Medicine in ancient Egypt (from the predynastic period to the beginning of the Hellenistic era) encompassed the knowledge available at the time about human health and diseases, as well as methods of treatment and prevention. Ancient medicine had partly a magical-religious character and partly an empirical-rational one. In temples, physicians of various specialties were trained, surgical procedures were performed, formulations of medicines were developed, and so forth. A healthcare system was in operation, which influenced the later development of medicine in Greece and Rome.
Historical and Cultural Background
The history of Egypt spans over 5,000 years (approximately XXX BC to the 21st century AD). In the history of the ancient state (from around 3200–3000 BC to around 305–30 BC), Egyptologists have identified 10 major periods, during which representatives of 31 consecutive dynasties ruled:
- Predynastic and protodynastic period (circa 5500-3150 BC) – early leaders and kings from Hierakonpolis, Nubt, Tinis, and Abydos in Upper Egypt (Dynasty 0) and kings from Per-Wadjet in Lower Egypt (known from the Palermo stone).
- Early dynastic, archaic period (circa 3150–2686 BC) – Dynasties I and II.
- Old Kingdom (circa 2686–2181 BC) – Dynasties III–VI.
- First Intermediate Period (2181–2133 BC) – Dynasties VII–X.
- Middle Kingdom (Theban) (circa 2133–1786 BC) – Dynasties XI and XII.
- Second Intermediate Period (circa 1786–1567 BC) – Dynasties XII–XVII.
- New Kingdom (circa 1567–1085 BC) – Dynasties XVIII–XX.
- Third Intermediate Period (circa 1085–730 BC) – rulers: XXI Dynasty, High Priests of the Temple of Amun (Thebes), Dynasties XXII and XXIII.
- Late Period (circa 730–305 BC) – Dynasties: XXIV, XXV, XXVI, XXVII (Achaemenids), XXVIII, XXIX, XXX, and XXXI (Achaemenids).
- Greco-Ptolemaic period (circa 305–30 BC) – Macedonian rulers and the Ptolemaic dynasty (Ptolemies).
The ancient Egyptians mainly sustained themselves through agriculture, fishing, and animal husbandry—the hard work of fellahs, the effects of which depended largely on meteorological conditions, especially the enriching floods of the Nile. Prolonged droughts and floods also posed health and life hazards to the population, such as famine or epidemics (Egyptian plagues, for example). High mortality was also caused by wars, the difficult physical conditions of fellahs’ work, unhealthy nutrition, and others. The life expectancy for men was approximately 35 years, and for women, about 30 years. About one-third of children died in early childhood.
It is believed that the complete dependence on the river was the source of belief in deities determining the fate of people. The sages residing in the temples mastered mathematics and writing (hieroglyphic writing, cuneiform writing) and could predict meteorological and astronomical phenomena. The high level of extensive medical knowledge required the development of methods for embalming bodies (worshipped animals were also mummified, e.g., cats, Bastet, and Sekhmet). The sages were revered as gods (gods of wisdom, polytheism, Thoth, and Maat, considered the daughters of Ra). The sages, advisors to the pharaohs, prepared the Egyptian calendar, calculated tax rates and commodity prices in trade, designed structures enabling the regulation of the river, granaries, temples, and tombs (the Valley of the Kings, for example), and pondered philosophical problems. Medical experiments were also conducted in temples, and the first physicians were taught there.
Surviving traces of medicine
Sources of knowledge about ancient Egyptian medicine include archaeological objects and various artifacts of medical culture, such as surgical and dental instruments, pharmacy equipment (e.g., scales, pharmacy vessels, mortars, medicines), packaging of medicines, and medical instruments. Historians of medicine also have at their disposal numerous fragments of architecture, sculptures, and paintings. Numerous pieces of information about the health of Egyptians, their diseases, and treatment methods are obtained by examining mummies, canopic jars, or parts of skeletons found outside tombs. Artifacts of writing and literature—inscriptions and papyri, especially Egyptian medical papyri—are of particular importance.
Ancient Egyptian medicine
First physicians
The emergence of Egyptian medicine is often linked to the emergence of religion and the priestly class. Sages, who facilitated overcoming the Egyptians’ fear of floods, droughts, or diseases, were considered gods, demigods, or people blessed by the gods. The belief in the superhuman greatness of the kingdom and the immortality of rulers was reinforced by the customs of mummifying bodies and building pyramids.
Mastering the knowledge of methods for preserving bodies from decomposition (mummies, canopic jars) required many years of experiments by the specialists of the time; they are considered precursors of pathomorphology. It is known that effective procedures, which are very complex, were mastered as early as during the reign of the 4th Dynasty. The lack of information about unsuccessful earlier attempts to ensure the posthumous lives of rulers makes it difficult to date the beginning of the development of Egyptian medicine more precisely.
Among the ancient Egyptian physicians, called swnw (sunu), some of the best-known ones include:
III Dynasty (circa 2800–2500 BC)
- Imhotep (Egyptian: ỉỉ-m-ḥtp, “one who comes in peace”), the physician of Pharaoh Djoser and his surroundings, also titled “Prince of Peace,” “Chancellor of Lower Egypt,” “High Priest of Heliopolis,” “Chief Sculptor,” and others; his merits were honored with burial in a pyramid near Saqqara (Djoser’s pyramid).
- Hesy-Ra (Hesy-Re, Hesira, Hesire, Hesi), a physician from the reign of Djoser and probably also Sneferu, recognized as the first dentist (Wer-ibeh-senjw).
IV Dynasty (circa 2613–2494 BC)
- Iry, the court physician of the pharaoh and the head of physicians in the Old Kingdom, the first known specialist in eye diseases (ophthalmology); commemorated by a stela discovered in Giza, near the pyramids of Khufu, Khafre, and Menkaure (discovered in 1926 by Hermann Junker in one of the tombs).
- Peseshet, “overseer of female physicians,” probably the first female physician in Sais (a medical school operated in the temple in Sais).
V Dynasty (circa 2500–2300 BC)
- Sekhet-Enanach, the court physician of Pharaoh Sahure, a specialist in “diseases of the nose, throat, and ears” (otolaryngology), honored with an epitaph in the temple, indicating the pharaoh’s great gratitude for medical care.
VI Dynasty (circa 2347–2216 BC)
- Nin-anch-re, Nin-anchre, the physician of Pharaoh Teti, according to Hermann Junker, who discovered his statue, had “features of an educated man.”
