Richard Caton.

I. I-em-hotep and ancient Egyptian medicine: II. Prevention of valvular ... online

. (page 1 of 3)
Online LibraryRichard CatonI. I-em-hotep and ancient Egyptian medicine: II. Prevention of valvular ... → online text (page 1 of 3)
Font size
QR-code for this ebook


This is a digital copy of a book that was preserved for generations on library shelves before it was carefully scanned by Google as part of a project
to make the world's books discoverable online.

It has survived long enough for the copyright to expire and the book to enter the public domain. A public domain book is one that was never subject
to copyright or whose legal copyright term has expired. Whether a book is in the public domain may vary country to country. Public domain books
are our gateways to the past, representing a wealth of history, culture and knowledge that's often difficult to discover.

Marks, notations and other marginalia present in the original volume will appear in this file - a reminder of this book's long journey from the
publisher to a library and finally to you.

Usage guidelines

Google is proud to partner with libraries to digitize public domain materials and make them widely accessible. Public domain books belong to the
public and we are merely their custodians. Nevertheless, this work is expensive, so in order to keep providing this resource, we have taken steps to
prevent abuse by commercial parties, including placing technical restrictions on automated querying.

We also ask that you:

+ Make non-commercial use of the files We designed Google Book Search for use by individuals, and we request that you use these files for
personal, non-commercial purposes.

+ Refrain from automated querying Do not send automated queries of any sort to Google's system: If you are conducting research on machine
translation, optical character recognition or other areas where access to a large amount of text is helpful, please contact us. We encourage the
use of public domain materials for these purposes and may be able to help.

+ Maintain attribution The Google "watermark" you see on each file is essential for informing people about this project and helping them find
additional materials through Google Book Search. Please do not remove it.

+ Keep it legal Whatever your use, remember that you are responsible for ensuring that what you are doing is legal. Do not assume that just
because we believe a book is in the public domain for users in the United States, that the work is also in the public domain for users in other
countries. Whether a book is still in copyright varies from country to country, and we can't offer guidance on whether any specific use of
any specific book is allowed. Please do not assume that a book's appearance in Google Book Search means it can be used in any manner
anywhere in the world. Copyright infringement liability can be quite severe.

About Google Book Search

Google's mission is to organize the world's information and to make it universally accessible and useful. Google Book Search helps readers
discover the world's books while helping authors and publishers reach new audiences. You can search through the full text of this book on the web

at http : //books . google . com/|



Digitized by



Google




Digitized by



Google



With the Author's compliments



Digitized by



Google



Digitized by



Google



Digitized by



Google



Digitized by



Google






THE HARVEIAN ORATION



^



Digitized by CjOOQ IC



LONDON :

C. J. CLAY AND SONS

CAMBRIDGE UNIVERSITY PRESS WAREHOUSE, AVE MARIA LANE

GLASGOW : 50 Wellington Street,




LEIPZIG : F. A. Brockhaus

NEW YORK : The Macmillan Company

BOMBAY : Macmillan & Co., Limited



Digitized by



Google



I. I-EM-HOTEP AND AnCIENT EGYPTIAN MeDICINE

II. Prevention of Valvular Disease



THE

HARVEIAN ORATION

DELIVERED BEFORE THE? ROYAL COLLEGE OF
PHYSICIANS ON JUNE *i, 1904.



Gl. by
RICHARD CATON, M.D., F.R.C.P.

EMERITUS PROFEBSOX OF PHYSIOLOGY, UNIVERSITY OF LIVERPOOL }
CONSULTING PHYSICIAN, ROYAL INFIRMARY



With Seven Illustrations

BOSTON MEDICAL LIBRARY

IN THE
FRANCIS A. COUNTWAY

LIBRARY OF MEDICINE

PRINTED AT THE UNIVERSITY PRESS OF LIVERPOOL

LONDON : C. J. CLAY AND SONS .
CAMBRIDGE UNIVERSITY PRESS WAREHOUSE, AVE MARIA LANE

1904

ALL RIGHTS RESERVED



Digitized by



Google




.^



Xi^



Digitized by



Google



TO

Sir TVILLIAM SELBY CHURCH, Bart.. K.C.B., M.D.

