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The physician was not connected in any way with the clergy, but was
considered a craftsman. In the code of Hammurapi, discussed in further
detail below, laws governing the physician's activities are included with
those of other craftsmen. Penalties for malpractice are not essentially
different from those for the mason who builds a house that collapses or a
boatwright who makes a boat that sinks.
No doubt there were various levels in the training and skill of physicians.
It is not known for certain that they were literate, but if they were
themselves able to read the medical texts, a long training in the scribal
schools before their apprenticeship would be implied. It should be
stressed, however, that we do not know to what extent the medical texts
served as handbooks for actual medical practice, since illnesses covered in
the texts are rarely referred to in letters, while wounds and broken bones,
mentioned in letters, are not included in the written medical repertory.
We also do not know what developments in medicine may have occurred
after the texts received the form in which they were transmitted unchanged
for more than a millennium.
An amusing Babylonian story of about the fourteenth century B.C.,25
which has a parallel in the Thousand and One Nights, includes a physician
who was clean-shaven and scantily clad. He carried a bag (probably
containing herbs and bandages) and a censer. More important, the
physician in the story is from the town of Isin, which is well known as the
cult centre of Gula, the goddess of healing, and of other healing dieties
associated with Gula, and which may have had an academy of medicine.
Scientific excavations have never been carried out on the site of Isin, but
they would probably yield ex votos to Gula such as have been found at
another site datable to about the fourteenth century B.C. (these usually
take the form of small terra cotta lions or dogs, Gula's sacred animal, or
human figures, often inscribed, some apparently clutching the ailing part
of the body).26
There are several texts referring to women physicians (not to be con-
fused with midwives), including one woman in Asia Minor. Veterinary
medicine is known from a few isolated references to the name of the pro-
fession, most of which are from the third millennium B.C., but a recently
published medical text mentions that a specific medication can be used
for the same ailment in horses. The Assyrian king Esarhaddon (680-
669 B.C.) mentions veterinarians among craftsmen and specialists who are
apparently deported from Egypt to Assyria.
Turning from the non-canonical sources (that is, texts outside the tra-
ditional scribal repertory and scribal curricula) to the "medical" texts
themselves, it may be said that they fall into two distinct groups, the
diagnostic and the therapeutic. The diagnostic series, a collection of forty
numbered chapters, not all of which have been recovered, has the ancient
title: enuma ana bit mar$i (WPU illaku "When the exorcist goes to the
These medical texts are normally divided into paragraphs, each one
beginning "if a patient has such and such symptoms, to cure him you do
the following". Instructions for preparing and administering the medi-
cation are then given, sometimes followed by the prognosis "then he will
get well". The greater part of the materia medica consists of plant and
animal products, augmented by a certain number of minerals.ss Particu-
larly in the case of plants, only a very small number can be identified
plausibly, and it is rarely possible to guess what prompted the use of a
specific plant for a certain ailment, though the specific effects of a number
of them were surely known.
In spite of the references in letters and other non-medical documents and
even in the medical texts themselves, it is difficult to know what degree of
technical knowledge the Mesopotamian physicians possessed. The princi-
pal source for conjectures for the second millennium B.C. has been the
Code of Hammurapi which fixed the fees of the physician (and the penal-
ties in case of malpractice) in setting broken bones, treating wounds
and performing surgical operations. The section most often cited is that
which has been thought to refer to an operation for cataracts.ss More
recent opinion is that this identification is not justified and that the
operation was more likely scarification." There is no doubt, however,
that the physicians did lance boils and make incisions. The word used
in the Code of Hammurapi for the special surgeon's knife employed occurs
several times in the therapeutic texts, and also in a description of the
paraphernalia of the patron god of medicine. There is no specific mention
of the catheter, but various medications were introduced into the body
through tubes, usually made of reeds (mainly used for the ears and nostrils)
but also of lead and bronze (used especially for introducing medications
into the urethra).
It was probably the physician who performed castration on human
beings. The principal reliable source for the existence of eunuchs is a
series of regulations for the royal harem in the Middle Assyrian period
(c. thirteenth to tenth centuries B.C.).36 The particular type of operation
and the age at which it was performed are unknown, but it is unlikely that
it included severing the penis as well as the testicles-as was often the
practice in Turkish harems, a dangerous operation with a high rate of
mortality. The fact that a physician needed to examine men entering the
Assyrian harem may imply that the testicles were crushed or damaged in
such a way as to destroy the function of the seminal ducts.
There is no evidence in ancient Mesopotamia for any other deliberate
mutilation of the human body. Circumcision was not practised.e?
Although there are recorded cases of trepanation in Palestine in the
first millennium B.C.,3S none is attested in ancient Mesopotamia. The
Caesarean section was known in the second millennium B.C.,3D but it
was an operation of last resort to save the infant of a dying woman.
REFERENCES
1. B. Meissner, Babylonien und Assyrien, ii (Heidelberg, 1925). 283-323.
2. Georges Contenau, La medicine en Assyrie et en Babylonie (Paris, 1938).
3. For references see ibid., pp. 223 ft.
4. Henri Sigerist, A history of medicine, i, Primitive and archaic medicine (New York, 1951).
5. R. Labat, Journal of cuneiform studies, vi (1952) 128-133.
6. Edith Ritter, "Magical-expert (=Mipu) and physician (= as'll): Notes on two comple-
mentary professions in Babylonian medicine", Studies in honor of Benno Lands-
berger (Assyyiological studies, xvi; Chicago, 1965), 299-321.
7. Meissner, op. cit., p. 321, cites a physician's letter to the king rejecting the king's
suggestion that his illness may be due to wrongdoing.
8. R. Labat in R. Taton (ed.), Histoire geneYale des sciences, i, La science antique et midi-
evale (Paris, 1957) 89-103; and more recently "Medicins. devins et pretres-gueri-
sseurs en Mesopotamie ancienne", Archeologia, no. 10 (May-June, 1966) II-IS.
9. A. L. Oppenheim, "Mesopotamian medicine", Bulletin of the history of medicine, xxxvi
(1962) 97-108; also in Ancient Mesopotamia: POl'trait of a dead civilization (Chicago,
1964) 289-30S·
10. E. Reiner, "Medicine in ancient Mesopotamia", Journal of the International College
of Surgeons, xli (1964) 544-550.
11. Martin Levey, "Some objective factors of Babylonian medicine in the light of new
evidence", Bulletin of the history of medicine, xxxv (1961) 61-70.
12. See, for example, E. Ebeling in Reallexikon del' Assyriologie, sub voce "Arzt", p. 165.
13. M. Civil, "Prescriptions medicates sumeriennes", Revue d'assyriologie, liv (1960)
S7-72, with further material in Revue d'assyriologie, Iv (1961) 91-94.
14. F. Kocher, KeilschYiftuYkunden aus Boghaekoy xxxvii (Berlin, 1953) nos. 19 and 30
(in cuneiform only).
15. H. G. Giiterbock, "Hittite medicine", Bulletin of the history of medicine, xxxvi (1962)
109-II3·
16. A. Finet, "Les medicins au royaume de Mari" , Annuaiye de l'Institut de Philologie et
d'Histoire Orientales et Slaves, xiv (1954-57) 123-144.
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