After 1550 bc, images of childbirth protectors aha/Bes and Ipy/Taweret are found on cosmetic equipment, particularly luxurious versions of eye paint containers, eye paint offering medicinal protection as well as adornment (see section “Healer Titles and Roles,” for physicians producing eye paint). The imagery is also found on headrests from 1800 bc onward, invoking the same protective powers for the body lying vulnerable in sleep. Other protectors of the vulnerable at home, including adults at sleep, include the female cobra, poised to strike, as clay figurines (Szpakowska 2003b). Serpents might be the enemy as much as defense; from 1350 bc, small wood round-topped plaques are known, incised with images of a young king or falcon overcoming serpents and inscribed with the name Horus or the Egyptian word shed, “Savior” after 900 bc, the child-ruler-deity motif is found in the more three-dimensional form of Horus stelae, on varying scales, from small portable amulets to larger-scale temple sculptures (Sternberg-el-Hotabi, 1999). On the front, the Horus child stands on two crocodiles, controlling in his hands the hostile forces of the desert - snakes, scorpions, oryx; sides, back and, on small versions, underside are inscribed with incantations against bites (Figure 6.6).
As an aggressive defense of order, the rearing cobra receives early expression in the defense of ruler and divine order (cf. Chapter 2.4). From 2400 bc and later, depictions of rituals set these serpent powers at the forehead, when the king, or later some deities, appears to a wider audience, marking a moment of risk (Roberts
Figure 6.6 Lion-headed and hippopotamus-lion protectors, earliest example on a headrest, inscribed for the accountant of the main recruitment enclosure, Neferhotep, from his burial in Waset, about 1750 bc. Photograph © Gianluca Miniaci.
1995). The protective imagery moves from kingship ritual not only toward the domestic sphere of different social classes but also into temple ritual and furniture in specific locations. After 700 bc, the image of Osiris at Abdju is defended against attack from all cardinal points by four lioness-headed rising cobras with special names. The four faces evoke earlier quadruple Hathor-face pillar capitals, a Complete Mathor, each side identified as a protective goddess - Bast, Shesmetet, Wadjyt, and Sekhmet (Coulon 2011). Here, in the domain of protection against ills, the imagery returns to the double aspect of Love (Hathor) and Fury (Sekhmet), prominent in the written sources (Chapter 4). For more information on the history of health strategies, with specific naming of the forces arrayed against well-being, the full surviving written record may be addressed next (Figure 6.7).
Health, healers, and healed: written evidence Healer titles and roles
In written sources, the main titles in the area of healing are physician (Egyptian sunu), pure one of Sekhmet (Egyptian wa'b Sekhmet), and controller of Serqet (Egyptian kherep Serqet). By rationalist prejudice, some histories of medicine excluded the titles referring to goddesses, as too priestly for scientific treatment. However, the ancient writings suggest instead that the difference was in types of ailment treated, rather than any underlying separation of medicine from religion (Kanel, 1984). The sunu, “physician,” seems to specialize in treatment of external wounds, but the term may also be used as a generalized term for healer. In the correspondence of King Ramses IX with the high priest of Amun, Ramsesnakht, about a delivery of galena, the lead ore used for eye paint, the sunu presides over this field of protective adornment; “when given to the physicians of the Bureau of Physicians of Pharaoh at the Residence, to be processed, it was found to be such weak galena that it contained nothing useable for the eye-paint of Pharaoh!” (Wente 1990, 37). Men with the other healing titles might also have provided general advice for healing; in one letter (Waset 1250 bc), controller of Serqet Amenmes advises temple accountant Piay on directions for preparing a medicine (Wente 1990, 142).
The hundred and fifty known sunu, “physicians,” include only one woman, Peseshet, serving in the household of the king's mother about 2250 bc (list in Nunn 1996). However, writing makes visible only some parts of life. Titles define what is considered, in that source, at that time, the primary activity of a person, but they do not seek to describe a social life as the modern job title might. This is clear from instances where physicians hold other titles: on a coffin from Bersha in Middle Egypt, 1900 bc, a man named Gua holds on one side the title physician, on the other estate overseer. Other holders of the common title estate overseer might also have served as healers, and other titles may conceal healing practice - including the nonspecific titles of women, such as lady of the house. Equally, individuals without titles in written records might have been involved in healing. Our lists of healers are important guides to the social profile in the official record and locate points of social recognition, with all the accompanying prestige, but they must be read in context.
