Ancient Egyptian Medicine Part I – Fertility and Childbirth
Charles Savona-Ventura MD DScMed FRCOG AccrCOG MRCPI
Professor of Obstetrics & Gynaecology
Faculty of Medicine & Surgery, University of Malta
The Ancient Egyptians with their belief in the afterlife left detailed representations of their way of life in the various contemporary inscriptions and pictograms left in their tombs and temples. A tour of the various sites in Egypt will allow for a visual resume of various aspects of life in Ancient Egypt ranging from daily activities to leisure. There are in addition, several aspects related to health and medicine.
Fertility and Childbirth
Bearing children is an essential sine qua non for the continuation of the community. This important requisite resulted in the development of protective deities such as Bes and Thouris. There was also an attempt to understand and manage the reproductive process.
An intriguing relief in the Barque Chamber at Luxor Temple dedicated to the Theban Triad of Amon, Mut and Chons shows the pharaoh collecting the ‘essence of life’ from the ithyphallic fertility deity Amon-Ra, creator of the universe. The subsequent relief in the series shows the pharaoh presenting his offering to the diety. This latter relief depicts the deity with an erect phallus exuding sperm. A close-up view of this relief identifies a spermatozoon-like structure in relation to the semen flow. The availability of magnification to the Egyptians is not surprising in the light of the discovery of a number of lenses dated to the 3rd century BC. One such crystal lens, discovered in Karanis, Egypt between 1924 and 1929, is kept in the Cairo Egyptian Museum. The fine grinding of rock crystal to produce lenses in Egypt however dates significantly earlier to the IV Dynasty (3rd millennium BC) as evidenced by the numerous ground rock-crystal eyes found in statutes dated to that period. These include the inlaid eyes found in the Nofret statute from Maydun and the seated scribe statute from Saqqara, both in the Cairo Museum. These ground rock-crystal lenses have a convex surface and a flat base, except for a central concavity in the region of the pupil. These lenses confirm that the Egyptians had the necessary technology to manufacture optic-based instruments, including a high resolution magnifying glass suitable for studying microscopic structures.
Detailed information relating to gynaecological problems and their management in Ancient Egypt is documented in the Kahun Gynaecological Papyrus [for the transcribed text see http://www.reshafim.org.il/ad/egypt/timelines/topics/kahunpapyrus.htm]. The Kahun Papyrus, housed in the University College London, is dated to this period by a note on the recto which states the date as being the 29th year of the reign of Amenenhat III (c. 1825 BC).
According to the Kahun Papyrus, fertility in the female was tested by placing an onion bulb in the vagina overnight and identifying the odour in the patient’s nose the next day [para. 28]. Contraception was achieved by using crocodile dung, 45ml of honey, and sour milk [para. 21-23]. The Ebers Papyrus gives different contraceptive remedies: “To cause a woman to stop being pregnant, be it one, two or three years: part of acacia, colocynth, dates, finely ground in a hin of honey, fibers are moistened therewith, introduced into her vagina”. To assist pregnancy: “after ceases the return ……………… pound, grind fine, [strain] in cloth on gruel auyt, pour mehuyu …………… Incense, fresh fat, dates, sweet beer, put inside a rack (of wood) in the flame; thou shalt fumigate ………. as a sweetener of the mouth” [Kahun papyrus, para. 20].
Diagnosis of pregnancy was made on the ability of pregnant urine to germinate cereals: “Means for knowing if a woman will give birth or will not give birth: (Put) some barley and some wheat (into two bags of cloth) which the woman will moisten with her urine every day, equally barley and grain in the two bags. If both the barley and the wheat sprout she will give birth. If (only) the barley germinates it will be a boy, if it is the wheat which alone germinates it will be a girl. If neither germinates she will not give birth” [Berlin papyrus 3.038].
Abortions were carried out by the introduction of warm oil and fat in the vagina. The Ebers papyrus mentions two remedies which “cause all to come out which is in the stomach of a woman“, possibly referring to inducing a miscarriage. Delivery was performed in the squatting position as depicted in the frieze in the Sobek temple at Kom Ombo. Assistance was furnished by midwives, two of whom are known by name – Shiphrah and Puah [Exodus: 1:15-16]. Difficult labours were aided by burning resin, or massaging the abdomen by saffron powder and beer. Obstructed labour gave rise to serious complications including the development of vesico-vaginal fistulae [Kahun papyrus, para. 35]. The mummy of Queen Henhenit dated to 2050 BC was found to have such a fistula which was most likely caused by obstructed labour causing also her death. The prognostic signs of survival of the newborn were detailed by the Ebers Papyrus: “Another way of knowing about a child the day he is born: If he says ny, this means he will live. If he says mbj, this means his death. Another way of knowing: When one hears his voice groan, this means his death. If he turns his face downwards, this too means death” [para. 839-839].
Mammisi or birth houses were annexed to temples, but these served to request divine help by pregnant women rather than being a birthing place. Deity protectors of the parturient woman were Taweret and Bes. Taweret was depicted with the head of a hippopotamus, the legs and arms of a lion, the tail of a crocodile, human breasts, and a swollen belly. She was often depicted holding the Sa amulet symbolizing protection. Bes was depicted as a dwarf with ugly features. The appearance was meant to frighten off any spirits that might be harmful to the child.
Mothers were encouraged to breastfeed their infants for three years “Nothing is more lawful than one’s mother milk”. The mother deity Isis was repeatedly depicted breastfeeding her son Horus. Infants were generally breastfed for three years, and the Ebers Papyrus describes the use of milk stimulants: “To bring forth the milk of a nurse who feeds sbj: who must feed a child: Spine of Nile-perch, fried in oil/fat, her spine is anointed therewith”. When breastfeeding failed, resort was made to cow’s milk. In this case, the breastfeeding mother had further recourse to the deity Taweret.
There can be no doubt that ancient, like modern human society was affected with all forms of congenital anomalies. These included lethal abnormalities such as the spina bifida affecting one of the embalmed foetuses discovered in Tutankhamun’s tomb in 1926. Other abnormalities reported from various mummies included clubfoot, cleft palate, and hydrocephalus. Tolerance towards malformed individuals was taught in the Instruction of Amenoemope dated to the end of the 2nd millennium BC: Mock not the blind nor deride the dwarf nor block the cripple’s path; don’t tease a man made ill by a god nor make outcry when he blunders. Malformed individuals who survived were accepted in society and could advance themselves in the social hierarchy. In the ancient necropolis of Gaza and Saqqara, dwarves hailing from various occupations – jewellers, animal handlers, fishermen, entertainers, nurses – are depicted in at least 50 tombs. At least 207 recorded representations of dwarfism have been recorded. There are in addition at least nine skeletons with dwarfism in the archaeological record.
Some dwarfs reached the pinnacle of the social strata as evidenced by the VI Dynasty limestone-painted statute depicting the achondroplastic dwarf Seneb and his normal family who was honoured with a lavish tomb in a royal cemetery close to the pyramids. Seneb was the overseer of the palace dwarfs, chief of the royal wardrobe and priest of the funerary cults of Khufu. A fine statue in the Cairo Museum depicts him with his family, including his wife who was of normal stature, and two children. His wife was known to have been a lady of the court and a priestess.