XVIII Dynasty (circa 1550–1292 BC)
- Nebamon, the physician of Amenhotep II, in whose tomb a painting depicting a prince of Mesopotamia, who came to Egypt for medical assistance, was placed, even though medicine also existed in Mesopotamia, but at a lower level. Herodotus confirmed this, and in the Amarna letters (archives of clay tablets from Tell el-Amarna), there is a letter from the king of Mitanni to the sick Amenhotep III (1408–1372 BC), whose sender promises to send the sick “healing” image of the goddess Ishtar from Nineveh.
XIX Dynasty (circa 1292–1186 BC)
- Iwti, the court physician of Ramesses I and Seti II, knew the “internal juices of the body” and personally prepared medicines from available plant and mineral resources (“the court physician Iwti’s pharmacy”), also had papyri with prescriptions and indications of their applications.
XXVII Dynasty, Achaemenids (circa 525–404 BC)
- Uzahor-resinet – the court physician at the time when the Persian king Darius I conquered Egypt; Darius’s command for Uzahor-resinet to reopen the old medical school (with a surgery department and a botanical garden at the temple of Horus) was a recognition of the high level of Egyptian medical art.
Egyptian Medical Papyri
Valuable sources of information about ancient Egyptian medicine are the “medical papyri” – twelve found documents, written on papyrus. One of them is written using Egyptian hieroglyphs, and the rest in hieratic script (translations of texts can be problematic). They are dated from around 1820 BC to 250 AD. Some are believed to be copies of earlier writings or compilations, even texts of Imhotep. The texts mainly refer to the symptoms and treatment methods of various diseases; they also evidence the broader interests of ancient Egyptian physicians, e.g., the construction and functions of the circulatory system.
Some of the “medical papyri” have a magical-religious character – they contain descriptions of the use of amulets, spells, and rituals, while others are the result of experience gained from observing patients undergoing treatment.
References to magic are particularly numerous in the Berlin and London papyri. Spells are also mentioned in the Ebers papyrus, but this text also addresses surgical procedures and symptoms of internal diseases and their treatment using minerals and medicinal plants; it also contains the chapter “The Physician’s Secret.” Knowledge of heartbeat and heart knowledge—a topic also addressed in the Smith papyrus.
The Edwin Smith papyrus stands out for its scientific nature; it is considered the first surgical manual. It contains systematically arranged instructions for dealing with 48 cases (examination, diagnosis, treatment, and prognosis) and descriptions of anatomical observations, including the first known descriptions of cranial sutures, meninges, the outer surface of the brain, cerebrospinal fluid (subarachnoid space), and intracranial pulsations (traumatic brain injury, intracranial hypertension).
The first sentences of the text concern the heart and blood vessels. Fragments that were difficult to read made a big impression on Egyptologists:
One must measure as if one counts using a measure, etc. Counting anything with fingers [takes place] to know the action of the heart. There are vessels in all parts of the body […]. If the priest of Sekhmet, some physician swnw […] places his fingers on the head […] on both hands, in the place of the heart […] on both legs, then he measures the heart […] it speaks […] in every vessel, in every part of the body […] vessels of his heart are measured to know the symptoms manifested in it.
The analogy of the circulatory system with the life-giving Nile formed the basis of ancient Egyptian physiology and internal medicine. Just as the Nile carries nutrients and harmful substances from its sources, sometimes encountering blockages, so do all bodily fluids (blood, tears, urine, semen, mucus, “vedehu” – compounds causing pain, inflammation, fever, etc.…), flow from the heart through a system of channels (“metu”) to all parts of the body, and then outside (the phenomenon of blood circulation was not known). The flow is driven by the beating of the heart. In cases of disease detection, the physician removes the “blockage of metu” by using, for example, leeches, bloodletting, laxatives, or an enema (probably one of the tasks of the “royal rectal attendant”).
Instruction no. 6 probably contains the earliest description of the brain:
If you examine a man with […] a wound on the head, reaching to the bone; the skull is fractured, the brain has come out of the skull […] convolutions, which form as in cast metal. There is something in it […] that trembles [and] pulsates under your fingers, like the fontanelle of a child that has not yet ossified. This trembling arises under your fingers because the brain of his skull is exposed. Blood flows from both nostrils. Then you must say: someone with a gaping head wound […] an untreatable disease.
The last of the instructions – instruction no. 48, referring to “stretching the vertebrae” – ends with a broken recommendation: “then you must do to him…”.
Diseases of the Egyptians and Their Treatment
Sources of information on the diseases of ancient Egyptians can be descriptions of symptoms preserved in some medical papyri or observations and analyses, which are equivalent to modern autopsy sections, conducted thousands of years later. In some cases, the preserved fragmentary “clinical picture” is almost unequivocal for specialists, while in many others, there is a lack of scientific confirmation of the occurrence of diseases (e.g., mental disorders). It is also impossible, among other things, to confirm whether there is a valid suspicion of thyroid disease in Cleopatra VII based on her image on a relief or a suspicion of Queen Punt’s lipomas based on the shape of her silhouette depicted in the temple of Deir el-Bahari.
The results of studies of human remains, images, and manuscripts have confirmed the occurrence in ancient Egypt of:
- Eye diseases, associated, among others, with exposure to desert sand and dust; the Ebers Papyrus indicates that Egyptian ophthalmologists distinguished symptoms of diseases such as trachoma, glaucoma, cataracts, night blindness, conjunctivitis, styes, corneal ulcers, iritis, pterygium, excessive tearing, and strabismus; the existence of the specialty of “palace ophthalmologist” testifies to the significant suffering caused by these diseases (descriptions of ancient Egyptian methods of treating trachoma surprised Egyptologists)
- Diseases caused by scorpion or snake bites
- Internal organ diseases, usually difficult to detect but sometimes leave clear traces (e.g., kidney and gallstones)
- Tuberculosis, e.g., spinal tuberculosis (Pott’s disease), the diagnosis of which based on depictions of ancient Egyptians is doubtful because it is difficult to exclude other causes of humpback, such as other diseases or postural defects
- Heine-Medin disease (polio, poliomyelitis), a viral disease that probably affected, among others, Pharaoh Siptah (circa 1194–1190 BC) and the doorkeeper Ruma (2nd century BC); congenital defects are not ruled out
- Parasitic diseases, such as schistosomiasis (bilharzia), hookworm causing dracunculiasis, roundworms, tapeworms, and others.
