Health, Illnesses and Medicine in Mesopotamia | Middle East And North Africa

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HEALTH IN MESOPOTAMIA

20120208-Amulet to ward off plague.jpg
Amulet to ward off plague
Anthropologist J. Lawrence Angel discovered that 30,000 years ago men averaged 5 feet 11 and women averaged 5 foot 6. In Greco-Roman times men were 5 foot 6 and women were 5 foot 0. In 1960, American men were 5 foot 9. Angel also estimated that on average men lived to be 33.3 years old and women 28.7 years old during paleolithic times and that men had lost an average of 2.2 teeth when died: 3.5 teeth in 6,500 B.C.; 6.6 missing in Roman times.

Illness had traditionally been thought of as punishment from the gods. Even so Sumerian cuneiform tablets relate that Mesopotamians had some awareness of deadly pathogens in 1770 B.C. Excavation of Assyrian tombs belonging to the elite, perhaps kings and queens, revealed that the people had few cavities but suffered from dental abscesses. Many ancient people believed that tooth pain was caused by creatures called toothworms. Describing one such worm a Babylonian poet wrote:
” The earth had created the rivers...
The marsh had created the worm
The worm went weeping...
Lift me up among the teeth
And the gums cause me to dwell!
The blood of the tooth I will suck.
And the gums will I gnaw the roots!”

Nancy Demand of Indiana University wrote: “Mesopotamian diseases are often blamed on pre-existing spirits: gods, ghosts, etc. However, each spirit was held responsible for only one of what we would call a disease in any one part of the body. So usually "Hand of God X" of the stomach corresponds to what we call a disease of the stomach. A number of diseases simply were identified by names, "bennu" for example. Also, it was recognized that various organs could simply malfunction, causing illness. Gods could also be blamed at a higher level for causing named diseases or malfunctioning of organs, although in some cases this was a way of saying that symptom X was not independent as usual, but was caused in this case by disease Y. It can also be shown that the plants used in treatment were generally used to treat the symptoms of the disease, and were not the sorts of things generally given for magical purposes to such a spirit. Presumably specific offerings were made to a particular god or ghost when it was considered to be a causative factor, but these offerings are not indicated in the medical texts, and must have been found in other texts. [Source: The Asclepion, Prof.Nancy Demand, Indiana University - Bloomington]

Analysis of excavated Assyrian skeletons revealed signs of sinus infections, poor nutrition and good nutrition, high fevers and thickness of the skull associated with meningitis. The "eye for an eye" phrase came from a list of penalties for surgeons on the Code of Hammurabi. If a surgeon caused someone to lose an eye through negligence the surgeon could lose his eyes.

Websites and Resources on Mesopotamia: Ancient History Encyclopedia ancient.eu.com/Mesopotamia ; Mesopotamia University of Chicago site mesopotamia.lib.uchicago.edu; British Museum mesopotamia.co.uk ; Internet Ancient History Sourcebook: Mesopotamia sourcebooks.fordham.edu ; Louvre louvre.fr/llv/oeuvres/detail_periode.jsp ; Metropolitan Museum of Art metmuseum.org/toah ; University of Pennsylvania Museum of Archaeology and Anthropology penn.museum/sites/iraq ; Oriental Institute of the University of Chicago uchicago.edu/museum/highlights/meso ; Iraq Museum Database oi.uchicago.edu/OI/IRAQ/dbfiles/Iraqdatabasehome ; Wikipedia article Wikipedia ; ABZU etana.org/abzubib; Oriental Institute Virtual Museum oi.uchicago.edu/virtualtour ; Treasures from the Royal Tombs of Ur oi.uchicago.edu/museum-exhibits ; Ancient Near Eastern Art Metropolitan Museum of Art www.metmuseum.org

