Pain relief in ancient Egypt: Part 2 – Physical and magical interventions – The Past

Pain has been an ever- present factor of everyday life, particularly in ancient Egypt, where disease, the harsh climate, and work-related trauma and wear and tear were common. While medical papyri highlight the large range of plant and mineral- based medical treatments available, in some cases something more physical or magical was required.

Setting broken bones

Broken bones were not uncommon: estimates range from an average of 3% to 7% of the general population from the Predynastic Period through to Roman times. For menial labourers, the rate was understandably higher. In 1908, Frederic Wood Jones examined 6,000 burials at Aswan and found 200 (3.3%) had healed fractures, whereas, at the pyramid builders’ cemetery at Giza, anthropologist Fawzia Hussein (2010) found almost 44% of male labourers had fractures – although 90% of those were completely healed with good alignment. By comparison, about 10% of the artisans (sculptors and engravers) buried at Deir el-Medina had fractures, most of which were well healed. In the semi-elite burials at Saqqara, the incidence of fractures was about 2%, mostly healed in good alignment.

Reducing (aligning) and immobilising (splinting) a fracture not only reduces pain, but strongly aids recovery of function. The Egyptians were well aware of these orthopaedic techniques, and the skeletal remains often show excellent healing. The Edwin Smith Surgical Papyrus provides case studies on the management of fractured clavicles (Case 35), simple fractures of the upper arm (Case 36), compound but closed fractures of the upper arm (37), and spiral-type fractures of the upper arm (38).

The text recommends reducing these fractures by traction, then splinting with linen bandaging. The skin around the fracture site is treated daily with alum and honey. Case 44 deals with rib fractures, where the primary symptom is pain during breathing. Unfortunately, the text has lacunae where treatment would have been discussed. Chest binding – a form of splinting – was, until recently, the customary modern treatment. Today we tend to use analgesics rather than binding so as not to impair the mechanics of breathing or to cause lung issues.

Massage

Various forms of physiotherapy including rubbing, kneading, anointing, and manipulation of the body, are frequently cited in the medical papyri and elsewhere. This could be used alone or in conjunction with unguents, oils, heat, and poultices.

An example is found in the Ebers Papyrus 119, where a mixture of fat, plants, salt, and mussels is rubbed over the body to treat a fever. In 735, a haematoma is treated by massaging the area with a mixture of mud, sand, myrrh, date juice, and a drug Dam.w which has not yet been identified. The Kahun Gynaecological Papyrus mentions a case of a woman with cramps in her calves. The prescription is for a massage with mud, as it was believed that massage and manipulation would help clear clogged metu channels.

There are depictions of massage in several tombs. In his Saqqara tomb (D62), the Fifth Dynasty vizier Ptahhotep is shown getting a leg massage. In the mastaba of the Sixth Dynasty ka-priest Ankhmahor at Saqqara, there is a wall relief showing a foot massage. The adjacent inscription reads ‘Do not let it be painful’. This is the so-called ‘Tomb of the Physician’ which includes the famous circumcision scene – a procedure that cries out for some form of pain relief!

The nearby Tomb of Khentika has a similar panel of foot and hand massage, while the Sixth Dynasty pharaoh Niuserra is depicted enjoying a foot wash and massage in his Sun Temple.

Dental pain relief

Dentists (ibH.i) were well attested in Egypt from at least the Old Kingdom. The first known dentist was Hesyre of the Third Dynasty. The typical Egyptian diet was usually contaminated with abrasive sand, leading to many conditions associated with terrible pain and infected abscesses. Egyptian dentists used both practical and magical therapies.

Among the practical treatments for tooth pain and gum ulcers was that recorded in Ebers 742: the application of cumin, which has analgesic and antiseptic effects. A Ptolemaic mummy of a man called Sekhem in the National Archaeological Museum of Athens is thought to have an early example of the filling of a tooth cavity. Other practical therapies included tooth extraction, tooth stabilisation with gold wire, and even surgical drainage of dental abscesses. Anthropologist Earnest Hooton (in 1917) and J H Breasted (in 1930) described an Old Kingdom jaw that had what appeared to be two holes into a bony abscess cavity below a right- sided molar tooth. These may have been naturally eroded sinus tracks, or may have been drilled.

Another example from the New Kingdom was found in the mummy of the lady Djedmaatesankh. A CT scan showed a large abscess in her maxilla (cheekbone), with five drill tracks nearby. This was apparently an unsuccessful attempt to resolve the abscess which, given its extent, may have been fatal. (For more on Hesyre and dental practice in ancient Egypt, see AE 151.)

Electrical stimulation?

While no direct evidence exists, some scholars speculate that the ancient Egyptians might have employed a form of electrical stimulation akin to today’s TENS application. This is speculative, since the practice was not described until the 1st century AD by Roman physician Scribonius Largus. However, the electric catfish (Malapterurus electricus) is native to the Nile, and it appears in a number of tomb reliefs and paintings, including those of Kagemni (LS10) and Rekhmira (TT100).

