There is no treatment…
From an Egyptian medical text @1600 BCE describing removal of breast cancer tumor.
As a disease of the cells, cancer is likely the oldest disease on Earth. Oncology is the study of cancer, of tumors specifically, since tumors are how cancer shouts Hey, I’m here! to the body. Cancerous tumors have been found on fossils, both dinosaurs and fish from earlier ages. As soon as there were cellular life forms, there must have been cancer.
Before I go any further, F#CK Cancer. Though it’s not really cancer’s fault, that’s just what it is. It’s part of the natural world, and Mother Nature makes the rules, not me. Even so, F#CK Cancer.
I don’t know any Egyptian swear words, so I can’t translate that into hieroglyphics for you. But the Egyptians knew about cancer, as did the ancient Greeks, Indians, and Chinese. Other than finding skeletons with tumors, what we know now about what they knew then comes from what they wrote. And what they wrote shows that this scourge of our modern health system has been a scourge since they put up stone towers and started figuring out how to make bread.
In investigating the ancient approach to Oncology, I will ask my three questions:
- What is Oncology and what did it mean to ancient cultures?
- Where and when did ancient cultures encounter cancer, and what did they do about it?
- What do these ancient oncological practices tell us about people in general?
Those Wicked Wizard Cells
This is my simple explanation for what cancer is: wicked wizard cells that desire immortality. Hear me out. Most of the different types of cells in our body, skin cells, blood cells, bone cells, etc. grow, reproduce, and die in a natural order. These cells have an internal mechanism that tells them when it’s time to go. Occasionally, a cell figures out how to turn that mechanism off. Then, it goes rogue Peter Thiel *coff* and not only reaches for immortality but creates other cells which also have the turned-off mechanism. Out of control, they reproduce, until their growth becomes a swelling, tumor, ulcer, blob, whatever you want to call it.
Not all swellings are evil. There are other kinds of growth, where cells go wild and multiply without permission. Sometimes the blob (you can tell I was not a pre-med student) on the body does not plan a takeover. Cysts, edemas, and other growths can be benign, although still dangerous.
Patrick Randolph-Quinney.
For instance, researchers found an Australopithecus skeleton–one of the early hominids that branched off from other primates–with a non-cancerous tumor on its throat. Although the growth was benign, it was a growth in the throat, which may be why this is an Australopithecus child’s skeleton.
Cancer is a disease of the cells, but we know it mostly because if what it does. The tumor created by the multiplying cells is how it is discovered. The cause of the growth, the temptstion to the dark side, could stem from many sources. Bodies are exposed to many things: tobacco, excessive alcohol, chemical additives, viruses, or radiation. These are all foreign substances which might convince the demon cell to try to live forever. Which ironically, kills the body. Who wants to live forever? Should have listened to Freddie Mercury, rogue cells!
Why Cancer Was Linked to a Greek Demigod
The origin of the words is very really. Oncology is Greek for lump or mass, tumor. Edema also comes from the Greek for swelling, but it was understood that a swelling of fluid was different from the hard swelling of a tumor. What about the word cancer? Since I was born in July, under the sun sign of Cancer, I’ve always been a little miffed that my astrological sign is linked to a disease. I thought it was a case of an unfortunate homonym, (words spelled the same, different meaning). But it’s not. The Greek physician Hippocrates linked the term carcinoma explicitly to a myth.
The Greek story of Heracles, (Hercules is the Roman version) was given twelve Labors, one of which was slaying the Lernaean Hydra. The swamp Hydra was a beast where, if one head was cut off, two grew in its place. When Heracles engaged in combat with this monster, a large crab Karkinos appeared because, of course! It had to help its buddy, the Hydra, who was just sitting around in a swamp eating bon-bons when this burly guy attacked, outta nowhere! Karkinos bit Heracles on the foot, but was pretty small, so squish! Hera, who despised Heracles, rewarded Karkinos the crab for his attempt by placing the crab up in the stars, which was a common fate for dead Greek “heroes,” see Orion, Andromeda, etc.
Hippocrates, thinking about diseases in 400 BCE, thought the hard masses of tumors were like the shell of the famous constellation, so he named the disease carcinos–crab. The Roman physician Celsus in 25 BCE later applied the Latin version: cancer.
