Ancient Alexandria and the dawn of medical science

THE ANCIENT WORLD AND THE BIRTH OF MEDICINE From the banks of the Nile to the shores of the Mediterranean, it is in the land of Egypt where medicine probably started. This is the story of a great period in the history of medicine. But let us start at the beginning. Imhotep, who flourished about 5,000 years ago, is the first person whose name is recorded not for being a king or a conqueror, but for the way he contributed to knowledge. He was a statesman: he advised Pharaoh Zoser. He was an engineer: he built the stepped pyramid of Saqqara, precursor to the many great pyramids to come. But above all he was a physician of talent, who launched the first true medical revolution: that disease was not something to be dealt with by magic, but by science: observation, diagnosis, and treatment. Egyptians would later deify him as the god of medicine. The great tradition of ancient Egyptian medicine was maintained for millennia. The Edwin Smith papyrus and the Ebers papyrus both speak of exquisite knowledge and understanding. The Edwin Smith papyrus is the earliest known medical document, written around 1600 BCE, but is thought to be based on material from as early as 3000 BCE. It is an ancient textbook on trauma surgery. It mentions trepanation. It describes anatomical observations and the examination, diagnosis, treatment, and prognosis of numerous injuries in exquisite detail. It gives the first descriptions of the cranial sutures, the meninges, the external surface of the brain, the cerebrospinal fluid, and the intracranial pulsations (Figure 1). Other documents, like the Ebers Papyrus, give details showing an in-depth understanding of how the body works. It defines the heart as the center of the blood supply, with vessels attached for every member of the body. Mental disorders such as depression and dementia are covered, and the descriptions suggest that mental and physical diseases were considered in the same way. The document also has chapters on contraception, diagnosis of pregnancy and other gynecological matters, intestinal disease and parasites, eye and skin problems, and the surgical treatment of abscesses and tumors, bone-setting and burns. Dentistry is also covered, and we have evidence of false teeth existing in Egypt some 4,000 years ago (Figure 2). In a number of ways, this ancient Egyptian knowledge was superior to the later Greek knowledge that would flourish in the first millennium BCE. But civilizations wax and wane, and Egypt was in a slow decline. It was finally conquered by the Persians in 525 BCE, while Greek civilization, already well-established from the time of the Minoan and Mycenaean Civilizations, would take over the torch of knowledge and enter a golden period whose achievements continue to dazzle the world to this day. The Greeks erected a philosophical, artistic and scientific culture that was to rival the best that the world has seen before or since. Medicine would be an important part of this edifice of knowledge, as it