The Origin: Surgery in Ancient Africa — Teacher Resources

The Origin

Surgery in Ancient Africa — Teacher Resources

This was not luck. This was written down. Studied. Passed on.

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Quiz — The Origin

PART A — MULTIPLE CHOICE

1. How many cases does the Edwin Smith Papyrus describe?

B) Forty-eight.

Students should be able to state that the Edwin Smith Papyrus describes forty-eight cases, most of them injuries to the head, the neck, the chest, and the spine. Each case follows the same order — examination, diagnosis, verdict, treatment. [3]Breasted, James Henry. The Edwin Smith Surgical Papyrus. 2 vols. Chicago: University of Chicago Press, 1930. The forty-eight cases, their verdicts, and their treatments. Students who answer D are confusing it with the Ebers Papyrus, which holds about seven hundred remedies. Students who answer A or C are giving numbers that do not appear in the lesson.

2. According to the Edwin Smith Papyrus, what was bound on a wound on the first day?

B) Fresh meat.

Students should be able to state that fresh meat was bound on the wound on the first day to help stop bleeding, and that the wound was then treated with grease and honey every day until the patient recovered. [3]Breasted, James Henry. The Edwin Smith Surgical Papyrus. 2 vols. Chicago: University of Chicago Press, 1930. The forty-eight cases, their verdicts, and their treatments. Students who answer A, C, or D are naming dressings that do not appear in the papyrus.

3. Where is the tomb of Ankhmahor located?

A) Saqqara.

Students should be able to place the tomb of Ankhmahor at Saqqara, the great burial ground of the kings and nobles of Kemet. It is called the Physician’s Tomb because of its carved scenes of medical procedures, although Ankhmahor himself was a high official, not a doctor. [2]Kanawati, Naguib, and Mahmoud Hassan. The Teti Cemetery at Saqqara, Vol. II: The Tomb of Ankhmahor. Warminster: Aris & Phillips, 1997. The Physician’s Tomb and its medical reliefs. Students who answer B, C, or D are naming other places from the lesson or from other lessons.

4. Who was Edwin Smith?

C) An American dealer who bought the papyrus in 1862.

Students should be able to identify Edwin Smith as the American dealer who bought the scroll in 1862 in Waset, now known as Luxor. The papyrus carries his name, but it was written by physicians of Kemet. [4]“Edwin Smith Papyrus.” Encyclopaedia Britannica. Its date, its purchase in 1862, and its translation. Students who answer A have confused the buyer with the authors. Students who answer B or D are describing other kinds of people who do not match the record.

5. What does the Ebers Papyrus say about the heart?

B) It has vessels going to every limb of the body.

Students should be able to explain the Ebers Papyrus’s treatise on the heart: the heart has vessels going to every limb, and “the heart speaks out of the vessels of every limb” — in other words, the pulse comes from the heart. [5]“Ebers Papyrus.” Encyclopaedia Britannica. Its date, its remedies, its treatise on the heart, and its acquisition in 1873.[6]“The Papyrus Ebers.” Document held in CDC Stacks (cdc:72351). The treatise on the heart and vessels, with an English translation of its passage on the pulse. Students who answer A, C, or D are contradicting what the treatise says.

6. What did the healer in Bunyoro use to dull the mother’s pain?

B) Banana wine.

Students should be able to state that the healer gave the mother banana wine to dull the pain, and also used banana wine, then water, to wash his hands and the mother’s abdomen. [8]Felkin, Robert W. “Notes on Labour in Central Africa.” Edinburgh Medical Journal, April 1884. The cesarean birth at Kahura in 1879. Students who answer A, C, or D are naming substances that do not appear in Felkin’s account.

7. How was bleeding stopped during the cesarean birth Felkin witnessed?

A) With a red-hot iron.

Students should be able to state that the healer’s assistant used a red-hot iron to stop the bleeding — cauterization, the same principle surgeons use today with electric current. [8]Felkin, Robert W. “Notes on Labour in Central Africa.” Edinburgh Medical Journal, April 1884. The cesarean birth at Kahura in 1879. Students who answer C are confusing this with the first-day dressing described in the Edwin Smith Papyrus. Students who answer B or D are naming methods that do not appear in the account.

