Case Eight: Instructions concerning a smash in his skull under the skin of his head.

“Examination: If thou examinest a man having a smash of his skull, under the skin of his head, while there is nothing at all upon it, thou shouldst palpate his wound. Shouldst thou find that there is a swelling protruding on the out side of that smash which is in his skull, while his eye is askew because of it, on the side of him having that injury which is in his skull; (and) he walks shuffling with his sole, on the side of him having that injury which is in his skull…

Diagnosis: Thou shouldst account him one whom something entering from outside has smitten, as one who does not release the head of his shoul fork, and one who does not fall with his nails in the middle of his palm; while he discharges blood from both his nostrils (and) from both his ears, (and) he suffers with stiffness in his neck. An ailment not to be treated.

Treatment: His treatment is sitting, until he [gains color], (and) until thou knowest he has reached the decisive point….

Gloss: As for: “He walks shuffling with his sole,” he (the surgeon) is speaking about his walking with his sole dragging, so that it is not easy for him to walk, when it (the sole) is feeble and turned over, while the tips of his toes are contracted to the ball of his sole, and they (the toes) walk fumbling the ground. He (the surgeon) says: “He shuffles,” concerning it…”

Edwin Smith (Surgical) Papyrus

(The text is attributed by some to Imhotep, an architect, high priest, and physician of the Old Kingdom, 3000–2500 BCE; Perhaps the first neural-motor lesion correlation observed in history.)

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