On the myth of the Edwin Smith papyrus: is it magic or science?

Abstract

The Edwin Smith papyrus (ESP) [1] holds a very special position in the canon of the ten surviving major medical papyri from ancient Egypt. The text has a clear, logical structure. It describes injuries and wounds from head to toe (a capite ad calcem), separated into 48 cases. Again, each case is presented in a clearly structured manner. After the title, the diagnostic procedure and relevant clinical signs are enumerated. When deemed necessary, differential diagnostics are mentioned as well as an additional explanation of some of the clinical symptoms and specific medical terms. A verdict follows that comprises three treatment possibilities: either the disease can be treated, or it is a disease “the physician will fight with,” or nothing can be done for the patient. Depending on this, treatment options are given. After the editio princeps (Fig. 1) by Breasted in 1930 [2] and the standard edition of the hieroglyphic text in 1959 [3], three more recent major editions of this papyrus in translation with commentary have been published [1, 4, 5], in addition to some articles that studied single cases [6–11]. Most of these publications were more or less philogically oriented. Consequently, since its publication the ESP has attracted modern physicians, who have explained the injuries based on their knowledge of modern medicine and tried to evaluate the efficacy of the proposed treatments from a modern medical point of view [12–14].Many of these students praised the ESP as the first scientific work of medicine because of its clearly structured layout and the lack of magical practice [15, 16]. Unfortunately, often it is not mentioned or missed that the ESP also contains prescriptions with magical spells or allusions. This holds true for cases 8 and 9 in the surgical part and several magical spells on the verso of the last page, which are not directly related to the surgical treatise. These, of course, do not fit the pure scientific approach. When mentioned, the magic interludes in this papyrus were often defined as unnecessary slips of the otherwise scientific approach and were mostly discarded as a “fall back” to more pagan times [17], which allegedly happened to ancient Egyptian medicine in the course of its later development [18]. The aim of this article is to define the socio-cultural environment (“Sitz im Leben”) of this document in order to explain this putative contradiction. Furthermore, its “scientific character” will be discussed. In detail, the following issues will be addressed: What was the social organization of ancient Egypt at the time of the ESP (1600 BCE)? How does medicine fit into this, and how was it executed practically? What are the treatment concepts and how does magic fit into all this? How did the individual patient fare? This article will not discuss the ESP on a case-by-case basis, but tries to give an overview.