Archaeology News and Resources: Anthropology.net anthropology.net : serves the online community interested in anthropology and archaeology; archaeologica.org archaeologica.org is good source for archaeological news and information. Archaeology in Europe archeurope.com features educational resources, original material on many archaeological subjects and has information on archaeological events, study tours, field trips and archaeological courses, links to web sites and articles; Archaeology magazine archaeology.org has archaeology news and articles and is a publication of the Archaeological Institute of America; Archaeology News Network archaeologynewsnetwork is a non-profit, online open access, pro- community news website on archaeology; British Archaeology magazine british-archaeology-magazine is an excellent source published by the Council for British Archaeology; Current Archaeology magazine archaeology.co.uk is produced by the UK’s leading archaeology magazine; HeritageDaily heritagedaily.com is an online heritage and archaeology magazine, highlighting the latest news and new discoveries; Livescience livescience.com/ : general science website with plenty of archaeological content and news; Past Horizons, an online magazine site covering archaeology and heritage news as well as news on other science fields; The Archaeology Channel archaeologychannel.org explores archaeology and cultural heritage through streaming media; Ancient History Encyclopedia ancient.eu : is put out by a non-profit organization and includes articles on pre-history; Best of History Websites besthistorysites.net is a good source for links to other sites; Essential Humanities essential-humanities.net: provides information on History and Art History, including sections Prehistory

Mesopotamian Medicines

20120208-Incantation bowl demon Nippur.jpg
Incantation bowl
with demon, Nippur
The Sumerians are considered the originators of medication. They used medicines as early as 3,500 B.C. and developed enemas, suppositories, lotions, pills, inhalations, ointments, snuffs, poultices, and infusions.

The world oldest known prescriptions, cuneiform tablets dating back to 2000 B.C. from Nippur, Sumer, described how to make poultices, salves and washes. The ingredients, which included mustard, fig, myrrh, bat dropping, turtle shell powder, river silt, snakeskins and "hair from the stomach of a cow," were dissolved into wine, milk and beer.

Cuneiform tablets suggest Mesopotamians used salt water for gargling, sour wine as a disinfectant, potassium nitrate obtained from urine as an astringent, and willow bark (source of aspirin) to relieve fever.

By trial and error, the Sumerians discovered that alkaline substances neutralize the stomach's natural acids and reduce the production of pepsin, which irritates the stomach's lining. The chief ingredient in their stomach relief medicines was sodium bicarbonate (baking soda).

The earliest known laxatives, used in Mesopotamia and ancient Egypt, were made from ground senna pods and yellowish castor oil around 2500 B.C. The Assyrians were particularly adept laxative makers. They developed "bulk-forming" laxatives made from bran and "saline" laxatives with sodium and "stimulant" laxatives that acted on the intestinal walls to produce defecation.

“Astral Magic in Babylonia” (1995) by Erica Reiner traces the roots of Greek medicine and science to Babylonian magical practices using plants and other ingredients and seeking to harness the powers of celestial bodies.

Herodotus wrote in 430 B.C.:“The following custom seems to me the wisest of their institutions next to the one lately praised. They have no physicians, but when a man is ill, they lay him in the public square, and the passers-by come up to him, and if they have ever had his disease themselves or have known any one who has suffered from it, they give him advice, recommending him to do whatever they found good in their own case, or in the case known to them; and no one is allowed to pass the sick man in silence without asking him what his ailment is. I.198: They bury their dead in honey, and have funeral lamentations like the Egyptians. When a Babylonian has consorted with his wife, he sits down before a censer of burning incense, and the woman sits opposite to him. At dawn of day they wash; for till they are washed they will not touch any of their common vessels. This practice is observed also by the Arabians.” [Source: Herodotus, “The History”, translated by George Rawlinson, (New York: Dutton & Co., 1862]

Nancy Demand of Indiana University wrote: “Whether or not ancient Mesopotamian medicine passed on a legacy that ultimately influenced the doctors of subsequent civilizations is a question that will never be complete answered. While many of the basic tenants of medicine, such as bandaging and the collection of medical texts, began in Mesopotamia, other cultures may have developed these practices independently. Even in Mesopotamia itself, many of the ancient techniques became extinct after surviving for thousands of years. It was Egyptian medicine that seems to have had the most influence on the later development of medicine, through the medium of the Greeks.” [Source: The Asclepion, Prof.Nancy Demand, Indiana University - Bloomington]

