Today marks the thirty-third installment in a series of articles by HumanProgress.org called Centers of Progress. Where does progress happen? The story of civilization is in many ways the story of the city. It is the city that has helped to create and define the modern world. This bi-weekly column will give a short overview of urban centers that were the sites of pivotal advances in culture, economics, politics, technology, etc.
The thirty-third Center of Progress is Memphis, an important center and capital of ancient Egypt that greatly advanced humanity’s understanding of medicine. The ancient Egyptians pioneered medical specialization and arguably invented rational (“non-magical”) medicine.
Memphis is the Greek or Hellenized name for the city, which the Egyptians called Men-Nefer (“beautiful harbor”) since at least the third millennium BC. Today, the archeological zone at Memphis is a designated UNESCO World Heritage site. Tourists flock to view what is left of the ancient city in the Memphis Open Air Museum, which includes a famed fallen 30-foot-tall limestone colossus of Ramses II, Egypt’s most powerful ruler, who reigned from 1279-1213 BC. Outside the museum, visitors throng around other excavated monuments such as a giant alabaster sphinx and another large statue of Ramses II made of granite. The nearby necropolis at Saqqara, home to Egypt’s oldest pyramid and the tombs of numerous pharaohs, also draws many visitors—indeed, Memphis has been called “a city unusually overshadowed by its cemeteries.”
Memphis is located south of the Nile River delta, around 15 miles from modern Cairo, right at the entrance to the Nile River Valley. This strategic location perhaps destined the site to become the nucleus of Egyptian commerce and the capital of Lower Egypt, an independent political entity that existed from c. 3500 BC–c. 3100 BC in the northernmost region of Egypt.
Archeological evidence of agriculture and animal domestication suggests that the area has been inhabited since Neolithic times and had a well-developed culture by about 3600 BC. According to tradition, however, the city was founded in 2925 BC by Menes, Egypt’s semi-mythical first pharaoh, who is credited with uniting the prehistoric kingdoms of Upper and Lower Egypt and thus establishing the Egyptian state.
The Greek historian Herodotus claimed that Menes drained the plain of Memphis and built a large dam around the city to shield it from the sometimes-catastrophic Nile floods. Some scholars believe the name Menes may mean “the Memphite,” further linking Egypt’s founding to the city of Memphis. Menes is said to have reigned for 62 years before a lethal wildlife encounter. Conflicting accounts suggest he was killed by either a hippopotamus, a crocodile, or an allergic reaction to a wasp sting (if only the epi-pen had been invented, he might have lived).
Memphis was not only united Egypt’s first capital but served as the capital on-and-off “for the best part of three and a half millennia, from the beginning of the pharaonic period (c. 3000 BC) until the Arab conquest (AD 641).” During the Second Dynasty (c. 2890 BC–c. 2686 BC), the capital moved to Thinis (the capital of Upper Egypt before unification with the north). But Memphis again served as Egypt’s capital city for the Third, Fourth, Fifth, Sixth, Seventh, and Eighth dynasties. Even after the seat of government moved to Thebes around 2240 BC, Memphis remained one of Egypt’s chief cultural, religious, and economic centers for centuries.
During the Old Kingdom (c. 2700–2200 BC), Egypt’s first golden age, Memphis was home to as many as 30,000 people, making it perhaps the world’s largest settlement at the time. If you could have visited the thriving, palm-filled city, you would have observed administrators, workers, and slaves (like most ancient societies, Egypt engaged in the practice of slavery) walking to and from the palace, people haggling for goods in the marketplace or chatting while playing board games, and worshipers thronging around the many temples. Within those temples, the ill could seek treatment in medical institutions called the Houses of Life, which were established in Memphis as early as the First Dynasty (c. 3100 BC–c. 2900 BC).
Urban centers have often been at the forefront of medical progress. One of the world’s oldest systems of medicine, which even included cosmetic reconstructive surgery, originated in the ancient Indian city of Kashi. Some call the Italian city of Padua, home to the first permanent anatomical theater, “the birthplace of modern medicine.” The first successful heart surgery, another turning point in medical history, took place in Cape Town, South Africa. Many point to Athens, our 7th Center of Progress, as the cradle of Western medicine, and the medical profession certainly owes a debt of gratitude to the Greek healer Hippocrates. But Memphis deserves distinct credit, as it was home to perhaps the earliest pioneer of medicine.
That great medical innovator was Imhotep, the chief minister and head magician for the Third Dynasty Pharaoh Djoser (reigned c. 2686–2648 BC), whose court was in Memphis. The Encyclopedia Britannica names Imhotep as the “first physician.” Imhotep is also thought to have designed the world’s oldest stone pyramid, the step pyramid built at the necropolis of Ṣaqqara outside Memphis, which houses Djoser’s tomb. Some think Imhotep founded the oldest school of medicine in Memphis.
In those days, “the chief magician of the pharaoh’s court also frequently served as the nation’s chief physician,” underscoring the blurred boundary between magic and medicine throughout much of human history. Yet an ancient Egyptian document known as the Edwin Smith Surgical Papyrus, dating to around 1600 BC but written in archaic hieroglyphs thought to be copied from a much older papyrus sometimes attributed to Imhotep, may represent the oldest known case of rational (“non-magical”) medicine. It’s a straightforward surgical guide and may have been a military medical field manual.
Humanity’s earliest efforts to treat disease were often highly unscientific, relying on rituals, incantations, and other literal attempts to work magic. Some ancient Babylonians thought kissing a human skull seven times before bed could cure nighttime teeth-grinding, and some ancient Romans thought that consuming the blood of fallen gladiators could cure epilepsy. “Abracadabra,” the famed gibberish incantation, was once a supposed treatment for malaria. In the 2nd century AD, the Roman writer Serenus Sammonicus in his Liber Medicinalis (“Medical Book”) advised fevered patients to write the magic word over and over on a piece of paper, tie the paper with flax, wear it as a necklace for nine days and then, before sunrise, toss the charm into an east-running stream. Throughout much of antiquity, illness prompted a visit not from a doctor but a shaman healer or magician.
