Who won? In the aftermath of battle, Ramesses and Muwattalli withdrew from Kadesh. We discuss the short- and long-term fallout and consider the “score card” for the respective armies. Then, we spend time with the wounded soldiers, using the Edwin Smith Papyrus to understand diagnoses and treatments used by ancient Egyptian physicians (swnw). Finally, we explore a curious hypothesis, suggesting that Ramesses practiced a form of “decimation” on his troops…
Want more medicine? My interview with Dr. Bob Brier is available at https://open.spotify.com/episode/3mOg7BanFze6F4DYbSWT4K?si=816dc5581d9442df.
The Edwin Smith Papyrus
Breasted, J. H. (1930). The Edwin Smith Surgical Papyrus (Vols. 1–2). Available free via the University of Chicago: https://hdl.handle.net/2027/mdp.39015027232282.
Resche, F. (with Roccati, A.). (2016). Le papyrus médical Edwin Smith: Chirurgie et magie en Egypte antique.
Sanchez, G. M., & Meltzer, E. S. (2012). The Edwin Smith Papyrus: Updated Translation of the Trauma Treatise and Modern Medical Commentaries. Lockwood Press. https://isdistribution.com/BookDetail.aspx?aId=6376
Strouhal, E., Vachala, B., & Vymazalová, H. (2014). The Medicine of the Ancient Egyptians 1: Surgery, Gynecology, Obstetrics, and Pediatrics.
Transcript
Prologue: Casualties
In June of 1287 BCE, the sun rose over Syria, and a mess.[1] Across a floodplain and hilly region, near the town of Kadesh, the remnants of battle strew fields and riverbanks. Overturned chariots, dead horses, broken weapons littered the ground. Of course, there were also human bodies. Warriors from Egypt, Nubia, Libya, the Mediterranean, Syria, and Anatolia, had fallen in service to the “Great Kings” Muwattalli and Ramesses. Now, they lay pierced by arrows and javelins, cut down by axes and swords, crushed by maces, or pinioned by spears. Above, dust clouds lingered over a battlefield, kicked up by wheels and hooves. On the ground, the yellow sands and dark soils mingled with blood and offal, spilled from limbs and torsos. The smell must have been awful. The stink of faeces, from animals and terrified humans, the sour odour of vomit and sweat; above it all, the coppery tang of blood, spilled from countless wounds.
We do not know how many soldiers or animals died at Kadesh. Ramesses makes vague allusions to “overthrowing multitudes” and “slaughtering them all,” but firm numbers are absent. The best we can do is take the total number of Hittites that are referenced in the art and hieroglyphs (37,000 infantry and 3,500 chariots, carrying some 10,000 men as their crews).[2] Bearing in mind the Hittite attack was primarily chariot driven (a sudden ambush, a northward drive, and a running battle around the camp), actual human deaths may have been relatively low. Perhaps a few thousand in the upper estimate, as low as several hundred in a conservative reading.
This is not to downplay the brutality, or the injuries that must have been sustained (and we’ll talk about those a bit later). But overall, the number of battlefield casualties may have been in the hundreds rather than the thousands. Realistically, far more would die after the battle; brought down by wounds, infections, or diseases picked up on the march through unfamiliar lands.[3] If we include those, the number of casualties for the entire campaign may have been several thousand on each side. But that is purely a guesstimate; there is simply no way to know.
Collecting Trophies
Regardless the exact numbers, the floodplain and hills around Kadesh must have been chaotic. After two days of bloody combat, the fields would have been strewn with broken weapons, and the bodies of men and animals, wound, dying, and dead. Amid that carnage, the survivors (on both sides) probably went hunting.
According to his art, Ramesses ended his time at Kadesh with a ceremony. Wall carvings at Abu Simbel and Abydos show the pharaoh seated upon his chariot. He’s not riding it, merely “perching” on the rim, and watching his army clean up the battlefield.[4] The process was… grisly.
