LAUSR

An instruction for treating a dislocation of the mandible written more than three and a half millennia ago has been reproduced in The James Lind Library. This is because it provides an illustration of a treatment with effects that can be inferred confidently without the need for formal comparative studies, and which has stood the test of time. The ancient Egyptian medical papyri contain many accounts of diseases and their treatments, but there are often major difficulties in translating the name of the disease, and also many of the treatments which are prescribed. It is therefore a delight to read Case 25 in the Edwin Smith Surgical Papyrus, where the uncertainties of translation are minimal. The Edwin Smith Surgical Papyrus has been dated to 1550 BC, during the reign of Ahmose I, in the 18th Dynasty (New Kingdom). The only extant copy of the papyrus was purchased in Luxor by Edwin Smith himself in 1862. Its original provenance is unknown. It is now in the New York Academy of Medicine, but it was intensively studied by the director of the Oriental Institute in Chicago, James Breasted, who published two magnificent volumes reproducing, translating and commenting on the papyrus. The second of these two volumes comprises superb, full-sized colour plates (approximately A3 in size) of all 22 columns of the original papyrus. The text is written in cursive hieratic, but Breasted has provided transliteration into the classical and more familiar hieroglyphic text. All of the text is written from right to left. The surviving column 1, comprising cases 1–3, was on the outside of the papyrus roll and, as usual, was damaged, with many lacunae. Breasted therefore added his restoration of the missing parts in two additional pages, with hieratic and hieroglyphic texts. Volume I of Breasted’s commentary comprises 596 pages (approximately A4) and contains the full hieroglyphic text (as in Volume II) with his translation into English and his commentary on each case. The text comprises 48 clinical cases, nearly all of whom are victims of trauma. Each case starts with a title, typically starting ‘Instructions concerning. . .’. Next is the examination, typically starting ‘If you examine a man having. . .’. This is followed by a pronouncement of the diagnosis and prognosis, typically starting ‘You shall then say concerning him. . .. . .’ The final section is the treatment, which has sometimes been omitted if the prognosis was unfavourable.