Thursday, April 14, 2016

Ancient Egyptian Footwork: Reflexology therapy, beauty tool or relaxing foot rub?

How much attention was paid to the feet in ancient Egypt? What exactly were Egyptians doing? And could it be that surviving artifacts of work on feet show we’re doing the same things today?

There are so many questions in time. At least five clues have survived from ancient times to provide some answers to such questions. Is reflexology among the earliest of medical practices? Did Egyptians practice reflexology? Provide manicures and pedicures? Give relaxing foot rubs? There is evidence for each.

Papyrus rendering of pictograph  from the Tomb of the Physician, Ankhmahor, Saqqara, 2323 B. C. E.

The Artifacts
Egyptologists study artifacts and their placement such as the location of pictographs in tombs and on temples to glean information about their meanings.

Bas-relief pictograph carvings and a report from an ancient historian provide illustrations of Ancient Egyptian footwork:

  • A pictograph carving from the Tomb of the Physician is disputed as representing therapy, a foot operation or a pedicure. 
  • A pictograph carving in the tomb of Ptah-hotep, a pharaoh’s official, noted as representing pedicure and manicure
• A pictograph carving of manicure and pedicure at tomb of Niankhkhnumin and Khnumhotep
  • A pictograph carving of “tending to feet” is included with others representing victory at the battle of Kadesh on one of the temples built by Rameses II
  • A historian’s account of Mark Anthony rubbing Cleopatra’s feet at dinner parties

Artifacts found in Saqqara, city of the dead

The stepped pyramid, tomb of Teti, First Pharaoh, Sixth Dynasty, 2323-2291 B. C. E., Photograph by Trudy Baker

Egyptian pyramids served as burial chambers of the pharaohs. Saqqara served as a testing ground for pyramid construction and burial ground of Egyptian pharaohs from the earliest organization of the civilizations of Egypt’s upper and lower Nile Valley, the First Dynasty in 2750 B. C. E. For over a thousand years, Saqqara was a necropolis, a city of the dead for pharaohs.

The grounds of Egyptian pyramids came to resemble graveyards with individual tombs for government officials, royal family members, and those who could afford the expense.

Three of the foot work artifacts are found in individual official’s tombs in Saqqara: Ankhmahor (Tomb of the Physician), Khentika and Ptah-hotep.

The Pictograph from the Tomb of the Physician

The pictograph and accompanying hieroglyphic from The Tomb of the Physician, Ankhmahor are the earliest known artifacts of reflexology, and some would argue, one of the earliest of any type of medical practice. 

The Tomb lies to the north of the pyramid of the pharaoh Teti in “Teti’s cemetery,” the graveyard of the pharaoh’s officials. Teti ruled from 2323 to 2291 B. C. E. as the First Pharaoh of Egypt’s Sixth Dynasty. The stepped pyramid is one of the earlier experiments in pyramid building perfected by ancient builders in the smooth sided pyramids at Giza.

Entrance to Ankmahor’s Tomb (Tomb of the Physician), Saqqara, Egypt, date: 2350 BCE, Photograph by Trudy Baker

In the entrance hall to the left are pictograph carvings of working on feet and hands. The placement of such carvings in an entrance typically signified the profession of the individual. The tomb is referred to as “Tomb of the Physician.” As an official to the pharaoh Teti, Ankhmahor’s titles include: “Vizier,” “First after the King,” “Overseer of the Great House.”

There are two series of pictographs with accompanying hieroglyphs. 

One appears to show therapy. It (half of which is shown below) depicts an “operator” and “patient” with the toe of the left foot being “treated.” The other half of this pictograph shows an “operator” and “patient” with the left hand being “treated.”

The hieroglyphs accompanying the pictograph read: “‘Make these give strength!’ To which the operator responds: ‘I will do thy pleasure, sovereign!’ This answer inscribed between the two operators, could also be valid for the one to the right, who treats the toe of a patient who is begging: ‘Do not cause pain!’”

Above this familiar pictograph is another pictograph of work on hands, The pictograph is virtually identical to a pictograph found in the Mastaba of Khentika clearly defined as manicure and pedicure. 