Sources on Mesopotamian Medicine

Pharmacopoeia from Nippur, around 225 BC

Nancy Demand of Indiana University wrote: “Most of the information available to modern scholars comes from cuneiform tablets. There are no useful pictorial representations that have survived in ancient Mesopotamian art, nor has a significant amount of skeletal material yet been analyzed. Unfortunately, while an abundance of cuneiform tablets have survived from ancient Mesopotamia, relatively few are concerned with medical issues. Many of the tablets that do mention medical practices have survived from the library of Asshurbanipal, the last great king of Assyria. The library of Asshurbanipal was housed in the king's palace at Nineveh, and when the palace was burned by invaders, around 20,000 clay tablets were baked (and thereby preserved) by the great fire. [Source: The Asclepion, Prof.Nancy Demand, Indiana University - Bloomington +++]

“In the early 1920's, the 660 medical tablets from the library of Asshurbanipal were published by Cambell Thompson. Other medical texts have been published more recently. For example, Franz Kocher has published a series of volumes called Die Babylonishch-Assyrische Medizin. The first four of these contain 420 tablets found from sites other than Assurbanipal's library, including the library of a medical practitioner (an asipu) from Neo-Assyrian Assur, as well as Middle Assyrian and Middle Babylonian texts.

“The remaining two volumes of Kocher's work augment Campbell Thompson, providing new joins of broken fragments and much material uncovered in the British Museum. At least one more volume of Nineveh texts has been announced. In addition, the series Spaet Babylonische Texte aus Uruk contains some 30 medical texts not included in Kocher's work. The vast majority of these tablets are prescriptions, but there are a few series of tablets that contained entries that were directly related to one another, and these have been labeled "treatises." +++”

“Modern Sources: Hector Avalos, Illness and Health Care in the Ancient Near East: the Role of the Temple in Greece, Mesopotamia, and Israel; M.Stol, Epilepsy in Babylonia (1993) JoAnn Scurlock, "Witchcraft and Magic in the Ancient Nar East and the Bible," in Encyclopedia of Women and World Religion; JoAnn Scurlock, "Physician, Exorcist, Conjurer, Magician: A Tale of Two Healing Professionals," Papers of the 1995 Mesopotamian Magic Conference. Mary Coleman and JoAnn Scurlock, "Viral Hemorrhagic Fevers in Ancient Mesopotamia," Journal of Tropical Medicine (forthcoming); Journal des Médecines Cunéiformes http://www.oriental.cam.ac.uk/jmc

"Treatise of Medical Diagnosis and Prognoses”

18th century Ottoman deiction of tooth worms

Nancy Demand of Indiana University wrote: “The largest surviving such medical treatise from ancient Mesopotamia is known as "Treatise of Medical Diagnosis and Prognoses." The text of this treatise consists of 40 tablets collected and studied by the French scholar R. Labat. Although the oldest surviving copy of this treatise dates to around 1600 B.C., the information contained in the text is an amalgamation of several centuries of Mesopotamian medical knowledge. [Source: The Asclepion, Prof.Nancy Demand, Indiana University - Bloomington +++]

“The diagnostic treatise is organized in head to toe order with separate subsections covering convulsive disorders, gynecology and pediatrics. It is unfortunate that the antiquated translations available at present to the non-specialist make ancient Mesopotamian medical texts sound like excerpts from a sorceror's handbook. In fact, as recent research is showing, the descriptions of diseases contained in the diagnostic treatise demonstrate a keen ability to observe and are usually astute. +++

“Virtually all expected diseases can be found described in parts of the diagnostic treatise, when those parts are fully preserved, as they are for neurology, fevers, worms and flukes, VD and skin lesions. The medical texts are, moreover, essentially rational, and some of the treatments, as for example those designed for excessive bleeding (where all the plants mentioned can be easily identified), are essentially the same as modern treatments for the same condition.” +++

