Book manuscript: Arkhipov S.V. Medical Record: The Contribution of a Middle Bronze Age Egyptian Physician to the Book of Genesis. Kyrö: Author’s Edition, 2026. – 312 pp. – 2 tables. – Bibliographical references: 856 entries. play.google.com , books.google.com
Chapter 20
GENERAL STATUS OF THE PATIENT
The
sequence of examining a patient with a trauma or its consequences begins with
clarifying complaints and the circumstances of the incident. In compiling Jacob's
"medical chart", we have somewhat departed from the accepted
sequence. At the first stage, the "life history" (anamnesis vitae)
was assembled, and at the second – the "history of the present
illness" (anamnesis morbi). In these sections, everything that could in
one way or another affect the victim's state of health has been collected.
In
this section, we have carried out a reconstruction of the possible complaints
of Jacob's prototype. In addition, we have reflected the general condition of
the injured patient. In an actual medical chart, it is described in two parts,
termed in Latin as "status praesens" and "status localis".
"Status praesens", literally "present status" – that is,
"present condition" or "general status" – describes the
overall state of health at the time of examination. "Status localis"
("local status") reflects local changes resulting from trauma or
disease. General status includes information on the function of vital organs
and systems. Its component is often "status mentalis", or "mental
status", which allows assessing the patient from a psychiatric
perspective.
In
both general and local statuses, the main external signs of pathology,
identified functional impairments, and the results of special tests and
assessments are described. Certain individual items among them – "signs of
disease", or "symptoms" – are combined into stable combinations
called "syndromes". In our case, these data are extremely scarce.
Moreover, according to the text of the Book of Genesis, the information is
retold by a third person
who was not an eyewitness to the accident.
Certain
facts regarding the state of health can be extracted from a conversation with
the patient, from the narrative of the incident that caused the disease, and
from his established perceptions regarding the sequence of the development of
pathological processes. The most essential of what the physician has heard and
understood forms the basis of all sections of the "medical history".
The section of the medical chart called "General Status" is formed
from information gleaned from the primary source. Its presentation, analysis,
and synthesis have been cast by us, where possible, into modern form. We have
thereby attempted to reflect various medical aspects of the condition of the
literary Jacob before and after the hip joint injury. We shall endeavor to show
how it was previously understood by doctors and patients, as well as what
laymen and professionals think about it now. The medical interpretation of one
of the oldest written monuments, as intended by us, will contribute to
improving the diagnosis, treatment, and prevention of pathology of the ligament
of the head of femur in the future.
[ii]
In
the Book of Genesis, there are no complaints from Jacob. Neither the narrator
nor the translator nor the "editor" of the tradition conveys them.
This does not mean that the patient had no complaints. He sustained a trauma at
night, clearly in the dark, "before the rising" of the sun, and
without eyewitnesses: "And Ya'akov was left alone" (Gen. 32:23–25).
The phrase immediately following this sounds like a dissonance: "A man
wrestled with him" (Gen. 32:25). The authors either contradict themselves
or imply that what follows is a retelling of a dream or hallucination. The
latter version is preferable. Next comes an abnormal clarification: the
struggle took place "with an angel". Both Jacob and his adversary
speak of this: "You have wrestled with an angel", "I have seen
an angel" (Gen. 32:29, 31). From what has been said, it is clear that a
virtual entity is being narrated here. Accordingly, in the case of a fight with
a "man", it may also be a question of an ephemeral creature – a
"demon of disease". The above satisfactorily explains why there were
no witnesses to the night battle. Hence, after the "injury", Jacob
could not complain to anyone. Therein lies the reason why there are no
complaints in the text. Nobody "told" them to the authors. Exercising
caution, they do not set forth an explicit fiction.
The
trauma was sustained by Jacob in the dark time of day. This is evident from the
sequence of the description of events. First "he spent that night",
then "he arose that night", later "he wrestled… until the rising
of the dawn", and then "the dawn rose", and only then "the
sun shone upon him" (Gen. 32:22, 23, 25, 27, 32). Thus, Jacob's companions
were able to see anything only after some time had passed since the incident.
For example, the mentioned visible symptom of damage – limping – is detected
only when "the sun shone upon him" (Gen. 32:32).
Asymmetry
and arrhythmia of gait are usually detected by a third-party observer. In cases
of a "mild" degree of limping, patients usually "do not notice",
or more precisely, pay no attention to it. Impairment of walking function is
noted by them when performing forced atypical movements with large amplitude,
such as swaying of the body. Then the anomaly is clearly registered by one's
own muscle-joint sense, visual analyzer, and vestibular apparatus.
