Ancient Egyptian Medicine

The great Egyptian civilization that existed along the Nile River is well known for its amazing achievements in art, medicine, architecture, and science. Ancient Egyptians (3300 BCE to 525 BCE) established the basics of dentistry, surgeries, and medical prescriptions. The first documented physician is Sekhet'enanch, the chief physician who healed the Pharaoh Sahura of the fifth dynasty, who had a disease in his nostril. Imhotep (2780 BCE), a popular early Egyptian physician, was the chief vizier to the pharaoh Zoser, who was the first king of the Third Dynasty of the Old Kingdom. 

Some pictures, which are considered the earliest known pictures of surgical operations, are carved on the door-posts of a tomb in Memphis. A painting was found inside the Egyptian tomb of Bani Hassan representing a neurosurgical procedure in a sitting position. On the tombs and temple walls, ancient Egyptians made paintings describing hemiplegia, hydrocephalus, epistaxis, spine fractures, and skull base fractures. Lesions resembling meningiomas were found in the skulls of two different mummies, according to the recent archaeological findings.

Ancient Egyptians knew that having a healthy body and good health is through good hygiene and eating habits, and this includes healthy food, personal hygiene, in addition to sport and exercise. 

The ancient Egyptian medical papyri described how ancient Egyptians diagnosed and treated various diseases using different remedies and surgeries. The Ebers papyrus and the Edwin Smith papyrus, written in 1500 BC, are two of the oldest medical records in history. In the Edwin Smith papyrus, there is a description of the clinical examination, diagnosis, treatment, and prognosis of different cases, and it has a section of the central nervous system (CNS) with 27 cases related to head trauma (3 cases with head injuries, 4 cases with deep wounds in the scalp, and 11 cases with skull fractures) and 6 cases related to spinal trauma. In the Ebers papyrus, there is a description of various medical treatments for multiple medical conditions and ailments, such as migraines. Ancient Egyptians considered health and illness were a result of the relationship of the person and the universe, including God, people, animals, good and evil. They combined knowledge, magic, and faith in understanding the body's physiology and different diseases.

According to the Ebers Papyrus, the body has 22 mtw (vessels) carrying blood, air, mucus, tears and other substances and controlled by the heart. Examination of the patient’s pulse helped the Egyptian healers to determine the condition of the mtw-vessels. The disease occurs if the mtw-vessels are blocked by noxious substances which may enter the body through wounds or natural openings. 

Ancient Egyptians strongly believed in the afterlife, and they believed that the soul had to recognize its body in order to move onto the afterlife. Egyptians realized that removal of internal organs would help to prevent post-mortem putrefaction, and this was the beginning of the mummification process. Trans-nasal exacerbation is a procedure that was performed during mummification through which the brain is removed through the nose, similar to the modern trans-ethmoidal minimally invasive anterior skull base approach. Trepanned skulls were found belonging to the ancient Egyptian Civilization between 2000 and 1788 BC. Local anaesthetic agents, compounds of ground marble and vinegar used in these procedures. Different tools were used for these surgeries, but chisel and hammer were the most common for trepanation.

Ancient Egyptians had great knowledge about several diseases of the circulatory, respiratory, alimentary, nervous, olfactory, ocular, auditory, genital, and skeletal systems. They described the anatomy and the diseases of these various systems in details. Ancient Egyptians were also great at surgeries. They used forceps, scissors, scalpels, and splints which were tied together by strips of linen or pieces of wood. Linen soaked in a sticky material, which hardened, was used as a plaster for fractures. They used cautery to stop bleeding and sutured the wounds. Pieces of linen were used in the process of opening and surgically draining boils, abscesses, and septic wounds. Similar to the Kocher method, a dislocated joint was treated. It was documented that they performed circumcisions and surgically treated hernias. 

Ancient Egyptians had knowledge about cardiac diseases, including congestive heart failure, arrhythmia, venous insufficiency, and aneurysm. They had a deep understanding of the human nervous system and the relation between brain lesions and peripheral deficits. They also prescribed the management of various urinary disorders, including infection, urine retention, haematuria, and urine frequency. They were great dentists treating dental caries, doing tooth extraction, and other dental problems, including mouth ulcers, gum inflammation, abscesses, calculus formation, and jaw dislocation. A hole used to drain an abscess was found under the 1st molar in the mandible of a 4th dynasty mummy (around 2625–2510 BCE). 

Diabetes mellitus was first described in the Ebers Papyrus, containing the following description: "to eliminate urine which is too plentiful.” describing polyuria which is increasing the volume of urine, a symptom known in diabetes. Cancer was first reported in the Edwin Smith Papyrus. It was described by the following: “bulging tumour of the breast was a grave disease and there was no treatment for it.” Several tumours were reported in the Ebers Papyrus, including tumours of the pharynx, stomach, rectum, skin, uterus, polyps, and enlarged thyroids, using various methods such as knives, cautery, salts of lead and sulphur, or arsenic paste to treat such tumours. 

