Effective remediesSo the ancient Egyptians had expert knowledge of drugs and knew the most effective ways to prepare and deliver them, but was that enough to call them pharmacists? For that, their remedies had to be effective.
Ignorant of the causes of most diseases, ancient Egyptian doctors inevitably focused on symptoms. Then, as now, a soothing linctus quietened a cough whatever the cause, and a warming poultice that stimulated blood flow would relieve joint pain, whether from rheumatism or osteoarthritis. In some instances, where the cause was obvious, as with a wound or intestinal worms, the chosen drug tackled both symptoms and cause.
Knowing the drug, the dose, how it was to be administered and what it was prescribed for meant it was possible to compare its effectiveness with modern remedies. Campbell was impressed. "Sixty-four per cent of the prescriptions had therapeutic value on a par with drugs used in the past 50 years. In many cases even the dosing was right."
So what did Egyptian doctors prescribe? They were especially keen on laxatives, and dispensed irritants such as castor oil or colocynth, lubricants including balanites (extracted from the kernel of the desert date), or simply recommended bulk fibre, such as figs or bran. For indigestion, they prescribed an antacid of powdered limestone (calcium carbonate) where we take magnesium carbonate. For diarrhoea, doctors dispensed something to absorb water and toxins from the gut, such as kaolin or powdered carob, or a plant containing hyoscine, an alkaloid that relaxes smooth muscle and reduces gut movement. For flatulence and intestinal cramps, patients could rely on cumin and coriander - both effective antispasmodics. The discomfort of piles was eased with a suppository laced with hemp.
The ancient Egyptians had effective remedies for waterborne parasites too. The most common was extract of pomegranate, which contains pelletierine, a powerful antihelminthic used until 50 years ago to get rid of tapeworms. Antimony was effective against flukes, and balanites oil, although given to soothe burning in the bladder symptomatic of schistosomiasis, would also have killed the worms that caused it.
Like Asru the chantress, many people suffered from musculoskeletal disorders. The treatments were also many and varied. A patient might be instructed to rub liniment into aching joints, or bandage a warming poultice over the painful area. Extracts of mustard, juniper and frankincense or turpentine stimulated blood flow, providing warmth and enhancing the immune response.
Treatments for wounds were clearly effective. Mummy studies have revealed evidence of potentially fatal injuries that had healed. Egyptian physicians treated wounds with resins and metals, both of which have antimicrobial properties, and with honey - which does not comply with modern pharmaceutical standards but nevertheless works and is increasingly used to treat ulcers and burns when antibiotics fail. By extracting water from the wound by osmosis, it makes conditions too dry for the growth of bacteria.
If two-thirds of remedies were sound, what of the remainder? Some were obviously symbolic: hedgehog quills will not cure baldness, and a tap on the head with a dead fish won't do much for a migraine. Others were more a case of hope triumphing over experience: when it came to impotence, for instance, the Egyptians prescribed a remedy with 39 active ingredients - none of which would have had the slightest effect.
Yet some of the odder prescriptions may turn out to be more sensible than anyone imagined. Crocodile dung as a contraceptive? There is some suggestion that, applied as a pessary, its acidity would be spermicidal. For pain relief, the papyri recommend celery seed, chewed and swallowed in alcohol. "When I began this study I thought that was one of the fanciful remedies but today celery is being investigated for its anti-rheumatic properties," says Campbell. Ancient Egyptian physicians also recommended saffron for back pain and both Crocus sativa, the source of saffron, and safflower (false saffron) are used this way in traditional medicine.
Although Campbell's findings show that the ancient Egyptians were practising a genuine form of pharmacy long before the Greeks, many questions remain about how advanced it was. Campbell hopes to answer some of these in collaboration with Mohamed El-Demerdash and his team, which is working on Egypt's Conservation of Medicinal Plants Project. The project aims to re-establish and protect wild medicinal plants and to preserve the age-old knowledge of Bedouin healers.
One puzzle is why both ancient prescriptions and Bedouin healers specify doses for some drugs that appear to fall below the threshold for activity. Campbell and El-Demerdash suspect that Egypt's wild-grown plants are more potent than those cultivated for conventional medicine. "Plants that grow in harsh environments synthesise more of certain active compounds to enable them to withstand the stress of drought or extreme temperature," says El-Demerdash. Analyses of plants grown by the team should resolve this.
The project could also help Campbell identify some of the ingredients that still defy translation. Bedouin healers harvest the same species and make remarkably similar remedies as in pharaonic times. If Campbell is lucky, she may find they still make remedies containing some of the mystery ingredients - and for once there will be samples to analyse.
On a visit to Sinai in October, Campbell ran through her pharmacopoeia with Ahmed Mansoor, a prominent local healer. "For days all I could find was similarity - nothing that I didn't know of already," she says. Before she returned to Manchester, however, Mansoor surprised her with a gift - a bag containing dung from feral donkeys that roam the mountainsides where many medicinal plants grow. "This is nature's pharmacy," he said, explaining that the Bedouin boil the dung to make a tea, which they drink as a tonic or for upset stomachs, or apply to wounds.
The Egyptian papyri include half a dozen apparently irrational prescriptions based on animal dung - so did Campbell try it? "No. But I brought a sample back for analysis."
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