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PART B — SHORT ANSWER KEY POINTS

Question 8. Using at least two specific details from the lesson, explain how the Edwin Smith Papyrus shows that medicine in Kemet followed an organized method.

A strong answer should include:

• At least two specific details: the papyrus describes forty-eight cases arranged by part of the body; each case follows the same order — examination, diagnosis, verdict, treatment; the physician gives one of three verdicts — an ailment I will treat, an ailment I will contend with, or an ailment not to be treated [3]Breasted, James Henry. The Edwin Smith Surgical Papyrus. 2 vols. Chicago: University of Chicago Press, 1930. The forty-eight cases, their verdicts, and their treatments.
• Why it shows an organized method: the same steps are repeated for every case, so a physician could apply them to a new patient. This is the same order a doctor follows today: examine, diagnose, decide, treat
• Strong answers will note: the honest verdict “not to be treated” shows physicians judged their own limits instead of promising a cure every time
• Strong answers will connect: the papyrus is a written text, so the method could be copied, studied, and passed on

Question 9. Using at least two specific details from the lesson, compare one treatment from Kemet with a practice still used in medicine today.

A strong answer should include:

• At least two specific details from one of these pairs: honey on wounds, and modern hospitals using medical honey because honey fights bacteria; cauterization with heat, and surgeons today cauterizing with electric current; the dislocated-jaw method in Case 25, and doctors today pressing the jaw down and back; splints of wood and linen, and splints used today to hold broken bones still [3]Breasted, James Henry. The Edwin Smith Surgical Papyrus. 2 vols. Chicago: University of Chicago Press, 1930. The forty-eight cases, their verdicts, and their treatments.[7]British Dental Journal, 2015. Article on Case 25 of the Edwin Smith Papyrus and the reduction of a dislocated mandible (doi:10.1038/sj.bdj.2015.438). The papyrus method and the later Hippocratic method.[11]Mandal, Manisha D., and Shyamapada Mandal. “Honey: Its Medicinal Property and Antibacterial Activity.” Asian Pacific Journal of Tropical Biomedicine 1, no. 2 (2011). Honey’s antibacterial action.
• A clear comparison: what stayed the same (the principle) and what changed (the tools or materials)
• Strong answers will note: the Greek physician Hippocrates described a very similar jaw method more than a thousand years later [7]British Dental Journal, 2015. Article on Case 25 of the Edwin Smith Papyrus and the reduction of a dislocated mandible (doi:10.1038/sj.bdj.2015.438). The papyrus method and the later Hippocratic method.
• Strong answers will use the lesson’s own words or a quotation from the Note on This Lesson as evidence

Question 10. Using at least two specific details from the lesson, explain why the cesarean birth in Bunyoro in 1879 matters to the history of surgery.

A strong answer should include:

• At least two specific details: the healer gave banana wine to dull the pain; he washed his hands and the mother’s abdomen with banana wine and then water; his assistant used a red-hot iron to stop bleeding; the wound was closed with iron pins and string and covered with a paste of roots; mother and child both recovered [8]Felkin, Robert W. “Notes on Labour in Central Africa.” Edinburgh Medical Journal, April 1884. The cesarean birth at Kahura in 1879.
• Why it matters: the procedure combined pain control, cleanliness, control of bleeding, and wound care at a time when a cesarean birth in Europe often killed the mother, and only three years after the first European case in which mother and child both survived [10]deCosta, Caroline. “Banana Wine and Cross Dressing.” O&G Magazine 15, no. 2 (2013). Felkin’s report and Porro’s 1876 operation in Padua.
• Strong answers will note: some doctors in Britain refused to believe Felkin’s report, which shows how African medical knowledge was doubted [12]“A Cesarean Section in Uganda in 1879.” Hektoen International, May 2023. The procedure Felkin described and the doubt it met in Britain.
• Strong answers will connect: Bunyoro shows that advanced surgical knowledge in Africa did not end in ancient times