Health Care in Mesopotamia

fragment of a talisman used to exorcise the sick

Nancy Demand of Indiana University wrote: By examining the surviving medical tablets it is clear that there were two distinct types of professional medical practitioners in ancient Mesopotamia. The first type of practitioner was the ashipu, in older accounts of Mesopotamian medicine often called a "sorcerer." One of the most important roles of the ashipu was to diagnose the ailment. In the case of internal diseases, this most often meant that the ashipu determined which god or demon was causing the illness. The ashipu also attempted to determine if the disease was the result of some error or sin on the part of the patient. The phrase, "the Hand of..." was used to indicate the divine entity responsible for the ailment in question, who could then be propitiated by the patient. The ashipu could also attempt to cure the patient by means of charms and spells that were designed to entice away or drive out the spirit causing the disease.The ashipu could also refer the patient to a different type of healer called an asu. [Source: The Asclepion, Prof.Nancy Demand, Indiana University - Bloomington +++]

“Beyond the role of the ashipu and the asu, there were other means of procuring health care in ancient Mesopotamia. One of these alternative sources was the Temple of Gula. Gula, often envisioned in canine form, was one of the more significant gods of healing. While excavations of temples dedicated to Gula have not revealed signs that patients were housed at the temple while they were treated (as was the case with the later temples of Asclepius in Greece), these temples may have been sites for the diagnosis of illness. In his book Illness and Health Care in the Ancient Near East: the Role of the Temple in Greece, Mesopotamia, and Israel, Hector Avalos states that not only were the temples of Gula sites for the diagnosis of illness (Gula was consulted as to which god was responsible for a given illness), but that these temples were also libraries that held many useful medical texts. +++

“The primary center for health care was the home, as it was when the ashipu or asu were employed. The majority of health care was provided at the patient's own house, with the family acting as care givers in whatever capacity their lay knowledge afforded them. Outside of the home, other important sites for religious healing were nearby rivers. The Mesopotamian believed that the rivers had the power to care away evil substances and forces that were causing the illness. Sometimes a small hut was set up for the afflicted person either near the home or the river to aid in the families centralization of home health care.” +++

Mesopotamian Physicians

Adad, the god that causes colds

Nancy Demand of Indiana University wrote: The asu “was a specialist in herbal remedies, and in older treatments of Mesopotamian medicine was frequently called "physician" because he dealt in what were often classifiable as empirical applications of medication. For example, when treating wounds the asu generally relied on three fundamental techniques: washing, bandaging, and making plasters. All three of these techniques of the asu appear in the world's oldest known medical document (c. 2100 B.C.). [Source: The Asclepion, Prof.Nancy Demand, Indiana University - Bloomington +++]

“The knowledge of the asu in making plasters is of particular interest. Many of the ancient plasters (a mixture of medicinal ingredients applied to a wound often held on by a bandage) seem to have had some helpful benefits. For instance, some of the more complicated plasters called for the heating of plant resin or animal fat with alkali. This particular mixture when heated yields soap which would have helped to ward off bacterial infection. +++

“While the relationship between the ashipu and the asu is not entirely clear, the two kinds of healers seemed to have worked together in order to obtain cures. The wealthiest patients probably sought medical attention from both an ashipu and an asu in order to cure an illness. It seems that the ashipu and the asu often worked in cooperation with each other in order to treat certain ailments. Beyond sharing patients, there seems to have been some overlap between the skills of the two types of healers: an asu might occasionally cast a spell and an ashipu might prescribe drugs. Evidence for this crossing of supposed occupational lines has been found in the library of an ashipu that contained pharmaceutical recipes.” +++

Hammurabi's Code of Laws 215-227: Physicians, Barbers and Vets

The Babylonian king Hammurabi (1792-1750 B.C.) is credited with producing the Code of Hammurabi, the oldest surviving set of laws. Recognized for putting eye for an eye justice into writing and remarkable for its depth and judiciousness, it consists of 282 case laws with legal procedures and penalties. Many of the laws had been around before the code was etched in the eight-foot-highin black diorite stone that bears them. Hammurabi codified them into a fixed and standardized set of laws. [Source: Translated by L. W. King]