In
such a case, the patient, even "without prompting", mentions limping
among their complaints. Sometimes, upon leading questions, he "remembers"
that someone among those around – a relative or acquaintance – had paid
attention to the change in gait. In both the first and second scenarios, it is
not always possible to understand what the cause of the problem is and where it
is localized. The pathological sign commonly referred to as "limping"
can be the result of a multitude of causes. Listing them should begin with
uncomfortable footwear, continue with functional disorders of the nervous
system, vestibular apparatus, vascular pathology, skin lesions of the foot,
local infection of the lower extremity, and end with changes in the
musculoskeletal system.
Difficulties
in establishing the cause of gait impairment arise when it is not accompanied
by unusual sensations. Among these, pain takes first place, followed by
discomfort. Less frequently, the patient expresses his feelings differently,
depending on his level of education, personality type, and imagery of thought.
Sometimes the absence of pain is stated with confidence, but the presence of
"strange" phenomena is reported. Clarified localization of sensations
uncharacteristic of the norm allows determining the approximate region of
pathology. In the presence of pain or discomfort in a specific place, the
physician's task during the diagnostic search is significantly facilitated.
Our primary source describes Jacob's
gait impairment with the phrase: "he limped upon his thigh" (1978БроерМ_ЙосифонД,a, Gen. 32:32); "he halted upon his thigh" (1922LeeserI, Gen. 32:32). We
believe that only the patriarch himself could have said this, and his story was
later retold in the third person. In most cases, only the patient is able to
clarify for what reason he is limping. The leading guide is pain. A writer
unfamiliar with medicine would have limited himself to a general description or
a statement of impaired gait. At the same time, it is impossible to imagine
that a physician would write about the consequences of a past trauma in this
way. It is thought that initially a verbatim transcript of Jacob's tradition
was created in the first person. It recorded his words describing how the night
of the crossing ended. In the narrative, he does not say so directly, but it is
clear to us that unpleasant sensations were present in the thigh region. That
is, the phrase "he halted upon his thigh" reflects pain in the upper
part of the leg.
It
is impossible to say what the severity of the pain was. Jacob had an urgent
need to move forward to meet his brother. We think that unbearable pain would
have forced him to make a long stop or continue the journey riding an animal,
such as a camel or donkey, which were present in the caravan (Gen. 32:6, 8,
16). According to the Book of Genesis, Jacob set off on foot in the morning
after sunrise (Gen. 32:32). The victim's condition allowed him to walk
independently later on, right up to the meeting with Esau (Gen. 33:3).
According to his words, it was planned to continue the trek on foot later (Gen.
33:14). Indeed, having completed the conversation with his brother, Jacob
"journeyed to Succoth", and moreover, built "himself a
house" there and "booths" for the livestock (Gen. 33:17). All
this indicates that if the pain was present, it was moderate according to the
Visual Analogue Scale (1911HawkerGA_FrenchM).
From
Jacob's prayer, it is evident that he used a staff while walking (Gen. 32:11).
This device, now classified as a rehabilitation aid, facilitates movement in
pathologies of the lower extremities and spine. Additional support reduces the
load on articular cartilage and bones of the legs, unloads ligaments and
tenomuscular complexes, and increases body stability. A staff helps to move
across rough terrain; therefore, it is often used by shepherds even in the
absence of musculoskeletal diseases. With the use of the said auxiliary aid,
the intensity of pain undoubtedly decreased. In connection with this, the
caravan did not linger at the crossing but moved forward practically the entire
next day (Gen. 32:32, 33:3, 14, 17). The above emphasizes the realism of the
tradition and the literary skill of the author, who possessed clear concepts
regarding injuries and their consequences.
After
sustaining the injury, Jacob was able to move, albeit slowly. Unwilling to
reveal his vulnerability to his brother, he cited the nursing livestock and
children when there was a need to hasten (Gen. 33:13–14). Low walking speed
contributes to reducing the acting load on the joints by lowering the magnitude
of the dynamic component. This spares the affected joint and, consequently,
additionally leads to a decrease in pain intensity.
From the Book of Genesis, we learn
that Jacob's hip joint was "dislocated" (1978БроерМ_ЙосифонД,a, Gen. 32:26); "put out of joint" (1922LeeserI;
Gen. 32:26). Further below, it is reported that in this process the "sinew
that shrank, which is upon the hip joint" suffered (1978БроерМ_ЙосифонД,a, Gen. 32:33); "sinew which shrank,
which is upon the hollow of the thigh" (1922LeeserI,
Gen. 32:33). In the first century, Rabbi Eliezer (Eliezer ben Hurcanus, ca.