The hieroglyphs accompanying the second  Ankhm’ahor pictograph read: “… representing a patient whose two hands are being treated simultaneously by two operators flanking him The inscription giving the patient’s utterance is badly defaced (and virtually illegible) ‘ … by thy life!’ And the answer of the operator to the left is ‘I will make this agreeable, dear!’ This last inscription is … above a similar scene defined as manicure and pedicure in the Mastaba of Khentika.” (Badawy, Alexander, The Tomb of Nyhetep-Ptah and the Tomb of Ankhm’ahor at Saqqara,  University of California Press, 1978)

What is the pictograph in the Tomb of the Physician?
What is represented by the Egyptian pictograph of work on feet from the Tomb of the Physician? Ask four different Egyptologists and you get fourdifferent answers. Egyptologists have argued that the pictograph depicted therapy, reflexology, an operation, or a pedicure/manicure.

Pictograph as Therapy
At least three Egyptian scholars credit and defend a therapeutic aspect to the work displayed in the pictograph.

  • “… The most well-known is that of Ankhmahor, who held the titles of vizier, 'first after the king' and Overseer of the Great House. This tomb is also known as the Tomb of the Physician, as his bas-reliefs depict a foot operation and a circumcision in addition to the usual scenes of daily life and funerary themes.” (Siliotti, Alberto, Guide to the Pyramids of Egypt, Barnes and Noble, 1997, p. 121)

  • “In the same ancient Empire tomb that displays the operation of circumcision, some reliefs illustrate care given to the hands and feet, and it has been suggested that they represent manicure and pedicure (see below), in spite of the fact that the hand of the practitioner, applied to the shoulder in one figure and to the knee in another, rule out this possibility, and strongly suggest some form of massage or manipulation.” (Ghalioungui, p. and ElDawakhly, Z., Health and Healing in Ancient Egypt, The Egyptian Organization for Authorship and Translation, pp. 25-26)

  • As further indication that the Tomb is that of a medical practitioner some Egyptologists argue that Ankmahor would be identified by the title of manicurist and pedicurist. After all manicurists and pedicurists in other tombs are identified by this title. See below. “But nothing in Ankhmahor's tomb indicates that the men depicted at work bore such honorable titles. Should further proof be needed, we could find it, according to Prof. Clamminess of Copenhagen, in the position of the arm of the manipulator.” Egyptians followed two particular positions when representing the arm in profile. “That both positions are shown in different persons of the same scene shows that the second position is not merely the result of an artistic convention designed no to mask the distant arm. ... The position adopted by the manipulator on these scenes is thus a correct rendering of the (massage) movement.” (Ghalioungui, p. and ElDawakhly, Z., Health and Healing in Ancient Egypt, The Egyptian Organization for Authorship and Translation, pp. 25-26)

Pictograph as Reflexology
In his book Ancient Egyptian Medicine, Dr. John F. Nunn is the first Egyptologist to label the pictograph in Ankhmahor’s Tomb of the Physician in Saqara as reflexology. Previously, Egyptologists had argued that the pictograph depicted therapy, an operation, or a pedicure/manicure. “Alternatively, it has been suggested that these scenes represent a form of reflexology and current illustration of this type of treatment certainly look remarkably like these tomb reliefs (pictographs from Ankhmahor's Tomb and Khentika's Tomb at Saqqara memorializing two viziers to Teti, 6th dynasty (2345-2040)).”

Dr. Nunn notes of the work on feet and hands depicted in Ankhmahor's tomb, “It is again inconceivable that the Egyptians had not discovered the beneficial and pleasurable effects of manipulation and massage... Figure 6.14 shows the remarkable scenes in the tombs of Ankh-ma-hor and Khentika, which appear to represent manipulation of fingers and toes. This could be manicure and pedicure, but the words of the patients and therapists shown in the figure suggest very strongly that a therapeutic effect is intended. Alternatively, it has been suggested that these scenes represent a form of reflexology and current illustration of this type of treatment certainly look remarkably like these tomb reliefs (pictographs from Ankhmahor's Tomb and Khentika's Tomb at Saqqara memorializing two viziers to Teti, 6th dynasty (2345-2040)).” (p. 133)

Dr. Nunn adds to the mystery of the pictograph. In his discussion of “The Healers” which includes types of medical practice and the names of known physicians, he notes that Ankhmahor was not a physician but a ka-priest and vizier to the pharaoh Teti.