Microscopic examination of mummy skin revealed the presence of infectious smallpox, and Gram staining found Yersinia pestis bacteria in the lungs and liver of another mummy.
It is presumed that Imhotep himself diagnosed and treated over 200 diseases, including 15 abdominal diseases, 11 urinary bladder diseases, 10 rectal diseases, 29 eye diseases, and 18 skin, hair, nail, and tongue diseases. He probably used medical knowledge gathered by nomadic tribes, which later united to form ancient Egypt, and by people inhabiting more distant areas of Africa (e.g., the land of Cush, among others).
Epidemics
The power of epidemic threats in the times of the 26th dynasty is illustrated by discoveries made in Luxor (Western Thebes) by Italian archaeologists (Italian Archaeological Mission to Luxor, MAIL; led by Francesco Tiradritti) between 1997 and 2012. In the burial complexes of Harwa and Akhimenru, the team discovered remains of a large operation to destroy the bodies of epidemic victims from the 7th century BC—human remains buried in lime, lime-burning kilns, and traces of fires where cremations were performed. It is suspected that it was an epidemic of measles or smallpox.
A catastrophic epidemic resembling plague or typhus spread from the port of Avaris in the middle of the Bronze Age (circa 1715 BC). It severely weakened Egypt, which already had serious socio-political problems. The Hebrews turned out to be a relatively resistant ethnic group, allowing the etiological factor of this epidemic to be identified: the bacterium Francisella tularensis, which causes tularemia and is transmitted, among others, by ticks.
The cellular immunity of the Hebrews was probably due to their earlier way of life among animals—they could have continuous contact with non-pathogenic strains of bacteria. It is hypothesized that such diversity in immunity could have been the cause of repression against the Israelites (documented in the archaeological layer F in Avaris), their internment, and then the exodus from Egypt under the leadership of Moses.
Vascular Diseases
Vascular diseases (atherosclerosis, calcifications, ulcers) were among the common diseases throughout the long history of ancient Egypt, as clearly indicated by the appearance of the blood vessels of many pharaohs’ mummies and less dignified officials who died at various ages (including those who would be considered young today).
One of these pharaohs was Ramesses II, who actively lived to the ripe old age of 91. The probable cause of death was angina pectoris, vividly described in the Ebers Papyrus.
Marc Armand Ruffer and his colleagues and successors conducted extensive research into the reasons for the prevalence of these diseases. They analyzed risk factors listed in 20th-century textbooks: tobacco, syphilis and related diseases, alcohol, improper diet and obesity, stress, and inflammatory foci in teeth, gums, or tonsils.
Elliot Smith examined 25,000 skulls of ancient Egyptians and found no evidence of syphilis; tobacco, which was only known in America in antiquity, was also excluded from the list of risk factors. Common risk factors included inflammatory conditions of the teeth, gums, and tonsils, as well as obesity (not visible in the depictions of pharaohs, but indicated by the folds of skin in their mummies).
Cancer
Traces of tumors (probably osteosarcomas) were discovered on the skeletons of three mummies from the Fifth Dynasty by Smith and Dawson. It is probable that other tumors, not leaving such lasting traces, also occurred, as confirmed; in 39 mummies, traces of female genital tumors were found, and from the Ebers Papyrus, a clear description of palpation of the breasts was read, known from modern times, with a description of symptoms ending with the statement: “A disease I will not treat.”
Obstetrics and Gynecology
In texts concerning obstetrics and gynecology, there are two different hieroglyphs indicating a woman and a pregnant woman. Two others refer to the course of childbirth. They indicate that the correct position of the fetus with the head leading was considered, and that childbirth occurred in a squatting position (as in most ancient peoples). Contemporary birthing chairs replaced “birthing stools” – two posts made of several bricks placed a short distance apart. The text of the Westcar Papyrus informs us that the newborn was washed, “the umbilical cord was cut, and it was placed on a bed of bricks.”
The gynecological papyrus from 2200–2100 BC found in Kahun, which contains 17 medical indications, beginning with the words “A remedy for a woman suffering from…,” is considered a textbook of ancient Egyptian obstetrics and gynecology. It describes, among other things, disorders of the bladder during pregnancy, changes resembling thrombophlebitis, or symptoms (“the smell of something baked”) that could be caused by an abdominal tumor.
Ancient Egyptian physicians also described menstrual disorders, inflammatory conditions of the genital and breast organs, fertility problems, prevention, diagnosis, and course of pregnancy, sexually transmitted diseases, etc. It described, among other things, a method of obtaining a contraceptive from acacia thorns, crushed with dates, and mixed with honey. It was probably known during the reign of Amenemhat I, as evidenced by the paintings from the tomb of Khnumhotep in Beni Hassan. After millennia, it was confirmed that the liquid prepared in this way contained lactic acid, an ingredient in various modern contraceptive gels.
Surgery
Ancient physicians amassed a rich collection of experiences by treating wounds sustained in numerous battles and attempting to prevent infections (the beginnings of antiseptics). Wounds were stitched with a needle and thread or sealed with bandages made of strips of sticky linen fabric soaked in resin or asphalt (replacing modern plaster dressings). In some cases, gently compressing dressings made from fresh meat, which contains enzymes that stop bleeding, were used, while in others, cauterization was applied. Broken bones were immobilized using splints made from sections of bark that were appropriately shaped. Preventive measures against infections were also taken, as evidenced by a fragment of the papyrus text:
“If you examine a man with an abnormal wound […] and that wound is inflamed […] if your hand feels heat emanating from that wound, the edges of that wound are reddened, and that man is feverish because of it, then you must say: someone with an abnormal wound […] a disease I treat. Then prepare cooling agents for him to remove the fever […] willow leaves.”
Much more developed is “directive 35” from the Smith papyrus, regarding the subsequent steps in the case of “a man with […] fractures of both […] clavicles”, from bone setting to dressing with rolls of material using “mineral”. Ancient Egyptian surgeons were also familiar with replacing amputated body parts with prostheses.
Mental Disorders
Medical papyri contain descriptions of activities and behaviors that are now classified as mental disorders, such as depression and hysteria. According to ancient Egyptian physicians (the Kahun papyrus), depression was a heart and mind ailment, called “fever in the heart,” “dryness of the heart,” “heart sinking,” “heart weakness,” and “mind kneeling.” Hysteria was explained by the movement of the uterus, an animal with the Greek name hystera. Psychotherapy methods similar to those used today in similar cases were recommended, including “temple sleep” (likely under the influence of psychedelics such as opium and henbane), e.g., in the temple on Philae island, under the care of divine healers interpreting dream content.
