Evidence-Based Papyrus
In our modern medical world, evidence-based practice has reached buzzword status. The phrase, its three-letter acronym, and its discipline-based variants appear everywhere, giving the impression that evidence-based practice is a modern phenomenon.
Now, thanks to the efforts of collectors, curators, and translators, we have access to an Egyptian medical treatise from at least 1,600 B.C. View the Edwin Smith Surgical Papyrus [requires Adobe Flash player]. After the page loads, use your mouse to drag the scroll open. With the zoom icon at the bottom of the page you can magnify the hieroglyphic script. With the text icon, you can highlight the cases within the scroll. Selecting a case scroll brings up an overlay page that transliterates the text.
The scroll, as it currently exists, presents 48 trauma and wound cases. Each case has a description, diagnosis, prognosis, treatment, and further explanations specific to the case. The prognosis seems to include one of these three phrases:
- An ailment I will handle
- An ailment I will fight with
- An ailment for which nothing is done
These prognoses seem to be based on the existing evidence, resulting in an ancient system of triage. A serious perforation of the temple is "an ailment I will handle"; a split temple is "an ailment I will fight with"; and a fracture of the temporal bone is "an ailment for which nothing is done". It must have taken time to determine which injuries fell into which category. This papyrus likely sought to pass down that experience.
Among the treatments, a dressing with oil and honey is listed frequently. At first glance, this might seem far from evidence-based, but these substances address two of the four items that comprise the TIME acronym of modern wound healing: Tissue, Infection, Moisture control, and Epidermal margin.
Honey is a well-known wound dressing. View PUBMED search results for english language articles on honey and wound healing. In recent years, the Food and Drug Administration has approved a wound dressing called MEDIHONEY™.
While health care has certainly advanced in the last 3,600 years; but let's not assume the ancient Egyptians were not also asking themselves: is this injury treatable? and what treatment produces the best outcome? And clearly, they must have had a medical librarian to index and store their papyrus documents ;-)
1 comments - Posted by Steve Rauch at 10:28 AM - Categories: