The history of medicine is as old and as rich as the civilization in Mesopotamia.
Mesopotamians are known for inventing agriculture but history often forget to credit them for also
developing a health care system and medicine. Even for their time, their diagnostics had
the knowledge and accurate observation skills to describe convulsive disorders,
issues related to gynecology, and pediatrics. Welcome to Nutty History, today we are going
to find out what medicine was like and how it evolved over the years in Mesopotamia.
Medical practice in ancient Mesopotamia was divided into two broad categories. The first kind
of practitioner was ashipu and the most important part of their job, according to older texts,
was to identify or diagnose the ailment. Yes, just like Hugh Laurie did as Doctor
House on television. However, Doctor House was a medical Sherlock Holmes
whose job was to identify the rarest diseases by using inquisitive reasoning and immense knowledge
of human anatomy and medical science. Ashipu, on the other hand, were particularly witch doctors
or straight-up sorcerers. In the case of internal diseases or difficult cases,
the ashipu would determine which god or demon was causing the illness. The technical term for
Illness back in Sumer was `the hand of…', as in “The patient is touched by the hand of the
god Shamash” or “The hand of the demon Lamashtu is upon her.” This would also apply to ailments they
thought were caused by lesser supernatural beings such as the hand of this or that unpleasant ghost.
Whatever malady the patient presented with, and whatever the final cure,
the diagnosis always referenced the will of the gods and their intervention in human affairs.
They would also attempt to determine if the disease was the result of some error or sin
on the part of the patient and if a confession was required before commencing the treatment.
The Ashipu would prescribe charms and spells that were designed to drive out the spirit causing the
disease. Patients would often pledge in the name of a god to not commit the particular sin again
that made them sick. Got to say, Sumerian religious leaders ran a pretty tight ship!
However, if an ailment needed proper medical attention, then the ashipu could also refer
the patient to a different type of healer called an asu. Asu were a specialist in herbal remedies,
making them proper physicians and they would deal with empirical applications of medication.
For example, in the case of wounds, the asu would apply washing,
bandaging, and making plasters which also qualify them as the orthopedic of their time.
The knowledge of the asu in making plasters is quite an interesting subject!
Many of the ancient plasters were a mixture of medicinal ingredients applied to a wound
often held on by a bandage and seem to have had some helpful benefits. For instance, some of the
more complicated plasters required the heating of plant resin or animal fat with an alkali.
This particular mixture at high temperatures would yield soap that would have helped to fight
against bacterial infections. Asu mostly relied on herbal medicine and other available and then known
pharmaceuticals as their primary and ubiquitously used tools in ancient Mesopotamia. Some treatments
were likely based on empirically discovered characteristics of the ingredients used,
while others were less based on effectiveness and more based on the attribution of superstition
or symbolic qualities. A Sumerian cuneiform tablet circa 3000 BCE is evidence of their
medicinal prowess as it describes fifteen different pharmaceutical prescriptions
for various ailments. However, though that certain tablet is missing the name of concerned ailments
or the exact recipe of prescriptions, maybe it was simply a “tablet of index.” Elements that we do
know that was used by an asu were faunal, botanic, and mineral such as sodium chloride as in salt,
potassium nitrate as in saltpeter, milk, snakeskin, turtle shell, cassia, myrtle,
asafetida, thyme, willow, pear, fig, fir, and date. An Asu would also use hallucinogens like
Opiates, maryjane, mandrake, and darnel as ingredients for their pharmaceuticals
and medicinal treatments. While opium poppy was mostly used by diagnosticians
Ashipu in conjunction with hemp for euthanasia. Asu also had proficient knowledge of plant anatomy
and how to use different parts for different treatments. These essential components were
administered in vehicles of honey, water, brewskies, wine, and bitumen, as poultices
and internal medicine. Not too shabby for primordial first aid and standard physician work!
A lot of times asu and ashipu would work together to treat patients and practitioners were allowed
to switch the school of their work with proper training as well. This means that both schools
of medicine were considered equal and important in Sumer. There was no restriction on the basis of
gender in the health sector of ancient Sumer and men and women were both allowed to become an asu
or ashipu. Sadly, that changed after the advent of the Akkadian Empire, as in their social structure,
women were considered subordinate to men. Becoming a surgeon was the next step for both asu
and ashipu and ashipu as one could take either of the two expertise to then train further and
become a surgeon. However, becoming a surgeon was a risky business as though in the case of other
treatments doctors were not held liable if their procedures did not work. But a surgeon would have
their hand amputated if the operation would fail. Tough crowd.. Similarly, asu and ashipu and ashipu
were also allowed to expand their expertise as veterinarians, dentists, and even gynecologists!