A physician is depicted by pictograph in Ankmahor’s Tomb, Ankh, an individual whose pictograph indicates that he was a physician. In “Notes on ten selected pharaonic doctors,” Dr. Nunn discusses the possibility that Ankh was a friend or physical to Ankhmahor, represented to provide medical care in his afterlife:
 “We have no knowledge of Ankh’s tomb. He is, however, an example of the many doctors known to posterity only because of mention in a relief on the wall of someone else’s tomb, in this case a tomb of exceptional interest from the medical point of view. Ankh is seen bearing four ducks as offerings in the funerary procession of the tomb owner Ankh-ma-hor. In front of him in his title and name, swne per aa Ankh. As court physician he might well have been a personal friend of Ankh-ma-hor, or perhaps he was his doctor (or both). Those represented in reliefs were believed to be accessible to the tomb owner in the hereafter, and there might be distinct advantage in having your own doctor with you in the afterworld.” An illustration accompanies the discussion: “(A) Relief of the physician of the great house (i. e. palace) Ankh as an offering bearer in the tomb of Ankh-ma-hor (6th Dynasty, Saqqara)” (p. 126)

Some argue that Ankhmahor’s tomb in Saqqara has been mislabeled as the Tomb of the Physician. Many agree that the inclusion of pictographs representing medical practices of the time provides invaluable insights of the times. Nunn notes that “... Ankhmahor possessed many important titles but none of direct relevance to medicine. Nevertheless, his tomb contains no fewer than seven items of medical interest to us today. (List includes the physician Ankh, circumcision, “manipulation of toes and fingers,” “hydrocele,” “achonodroplasiac” dwarfs, obesity, gynaecomastia)... We are fortunate that Ankh-ma-hor should have chosen to display this remarkable concentration of items of medical interest. There is evidence he went to great trouble in the planning, supervision and even the alteration of the reliefs in his tomb.” (p. 126)

Pictograph as foot operation
“It (Ankhmahor's Tomb) is popularly known as the ‘Physician's Tomb’ because although Ankhmahor was not himself a physician his monument contains some interesting scenes of medical practices... Another relief shows a foot operation being performed - sited (sic) by many reflexologists as proof of ancient alternative therapies practiced (sic) on the hands and feet." (

Both pictographs in Ankhmahor’s Tomb as pedicure and manicure

A Danish Egyptologist labels an illustration of the well-known pictograph of work on feet and hands as pedicure and manicure work.[2] One scholar declares that there is an instrument held in the working hands depicted in the pictograph thus supporting the pedicure/manicure theory. Another scholar notes that pictographs of work on feet and hands are common throughout the pyramids of Egypt’s Old Kingdom. He reports that the commonly held belief among Egyptologists is that all depict pedicure and manicure work. (Reeder's Egypt Page, the Internet)

Photo credit Trudy Baker

Pictoglyph of manicure and pedicure at tomb of Ptah-hotep
Ghalioungui and ElDawakhly note that at the time of pharaohs "... in his tomb in Saqqara, Ptah-Hotep is having his fingers and toes manicured." Ptah-Hotep was the vizier and judge supervising the pyramids of recently dead pharaohs. He served as an official for pharaohs Djedkare Isei and Unas, the eighth and ninth pharaohs of the Fifth Dynasty (2450-2321 B. C.).

Another Egyptologist notes, “The chapel of Ptah-Hotep (’s tomb) in particular contains another series of lovely painted bas-reliefs, once more with offering scenes where original details can be noted (such as that the whippets under the owner's chair, and that of the servant who massages his legs).”

Pictoglyph of manicure and pedicure in the tomb of Niankhkhnumin and Khnumhotep
Providers of such services held a special place in the culture of the times. Tombs were built for only a few private individuals. Pictographs carved into the left die of entry to the tomb of Niankhkhnumin and Khnumhotep read “Royal confidant … in work manicurist Palace Chief Manicurist … King’s Acquaintance Niankhkhnumin”. The right side reads the same but includes the name Khnumhotep. The Tomb in Saqqara dates from the time of the sixth king of the Fifth Dynasty. (2400 B. C. E.)

Tending to Feet, Battle of Kadesh
Pharaoh Ramesses II lead some 20,000 soldiers in 1275 B. C. E. on a long march from Egypt to Kadesh, a town close to what is now the border of Lebanon and Syria. The goal was to secure the territory for Egyptian domination from the Hittite Empire. Ramesses would claim victory in the battle and document the victory with the building of temples in his name.  “Tending” to the feet of foot soldiers during the long trek is shown among pictographs celebrating the victory on the wall of a temple. Ramesses II ruled Egypt from 1279-1213 B. C. E. as the Third Pharaoh of the Nineteenth Dynasty.

Anthony and Cleopatra
Roman emperor Octavian complained of Mark Anthony’s “pathetic enslavement to her (Cleopatra) -- he even massaged her feet at dinner parties.” Cleopatra, born in 69 B. C. E., ruled Egypt during the Greco-Roman Period from 51-30 B. C. E.

The statement adds an intriguing piece of information to a topic of interest to many reflexologists. 

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