The oldest known medical procedure was quite extreme. Between 5 and 10 percent of skulls from the Neolithic era show evidence of trepanation: the deliberate drilling or scraping of holes in the skull, probably in an attempt to treat epilepsy, mental illness, or head injuries. Strangely, that primitive surgery may represent a precursor to rational medicine. Prehistoric people likely observed that head injuries resulted in the loss of consciousness more often than other injuries and concluded the head held special significance. “The head was chosen for the procedure, not because of … magic … but because of … accumulated experience observed by primitive man in the Stone Age with ubiquitous head injuries during altercations and hunting,” according to Cuban-American medical historian Miguel Faria.
But while there may have been a certain logic to trepanation, the often-fatal surgery is no longer in use for good reason. The ancient Egyptians almost never employed the technique, although they made impressive breakthroughs in surgery. The first recorded account of a surgical suture dates to around 3000 BC in Egypt, and the oldest confirmed suture is on an Egyptian mummy thought to date to around 1100 BC. The ancient Egyptian physicians created sutures from plant fibers, tendons, hair, and woolen threads.
The ancient Egyptians were arguably the first people to develop a medical system with a high level of documentation, and a growing body of research suggests that there was rational medicine in Egypt before Greece. The Greeks themselves admired Egyptian medicine. Homer (c. 800 BC) remarked in The Odyssey: “In Egypt, the men are more skilled in medicine than any of humankind.” Hippocrates, Herophilos, Erasistratus, and later Galen studied in Egypt and acknowledged the Egyptian influence on Greek medicine. Some scholars even claim that “Egyptian medicine is the base of Greek medicine.”
The Edwin Smith papyrus has been called “the birth of analytical thinking in medicine.” It describes 48 different medical scenarios, mostly involving traumatic injuries. The text instructs the physician on how to examine the patient, describes the outlook for the patient’s survival based upon the physical signs revealed by the examination, and suggests specific treatments, including simple surgeries. While we now take physical examinations, diagnoses, and prognoses for granted, at the time these were extraordinary breakthroughs.
Another well-preserved medical treatise, the Ebers Papyrus (c. 1550 BC, but likely copied from an older text), consisted of both “magical” treatments and more sensible remedies. (The course of action the Ebers Papyrus recommends for Guinea-worm disease–wrapping the emerging end of the worm around a stick and slowly pulling it out–remains the standard treatment to this day). Rational medicine coexisted with magic-based medical practices for millennia and would not start to supplant the latter until the Scientific Revolution in the 16th and 17th centuries AD. The medical system developed in Memphis—like the much-lauded Greek medicine that came later with its emphasis on “humorism,” bloodletting, and belief in “wandering wombs”—included many bizarre errors.
While no modern patient would want to receive treatment in Memphis, the medical advancements made there were remarkable for the era. Ancient Egypt was arguably “the birthplace of anatomical science,” partly thanks to the practice of mummification—a method of preserving the body after death—which dates to approximately 3500 BC and was already entrenched in Egyptian society by the time Memphis rose to prominence. Embalmers and physicians in Memphis broke new ground in the understanding of the circulatory system and internal organs and knew how to take a pulse.
The physicians of Memphis also developed many medical specializations. According to Herodotus, “the practice of medicine [was] so specialized among [Egyptians] that each physician [was] a healer of one disease and no more.” Egyptian writings refer to “eye physicians,” “stomach physicians,” “shepherds of the anus” (i.e., proctologists), and more. Many scholars believe one of the titles of Hesy-Ra, a high court official in Memphis during the early Third Dynasty (2686-2613 BC), may translate to “great one of the dentists”—making him the first dentist whose name is known to history. The Kahun Gynecological Papyrus (c. 1800 BC) represents the oldest surviving text on gynecology. A noblewoman named Peseshet, who lived around 2500 BC, when Memphis was the capital, held the title “lady overseer of women physicians” and may be the earliest named female doctor.
In addition to specializing, the physicians of ancient Egypt discovered many effective treatments and pioneered areas including surgery, nutrition, pharmacology, and prosthetics. For example, The Lancet notes, “[a]natomical and radiological studies on skeletal and mummified remains [have] revealed healed fractures and amputation sites, confirming that the Egyptians did successful surgery.” A healed mandible suggests successful oral surgery as early as the Fourth Dynasty (2900–2750 BC). In Memphis, court surgeons used scalpels made from copper, ivory, or obsidian. And perhaps as early as 3000 BC, the Egyptians made a medicinal drink from boiled willow tree bark for pain relief. Centuries later, the active ingredient, salicin, formed the basis of the discovery of aspirin, which remains one of the most commonly used drugs in the world.
A century after Imhotep’s death, Egyptians began to worship him as the god of healing. Posthumous deification was a rare honor for non-royal Egyptians, but Imhotep’s cult grew over the centuries until he became one of the patron deities of Memphis. In the Ptolemaic times, Memphis’s importance dwindled as the new sea-port of Alexandria (our 8th Center of Progress) supplanted the former as an intellectual center, exporting Egyptian medical understanding to other parts of the Mediterranean. The Arab conquest in the 7thcentury AD dealt the last blow to Memphis, as the city became a quarry, stripped for building materials to construct new settlements, including Fustat, the Arab capital.
Without rational medicine, medical specialists, and the numerous other foundational advances in the treatment of disease originating in ancient Memphis, our lives would be far shorter and sicklier. It is for those reasons that Memphis deserves its place as our thirty-third Center of Progress.