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    Ancient Egyptian records provide clues to ophthalmic care

    Two papyrus scrolls offer insight into treatments for chronic trachoma, leukoma, chalazion, trichiasis

    Norman B. Medow, MD, is director of pediatric ophthalmology at Manhattan Eye, Ear & Throat Hospital, and chair of the Museum of Vision at The Foundation of the American Academy of Ophthalmology.
    What did the ancient Egyptians know about ophthalmology and when did they know it? A good starting point might be the ancient tombs of well-preserved mummies dating centuries before the birth of Christ.

    Figure 1 Edwin Smith Papyrus, circa 1600 B.C.
    Studies of these mummies have revealed much about the early Egyptians and their medical conditions, including fractured bones, dental cavities, scoliosis, and rheumatic diseases. The only problem is that the eye never survived very well, so information about early ocular disorders from the study of mummies has not been fruitful. We therefore have had to look elsewhere for other clues.

    Figure 2 George Ebers Papyrus, circa 1550 B.C.
    Imhotep, a physician and an architect who lived in approximately 2900 B.C., was worshiped as if he were a god. He may have written texts of medicine but none of them survived. Hesy Re, another physician who lived about 2600 B.C., was identified by the cartouches and panels found in his tomb.

    Figure 3 Blind harpist with blind choristers, circa 1500 B.C. (Illustrations courtesy of Norman B. Medow, MD)
    The ancient Egyptians also knew about anatomy, according to scholars who have studied various papyri and wall paintings from approximately the same period. A papyrus and a painting from Ani show the weighing of a heart from approximately 1500 B.C.

    Two revealing scrolls

    Most of the medical information from this early period comes from two papyrus scrolls, each of which is named after its archaeological discoverer or the person who purchased it.

    The Ebers papyrus was named after George Ebers, a German professor. In the late 1800s he obtained the 20-meter papyrus, which dates from approximately 1550 B.C. Today it is housed at the University of Leipzig. The other well-known one is the Edwin Smith papyrus, dating from approximately 1600 B.C., which can be found at the New York Academy of Medicine. The Edwin Smith papyrus is approximately 4.5 meters in length and thought to be a copied text that was originally made in 3000 B.C. Both of these scrolls provide insight into what the Egyptians knew during the period around 2000 B.C.

    Chronic trachoma was most likely a serious disease of the period. Eye blurriness in both acute and chronic forms is mentioned in the Ebers papyrus. The condition was treated with oily or fatty ointments, which contained myrrh, resin, malachite, yellow ocher, and red natron. These treatments were used by Greek and Arab physicians later.

    Leukoma or a white spot of the cornea was treated with a variety of animal galls, specifically that of the tortoise. Chalazion, or little grain, was treated with ointments. Pterygium and cataracts also were mentioned in both of these scrolls but there was no indication that surgery was ever considered in either of these disorders. Bending of the hairs of the lid (trichiasis) and eversion of the flesh (ectropion) involved pulling the hairs out of the lid margin when they became too long and injured the eye. Other remedies for lid disorders included sulfite of antimony and a variety of copper solutions. Milk, blood, urine, and animal excrements were also part of the ancient Egyptian pharmacopoeia.

    Blindness was also depicted in Egyptian paintings and on monuments. It is well-known that blind musicians were admitted to the harems of kings and nobles. One of the most famous paintings of the blind from 1500 B.C. is that of a blind harpist with seven blind choral singers sitting behind him.

    Blindness was a troublesome problem for the ancient Egyptians. Our search for curing vision-threatening diseases continues today.

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