Over 3000 years ago, ancient Egyptians documented the use of cardiotonic steroids (CTS). CTS have therapeutic effect against congestive heart failure and atrial fibrillation. CTS are a group of hormones in the amphibians and toads and can be extracted from natural products such as herbs, plants, and marines. CTS are divided into cardenolides (plant-origin), such as ouabain and digoxin, and bufadienolides (mainly of animal origin), such as marinobufagenin, telocinobufagin, and bufalin. Various CTS isolated from toad species had superior anti-inflammatory, antiviral, and anticancer activities in some models. Molecular and biotechnological techniques were used to identify these compounds and their bioactivities. These steroids have a role in regulating cell growth, differentiation, apoptosis, and fibrosis in addition to the control of central nervous functions, behaviour, and modulating immunity. CTS may be useful in the treatment of cancer over the next decades, but further research is needed.

Music therapy was used to manage some diseases. A sleep therapy using opium or mandrake plant extract was also used to treat patients, and this shows that they had knowledge about sedation even before the development of modern anaesthesia. They used cauterization to inflammation and after surgery to promote healing. They had knowledge about prosthetic limbs, as big artificial toes were discovered on the feet of numerous mummies. Various skin conditions were treated with sunlight exposure and topical remedies for cosmetic purposes. They used castor oil to promote hair growth in patients with alopecia or suffering from hair loss due to malignancies.

Ancient Egyptian treatments included plant sources (fruit, root, leaves, or juice), minerals, metals, and animals. A wide variety of plant species were used, such as castor bean, cumin, cucumber, cassia, coriander, barley, anise, acacia, date, garlic, mulberry, lotus, lettuce, leek, poppy seeds, sunflower, wheat, and wormwood. These plants contain bioactive secondary compounds such as flavonoids, isoflavonoids, isochromenes, saponins, pyrones, alkaloids, and diterpenes.

Minerals and metals used in ancient Egyptian civilization included copper, antimony, alum, iron oxide, limestone, sodium bicarbonate, sodium carbonate, red ochre, sulphur, salt, and arsenical compounds. These compounds were used mainly as mild astringent or antiseptic substances for local application for burns, boils, or felons. Sulphur was used for scabies, antimony sulphide orally for bilharziasis, yellow ochre hydrated oxide of iron for anaemia caused by ankylostoma, green copper ore for eye inflammation, and red ochre natural oxide of iron in cases of haemorrhage.

These remedies were not only for medical application but also for cosmetic purposes, as some minerals had strong colours, such as antimony and lead sulphides used to produce black paints, malachite, which produced the green colour used in eye make-up, and chrysocolla and copper silicate, which produced a blue-green colour also used for cosmetic purposes.

A cleansing product was made of natron, which was also used for household cleansing. It was documented in the Kahun papyrus that natron can be used for contraception: “Honey, sprinkle over her womb, this to be done on a natron bed.” Nubian ochre was used to fix a loose tooth and as an antidiabetic substance.

Fat and grease from different animals were used in various prescriptions and were mentioned in multiple medical papyri. These sources sometimes were used for external use only in the form of ointments and sometimes for internal use; for example, goose fat was used orally to relieve pain and also for relaxation through external use. Animal products that were used include milk, eggs, blood, bone, bone marrow, spleen, liver, bile, skin, and even urine and faeces. Liver was used to prevent grey hair and for night blindness, as it is rich in vitamin A. Honey is well known for its benefits. Honey was used as an antidiarrheal, anti-cough, and antiseptic, for wound healing, toothache, and fixing a loose tooth.

Here are some ingredients and drugs used by ancient Egyptians:

-Antiseptics: Using oils and lipids combined with wound dressings to enhance postsurgical epithelialization. A drug known as Abies Cilicia (Pinaceae), composed of resin and oils, was used as an antiseptic and an embalming material promoting hair growth. Mouldy bread was used on infected wounds before the discovery of penicillin secreted by moulds by Alexander Fleming. Vitis vinifera (Vitaceae), composed of catechins and procyanidins, are seeds used for wound healing and fruits in a laxative remedy.

-Antibiotics: Natural substances such as onions and honey were used to treat infections. Carob tree extracts that contain gallic acid and polyphenol derivatives had antioxidant, antimicrobial, and antidepressant effects. Matricaria chamomilla (chamomile) (Compositae), formed of volatile oils, coumarins, and flavonoids, was used for wound healing and as an antibacterial. Yeast (Saccharomycetaceae), formed of nitrogenous compounds and amino acids, was used locally to relieve boils and ulcers and orally to relieve digestive disorders. 

-Anti-inflammatory: Incense, derived from the olibanum tree, had anti-inflammatory properties and was used to treat different conditions. Salicin extracted from the willow tree was also used to reduce inflammation and pain. A drug known as Allium ampeloprasum (Amaryllidaceae), composed of sulphur-containing bioactive constituents, was used for local application to insect bites and skin irritations. Allium kurrat (leek) (Amaryllidaceae), formed of sulphur-containing compounds and phenolics, was used for eye treatment, night blindness, and genital warts. 

-Anti-proliferative: Boswellic acid acetate had anti-proliferative effects on malignant cells. 