80 – ca. 110) wrote: "What did the angel do? He took hold of the sinew of
the thigh, which was in the socket of Jacob's thigh, and displaced his thigh
sinew [from its place], and it became like the fat of a dead man"
(1916FriedlanderG).
In
the Hebrew version, the said structure is designated by the term "גיד" (gid, gheed), which
translates as "string, chord, sinew, artery, tendon" (1903JastrowM).
According to the Pennsylvania Sumerian Dictionary, the Sumerian noun
"gid" can mean: "an elongated bead or pearl". The later
Akkadian concept "gīdu" already denoted "animal sinew"
(1995OppenheimAL).
From
our point of view, as well as in the opinion of other authors, the Old
Testament text implies the ligament of the head of femur. The earliest
reference to this anatomical structure is present in the treatise Chullin,
included in the Babylonian Talmud. It quotes the words of the physician and
religious teacher Samuel (Shmuel, ca. 165 – ca. 257) that this element of the
joint attaches to the head of the femur (1948EpsteinI). Translated into Hebrew,
this part of the bone is referred to as "על כף הירך", that is, "the spoon of
the hip" (1948EpsteinI, 1978БроерМ_ЙосифонД,a). This is how the Jews in ancient times
called the proximal end of the femur. It indeed resembles an inverted ladle
partially protruding from the soft tissues of a butchered animal carcass. By
the period of the physician Samuel's activity, scientific works describing the
norm and pathology of the ligament of the head of femur already existed: by
Hippocrates of Cos, Heraclides of Tarentum, Hegetor of Alexandria, Apollonius
of Citium, Rufus of Ephesus, Galen of Pergamon, and Pseudo-Galen
(2020ArkhipovSV_ProlyginaIV). Physicians of the Near East widely utilized the
knowledge accumulated by their Greco-Roman colleagues. This can be traced all
the way to Avicenna, who, discussing the ligament of the head of femur in The
Canon of Medicine (11th century), paraphrases quotes from Hippocrates of Cos
and Galen of Pergamon (1980Абу Али ибн
Сина).
No
muscles, tendons, large nerves, or blood vessels attach to the femoral head or
femoral neck. Among the ligaments of the hip joint, only the ligament of the
head of femur attaches to the head of the femur. In Latin, the structure is
designated by the term "ligamentum capitis femoris", as well as
"ligamentum teres femoris" (round ligament of femur) (1996СинельниковРД_СинельниковЯР). The latter term is obsolete, but
still appears in publications (2020RosinskyPJ_DombBG,a; 2023АрхиповСВ).
The
medieval rabbi-philosopher David Kimhi (Radak, 1160–1236) noted regarding the ligament
of the head of femur: this "sinew … is directly attached to the hip
joint" and is not equal to the sciatic nerve (1842KimhiD). The commentator
with a medical background Moses Maimonides in the Mishneh Torah (1176–1178)
implies an anatomical element located inside the joint next to the femur – that
is, the ligament of the head of femur – and also distinguishes it from the
nerve. In the treatise Laws of Forbidden Foods, the physician writes that in
the Torah there is a mention of the "inner sinew that shrank on the [hip]
joint". "Inner" means "adjacent to the bone"; it is a
"separate thing" present "on the right hip and on the left
hip" and differs from the "outer" one (sciatic nerve). The inner
"sinew that shrank" is extracted by scraping (1851MaimonidesM; 2014Маймонид). In the latter case, the
separation of the ligament of the head of femur from the fovea of the femoral
head and the surface of the acetabular fossa is implied.
Analyzing
the text of the theologian with a medical background, it is clear that the Book
of Genesis narrates the ligament of the head of femur, rather than another
anatomical element: a nerve, blood vessel, tendon, or muscle. The Talmudic
physician J. Preuss (1923) remarked regarding the
anatomical structure from Chapter 32 that "the sinew of the thigh is the ligamentum
teres, which in the Talmud is called 'nib'. Dislocation of the femoral head
with rupture of this ligament was considered life-threatening for an
animal." (see rep. J. Preuss, 2004). It must be assumed that a similar
conclusion should be drawn regarding Jacob's injury (Gen. 32:26).
