A copy of the publication on the portal: medium.com
Interdisciplinary analysis of the world's first medical case history
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Fragment of an
Ancient Egyptian Stela Cairo CG 20023. Reproduction featuring digital colour
correction and tone inversion based on a negative photograph (AI-generated
image based on the original historical photograph). |
The present work (A Bronze Age Medical Case History, 2026) is based on a medical hypothesis formulated by the author. According to this assumption, the protograph of the Book of Genesis was written in Egypt in the late 17th century BCE following the Minoan eruption, with the participation of an encyclopaedic physician. The formulated hypothesis undoubtedly requires comprehensive discussion by the interdisciplinary research community.
The theoretical possibility of such a work
appearing in the Nile Valley finds support in the history of writing. The
earliest texts were compiled in the Tigris – Euphrates basin and Ancient Egypt.
In this regard, concerning the numerous Mesopotamian writings that have come
down to us, Academician B. A. Turaev noted: "Babylonian literature,
throughout its centuries-long existence, shows so little development that, in
the words of its recent describer Weber, 'it is often difficult to decide
whether a given text belongs to the 20th or the 7th century BCE'" (1920ТураевБА). In contrast to this, starting from the
archaic period, a gradual progression of the literary word can be traced in
Egypt. Linguists note a remarkable variety of texts created during the Middle
Kingdom, truly the golden age of ancient Egyptian literature. It has been observed
that "Egyptian culture influenced surrounding peoples more than the latter
influenced the Egyptians. … if we discover in the literature of any people
phenomena and features not intrinsic to it, but typical of Egypt, we can safely
consider them Egyptian borrowings, even if it is impossible to trace
step-by-step the path of this borrowing or influence" (2001КоростовцевМА). "On the whole, ancient Egyptian
literature was more a giving than a borrowing literature, exerting influence
rather than being influenced by it" (1978КоростовцевМ).
In the Book of Genesis, we have noted multiple
literary parallels, cosmogonic similarities, ethical correspondences, lexical
and cultural borrowings, various inversions, and narrative convergences with
ancient Egyptian, Mesopotamian, and Hittite texts. Based on the analysis
carried out, taking into account archaeological, historical, and scientific
data, we believe that the Book of Genesis is a high-level compilation. Its
Hebrew version is a translation from the ancient Egyptian language.
The scope of the work and the use of diverse
source material imply the participation of two authors well-versed in the
scientific, social, technical, and technological achievements of the Ancient
Near East and North Africa. The first was a scribe-administrator, apparently of
Asian descent, while the second was an erudite, materialistic Egyptian
physician. We cannot rule out the possibility that the co-authors were ethnic
Egyptians, working on commission for an influential official of the 15th Dynasty
who was of Asian origin. We believe the protograph appeared in the Nile Delta
within the scriptorium of the House of Life, which possessed a rich collection
of manuscripts. Heliopolis and Avaris appear to be the most likely locations
for its direct composition.
The scribe recorded the genealogy and family
traditions of the Asian client, as well as Mesopotamian jurisprudence and
myths, thus creating a powerful Near Eastern stratum. The doctor endowed the
narratives with the empirical reliability characteristic of Egyptian
literature, including the use of medical knowledge and observations. The
archaic polymath-level healer reflected a wide spectrum of nosological
conditions: Charles Bonnet syndrome, congenital hypertrichosis, parasitic brain
infection, genetically conditioned polycystic ovary syndrome, myopia, anthrax,
hip joint injury, obstructive sleep apnoea, or Undine's curse. Among the
biblical verses are accounts of dangerous states during physiological
processes, disease complications, and surgical operations: inflammation
following circumcision, prolapse of small foetal parts in multiple pregnancy,
fatal outcome of postpartum haemorrhage, blindness due to trachoma, hypnagogic
hallucination, and dreams during nocturnal hypoxaemia. Particularly noteworthy
in the primary source are: a rib resection project under anaesthesia,
anticipation of genetic and cellular modification with subsequent incubation of
a person of the opposite sex. In the narrative about the participation of
physicians in embalming, one can discern the earliest evidence of a
pathoanatomical examination. Apparently, for educational purposes, the basic
elements of human conception physiology are expounded and a folk method for
treating infertility is debunked. The text also features observational,
sanitary, and hygienic measures that later became the basis for the prevention
of infectious diseases and the control of epidemics. It is important to
emphasise here that ancient physicians recorded external manifestations rather
than modern diagnoses in their strict clinical sense. However, this does not
diminish their acuity of observation and attention to detail regarding
nosologies known since ancient times.
