RBMOnline - Vol 2. No 2.

106112 Reproductive BioMedicine Online webpaper 2000/029 on web 16 Mar 2001

Articles An introduction to reproduction in pharaonic egypt

Dr Jauniaux qualified in medicine in 1986 from the Free University of Brussels. After 5 years of part-time research on the pathophysiology of early human pregnancy, his PhD degree was awarded in May 1992. In Nov 1994 he became senior lecturer/hon consultant in Fetal Medicine and since 1998 has been a Reader in Obstetrics and Gynaecology at University College London. His research interests include fetal and placental histopathology, transplacental transmission of HIV, ultrasound-pathological correlation of placental anomalies, the physiology and anatomy of early placental circulations, the mechanism of early pregnancy failure, and early prenatal diagnosis. His main scientific research concerns the role of placenta and the yolk sac in determining the composition of fetal fluid. Together with Dr GJ Burton (Anatomy, University of Cambridge), Dr Jauniaux was awarded the 2001 international scientific prize of the SPA Foundation for their work on placental oxygenation in early pregnancy and its role in normal and abnormal fetal development.

Dr Eric Jauniaux

Eric Jauniaux Academic Departments of Obstetrics and Gynaecology, Royal Free and University College London Medical School, UCL Campus, London, UK. Correspondence: Academic Department of Obstetrics and Gynaecology, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK. Tel. +44 (0) 207 6796057; Fax +44 (0) 207 3837429; e-mail: e.jauniaux@ucl.ac.uk

Abstract
Reproductive science is a new-born medical speciality compared with other specialities such as surgery or dentistry. However, infertility and obstetrical complications commonly diagnosed in the 20th century have a history as old as medicine itself. In an attempt to distance themselves from the African and Middle-Eastern roots of our culture, the European intellectuals of the 18th and 19th century have written the history of the democratic world starting with the Greco-Roman period. Egyptian medicine has influenced the medicine of neighbouring civilisations, including the culture of ancient Greece and its influence spread onward, thereby affecting Western civilisation. The aim of this review is to give credit to these early researchers, who often concluded with extremely accurate observations and to present their colourful and sometimes controversial contribution to our knowledge of reproductive anatomy, physiology and pathology. Keywords: ancient Greece, Egyptian, infertility, pathology, physiology, reproductive science

Introduction
Around 4000 BC, the ancient Egyptians created one of the worlds earliest cultures. Long before the rest of Africa and Europe had shown any signs of civilisation, the ancient Egyptians had a political state with a central administration and army, a unified alphabet, a common religion. Furthermore they also had a flourishing industry with commercial links with other great civilisations of the time, as far away as China, and most of the attributes of our modern Western civilisation including all forms of art and science. Individual Egyptians, men and women, enjoyed a position and importance in proportion to their respectability, their talents or their wealth that could only be matched in Europe during the 18th century AD. Although these evidence-based historical facts became known to the Western world soon after the famous French Egyptologist Champolion published his first book on the translation of the hieroglyphic texts in 1824, the contribution of the ancient Egyptians to our civilisation and religions has often been ignored (Sullivan, 1995; Jauniaux, 1999). Famous ancient Greek historians such as Herodotos could not believe that the Pyramids were the creation of humans but rather that they were made by giant semi-gods (Lacarriere, 1981). These distorted historical views and the loss of the keys to reading hieroglyphs has contributed to our chronic ignorance of the ancient Egyptians science and in particular, medicine. Thus not surprisingly, most modern historical reviews of medicine classically start with Greco-Roman medicine which is widely accepted as the origin of clinical practice in western culture (Cruse, 1999). In fact, most of the prominent ancient Greek philosophers and scientists lived, at some point in their career, in Egypt, mainly in Alexandria, and a large portion of Greek science and mythology has its roots in ancient Egypt. However, the influence of the ancient Egyptian knowledge on the medical science of Hippocrates has been minimized if not completely ignored by modern medical historians (Aterman, 1999).

Articles - An introduction to reproduction in pharaonic Egypt - Eric Jauniaux

The aim of this review is to highlight the knowledge of fertility and reproduction in ancient Egypt. This only represents a small fragment of the scientific developments that took place over more than 45 centuries in this exceptional civilisation. In ancient Egypt, religion and magic were at the centre of most fertility and regeneration rituals. However, observation studies and evidence-based medicine were current practice. This review also demonstrates that at least 2000 years before the Greek and Roman civilisations emerged from obscurity, the Egyptians had already mastered some of the most important concepts in medical science. These concepts inspired the GrecoRoman invaders and many of them were only rediscovered in Europe after the Renaissance.