However, the last one is a bit doubtful because of the lack of clear evidence but there were doctors,
who would preside over childbirth. It is positive that midwives, which were called sabsutu,
delivered the child and not the doctor. Yet the doctor was paid a fee for providing some kind
of service at births since records make it clear that they were paid more for the birth of a male
child than a female. Gender equality became a myth. The speculation about doctors’ role during
childbirth is that ashipu would perhaps recite chants and prayers to Pazuzu to protect mother
and child and ward off demons like Lamashtu . An Asu’s role could have been to ease labor pains
with herbs but it’s hard to say if they were in any way assisting with the actual birth.
As gods and demons played an important part in the health care system of Sumer,
healing inside the temple was the most reasonable choice for locations of the clinics
as it allowed better connectivity with the supernatural. However, that said, patients prefer
to be treated at their home and doctors would make home calls and yes, they charged extra for it.
It is assumed that as the city of Isin was the cult center for the goddess Gula, that city
served as a training center for physicians who were then sent to temples in various cities as
needed. There is no evidence of private practice per se although kings and the more affluent had
their own physicians. And yes, these physicians in royal service made a lot more money than the rest.
Ancient texts described that only doctors were supposed to shave their heads in Ancient
Mesopotamia as it was part of their dress code. They would also travel around their city daily
and carry their tools with them like street hawkers and vendors. There is even a proper
hymn about it from 1400 BCE that they will recite loudly on the streets. I am a physician,
I can heal, I carry around all healing herbs, I drive away disease, I gird myself with the
leather bag containing health-giving incantations, I carry around texts which bring recovery, I give
cures to mankind. My pure dressing alleviates the wound, My soft bandage relieves the sick.
As bizarre as it may sound, Mesopotamian medicine is the origin of health care as we know it.
From there, medicine traveled to Ancient Egypt and they rationalized it further and then it
reached Greece where further advances had the science codified by Hippocrates.
The influence of the cradle of human civilization still lives among us as the legacy of medicine.
Science and medicine were an integral part of the Sumer settlement even as early as
three thousand BC. Cities as ancient as Uruk have yielded many cuneiform tablets that have
mentioned medicine being developed as a distinct and honorable profession in Sumerian civilization.
To the non-specialist, the content of these tablets may sound like magic and sorcery,
but there was indeed a method and accuracy in diagnosis and depictions of diseases like fevers,
worms and flukes, neurotic ailments, venereal disease, and skin lesions.
In fact, some of their treatments, such as the procedure for excessive bleeding, are not
only rational but essentially the same as modern solutions and procedures for similar conditions.
That said, it was still a very early age of human civilization, and Gods and Demons were still
very real to them, thus they were considered the root cause of the diseases and ailments.
Ancient mythologies tell stories of diseases that were put in the world by supernatural forces.
The goddess Gula, also known as Ninkarrak and Ninisinna, presided over health and healing,
aided by her consort Pabilsag, the divine judge. Another example was Lamashtu, the daughter of the
supreme god Anu, a terrible she-demon of disease and death. The Rod of Asclepius which is the
universal symbol of medicine in the present world is often credited to the Greek god Asclepius.
But, it was originally an insignia associated with Gula’s son, Ninazu who also was the god of healing
but also of the underworld and serpents. In fact, Ninazu’s name literally means Lord Healer.
Not only in Mesopotamia but in many ancient civilizations from India to Celts
serpent symbolizes regeneration and transformation because it sheds its skin and that could mean both
recovery and reincarnation. It is important to note that the Mesopotamians patterned their gods
on themselves and their own communities. So, just as a king might choose to pardon one's offense,
so could the gods. A person suffering from ailments had to confess the sin
and submit themselves to the proper treatment so that gods could forgive them. Then it was believed
that the gods would remove the hand of whatever demon had been sent to inflict the punishment
on the patient. Doctors and healers in Mesopotamia were considered simply the agents through which
these deities worked to maintain the health of the people of Mesopotamia. Despite such strong
religious beliefs regarding health care and general well-being, Sumerians acknowledged the
fact that various organs could simply malfunction, causing illness. Medicinal remedies used as cures
were specifically used to treat the symptoms of the disease, and are clearly distinguished
from mixes or plants used as offerings to such spirits. Tell us in the comments, which
civilization shall we cover next in this series? And as always, thanks for watching Nutty History!