THE PRESIDENT
AND TO

THE FELLOWS
OF THE ROYAL COLLEGE OF PHYSICIANS OF LONDON

THIS ORATION IS DEDICATED
WITH MUCH RESPECT



Digitized by



Google



Digitized by



Google




THE

HARVEIAN ORATION

1904

MR. PRESIDENT and GENTLEMEN,
The officials fellows and friends of this
college assemble to-day, as we and our
predecessors have assembled year by year for
two-and-a-half centuries, to commemorate the
services which William Harvey has rendered to
mankind, and in order to keep alive in our own
minds the wise counsels which he addressed to
us, the memory of which he desired us ever to
renew at the festival which he founded. We are
to honour our great profession, to continue in
mutual love and affection among ourselves, and to
search and to study out the secrets of nature by
way of experiment in order to prevent suffering
and to ameliorate human life.

In commencing the pleasing duty which the
kindness of our President has placed in my hands
it is needful to comply with the desire of our
founder that we commemorate the names of



Digitized by



Google



2 THE HARVEIAN ORATION, 1904

benefactors of this college. The lengthy and
honourable roll was so fully dealt with by the
learned orator of last year that I shall merely add
to his recital the names of those who since that
time have given^of their substance for the advance-
ment of medicine. Dr. Horace Dobell of Park-
stone Heights, Dorset, gave the sum of jCs^o to
encourage research into the ultimate origin,
evolution, and life-history of bacilli and other
pathogenic micro-organisms ; Dr. George Oliver,
Fellow of this College, of Harrogate, and Farn-
ham, Surrey, has given ^^2,000 to found the
Oliver-Sharpey lectureship or prize in memory
of William Sharpey of University College, and
to encourage the application of physiological
knowledge for the prevention and cure of disease
and for the prolongation of life ; and Lady Clark
has presented to us a bust of our revered and
lamented former president. Sir Andrew Clark.

No student of the works of Harvey can fail
to bear in mind the great loss we have sustained
this year in the decease of Sir Edward Sieveking,
who in his Harveian Oration drew special attention
to the Prelectiones Anatomiae and in conjunction
with Dr. George Johnson and other Fellows of
this College arranged for the admirable autotype
reproduction of Harvey's manuscript which we
possess.



Digitized by



Google



THE HARVEIAN ORATION, 1904 3

Desiring to render this address as little
wearisome as may be I propose to divide it into
two parts : the first archaeological, dealing with
Egyptian medicine, the medicine god, and the
earliest inquiries known to have been made con-
cerning the circulation and circulatory diseases —
viz., those of the physicians of ancient Egypt, a
department of pre-Harveian work, and perhaps
the only one, which has not been dealt with in
this room. Secondly, I wish to speak with great
brevity on the more practical subject of the pre-
ventive treatment of certain forms of circulatory
disease.

1

Egypt and the Earliest Researches on the

Circulation

To all who love our venerable and beneficent
profession the spectacle of our predecessors in early
ages striving in darkness and difficulty to acquire
that hidden knowledge to which we have partially
attained is interesting and should awaken our
sympathy. As was remarked by the learned
Harveian Orator of 1 896 : 'The past is worth our
study and ever more so the further we advance.''

The information which archaeological re-
search has of late affbrded, though in a fitful and
partial manner, as to the earliest history of
medicine, and particularly in regard to that de-
partment in which our founder laboured, is not
unworthy of our attention.