Gula, the Sumerian god of healing

If a physician make a large incision with an operating knife and cure it, or if he open a tumor (over the eye) with an operating knife, and saves the eye, he shall receive ten shekels in money. [Source: Translated by L. W. King]
If the patient be a freed man, he receives five shekels.
If he be the slave of some one, his owner shall give the physician two shekels.
If a physician make a large incision with the operating knife, and kill him, or open a tumor with the operating knife, and cut out the eye, his hands shall be cut off.
If a physician make a large incision in the slave of a freed man, and kill him, he shall replace the slave with another slave.
If he had opened a tumor with the operating knife, and put out his eye, he shall pay half his value.
If a physician heal the broken bone or diseased soft part of a man, the patient shall pay the physician five shekels in money.
If he were a freed man he shall pay three shekels.
If he were a slave his owner shall pay the physician two shekels.
If a veterinary surgeon perform a serious operation on an ass or an ox, and cure it, the owner shall pay the surgeon one-sixth of a shekel as a fee.
If he perform a serious operation on an ass or ox, and kill it, he shall pay the owner one-fourth of its value.
If a barber, without the knowledge of his master, cut the sign of a slave on a slave not to be sold, the hands of this barber shall be cut off.
If any one deceive a barber, and have him mark a slave not for sale with the sign of a slave, he shall be put to death, and buried in his house. The barber shall swear: "I did not mark him wittingly," and shall be guiltless.

Surgery and Medicines in Mesopotamia

entwined snakes of Mesopotamia

Nancy Demand of Indiana University wrote: “Among Hammurabi's laws were several that pertained to the liability of physicians who performed surgery. These laws state that a doctor was to be held responsible for surgical errors and failures. Since the laws only mention liability in connection with "the use of a knife," it can be assumed that doctors in Hammurabi's kingdom were not liable for any non-surgical mistakes or failed attempts to cure an ailment. [Source: The Asclepion, Prof.Nancy Demand, Indiana University - Bloomington +++]

“It is also interesting to note that according to these laws, both the successful surgeon's compensation and the failed surgeon's liability were determined by the status of his patient. Therefore, if a surgeon operated and saved the life of a person of high status, the patient was to pay ten shekels of silver. If the surgeon saved the life of a slave, he only received two shekels. However, if a person of high status died as a result of surgery, the surgeon risked having his hand cut off. While if a slave died from receiving surgical treatment, the surgeon only had to pay to replace the slave. This use of status to evaluate misdeeds does not seem to appear in other, similar "codes" however. +++

“Regardless of the risks associated with performing surgery, at least four clay tablets have survived that describe a specific surgical procedure. Unfortunately, one of the four tablets is too fragmentary to be deciphered. Of the remaining three, one seems to describe a procedure in which the asu cuts into the chest of the patient in order to drain pus from the pleura. The other two surgical texts belong to the collection of tablets entitled "Prescriptions for Diseases of the Head." One of these texts mentions the knife of the asu scraping the skull of the patient. The final surgical tablet mentions the postoperative care of a surgical wound. This tablet recommends the application of a dressing consisting mainly of sesame oil, which acted as an anti-bacterial agent. +++

“ Another important consideration for the study of ancient Mesopotamian medicine is the identification of the various drugs mentioned in the tablets. Unfortunately, many of these drugs are difficult or impossible to identify with any degree of certainty. Often the asu used metaphorical names for common drugs, such as "lion's fat" (much as we use the terms "tiger lilly" or "baby's breath"). Of the drugs that have been identified, most were plant extracts, resins, or spices. Many of the plants incorporated into the asu medicinal repertoire had antibiotic properties, while several resins and many spices have some antiseptic value, and would mask the smell of a malodorous wound. Beyond these benefits, it is important to keep in mind that both the pharmaceuticals and the actions of the ancient physicians must have carried a strong placebo effect. Patients undoubtedly believed that the doctors were capable of healing them. Therefore, at the very least, visiting the doctor psychologically reinforced the notion of health and wellness." +++

