Popular legend tells us that during the process of mummification, the ancient Egyptians removed the vital organs, including the brain, and placed some of them in jars. The earliest known mummies date to around 3300 BC in Egypt. During the removal of the brain, the bone behind the nose (the cribiform plate) would be broken with a long metal tool. The embalmer would dice the brain into small pieces so it could be pulled out through the nasal passage. They would then refill the skull half-way with either sawdust or a plant-based resin (see below for half-filled skull).
Check out this cool video which follows the path of the metal “brain removal tool” past the cribiform plate.
The Egyptians believed that the “soul” was contained in the heart, and saw no reason to preserve the brain for the afterlife. Occasionally, during low-status mummifications, short-cuts were made and the brain was left in place (see CT scan below). You can also notice that the cribiform plate is intact in the below mummy, but completely broken in the mummy above.
Furthermore, the ancient Egyptians were the first to write about the brain. The oldest written record using the word “brain” (shown in hieroglyphics at the top of this post) appeared on an ancient papyrus called the Edwin Smith Surgical Papyrus, which is also considered the world’s oldest medical document. This document has been dated to around 1700 BC, but is based on texts that go back to 3000 BC, which is consistent to when the Egyptians began removing brains in mummies. It was thought to have been penned (hmmm, is ‘penned’ correct for papyrus?) by a renowned physician named Imhotep, and provided the first account of neuroanatomy including descriptions of the meninges and cerebrospinal fluid.
The Edwin Smith Surgical Papyrus is unsurprisingly named after an Egyptologist named Edwin Smith, who on January 20, 1862 in the city of Luxor, bought the surgical papyrus from a dealer named Mustapha Aga. When Smith died in 1906, his daughter gave the papyrus to The New York Historical Society. In 1920, James Henry Breasted, founder of the Oriental Institute of Chicago, was asked to translate the papyrus and he published an English translation for The New York Historical Society ten years later. It now resides at The New York Academy of Medicine, where it has been since December 2, 1948.
The papyrus contains 48 descriptions of injuries:
27 head injuries (cases #1-27)
6 throat and neck injuries (cases #28-33)
2 injuries to the clavicle (collarbone) (cases #34-35)
3 injuries to the arm (cases #36-38)
8 injuries to the sternum (breastbone) and ribs (cases #39-46)
1 injury to the shoulder(case #47)
1 injury to the spine (case #48)
(Continued below the fold….)
Most of the cases seem to describe injuries from either falls (perhaps from building pyramids?) or battle wounds caused by spears and daggers. The hieroglyphic for the brain is mentioned 7 times, although there is no analogous term for “nerve.” The organization of the case studies is impressive in both detail and level of rational thought; the examinations and diagnoses are methodical and free of magical thinking. All the cases are presented like this:
Title: the type of injury and its location are described.
Examination: the case and the manner in which the patient should be examined are described. The examination may include sensory testing, probing of the wound and movement of the affected body part. Some patients were examined more than once. The examination section of the papyrus always starts as:
“If thou examinest a man having…”
Diagnosis: the doctor has three choices and will say one of the following about the condition:
“An ailment which I will treat” – this is used for injuries that most likely will be cured.
“An ailment with which I will contend” – this is used for difficult, but not impossible cases. The doctor will try to treat the condition, but the outcome is uncertain.
“An ailment not to be treated” – in these cases, the condition cannot be treated at all because the injury is thought to be incurable.
Treatment: these include bandages, plasters, stitching, cauterization (heating of a wound), and splints. Surgical dressings included honey, grease and lint.
Glosses: short glossary of terms
Interestingly, many of the cases describe neurological disorders which would not be given names for thousands of years. For example, Case 22 described the fracture of the temporal bone, which resulted in the patient being unable to speak (aphasia). Case 31 described the dislocation of cervical vertebra and case 33 detailed a patient with crushed cervical vertebra; both describe paralysis and sensory problems caused by injuries to the spinal cord. The commentary following these cases suggested that the Egyptian doctor understood that the brain controlled movement and some sensory functions.
CT scans from (http://www.carlos.emory.edu/RAMESSES/3_physicalevidence.html.)