Ancient Medicine Rooted in the Egyptian, Greek and Roman Societies:
The Influence of Religion, Ritual, and Communal Beliefs
Ancient medicine in Egyptian, Greek, and Roman communities was practiced as an integral part of the respective societies, reflecting their religion, ritual, and communal beliefs. I will examine primary sources to demonstrate the influence of these ancient societies on the roots of medical practice and the importance of each culture’s impact on their medical practice. Egyptian medical, magical and religious papyri and inscriptions compared with later historians’ reports and the literary records of Greek and Roman societies will support my thesis that medicine is heavily influenced by its parent society. The three societies each had distinct differences in how they viewed the world and man’s importance in nature but all three have the common loci of ritual, religion and communal beliefs influence on their particular society. These sources will be used to trace the interconnectedness of ancient medical practice and each society. I will use secondary sources to help interpret the primary evidence and to evaluate the continuing influence of the shared medical background and belief systems of these ancient sources.
Ancient Egyptian medicine rooted in religion, ritual, and magic evolved to form a foundation for medical science. Many contributing factors built this foundation, including practical skills gleaned from other fields, an abundance of pharmacological pursuits, keen observation of medical cases, advanced preventative medicine practices, and the copious and detailed medical information recorded in the medical papyri. Medicine in ancient Egypt first sought to become a rational science as it emerged from “mists and myths of demonology: a body of sound medical knowledge.” The records indicate, however, that physicians never completely abandoned magic and superstition since one of the medical papyri has medical information on one side and magic spells printed on the reverse side of the papyrus.
Ritual was such an important part of Egyptian culture that new information was doubted and old ways were seldom discarded. New was simply added onto the old ways as revealed in divine papyrus. The older material was holy and eternal. A shotgun approach of medical practice involved a list of chants, prescriptions and treatments in a hit or miss style until a cure or failure resulted. If a patient died and the proper rituals had been followed, then the Egyptians thought it was the will of the gods – not the fault of the physician. A patient’s death was unpleasant and unhappy but sometimes inevitable. However, a violation of the rituals was absolutely unacceptable to the Egyptians.
The Egyptian medical and pharmaceutical influence weaves through ancient history. Homer talked of Egyptian prominence in medical practice. In the Odyssey, Homer says, "In Egypt the men are more skilled in human medicine that any other human kind.” Greek historian Herodotus mentions the Egyptian medical specialists studying particular branches of medicine and speaks of Persian King Cyrus sending all the way to Egypt for an oculist. The Greeks used the libraries at Alexandria for medical and scientific research since those libraries were considered the best in the world. The historical records thus support the importance and prominence of Egyptian contributions to medicine in the ancient world. The foundations Egyptians laid down for medical science were obviously revered by the learned populations of ancient civilizations.
Religion was an integral part of Egyptians daily life. Their ruler, the Pharaoh was considered the living incarnation of a god. He was a totalitarian ruler – his word was law. As he spoke, scribes or priests wrote down every word to keep a record even though most Egyptians could not read these laws. Detailed records of day-to-day life in these writings help to prove the society’s inclination to side with things going on as they had always been. In keeping with this system, priests were the first surgeons – they were skilled in rituals and religion practices so the only person Egyptians would trust to take care of their bodies were their religious leaders and advisors. The human body was sacred to the Egyptians since an afterlife depended on preservation of the human form amputation could have stopped the spreading infection and ultimate death. Amputations were not acceptable – the body was needed whole for the afterlife so many Egyptians died from gross infections of the limbs when amputation could have stopped the spreading infection and ultimate death. The afterlife or cyclic notion of life in the Egyptian society thus dictated that the passing through one life was not as important as eternal rebirth.
The priests’ first case histories dealt with practical matters -- arrow wounds, fractures and abscesses. The surgeons did not practice on internal problems such as stomach or chest pains; these were left to other specialists – probably magicians trying to exorcise evil spirits and pharmacologists with purges to eliminate the internal problems. The Egyptians were not prepared emotionally or physically to do deep inner body surgery due to their reverence for the preservation of the body and an inability to control the blood flow or possible infection that accompanies deep wounds.