Hands
As the sun beat down over the battlefield, Egyptian warriors went about counting the enemy dead. They did this by removing body parts, for tallying up at the camp. In the art, we see this on full display. While the pharaoh sits on his chariot, officers come forth with baskets which they empty on the ground. The pile is made of hands.[5]
From around 1500 BCE, at the end of the Second Intermediate Period, Egyptian rulers started to reckon the enemy dead by removing a single hand. Those hands would be tallied up as evidence for the victory. We see it in art, starting with kings like Ahmose;[6] and at least one example survives archaeologically, a pit at Avaris, filled with the right hands of unknown foes.[7]
And Ramesses is pretty happy to show the process as well. At Abydos, on the western wall, you can find Sherden warriors (the King’s “Sea Peoples” bodyguard) actively cutting into enemy wrists with swords and daggers.[8] Later, the courtiers (including Ramesses’ sons and the tjaty or Vizier) celebrate the pile as it grows higher and higher. Oof.
Looting
Presumably, the process of removing hands also involved some looting. We don’t see that in the art, but you can imagine soldiers (of both sides) searching the enemy dead for trinkets and valuables. Of particular interest were the officers, better armed and dressed than their countrymen, and ripe for the looting. Ramesses mentions Hittite commanders, courtiers, and royal family members among the enemy casualties. Assuming that list is even partially accurate, there must have been some tempting targets amid the overturned chariots and heaps of bodies. Finding survivors to take captive, or finding bodies to loot, may have been quite profitable.
Prisoners
Speaking of captives, Ramesses shows that as well.[9] Behind the piles of hands, we have long trains of prisoners marching towards the pharaoh. They are bound with ropes, tied behind their backs or raising their arms over their shoulders; along the line, Egyptian soldiers (armed with bows and spears) shove them forward before the king. Hieroglyphs describe the scene as:
“Receiving the captives that His Person (Ramesses) brought back, by the victories of his strong arm, in this wretched land of Hatti and this vile land of Naharina, together with the chiefs of every foreign land who came with the Wretched One of Hatti, as prisoners…”[10]
Typical stuff, you can find that kind of rhetoric on many temples and royal proclamations. We can imagine a similar ceremony took place in the Hittite camp, with Egyptian captives paraded before Muwattalli.
It’s unclear if Ramesses held this “presentation ceremony” at Kadesh itself, or after his return to Egypt. The artistic scenes do overlap with the battle imagery, but that’s just iconography. The hieroglyphs don’t give any sense of the timeline. So, either one is equally feasible. Maybe the “hand presentation” happened at Kadesh itself. Keeping those amputated body parts fresh, and in one piece, would have been tricky; much easier to do it immediately. At any rate, that is the picture we receive. The counting of the enemy dead; the presentation of the living. With that ceremony, the campaign could start to end.
Slaughtering Troops?
Now, before the armies withdraw, I’d like to address one little question that appears in the aftermath of Kadesh. You could call it an “alternate” or “revisionist” reading. The idea goes that, on the second day of the battle, Ramesses lined up his troops and punished them, violently, for their cowardice. Supposedly, the King was furious with his troops and executed many of them, particularly the Amun Division.[11]
You can find this interpretation in two works. First, a book by Prof. Toby Wilkinson, titled Ramesses the Great, Egypt’s King of Kings from 2023. He based his view on a paper by Dr. Hans Goedicke, titled “The Battle of Kadesh: A Reassessment,” from 1985.[12] It also appeared in Mark Healy’s book, from Osprey publishing, titled Qadesh 1300 BC: Clash of the Warrior Kings, or the alternate title The Warrior Pharaoh: Ramesses II and the Battle of Qadesh.[13] In those books, building off Goedicke, we get a picture of Ramesses “decimating” his troops, Roman-style, in punishment for their cowardice.
Obviously, I did not follow that viewpoint myself. Nor do scholars like Peter Brand, Claude Obsomer, Anthony Spalinger, Kenneth Kitchen, Alan Gardiner, or James Henry Breasted, all of whom published detailed works on the battle. Goedicke’s interpretation is the “fringe” reading. But it appears on Wikipedia. So, there’s a good chance many people will read it and believe it automatically. To cover all our bases, let’s talk about it briefly.
Firstly, there’s no evidence for such “decimation” practices in the New Kingdom army (or earlier). Punishment, certainly, like beatings and even disfigurement. In episode 213, I quoted some texts about the soldiers’ life, which included regular discipline and “beatings.”[14] But to date, there is no record of a ruler mass-executing troops (personally or otherwise) as a response to cowardice. On current evidence, that just doesn’t seem their style when it comes to motivation. Ramesses’ own speech to his troops, haranguing them for cowardice, appeals to different ideas like “make a good name for yourself” and “win fame in your hometown;” he appeals to his own support and generosity, given to them, and suggests that cowards will be the subject of “gossip” at home.[15] But he doesn’t threaten violence or anything like that. So, the idea of decimation just doesn’t line up with the public image of Egyptian leadership, when it comes to their troops.