I, Dr. Payne, Harveian Oration, p. 51



Digitized by



Google



4 THE HARVEIAN ORATION, 1904

The first evidence of definite inquiry, in any
degree worthy to be called scientific by a body of
men specially educated for, and devoting their
lives to medical service, occurs in the early history
of Egypt. The ability, learning, and artistic skill
shown during the early dynasties, which all
Egyptologists recognize, are paralleled by the
remarkable interest then manifested in medicine.
Works on anatomy and medicine are stated to have
been written even by the early sovereigns of
Egypt. Athothis, the son of Menes, who lived
Y six thousand years ago,' is stated in the Berlin
papyrus to have written a book on medicine, and
I shall soon have to quote from the anatomical
writings of the Pharaoh Usaphais, one of his
successors ; Semti, the seventh monarch of the
same dynasty, pursued similar investigations. It
is clear that, like the Greeks, these men in the
childhood of the world believed that vymlveiv fiiv
apiarov itrriv^ Sanitation was to them the first of the
sciences.

The Medicine God I-em-hotep

During the third dynasty, about the year
3,500 B.C. there lived a learned physician (pro-
bably a priest of Ra, the sun-god) the founder of
a cult, whose eminence was such that in course
of iages he is deified and becomes for later genera-
tions the special god of medicine. His temples

I. In all estimations of date I have taken the lower limit, thus probably much
understating the remoteness of the events recorded.



Digitized by



Google



PLATE I



Ancient bronze figure of I-em-hotep, the Egyptian God of Medicine

(By the kind permission of the Committee and Curator of the
Liverpool Museum)



To fact pAgt 4



Digitized by



Google



Digitized by



Google



THE HARVEIAN ORATION, 1904 5

were places of healing for the people. His name
is I-em-hotep, meaning 'he who cometh in peace/
According to ancient inscriptions he was the son
of a certain architect named Kanofer, but when
raised in popular esteem to the rank of a demi-
god he is called the son of the supreme god Ptah,
the Hephaistos of Egypt, and he becomes one of
the great god-triad of Memphis, I-em-hotep is
described as *the good physician of gods and men,
a kind and merciful god, assuaging the sufferings
of those in pain, healing the diseases of men,
giving peaceful sleep to the restless and suffering';
he is called 'the creative god who giveth life to all
men, who comes unto them who call upon him
in every place, and who gives sons to the child-
less.'* He was great in magic and all learning.
He and his followers had to do with the embalming
of the body, and he protected the soul of the dead
man from all spiritual enemies after it had left the
body. In the ritual of embalmment the dead man
was encouraged by these words, 'Thy soul uniteth
itself to I-em-hotep ; while thou art in the funeral
valley thy heart rejoiceth because thou dost not
go into the dwelling of Sebek, but thou are like
a son in the house of his father.'*

From the testimony of temple inscriptions
and papyri, as well as from the writings of Man-
ctho, it is clear that the cult of the medicine-god

1. Hieroglyphic inscription on Temple of I-^m-hotep at Phiiae.
See Bnigschy Thtsmurus^ p. 783

2, Matpero^ La Afytkol. Egypt^ p. 80



Digitized by



Google



/'



6 THE HARVEIAN ORATION, 1904

I-cm-hotcp was established first in early times at
Memphis. In, or adjacent to, some temple — per-
haps that of Ra — I-em-hotep and his assistant
priests gave advice and medical aid to multitudes
of the sick and ailing. It is evident that he gained
great renown for his skill and learning. When
at length he died he was buried in or near the
temple. The priests whom he had taught
continued there the work of healing, always in
association with his name. Just as the Greeks
came to Epidaurus to be healed by Asklepios, so
did the Egyptians, many centuries earlier, visit
Memphis to seek help from I-em-hotep. It seems
probable that in course of time the temple
formerly dedicated to some well-known Egyptian
god ceased to be known by his name, and in
popular speech became the house of I-em-hotep.
There is the clearest evidence of the existence ot
an important temple in later times dedicated to
I-em-hotep at Memphis.