Min

Mythology and reproduction in ancient Egypt

The creation of the world and of mankind, were subjects of constant interest to the Egyptians. Not surprisingly almost every Egyptian god and goddess had a role to play in the creation of world. The sun god Re is the supreme being and quintessence of all forces and elements of nature. He contains within himself the life force of every other deity yet to come into being and Res supremacy was the basis of the pharaohs own security and power (Hart, 1986).

Anthropomorphic and ithyphallic god who was the supreme symbol of procreativity and renewal of sovereignty, featured in many temple reliefs all over Egypt from the time of the first pyramid (Hart, 1986). In texts found in the coffin of the common people of the Middle Kingdom, the sexual prowess of the god is described as a desirable quality to possess in the afterlife. In honour of Min, a major procession and festival was organised during the celebratory rituals surrounding the coronation of the pharoes of the New Kingdom. The longleafed lettuce (Lactuca sativa) became the special emblem of Min, appearing on stands or chests near him, carried by priests in his festivals and grown at the entrance to private homes. This plant was supposed to assist the god in performing the sexual act untiringly, the symbolism arising from its milk-sap, which was compared to semen and was used as an aphrodisiac. Min was still worshipped during the reign of the Roman Emperor Augustus and the Min lettuce was exported to Rome where it became known as the Lectuca Romana in the rest of Europe.

Hathor

Supreme cow-goddess of sexual love and fertility and symbolic mother of the pharaoh. The Greeks identified her with Aphrodite when they came into contact with her cult. She gave way to Isis, when her legend was absorbed into the myth of Osiris (Hart, 1986).

Amun Kamutef

Creation of the world

The ancient Egyptians texts reported several myths and legends to explain creation. The cult would vary with the ruling family in power at the time and its establishment in a particular region of the kingdom. Emphasis has always been placed on Res coming into being at the beginning of time. For the act of creation, Re often coalesces with his other forms Athum and Khepri. Re-Atum ejaculated and spat out to give birth to the twins Shu and Tefnu, respectively the god of air and sunlight and the goddess of personifying moisture (Hart, 1986). By natural process Shu and his sister-wife Tefnu gave birth to Geb and Nut, respectively the earth god which personified the land of Egypt and the sky-goddess whose body is stretched across Geb. Nut bore Geb four children: Osiris, Isis, Seth and Nephtys. The birth of Horus, son of Isis and Osiris and symbol of divine Kingship created the connection between the elder cosmic deities and the political world. The popularity of Isis, the sacred mother was immense, reaching countries as far away as Ireland, and Christianity had an uphill struggle in eclipsing her worship.

Ithyphallic form of Amun-Re, creator of his own egg and sexual athlete resulting in a never-ending cycle of successful pregnancies. Royal symbol since the predynastic period (Hart, 1986).

Hapy

God of the annual Nile inundation which was the source of Egypts prosperity (Hart, 1986). His body emphasized pendulous breasts and a prominent paunch, which symbolised abundance and fertility. There is also evidence of spells which invoked Hathor to be present and to protect women in childbirth (Robins, 1993).

The gods of pregnancy and childbirth

Taweret
Hippopotamus-goddess, the great one protector of women in childbirth. She had the head of a hippopotamus, a fulsome belly, the legs and arms of a lion, the tail of a crocodile and human breasts (Figure 1). This ferocious appearance was supposed to deter malevolent forces from harming the pregnant in labour, and she was a great favourite with ordinary Egyptians (Fayad, 1998a).

The gods of fertility

Like many ancient human societies existing before and after the ancient Egyptians, the prime concern of a couple after establishing a home must have been their fertility (Morice et al., 1995). The survival of the society as a whole was highly dependent on the fertility of the people but also on the land that provided for them. Religion and magic were, therefore, at the centre of most fertility and regeneration rituals. Fertility was of prime importance, and infertility may have been a possible reason for divorce but there is evidence that adoption was recommended under those circumstances (DesrochesNoblecourt, 1993; Robins, 1993). Polygamy was the privilege of Kings and only they could marry their sisters or more rarely their daughters, in order to establish an inheritance through the female line (Fayad, 1998a).