In the narrative, Ramesses’ description of the slaughter is slightly vague; and he uses the word sbiw or “rebels” to describe his targets.[16] For Goedicke, that implied that Ramesses’ own troops, who had deserted him, were the King’s victims. But that is a misinterpretation.[17] In Egyptian royal narrative, all foes (no matter how legitimate) are described as “rebels” (sbiw). That applies to powerful empires, like Hatti, or minor uprisings in Nubia. It’s a trope of pharaonic messaging, that treats the King’s authority as “absolute” and resistance as “rebellion.” So, when Ramesses calls his foe “rebels,” it doesn’t automatically mean that they were literally disobedient or rebelling; merely that they were foes.
Additionally, the idea that Ramesses executed the Division of Amun specifically is unsupported in the text. The King doesn’t even mention Amun, Ra, Ptah, or any troops, in this section. Nor does he mention the troops, officers, or chariots, whom he describes repeatedly in his tale. So, the interpretation that Rameses is killing his own troops seems inconsistent with the way he has described things so far. Instead, the passage is a continuation of the earlier theme: the King goes forth, single-handedly, and overwhelms his enemy. It’s the same trope we saw again, and again, in the Battle itself. Ramesses’ description of the slaughter is vague, for sure.
Thirdly, this interpretation seems incompatible with the way Ramesses chooses to describe his role in the battle. Throughout the tale, we hear about his personal valour. The troops are described as cowardly. But Ramesses repeatedly emphasises the idea that he is braver than them and protects his cowardly troops. We see this in the very next passage, after the slaughter, when the King calls himself “The Ruler who protects his army, valiant through his strong arm; the Rampart for his troops on the day of battle.”[18] Now, we might view that as mere rhetoric, but it has a function: the King is painting himself as the saviour of his troops. It wouldn’t make much sense to do that, while also saying “I killed my own troops.”
Finally, and most importantly. The description of this (alleged) slaughter comes immediately after Ramesses is talking about “overthrowing myriads by my strong arm”[19] and immediately before the Hittites ask for peace. Following the slaughter, Muwattalli sends his message of ceasefire. The King of Hatti clearly responds directly to Ramesses’ ferocity, and he begs the King “Do not overwhelm us! Behold, your power is great… (etc).”[20]
So, in the same passage as the slaughter, we get the response, from the Hittites, begging Ramesses to stop. Now, Goedicke (and thus Wilkinson) suggested that Ramesses killed his own troops in front of the Hittites. Wilkinson describes the violence as being “all in full view of the horror-struck Hittite army.”[21] But that doesn’t make a heck of a lot of sense. Why would a general (Ramesses) who had just escaped a day of ambush, with his army barely intact, turn around and decimate that very army, while the enemy were still present? Not a good way to inspire your troops’ loyalty; and certainly not a good way to show strength to your enemy. Just on the internal logic of the battle, it doesn’t really add up.
For those reasons, I did not use the “Decimation” interpretation in my narrative of the Battle. But for those reading Wikipedia, or casually leafing through Wilkinson’s book, just know that such an interpretation is inconsistent with the text itself and the practices of the Egyptian rulers. I won’t say that Goedicke (and thus Healy and Wilkinson) are absolutely, 100% wrong – information might change with future discoveries. But on the current evidence, it seems to be a misunderstanding of the Kadesh inscription; and a rather extreme one.[22]
Withdrawals
Finally, it was time to leave. Presumably, this happened after the second day of combat. Maybe the next day, at dawn, maybe slightly later. Either way, the Egyptian forces packed up their equipment and withdrew from Kadesh.
Looking back, the outcome of the conflict is relatively clear. On a strategic level, Ramesses’ northern campaign had failed in its objective. He would not retake Kadesh; the city remained a vassal of the Hittites.