A hieroglyphic inscription describes I-em-
hotep appearing in a vision to the high priest of
Memphis, and addressing him thus : — * I desire
that a great building be erected in the holy place
at Anche-tewej (a part of Memphis), where my
body is hidden, for building it I will give thee
the reward of a son.'^ We know this temple was
built. Later again, similar temples were erected
elsewhere; doubtless priest physicians were
transferred from Memphis to new centres, just as to

I. Brugsch, Tktsaurus^ V, 923



Digitized by



Google



THE HARVEIAN ORATION, 1904 7

Greece and Magna Graecia Epidaurus sent forth
trained priests to establish Asklepieia at Athens,
Cos, or Pergamos.

As the centuries and millenniums passed on
the cult of I-em-hotep seems to have become
more and more popular In later times, when
Greek colonists appeared in Egypt, they gave him
the name Imouthes, and applied to his temples
the Greek term 'Asklepieia,' clearly regarding
him as alike in kind to the Greek Asklepios and
his temples as hospitals for the sick. The
following phrase occurs in the Serapeum Greek
papyrus : —

* TO irpog Me/i^£i/ uiya ^AcTKKtiTriclov *'

The great temple stood outside the eastern
wall of Memphis close to the Serapeum. We
may reasonably hope that a careful examination
of the site may yet reveal to us traces of the
temple and perhaps even the tomb and remains
qf I-em-hotep himself. Some of those who are
present to-day when visiting the site of the temple
of I-em-hotep have been impressed by the thought
that on this spot, long before Asklepios, the source,
or Hippocrates, commonly called the father of
medicine, were born, probably before the Homeric
poems were written, before the Israelites were in
Egypt, before the Stone Age had passed, learned
men here devoted themselves to the consideration

I. Peyroiiy AcdJ, Se, dt Torino,, Ser. II, Tom. Ill, 1841, p. 40



Digitized by



Google



8 THE HARVEIAN ORATION, 1904

V of the nature of human life, strove to prolong it,
to assuage suffering, and to cure disease. They
studied and treated many of the ailments familiar
to us, such as tubercle, leprosy, plague, anaemia,
and other diseases prevalent in Egypt to-day.
Near the site of this temple, securely sealed in an
earthen vessel which had been hidden in the sand,
was found one of the medical papyri from which
I shall quote some passages ; doubtless it belonged
to an early physician who sought, perhaps during
the invasion of Ethiopian or other barbarians, to
preserve for mankind the precious knowledge
that seemed in danger of extinction.

As we should naturally expect in the case of
one so eminent, the Egyptian artists made many
drawings and bronze figures of I-em-hotep ; they
usually represent him as a man rather than as a
god, with few mystic or metaphorical emblems
excepting those related to learning or human life.
He is represented in art as a bald-headed man,
usually in a sitting posture, bearing on his knees
an open papyrus scroll, and sometimes holding in
his hand the symbol of life.'

Testimonies as to I-em-hotep

I-em-hotep rises before us as one of those
intellectual giants who take all knowledge for their
province. In his comprehensiveness he surpasses
Leonardo da Vinci or our own Linacre ; he is

I. See Plate J



Digitized by



Google



PLATE II



o
B



^






« o



^:5



o



o



Digitized by



Google



Digitized by CjOOQ IC



Digitized by



Google



PLATE III






2 2



O «



o



a.

5



•^



Digitized by



Google



THE HARVEIAN ORATION, 1904 9

distinguished as a physician, a minister of the
king, a priest, a writer, an architect, an alchemist,
and an astronomer — great in all, but greatest in
medicine ; so eminent that in the view of Egypt
he is a god.

