An Ancient Medical Treasure at Your Fingertips

NLM's "Turning The Pages" Lets Users Explore Egyptian Medical

Papyrus On Virtually Any Computer, Anywhere

History and high-tech merge in a new offering from the National Library of Medicine (NLM), the world's largest medical library and an arm of the National Institutes of Health. It's a novel twist on NLM's popular online system, Turning The Pages, (https://ceb.nlm.nih.gov/proj/ttp/books.htm), which allows you to turn the pages of a rare book on your computer screen. Now, users can journey back to pre-book times and "unroll the scroll" or, more specifically, the Edwin Smith Papyrus, the world's oldest known surgical document. The new offering is at https://ceb.nlm.nih.gov/proj/ttp/flash/smith/smith.html.

The Smith Papyrus was written in Egyptian hieratic script around the 17th century BCE but probably based on material from a thousand years earlier. This collaborative online representation features an important new translation by James P. Allen, formerly of the Metropolitan Museum of Art, and high-resolution scans lent by the scroll's owner, the New York Academy of Medicine.

"We are delighted to collaborate with NLM in bringing the Edwin Smith Surgical Papyrus to a much wider audience and the use of interactive technology will allow researchers and the public to explore the document more deeply," said Academy President Jo Ivey Boufford, MD.

"The Smith Papyrus is extremely important," added NLM Director Donald A.B. Lindberg, MD, "because it showed for the first time that Egyptians had a scientific understanding of traumatic injuries based on observable anatomy rather than relying on magic or potions."

The text is a treatise on trauma surgery and consists of 48 cases dealing with wounds and trauma. Each case is laid out using a carefully prescribed formula: a description of the injury; diagnosis; prognosis; treatment; and further explanations of the case, which resemble footnotes.

"This papyrus is unlike most other medical papyri in that it is chiefly rational and does not usually bring the supernatural into the explanations or treatments for injuries-for instance, there is only one incantation," said Michael North, curator of the project and of rare books in the Library's History of Medicine Division.

Fortunately for potential viewers of the scroll, the computer scientists at the National Library of Medicine also relied on sound scientific principles rather than magic to devise a system that allows the unfurling of the scroll on a computer.

"The technical challenges of digitally transforming and making this scroll available on a personal computer were enormous," said George Thoma, PhD, chief of the Communications Engineering Branch at NLM's Lister Hill Center. Thoma led the Library's technical efforts and team. "The memory requirements were immense, so we had to come up with ways to manage the memory for home use. We created the illusion of rolling and unrolling by superimposing the frame by frame animation of the rolled section of the scroll on the large image of the entire papyrus."

In addition, creative animation techniques, dealing with bend modifying and lattice deformation, were necessary in order for the scroll to unroll and flip over correctly. Also, to explore the graceful, two-color calligraphy, a "zoom" mode offers a roving magnifying window, the design for which came with its own complexity.

NLM computer scientists were also faced with the challenge of putting the scroll back together in the first place. When Edwin Smith, an American dealer and collector of antiquities, acquired the papyrus in Egypt in 1862, it consisted of a single scroll about 15 feet long with some loose fragments, but it was cut into 17 columns sometime in the 19th century. The leaves had to be digitally "stitched" together to recreate the original appearance of the scroll.

"As far as I know, we may be the only Library in the world that has mastered the computation and technology to create an easily usable virtual scroll for a personal computer user," Dr. Thoma added.

The British Library created Turning The Pages, but NLM has collaborated with that institution to create its own version. There are now six books, in addition to the scroll, in the online version. Two touch-screen versions are also on view at the National Library of Medicine, on the NIH campus in Bethesda, Maryland.

For Turning The Pages technical requirements for computers: https://ceb.nlm.nih.gov/proj/ttp/requirements.htm.

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