On the tactical level, the battle itself, the outcome is slightly more ambiguous. Clearly, Ramesses had come dangerously close to a catastrophic defeat; but to his credit (and that of his army) they had defended their camp against a surprise assault. Then they launched a successful counterattack, pushing the Hittites back. And on the flipside, Muwattalli had failed to achieve his tactical goals; he had not destroyed the Egyptian force or killed its leader. Then, the second day of battle seems to have been an inconclusive skirmish, with neither side gaining advantage.
In that sense, the question of “who won Kadesh” depends on which layer (the tactical or strategic) you find more interesting. Strategically, the Hittites came out ahead, defending their control of an important vassal. Tactically, though, the Egyptians seem to have the edge, by mounting a successful defence, counterattack, and then fighting the Hittites to a ceasefire.
Finally, the picture is complicated by what comes after. In the years that follow, the war will resume with additional campaigns. In some cases, Ramesses and his army will invade Syria again, pushing even further north than Kadesh itself. Then, there is the “ideological” war, in which Ramesses and the Hittites seek to control the narrative for their respective audiences. We’ll explore that as we reach it, chronologically. But long story short, the aftermath of Kadesh is less clear-cut than we might like; and that significantly affects our understanding, three thousand years later, of what happened over those two days in Syria.
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At any rate, the Egyptians withdrew and started their southward march. It’s possible that the Hittite army shadowed the Egyptians as they headed south. A set of letters, written some fifteen years after the battle, might hint at post-combat movements. If those records are accurate, Muwattalli may have led his army south, just behind Ramesses, until the Egyptians were gone. After that, he may have turned east to other targets. However, those records are fragmentary (and it’s quite unclear if they actually describe Kadesh, or a set of earlier conflicts). Again, I’ll explore those records in the future, when they actually appear chronologically. For now, the best we can say is that maybe the Hittites followed Ramesses; maybe they didn’t.
Of course, Ramesses mentions none of that. In one of the Kadesh texts (often called the “Poem” or “Literary Record”), the King describes his return to Egypt. It is brief and, as you’d expect, rather grandiose:
“Thus, His Person… turned peacefully southwards. He set off back to Egypt, in peace, with his troops and chariots, all life, stability, and dominion being with him, the gods and goddesses being amulets-of-protection for his body, and subduing all foreign lands, through fear of him. It was the might of His Person that protected his army, all foreign lands praising his beautiful visage.
Arriving peacefully in the Black Land (Kmt), at Pi-Ramesses-Great-of-Victories, and resting in his Palace of life and dominion, just like Ra who is within his horizon. The gods of the land came to [Ramesses] in greeting, saying, ‘Welcome, our beloved son, King of South and North (etc etc)…’ [The gods] have granted [Ramesses] a million sed-festivals and eternity upon the throne of Ra, all lands and all foreign lands being overthrown and slain beneath his sandals, eternally and forever.”
The narrative ends, there, in a “happily ever after;” and with that, properly, the story of the Kadesh campaign finishes.
For now.
Again, there will be epilogues or codas to the story of Kadesh. About four years after the battle, Ramesses will commission his grandiose art and hieroglyphs;[23] and ten-plus years after that, we’ll see the pharaoh “debating” this tale with the King of Hatti. But that is a story for another day…
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For the rest of this episode, I’d like to explore an important part of the soldiers’ experience in war. Specifically, their injuries and treatment. We have a remarkably detailed record of the medical procedures around wounds and traumas. I’ll describe those after the break. If this is your stepping-off point, thank you for listening. Otherwise, I’ll see you in a moment.
Head Injuries
On the day after the battle, the Egyptian camp bustled with activity. Soldiers looting the dead or gathering captives; porters bringing supplies and tending to the animals. There were also the medical areas. A series of tents, or open space, somewhere in the camp, where injured troops could receive treatment from physicians.
Egyptian doctors (or swnw) are exceptionally well-recorded.[24] Papyrus documents, artefacts, and artistic scenes, describe aspects of their profession and medical knowledge. When it came to injuries, the sort you might sustain in battle, we have a top-tier historical source. It’s called the Edwin Smith Papyrus.[25] Originally composed around 1600 BCE, during the Second Intermediate Period,[26] the papyrus includes diagnoses for external injuries and wounds, mainly to the body and head. They range from minor to severe and include a variety of methods of treatments. There are forty-eight cases in total. I won’t read all of them, but a few examples, from different parts of the body and different levels of severity, will give us an idea of the process.