In the reign of Tosorthros, of the third
dynasty, five or six thousand years ago, we meet
with the wise I-em-hotep in an inscription refer-
ring to the seven years of famine which befell
Egypt in consequence of a succession of low Niles.
He is there the adviser of Pharaoh ; to him the
king applies in his trouble for counsel and help.' In
the inscriptions in the temple of Edfu* he is des-
cribed at length as the great priest I-em-hotep,
the son of Ptah, who speaks or lectures.^ Perhaps
his discourses or lectures were on medicine. Else-
where he is described as the writer of the divine
books. It may here be remarked that probably
Eber*s papyrus was one of the six divine books
attributed to Thoth ceremonially, but not
improbably in large part the work or I-em-hotep.
Manetho, while speaking of his eminence as a
physician, refers to him also as an architect, the
first to build with hewn stone.* Not improbably
he built the step pyramid of Sakkara, the tomo
of his patron Tosorthros.^ Manetho also suggests
that I-em-hotep improved and completed the

I. Maspcro, His. Anc. de t Orient^ I, 240

2. See Plate II

3. De Rougi, Ime. du Temps, d*EJfou^ II, 89

4. Euscbius on Manetho ; Lauth, Matutka und d*r Turiner KSnigspafyrut^ 144

$ee FUt« III



Digitized by



Google



lo THE HARVEIAN ORATION, 1904

hieroglyphic script of Egypt. In the Hermetic
literature he is famed for his knowledge of
astronomy or astrology ; the Westcar papyrus
describes him further as an alchemist and magi-
cian.' These powers were always associated with
medicine, and even to-day in the popular view
they are not entirely dissociated from it. What
share I-em-hotep may have had in those early
discoveries of the movement of the blood, to which
I am about to advert, we do not know. It does,
however, seem clear that either through the
labours of I-em-hotep or of other priest physicians,
the Egyptians had discovered certain elementary
facts and knew as much as the Greeks, as much
as we find in the Hippocratic writings, or in those
of Aristotle and the later Alexandrian school, and
the hypothesis seems a natural one that the know-
ledge possessed by the Greeks was acquired from
Egypt.

Necropsies made by the Egyptian Priests

It is of some interest to note that these priests
of I-em-hotep, themselves learned men, not only
saw and prescribed daily for vast numbers of sick
persons but also performed innumerable necropsies.
They removed the heart, large blood-vessels,
viscera, and brain from the bodies of deceased
persons, also from the bodies of sacred animals,
prior to embalmment ; the heart was placed in a

I. Erman, Dit Marcktn d«t Pmpyrus fTtsicMr^ I» S la



Digitized by



Google



THE HARVEIAN ORATION, 1904 n

separate jar by itself and the remainder of the
viseera in a larger vessel. We are told by Pliny
that in later times an examination of the body
was made after death in order to ascertain the
nature of the disease which was the cause of death."
Thus these men had an opportunity of learning
something of anatomy and pathology. They
may have gained some insight into the intricate
problem of the action of the heart, the movement
of the blood, and. the changes of heart and vessels
produced by disease ; no nation of antiquity had
such opportunities. Did they discover anything ?
I think I can demonstrate to you that they did
obtain a partial knowledge ot the circulation ;
they did not solve the problem, but they
approached it as nearly as did the Greeks, and
probably from them the Greeks obtained such
knowledge as they possessed in early times.

Referbncbs to the Circulation in the Medical
Papyri

Certain of the contents of the medical papyri
are at present almost incomprehensible, partly on
account of the difficulty of translating technical
terms ; these parts I shall not refer to at all ;
those portions which are more easily understood
still present difficulties, and translations must
necessarily be free and at times vague. It must
be remembered that the hieratic script was not

I. Plinjry N^t. HUt^ six, 5



Digitized by



Google



12 THE HARVEIAN ORATION, 1904

a good medium for the clear and definite state-
ment of facts, also that the modes of thought and
forms of expression of the time were far removed
from our own, even far remote from those of the
Hellenes. We enter a different world when we
try to comprehend the beliefs and conceptions of
the ancient Egyptian, the platform of thought on
which he built is imperfectly known to us.
Furthermore, the philosophic conceptions which
the Greeks gave to mankind and their lucidity
of expression had not then come into existence.

