid and air to the lower abdomen, going to the right and left
sides; from them is formed the alvine excretion.’[18] These vessels here
described are clearly the iliac arteries and veins. ‘When the heart is
diseased its work is imperfectly performed: the vessels proceeding from
the heart become inactive, so that you cannot feel them’ [no doubt this
is a reference to changes in the pulse], ‘they become full of air and
water.... When the heart is dilated the vessels from it contain effete
matter. If a suppurative or putrefactive disease occur in the body’
[abscess, I imagine, for which various sites are suggested] ‘then the
heart causes it’ [_it_ being probably purulent or septic material] ‘to
traverse the vessels, fever or inflammation of various kinds occur in
the body, the heart is in a morbid state while the fever continues.’ [It
may be noted in passing that the septic infection is asserted to enter
the body by the _left_ eye]. ‘In heart disease there is either
disturbance of the action of the heart or the heart is congested or
overfilled with blood, the heart is moved downwards, comes nearer the
praecordia, and weakness and nausea occur....[19] When the disease
affects the basic region or lower mass of the heart there is shortness
of breath, the heart is displaced on account of the volume of blood from
the abdomen’ [probably the old idea of the rush of blood entering the
heart from the liver]. ‘There may be fever or inflammation of the
heart.’ At this point comes a passage of some therapeutic interest. ‘The
heart during such disease must be made to rest to some extent if it be
possible.’ Here we have wise advice from the ancient Egyptians, advice
the importance of which we have scarcely as yet recognized, and which we
may to-day follow with advantage. ‘If the heart is atrophied (or wastes
itself) there will be an accumulation of blood within it. When the
disease of the substance of the heart is accompanied by dropsy there is
a lessening’ [in strength probably] ‘in the ventricle or cavity.... When
the weakness of the heart is due to old age there is dropsy. When there
is raising or increase of the heart it presses towards the left side, it
is increased by its own fat, and is displaced; there may be much fat
contained within its covering or pericardium. If in a suppurative
disease the heart is pushed forward it floats or sinks in the fluid and
is displaced.’ Here we surely have a reference to pericardial
effusion.... ‘If the heart trembles or palpitates, has little power, and
sinks downwards, the disease is advancing. When there is much beating at
the praecordia, with a feeling of weight, when the mouth is hot and
languid, and the heart is exhausted the disease is a fever or
inflammation.’ In another place (folio 102) the heart is spoken of as
being full of blood which comes or flows from it again. In folio 39,
after a description of symptoms, follows a statement to the effect that
the heart is distended, the sick man is short of breath because the
blood has stagnated and does not circulate. This is an interesting
expression, but judging from other parts of the papyrus the word
translated circulate can only have a vague meaning, implying movement to
and fro, just like the expression ‘περίοδος αἴµατος’ in the Hippocratic
writings, which seems to imply the circuit of the blood, but in reality
has only a similar indefinite meaning. It is evident that the Egyptians
knew that blood flowed from the heart, but, like the Greeks, they never
seem to have realized that the heart is a pump, nor did they recognize
valves.
The Leyden medical papyrus speaks of a paralysis or disturbance of some
sort in the blood-vessels of the head, causing blindness and disorder in
the body and in the limbs; this seems to be a description of the results
of cerebral haemorrhage. Remedies are suggested to subdue the vascular
activity occurring in certain diseases.[20]
The Passalaqua papyrus is rather interesting. It was found in an earthen
jar at Thebes, and deals largely with leprosy (which prevailed greatly
in ancient Egypt). This papyrus appears to date from the time of
Mencheres of the fourth dynasty, and for many centuries was enclosed in
a case or box beneath the feet of the figure of the god Anubis, and
forgotten for ages. It was rediscovered in the reign of a later monarch,
and recopied on to a new roll of papyrus.[21] The British Museum papyrus
dates back, as regards the major part of its contents, to the time of
Khufu or Cheops the pyramid builder. It bears some evidence of Semitic
influence. In the section on the treatment of wounds it contains the
following prayer:—‘Oh Ra, creator of the gods, pass ye me along, renew
ye me, avert from me all evil things, all evil maladies, all wounds in
the flesh of these limbs.’[22] In earlier times these prayers are much
more common than during the later dynasties, when the physician seems to
have relied more upon treatment.
The various papyri from which I quote deal of course with practical
medicine and not with physiology; no distinct definition as to structure
or function is to be looked for in them; only as associated with
diagnosis, prognosis, or treatment do we get statements as to the nature
of the heart, the vessels, and the movement of the blood.