The Edwin Smith Papyrus

One of the earliest medical documents describing the effects of brain damage on function is the Edwin Smith Surgical Papyrus, dating from the 17th Century and named after the Egyptologist who discovered it. It is thought to be a copy of an earlier composite manuscript dated around 3000-2500 BC.

(An extract from the papyrus, original on left and 'clean' version on right)

Using hieroglyphs, the manuscript describes 48 separate observations (case studies) of brain and spinal injury as well as the treatment used in each. Altogether an extraordinary document that was probably the first to contain descriptions of various brain structures including cranial sutures, meninges, external surface (neocortex), cerebrospinal fluid, and is even the first scientific document to use the word 'brain'.

The manuscript also contains the first reported case of disorders such as quadriplegia, urinary incontinence, priaprism, as well as seminal emission following vertebral dislocation. Many of the cases are presented in something of a formal format: Title, examination, diagnosis, treatment.

The following is Case Two of the Edwin Smith papyrus and describes a wound to the head:

Title: Instructions concerning a [gaping] wound [in his head], penetrating to the bone.
Examination: If thou examinest a man having a [gaping] wound [in] his [head], penetrating to the bone, thou shouldst lay thy hand upon it (and) [thou shouldst] pal[pate hi]s wound. If thou findest his skull [uninjured, not hav]ing a perforation in it...
Diagnosis: Thou shouldst say regarding [him]: 'One hav[ing a gaping wou]nd in his head. An ailment which I will treat'.
Treatment: [Thou] shouldst bind [fresh meat upon it the first day; thou shouldst apply for him two strips of linen, and treat afterward with grease, honey (and) lin]t every day until he recovers.
Gloss: As for 'two strips of linen,' [it means] two bands [of linen which one applies upon the two lips of the gaping wound in order to cause that one join] to the other.

(Materials from G. Neil Martin's Human Neuropsychology, 2nd ed.)