The Treatments of Imhotep: Surgery, Arsenic, and Offerings
Although cancerous tumors have been identified on fossils, like a 340-million-ya Dinichthys and a 70-million-ya Mosasaurus, most of what we know about ancient knowledge of cancer comes from medical manuals. Paleopathologists occasionally vent their frustration that cancer is a soft tissue disease and soft tissues don’t last 5000 years. Despite the phenomenal preservation techniques of Egyptian mummies, as Galassi puts it, there are still “poor preservation of mammary tissues in ancient human remains.” Bummer.
Fortunately, though, the extensive Egyptian medical knowledge can be found in medical textbooks of the Middle Kingdom. The Edwin Smith papyrus, as well as the Ebers papyrus, were sources that provide descriptions on how the Egyptian doctors used strategic approaches to treat diseases.
There seems to be confusion about the source of the Edwin Smith papyrus and its relation to the god of medicine, Imhotep. I think I’ve sorted it out. First and foremost, Edwin Smith was just some white British archaeologist (constantly irritating to read about the Plimpton cuneiform or Rhind document–these should be named based on where they’re found, not the archaeologist, grr….) Furthermore, based on the terminology, grammar, and references in the text, it was probably written around 3000-2500 BCE, only a few centuries after Egyptian writing itself had been created. This makes it, by far, the oldest medical text in history. However, the version dug up by E.S. was a copy from @1600 BCE, based on the hieratic writing itself, a shortened variation of hieroglyphics. Lastly, it was probably not written by the physician, Imhotep, who was a god, not a doctor.
Imhotep was a chancellor to the Pharaoh Djoser (@2600 BCE) but nobody at the time called him a physician. Probably he was physician to the pharaoh as well as consulting on major public works and writing astrological predictions–basic chancellor stuff. After centuries passed, though, he was deified as a god of architecture and medicine, credited with helping design the pyramid of Djoser and pioneering Egyptian medicine, perhaps writing the famous E.S. papyrus. Kind of like crediting Einstein or Abe Lincoln with inventing compound interest. At any rate, Imhotep got his own temple, and sick people made offerings to Imhotep as part of the treatment plan. Today, we just make our offerings to the HMO.
The Edwin Smith papyrus is extensive, generating hundreds of pages of medical advice. Much of the text is about head wounds and broken bones, which has led some to think it was a military text. However, there are also references to tumors and cancer–specifically breast cancer. This is also curious in that it would not then be a military text. The one core English translation everyone uses, from 1930, translates the cancer passages as “his breast,” as in the physician should “palpate his breast.” Yet most modern scholars connect the breast cancer passages to women, which suggests that the physician who wrote this papyrus was knowledgeable and compassionate in treating women.
Treatment of tumors included separating the hard, cancerous masses from the non-fatal swellings. Several kinds of tumors and their patients are described; hot tumors, cold tumors, oily tumors, solid tumors, patients with fever, lack of fever, and patients that shudder when the tumor is touched. Physicians might attempt to cauterize the tumor with heat; it was recognized that might not work. Arsenic paste was suggested–perhaps an early form of chemotherapy. Try to kill the tumor without killing the patient.
Yet the physician here notes that these remedies may not work, in which case, the recommendation is to make the patient comfortable. “Do thou nothing there against; there is no treatment.” It is another indication that the author was, indeed, looking at cancer in 3000 BCE.
The Rational Approach of the Greeks
Historical descriptions of ancient cancer treatment typically say less about the Egyptians than about the Mediterranean physicians: the Greeks, Hippocrates (@400 BCE) and Galen (@200 CE), and the Roman Celus (25 BCE). While the Egyptians remedies are sometimes termed “magical formulas” or “folk remedies” like salts, herbs, and poultices as treatments, or irrational because the treatment included religious offerings–how crazy! the Greeks in contrast used a “rational approach.” That phrase “rational” is universal. You may recall that the rational Greek approach was based on the four humors.
Cancer was considered an excess of black bile from the liver. The treatment was to balance the excess bile by bolstering one of the other humors: phlegm, yellow bile, or blood. (Why this is considered more rational is a mystery.) Treatment was to apply a variety of drugs, i.e. herbs, such as: crocus, white thorn, or alisma. Herbal remedies, drug therapy, same thing.