-Cardiotonics: Drimia maritima (Asparagaceae), formed of bufadienolides (cardiac glycosides) and phenolics, was one of the cardiotonics used by ancient Egyptians. 

-Painkillers: Shepen plant and propolis were used as sedatives and painkillers for pain and fever. Mandragora officinarum (Mandrake) (Solanaceae), formed of alkaloids, was used as a pain reliever, with aphrodisiac properties, to promote conception, and for healthy teeth. Thymus vulgaris (thyme) (Lamiaceae), formed of volatile oils, was also used as a pain reliever and against tapeworm.

-Anti-cough: a drug known as Ceratonia siliqua (carob pods) (Leguminosae), formed of carbohydrates, proteins, tannins, and pectins, was used as an anti-cough remedy. Borinella sp., formed of triterpenoids, diterpenoids, and volatile oils, was used as an anti-asthmatic. Ammi visnaga (Apiaceae), formed of furanochromone, coumarins and essential oils, was used against asthmatic cough. 

-Gastrointestinal disorders (GIT): Allium cepa (onion) (Amaryllidaceae), composed of volatile oil with organosulfur compounds, flavonoids, and phenolic acids, was used as an antidiarrheal, diuretic, and perspiration inducer; to prevent colds; to soothe sciatica; to relieve pains; and for some cardiovascular problems. Althea species (marshmallow) (Malvaceae), formed of starch, mucilage, pectin, and flavonoids, was used as an enema. Anethum graveolens (Dill) (Apiaceae), formed of volatile oils, was used to relieve flatulence, relieve dyspepsia, and act as a laxative and a diuretic. Hyoscyamus niger (Solanaceae), formed of alkaloids, was used to relieve colic from Ascaris, against fever, and for intestinal troubles.

-Antidiabetics: Acacia senegal (Gum arabic) (Fabaceae), formed of gums and polysaccharides, was used in a remedy for diabetes. Balanites aegyptiaca (Zygophyllaceae), formed of saponins, alkaloids, flavonoids, and pregnane glycosides, was used as an antidiabetic. Poa sp. (Poaceae), formed of carbohydrates and flavonoids, was also used as an antidiabetic. 

-Contraception: Gum acacia (Fabaceae), formed of polysaccharides, was used as a local vaginal contraceptive and mild antiseptic.

-Cosmetics: A mixture of honey, red natron, lower Egyptian salt, and alabaster flour was used as an ointment to restore wrinkles and spots. Malachite was used by ancient Egyptians as an eye paint and treatment.

A lot of the remedies and substances used by ancient Egyptians are still used these days, and their efficacy has been proven. Ammi majus fruit was used to treat vitiligo. Nowadays, a compound (8-methoxypsoralen) isolated from Ammi majus is used to treat psoriasis and vitiligo. Ziziphus spina was used under the name nebes, was documented in about 33 ancient Egyptian prescriptions, and was used to treat inflammation. Nowadays, gallocatechin and epigallocatechin were found as two major compounds that are strongly related to the expression of 79 inflammation-related genes in the National Cancer Institute (NCI, USA) cell lines. Moreover, the efficacy of honey as an antimicrobial agent by 6 mechanisms has been reported and proven in research. More research is still required, but it is sure that ancient Egyptians were intelligent and amazingly knew how to deal with different diseases using the power of knowledge and faith.

(1) Metwaly AM, Ghoneim MM, Eissa IH, Elsehemy IA, Mostafa AE, Hegazy MM, Afifi WM, Dou D. Traditional ancient Egyptian medicine: A review. Saudi J Biol Sci. 2021 Oct;28(10):5823-5832.

(2) Elsayad K. What Ancient Egyptian Medicine Can Teach Us. JCO Glob Oncol. 2023 Jun;9:e2300146.

(3) ReFaey K, Quinones GC, Clifton W, Tripathi S, Quiñones-Hinojosa A. The Eye of Horus: The Connection Between Art, Medicine, and Mythology in Ancient Egypt. Cureus. 2019 May 23;11(5):e4731.  

(4) Ancient Egyptian Medicine: The sacred science and origins of healing practices. 

(5) Gordetsky J, O'Brien J. Urology and the scientific method in ancient Egypt. Urology. 2009 Mar;73(3):476-9. 

(6) El-Seedi HR, Yosri N, El-Aarag B, Mahmoud SH, Zayed A, Du M, Saeed A, Musharraf SG, El-Garawani IM, Habib MR, Tahir HE, Hegab MM, Zou X, Guo Z, Efferth T, Khalifa SAM. Chemistry and the Potential Antiviral, Anticancer, and Anti-Inflammatory Activities of Cardiotonic Steroids Derived from Toads. Molecules. 2022 Oct 5;27(19):6586. 

(7) ReFaey K, Clifton W, Quinones GC, Tripathi S, Quiñones-Hinojosa A. Mysterious Civilizations: Is There a Connection between Medicine and Architecture in Ancient Egypt and Peru? Cureus. 2019 Apr 30;11(4):e4576.