An Egyptian perceived life as a continuation, a cycle of birth, life, death and rebirth. The Nile River’s flooding and receding waters that constantly brought layers of rich new top soil to its banks taught the Egyptians about nature’s cycles and helped to create their society’s cyclical view of life. Throughout the 3000-year stasis of their society, ritualistic belief was so ingrained that it spilled over into their remedies for common personal problems. Remedies without magic were valueless or not of full effect, healing developed with magic and was inseparably connect with it and “all evidence indicates that it was never emancipated from it.” The Egyptians made “constant use of spells and incantations combined with remedies and are evidently the product of a medical practice still dominated by the primitive folk medicine.” It then seems that even while the Egyptians had some very good medicine, the society religion and worldviews dictated that medicine go hand in hand with magic or spiritual healing.
As with all authority and knowledge in Egypt, their medical practice began with the gods. According to Egyptian lore, Ra, Isis, Osiris and Set reigned in the Nile valley. One day Set badly damaged Horus’ eye. Thoth, the healing god, was called in for a consultation. By Thoth repeating the proper ritual, Horus once again had two good eyes. The two main deities of Egyptian medicine were Horus, the healed; and Thoth, the healer.
From these legendary gods came some of the first and most common medical practices of Egypt. The Eye of Horus, simulated by a bejeweled stone, was the most widely used amulet in Egypt. It provided protection against disease or lurking demons for a person who wore it on a strap around the neck, wrist or ankle. Amulets are still used in various cultures to protect against evil or disease. The Books of Thoth included treatments for almost any disease. These books were allegedly not written by men, but appeared miraculously from the gods in temples during the night. Of course, today it is obvious that a medical priest actually had a hand in the discovery of how to treat a condition or disease and produced the papyrus. One such treatment entitled “Treatise upon the Destruction of the Pustules upon the Limbs of Man” appeared at the foot of the statue of Anubis in a temple in the middle of the night. In religious Egypt, since the gods were the authority and source for everything, a priest had to present such information through deception as the divine appearance of the papyrus. This type of appearance is mentioned in the London Medical Papyrus, “This book was found in the night, having fallen into the court of the temple in Khemmis, as secret knowledge of this goddess.”
Later a revered medical man, Imhotep would join these older gods. He was considered the universal father of medicine and was believed to be the author of the original text for the Smith Papyrus. A physician and architect, Imhotep lived around 3000 BCE. He became a demi-god circa 1500 BCE and achieved full godhood around 800 BCE. Egyptian doctors that followed Imhotep were a combination of religious figure and medical professional. Most Egyptian doctors were priests and, as such, were also magicians. The high priests, Wabw Skhment, knew how to take a man’s pulse at various points of his body (as well as did the swnw, the lay physicians) and were also steeped in ritualistic religious practices. The Smith Papyrus reports: “When a Sacheted priest, any swnw doctor…puts his fingers to the head…to the hands, to the place of the heart…; it speaks…in every vessel, every part of the body…” By keen observation, Egyptians realized that the pulse felt in the various body locations was tied to the heart and its workings. This process makes it easy to see as James Breasted stated that the Egyptians were natural scientists, “confronting a world of objective conclusions upon bodies of observed fact.” Only some of the texts recognize this use of wabw meaning physician. Breasted lists the word only as wound. The hieroglyph for wound put together with the word for priest appears as a logical way to mean a priest that cares for the injured. Actual gods who were called swnw (lay physicians) of various specialties tie religion and the practice of medicine even closer.
The Egyptian hieroglyph for the word “heart” looks so much like a human heart that someone must have seen a heart in order to design the hieroglyph. Embalmers who had access to the dead bodies in their occupation were probably the source of much of the information about human anatomy. No one else would have had the opportunity or inclination to delve into the human body, which was needed in the afterlife in top condition. The embalmers that prepared the mummies for afterlife removed the intestines and thus had access to many of the body’s organs in the process. Those internal organs were placed in Coptic Jars and buried along with the mummies in tombs for use in the afterlife. However, the embalmers at least saw the organs in place and that was more than most people could have done in that society. No surgery on a living person to the internal organs could have possibly taken place. Autopsy as we know it today would never have taken place in Egypt because of their reverence for the protection of the body for the afterlife. The embalmers were the only people in this culture that would have had the chance to investigate body parts. Egyptians that could afford it had copies of the Book of the Dead placed with their embalmed mummy for safe passage into the next world. However, since only scribes and priests could read, most of these people could actually read the messages that were prepared for them. Within this society, what mattered was that the ritual be followed not that one understood the writing. These copies of the Book of the Dead contained special passwords that would help the body at the various points of encounter. Having such information as the special names for gods was all that mattered. Possession of the material and practice of the ritual in Egyptian society were more important than knowledge.