Egyptian Pharmacopoeia
The Ebers papyrus describes, according to J. Thornwald, about 900, and according to other sources (e.g., Tanja Pommerening), about 2000 recipes for preparing medicines from several (up to 37) natural ingredients. Ancient Egyptian prescriptions are similar to modern ones, usually specifying the qualitative and quantitative composition, information on the preparation of the medicine, method of administration, and duration of use.
The Ebers papyrus has not been fully deciphered due to difficulties in recognizing the signs corresponding to individual components of medicines and their quantities (determining the meaning of measurement units). It is now known that in ancient Egypt, numerous approximate units resembling modern non-metric measurement units were used, such as hekat, ro, hin, and others as volume units, and deben and others as mass units.
As ingredients for medicines, the following were used:
- natural plant ingredients
- ingredients of animal origin (e.g., honey, fats)
- mineral ingredients, e.g., zinc, sulfur, antimony from the Zambezi River (part of numerous ointments, after 4 thousand years administered orally as a remedy for leprosy, plague, malaria, and others.), lead and copper ores (e.g., malachite, galena, used as paint for wall paintings and medicinal eye makeup)
- Mandrake described in Tacuinum Sanitatis (15th century) was already used by ancient Egyptians
Among the known and used medicinal plants are, among others:
- onion, garlic, radish, dill, caraway, thyme, juniper, flaxseed, swallowwort,
- ragwort leaves, the root of mandrake, cinquefoil, fenugreek,
- opium poppy (medicinal or poisonous properties due to the content of alkaloids such as thebacon, narcotine, morphine, codeine, papaverine, and others.)
- Egyptian henbane, containing scopolamine,
- seeds of henbane, containing hyoscyamine and atropine
- myrrh and aloe from the kingdom of Sheba
and many others, with various uses, such as the production of essential oils, used for aroma therapy and simultaneous air disinfection (the antiseptic action of carbolic acid, incense).
Many medicines containing feces and urine were recorded in medical papyri. Initially, it was thought that their purpose was solely to “ward off demons,” but the discovery of antibiotics explained why their use was sometimes effective. Similarly, the effectiveness of Egyptian medicines containing ingredients called “beer sediment” or “beer residue” or treating wounds with moldy bread, yeast, and earth is explained today.
Physiotherapy
In ancient Egypt, physiotherapeutic procedures included the following:
- massages – shoulder and knee massage was depicted in relief form in the tomb at Saqqara
- heliotherapy – mentioned in the Ebers papyrus as a method of pain relief
- balneotherapy – for example, described in the “Kalup Papyrus” treatment with mud and clay
- hydrotherapy – used, for example, in a sanatorium near the Dendara temple, where there are chambers with pools into which washing water flows onto the statue
Public Health
The existence of organized state (secular) health care is evidenced by the existence of a professional hierarchy – positions defined by symbols: secular physician (swnw, sunu), chief physician (imy-r swnw), head physician (wrnw), senior physician (smsw swnw), physician inspector (shd swnw), and supervisor of physicians of Upper and Lower Egypt. Not all sunu were authorized to read medical texts.
Diodorus Siculus wrote in the 1st century B.C. among other things:
“The entire way of life of the Egyptians was so uniformly organized that one might think it was not some legislator, but a capable physician who devised it according to all the rules of health.”
J. Thorwald warns that the opinions of the Sicilian are considered unreliable, but also quotes Herodotus’ statement that the Egyptians are “the healthiest nation known.” Herodotus probably expressed this opinion while being impressed by the prevailing practice of using fishing nets hung over beds to protect against insect bites. It does not seem possible that he already recognized the connection between insect plagues and malaria epidemics (it was believed that their cause was the vapors from swamps), but he probably saw the difference in the frequency of this disease in Egypt and in his native Caria.
It is documented that he paid attention to the health protection of pyramid builders – many thousands of people crowded into camps around the construction sites. Describing these camps, he presented the content of a message placed on the pyramid, informing how many radishes, onions, and garlic were issued to the workers (the cost of this action was estimated at about 1600 talents in silver, or about 16 million DM).
Evidence of concern for sanitation levels was found in the remains of the city of Akhetaten, built by Akhenaten (Amenhotep IV), a religious reformer who tried to replace Egyptian polytheism with henotheism—faith in Aten, already in the time of Queen Hatshepsut, who was treated as the Creator (an emanation of the god Re). In the capital of Aten, there were tree-lined, broad avenues, with canals beside them for nighttime sewage drainage from toilets. In the ruins of the house of one of the dignitaries, a stone toilet was found; simpler sanitary facilities were installed in the small houses of the workers’ districts. The revolutionary reforms of Akhenaten (e.g., he ordered the closure of temples dedicated to other gods) were opposed by priests and other representatives of the upper social classes. In their palaces and temples, the lack of hygiene was masked by incense scents. They were used in large quantities during religious ceremonies, attended by numerous participants. This simultaneously served as aromatization and air disinfection, discovered only in the 19th century AD.
It is presumed that the hygiene principles known to the ancient Egyptians influenced Moses and facilitated the Israelites’ survival through the hardships of their Exodus).
Historical Sources
Medicine in ancient Egypt refers to the common practice of medicine in Egypt from the 33rd century BCE until the Persian invasion of 525 BC.
This highly advanced medicine for its time was the result of a specific system of care, with specifically trained physicians and controlled practices, practicing either privately or in reserved locations, establishing diagnostic conclusions, employing various therapeutic means, and always in connection with the divine. The concept of illness was different from the modern definition:
- In ancient Egypt, one does not die in good health;
- illness is the bodily manifestation of the “possession” of the patient’s body, the work of supernatural agents (an enemy with magical power, a discontented deceased, an angry deity, etc.);
- the bodily envelope is a necessary element for accessing eternal life, and its destruction would forbid hope for it (the worst situation for an ancient Egyptian was to have their body burned, as the body would then be lost).
There is a hypothesis about the origin of ancient Egyptian medical knowledge, suggesting it may be a “copy” of Mesopotamian medicine, to which it is argued that the development of Mesopotamian civilization occurred after that of Egypt. This controversy is off-topic and cannot contribute to the subject of this encyclopedic article.
