Edwin Smith, born in Connecticut, lived in Egypt in the late 1800s. An antiquities dealer, he bought a papyrus in 1862 that he was unable to translate.
Smith died in 1906, and his daughter donated the scroll to the New York Historical Society.
In 1920, Egyptologist Caroline Ransom Williams found it and recognized its worth. She wrote to her mentor James Henry Breasted and asked him to translate it. brewminate.com/the-contributi…
Ransom Williams felt she was too occupied with family to take it on.
“The papyrus is probably the most valuable one owned by the Society and I am ready to waive my interest in it, in the hope that it may be published sooner and better than I could do it.” [November 22, 1920]
In 1930, Breasted published a translation of the papyrus, with the help of Dr. Arno B. Luckhardt, a physiologist and professor at @UChicago with an interest in medical history (he was particularly interested in the discoveries of Dr. William Beaumont).
The Edwin Smith papyrus has been dated to 1600 B.C.E., but based on the writing, it's thought to be a copy of another text from 1900 B.C.E.
That makes it the oldest surviving medical text.
It contains descriptions, exams, and treatments for 48 injuries - mostly sustained by young, healthy men in battle or construction.
Injuries fall in 3 categories: 1) An ailment I will handle; 2) An ailment I will fight with; and 3) An ailment for which nothing can be done.
...and because these cases start from the head and move downward, you get NEUROLOGY.
You get descriptions of meninges, cerebrospinal fluid, dural pulsations, and brain anatomy. Plus, prognostication, and a pattern of paralysis following brain injury.
The Edwin Smith Papyrus has the first surviving use of the hieroglyph for "brain."
What really strikes historians, though, is the rational observational nature of the work. Later writing, like the Ebers papyrus, is more magical, less connected to observation and science. onlinelibrary.wiley.com/doi/full/10.10…
Also, the Edwin Smith Papyrus contains the first known use of an asterisk (the red cross in this photo). nature.com/articles/sc198…
(I feel like, if we have to name this papyrus after someone, it shouldn't be the guy who showed up in Egypt, bought it, and then did nothing with it. Can we call this the Caroline Ransom Williams Papyrus? Ok, the Breasted Papyrus, if we must.)
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Bradford-Hill's trial of streptomycin for TB (see my thread from earlier today) was the first randomized controlled trial - but not blinded, and not placebo controlled. There was another trial, around the same time, for a medication called patulin. 1/6
You've never heard of patulin? It's a mycotoxin (it grows on apples), once used as an antibiotic (but not any more, due to toxicity).
In the 1940s, it was billed as the cure for the common cold. 2/6
A study showed that if you spray patulin in someone's nose when they have a cold, they feel much better - within 48 hours - than people who didn't receive any treatment.
This was huge! Everyone wanted patulin to treat colds.
So what happened? 3/6
Here’s a good story about the placebo effect – on physicians:
If you had a stroke in 1810, it would have been diagnosed clinically, without MRI. Your doctors knew that if you died, your brain held either fluid (edema, ischemic stroke) or blood (hemorrhagic stroke). 1/
So obviously the problem was that there was too much fluid in your body.
Solution? Reduce fluid, by blood-letting. This was the solution to a lot of things (one of these days I'll do a #histmed#tweetorial on Benjamin Rush).
And many people got better. 2/
People got better because when you have a small stroke, inflammation and edema make symptoms worse initially, and then, over time, symptoms improve.
If they didn't get better? Easy - you didn't bleed them enough. 3/
James Lind conducted the 1st randomized medical trial in 1747 when he gave sailors different remedies for scurvy.
In 1863, Austin Flint gave patients with rheumatism a "placebo," and it worked as well as medicines - possibly the first placebo-controlled trial. #histmed 1/7
"Placebo" was already a well-known term and concept. Initially defined as a common medication (seen here in a dictionary from 1785), it came to mean an inert substance that had no effect on a disease, but pleased the patient. 2/7
The history of medicine is full of placebos: commonly, impure placebos, meaning they did something (made you poop or vomit, got you drunk or sedated, or tasted spicy or bitter), but didn't do the thing they were supposed to do (fix your cold, or your cancer, or your tetany). 1/7
One of my favorite #histmed stories is the discovery of EEG by Hans Berger in the 1920s. #NeuroTwitter
At age 19, Berger (1873-1940) fell off a horse. On the same day, his sister, miles away, sent a telegraph to ask if he was doing ok. 1/10
He was fine, but he thought he had communicated his frightened thoughts about getting hurt to his sister by telepathy. He decided to study psychiatry, to learn more about inter-brain communication. 2/10
Berger wanted to measure the "psychic energy" that, he thought, tied us all together. He wrote about the "radioactivity of the brain," he studied circulation, he measured temperature of the brain during mental exertion (in a 23 yo patient with a gunshot wound to the head) 3/10