Remember when you were a child playing with your parent's books? You would pull them out of the shelf, stacking them like bricks into towers or castles or raising them like walls. You probably knew that these books were important, but you lacked the skills to understand why. You probably understood that their texts held some kind of wisdom, but that it was out of reach. You may have realized that it was incomprehensible to you now, but that you might later could learn to understand the content of these bricks.
That is the paradox of neuroscience. Trying to grasp the importance of what is right in front of you, knowing well enough that you cannot possibly hope to understand all of it. You simply lack the skills to see through the bricks and read the text.
Our understanding of the mind is limited by our own cognition itself. Our insight into psychology and neurology is too often limited by our lack of knowledge. Our understanding of the brain is halted by our own insufficient mental capacities.
This paradox of neuroscience is appropriately illustrated by the story of Edwin Smith. And by the unknown author of the papyrus that holds his name.
In 1862 in Luxor in Egypt, Edwin Smith purchased a papyrus from the antique dealer Mustapha Aga. Although an egyptologist, Smith's knowledge of the hieroglyphs on the papyrus was insufficient, and he was unable to read the text. Like so many other scientists, he could not penetrate or interpret the subject before him, simply because he lacked skills. Edwin Smiths was unable to realize the value of his purchase.
He kept the papyrus in his own possession until his death, at which point his daughter donated it to New York Historical Society where the task of translating the hieratics was given to James Henry Breasted. It was soon realized that the papyrus was a medical text describing the diagnostics and treatments of 48 traumatic injuries. Dated to 1600 BCE, it is speculated that the papyrus may have been a manual of military surgery. The text not only includes the first recorded mention of the brain, but holds also the first neurologic examinations and diagnostic findings.
In 1862 in Luxor in Egypt, Edwin Smith purchased a papyrus from the antique dealer Mustapha Aga. Although an egyptologist, Smith's knowledge of the hieroglyphs on the papyrus was insufficient, and he was unable to read the text. Like so many other scientists, he could not penetrate or interpret the subject before him, simply because he lacked skills. Edwin Smiths was unable to realize the value of his purchase.
He kept the papyrus in his own possession until his death, at which point his daughter donated it to New York Historical Society where the task of translating the hieratics was given to James Henry Breasted. It was soon realized that the papyrus was a medical text describing the diagnostics and treatments of 48 traumatic injuries. Dated to 1600 BCE, it is speculated that the papyrus may have been a manual of military surgery. The text not only includes the first recorded mention of the brain, but holds also the first neurologic examinations and diagnostic findings.
In much the same way it is argued that war is the catalyst of civilizations, it must be admitted that the neurological sciences are based on deficits and injuries of the brain. The Edwin Smith Papyrus illustrates this discouragingly well; written as a military necessity, it is violence and traumatic injury that passes knowledge of the brain through more than three millennia to our present.
Case 6:
If thou examinest a man having a gaping wound in his head, penetrating to the bone, smashing his skull, (and) rending open the brain of his skull, thou shouldst palpate his wound. Shouldst thou find that smash which is in his skull [like] those corrugations which form in molten copper, (and) something therein throbbing (and) fluttering under thy fingers, like the weak place of an infant’s crown before it becomes whole [...] (and) he discharges blood from both his nostrils, (and) he suffers with stiffness in his neck, [thou shouldst say]: An ailment not to be treated.
In the commentary, Breasted cannot conceal his excitement of identifying the word:
as being “the earliest reference to the brain anywhere in human records.” The description is however rather disgusting, and the importance of this pulpish organ slips the author of the papyrus. Nevertheless, the text realizes that a trauma of this severity cannot be treated with any favorable outcome. It is an ailment "not to be treated," as so many battlefield surgeons have experienced since then.
The papyrus holds plenty of interesting details. In cases concerning head trauma, neck stiffness is often mentioned as “he suffers with stiffness in his neck, so that he is unable to look at his two shoulders and his breast.” This could easily be interpreted as the well known observation that head traumas with subarachnoid haemorrhage will cause neck stiffness in the patient. This finding is still a key diagnostic in clinical neurology today.
It also describes epileptic seizures following head trauma as a patient “shudders exceedingly”, realizing that this is “an ailment which I will contend. [...] thou shouldst not bind him, (but) moor (him) at his mooring stakes until the period of his injury passes by.”
And in case 20, like the child playing with books, the battlefield surgeon authoring the papyrus was on the brink of a very important realization. Describing a head trauma penetrating the temporal bone, it is noted that “if thou ask of him concerning his malady [...] he speak not to thee.” The description of speechlessness is exclusively limited to the traumas at the temple, and the conclusion that the temporal part of the brain holds the capacity for speech, seems imminent. However, this concept of cortical localization was missed by the author.
The Edwin Smith Papyrus reflects our current knowledge that the centre for speech is located in the temporal lobe of the human brain. But the idea that certain areas of the brain controls specific mental functions, slips the author. The concept of cortical localization would not emerge until the late 19th century. At that point it would be exactly the temporal lobe and the localization of speech that fascinated anatomist Paul Broca.
The Edwin Smith Papyrus reflects our current knowledge that the centre for speech is located in the temporal lobe of the human brain. But the idea that certain areas of the brain controls specific mental functions, slips the author. The concept of cortical localization would not emerge until the late 19th century. At that point it would be exactly the temporal lobe and the localization of speech that fascinated anatomist Paul Broca.
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Breasted JH: The Edwin Smith Surgical Papyrus. Published in facsimile and hieroglyphic transliteration with translation and commentary in two volumes. The University of Chicago Press. 1930.
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Find all chapters of
The History of the Brain
here:
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