The earliest mention of a black bag

Abstract

A black bag, needed especially for home visits, has been used since the time of Hippocrates who, in his treatise “On good manners”, gave the first detailed description of a medical bag with guidelines for the required equipment and structure. Ancient Egyptian and Palestinian references also date back at least two millenniums.

Key Words::

• Black bag
• Hippocrates
• history

General practitioners and family physicians are usually required to carry a medical bag, especially for their house-bound patients [1,2]. Nowadays, with the need for a shift towards family medicine emerging more prominently [3], it is important for general practitioners to be sufficiently equipped in order to meet most situations that can occur during house visits and emergency calls [4]. The structure of the drugs and the medical equipment in the black bag need to facilitate and accelerate everyday practice.

Tracing the origins of the introduction into practice of physicians’ bags, one runs into the wall paintings in the Temple of Kom Ombo in Egypt, a renowned medical care center of the late Ptolemaic Dynasty (circa 180–30 bc). Among the fascinating hieroglyphs on the inner face of the rear wall, which testify to significant advances in various fields of medicine, a medical kit is delineated [5]. Moreover, ancient Palestinian medical toolkits have been found in shipwrecks which could date back to Ezra's (circa 450–350 bc) or even King David's times [6].

However, the first detailed description of a medical bag, with guidelines for the required equipment and structure, is found in Hippocrates’ writings (circa 460–370 bc). In his treatise “On good manners” (De decenti habitu, original: “Πϵρίϵυσχημοσύνης”), Hippocrates mentions: “All these require arrangements, depending on the materials, so that you can have the tools, the equipment, the metallics and the rest of it (gauzes, compresses, bandages, drugs) already prepared. Because the shortage of these things creates embarrassment and causes harm. For your trips, you will carry a simple and portable kit. The most appropriate is the one which follows a methodic layout, because the physician cannot keep everything in mind.” [7]. The great Greek doctor was not far from today's notion as the main contents of the black bag include the basic tools (such as stethoscope, sphygmomanometer, flashlight), with gauzes and bandages being always indispensable [2,4]. Hippocrates did not emphasize drugs (which is the contemporary trend, too) [4], but focused more on practical and structural issues.

The question of when the first special doctor's portable bag was introduced in medical practice, which remained unresolved until recently, seems to date back to the time of Hippocrates.

Conflict of interest

None reported by any of the authors.