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Sources & Footnotes

1. [1] Smith, G. Elliot. “The Most Ancient Splints.” British Medical Journal, 1908. Splints of wood bound in linen found at Naga ed-Deir.
2. [2] Kanawati, Naguib, and Mahmoud Hassan. The Teti Cemetery at Saqqara, Vol. II: The Tomb of Ankhmahor. Warminster: Aris & Phillips, 1997. The Physician’s Tomb and its medical reliefs.
3. [3] Breasted, James Henry. The Edwin Smith Surgical Papyrus. 2 vols. Chicago: University of Chicago Press, 1930. The forty-eight cases, their verdicts, and their treatments.
4. [4] “Edwin Smith Papyrus.” Encyclopaedia Britannica. Its date, its purchase in 1862, and its translation.
5. [5] “Ebers Papyrus.” Encyclopaedia Britannica. Its date, its remedies, its treatise on the heart, and its acquisition in 1873.
6. [6] “The Papyrus Ebers.” Document held in CDC Stacks (cdc:72351). The treatise on the heart and vessels, with an English translation of its passage on the pulse.
7. [7] British Dental Journal, 2015. Article on Case 25 of the Edwin Smith Papyrus and the reduction of a dislocated mandible (doi:10.1038/sj.bdj.2015.438). The papyrus method and the later Hippocratic method.
8. [8] Felkin, Robert W. “Notes on Labour in Central Africa.” Edinburgh Medical Journal, April 1884. The cesarean birth at Kahura in 1879.
9. [9] Davies, J.N.P. “The Development of ‘Scientific’ Medicine in the African Kingdom of Bunyoro-Kitara.” Medical History 3, no. 1 (1959). Medicine in Bunyoro.
10. [10] deCosta, Caroline. “Banana Wine and Cross Dressing.” O&G Magazine 15, no. 2 (2013). Felkin’s report and Porro’s 1876 operation in Padua.
11. [11] Mandal, Manisha D., and Shyamapada Mandal. “Honey: Its Medicinal Property and Antibacterial Activity.” Asian Pacific Journal of Tropical Biomedicine 1, no. 2 (2011). Honey’s antibacterial action.
12. [12] “A Cesarean Section in Uganda in 1879.” Hektoen International, May 2023. The procedure Felkin described and the doubt it met in Britain.
13. [13] Nutton, Vivian. Ancient Medicine. 2nd ed. London: Routledge, 2013. Greek physicians’ later study of the pulse.

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Note on This Lesson

In their own words: The Edwin Smith Papyrus, Case 10: “Now after thou hast stitched it, thou shouldst bind fresh meat upon it the first day. If thou findest that the stitching of this wound is loose, thou shouldst draw (it) together for him with two strips (of plaster), and thou shouldst treat it with grease and honey every day until he recovers.” Case 25, the dislocated jaw: the physician “should put your thumbs upon the ends of the two rami of the mandible in the inside of his mouth, and your two claws (the other fingers) under his chin, and you should cause them to fall back so that they rest in their place.” [3]Breasted, James Henry. The Edwin Smith Surgical Papyrus. 2 vols. Chicago: University of Chicago Press, 1930. The forty-eight cases, their verdicts, and their treatments.

The Ebers Papyrus on the heart: “The heart speaks out of the vessels of every limb.” [6]“The Papyrus Ebers.” Document held in CDC Stacks (cdc:72351). The treatise on the heart and vessels, with an English translation of its passage on the pulse. Robert Felkin, 1884: “So far as I know, Uganda is the only country in Central Africa where abdominal section is practised with the hope of saving both mother and child.” [8]Felkin, Robert W. “Notes on Labour in Central Africa.” Edinburgh Medical Journal, April 1884. The cesarean birth at Kahura in 1879.

On names: the Edwin Smith Papyrus and the Ebers Papyrus are named after the nineteenth-century buyers of the scrolls, not the physicians of Kemet who wrote them. Ankhmahor bore no medical titles; his tomb is called the Physician’s Tomb because of its scenes. [2]Kanawati, Naguib, and Mahmoud Hassan. The Teti Cemetery at Saqqara, Vol. II: The Tomb of Ankhmahor. Warminster: Aris & Phillips, 1997. The Physician’s Tomb and its medical reliefs.[4]“Edwin Smith Papyrus.” Encyclopaedia Britannica. Its date, its purchase in 1862, and its translation.[5]“Ebers Papyrus.” Encyclopaedia Britannica. Its date, its remedies, its treatise on the heart, and its acquisition in 1873.

The images in this lesson are illustrations created for teaching. They are not photographs of historical people or documents.

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