Egyptian physicians practiced minor, non-invasive surgery, fracture reduction, had a rich pharmacopoeia, and utilized magical formulas. Although remedies from ancient Egypt are often regarded in modern culture as magical incantations and dubious ingredients, research in biomedical Egyptology shows that they were often effective, with sixty-seven percent of known formulas adhering to the rules of the 1973 British Pharmaceutical Codex, except for sterilization rules. Medical texts specify the steps of clinical examination, diagnosis, prognosis, and treatments, which were often rational and appropriate.
Knowledge about medicine in ancient Egypt comes from papyri, accounts from Greek and Roman scholars, bas-reliefs, and ostraca.
Written Sources
Until the 19th century, the main sources of information on ancient Egyptian medicine were the writings of late antiquity. Homer in 800 BC noted in the Odyssey: “In Egypt, men are more qualified in medicine than all other men” and “the Egyptians had more competence in medicine than in any other art.” The Greek historian Herodotus visited Egypt around 440 BC and reported detailed descriptions of their medical practices. Pliny the Elder also spoke highly of them in his historical work. Hippocrates (the father of medicine), Herophilos, Erasistratus, and later Galen studied at the temple of Amenhotep and recognized the contribution of ancient Egypt to Greek medicine.
In 1822, the discovery of the Rosetta Stone finally allowed the translation of hieroglyphic inscriptions and papyri from ancient Egypt, including many texts dedicated to medical themes. The resulting interest in Egyptology during the 19th century led to the discovery of medical documents.
There was a medical encyclopedia in six volumes at the Library of Alexandria, of which only the summary remains. However, the importance of medical practice was recorded in about fifteen papyri, written in the sacred Greek language. The most famous and oldest is the Ebers Papyrus, written during the New Kingdom and containing seven hundred formulas for internal diseases, classified according to the organs involved. The Edwin Smith Papyrus was, according to its author, a copy from the Middle Kingdom of Imhotep’s book, titled The Secret Book of Physicians, an exoteric and esoteric teaching book, of which only a few chapters remain, notably on the heart, but which presented an objective, scientific medicine based on meticulous observations and a very good knowledge of human anatomy.
- Medical papyri: Ebers Papyrus, Edwin Smith Papyrus, Hearst Papyrus, and others dating back to 3000 years BCE. An Egyptian medical papyrus from the New Kingdom has recently joined the collections of the Louvre (2007):
- the Edwin Smith Papyrus is a manual of surgery and detailed anatomical observations dealing with examination, diagnosis, treatment, and prognosis for many conditions. It was probably written around 1600 BC but is considered a copy of several earlier texts. The medical knowledge it contains dates back to 3000 years BCE. Imhotep during the Third Dynasty is considered the author of the original papyrus text and the founder of ancient Egyptian medicine. The earliest known surgical interventions were performed in Egypt around 2750 BC,
- the Ebers Papyrus (c. 1550 BC) is filled with incantations and horrifying imprecations intended to drive away the demons responsible for diseases and also includes 877 prescriptions. It may also contain the oldest documented reference to tumors, if what little is understood of ancient medical terminology has been correctly interpreted. Other information comes from paintings that often adorn the walls of Egyptian tombs and from the translation of the inscriptions that accompany them. The tomb of Ânkh-ma-hor from the Sixth Dynasty (around 2200 BC) depicts what appears to be the sequence of a circumcision ceremony,
- Medical ostraca: in ancient Egypt, this term applied to limestone chips or pottery fragments on which the scribe, or apprentice scribe, inscribed a text or made a quick drawing. The cost of papyrus did not allow for the use of this medium for unofficial written notes, explanatory or satirical drawings, and certainly not for learning hieroglyphic writing;
- steles (votive or funerary) and figurative representations (tomb walls, temple walls, or columns).
Archaeological Sources
Advancements in modern medical technology have also contributed to the understanding of ancient Egyptian medicine. Paleopathologists have been able to use X-rays and later CT scans to visualize the bones and organs of mummies. Electron microscopy, mass spectrometry, and various forensic techniques have provided scientists with a unique insight into the health status of Egypt 4,000 years ago.
The Healthcare System in Ancient Egypt
The worldview of the 20th century prompts us to discuss medicine in ancient Egypt in comparison to the services we know. It seems more legitimate, without being derogatory to the ancient Egyptians, to present what we know as a “healthcare system” dependent on the institution of the temple.
The healthcare system of the ancient Egyptians was a public service:
- It is free, meaning it is accessible to all, regardless of wealth status.
- It is available throughout the country.
- It is available at all times.
The system is part of a broader public service that manages irrigation channels, education, justice, and grain reserves, all for the population of ancient Egypt.
Medical establishments, also known as Houses of Life, are known to have been established in ancient Egypt as early as the First Dynasty. During the time of the New Kingdom, their employees enjoyed benefits that can be likened to health insurance, retirement, and sick leave.
It is under the authority of the temple institution. In the House of Life, the temple institution manages, among other things, the school of scribes, open to all, which trains future scribes but retains only the best. The House of Life ensures the training of future physicians and priests. This institution also manages healthcare facilities within the temple, particularly a care space called a “sanatorium,” retroactively:
- These are not “climatological” health houses with balneotherapy.
- They are priestly spaces, containing tanks and tubs filled with sacred water, and the sick part is immersed in the hope of divine healing.
In some temples, buildings are named “mammisi,” sometimes hastily translated as “maternity ward.” This drift is misleading: the “mammisi” is where the divine and mythical birth of the future pharaoh takes place, resulting from the union of the great royal wife with the god during the theogamy, or hierogamy. Furthermore, in ancient Egypt, childbirth took place at home and was part of daily life.
Physician Training
The word used for physician in ancient Egyptian is swnw. There is a long history of swnw in ancient Egypt. The world’s first recorded physician, Hesire, chief of dentists and physicians to King Djoser in the 27th century BCE, is also attributed to ancient Egypt. Peseshet (c. 2400 BCE) may have been the first female physician: she may be the mother of Akhethetep, and on a stela dedicated to her in her tomb, she is referred to as imy-r swnwt, translated as the “overseer of female physicians” (swnwt being the feminine form of swnw).
There were many categories and specializations among physicians. Kings had their own swnw and even their own specialists. There were inspecting physicians, supervisors, and chief physicians. Known specialists among the Egyptians were ophthalmologists, gastroenterologists, proctologists, dentists, the physician who supervised butchers, and a liquid inspector whose role is not specified. The ancient Egyptian term for proctologist, neru phuyt, is literally translated as “shepherd of the anus.”
