The Edwin Smith Papyrus: the birth of analytical thinking in medicine and otolaryngology

The Edwin Smith Papyrus, discovered in 1862 outside of Luxor, Egypt, is the oldest known surgical text in the history of civilization. The surviving scroll, a copy of an earlier text from around 3,000 B.C., gives us remarkable insight into the medical practice of ancient Egyptians in the Nile River bed during the dawn of civilization. The Papyrus is divided into 48 cases, most of which describe traumatic injuries. The text instructs the physician to examine the patient and look for revealing physical signs that may indicate the outcome of the injury. Although in modern medicine we take for granted that the use of physical examination and rational thinking lead to an accurate conclusion, 5,000 years ago, this was extraordinary. The Edwin Smith Papyrus cast aside the prevailing magic and mysticism of that time in favor of logic and deductive reasoning. As Egyptian civilization declined during the next millennium, the teachings of the Papyrus would be lost. It would not be until 300 B.C. when Hippocrates and his disciples in ancient Greece would once again revive logic in medical thinking and teaching. It is believed that the ancient Greeks had knowledge of the contents of the Edwin Smith Papyrus and its teachings and used them as the basis for their writings. As Europe entered the Dark Ages, so did medicine yet again, reverting to spells and prayers instead of judgment and reason. Although Hippocrates teachings were recognized by some scholars during the Middle Ages, they did not make up the basis for mainstream medical knowledge. With the dawn of the Renaissance, medicine would finally purge itself of its past supernatural foundation. Hippocratic teachings were used to form the basis of modern medicine, and medical pioneers in the 17 century studied the ancient Greek texts as the origin for their ideas. Many of the concepts physicians and patients today take as common knowledge originated in the Edwin Smith Papyrus. The authors attempt to uncover some of these fundamental ideas and trace them through time until their incorporation in our modern medical knowledge base. It is the rational, logical, and advanced thinking exhibited in the Edwin Smith Papyrus that mandates its respect from modern otolaryngologists and all physicians alike.