Curiously, for all the attention paid to the Greeks and Romans, their diagnosis and treatment of cancer was limited. The most detailed discussions after the Egyptians came from two other sources further east: the Hindus and the Chinese.
The Charaka Samhita: The Wandering Physicians of India
The Vedic texts from the Indus Valley, which I briefly mentioned a few days ago, were a revered compendium of ancient knowledge. A subcategory of these Sanskrit writings were the Ayurvedic texts, the medical textbooks of 800 BCE . The Charaka Samhita and the Susruta Samhita were named according to the authors: Charaka was known as the wandering physician while Susruta meant one who is a good listener. The wanderer would pick up knowledge from extensive experience, and everyone wants a doctor who listens.
These two texts go into extensive detail about types of tumors. As noted by P. Ram Manohar, both Charaka and Susruta describe swellings. Charaka notes that granthi is hard to the touch and continues to grow. Susruta describes the other, arbuda, as also hard to the touch and having much deeper roots. Arbuda, say the texts, might attach itself to a vital organ or be floating. This tumor’s appearance is irregular, and it also might reappear after being removed or even move to a different organ. Arbuda is the one to be afraid of.
These Indian physicians of 800 BCE clearly recognized arbuda that we know as cancer. They tried multiple treatments. In some cases, there were poultices, sometimes with meat to attract maggots, which was known to clean wound (it’s disgusting until it saves your life). Similar to the Egyptians, they used cauterization, a version of radiation as well as surgery. Even the wandering physicians with good listening skills knew that arbuda was stubborn and often impossible to cure.
TCM (Traditional Chinese Medicine) and a Glimmer of Hope
The Inner Canon of the Yellow Emperor is the medical text from ancient China, dated at some point in the Han Dynasty, perhaps 100-200 BCE. While nearly every article on ancient cancer treatment mentions the Egyptians and the Greeks, none refer to this document. Yet it also has a detailed description of cancer causes, differentiated by type, and treatments.
The Su Wen covers medical diagnosis and methods. It describes cancer as a deep tissue disease (endogenous), which may originate from the outside, as forces attack a weakened body. These doctors understood the tumors represented a disease that could take a long time to treat: “In the early stage of the disease, the vital qi is strong, the evil qi is light and easily attacked; in the middle stage, the evil qi is deeper, the vital qi becomes weak and should be attacked or benefit; in the end, the evil qi is strong, the vital qi is weaker and should be well benefit.” Like the Greeks, the ancient Chinese doctors perceived the disease as an imbalance in the body, and while that may seem fanciful to us, it is not in the end a bad description.
Most interesting is the treatment, which is the epitome of holistic. As Jie Liu describes the approach of this 3000-year-old text, it is the “T” in TCM: Traditional Chinese Medicine. Su Wen describes multiple ways to attack the disease. First, the body must be strengthened with nourishment, fresh air, and mild exercise, to help it fight off pathogens. Secondly, tumerous masses are softened and removed. Next, activate the blood, clear heat, and “de-toxify” with herbal remedies and cauterization. Lastly, as with other TCM treatments, regulate emotion.
This latter might be tossed to the side with other disdained approaches, the so-called magic formulas or offerings to the gods. Yet doctors are still discovering how stress and emotions can negatively or positively influence the progress of disease. We may scoff, but any or all of these ways to bring hope to a patient may help. Hope can’t eliminate a tumor, but it might speed healing after the tumor is removed.
Meanwhile, many Chinese herbal cures listed in the Su Wen are still in use in treatment of some cancers, such as Xiaojin dan, the Xihuang pill, the Dahuangzhechong pill, the Liushen pill, and Pianzaihuang. For example, Xiaojin dan–a compound of Musk, Cochinchina momordica seed, Prepared aconite root, Frankincense, Myrrh, and Chinese angelica–has been shown to slow the cancerous growth by stopping cancer cells in their reproduction cell cycle phase and “activating mitochondrial pathways for cell death.”
Tell those rogue cells who seek immortality: You Shall Not Pass. Try everything, say these physicians, one thing and another. Try them all. Even so, these treatments may not work, if the disease has allowed the evil qi, the wicked cells, to take too much territory. Then, you must help the patient gain peace with their deities, offer compassion, and be a good listener. In that, the ancients were ahead of their time.