Ancient Babylonian Medicine

Theory and Practice

Markham J. Geller

Ancient Cultures
These enjoyable, straightforward surveys of key themes in ancient culture are ideal for anyone new to the study of the ancient world. Each book reveals the excitement of discovering the diverse lifestyles, ideals, and beliefs of ancient peoples.

1. Medicine, Assyro-Babylonian. 2. Medicine, Assyro-Babylonian–Philosophy. 3. Medicine, Assyro-Babylonian–Methodology. 4. Magic, Assyro-Babylonian.
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 2010 Markham J. Geller 

Introduction to Babylonian
Medicine and Magic
If a man has pain in his kidney, his groin constantly hurts him, and his
urine is white like donkey-urine, and later on his urine shows blood, that
man suffers from “discharge” (mus.û-disease). You boil 2 shekels of myrrh,
2 shekels of baluhhu-resin, (and) 2 sila-measures of vinegar together in a
jug; cool it and mix it in equal measure in pressed oil. You pour half into
his urethra via a copper tube, half mix in premium beer, you leave it out
overnight and he drinks it on an empty stomach and he will get better.
Babylonian recipe for disease of the kidneys, BAM 7 35
[If a] man has intestinal colic, he constantly scratches himself, he retains
wind in his anus, food and fluids are regurgitated (and) he suffers from
constipation of the rectum – its “redness” is raised and troubles him [without]
giving him relief – you desiccate a lion skin and mix it with lion fat,
you dry (it) a second time, crush and mix it in cedar oil, make a pessary
and insert it into his anus.
Babylonian recipe for disease of the anus, BAM 7 151

Medicine today is technological and scientific, often making it difficult
to cast our minds back to earlier ages when medicine was less understood
and less successful. Actually, we need not go back very far in
time, since any physician trained in medicine before the discovery of
penicillin would attest to how relatively unsophisticated medicine still
was, even by the middle of the twentieth century. As one physician
recalls, After the discovery of modern life-saving drugs, therapy dramatically
improved in most aspects of medicine, to the extent that medicine has
made more rapid and successful progress during the past 60 years than
in the entire cumulative previous history of Western medicine, from
Galen to the twentieth century.
Nevertheless, we do not yet have the answers to all medical questions,
and in some significant areas we are hardly better informed about human
behavior and medical practice than were ancient and medieval practitioners.
Medicine remains an art, and tracing back the history of this art can
help us better understand the processes of discovery and treatment.
Let us take one example, the problem of diet and health. Obesity has
recently been recognized as one of the scourges of modern times, with
little overall consensus as to how one should understand and act upon the
issues involved. According to one expert, our modern ideas of diet were
developed and promoted after the Second World War by the American
Heart Association, based upon studies comparing cholesterol and heart
attack rates in countries around the world. The research concluded that
high levels of fat in modern diets were specifically responsible for obesity
and heart disease, and recommended a low-fat, high-carbohydrate diet.1
After a low-fat diet did not have the anticipated effect, new diets were
introduced to improve health and reduce obesity, one requiring total fat
restriction while another recommended exactly the opposite, a high-fat
low-carbohydrate diet. Subsequent studies embraced contradictory
advice, advocating diets based upon a theory of “good” and “bad” fats as
well as “good” and “bad” carbohydrates (Agatston 2003: 16–21).
Our modern scientific world dispenses a great deal of confusing information
about health and prevention of disease, which is a trait modern
medicine shares with its ancient counterpart. Moreover, diets and trendy
medications tend to be the obsessions of wealthier classes in society, and
this situation hardly differs from antiquity, when the best medical advice
was only on offer to those patients who could afford the costly services.
When we turn to ancient Babylonian medicine, one question often
asked is whether any part of Babylonian medicine was actually effective.
Did it work? We have hundreds of drugs cited in Babylonian medical
recipes, in addition to long lists of plants and minerals used for medicinal
purposes, often with descriptions of the drugs and of the diseases for
which they could be used. We have no idea, however, how such data was
compiled, since there were no clinical trials. How would ancient physicians
know which plants were effective against which diseases? We can
surmise that plants were identified over a very long period, perhaps
going back to Neolithic times, and the use of such plants was determined
by a hit-or-miss means of trying something to see what happens, and
then keeping careful records of the results. The crucial point was to
remember, later on, if the drug seemed to work.
One redeeming feature of Babylonian medicine is the lack of surgery,
because of the substantial risks involved. Almost all Babylonian
medical texts are limited to pharmacological preparations administered
mostly as potions, salves, ointments, fumigations, or suppositories.
Surgery would have been dangerous without either proper
antiseptics or anesthesia, nor is there any firm evidence from Babylonia
of bloodletting. For this reason, the Babylonian physician probably
caused less harm to his patient than his later colleagues in medieval