So, how would a swnw (physician) treat the battle injuries at Kadesh?
Case 10 (Eyebrow, Treatable)
First, we have Case #10. Someone has a cut or laceration on their eyebrow. A sharp weapon, or edge, has cut their brow to the bone. The physician may approach it as follows:
“If you examine a man having a wound in the top of his eyebrow, penetrating to the bone… Say to him ‘I can handle this.’ Hold fast his slash wound with thread, then bind it with fresh meat for the first day. If you find it shifting with respect to it stitches, then hold it fast with two bandages [joined one to the other]. Apply oil and honey every day until he is well.”[27]
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In battle, wounds like this were probably quite common. Axe blades, swords, even a slingshot might slash the eyebrow, leaving an open wound. For the physician, this case was relatively minor. A painful inconvenience, to be sure, and left untreated the wound could easily fester and become infected (more on that in a moment). But the cut to the eye is readily treatable, and the papyrus has the cure. First, the physician inspects the injury, then he “holds it fast with thread.” That is, stitches on the cut. To protect the edges of the wound, the prescription is fresh meat applied on the first day; and then oil and honey, every day, until it is healed. The application of fresh meat might sound slightly strange today; but (apparently) it does have merit. Experiments in the 19th and 20th Century found that fresh muscle tissue can assist with wound healing.[28] But the meat must be fresh (with a slightly acidic content, around pH 5.5). Left too long, however, and the pH level rises and begins to hinder the treatment.[29] As a result, the methods on this papyrus universally advise fresh meat for injuries and wounds.
After that, the physician recommends a daily application of oil and honey. Both of these may genuinely help.[30] The oil, for example, was probably the Egyptian mrHt, a type of vegetable oil.[31] Depending on the vegetable in question, it might offer antioxidant properties.[32] Similarly honey, which (in its natural form) has antibacterial and antifungal properties.[33] Thus, applying these to the wound daily could protect from infection, help keep the wound clean, and assist recovery. It’s not terribly far off a treatment you might use today.
Anyway…
Case 4 (Skull, Fight)
The eyebrow wound was painful, but treatable without too much trouble. What about something more severe?
In Case #4, things get a bit more alarming. . Someone has received a powerful blow to the scalp, perhaps from a sword or battle-axe. The cut has penetrated the skin and cracked the casing of the skull itself. Ouch. The wound is serious, and probably quite messy. The skin layers, atop our skulls, have many blood vessels running through them, so even a minor cut will bleed profusely. Presumably, an attendant cleaned the injury first, before the physician began. At that point, we have the diagnosis and treatment:
“If you should examine a man, with a cut on his head that has penetrated to the bone (and is) splitting the [skull], you must palpate the wound [i.e. touch it, lightly, with your fingers to get a feeling]… If you find something shifting under your fingers… and the swelling… protrudes while [the patient] bleeds from both nostrils and ears, and also suffers rigidity in his neck…
“Then you will say to him ‘This is a medical condition I will fight with.’
“Treatment: Do not bandage [the patient]. Place him upon the ground, at his mooring stakes, until the critical time… passes.[34] His treatment is to sit upright. Make for him two supports of brick [upon which the patient will sit or squat] until you know that he has reached the turning point. Then, put ointment upon his head and massage/soften … the back of his neck together with both of his shoulders. Do the same for any man whose [skull] is split [in similar manner].”[35]
The injury is severe, not easily managed. The papyrus tells us that with its “level 2” messaging. Unlike the earlier case, the physician doesn’t say “I will deal with this.” Here, he says, “I will fight with it.” In short, a successful outcome is not guaranteed; the physician must wait until the critical phase passes. If the wound is not too severe, and the patient is lucky, they will come out the other side. In they do, the physician can apply bandaging and ointments. If not, well…
The treatment itself is a combination of topical ointments and physical therapy. The patient must sit, literally “at his mooring post,” like resting upright against a pole. Hopefully, they will soon leave the danger zone and be ready for direct treatment. The patient sits upright supported by two pillars of bricks (or mk.ty).[36] Lastly, the physician applies a type of grease or vegetable fat (mrHt), perhaps with the same antioxidant properties from earlier. With that, the patient is (hopefully) in the clear.