Figure 6.7 Sharp face, flame face, awake face, and alive face: protectors of the image of Osiris at Abdju. On limestone stela from Abdju, now British Museum EA808. Drawing © Wolfram Grajetzki, after Coulon 2011.
Before the name of a man, the term pure one most often denotes someone purified for performing rituals and offerings for a named deity at a cult place (Chapter 3). However, men with the title pure one of Sekhmet are not associated with temples of the goddess Sekhmet. Instead, the term appears among titles of healers. Sekhmet, the Fury, is associated in writings with the threat of disease and plague at the end of the Egyptian agricultural year, when midsummer heat at the lowest levels of the Nile raised real risks, precisely at the point that food and water were in shortest supply, and anxiety for the height of the next Nile flood at its most intense (Kanel 1984). We might expect, then, that the pure one of Sekhmet was involved with what we might call public hygiene, specifically precautions against spread of plague, and checks on any food particularly vulnerable to heat - such as meat in banquets or special offerings (cf. a later manual, first-second century AD, Osing and Rosati 1998).
The controller of Serqet similarly has no known links to any temples of that goddess, and again, no woman is recorded as having the title, whether or not any performed the roles. Serqet, “she who causes/allows to breathe,” is depicted in the third millennium as a water scorpion, a small pool insect unrelated to the land scorpion but with a breathing tube that recalls the scorpion's stinging tail. Later depictions show her as a scorpion, particularly as one of the forces enabling the lifeless to regain breath (Chapter 7). A unique late treatise preserves a collection of remedies in the hands of a controller of Serqet, which describes each type of snake, the effect of its bite, and instructions for treatment where possible (sixth-fourth centuries Bc, Sauneron 1989). In addition to scorpions, the Saharan Nile Valley is home to a far greater variety of snakes, many venomous, like the cobra, and some lethal, like the asp or viper. This geographical context explains the need for a specialist in this area.
Areas of treatment by titled and untitled healers
The three specialist roles of physician, plague expert, and bite expert chart the t errain of healing at formal level, but do not necessarily cover all the types of treatment needed in the ancient Nile. Written records allow us to check the formal picture to at least some extent. From the village of artists working on the project to decorate the tomb of the king at Thebes (1300-1100 Bc), documents record reasons for absence for work, including ill health, and offer a means of identifying the most needed treatments (Janssen 1980). One work record cites “sickness” a hundred times but only twice with a specific ailment, “suffering in his eye”; there is also one entry “the scorpion stung him,” as known from several other sources from this village. The records of absence thus confirm one specialist area, treatment of snakebites, and draw attention to eye problems, another affliction prominent in the Saharan Nile but one for which there is no specialist title in second-millennium BC sources. One late twentieth-century study notes:
Even today, Egypt has an inordinate share of blind and otherwise visually impaired citizens—most of them the rural poor and the victims of a chronic and sometimes blinding eye infection called trachoma, which is hyperendemic in rural Egypt. (Millar and Lane 1988, 654)
Other vast areas of challenges to health, above all pregnancy and birth, are also missing from the titles of male healers: for some of these, we turn to the manuscripts which they, and maybe others, were using.
Writings for good health
Surviving manuscripts indicate a recurrent triple strategy for all healers, each with its own Egyptian term: shesau, observation-based treatment (diagnosis and prognosis); pekheret, medicines, composed of specific ingredients in specific quantities or proportions; and ru, incantations, the words to reintegrate the individual back into the society of the healthy. In most manuscripts, one term dominates, so that a papyrus can be identified as predominantly treatments, prescriptions, and incantations already from the headings, before even reading the contents. The division may obscure the likely reality that this triple strategy is deployed by all three categories of healer. Modern prejudice might lead us to disassociate physician from chants and draw comfort from the dominance of shesau instructions for treatment of external wounds in the one surviving surgical treatise (Breasted 1930). However, the ancient writings are explicit that chants also accompanied their work; for “a wound in front of his face, shattering the skull shell,” requiring particularly risky treatment, the surgical treatise adds a passage of incantation (Allen 2005, 29-80, Papyrus Edwin Smith case 9). In general, modern medical historians excise magic from their view of past healing, sometimes allowing for a contaminated interface of medicomagical. However, these categories are alien to the unitary or holistic ancient practice of attending to the sick with hands-on treatment, medicaments from the material world around, and the healing power of words.
World History
