The Edwin Smith Papyrus is an ancient Egyptian medical text, named after Edwin Smith who bought it in 1862, and the oldest known surgical treatise on trauma. From a cited quotation in another text, it may have been known to ancient surgeons as the "Secret Book of the Physician".
This document, which may have been a manual of military surgery, describes 48 cases of injuries, fractures, wounds, dislocations and tumors. It dates to Dynasties 16–17 of the Second Intermediate Period in ancient Egypt, 1600 BCE. The papyrus is unique among the four principal medical papyri in existence that survive today. While other papyri, such as the Ebers Papyrus and London Medical Papyrus, are medical texts based in magic, the Edwin Smith Papyrus presents a rational and scientific approach to medicine in ancient Egypt, in which medicine and magic do not conflict. Magic would be more prevalent had the cases of illness been mysterious, such as internal disease.
The Edwin Smith papyrus is a scroll 4.68 meters or 15.3 feet in length. The recto (front side) has 377 lines in 17 columns, while the verso (backside) has 92 lines in five columns. Aside from the fragmentary outer column of the scroll, the remainder of the papyrus is intact, although it was cut into one-column pages some time in the 20th century. It is written right-to-left in hieratic, the Egyptian cursive form of hieroglyphs, in black ink with explanatory glosses in red ink. The vast majority of the papyrus is concerned with trauma and surgery, with short sections on gynaecology and cosmetics on the verso. On the recto side, there are 48 cases of injury. Each case details the type of the injury, examination of the patient, diagnosis and prognosis, and treatment. The verso side consists of eight magic spells and five prescriptions. The spells of the verso side and two incidents in Case 8 and Case 9 are the exceptions to the practical nature of this medical text. Generic spells and incantations may have been used as a last resort in terminal cases.
Authorship
Authorship of the Edwin Smith Papyrus is debated. The majority of the papyrus was written by one scribe, with only small sections copied by a second scribe. The papyrus ends abruptly in the middle of a line, without any inclusion of an author. It is believed that the papyrus is an incomplete copy of an older reference manuscript from the Old Kingdom, evidenced by archaic grammar, terminology, form and commentary. James Henry Breasted speculates - but emphasises that this is pure conjecture based on no evidence - that the original author might be Imhotep, an architect, high priest, and physician of the Old Kingdom, 3000–2500 BCE.
Procedure
The rational and practical nature of the papyrus is illustrated in 48 case histories, which are listed according to each organ. Presented cases are typical, not individual. The papyrus begins by addressing injuries to the head, and continues with treatments for injuries to neck, arms and torso, detailing injuries in descending anatomical order like a modern anatomical exposition. The title of each case details the nature of trauma, such as "Practices for a gaping wound in his head, which has penetrated to the bone and split the skull". The objective examination process included visual and olfactory clues, palpation and taking of the pulse. Following the examination are the diagnosis and prognosis, where the physician judges the patient’s chances of survival and makes one of three diagnoses: "An ailment which I will treat," "An ailment with which I will contend," or "An ailment not to be treated". Last, treatment options are offered. In many of the cases, explanations of trauma are included to provide further clarity.