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Case 5 (Skull, Untreatable)
Now, something difficult indeed. The soldier, or whoever, has received a severe head injury that has crushed part of the skull. The doctor examines:
“If you examine a man for a cutting wound on his head, that penetrates to the bone and [is] smashing in part of his [skull], you must palpate the wound [examine it by touch]. If you find this crushed fracture is deep and sunken beneath your fingers… and if the patient is bleeding from nostrils, ears, and suffering rigidity in his back, if he is unable to [turn his head and] look at both of his shoulders or his chest… Then you will say to him ‘This is a condition that cannot be dealt with.’ You should not bandage [the wound]. Place him, seated, on the ground at his mooring-place… until the critical time… passes.”[37]
The wound is open, cutting right through the scalp and fracturing (even crushing) part of the skull. Such an injury might come from a mace, the blunt end of an axe, or even a stone hurled by a sling or from a parapet.[38] Unfortunately, the power of the blow has shattered part of the skull and likely damaged the brain within.
In this case, the physician reaches the limit of his capabilities. The blow was too severe; the wound too penetrating. At best, the physician could observe the patient for a day or two, to see if they were able to recover by themselves. But from the wording, the outcome seems rather unlikely. Perhaps, palliative care was the only option remaining.
Such a response brings us face-to-face with the limits of ancient Egyptian knowledge. Their understanding of external problems, like injuries, was excellent, built up over generations of trial-and-error. They also understood the presence and effects of infection (more on that in a moment). Alas, the internal workings of the body, and how to treat them… those were far less understood.[39] We may think that because the ancients practiced mummification, preserving the human body to a (sometimes) astonishing degree, that they had sophisticated knowledge of the insides. Sadly, that was not the case, because their means of entering the body were limited and largely blind (made through a small cut in the side, into which the embalmer inserted their hand and arm). The Egyptians’ cultural veneration of the body, and the desire to preserve it as intact as possible, likely limited their chances to dissect or even autopsy the deceased. As a result, the functioning of the organs and how to treat them, remained largely unknown. We can explore that in greater detail in future; but if you’re interested, I did an interview with Dr. Bob Brier a couple years ago, where we discussed some of those queries. For now, the swnw is unable to heal the patient with a badly crushed skull. Beyond rest and observation, there’s nothing he can do.
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Torso Injuries (Cases 36, 44, 29)
So far, we’ve only seen head injuries. What about the rest of the body? As the soldiers engaged with their enemy, arrows and sling-shots flew through the air, dealing pain and death to many. Naturally, many of those missiles would strike different parts of the body. Fortunately, the Edwin Smith Papyrus also records treatments for these. I’ll run through a couple, briefly, just to give you an idea.
In Case #36, a patient has suffered a fracture in their upper arm (humerus). Probably quite common in battle, with maces, clubs, and shields swinging around. Archaeologists also find them in construction injuries from workers’ graves, like the tombs of the pyramid builders at Giza.[40] In this case, the physician performs some recognisable tasks. They lay the patient down, with some padding or support under their shoulders. That raises the broken arm, allowing gravity to assist. The doctor takes the “loose” or separated part of the limb and carefully realigns it. Then, they apply a splint with multiple layers of bandages, to keep the arm as straight as possible for healing. This case is for a clean fracture (no jagged edges); there are other cases for more complicated examples, which get more severe depending how crushed the bone was.
In Case #44, the patient has fractured ribs. Again, probably quite common in battle and monument building. This one is intriguing, because it’s another case of “I cannot treat this.” But it’s not life threatening, just beyond the technological limits of the time. The papyrus describes the fracture, and contusions or swelling on the surface. If the rib fragments are shifting, under the doctor’s fingers, then there’s no way to fix them, and he must say ‘This cannot be treated.’”[41] Fortunately, such wounds are not automatically life threatening, through probably quite painful when breathing. Alas, the doctor has no physical tool to repair it. They must let the wound heal of its own accord, without any binding or restriction.
Finally, we get a really interesting case (Case #29), because it deals with infection. The ancients did not understand (or know about) bacteria. But they could observe the symptoms and, through trial-and-error, determine solutions. I’ll quote this one fully, because it’s quite intriguing:
“If you examine a man with a diseased wound in his chest and… heat flows out from the mouth of that wound to your hand [i.e., the wound is inflamed]… and the man himself is feverish [febrile] on account of it, and his flesh cannot accept a bandage, and the wound will not accept… new skin, and oily secretions [pus] drip from it… Say to the patient ‘This is a condition I can deal with.’