Dissection and Disease Taxonomy
As we go back in time, the relationship between magic and medicine
alters considerably, although not fundamentally. The technological basis
for what we know as modern medicine has a long and tedious history,
which actually made precious little advancement over many centuries.
The major breakthrough leading to a scientific understanding of medicine
came relatively late, in the fifteenth century, with dissection of the
human body providing more precise knowledge of human anatomy.
Meanwhile, autopsies were primarily an academic exercise, carried out
exceptionally by some noted Greek physicians in Alexandria in the third
century BC (von Staden 1998: 52). There are various practical reasons
why the taboo of cutting open the human body was usually observed,
even by Galen. First, before the invention of rubber gloves, dissection
could have been dangerous since the researcher could easily contract a
disease which had been the patient’s cause of death (see Geller 2007:
187f.). Second, religious taboos no doubt played an important role,
since disfiguring the human body was thought to have affected how the
soul might appear in the afterlife. In Homer, for instance, the soldier in
Hades is seen with his battle scars (Bernstein 1993: 30, 65). Apart from
the taboo itself, the most probable reason for the lack of interest in
dissection in ancient and medieval medicine was the fact that knowledge
of internal anatomy did not actually help in healing the patient. Knowing
where the organs were located and how the blood circulated were important
discoveries in themselves, but how did one convert this knowledge
into effective treatment?
It is not particularly easy to classify diseases within Babylonian medicine,
although they fall generally within similar categories in Hippocratic
medicine. Some diseases are simply associated with parts of the body,
such as head disease, tooth disease, eye disease, nose disease, even foot
disease, as well as kidney disease and anus disease. Baldness was treated
as a disease. There are varieties of skin diseases, including rashes and
pocks, as well as leprosy-like conditions affecting the nose and mouth,
but it is impossible to diagnose these conditions according to modern
disease terminology.
A major development in understanding disease only came with the
discovery of morbid anatomy in the eighteenth century in Padua and at
St George’s Hospital, London, where physicians began to realize that
autopsies after diagnosis could provide important clues to diagnosing
disease correctly (Porter 1997: 263f.). It took centuries, however, for this
idea to develop from the days of Egyptian mummification, which was the
last period when dissections were carried out on a regular basis as part
of embalming, or from third-century BC Alexandria, where a few Greek
physicians practiced vivisection on prisoners.
What this effectively means is that ancient and medieval medicine
had much in common, and that the fundamental relationship between
doctor and patient remained fairly constant over the centuries. The relationship
between magic and medicine – the psychological and technical
approaches to healing – was always present and was constantly evolving.
We will see that although real technological advancement in medicine
was slow in developing, knowledge about disease and healing improved
over time, and theories about disease and healing were changing as well.
Not every new idea is an advancement or an improvement on what
came before, but the complex relationship between magic and medicine
is usually affected by new theories of healing, or even by skepticism
towards accepted theories.
Another factor determining how magic and medicine relate to each
other is the complex relationship between doctor and patient, in the
ancient world as in our own society. Within Mesopotamia, there is much
we do not know about this relationship. Was the doctor paid, and how
much? What was his status within society? Would men and women be
treated by the same doctor? Was medical help readily available? How
many doctors were there within a community, or was medicine only
available to the royal household and those closely associated with either
the palace or temple? Although there is much here that we would like to
know but will probably never know, it is possible to make some reasonable
assumptions based upon the data which we have. But first, it is
important to clarify the nature of our sources.

Table of Contents
List of Illustrations viii
List of Abbreviations x
Acknowledgments xii
Introduction to Babylonian Medicine and Magic 1

1 Medicine as Science 11
2 Who Did What to Whom? 43
3 The Politics of Medicine 56
4 Medicine as Literature 89
5 Medicine and Philosophy 118
6 Medical Training: MD or PhD? 130
7 Uruk Medical Commentaries 141
8 Medicine and Magic as Independent Approaches to Healing 161

Appendix: An Edition of a Medical Commentary 168
Notes 177
References 202
Subject Index 211
Selective Index of Akkadian and Greek Words 217
Index of Akkadian Personal Names 220


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