In
the 21st century, when translating the Torah from Hebrew, David Safronov
rendered the lines speaking of the ligament of the head of femur of man and
animals as follows: "Therefore to this day the children of Israel do not
eat the ligament that is upon the hip joint, because He touched Jacob's hip
joint, his ligament" (2010СафроновД). The view of authors immersed in religious
subjects is confirmed by modern orthopedic surgeons, anatomists, biomechanists,
and philologists (2019ArkhipovSV_SkvortsovDV; 2020ArkhipovSV_ProlyginaIV;
2026SrinivasanS_SakthivelS).
The
primary source we are studying clearly links the emergence of limping with
traumatic alteration of the ligament of the head of femur. From the ancient
text, it is clear that in the absence of the aforementioned injury, Jacob's
gait would have remained natural: symmetrical and rhythmica. Limping following
hip dislocation in humans and injury to the ligament of the head of femur was
first noted in the mid-16th century. Professor of Anatomy and Surgery M. R.
Colombo (1559) gives the following explanation for the cause of gait impairment
in injury to the ligament of the head of femur: "...when it is weakened,
it often ruptures. And even if the bone returns to its place, after a
dislocation a limp always remains: this is explained by the fact that the
ligament prevents the bones from joining". Professor G. Bauhin (1605)
wrote: when the ligament of the head of femur "is weakened and lengthened,
it often causes dislocations, and sometimes ruptures, and although the bone
returns to its place, the dislocated leg always limps, since it no longer joins
correctly as before".
In
the translation of J. Z. Platner's book Thorough Instructions... (1761), we
read that during dislocation of the femur, the ligament of the head of femur is
damaged, and in this injury "it can rarely happen that it [the hip], being
truly dislocated, would be cured completely and without an unsightly limp".
The original work in Latin appeared earlier (1747PlatnerJZ). The biomechanical
phenomenon under discussion became the subject of scientific analysis at the
beginning of the 21st century. To date, it is recognized that the ligament of
the head of femur is a stabilizer of the hip, and its pathology is a potential
source of pain and mechanical symptoms in the hip joint, including gait
impairment (1997GrayAJR_VillarR; 2001RaoJ_VillarRN; 2004ByrdJWT_JonesKS;
2008TiborLM_SekiyaJK; 2009BardakosNV_VillarRN; 2009SampatchalitS_ResnickD;
2010, 2012CerezalL_Pérez-CarroL; 2011BotserIB_DombBG; 2011HavivB_O'DonnellJ;
2012PhillipsAR_FernD).
Our
data regarding the biomechanics of orthostatic postures and walking indicate
that a change in gait is also possible with isolated damage to the ligament of
the head of femur, even without hip dislocation (2004Архипов-БалтийскийСВ,a; 2008,2012,2018,2023АрхиповСВ). Personal clinical experience
demonstrates cases of overt trauma to the ligament of the head of femur with
preservation of the ability to walk independently and mild pain syndrome over a
long period.
The
ligament of the head of femur participates in organizing the act of walking as
a flexible supporting element. In addition, various nerve endings are present
in it – mechanoreceptors perceiving the degree of tension of collagen bundles
(1977ПерлинБЗ_БибиковаЛА). A. R. Phillips et al. (2012) point
out the role of the ligament of the head of femur in proprioception. The
aforementioned is a key prerequisite for the function of a pacemaker (rhythm
generator) and coordination of movements. Artificial stimulation of the ligament
of the head of femur in a cat demonstrated the presence of reflex arcs
terminating in the hip muscles, which is significant for stabilizing the pelvis
in a vertical single-support posture and during walking (1969DeeRD). Rupture of
the ligament of the head of femur and the sensory nerves passing within it
disrupts the automatism of the locomotor act due to the loss of reflexes. The
absence of a trigger accounts for the asymmetry and arrhythmia of the gait.
Taking
into account the presented arguments, we assert that Jacob's prototype had
complaints after the hip joint trauma (Gen. 32:26, 33). The patriarch reported
them to no one immediately after the incident, being focused on the upcoming
crucial meeting with his brother and an army of "four hundred men"
(Gen. 32:7, 33:1). Furthermore, Jacob was "greatly" afraid, expecting
an attack and even the murder of himself, his wives, and his children (Gen.
32:8–9, 12). Under such circumstances, a person as a rule does not get
distracted by physical discomfort if he does not wish to attract heightened
attention to themselves.
In
our conviction, Jacob had pain in the area of the injured hip joint and the
ipsilateral thigh. The pain was partially reduced when using a staff during
walking. To lessen the unpleasant sensations, the victim intuitively chose an
antalgic gait pattern with limping and a slow walking pace (Gen. 32:32, 33:14).