Sumerian Eye Makeup, Conjunctivitis and the 'Evil Eye'

physicians cylinder seal impression from ur-lugal-Edinna

John Alan Halloran wrote in sumerian.org: “The Sumerian language has preserved a record of their battles against conjunctivitis, also known as 'pink eye', an eye condition which the Sumerians called igi-hulu, 'evil eye'. Conjunctivitis is an inflammation of the mucous membrane that covers the eyeball, which can be brought on by bacteria, viruses, or inadvertent soap in the eye. You can read about this potentially dangerous condition here: [Source: John Alan Halloran, sumerian.org January 27, 2014 ***]

“There is a Sumerian expression that indicates that this condition had already become a subject of fear and superstition in Sumerian times — igi-hul...dim2: to put the evil eye (on someone) ('eyes/face' + 'evil' + 'to fashion'). In most traditional cultures there is an extreme fear of the 'Evil Eye'. They recite incantations, give signs, and will do everything possible to avoid its fateful curse. ***

“The Sumerians were like many other peoples in having traditions about the medicinal use of different plants and herbs, some of which have antiseptic properties. These traditions are preserved in the vocabulary of their language. When Logogram Publishing publishes the English-Sumerian index to my Sumerian Lexicon (2006) book, it will be easier for researchers to look up what are these plants and herbs. But the Sumerian natural remedies were largely the same as are used today among the inhabitants of Iraq and Arabia. ***

“The Sumerian vocabulary confirms that the practice of eye makeup originated for eye protection, not for cosmetic reasons. It also shows that the practice of applying protective eye makeup was not limited to the ancient Egyptians. Here are two entries from my Sumerian Lexicon (2006) book: 1) šembi, šimbi: kohl, i.e., a cosmetic, mascara, or eye-protection paste originally made from charred frankincense resin and later from powdered antimony (stibium) or lead compounds (cf., šem-bi-zi-da, 'kohl'; šim, 'perfumed resin'; šim-gig, 'frankincense'; im-sig7-sig7, 'antimony paste'). 2) šem-bi-zi-da: kohl; a paste originally made from charred frankincense resin and later from powdered antimony (stibium) or lead compounds; a darkening eye cosmetic with antibacterial properties - used as a protection against eye disease as well as giving relief from the glare of the sun ('kohl' + 'good; true' + nominative; Akk., guhlu, 'kohl' - cf., igi-hulu, 'evil-eye'). ***

“The etymology shows that Akkadian guhlu is a loanword from Sumerian, where it evolved through vowel harmony from the Sumerian term for 'evil-eye' into our word 'kohl'. Furthermore, according to Stephan Guth, Professor of Arabic at the University of Oslo, our word 'alcohol' "is derived from the Arabic al-kuhl, which means 'kohl'. When the Europeans became familiar with this substance in Andalusia, which was also used for medical purposes, they referred to it and gradually all other fine powders, and subsequently all kinds of volatile essences, as alcohol." So the etymology of 'alcohol' can now be traced through a circuitous path all the way back to ancient Sumerian igi-hulu, 'evil-eye'. ***

“Frankincense resin has such strong antibiotic properties that the ancient Egyptians used its oil to clean the body and organs during mummification, helping to prevent putrefaction. A Google search for "charred frankincense" returns almost a thousand results. Frankincense, however, was rare and expensive, having to be imported from Arabia, which explains why the Sumerians learned to substitute powdered antimony or lead compounds for it in their eye makeup.” ***

Image Sources: Wikimedia Commons

Text Sources: Internet Ancient History Sourcebook: Mesopotamia sourcebooks.fordham.edu , National Geographic, Smithsonian magazine, especially Merle Severy, National Geographic, May 1991 and Marion Steinmann, Smithsonian, December 1988, New York Times, Washington Post, Los Angeles Times, Discover magazine, Times of London, Natural History magazine, Archaeology magazine, The New Yorker, BBC, Encyclopædia Britannica, Metropolitan Museum of Art, Time, Newsweek, Wikipedia, Reuters, Associated Press, The Guardian, AFP, Lonely Planet Guides, “World Religions” edited by Geoffrey Parrinder (Facts on File Publications, New York); “History of Warfare” by John Keegan (Vintage Books); “History of Art” by H.W. Janson Prentice Hall, Englewood Cliffs, N.J.), Compton’s Encyclopedia and various books and other publications.

Last updated September 2018