Bes

Popular domestic dwarf-deity with leonine features who had a role as protector of childbirth in partnership with Taweret or Hathor. Its grotesque physical features were supposed to scare off evil demons. It was thought that Bes also brought good luck to married couples and their children and he was often a decorative element in bedrooms. His popularity spread to Cyprus and Assyria (Hart, 1986).

Khnum

Ram-god, creator of life on his potters wheel, starting with the egg inside the pregnant woman. He was also responsible for the normal position of the fetus during pregnancy and delivery (Fayad, 1998b).

Articles - An introduction to reproduction in pharaonic Egypt - Eric Jauniaux

Figure 1. Statue of Taweret, "the great one"; 26th Dynasty (664-610 B.C.).

Figure 2. Statue of Imhotep as a deity of medicine (Musee du Louvres).

Heket

Frog-goddess of birth, popular during the middle and new Kingdom. Her role was to hasten the last stage of labour and amulets bearing her image were worn by women to protect them during childbirth (Hart, 1986).

Meskhemet

Goddess presiding at childbirth and ensuring the safe delivery of a child from the womb. Her form of a tile with a female head represented one of the bricks upon which women used to give birth in the traditional squatting position (Hart, 1986).

Medical science at the pharaonic time

The "Arts Medica" emerged in Egypt exhibiting an unparalleled stage of evolution when compared with any other civilisation. The Egyptian science of healing constituted from the very beginning a system several thousand years in advance of most human societies. Egyptian medicine achieved an international status around 4000 years ago, during the New Kingdom, and there are reports of Egyptian remedies and sometimes doctors being sent to the Royal court of neighbouring countries, for example, during the reign of Rameses II (Desroches-Noblecourt, 1993). There is clear evidence that the origin of our knowledge of bedside examination is rooted in ancient Egyptian medicine (Zoneraich et al., 1996).

Probably the most famous physician of ancient Egypt was Imhotep, a high courtier under King Djoser about 2660 B.C (Hurry, 1926; Pickett, 1992). Imhotep was the architect of the Step Pyramid complex at Saqqara and the sanctuary to the sun god at Heliopolis. He held the office of chief executive and master sculptor. Imhotep also enjoyed a high reputation both as magician and as physician, which testifies to his skill as a healer of the sick (Figure 2). Imhotep was deified as son of the god Ptah. His cult spread quickly through the land of Egypt as a deity of medicine, and his ability as a healer identified him in the Greek mythology with Aesculapius, their own god of medicine, more than 2000 years later (Hurry, 1926). The cult of Imhotep became a focal point for married couples desiring a son during the Greco-Roman period (Hart, 1986). Imhotep is not the oldest known physician and a tomb found in Saqqara gives evidence on the life of a physician who practised during the third dynasty around 2800 BC (Fayad, 1998a).

The medical texts

Disease was generally attributed not to a disturbance of normal functions but to the malevolence of demons or malign spirits and thus magic was part of most therapeutic approaches. However, many distinct diseases were diagnosed and treated on definitive principles. Large numbers of drugs used by the ancient Egyptians still figure in modern pharmacopoeias (Hurry, 1926), in particular aspirin, which was extracted from a willow bark, was already used to treat inflammation (Vainio and Morgan, 1997). Prescriptions and treatments, sometimes based on clinical evidence, were sometimes surgical (Sullivan, 1998). Remedies for women were given orally, applied topically, or introduced internally, particularly for contraception or to induce abortion. In some cases, fumigation of the vagina was recommended to treat internal disease (Bardinet, 1995; Nunn, 1996).

The magician-physician
There are numerous references in the ancient Egyptian literature to the role of the doctor. Some physicians may have specialized in one disease only but no medical titles have been discovered that may be interpreted as those of a gynaecologist (Sullivan, 1997).

