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Health-care plan in ancient Egypt? Research suggests more than spells, prayers

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Druid
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« on: February 13, 2008, 01:02:28 am »

Health-care plan in ancient Egypt? Research suggests more than spells, prayers
Stephanie Pain | New Scientist Magazine
February 12, 2008
 
As Egyptian mummies go, Asru is a major celebrity. During her life in the 8th century B.C., she was known for her singing at the temple of Amun in Karnak; now she's famous for her medical problems. Forensic studies have revealed that although Asru lived into her 60s, she was not a well woman. She had furred-up arteries, desert lung (pneumoconiosis) caused by breathing in sand, osteoarthritis, a slipped disc, periodontal disease and possibly diabetes, as well as parasitic worms in her intestine and bladder. Her last years must have been full of pain and suffering. After all, what could her doctor do to help? Say a few prayers and recite a spell or two?

If you read the history books, that's about as much as Asru could expect. But not according to Jackie Campbell at the KNH Center for Biomedical Egyptology at the University of Manchester in England. Her research suggests that Asru's doctor probably consulted a handbook of remedies and prescribed something to soothe her cough, deaden the pain in her joints and perhaps even expel some of those worms. What's more, Campbell's findings indicate that Asru's doctor had more than 1,000 years of pharmaceutical expertise to draw on.

If she's right, the history of medicine needs rewriting.

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Druid
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« Reply #1 on: February 13, 2008, 01:03:20 am »

The biggest obstacle to determining the ancient Egyptians' grasp of pharmacology has been translation, their pharmacy records left on a handful of papyrus scrolls in a long-forgotten language.

"I'm not a linguistics expert so I used science to authenticate the prescriptions," Campbell says. With most drugs extracted from plants, her first check was whether a plant named in a prescription grew or was traded in Egypt at the time the papyri were written. If it wasn't, she could rule it out. Fortunately, the flora of ancient Egypt is well-known. Campbell's second approach was pharmacological: Could the named ingredient have worked the way a prescription indicated? Normally, this would be the province of a forensic chemist, who would take a sample, analyze its constituents and check for biological activity. Sadly, archaeologists have yet to find any pots of ointment or neatly molded suppositories. "But we had something better," she says. "Recipes."

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« Reply #2 on: February 13, 2008, 01:03:46 am »

Detailed prescriptions

Although often prefaced by a prayer or spell, each prescription provides all the information needed to reproduce the remedy, from its ingredients and method of preparation right down to the dose.

They follow a standard format, listing the active ingredient first, followed by stabilizers, flavorings to mask unpleasant tastes, perhaps a soothing agent to help it down and sometimes secondary drugs to alleviate the side effects of the principal drug. Last of all comes the medium, or "vehicle," in which everything is mixed.

Focusing on four key papyri, which contain 1,000 prescriptions and date from 1,850 B.C. to about 1,200 B.C., Campbell analyzed each prescription and compared it with contemporary standards and protocols.

"I looked at the source of the drug and the formulation: Was it a cream or an enema or a draught and so on. Then I looked at the preparation: Would the active drug have been extracted appropriately? And then, could it have worked? Was the drug given the right way and in a suitable dose?"

Several plants named in previous translations, such as cinnamon and aniseed, would not have worked in the ancient remedies and there is no evidence that they existed in Egypt at the time. Other plants existed but had been wrongly translated.

"Some were obviously so right while others seemed improbable," says Campbell.

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« Reply #3 on: February 13, 2008, 01:04:13 am »

Answers and mysteries

After five years of painstaking analyses, she had compiled an ancient Egyptian pharmacopoeia listing all of the drugs in the papyri, their sources and how they were used. She had confirmed or come up with more plausible identifications for 284 ingredients -- various parts of 134 species of plants, 24 animals and 28 minerals.

Of the original 1,000 prescriptions, she could now say exactly how 550 were made and whether they would work. For another 156, she knew all but a minor ingredient -- enough to say if the remedy worked. That left 234 with unknown ingredients and 27 for which the prescription failed to identify what the drug was intended for. "We've got some of the mystery ingredients down to half a dozen possibilities. Others we'll never identify," says Campbell.

The Egyptians' choice of ingredients has certainly stood the test of time. When Campbell consulted Martindale's Extra Pharmacopoeia -- the 1977 edition, when drugs were still prepared in a dispensary -- she found that 62 percent of ingredients named in the papyri were still in use in the 1970s. Many still are -- or at least synthetic versions of them.

When preparing their remedies, the Egyptians used techniques familiar to modern pharmacists. They knew when to concentrate a drug by boiling, when to dilute it and when grinding released more of the active ingredient. They were expert in extracting drugs from plants, steeping them in either water or alcohol depending on the solubility of the active compound.

"I didn't find one drug that wasn't prepared properly," Campbell says. "I have no evidence that they were aware of the chemistry of their actions, but fortuitously or otherwise, they adopted the right techniques."
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« Reply #4 on: February 13, 2008, 01:04:38 am »

The formulations stood comparison too. Checking against the 1973 British Pharmaceutical Codex, which lays down standards and protocols for making up medicines, Campbell found 67 percent of the ancient Egyptian remedies complied, with one proviso -- the Egyptians knew nothing of the need for sterility. Apart from drugs given by injection, they dispensed all the same types of medicines as we do.

They had enemas, draughts and linctuses, lotions and liniments, creams, ointments and mouthwashes. They had eye drops (to be dripped through a bird's quill), pills, powders and poultices and, for gynecological conditions, pessaries. For nasal congestion, doctors prescribed remedies to be inhaled (pour onto hot stones and breathe through a hollow reed). They were particularly adept at preparing suppositories, mixing the drug into a heavy grease and then rolling this into a pellet firm enough for insertion but which would melt at body temperature.

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« Reply #5 on: February 13, 2008, 01:05:15 am »

Potent medicine or placebo?

So 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.

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 percent 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."

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. 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," Campbell says, "but today celery is being investigated for its anti-rheumatic properties."

First photo and box ran on page E1.



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