A full understanding of blood vessels was obviously not possessed by the Egyptians since they numbered the vessels at 12, 22, or 50 depending on which source is consulted. They also confused vessels, nerves and tendons with one another. They had only a rudimentary idea of the pathways carrying messages and fluids throughout the body. Their belief in the connectedness of the vessels demonstrates a great leap of medical intelligence based on limited observations of the living and dead. However, they mistakenly thought that all vessels attached to the heart somehow and that they all came together again at the anus. Their enlightened but confused thinking was a move forward for medicine in its eventual evolution to a modern science.
Orthopedic specialists could make crude plaster casts and had some idea of the use of traction. Layers of linen were soaked in glue and then molded, while soft, to conform to the affected limb. Brick chairs were built with armrests to support patients with skull fractures or dislocated upper jaws to keep the patient in a sitting position. These devices are similar to modern hospital beds that elevate the torso of a patient to promote venous drainage, reduce intracranial pressure through decreased blood pressure and decrease swelling of the face. The Egyptians may not have known all the scientific reasons, but they managed to predict sound treatment from experience that closely coincides with modern medical practice because it fit their needs in their injury plagued building projects.
Egyptians’ first surgical instruments were beautifully designed and executed knives with elaborately carved gold and ivory handles. The elaborate design of these tools suggest that they were decorated so elaborately for use in religious/medical rites and ceremonies. The Egyptian surgeons were capable of setting fractures, repairing broken noses and cutting away growths on the surface of the body. Remedies were usually placed on the site of the problem, but were also taken by mouth and administered by rectal suppositories. The Egyptians were contributing to the process of making medicine into a rational science as they developed their skills. Sometimes what they practiced was helpful and sometimes it was ineffective but by observing closely the results, Egyptian physicians made adjustments so that their medical knowledge was growing and changing.
When the architect, Weshpatah of Pharaoh Neferirkere was stricken and collapsed, “His majesty had brought forth a case of writings….” These “writings” that he sent for were some of the first medical papyri consulted for the proper treatment of medical problems. The medical papyri provided many secrets of the Egyptian medical practice to compare to modern practices as well as to present an accurate recording of the state of medicine at that time. Fragments of the Books of Thoth included prescriptions, spells and incantations that represent medical textbooks used in the temples as references for the instruction of the priest-physicians. Instruction No. 6 from the Smith Papyrus lists the method for a physical examination, observation and diagnosis as follows:
This was a typical entry taking a physician through a description of the problem, diagnosis, prognosis and treatment. Also note the ritualistic tone: “That you must say” as if the repetition of the phrase was meaningful in the actions of the doctor in this case.
The oldest papyrus containing medical information is the Gynecological Papyrus of Kahun from around 1900 BCE. Seventeen female diseases and their treatment described in this papyrus contain no magic or incantations. Perhaps this indicates that the Egyptian society accepted the “naturalness” of women’s reproductive systems so that gynecological medicine separated from the magical world of other medical practices. Egyptians gave birth in an upright position on brick chairs built for that purpose. These chairs positioned their bodies in a very natural way similar to modern obstetrical used chairs in special birthing centers, not hospitals. Egyptian women also delivered their babies in special places, nearby, or in their homes reserved for just that one purpose. They would use a canopied area on their roof or a shady place in their yards.