Physician training in ancient Egypt takes place in the temple-dependent structure called the “House of Life.” Recruitment for this training occurs after a period of observation for young students and, later, for Greek physicians who would come to Egypt to supplement their knowledge. This additional training could last ten years. The methods are not known but are based on the master-apprentice relationship.
Places and Modes of Practice
Places of practice depend on the caregiver’s relationship with religion:
- Sounou physicians practice outside the temple. They practice in a “secular” manner but according to temple precepts. Their tutelary god is Thoth. They begin their practice as itinerant physicians: the caregiver goes to the patient and treats only one category of patient. Only an experienced and recognized physician is a “general practitioner.” After an itinerant period, the sounou can apply to enter a healthcare center or practice at home.
- Ouabou-Sekhmet physicians practice solely within the temple. Their practice is strongly imbued with religion, even magic. They are the pure physicians of the goddess Sekhmet, the goddess of healing. They are the physicians of the Pharaoh, the representative of the divine on earth.
- Exorcist physicians act through magical incantations and amulets.
Modes of practice vary: there are physicians for all parts of the body and the mind, for women, men, children, and even physicians who operate differently according to the seasons. Posterity remembers the cases of “eye physicians,” who operated for cataracts, and “women’s physicians,” who conducted diagnostic tests for pregnancy with a prognosis of the child’s gender.
The organization of medicine has been regulated since Imhotep, as evidenced by an inscription on a wall in Saqqara, with well-defined ethical rules regulating the profession: location of healthcare centers, monitoring of these centers, control of sounou activities, assessment of services rendered, disciplinary action.
Diagnostic Conclusions
The diagnostic approach is described in the Ebers Papyrus. The process is as follows:
- Ask the patient questions step by step, calmly.
- Conduct a background investigation.
- Identify the direct and indirect causes of suffering.
- Look for any family history of illness.
- In the event of a relapse, check if the treatment is being properly administered.
- Prepare a care plan for the short and medium term.
At this stage, diagnosis merges with prescription: it is more of a detailed report comprising a series of clinical signs followed by a list of medications. The first step is to alleviate suffering, then halt progression, and finally find a definitive solution.
Wḫdw
Wḫdw is a term referring to a particular type of agent of decomposition and disease in Egyptian medicine.
According to Steuer, the Egyptians believed it originated from fecal matter in the intestines. From there, wḫdw was considered to be absorbed by the blood vessels (mtw) from the lower intestines (pḥwj, literally “rear”), from where it spread to other parts of the body, causing abscesses and other disease symptoms in the living body; it was particularly associated with pus in the blood. Meanwhile, in the bodies of the deceased, wḫdw manifested as decomposition.
The similarity of this concept of disease and decomposition to the ancient Greek concept of perittōma has suggested that this element of ancient Greek medicine may have originated in Egypt.
In seeking a practical and concise translation of wḫdw into English, Steuer and Bertrand de Cusance Morant Saunders consider several possibilities:
- Residues, a translation used by Jones for perittōma, fails to suggest the pathogenic nature of wḫdw.
- Miasma, suggested by Jonckheere, misleadingly suggests airborne transmission and an external origin.
- Putrefaction or corruption, their own suggestion, does not fully satisfy them, as wḫdw encompasses a broader concept than just the biological process of decomposition.
The term wḫdw is attested in the Ebers Papyrus, the Hearst Papyrus, and the Berlin Papyrus 3038, among other sources.
Therapeutic Means
Medical knowledge in ancient Egypt enjoyed an excellent reputation, and leaders of other empires regularly asked the Pharaoh of Egypt to send them his best physician to treat their loved ones. The Egyptians had some knowledge of human anatomy, although they had never dissected a human body. For example, during the classical process of mummification, they knew how to insert a long hook through a nostril to break the thin bones of the skull and extract the brain.
Egyptian physicians also understood the importance of pulses and knew that there was a connection between the pulse and the heart. The author of the Smith Papyrus even had a vague idea of the cardiac system but was unaware of blood circulation and was unable, unless he deemed it unimportant, to distinguish between blood vessels, tendons, and nerves. They developed a theory referring to “channels,” which, according to this hypothesis, transported air, water, and blood through the body by analogy with the Nile; if blocked, crops would perish, and they applied this theory to the body. If a person was sick, they used laxatives to unblock the “channels.”
The therapeutic means used by the ancient Egyptians are simple, multiple, and varied, surprising a 21st-century audience. They belong to different categories:
Hygiene and Dietetics
A number of medical practices were effective, such as the many surgical methods mentioned in the Edwin Smith Papyrus. Most of the time, physicians’ advice for staying healthy was to wash and shave the body, including the armpits, which could prevent infections. They also advised their patients to pay attention to their diet and avoid foods such as raw fish or other animals considered unclean.
Substances with a Supposed Therapeutic Action
Drawn from the three kingdoms: mineral, vegetable, and animal.
- Minerals: northern salt (natron), copper particles, Memphis stone in powder form (local anesthetic), yellow ochre on burns,
- Vegetables: the pharmacopoeia appears to be very rich, especially since it has retained a secret character due to the difficulty of recognizing the plants used at that time among those of the current flora (climate change towards warming for more than 3,000 years has modified the fauna and flora of the region and the translation of names remains uncertain).
- Some substances are unidentified, while others are controversial (nicotine in ancient Egypt, while tobacco would be brought from the Americas by Nicot).
- Identified are, for example, coriander, carob, poppy, garlic, onion, acacia resin, roasted barley, etc. The Egyptian pharmacopoeia drew most of its remedies (potions, gargles, infusions, poultices, pills, etc.) from resins, fragrant herbs, and perfumes like kyphi.
- Animal Products: meat (wound healing), honey (local antiseptic), wax, spider webs (disinfectant as they would naturally contain a substance with weak antibiotic action), beef fat, donkey milk, pork viscera, etc.
The preparation of the medicine is the responsibility of the prescriber, according to rigorous protocols.
It is used in the form of plasters, ointments, and unguents; local preparations; preparations to be absorbed soaked in beer; and fumigations.