“Treatment: Prepare for him the cooling remedies, including leaves of willow and ziziphus, and the qsnty-mineral. Apply [it to the wound]. Also prepare the leaves of imA-trees, together with ox dung, ground up rushes, and the qsnty-mineral. Apply. Thirdly, prepare a remedy for drying the wound, being of green powder (malachite), the wSbt-mineral (possibly pumice),[42] and crushed frit. Grind it up and apply it [to the wound] with bandages. Apply natron salt and the fat of the ibex. Finally, make a powder of red poppy extract (Spnn),[43] together with nSS seeds, carob beans, and crushed sycamore leaves. Apply that [to the wound] with bandages.”[44]
The treatment is detailed, with several layers. A poultice to cool the skin (reducing the swelling or inflammation); another to dry the wound; and last, treatment perhaps to soothe the pain itself – a reference to red poppy (Spnn)[45] might indicate a kind of topical relief, or opiate. So, the physician had a variety of tools to apply in these situations.
There are many more cases (48 in total) that we could describe. But you get the idea. Each situation proceeds in the same language: describe the injury; what the physician should say to the patient; and then the treatment itself. In that sense, the Edwin Smith Papyrus reads like a “doctor’s manual.” Something to consult, actively, during the practice of medicine. You can imagine the physician (swnw) sitting next to his patient, with a copy of the scroll somewhere nearby; maybe in his bags, if he’s experienced; or, if not (or if the case is unusual) unrolling the papyrus to check it. Hopefully, they did that part in private, to avoid upsetting the injured.
Today, the Edwin Smith Papyrus is preserved in the New York Academy of Medicine. Fortunately, there are translations available in the public domain; notably the one by James Henry Breasted in 1930. I’ll put a link to that in the episode description. More recently, there was a revised translation (by an Egyptologist working together with a modern physician) to re-examine the text in light of 21st Century knowledge [Sanchez, G. M., & Meltzer, E. S. (2012). The Edwin Smith Papyrus: Updated Translation of the Trauma Treatise and Modern Medical Commentaries].
Conclusion / Outro
The ancient Egyptian treatment of external injury is remarkably well-documented, and many of its methods are recognisable today. Centuries of trial-and-error, picked up on battlefields and monumental work projects, gave the swnw a sophisticated knowledge of the limbs, head, and bodily traumas. This must have come in handy at Kadesh, when hundreds of warriors needed care. Whether light (a minor cut or break), moderate (a stab wound or fracture), or the severe (the untreatable cases), there was an approach for every situation. As the dust settled over Kadesh, many soldiers could receive prompt and effective treatment.
Then, they went home, and this phase of the tale comes to its end.
[1] See Brand, Ultimate Pharaoh, 157—158.
[2] KRITA, II, 5, 8, 22.
[3] Heagren, Art of War, 371.
[4] Desroches-Noblecourt, et al (1971). Grand temple d’Abou Simbel [II]: La bataille de Qadech, pl. XXXVI; Iskander, S., & Goelet, O. (2015). The Temple of Ramesses II in Abydos Volume 1, pls. 2.2.20, 2.2.22.
[5] Best example is Abydos, exterior north wall.
[6] Matić, U. (2019). Body and Frames of War in New Kingdom Egypt, 40—55, pl. I.
[7] Candelora, D. (2021). Grisly Trophies: Severed Hands and the Egyptian Military Reward System. Near Eastern Archaeology, 84, 192–199. https://doi.org/10.1086/716230; Gresky, J., Bietak, M., Petiti, E., Scheffler, C., & Schultz, M. (2023). First Osteological Evidence of Severed hands in Ancient Egypt. Scientific Reports, 13(Article No. 5239). https://doi.org/10.1038/s41598-023-32165-8.
[8] Abydos, exterior west wall.
[9] For following description, see Abydos, exterior north wall: Iskander & Goelet, The Temple of Ramesses II in Abydos Volume 1, pl. 2.2.20, 2.2.18.
[10] KRITA, II, 23.
[11] Wilkinson, Ramesses the Great, 52.
[12] Goedicke, H. (1985), “The “Battle of Kadesh:” A Reassessment,” 100—101; Wilkinson, T. (2023). Ramesses the Great: Egypt’s King of Kings.
