On 2014 Apr 26, Gonzalo Sanchez commented:

In order to explain concurrent signs of spastic hemiparesis with bleeding from the nose and the ear in the closed head injury of Case # 8 of the Edwin Smith Papyrus, JC Ganz states that recent trauma must have occurred in a patient with an already existing hemiparesis. This would be a good explanation if the Papyrus were describing a specific injury in a specific patient. The Edwin Smith papyrus is, rather, a teaching trauma treatise of “Case Types” with Case #8 addressing Closed Head Injuries. Sanchez and Meltzer (2012)1 note (p.5) their clinical interpretation is based on the textual evidence and the structure of the original document.<br> In Appendix II these authors acknowledge Case #8a as a closed head injury that has passed the acute stage “ as development of spasticity takes several weeks”. Fresh bleeding through the nose and the ears would indeed be unlikely present at this stage. Apparent inconsistencies in these clinical issues may be simply related to the various findings observed by the ancient Egyptians in cases of the same type. It is our opinion that strict criticism of the ancient physicians’ clinical methodology in structuring and documenting their teaching text cannot be applied using current criteria.

Gonzalo M. Sanchez MD. and Edmund S. Meltzer Ph.D. gonzalosanchez411@gmail.com

1 Sanchez GM and Meltzer ES. The Edwin Smith Papyrus – Updated Translation of the Trauma Treatise and Modern Medical Commentaries. Lockwood Press. Atlanta Ga. 2012.

On 2014 Apr 26, Gonzalo Sanchez commented:

In order to explain concurrent signs of spastic hemiparesis with bleeding from the nose and the ear in the closed head injury of Case # 8 of the Edwin Smith Papyrus, JC Ganz states that recent trauma must have occurred in a patient with an already existing hemiparesis. This would be a good explanation if the Papyrus were describing a specific injury in a specific patient. The Edwin Smith papyrus is, rather, a teaching trauma treatise of “Case Types” with Case #8 addressing Closed Head Injuries. Sanchez and Meltzer (2012)1 note (p.5) their clinical interpretation is based on the textual evidence and the structure of the original document.<br> In Appendix II these authors acknowledge Case #8a as a closed head injury that has passed the acute stage “ as development of spasticity takes several weeks”. Fresh bleeding through the nose and the ears would indeed be unlikely present at this stage. Apparent inconsistencies in these clinical issues may be simply related to the various findings observed by the ancient Egyptians in cases of the same type. It is our opinion that strict criticism of the ancient physicians’ clinical methodology in structuring and documenting their teaching text cannot be applied using current criteria.

Gonzalo M. Sanchez MD. and Edmund S. Meltzer Ph.D. gonzalosanchez411@gmail.com

1 Sanchez GM and Meltzer ES. The Edwin Smith Papyrus – Updated Translation of the Trauma Treatise and Modern Medical Commentaries. Lockwood Press. Atlanta Ga. 2012.