Articles - An introduction to reproduction in pharaonic Egypt - Eric Jauniaux

Only about 14 papyri related to medicine have been translated. Many of these texts are incomplete and only a few discuss gynaecology and childbirth. These texts, most of them based on older texts possibly from 3000 BC are comparatively free of the magicians approach to treating illness. 1911). The placenta was the seat of the "external soul" and as the wellbeing of the kingdom was believed to depend on that of the Pharaoh, his "secret helper", as it was also called, was preserved in a safe place. A special chamber, inside the main pyramid, and even a second pyramid may have been built for the King's placenta. A hieroglyph word, which is widely used as the phonetic sign for kh, is though to be a human placenta. The placenta of the cat was used in a mixture recommended to prevent hair turning grey (Nunn, 1996). According to the Ramesseum IV papyrus, a fragment of human placenta was mixed with milk and given to new-borns as a test to predict if they would survive (Bardinet, 1995). If he/she would not swallow it, it was a bad omen, as the ancient Egyptians believed that this mixture was what normal fetuses were fed with in utero.

The Kahun papyri

These are conveniently divided into 34 paragraphs many of which are so badly damaged that little sense can be made of them. The normal and abnormal female secretions are described in paragraph 5 of the first section (Bardinet, 1995). The second section describes a fumigation procedure used to aid the occurrence of conception and pessaries to prevent conception made of crocodile excrement, honey and/or sour milk. The third section is concerned with pregnancy testing and predicting delivery outcome whereas the fourth comprises two paragraphs, one describing treatment for toothache during pregnancy and the other a fistula between the bladder and the vagina (Nunn, 1996). One of the Kahun papyri also lists effective methods of contraception including crocodile dung which has some spermicidal action (Sullivan, 1997).

Congenital abnormalities
As well as acquired diseases, undoubtedly ancient Egyptians suffered from inherited and congenital deformities (Reeves, 1992; Nunn, 1996).

The Smith papyrus

This is the oldest medical papyrus found so far. It contains mainly prescriptions, including different therapies for the troubles of menstruation and various surgical treatments (Bardinet, 1995; Atta, 1999).

Skeletal dysplasia

The Ebers papyrus

This is the longest (>20 m) of all medical papyri. It displays among 878 prescriptions for various diseases, treatments for placental delivery that were to be put on the birthing bricks to attract the placenta back to the earth where it belongs (Bardinet, 1995; Fayad, 1998a) or to treat a prolapsed uterus (Sullivan, 1997). Of particular interest is prescription 783 which describes a tampon of lint, honey, and acacia to be inserted "pre vaginal" in order to prevent pregnancy (Fayad, 1998a).

The Berlin papyrus

This describes treatments for infertile women and different diagnostic tests to predict normal labour and delivery but also the gender of the baby to be born (Bardinet, 1995; Fayad, 1998a).

These were found by archaeologists in mummified remains from the predynastic period whereas our knowledge of most other congenital disorders come from representations in tombs. There is abundant evidence for the existence of dwarfs in ancient Egypt and in particular there is much skeletal evidence for achondroplasia (Fayad, 1998a). This condition may be inherited or may occur sporadically as the result of a gene mutation; it has been portrayed in Egyptian art more often than any other congenital deformity. It is unlikely that dwarfism was regarded as a disease but more likely as a divine manifestation. It is noteworthy that the god Bes showed many of the features of achondroplasia and some dwarfs enjoyed social status within the entourage of the Royal family (Figure 3). Other skeletal deformities found in the remains of ancient Egyptians include talipes, cleft palate and/or lip, hydrocephaly, spina bifida, anencephaly and osteogenesis imperfecta.

Genetic syndromes

The Carlsberg VIII papyrus

This is concerned with the detection of pregnancy, the sex of the unborn child and the ability to conceive (Nunn, 1996).

The Ramesseum papyri III and IV The Westcar papyrus

These include sections on diseases in women and children and relate also to parturition (Nunn, 1996). This indicates that midwifery was not regarded as a department of medicine (Hurry, 1926).

Organ anatomy
Knowledge of internal anatomy was almost exclusively in the hands of embalmers, while the physician would have little or no surgical training. However, if their knowledge of fetal physiology was rather limited, they did almost certainly know the different parts of the fe1male anatomy related to reproduction. The uterus was called the "Mother of mankind", the cervix "the mouth of the uterus", the vagina "the flesh" and the fetus the "egg" (Nunn, 1996). From 3400 BC down to the time of the Ptolemies, ancient Egyptians paid special respect to the royal placenta which was carried in ceremonial processions (Seligmann and Murray,