A remedy recommended for contraception was made from spikes from the acacia plant. These acacia spikes contain gum that forms lactic acid when dissolved in fluid. Many modern contraceptive jellies contain lactic acid. These are good examples of ancient medical information and practice that directly influenced modern treatment. The Egyptians simply used what they had on hand and then observed the results. Crocodile dung was also used as a contraceptive. The dried dung would act in two ways: as a barrier as a condom or diaphragm or as a contraceptive sponge. This is another clear example of trying something practical to accomplish a mission – practical because it was readily available near the riverbed, and if nothing else, perhaps the smell made the male less amorous. Egyptian women urinated on bags of wheat and barley to determine if they were pregnant. If the wheat germinated, the baby was a girl. If the barley germinated, the baby was a boy. If neither grain germinated, the woman was not pregnant. Grain and its fermentation was an important part of Egypt’s daily life. Egypt was the breadbasket of the ancient world. Its fertile soil and grain production probably influenced the first experimentation with this practice for determining pregnancy. Urine tests are still the basis for pregnancy tests today. The secretion of certain hormones (from the anterior lobe of the pituitary gland) is very strong in pregnant women. These hormones promoted the germination of the grains. In Germany, in 1933, Julius Manger did work that duplicated the gender results – the urine of women who later gave birth to boys accelerated the growth of wheat and the urine of women who bore girls accelerated the growth of barley. Since the Egyptians saw all things as connected in their cyclical view of life the sprouting grain associated with birth fits their society’s view that life for the baby and the seed were somehow connected. No new life or no sprouting seed was also a part a loc
The Smith Papyrus dating to about 1600 BCE is the “oldest nucleus of really scientific knowledge in the world” and “contains incomparably the most important body of medical knowledge which has survived to us from ancient Egypt, or, for that matter, from the ancient Orient anywhere.” However, this papyrus is probably only a much later copy of material first recorded as much as 1000 years before the copy was made. This papyrus includes a systematic study in progress of 48 cases of injury to the upper body. On the reverse side of the papyrus are five pages of magic incantations. Science could not be separated from the mystical. own, the colonists embraced Egypt’s medical technology and brought it back home.
The Ebers Papyrus covers a variety of topics in the medical field from a wasp sting to heart trouble. Prescriptions for salves poultices, plasters, inhalations, gargles, draughts, suppositories and enemas are included. A headache remedy read thus, “Berry-of-the-Coriander, Berry-of-the-Poppy Plant, Berry-of-the-Juniper-Plant. Make into one, mix with honey, and smear therewith.” The poppy portion of this prescription would cure a headache if taken internally – opium works wonders. Moreover, this successful Egyptian concept of transdermal medication infusion is used in today’s medical patches for pain medication, hormone therapy or nicotine transference to aid smokers trying to break the cigarette habit. This same papyrus, however, also included a hair loss remedy that reads like a witch’s brew “toes-of-a-dog, refuse of dates, hoof-of-an-ass.” These citations emphasize the fact that in Egypt, religion and society were so completely entwined that even with great scientific strides, the Egyptian doctors still had to follow the rituals that were a fact of daily life for all Egyptians.
The Hearst Medical Papyrus contains similar information to the Ebers Papyrus and makes references to the illnesses of Ra. It lists prescriptions for him with formulas. Also included are chants to be repeated over the sick while they were taking the medicines. Clearly again, one sees the combination of science and ritual or magical belief. Neither seemed complete without the other. The London Medical Papyrus mingles medical information with magic, which reflects the increased tendency of that period (1000 BCE) to rely on magical arts.
The same priest/surgeons covered bleeding wounds with fresh meat to stop the blood flow and to promote the growth of new tissue over the cut. The meat not only acted as a pressure bandage, but also contained blood-clotting chemicals. The idea of pressing flesh against flesh reflects a natural instinct of repairing something with an in kind type replacement. The Egyptians were very practical people that used their natural resources well as evidenced in their observation of the Nile’s flood cycles. It seems natural that they used practical solutions.
Preventative medicine was practiced in several forms in Egypt. One form was the ritualistic recitation of magical chants thought to ward off diseases, demonic possessions or even snakebite. The wearing of amulets, as mentioned earlier about the Eye of Horus, was also commonplace to protect the well from diseases. Herodotus recorded that they took purges, emetics and enemas to guard against bowel troubles and “they drink from brazen cups which they scour everyday – everyone without exception.” This Greek seemed surprised to witness their preventive measures to remain well. Workers received generous rations of radishes, onions and garlic when building the pyramids and living in cramped quarters with numerous other laborers. Radish juice yields a substance called raphanin, which has some antibiotic properties effective against a number of bacteria, including the cocci and coli. Allicin and allistatin are extracted from garlic and onions and are effective against a variety of infectious agents, including those of dysentery, typhoid fever and cholera. The Egyptians’ ability to adapt to their practical surroundings by including these elements in the workers’ diets was based on their ability to observe the disease process and experiment with preventatives. These rations were inscribed on one of the stones of a pyramid in an attempt to inform others of this successful adaptation.