The Egyptian endocrinologist Ghalioungui cautiously noted the possibility or plausibility of the ancient use of electric fish while acknowledging the lack of direct evidence. Anyone who steps on an electric catfish would notice a sharp pain, followed by a period of numbness in their leg. The Egyptians were particularly good at turning empiric observations into practical application.

Magical and religious treatments

Pain was often attributed to divine displeasure or demonic forces, and therefore spiritual remedies were considered just as essential as physical ones. The gods controlled events and well-being, and they could delegate this authority to the pharaoh. In turn, the pharaoh delegated certain powers to physicians and priests. Practitioners might try to cure maladies by expelling evil spirits, or sometimes by attracting benevolent ones. Magical formulae included spells and incantations, rituals to be performed, and magic-possessing ingredients of potions and poultices.

These actions would often have some salutary benefit by what we now recognise as a psychological placebo effect. This mainly derives from the cultural expectation of benefit and, while some believe this type of cure is ‘all in the mind’, placebo does actually involve interacting physiological, neurological, and psychological mechanisms. These have been shown experimentally to involve a variety of neuro-transmitters like dopamine and endorphins, as well as other mechanisms such as conditioned response learning, reduction in stress and anxiety from actions due to psychological belief in the treatment, and psychologically reframing the perception of symptoms.

There are many examples of placebo in medical spells. The Ebers Papyrus starts with this incantation, to be used at the start of any treatment:

…I have utterances that the Lord of the Universe has composed to eliminate the doings of a god, a goddess, a dead man, a dead woman etc, that are in my head, in my spine, in my shoulders, in my flesh, in my members, [and] to punish Slanderer, the Chief of those who let disturbances enter into this my flesh and disease into my members, …I am the one whom God wishes to keep alive.

(Ebers 1)

The Ebers author states that this spell was ‘to be recited during the application of a remedy on any member of a sick man. Really excellent [proved] a million times’.

The next spell (Ebers 2) includes the incantation: ‘O Isis, great of magic, loosen the pain of this man, drive out the evil that resides in his flesh!’, while the verso of Edwin Smith includes: ‘Begone, you knife demons! The winds shall not reach me, so that those who pass by with the intent to rage against my face will pass on. I am Horus, who passes by the vagabonds of Sekhmet – Horus, Horus, papyrus amulet of Sekhmet! I am the Unique One, the son of Bastet! I shall not die because of you!’

The Egyptian model, which was rooted in observation, innovation, and cultural belief, remains remarkably relevant.

Talismans

Amulets and household statues were extremely popular for the symbolic and ritual relief of pain in ancient Egypt. While they did not physically dull pain in the way willow or opium might, they were believed to fight off the spiritual or demonic sources of pain, making them a crucial part of the Egyptian multi-dimensional therapeutic belief system. Amulets were usually shaped to invoke certain animals or deities. Bes and Taweret amulets and figurines were thought to ease the pain of childbirth. Eye of Horus amulets were applied for general healing, and those of Sekhmet, or other lion-headed deities, were thought to ward off pain and disease. Sometimes amulets were rubbed with a medicinal salve or other topical medication to increase the power of that formula.

Holistic approach

The ancient Egyptians developed a multi-faceted approach to pain management, blending empirical remedies with spiritual practices. Their use of willow bark (a natural aspirin), opium, and anti-inflammatory resins like myrrh demonstrates an early knowledge of pharmacology, while fracture splinting and dental interventions reveal practical surgical expertise. Notably, their methods often aligned with modern principles – blocking prostaglandin synthesis, leveraging opioid receptors, and even exploiting the placebo effect through incantations.

Yet Egyptian medicine was not purely ‘scientific’: it reflected a holistic worldview, where pain stemmed from both physical and supernatural causes. This duality underscores a key insight: effective healing requires addressing the mind as well as the body. Today, as modern medicine reduces its dependence on opioids, it increasingly integrates psychological therapies, and acknowledges the neurobiology of placebo. The Egyptian model, which was rooted in observation, innovation, and cultural belief, remains remarkably relevant. This ancient Egyptian legacy endures not only in our pharmacies, but in our evolving appreciation of pain as a biopsychosocial phenomenon.

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Dr Ira Rampil is a retired Professor of Anaesthesiology with a long standing interest in ancient medical practice. He is currently a software entrepreneur specialising in mobile apps for Egyptology. You can read his articles on malaria in AE 132 and herbal pain relief in AE 155.

Further reading:
• J F Nunn (1996) Ancient Egyptian Medicine (London: British Museum Press).
• F Hussein et al. (2010) ‘Similarity of fracture treatment of workers and high officials of the pyramid builders’, in Pharmacy and Medicine in Ancient Egypt: Proceedings of Conferences in Cairo (2007) and Manchester (2008) (Oxford: Archaeopress).
• E Strouhal et al. (2021) The Medicine of the Ancient Egyptians: internal medicine (Cairo: AUC Press).
• R David and R Forshaw (2023) Medicine and Healing Practices In Ancient Egypt (Liverpool: Liverpool University Press).