Akhenaten and his family remain the most vehemently argued medical diagnostic problem of the ancient Egyptian period. Akhenaten, who began his reign as Amenhotep IV changed his name after rejecting the established worship of Theban's gods and goddesses in order to worship only the solar disk "Aten". During his reign as a monotheist he had chosen for himself and his family to be depicted with elongated heads. His other personal features were gynaecomastia, swollen feminine hips, slightly protuberant abdomen, massive lower jaw and spindly lower legs (Reeves, 1992; Nunn, 1996). Akhenaten and his wife had six daughters. Egyptologists have long speculated about the shape of their heads and suggested that the girls heads had been deliberately manipulated during infancy (Figure 4), which is unlikely as such artificial deformity was not common in ancient Egypt. It is possible that these depictions were simply to conform to the prevailing artistic style of the Amarna period, or in order to fit with the congenital syndrome of their father. Akhenaten's grandfather, Tuthmosis IV, his father, Amenhotep III and his successor and possibly son, Tutankhamun, all show some of his external features and in particular gynaecomastia. However, this last feature could be secondary to obesity or schistosomiasis (Reeves, 1992). Several endocrinological

Articles - An introduction to reproduction in pharaonic Egypt - Eric Jauniaux

Figure 3. Statue of Seneb the dwarf and his family. Seneb was the chief of all the dwarfs of the royal palace around 2475 BC (Cairo Egyptian Museum). explanations have been proposed to try to explain Akhenaten's unusual appearance: Frolich's syndrome (dystrophia adiposogenitalis), a pituitary adenoma with acromegaly, myotonic dystrophy (Cattaino and Vicario, 1999), Klinefelter's syndrome (47,XXY) and familial incomplete pseudo-hermaphroditism (Reeves, 1992; Nunn, 1996). The last two conditions are almost always associated with infertility and until Akhenaten's mummy is found, the debate will remain open. Molecular biology and in particular DNA analysis and cloning of proteins from ancient mummified remains will most certainly improve our knowledge on the history of genetic disorders (Paabo, 1985; Cook, 1993; Brown and Brown, 1994), the epidemiology of infectious diseases (Nerlich et al., 1997; Rollo and Marota, 1999) and migration patterns of ancient population (David, 1997).

Figure 4. Statue of the head of a royal princess, probably Meriaton, daughter of Akhenaton (1365-1349 BC). daughters could inherit from their father (DesrochesNoblecourt, 1993). Women were by no means confined to the household and theoretically had access to most professions, including medicine (Harer and el-Dawakhly, 1989; Nasser and Baligh, 2000) but seem to have been almost completely excluded from the official bureaucratic structure (Robins, 1993). This suggests that daughters from illiterate families were probably not taught to read and write. Titles for women almost exclusively related to the social status of their husband. Some professions such as brewer or miller were almost the prerogative of women. At least, three women have ruled in ancient Egypt, long before the time of the famous Cleopatra VII. In the Middle and New Kingdoms, administrative titles held by women virtually disappeared. Family was the backbone of society and, as illustrated in many artefacts from the Middle and New Kingdoms, the relationship between wife, husband and children was close and warm (Fayad, 1998b). It is in fact rare to find a similar example of serenity and intimacy in the other ancient civilisations .

Reproductive healthcare for the ancient Egyptians

There is no doubt that throughout history the social status of women in a human society is the scale by which the degree of civilisation can be evaluated.

The fertility and pregnancy tests

Sexual maturity was reached early, around the age of 12 years and adulthood at 16 (Fayad, 1998b). The necessity for coitus to produce a pregnancy and the connection between semen and pregnancy were well known (Robins, 1993). Sexual privacy was consecrated by a religious decree and social prostitution was well established (Sullivan, 1997). Although missing an expected menstruation was taken as a sign of conception, the ancient Egyptians had also developed a number of tests that could be performed to indicate if a women

The social status of women in ancient Egypt

Most of our information on the role of women in ancient Egyptian society is derived from sources from the New Kingdom and Ptolomeic period. Elite women from the upper class had legal rights equal to men and could engage in economic transactions on their own behalf in the same way as a man (Robins, 1993). Women could also own land and