This shortens the stance phase duration on the affected leg, which manifests in
step arrhythmia. Often, to compensate for the lost supporting function of the ligament
of the head of femur, a person excessively tilts the trunk, and sometimes tilts
the head and abducts the arm during stance on the leg with the compromised hip
joint (2012,2023АрхиповСВ).
Externally, this manifests as asymmetry of body part movements and
"swaying".
From
the context of the authors, it is clear that Jacob sustains the hip joint
injury precisely during the crossing of the Jabbok River. In the dark of the
night, the patriarch could have tripped or stepped on a large wet stone,
briefly lost his balance, and even fallen, but more likely misstepped. This is
often sufficient to damage the ligament of the head of femur (2018АрхиповСВ; 2019ArkhipovSV_SkvortsovDV). Amid
anxiety and the urge to complete the crossing as quickly as possible, the
victim would not pay attention to the emerging tolerable pain. Jacob vaguely
realized it later in a hypnopompic hallucination, in the envisioned scene of
the struggle.
A dynamic vision in which a joint was "dislocated" had to be accompanied by pain or pronounced discomfort. Hip dislocation is a severe, shock-inducing trauma leading to multiple concomitant injuries: of muscles, external ligaments, acetabular labrum, and sometimes bones, nerves, and skin. Such an injury cannot be perceived without painful sensations even in a dream. In Jacob's prototype, they were initially present at a subthreshold level, which conditioned the "touch" of the stranger to the hip joint in the virtual fight (Gen. 32:26). The representation of the dislocation in the hallucination initiated a vague recollection of the trauma and muscle-joint memory of the forced damaging movement during the wading across the river (Gen. 32:23–24). At that moment, proper attention was not paid to what had happened. The injury was realized only during the period of rest. Relying on the presented arguments, it seems to us that after the trauma, Jacob could present complaints of pain in the hip joint and thigh region, as well as impairment of walking function in the form of its "slowing down" and "limping".
[iii]
Jacob's
external features are unknown. In the Book of Genesis, there is not even a hint
of a description of his appearance. According to our hypothesis, this further
testifies to the fact that he told the story of his life, as well as the
tradition of moving from Haran, himself. Listeners to the narrative did not
need a description of the speaker, let alone clarification of his state of
health. Therefore, we do not know about Jacob's anthropometric, racial, or
constitutional differences. Calculations show that by the time of the injury he
was 37 years old, but according to the primary source, he was 60 (Gen. 26:34,
31:38, 41). A person's biological age is not fully capable of determining their
state of health. It is significantly influenced by genetic factors, climate,
living conditions and lifestyle, occupational hazards, availability of personal
transport, and access to the benefits of civilization, primarily medical care.
Jacob's
immediate ancestors were characterized by satisfactory physical health and enviable
longevity. His great-grandfather Terach died when he was over two hundred and
five years old (Gen. 11:32). His grandfather Abraham lived one hundred and
seventy-five years (Gen. 25:7). His paternal grandmother Sarah died at the age
of one hundred and twenty-seven (Gen. 23:1). His father Isaac lived to one
hundred and eighty years (Gen. 35:28). His mother, Rebekah, was the same age as
her husband or slightly younger (Gen. 22:5, 23). According to the epic
narrative, she gave birth to sons at about sixty years of age (Gen. 25:26), and
forty years after the birth of the children she was still alive and well (Gen.
26:34–35). All this is nothing more than literary hyperbole. The
above-mentioned personages came from Asia. For reference, we indicate that the
average age of deceased adults in Early Bronze Age Anatolia was 35 years for
men and 28 years for women (2026ArnottR). Most of the prototypes of our
characters lived approximately that long.
Prior
to the hip joint injury, Jacob worked in Haran and its environs (Gen. 27:43–44,
28:2, 5, 7, 10, 31:4, 18). In relation to the "land of Canaan", where
the patriarch lived previously, the settlement is located to the northeast
(Gen. 29:1). The region's climate is continental, with hot, arid summers and
humid, relatively warm winters with temperatures of 12–14 °C during the day.
The Haran valley is located at an altitude of 400–500 m above sea level,
protected in the north by the Eastern Taurus Mountain range. Since ancient
times, people here lived in stationary structures – domed houses made of mud
adobe bricks (2017BirinciS_CamciA). The aforementioned speaks of a civilized
mode of economy and life.