Greece established trading colonies in Egypt in the seventh century BCE. Since Egyptian medicine was superior to its own, the colonists embraced Egypt’s medical technology and brought it back home. The Greek medical treatises contain examples of repetitive scientific observations and of arguments based on systematic physiological theorizing. Medical practice reflected this philosophical view of the early Greek society. The keen Greek medical observers are reminiscent of the Egyptians practitioners who acquired considerable ability to describe the signs and course of disease in individual patients. Greek doctors made some use of therapeutic venesection (bloodletting) and herbal medication and performed a restricted range of simple surgeries. Much of their therapy consisted of the management of both health and disease by manipulation of diet. Echoes of the Egyptian preventative diets with purges and emetics are found in this type of treatment.
Greeks may have borrowed much medical technology from the Egyptians but soon it developed more skills and surpassed the Egyptians. Much of this accomplishment was due to Hippocrates (c. 460-377 BCE) who was probably the most famous doctor ever – doctors still take the Hippocratic oath. Hippocratic medical authors criticized traditional beliefs and attempted to construct casual accounts of health, disease and physiology that did not rely on magical, theological, or mythological forms of explanation. This does not imply that medicine was completely free of the traditional beliefs or that rational medicine was flourishing in isolation from or in opposition to religious belief especially religious healing. Along side the Hippocratic practices and religious healing, folkloric remedies stripped of their magical trappings found their way into medical treatises. The Greek practice of medicine incorporated their worldview of a panoply of anthropomorphic (manlike) gods each needing to be honored even while the tradition of the importance of an individual brought a different philosophical view to it – medicine was rational, ritualistic, and fatalistic at the same time. Even more important, in Greek antiquity, secular and religious forms of healing flourished side by side apparently with no cultural bias for either style.
The individual and his arête (his heroic image, being the very best at what you do) were very important to the Greek society but even the Greeks had a religion of rituals. Their manlike gods ruled a world filled with perilous adventures for each person. Zeus threw lighting bolts at people who displeased him which lead people to try not to catch the god’s attention by any behavior outside your normal day-to-day life. They also carried out rituals of sacrifice at temples built in his honor to appease an angry god. The Greek countryside was very rocky terrain and the Greeks’ view that life was harsh was derived from the natural harshness around them. They also believed in fate – you could not stop something bad from happening if it was your fate – but you could sacrifice animals and build temples to various gods – to keep them on your side in case you ever needed some help. The rational side was represented in some of the medical knowledge that Greeks borrowed from Egyptian medicine. In Withington’s translation of Hippocrates’ Treatise on Articulations verbatim instructions for restoring a dislocated jaw are contained as in the Smith Papyrus, one of the famous medical literature papyri found in Egypt.
These practical factors affected, even though they did not determine, discussions of some physiological considerations such as the role of the female in reproduction. The Greeks could see semen, but not the egg that women contributed to the birth process, so they thought that semen contained a Humanclus – a tiny complete human needing simply to grow in the woman’s womb. Man was responsible for the children – the woman was just a vessel.
Due to Hippocrates contributions to the rational practice of medicine his birthplace, the island of Cos, became an important center of rational medicine in the fifth century BCE, subsequently in the fourth century it also developed as one of the main centers of the worship of the healing god and patron of physicians, Asclepius, man-god derived from the Egyptian Imhotep. At shrines, secular and religious healing appeared to have functioned in harmonious symbiosis. The god was believed to appear in dreams to supplicants who slept the night in the shrine and to heal either them directly with miraculously or by means of medical advice resembling what a human physician would advise.
The Hippocratic Corpus (literally, the body of his work which may have been written by many people over time and fused together later) said that “equilibrium was health and illness an upset.” The four humors – blood, yellow bile, black bile and phlegm – that represented body fluids were balanced in health. This same idea of balance was important in Greek philosophy tying the medical practice to the society once again.
What led a patient in antiquity to either religious or secular healing is not clear, but recourse to either carried no stigma. Interaction between philosophy and medicine occurred from the earliest history of Greek science. For example, concepts shared with or derived from pre-Socratic natural philosophy (such as that of the four elements—earth, air fire, and water) are present in some of the Hippocratic treatises, and Plato propounded physiological theories in his cosmological Timacus. Greek medicine was so advanced that Rome, in the words of one ancient writer, was “swept along on the puffs of the clever brains of Greece.”