Articles - An introduction to reproduction in pharaonic Egypt - Eric Jauniaux

was fertile, or pregnant. These tests are described in various magicmedical papyri and they are introduced in order to "to distinguish between who will bear a child and who will not bear a child", and so it is not easy to distinguish between a fertility and pregnancy test. Tests included taking the pulse, observing the distension of the blood vessels of the breasts, placing an onion bulb in her flesh with a positive outcome being determined by the odour of the onion coming from the nose, and finally observing the effects of adding the womans urine to barley and emmer wheat and observing the effects on germination (Bardinet, 1995; Nunn, 1996). The latter, which is perhaps the most famous is described in the Berlin medical papyrus and says: "The lady should moisten with her urine emmer and barley. If they both grow, she will bear a child, if they don't she won't. If the barley grows first it will be a male and if the emmer grows first, it will be a female". A similar test was re-used by Hippocrates and still employed in 18th century Germany (Morice et al., 1995). The technique was put to the test in the 1960s and was found to be a good indication of pregnancy in 70% of cases but poor in predicting the fetal sex (Nunn, 1996).

The ordinary people did receive the attentions of the main goddesses and delivered at home with the help of one or two midwives. A number of remedies were used to speed the process of giving birth (give to the earth) such as honey, celery and milk which were placed on the belly, per vagina or orally, if the labour was obstructed. The Ebers papyrus also reports the use of labour stimulants by combining salt, onion, oil, mint, incense, wine and even ground-up scarabs and tortoise shells. Statues and other representations of Taweret and Bes were most certainly placed in the delivery room to protect the woman giving birth. Curved ivory wands were also used to provide magical protection for the mother and her child. There is evidence, at least from the New Kingdom, that birth took place in a specially built structure, and from the Ptolemaic period, perhaps in birth houses (mamisi) attached to temples or the Royal palaces. There was no definite Egyptian word for midwife and little account of their work. Maternal mortality was high and several mummies of women in labour have been found showing evidence of death due to obstructed labour (Sullivan, 1997). Probably, as nowadays, the main cause of maternal mortality was bleeding during or after delivery. Not surprisingly there were spells to try to protect women during delivery. In all cases, the delivery was womens business with no men in attendance (Fayad, 1998b).

Pregnancy and delivery

Pregnancy is rarely depicted in formal art, outside ritual processions of a Queen being led to the delivery room by their favourite god and goddess. The hieroglyph determining words relating to conception and pregnancy shows a kneeling women who is clearly pregnant (Robins, 1993). ancient Egyptian belief was that during pregnancy the semen generated the bones of the fetus whereas the milk and blood of the mother contributed to the formation of fetal flesh (Bardinet, 1995). There are examples of tampons, so-called Isis-knot, which were inserted into the vagina of pregnant women to prevent miscarriage (Robins, 1993). The medical papyri say little about the normal labour and nothing about any obstetric practice. The Ramasseum IV papyrus provides several sections relating to delivery, i.e. to separate [him] from his mother...who is giving birth, but they mainly concern magic. In a Middle Kingdom story describing the Miraculous Birth, as triplets of the first three Kings of the Fifth Dynasty, there is some indication on the various ways the navel cord was cut, after the midwife had washed the baby, but overall there is a tantalising lack of obstetrical detail. In the hieroglyphic alphabet childbirth is represented by a pregnant woman sitting over two bricks with the fetal head hanging between her thighs (Fayad, 1998a). However, there are only a few representations of women giving birth, most of which are ritual and involve queens and other goddesses. There is no drawing of the bricks, and most probably a birthing stool or chair was used during labour, rather than bricks or stones. One of the most famous representations is that of Cleopatra VII giving birth to the first of her six children Caesar. Several goddesses attended the birth, which took place in a sealed room. Isis mother of Horus, placed herself in front of the queen and the child rushed forth into her arms. It is this aspect of the goddess that was regarded as the vital link between deities and royalty, since the king was viewed as the living Horus on the throne of Egypt. Heket and Neptis often assisted Isis in chanting incantations, which were supposed to ease the delivery process of the future pharaoh.

Conclusion
This review has focussed mainly on reproduction in Pharaonic time but this only represents a small fragment of the scientific developments that took place over more than 45 centuries in this exceptional civilisation. In ancient Egypt, religion and magic were at the centre of most fertility and regeneration rituals. However, observation studies and evidence-based medicine was current practice. This review also demonstrates that at least 2000 years before the Greek and Roman civilisations emerged from obscurity, the Egyptians had already mastered some of the most important concepts in medical science. These concepts inspired the GrecoRoman invaders and many of them were only rediscovered in Europe after the Renaissance.

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Articles - An introduction to reproduction in pharaonic Egypt - Eric Jauniaux

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