To
travel long distances, Jacob could use a donkey or a camel (Gen. 31:17). This
allowed reducing the dynamic load on the joints of the lower extremities. At
the same time, he had to walk a lot. On foot, the patriarch arrived from Canaan
to Haran (Gen. 29:1). Prior to the trauma, he was actively engaged in physical
labor outdoors – herding livestock (Gen. 30:31). Pasturing domestic animals
implies exposure to adverse environmental factors. According to him, "in
the day the drought consumed me, and the frost by night" (Gen. 31:40). The
weather made it difficult to move across rough terrain with luggage, which
included at least personal belongings, provisions, utensils, and bedding. A
shepherd's activity is accompanied not only by physical but also by emotional
stress. The profession does not rule out sustaining injuries when protecting
domestic animals from predators and robbers (Gen. 31:39). Apparently, episodes
of sleep disturbance are associated with this (Gen. 31:40). Despite the
indicated, Jacob's health – namely the state of his internal organs and
musculoskeletal system – allowed him to work intensely and successfully (Gen.
30:43). Thanks to significant physical strength, he moved and lifted large
stones (Gen. 28:18, 29:10, 31:45).
By the date of the incident that led to the injury of the hip joint, Jacob was somatically stable, but apparently was in a state of emotional stress. He faced a difficult conversation with his brother, who was accompanied by an impressive detachment (Gen. 32:7, 33:1). The patriarch was reasonably afraid of violence against himself and his family members (Gen. 32:8–9, 12). Ahead was a water barrier through which he had to lead animals, carry "his property", and cross his children (Gen. 31:18, 32:23–24). Overcoming the river was scheduled for the night (Gen. 32:22–23). The use of the dark time of day was, among other things, due to ensuring the secrecy of the crossing in order to reduce the vulnerability of the caravan to attack. At the same time, it complicated overcoming the water obstacle due to limited visibility. This undoubtedly contributed to the injury of the hip joint (Gen. 32:26). Prior to the traumatic event, no functional disorders of the musculoskeletal system were noted in Jacob. However, it is known that he used a staff while walking (Gen. 32:11). In our opinion, the additional support facilitated pedestrian movement across the natural landscape. It is less reliable that the rehabilitation aid was acquired in early childhood due to birth trauma.
[iv]
Psychological
status significantly affects the likelihood of sustaining an injury. This
section of a medical document describes the psycho-emotional state based on
personality traits, speech, behavior, external appearance, thinking,
sensations, and various aspects of cognitive activity (2015,2016SilvermanJJ_YagerJ).
The features of Jacob's personality are highlighted through the analysis of
thoughts and actions described in the Book of Genesis. We do not claim to offer
a complete reconstruction of his psychological portrait. Moreover, even an
attempt to compile it draws the image of a real person with their weaknesses
and strengths that the writers wished to demonstrate.
Jacob
possibly knew two languages, but reliably expressed himself in Akkadian. Upon
arriving in Haran, he converses without difficulty with his relatives and other
local inhabitants (Gen. 29:4–9, 12–14). His speech is classical,
understandable, logical, and in places poetic. It is not known for certain
whether he was taught writing, but his son had a personal seal (Gen. 38:18, 25).
Usually, a name was inscribed on them, allowing the owner to be identified when
concluding agreements. Probably, Jacob also used his own seal and was able to
read inscriptions on the seal impressions of his counterparties. The primary
source contains information about transactions and agreements that clearly
required a signature, for example, the conclusion of labor contracts with his
father-in-law Laban and the purchase of land in Shechem (Gen. 29:15–19,
30:28–34, 33:19).
Whether
Jacob made notes and kept texts, we do not know for certain. Papyrus for
writing was very expensive and produced in another region. Writing could be
done on dressed animal hides or, as in Mesopotamia, on wet clay. After parting
with his brother, Jacob journeyed to Succoth, where he built a house (Gen.
33:17). Presumably, the location was near the Jabbok and Jordan rivers. Near
Succoth (Sukkoth), there were deposits of clay that was later used for casting
utensils and furnishings for the Temple in Jerusalem (1 Kings 7:46; 2 Chron.
4:17). It seems unlikely to us that cuneiform tablets were created by Jacob. It
is groundless to hope for the discovery of the patriarch's tradition about the
exodus from Haran on a clay tablet. But it is not excluded that staying at the
Succoth encampment for several months in 1640–1639 BCE could have prompted the
prototype of Jacob to record what he had experienced in a text or in a story to
his kinsmen.