The general belief in magic and religion may have contributed to a powerful placebo effect, which, along with the perception of successful treatment, may have contributed to its effectiveness. The impact of the emphasis on magic is apparent in the choice of remedies or ingredients that constitute them. Apparently, ingredients are sometimes chosen because they derive from a substance, plant, or animal that exhibits characteristics that somehow correspond to the patient’s symptoms. This is called the principle of simila similibus (“treatment by the similar”) found throughout the history of medicine and modern homeopathy. Thus, an ostrich egg is used for the treatment of skull fractures, and an amulet depicting a hedgehog could be prescribed for hair loss.
Repulsive Remedies
These are mixed methods, involving excremental remedies and magic, to provide repugnant nourishment to the spirit that has invaded the body and thus drive it away.
These excrements are borrowed from the donkey, crocodile, hippopotamus, lizard, pelican, small livestock, flies, and even humans.
Some of these practices have been found to be ineffective or harmful. Michael D. Parkins asserts that 72% of the 260 medical prescriptions in the Hearst Papyrus contained no active substance pharmacologically, and many remedies prepared from animal feces contained fermentation products and molds, some of which had healing properties but also bacteria that posed a serious risk of infection. Unable to distinguish between the original infection and the harmful effects of treatment with fecal matter, they may have been impressed by the few cases where an improvement in the patient’s condition was observed.
Dental care
They are not attested; poor dental health is known and explained by the presence of tiny grains of sand in flour (sand from sandstone millstones) responsible for significant dental wear. Thanks to a number of ancient texts, it is known that dental hygiene was understood, and some papyri contain lists of remedies for toothaches. It is also known that there were “tooth doctors,” mentioned by Herodotus.
The examination of mummies is also very informative. It was learned, for example, that one was a martyr to toothaches. Conservative therapy used fillings based on Nubian earth, hydrated copper silicate, stone chips, or solid gold blocks. Children’s teething accidents were treated by ingesting skinned and cooked mice. Mouse remains have been found in children’s mummies. This remedy would later be adopted by the Greeks, Romans, Copts, and Arabs.
On the other hand, tooth extraction is believed to have been unknown.
No texts from the period mention dental prostheses or their production. However, in 1914, for the first time, two teeth connected by a gold wire were discovered in a tomb. This work would date from the end of the IVth or the beginning of the Vth dynasty. There is an example of a dental prosthesis (two molars joined by a gold wire) that resembles more the work of an embalmer, solving an aesthetic concern. After the study, it was concluded that the ligature had been made in vivo.
In 1948, a bridge of three mandibular teeth connected by a gold wire was found in a tomb from the IIIrd century, and artificial teeth made of sycamore wood, held by gold hooks, were described in the mouths of some mummies.
Egyptian Heritage in Modern Medicine
Discoveries and Medical Treatises
Some medical treatises have been preserved (Ebers Papyrus, Edwin Smith) and clearly show that the Egyptians were the first to observe that the heart was the “essential organ of life” and that it manifested itself “by speaking,” meaning they understood that it beat at a regular rhythm defined by the pulse. It is not certain that they had, upon discovering the clepsydra, the idea of counting heartbeats with this kind of water clock. However, some indications suggest this. The clepsydra was only used much later by Herophilus, a Greek physician from the school of Alexandria, his hometown, who was the first to use it in the practice of his art, in the 3rd century BCE. He somewhat improved the process to measure patients’ pulses with a bit more accuracy.
Vocabulary
Egyptian medicine has not only bequeathed us techniques but also many medical terms whose etymology we encounter in everyday life.
A first example would be the term “migraine,” which comes from the Egyptian ges-tep meaning half (of the) skull. This term was adopted by the Greeks becoming hemicrania.
Another revealing example is the word “cataract,” which directly comes from the term akhet-net-mou, which literally means “water gathering.” In Egyptian, the pupil of the eye was called tout net iret, which means “image of the eye,” or hounet imyt iret, namely: “the young girl in the eye.” It is interesting to note the etymological evolution of this word through various languages, because in Greek, the young girl was a coré, in Latin a pupilla, and in Spanish a niña de los ojos.
The permanent connection with the divine
Medicine and magic were intimately linked in ancient Egypt, with illness resulting from the intervention of evil spirits, malicious humans, or deities. These are mainly the emissaries of Sekhmet, a lion-headed goddess, who spread disease and death. However, in addition to having the power to bring healing, this deity is the patroness of physicians, who are often her priests.
Magic and divine incantations
Magic has a particular resonance due to the myth of Osiris: Isis, “the great magician,” after reconstituting the corpse of her divine spouse, will be magically fertilized and give birth to Horus.
Magic and religion were part of daily life in ancient Egypt. Gods and demons were deemed responsible for many illnesses, so treatment often involved a supernatural element. Often, the first resort was to appeal to a deity. Often, priests and magicians were called upon to treat the illness, in addition to or instead of the physician. Physicians themselves often used incantations and magic as part of treatment, and many medicines apparently had no active ingredients.
Incantations
They are often associated with other means; it is most often an incantation that a deity of the pantheon had pronounced under (mythical) analogous conditions, recited to ensure the effectiveness of the remedy.
Each condition corresponds to a formula to be recited.
They were regularly used in care against scorpion stings, recognized as formidable.
The magical act consists of the incantation, the rite, and the person of the sorcerer. The incantation remains the most important step. All the power of the cult emerges from the incantation. It is composed of a set of words that the exorcist must pronounce. There are several criteria for effectiveness in reciting an incantation. There is the form, the sound, and the rhythm of its words without taking into account the intentions of the receiver or the person of the subject. The terms of an incantation must be faithfully repeated under penalty of this incantation becoming null. The force that emerges from the incantation can no longer be controlled once released; it continues its inexorable course, and if it does not achieve its goal, it turns against its author.
In Egyptian philosophical thought, the world was created by what the heart thought and the tongue commanded. In other words, the instrument of the mind is the spoken word that gives the idea its material reality. Creating an object means first naming it, hence the importance of words and speech in ancient Egypt.
Prophylactic actions
- Amulets.
- Prophylactic stelae: stelae representing Horus on a crocodile are supposed to protect against bites and stings from venomous animals.
- Healing statues.
Amulets in general were very popular and worn for magical purposes for many reasons. Amulets intended to play a role in health are classified as homeopoetic, prophylactic, and theophoric amulets. Homeopoetic amulets represented an animal or part of an animal whose user wished to assimilate certain positive attributes such as strength or speed. Prophylactic amulets protected against gods and demons. The famous Eye of Horus was often used on a prophylactic amulet. Theophoric amulets represented Egyptian gods, one representing the loincloth of Isis was intended to stem the hemorrhage of miscarriage.