[13] Healy, M. (1993). The Warrior Pharaoh: Ramesses II and the Battle of Qadesh, 83—84.
[14] See Shaw, Ancient Egyptian Warfare, 83—84; Spalinger, War in Ancient Egypt, 266.
[15] KRITA, II, 11.
[16] Goedicke, “The “Battle of Kadesh:” A Reassessment,” 100—101.
[17] KRITANC, II, 29.
[18] KRITA, II, 12.
[19] KRI, II, 84:15; KRITA, II, 12.
[20] KRITA, II, 12—13.
[21] Wilkinson, Ramesses the Great: Egypt’s King of Kings, 52.
[22] KRITANC, II, 29.
[23] Based on the date in the Poem. KRI, II, 101:1—101:15; KRITA, II, 14.
[24] Ghalioungui, P. (1983). The Physicians of Pharaonic Egypt, 1—3.
[25] Breasted, J. H. (1930). The Edwin Smith Surgical Papyrus. https://hdl.handle.net/2027/mdp.39015027232282; Sanchez, G. M., & Meltzer, E. S. (2012). The Edwin Smith Papyrus: Updated Translation of the Trauma Treatise and Modern Medical Commentaries; Allen, The Art of Medicine in Ancient Egypt, 70—71.
[26] Allen, The Art of Medicine in Ancient Egypt, 70.
[27] Sanchez & Meltzer, Edwin Smith Papyrus: Updated Translation, 104—106; Breasted, Edwin Smith Papyrus, 225—233.
[28] Sanchez & Meltzer, Edwin Smith Papyrus: Updated Translation, 35.
[29] Sim, P., Strudwick, X. L., Song, Y., Cowin, A. J., & Garg, S. (2022). Influence of Acidic pH on Wound Healing In Vivo: A Novel Perspective for Wound Treatment. International Journal of Molecular Sciences, 23(21), 13655. https://doi.org/10.3390/ijms232113655
[30] Sanchez & Meltzer, Edwin Smith Papyrus: Updated Translation, 38 with references.
[31] Strouhal, E., Vachala, B., & Vymazalová, H. (2014). The Medicine of the Ancient Egyptians 1, 26—27.
[32] Sanchez & Meltzer, Edwin Smith Papyrus: Updated Translation, 38 with references.
[33] Almasaudi, S. (2021). The antibacterial activities of honey. Saudi Journal of Biological Sciences, 28(4), 2188–2196. https://doi.org/10.1016/j.sjbs.2020.10.017; Mandal, M. D., & Mandal, S. (2011). Honey: Its medicinal property and antibacterial activity. Asian Pacific Journal of Tropical Biomedicine, 1(2), 154–160. https://doi.org/10.1016/S2221-1691(11)60016-6
[34] Sanchez & Meltzer have “on his bed under observation,” but the text literally translates as “mooring place,” like an upright pole against which the patient rests. Breasted, Edwin Smith Papyrus, 149—150.
[35] Sanchez & Meltzer, Edwin Smith Papyrus: Updated Translation, 52—59; Breasted, Edwin Smith Papyrus, 139—155.
[36] Breasted, Edwin Smith Papyrus, 150—151.
[37] Sanchez & Meltzer, Edwin Smith Papyrus: Updated Translation, 60—64; Breasted, Edwin Smith Papyrus, 156—163.
[38] Sanchez & Meltzer, Edwin Smith Papyrus: Updated Translation, 64.
[39] Allen, The Art of Medicine, 9.
[40] Sanchez & Meltzer, Edwin Smith Papyrus: Updated Translation, 233n. 238, 239; Hawass, “The Discover of the Tombs of the Pyramid Builders at Giza;” Jones, in British Medical Journal (1908), 455—458.
[41] Sanchez & Meltzer, Edwin Smith Papyrus: Updated Translation, 266—268.
[42] Strouhal, E. et al., Medicine of the Ancient Egyptians 1, 25.
[43] Breasted, Edwin Smith Papyrus, 378, 379.
[44] Sanchez & Meltzer, Edwin Smith Papyrus: Updated Translation, 250—257; Breasted, Edwin Smith Papyrus, 374—390.
[45] Breasted, Edwin Smith Papyrus, 378, 379.
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