The literary document we studied initially had
no religious significance. The mention of supernatural entities is quite usual
for Bronze Age narrative literature, as well as for the writings of Egyptian
physicians. Unfortunately, almost nothing is known from textual sources about
the level of medical knowledge in the Old Kingdom (ca. 2650–2135 BCE). Written
evidence from the Middle Kingdom (ca. 2040–1650 BCE) points to relatively
developed concepts in the biomedical sciences. The surviving works—the Gynaecological
Papyrus, the Veterinary Papyrus, and the Ramesseum Papyri—are saturated with
magic, yet contain elements of a rational approach to diseases. The Edwin Smith
Papyrus, created later (1650–1550 BCE), proves to be anomalously materialistic.
The Ebers Papyrus, the Hearst Medical Papyrus, and the Berlin Papyrus (Erman Papyrus), which appeared in the New Kingdom (ca.
1550–1080 BCE), once again slip back into the realm of mystification.
Consequently, in the relatively narrow
historical Second Intermediate Period (1650–1550 BCE), the physicians of
Ancient Egypt were reliably progressive and pragmatic, resorting to
supernatural forces only in incurable cases. A similar clinical observation is
contained, in our view, in a contemporary of the Edwin Smith Papyrus—the Book
of Genesis. In its 32nd chapter, we find a realistic narrative concerning the
injury to the ligament of the head of femur, symptomatology, pathological
anatomy, and differential diagnosis. Such a case could not have been invented
by Asian nomadic pastoralists, but only by representatives of a highly
educated, sedentary community.
Even today, injury to the ligament of the head
of femur puzzles practising physicians. There is no consensus regarding either
its role or the approaches to treating its injuries. In view of the above, we
have named this anatomical structure of the body ligamentum incognitum, thereby
supplementing the list of dozens of Latin synonyms (2004Архипов-БалтийскийСВ; 2018АрхиповСВ). This terminological diversity uniquely underscores
the ambiguity of views concerning the ligament of the head of femur. At the
same time, its designation was approved by the decision of the 15th
International Anatomical Congress (1999): ligamentum capitis femoris in Latin,
and ligament of head of femur in English (2003КолесниковЛЛ). For over a quarter of a century, scientific
publications have continued to use the outdated name ligamentum teres
(round-oblong ligament) and its equivalent, round ligament. The term was
introduced into scientific circulation by Galen of Pergamon (2nd–3rd
centuries), who named the ligament of the head of femur σύνδεσμον δὲ στρογγύλον (round syndesmosis) in his treatise On the
Usefulness of the Parts of the Body (1822KühnCG; 2020ArkhipovSV_ProlyginaIV).
For nearly two millennia, physicians have similarly named the ligament of the
head of femur in their native languages. Paradoxically, while using the term of
Galen of Pergamon, physicians are unwilling to heed his words regarding the
importance of this anatomical element (1829KühnCG; 2020ArkhipovSV_ProlyginaIV).
The appearance, structure, and
normal attachments, along with pathological variants of the ligament of the
head of femur, are exceptionally diverse. This introduces even greater
uncertainty into the attitudes of practising doctors and researchers towards
it. As an allegory for the ligament of the head of femur, the words from the
Aeneid (IV:568–570) describing Aurora are appropriate: "Woman is ever a fickle and changing
thing" (1979Вергилий).
The normal human ligament of the head of femur
is small in size, measuring 2–3 cm, and is localised within the osteochondral
cavity of the deepest-seated joint. In the Russian folk tale The Frog Princess,
the life-needle of Koshchei the Deathless was similarly securely concealed:
"the needle is in the egg, the egg is in the duck, the duck is in the
hare, the hare is in the chest." The hard-to-reach region of function of
the ligament of the head of femur creates significant difficulties for its
visualisation. At the same time, since ancient times humans have dismembered
their own kind while practising cannibalism and preparing bodies for burial
(2016MariottiV_CondemiS; 2024YeZ_LiFJ; 2025HungHC_MatsumuraH). Authentically
since the Late Palaeolithic era, humans have known of the presence of the
ligament of the head of femur within themselves. In the Egypt of the Second
Intermediate Period, cannibalism was not recorded, nor were arthrotomies performed
for research purposes or during the mummification of the dead. However, rare
cases of open hip dislocation allowed for the direct observation of such a
difficult-to-study anatomical element. Such an opportunity could have been
provided by falls from a height by pyramid builders, attacks by large animals
on shepherds, and sports injuries.