Cases for fingers and toes, gold jewelry pieces used to protect the fingers during burial, were supposed to protect the deceased from magical and physical dangers, such as damage that could occur during the mummification process. Additionally, they were sometimes used to replace the missing fingers of the deceased, as a complete body was believed necessary for successful passage into the afterlife.
The sanctuaries of the healing gods
In the Late Period, many patients visited the sanctuaries of healing gods such as Imhotep and Amenhotep, sons of Hapu (both deified mortals), in the hope of obtaining healing. Others attempted to obtain it in sanatoria, attested to in the temple of Hathor at Dendera and in the temple of Hatshepsut.
The gods
- Isis, goddess of health and fertility, inventor of remedies,
- Horus often invoked in cases of animal bites,
- Hathor, goddess of love, protector of women,
- Thoth, god of scribes and patron of ophthalmologists,
- Sekhmet, healing goddess,
- Bes protects the sleep of sleepers and is the good genius of pregnant women,
- Serket protects men from bites, healer of bites and insect stings
Men elevated to the rank of gods:
- Imhotep, vizier and chief architect of Pharaoh Djoser – III dynasty;
- Amenhotep son of Hapu, architect of the pharaoh – XVIII dynasty.
Imhotep, Asclepius, Aesculapius: a filiation
Imhotep is known for his multiple activities and numerous official titles: high priest of Ptah, senior official, architect of the Djoser complex in Saqqara, poet-editor of the first known collection of Egyptian wisdom, and renowned physician.
He is the first known character described as a practicing physician – which made him the father of medicine. Over time, his aura grew: he became the patron of scribes. In the Late Period, he was deified as the son of Ptah and became a divine healer with a sanctuary. Under the Ptolemies, his name was Hellenized to Ἰμούθης / Imoúthês, and his deified image merged with that of Asclepius: the Greeks learned medicine in Alexandria (cf. medicine in ancient Greece).
Other known physicians
Meryt-Ptah, probably legendary female physician (III dynasty);
Chepseskaf-ânkh, Egyptian physician and priest (V dynasty);
Qar who was a priest-physician under (VI dynasty);
Pa-ân-meniou, chief physician of the court of ;
Penthou, physician of Akhenaton (XVIII dynasty).
Historians of Egyptian medicine
The history of Egyptian medicine was long overshadowed by great respect for the thought of Ancient Greece (“the myth of Hippocrates” (460–370 BC), nicknamed “the father of medicine”), while as early as around 450 BC, Herodotus wrote with admiration in his account of his journey to Egypt:
As for Egyptian medicine, it is organized as follows: each physician deals with only one disease, not several. There are many physicians throughout the country because there are specialists in eye diseases, others in head diseases, and others in tooth diseases. Others deal with abdominal diseases, and still others have diseases deeper hidden.
Herodotus, Histories (book II Euterpe)
Until the emergence of Egyptology (Jean-François Champollion, 1790–1832) and the great discoveries of the 19th and 20th centuries, Herodotus’ description was skeptically accepted. As late as 1810, Carl Gustav Carus (a German physician, painter, and philosopher and friend of Goethe) was amazed by the sight of the remains of ancient Egyptian buildings. He exclaimed with enthusiasm:
Such buildings can be nothing but signs of a primordial forgotten science, the greatness of which could shame the humanity of the 19th century.
The description of ancient Egyptian medicine included in the Histories was only partially confirmed in the 19th century, thanks to new research techniques, including the examination of pharaohs’ mummies using bacteriological and X-ray techniques, among others. Among the numerous Egyptologists who have contributed to the history of medicine, the following are mentioned:
- Marc Armand Ruffer (1859–1917) – English-German pathologist, bacteriologist fascinated by the results of Pasteur’s and Miecznikow’s work, a pioneer of modern paleopathology.
- Grafton Elliot Smith (1871–1937) – British-Australian physician, anatomist, anthropologist, and Egyptologist, fascinated by the possibilities of X-ray examination of pharaohs’ mummies.
- Douglas Erith Derry (1874–1961) – Professor of anatomy at the University of Cairo, involved in archaeology and anthropology of the Nile Valley; the first anatomist to examine Tutankhamun’s mummy.
- F. Wood Jones (1879–1954) – British naturalist, embryologist, anatomist, and anthropologist.
- Hermann Junker (1877–1962) – German Egyptologist, participant in archaeological work in Giza (discoverer of the stela of the court physician of the 4th Dynasty pharaoh).
- W.C. Boyd (1903–1983) – American histochemist who determined the blood groups of deceased pharaohs.
Finding, preserving and translating Egyptian medical papyri, which confirmed the primacy of Egyptian physicians over Hippocrates, contributed in particular:
- Joseph Smith (1805–1844) – American religious leader, founder of the Latter Day Saint movement (Joseph Smith Papyrus).
- Edwin Smith (1822–1906) – American collector and dealer of antiques (Edwin Smith Papyrus).
- Georg Ebers (1837–1898) – German Egyptologist and writer (Ebers Papyrus).
- James H. Breasted (1865–1935) – American archaeologist, Egyptologist, and historian from the University of Chicago, who translated the Edwin Smith Papyrus.
Currently, intensive research in the field of ancient Egyptian pharmacology is conducted by Tanja Pommerening from the University of Mainz.
The subject of ancient Egyptian medicine is addressed by numerous authors of scientific and popular science books, including:
- Warren Royal Dawson (1888–1968); author of Egyptian mummies (1924, co-author: Grafton Elliot Smith), Who Was Who in Egyptology (1951), Bibliography of Works relating to Mummification in Egypt (1928), Magician and leech: a study in the beginnings of medicine with special reference to ancient Egypt (1929).
- Eugen Strouhal: Life in Ancient Egypt. Norman, Oklahoma: University of Oklahoma Press, 1989. ISBN 0-8061-2475-X.
- Joyce Filer: Disease. Austin, Texas: University of Texas Press, 1996. ISBN 0-292-72498-5.
- Jürgen Thorwald: Dawna medycyna, jej tajemnice i potęga: Egipt, Babilonia, Indie, Chiny, Meksyk, Peru. Wydawnictwo Literackie, 2017, s. 304. ISBN 978-83-0806384-2., based on the edition by Ossolineum 1990 ISBN 83-04-03344-5