Roman medicine, in fact, was built on Greek and Egyptian medicine. Rome conquered much of the Ancient World along its path to Empire. As Romans traveled in the other countries they conquered, they adopted foreign technologies that sometimes included medical technologies that offered people different treatments not included in Roman folk remedies. The Romans borrowed the Egyptian practice of magical medical practice. There were five main kinds of Graeco-Roman practitioners concerned mainly with magical healing: diviner-healers, root-cutters, purifiers, exorcists, sorcerers, and numerous sub-types of each. Each type of practitioner was only roughly correlated with different modes of healing: divination, simple application of materia medica (drugs), incantation alone, by amulet, or counter magic. Much of this folk medicine correlates with Egyptian practices learned possibly through conquest, trade, and the interchange of ideas that naturally occurs through assimilation. Galen, best known of Roman doctors, built on the knowledge that came before him including clinical Hippocratic medicine and expanded it just as the Roman State built on the architecture or art styles of other countries but always putting a Roman stamp on them by doing them bigger, but not necessarily better.
The Romans considered medicine a low-class occupation, fit only for imported foreigners or slaves. Roy Porter commented on their view, saying, “No-nonsense Roman tradition held that one was better off without doctors. Romans had no need of professional physicians, insisted authors like Cato (234-149 BCE), for they were hale and hearty, unlike the effete Greeks.” Pliny wrote of the early Romans’ dislike of physicians: “It was not medicine itself that the ancients condemned, but medicine as a profession, mainly because they refused to pay fees to profiteers in order to save their own lives.” Dislike for paying professionals was common practice for Romans; they even looked down on the Sophists, who were teachers that accepted pay. Romans had a large safety network in their extended families made up of the actual relations and the people who worked on their property. Romans believed that within that large family was the place where healing should take place.
Romans attitude toward religion was translated into their attitude toward various medical practices. Romans practiced many types of religion including the state religion that recognized most of the Greek gods, simply with different names. Sacrifice and rituals were important to the point that when the Jewish Christians converts would not practice the token grain offering to one god, the Roman state ruled that they would be punished. Christianity was actually only one of many religious cults that were adopted by the Roman citizenry. Guilds formed social clubs and practiced certain rituals together and Islamic versions of religion were openly practiced. The Roman State and its survival were all that was sacred. You could simply practice your own mystery cult religion, if you would only also pay homage to the State’s gods. The first Christians were not allowed by their commandments to honor other gods and that was problematic. This laissez-faire attitude left a wide open door for practitioners to try alternative styles of medicine. As long as you respected the State, nothing was taboo except magic (near the end of the decline of the Roman Empire). This happened when the Empire was chaotic and dying. During the confusion and fault finding at the end of the Roman Empire, the practice of magic or witchcraft was an easy charge to lay against another person to accomplish your own goals. The Senatorial class was guilty of this type of game playing – making false charges and bribing witnesses – or accusing someone else when so many practiced magic themselves.
On a more scientific note, Galen dominated medicine for over one thousand years. His writings did much for Roman medicine and future doctors by his faithful recording of the body and its actions, as he knew them. Interestingly, he was first schooled in rhetoric and philosophy before his interest turned to medicine. He was appointed physician to the gladiators which allowed him to study wounds and increased his anatomical and surgical skills. He dissected animals (no humans) to produce very detailed works on anatomy and physiology. He practiced vivisection (dissection of living things), which helped him study the nervous system. He, like many Romans in his society, believed in divinely ordered universe and his medical work was also built on an ordered system. “The unknown was thereby explained in terms of a structural/functional physiology.” His medical practice reflected the Roman State that was functional and ordered. As the Roman armies conquered countries, Galen conquered the world of medicine. Within his ordered system, he still believed in the four humors and that a patient’s health was dependent on the four being in balance.
Each of the three societies had some excellent medical knowledge but they also all still clung to rituals and magic as operative partners with their medical practice. Medicine was influenced by the society that surrounded it. In these three societies the religion, ritual and communal beliefs held by their people influenced the growth of their medical practice. The worldview and philosophy of each society defined the parameters of the medicine each society practiced.
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