Scenes of wrestling featuring brutal techniques
of twisting the leg at the hip joint are present in the paintings of a number
of Middle Kingdom tombs in Beni Hasan. Examining them, it appears that at the
height of the combat, a ruthless wrestler was capable, at the very least, of
damaging his partner's ligament of the head of femur. The consequence of such
an injury is always a specific, incurable limping "upon his thigh"
(in Old Testament terminology). The authors of the Book of Genesis describe a
similar hip joint injury in the patriarch Jacob, blessed by an angel and God
(Gen. 32:25–33, 35:10–13; here and hereafter the Pentateuch is cited according
to 1978БроерМ_ЙосифонД,a). Ideal, invulnerable characters in works of
fiction rarely evoke empathy. Vulnerability makes a hero come alive. Later,
Homer would also devise a hip injury for the favourites of the gods, Aeneas
(Iliad, V:302–310) and Odysseus (Odyssey, XIX:448–464) (1953,1960Гомер). Both, apparently, limped after their
injuries, which brought their images closer to Jacob and also to the powerful,
lame god Hephaestus (1999ГаспаровМЛ). In the
ancient world, wrestling was seen as an earthly reflection of mythological scenes,
a form of communication with supernatural entities, and a ritual for
maintaining order in nature. For example, duels in the pre-Greek Minoan culture
bore a sacred character, which is reflected in the frescoes of the houses of
Akrotiri (2007НемировскийАИ). Wrestling
competitions in honour of the gods became an integral part of the Ancient
Olympic Games from the 8th century BCE onwards, and consequently, so did the
"honourable" hip injuries sustained in bouts.
The Book of Genesis does not specify the identity
of the opponent who injured Jacob during the wrestling match. From the text,
one may assume that it was a man, an angel, or God (Gen. 32:25, 29, 35:10).
This ambiguity was reflected in the work of medieval and modern artists who
created over a hundred paintings, icons, and engravings on this subject (2024АрхиповСВ). Naturally, the medical component of the Old
Testament battle was not taken into account by them. In the Middle Kingdom of
Egypt, the literary Sinuhe boasted that he had fought and defeated the
strongman of the land of Retenu (1956КацнельсонИС_МендельсонФЛ). As can be
understood from the Mesopotamian Epic of Gilgamesh, a spirit fought with the
sick Enkidu (1961ДьяконовИМ). In the
Akkadian culture of the Old Babylonian period (2000–1600 BCE), disease demons
were depicted in the form of men (1963PinchesTG; 2011FinkelIL). In a number of
cases, humanoid figures of the bearers of demonic forces were drawn with a
tail, horns (or long ears), and a narrow muzzle (2016ZilbergP_HorowitzW).
According to a Hittite ritual text, a certain king wrestles with a goddess
(1983TsevatM; 2003УолтонДХ_ЧавалесМУ). Appealing to the desire for suspense, the
creators of the Book of Genesis implied all such characters simultaneously.
Each of them was capable of dislocating the hip of the Old Testament patriarch.
However, that this resulted in damage to the ligament of the head of femur
could not have been known by a writer without medical training, an
understanding of anatomy, and a grasp of the biomechanics of the musculoskeletal
system.
During forced rotation in the hip joint, the
ligament of the head of femur can be injured as a result of stretching, as well
as by being pressed by the femoral head against the inner margin of the lunate
surface of the acetabulum. In a similar manner, in the ancient Greek myth, the
colliding rocks of the Symplegades crushed ships sailing past (2004КунНА). Retrospectively, it is difficult to choose
"between Scylla and Charybdis," specifically between the probability
of intensive stretching and the shearing force acting upon the ligament of the
head of femur. A probing ancient doctor could have conducted an experiment on
the hip joint of a vertebrate animal. Through empirical trial, it was possible
to ascertain the preferred mechanism of injury to the ligament of the head of
femur, including in humans. Moreover, with a good understanding of the
structure of the hip joint, it is not difficult to guess how one can touch and
transect the ligament of the head of femur without dislocation. Spoiler: this
can be achieved using an instrument inserted into the acetabular notch. One
would like to believe that the Book of Genesis hints at this with a certain
degree of fairy-tale embellishment (Gen. 32:33). Entering the central
compartment of the hip joint via such a portal makes it possible to reduce the
invasiveness and cost of an arthroscopic operation (2025ArkhipovSV).
