The Edwin Smith Papyrus, one of the world’s earliest known medical documents, has been digitally transformed by NLM into a document that can be perused on computer screen.

The latest addition to the eye-catching Turning The Pages presentation in kiosks at the National Library of Medicine is the Edwin Smith Papyrus, one of the world’s earliest known medical documents. It was written in Egyptian hieratic script around the 17th century BCE, but probably based on material from a thousand years earlier. Originally in the form of a scroll with text on both sides, its columns of text had been chopped into individual pages at some point.

Starting with 15 digitized images of those pages from the New York Academy of Medicine, Michael Chung and Dr. Glenn Pearson of NLM’s Communications Engineering Branch used Photoshop, Maya and Director animation and rendering software tools to create a virtual scroll, in collaboration with curator Michael North of NLM’s History of Medicine Division. Unlike the other books in NLM’s Turning The Pages series, which entail touching and turning the pages, the virtual papyrus is touched and scrolled.

The papyrus is a textbook on trauma surgery and describes anatomical observations and the examination, diagnosis, treatment and prognosis of numerous injuries in exquisite detail. Described are cranial sutures, the meninges, the external surface of the brain, the cerebrospinal fluid and intracranial pulsations.

The contents of the papyrus show that the heart, vessels, liver, spleen, kidneys, ureters and bladder were recognized and that blood vessels were known to be connected to the heart. Other vessels are described, some carrying air, some mucus, while two to the right ear are said to carry the breath of life, and two to the left ear the breath of death. However, it appears that the physiological functions of organs and vessels remained a mystery to the ancient Egyptians.

Listed in addition are 48 traumatic injury cases, each with a description of the examination, diagnosis and treatment. It starts with injuries to the head, continues with treatments for injuries to neck, arms and torso, where the surviving copy of the text breaks off. The treatments appear scientific and magic is resorted to in only one case: Case 9, “Instructions concerning a wound in his forehead, smashing the shell of his skull.” The remedy prescribed involves an ostrich egg, figs, grease and honey. In addition, a charm is to be sung over this recipe.

The technical challenges in creating the virtual papyrus were considerable. Creative animation techniques, dealing with bend modifier and lattice deformation, were necessary to have the scroll unroll and flip over correctly. A “text” mode fades in curator notes atop the scroll, as well as buttons (amusingly shaped like miniature scrolls) that when pressed cause a full English translation of the corresponding section to drop like a curtain.

A “curtain drop” was also used in “menu” mode, to display a thumbnail of the scroll with category buttons (such as “Shoulder and Back Wounds”). Pressing a button rolls the scroll rapidly to the topic of interest. To explore the graceful, two-color calligraphy, “zoom” mode offers a roving magnifying window, which is considerably different from the zoom technique used in earlier Turning The Pages books.

The development of this system is another major step in NLM’s effort to bring the treasures of medical antiquity to the public. Planning is now under way to create a web version of the papyrus.—George Thoma