It
is unclear where, but Jacob was clearly trained in mathematics. He knew
numbers, understood their meaning and difference, for example "one",
"two", "three", and "seven" (Gen. 31:22–23,
32:8–9). Counting up to a thousand was accessible to him (Gen. 32:7, 15–16). He
added two-digit numbers well and knew how to divide (Gen. 31:41, 32:8). He
possessed an understanding of "difference" and
"multiplication" (Gen. 31:9, 16, 35:11). Undoubtedly, the patriarch
knew the sequence of climatic changes in nature, the geography of the Near East
region, its flora and fauna, and political formations (Gen. 42:1–2). Political
and tribal-clan relations were understandable to the head of the family and
were taken into account during work and life among various peoples. Jacob
understood what commodity-money relations were and made wide use of them (Gen.
31:15, 18, 33:19). Working for a relative under contract, he effectively
engaged in selective breeding when raising livestock (Gen. 30:42–43). For a
Bronze Age person, Jacob was a satisfactorily educated individual.
By
character, Jacob is described as a "meek man" (1978БроерМ_ЙосифонД,a, Gen. 25:27); "plain man"
(1922LeeserI, Gen. 25:27). According to V.I. Dahl, the concept of
"meek" means: "quiet, modest, humble, loving, lenient; not
hot-tempered, not prone to anger, long-suffering". (1881ДальВИ). He was his mother's favorite son,
distinguished by gentleness, obedience, conscientiousness, and honesty (Gen.
25:28, 27:8–14, 43–45). A specific trait of his was impressionability, which
manifested in visions and vivid dreams during significant events of his life.
Thus, after the conflict with his brother, a ladder "to heaven" with
angels ascending and descending on it appeared in a dream, and the words of God
were heard (Gen. 28:12–15). Fearing an attack by his wife's brothers, Jacob
again has a night vision, sees multicolored animals, and speaks with an angel
and God (Gen. 31:1, 10–13). At night, upon completing the crossing of the
Jabbok stream, anxious before the meeting with Esau, the patriarch in a
hallucination wrestles with an unknown power "until the rising of the
dawn" and converses with an angel (Gen. 32:25–30). During the famine,
prior to migrating to Egypt, sensing uncertainty but expecting to see his
"lost" son again, Jacob in "visions of the night" hears the
words of God (Gen. 46:2–4).
Dreams
are a common phenomenon in human life, observed during the rapid eye movement
(REM) sleep phase (2011MallickBN_MorrisonAR). Not only emotional distress, but
also a decrease in blood oxygenation can lead to vivid dreams. The most common
causes are nasal mucosal edema, an uncomfortable position in bed, and
relaxation of the soft palate and tongue muscles (2007ChokrovertyS).
Sleep
represents events of the past and anticipated future refracted by the
subconscious. In relation to Jacob, the indicated manifested to the full
extent. Telling his vision of the fight with the angel, he describes his
personal understanding of the hip joint trauma, altered by a religious
worldview. Such a consciousness in ancient times was an integral part of human
communities practically everywhere. At present, it is less common, but still
encountered.
Jacob's
sensitivity was manifested upon returning to his homeland. Thus, descending
from the Jebel Ajloun highlands into the Jordan Valley, observing the sprawling
blooming fields, sensing the scent of mixed herbs, and hearing the singing of
birds, the traveler's feelings were overwhelmed with awe. The aforementioned
was manifested in poetic words: "the angels of God met him", as well
as the epithet: "God's camp" (Gen. 32:3). In this place today is the
Jordanian city of Northern Shuna. From it indeed opens a beautiful view of the
spacious emerald plain of the Jordan River. At the beginning of the 20th
century, this territory was called a "blessed, rich country", covered
with groves of "evergreen oaks mixed with coniferous trees, wild
pistachios, pears, pomegranates, and other plants", between which were
"magnificent pastures; fresh, lush meadows completely dotted with
beautiful flowers" (1908–1913КацельсонъЛ_ГинцбургъДГ).
Jacob
was distinguished by fortitude and courage during his work as a shepherd (Gen.
31:39–40). Diligence and teachability helped him achieve material prosperity
(Gen. 30:43). Prudence, foresight, and the ability to find compromises made it
possible to avoid fatal conflicts (Gen. 31:44–45). Sociability and knowledge of
human psychology ensured a stable life and successful work activity among other
tribes (Gen. 29:1, 30:43).