In addition to these negative aspects of
difference there are positive ones. The Egyptian
believed himself to dwell in a universe peopled
by spirits and demons, good and evil, whose
influence must be propitiated or averted by charms
and spells. It will, therefore, be understood that
a hieratic papyrus is vastly more difficult to
interpret than a Greek manuscript.

The references in various papyri to the
circulation, though somewhat vague, are not
without interest. Where the sense is important
I have had the help of one or two learned living
Egyptologists, and here I must express my
acknowledgments to Dr. Budge, Professor Kurt
Sethe, Dr. Brugsch, Dr. Joachim, Dr. Leemans,
Dr. Withington, Dr. Grant Bey, Dr. Sandwich,
Mr. Garstang, Professor Carrington Bolton, Pro-
fessor Flinders Petrie, Mr. Percy E. Newberry,
and others, for help orally, or from their writings,
without which, in my ignorance, I should have



Digitized by



Google



THE HARVEIAN ORATION, 1904 13

done little. I am especially indebted to Professor
Kurt Sethe's work on * Imhotep ' and to Dr. H.
Joachim's * Papyros Ebers.'

Let me read you one or two extracts from \
the work of the Pharaoh Usaphais quoted in
Eber's papyrus' : ' Man hath twelve vessels pro-
ceeding from his heart which extend to his body
and limbs ; two vessels go to the contents of his
chest, two vessels go to each leg, two to each
arm, two vessels go to the back of the head, two
to the front of the head, two branches go to the
eyes, two to the nose, two vessels go to the right
ear, the breath of life goes through them, two go
to the left ear, and through them passes the
breath of death ; they all proceed from the heart/
The concluding sentence is the earliest example
I know of the ancient superstition that the left
side of the body is sinister and evil. This is very
early anatomy, professing to be at least six thousand
years old ; we must not expect it to be quite
accurate.

Turning to a comparatively recent period,
I shall quote from other parts of Eber's papyrus ;
the only existing copy of this papyrus (found in
a tomb at Thebes) was written in or before the
sixteenth century b.c. No doubt most, if not all,
its contents are much older than that date.* The
extracts which I am about to read commence
thus : ' From the secret book of the physician,

I. Fo. 103
s. Fo. 99



APR 8 - 1921




Digitized by CjOOQ IC



14 THE HARVEIAN ORATION, 1904

a description of the action of the heart and of
the heart itself. From the heart arise the vessels
which go to the whole body . . . if the physician
lays his finger on the head, on the neck, on the
hand, on the epigastrium, on the arm or the leg,
/ 1 everywhere the motion of the heart touches him,
coursing through the vessels to all the members *
[the reference is clearly to the pulse] ; * thus the
heart is known as the centre of all the vessels.
Four vessels go to the nasal chambers, of which
two convey mucus and two convey blood. There
are four vessels within the temples or skull, from
these the eyes obtain their blood. . . . The four
vessels divide inside the head and spread towards
the hinder part.' The Berlin papyrus speaks of
the division into thirty-two vessels within the
skull, and implies that air traverses, at any rate,
some of them.

Returning to Ebers's papyrus' — ' When the
breath enters the nostrils it penetrates to the
heart and to the internal organs, and supplies the
whole body abundantly.' This idea that certain
of the vessels convey air, you will observe, is
identical with the Greek conception and probably
was its source. ' Three vessels traverse the arms
and extend to the fingers, three vessels also pass
down the leg and are distributed to the sole of
the foot, a vessel goes to each testis and one to
each kidney. Four vessels enter the liver, con-
veying fluid and air ; these may be the seat of


1 3

Online LibraryRichard CatonI. I-em-hotep and ancient Egyptian medicine: II. Prevention of valvular ... → online text (page 1 of 3)