The compilers of the Coffin Texts in 2134–2040
BCE were the first to contemplate the repair of articular ligaments. In particular,
on one of the ancient Egyptian coffins, inscribed for the pacification of the
deceased, is the phrase: the goddess "Nut has come so that she may join
your bones together, knit up your sinews, make your members firm"
(1978FaulknerRO). The technique for suturing a ruptured ligament of the head of
femur has not yet been developed, but a variant of its reconstruction was first
proposed in the early 20th century (1926,1927HeyGrovesEW). Exactly a hundred
years have passed, yet for some mysterious reason, no modification of such an
operation has ever become routine. At the same time, the method for
reconstructing the anterior cruciate ligament, introduced more than a century
ago, is actively developing (1917HeyGrovesEW). Today, arthroscopic
reconstruction of this ligament is cited as the foremost among the most common
elective orthopaedic operations (2021BlomAW_KunutsorSK). Papers devoted to the
treatment of an injured anterior cruciate ligament constitute the largest
proportion of publications in journals specialising in arthroscopy and knee
joint sports medicine (2026KambhampatiSB_VaishA). We believe that in time, the
topic of reconstructing the ligament of the head of femur will top the rankings
of citations. Therefore, we continue to study this morphological element and
share our ideas, realising that the gathered material will serve as a basis for
research by future generations of colleagues.
The author of these lines first paid attention
to the Old Testament narrative recounting a hip joint injury when he was a
student. Thirty-five years have passed since then. Episodic reflections on the
medical aspects of the biblical event evolved into a desire to clarify where
and when the epic itself appeared. Gradually, a complex of facts accumulated,
pointing to an earlier origin of the Book of Genesis than is commonly believed.
Their analysis transformed into the monograph: 50 Tables of Evidence for the
Composition of Genesis in Late Second Intermediate Period Egypt. The
aforementioned work only partially touched upon the medical aspect of our
primary source. To remedy this, the book Medical Record: The Contribution of a
Middle Bronze Age Egyptian Physician to the Book of Genesis was written. The
present work unites these two monographs, including an analysis of linguistic,
archaeological, historical, natural science, and medical data discovered in the
primary source. It would seem that anyone wishing to familiarise themselves
with our hypothesis will find it more convenient to have all the material we
have gathered close at hand. The book is concentrated on the episode of the
injury to the ligament of the head of femur, which is discussed in the first
part of the work. Following this, tables containing a list of biblical texts
and their correspondences in the texts and traditions of the Middle Bronze Age
are placed as an appendix. To compile them, we studied available written
monuments created for the most part in the period between the Old and New
Kingdoms of Egypt, as well as contemporary Mesopotamian texts. These were
examples of fiction, myths, inscriptions on pyramid walls, sarcophagi, and
stelae. We took into account the synthesis of philologists, archaeological and
medical data, and familiarised ourselves with the history and technologies of
the Bronze and Iron Ages of Egypt and the Near East. In the tables, opposite
selected verses from the Book of Genesis, quotations from ancient texts close
in meaning, fragments of Egyptological commentaries, and linguists' conclusions
are placed. In some cases, references to archaeological findings and
information from the history of medicine are provided. To the initially formed
two columns—containing the text of the Book of Genesis and the Egyptian-Asian
parallels—a third has been added, including the identified type of similarity
and its rationale. Such tables have been compiled for each chapter of our
primary source, indicating the oldest analogies, parallels, and borrowings from
Egyptian and Mesopotamian culture that we have discovered. It is assumed that
the interested reader will turn to this section to verify the author's
judgements.
The main purpose presented to the reader's
judgement in the work has been the popularisation of our own point of view
regarding the dating of the earliest mention of an injury to the human ligament
of the head of femur. At the same time, the monograph continues the discussion
on the essence of the Book of Genesis and the level of medical knowledge in the
Bronze Age. It is difficult to predict whether this work will become a stimulus
for the reformation of religious and philosophical thought due to the
neutralisation of the sacredness of a fundamental section of the Bible. This
cannot be ruled out, realising that the Book of Genesis is a work of fiction
based on the traditions of the Middle Bronze Age, yet one must live in the
present and look to the future. At the very least, we hope that the presented
publication will serve the cause of improving the diagnosis and treatment of
pathologies of the ligament of the head of femur—an urgent task of modern
orthopaedics. It is to be hoped that in the twenty-first century, it will
finally be possible to develop a technique for its effective reconstruction and
to equip a hip joint
endoprosthesis with an analogue of the ligament of the head of femur.
More details:
Arkhipov
S.V. A
Bronze Age Medical Case History: Interpreting the Book
of Genesis in the Light of Modern Medicine. Kyrö: Author’s Edition, 2026. – 808 pp. – 52 tables.
– Bibliographical references: 959 entries. (a synthesis of two previous monographs).
Available for free access at the following link: http://books.google.com/books/about?id=viIpEgAAQBAJ
Information about the book, along with the manuscript itself, can be accessed via this link: https://roundligament.blogspot.com/2026/11/a-bronze-age-medical-case-history-title.html
Arkhipov SV, Prolygina IV. Ancient
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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
11.11.2026 publication on the portal: medium.com
Suggested citation
Arkhipov S.V. Interdisciplinary analysis of the world's first medical case history. About the round ligament of the femur. November 14, 2026.
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
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