Further evidence has come to light that prosthesis to make up for physical defects was a branch of surgery practised in ancient times. Nevine El-Aref looks at the big toe of a noblewoman Click to view caption It was another chance discovery. Four months ago members of an Egyptian- German mission working in the Sheikh Abdel-Gurna area of the Theban necropolis were carefully brushing away accumulated dirt from the burial shaft inside the rock-hewn tomb of Mery, a priest of Amun in the reign of the 18th- Dynasty Pharaoh Amenophis II (1424- 1398 BC). Suddenly, and to their surprise, they came upon a well-preserved mummified foot with an artificial wooden toe. Early studies of Mery's T-shaped tomb revealed that it was reused as a burial place for nobles during the late 20th and early 21st Dynasties. The newly-discovered foot belonged to a high-ranking woman who may have been the wife or daughter of a 21st- Dynasty priest, and her missing toe had been accurately produced, complete with subtly-tinted toenail, and attached to the foot with linen threads. Mohamed El-Bialy, director-general of antiquities of Upper Egypt, says there is evidence that the surgery was executed during the life of the deceased and that the wound had been cauterised to stop the bleeding. "She evidently lost the toe in an accident, and it was so well made and attached to the foot that she was able to walk with an artificial toe for more than 30 years," he says. Anthropologist Andras Nerlich, who examined the foot, confirmed that the artificial toe was "very well used and very comfortable". However Zahi Hawass, secretary-general of the Supreme Council of Antiquities (SCA), is of another opinion. "The wooden toe would not have been used during the deceased's lifetime," he says. "It would be extremely difficult for a person to walk with an artificial toe. If an attempt were made, the individual would undoubtedly fall over." Hawass suggests the toe was added when the woman was being mummified. "This was in order to send her body intact to the afterlife without any deformity," he says. Medical practice in ancient Egypt is well documented and its physicians, who sometimes travelled over much of the ancient world to treat patients, were highly commended. They were professionals of various specialisations, and their expertise was passed from one generation to the next. An early New Kingdom copy of the Edwin Smith Surgical Papyrus provides case descriptions dealing with injuries typical on heavy construction sites, as well as injuries from other accidents or sustained in battle. The compiler arranged the cases in order, proceeding from the head downwards and from the least serious cases to the most grave. A big toe at the lower extremity of the body would have come at the end of the list, but no toes are described. We do not know how it would have ranked in seriousness. What we do know, from a box of surgical instruments carved in relief on the outer corridor wall of the temple at Kom Ombo, is that doctors used metal shears, surgical knives and saws, spatulas, and forceps. We know that they could distinguish between clean and infected wounds. Plaster for setting a fracture was made of cow's milk mixed with barley, or acacia leaves mixed with gum and water (Hearst Papyrus 219 and 223). Fractures were set with bark splints and bandages, and poultices to draw out infections from a wound were made up of clay, sawdust and wax. We know that false teeth were made even in very early times. The discovery in a 4th-Dynasty grave at Giza of several teeth wired together suggests that attempts were even made to manufacture dental bridges. Perhaps such a task would have been carried out by a jeweller. As for the beautifully-made toe of a noble lady, perhaps a first-class sculptor was commissioned with its creation, and if the exercise was indeed performed when the deceased was still alive the surgeon would have devised a method by which it would be held in position by a secure band. Perhaps, though, Hawass is right and it was added after her death. We do know from examination of mummies that every effort was made to preserve the deceased in perfect condition. Even finger and toe nails show evidence of having been tied onto the digits with string while the body was being dried out with natron. This practice saved the nails from falling off the extremities when the surrounding skin shrank. Before the actual wrapping of the body, great care was taken to protect the ears, knees, ankles and feet of the deceased. Minister of Culture Farouk Hosni says the foot, which was found wrapped in linen, will be among the items on display at a special exhibition due to open on 9 December to mark the centenary of the Egyptian Museum.