[v]
In
old age, by the time of relocation to Egypt and up to the moment of his death,
Jacob retained his mind, remembered the events of his past life, and was able
to speak (Gen. 46:30, 47:8–9, 48:3–7). Walking remained within the patriarch's
capability; in particular, he departs independently after an audience with
Pharaoh (Gen. 47:7, 10). On the date of arrival in Egypt, Jacob had
satisfactory vision and hearing (Gen. 46:30, 47:8–9). From his words, it seems,
a part of the traditions was recorded, including the story of the family's
exodus from Haran. Apparently, such a general status was observed by the
Egyptian physician involved in diagnosing and treating the consequences of the
injury to the ligament of the head of femur in the father of the vizier Joseph.
Before
his death, Jacob fell ill (Gen. 48:1). As a result, the patriarch observed bed
rest, but was able to sit up in bed on his own (Gen. 48:2). On the threshold of
death, his vision became impaired: "for age, so that he could not
see" (Gen. 48:10). The function of both hands and coordination of movements
were in satisfactory condition (Gen. 48:14). By the time of the fatal outcome,
Jacob's hearing and speech were preserved (Gen. 48:18–19). The patriarch was
able to deliver a lengthy monologue filled with poetic expressions and
abstractions, mentioning each of his sons in the prophecy (Gen. 49:1–27). He
demonstrated clarity of mind and good memory for the events of his past life
(Gen. 49:29–32). The words of blessing resemble the songs of blind Egyptian
harpers intended to comfort the occupant of the tomb (2006LichtheimM).
Jacob
dies peacefully, surrounded by his family, remaining conscious, rather than as
a result of some fatal event (Gen. 49:1–2, 28). Until the minute of death, the
patriarch retained the ability to move independently: "he gathered up his
feet into the bed" (Gen. 49:33). On the date of his death, he was one
hundred and forty-seven years old (Gen. 47:28). Jacob did not reach the age of
his father, grandfather, and great-grandfather (Gen. 11:32, 25:7, 35:28).
Thus, the authors of the Book of Genesis described Jacob. A number of aspects appear to us as the result of artistic creativity. Despite this, a sense of the reality of the prototype of our hero, who lived and sustained an injury in the Middle Bronze Age, remains. Into the mouth of the literary Jacob, the words are put: "few and evil have been the days of the years of my life" (Gen. 47:9). We mentally place them as an epitaph on the unmarked grave of Yakov Ivanovich Chupin, my grandmother's brother, a soldier and worker who stoically survived the horrors of World War II and the events in his home country. The common name shared by the biblical hero and our relative brings their fates even closer together.
Title & Contents / Chapter 1 / Chapter 2 / Chapter 3 / Chapter 4 / Chapter 5 / Chapter 6 / Chapter 7 / Chapter 8 / Chapter 9 / Chapter 10 / Chapter 11 / Chapter 12 / Chapter 13 / Chapter 14 / Chapter 15 / Chapter 16 / Chapter 17 / Chapter 18 / Chapter 19 / Chapter 20 / Chapter 21 / Chapter 22 / Chapter 23 / Chapter 24 / Chapter 25 / References / Notes
Russian-language version:
Титул и оглавление / Глава 1 / Глава 2 / Глава 3 / Глава 4 / Глава 5 / Глава 6 / Глава 7 / Глава 8 / Глава 9 / Глава 10 / Глава 11 / Глава 12 / Глава 13 / Глава 14 / Глава 15 / Глава 16 / Глава 17 / Глава 18 / Глава 19 / Глава 20 / Глава 21 / Глава 22 / Глава 23 / Глава 24 / Глава 25 / Список литературы
Author of the publication
Arkhipov S.V. – Independent Researcher, MD, PhD, Orthopedic Surgeon, Medical Writer, Finland.
Correspondence: Sergey Arkhipov, e-mail: archipovsv @ gmail.com
Publication history
October 23, 2026 - online version of the book is published.
Suggested citation
Arkhipov S.V. Medical Record: The Contribution of a Middle Bronze Age Egyptian Physician to the Book of Genesis. Chapter 20. About the round ligament of the femur. October 23, 2026. https://roundligament.blogspot.com/2026/10/medical-record-chapter-20.html
Note
Keywords
hip joint, hip dislocation, osteoarthritis, ligament of the head of femur, ligamentum teres, ligamentum capitis femoris, Minoan Eruption, Bronze Age, Ancient Medicine, Ancient Egypt, Edwin Smith Papyrus, Biblical Chronology, Genesis, Genesis Protograph, Bereshit
NB! Fair practice / use: copied for the purposes of criticism, review, comment, research and private study in accordance with Copyright Laws of the US: 17 U.S.C. §107; Copyright Law of the EU: Dir. 2001/29/EC, art.5/3a,d; Copyright Law of the RU: ГК РФ ст.1274/1.1-2,7
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