is increased by its own fat, and is displaced; there may be much fat contained within its covering or pericardium. If in a suppurative disease the heart is pushed forward it floats or sinks in the fluid and is displaced.’ Here we surely have a reference to pericardial effusion.... ‘If the heart trembles or palpitates, has little power, and sinks downwards, the disease is advancing. When there is much beating at the praecordia, with a feeling of weight, when the mouth is hot and languid, and the heart is exhausted the disease is a fever or inflammation.’ In another place (folio 102) the heart is spoken of as being full of blood which comes or flows from it again. In folio 39, after a description of symptoms, follows a statement to the effect that the heart is distended, the sick man is short of breath because the blood has stagnated and does not circulate. This is an interesting expression, but judging from other parts of the papyrus the word translated circulate can only have a vague meaning, implying movement to and fro, just like the expression ‘περίοδος αἴµατος’ in the Hippocratic writings, which seems to imply the circuit of the blood, but in reality has only a similar indefinite meaning. It is evident that the Egyptians knew that blood flowed from the heart, but, like the Greeks, they never seem to have realized that the heart is a pump, nor did they recognize valves. The Leyden medical papyrus speaks of a paralysis or disturbance of some sort in the blood-vessels of the head, causing blindness and disorder in the body and in the limbs; this seems to be a description of the results of cerebral haemorrhage. Remedies are suggested to subdue the vascular activity occurring in certain diseases.[20] The Passalaqua papyrus is rather interesting. It was found in an earthen jar at Thebes, and deals largely with leprosy (which prevailed greatly in ancient Egypt). This papyrus appears to date from the time of Mencheres of the fourth dynasty, and for many centuries was enclosed in a case or box beneath the feet of the figure of the god Anubis, and forgotten for ages. It was rediscovered in the reign of a later monarch, and recopied on to a new roll of papyrus.[21] The British Museum papyrus dates back, as regards the major part of its contents, to the time of Khufu or Cheops the pyramid builder. It bears some evidence of Semitic influence. In the section on the treatment of wounds it contains the following prayer:—‘Oh Ra, creator of the gods, pass ye me along, renew ye me, avert from me all evil things, all evil maladies, all wounds in the flesh of these limbs.’[22] In earlier times these prayers are much more common than during the later dynasties, when the physician seems to have relied more upon treatment.