JoAnn Scurlock, Magico-Medical Means of Treating Ghost-Induced Illnesses in Ancient Mesopotamia.
(Ancient Magic and Divination, III; Leiden: Brill/Styx, 2006). Pp. xi + 788. Cloth, €199,00, US$269.00. ISBN 90 04 12397 0. (= A).

JoAnn Scurlock and Burton Andersen, Diagnoses in Assyrian and Babylonian Medicine: Ancient Sources, Translations, and Modern Medical Analyses.
(Urbana and Chicago: University of Illinois Press, 2005), Pp. xxiii + 879. Cloth, US$150. ISBN 0-252-02956-9 (= B).
Reviewed by Scott Noegel
University of Washington

Given the overlapping subject matter between these two books, and the fact that the first book (A, p. 10) directs readers to the second (B) for definitions of its medical terminology and the interpretations of diseases, I have chosen to review them together. Nevertheless, before offering a combined review concerning the contributions of both volumes, I provide below individual summaries of each book’s contents.

Opening the first volume is a well-organized overview of ghostly affliction in Mesopotamia in which the author discusses the relevant texts and their formats, the numerous symptoms associated with ghostly afflictions, and the time and place of the accompanying ritual performances. Also discussed are the division of labor between healers and patients, the types of Akkadian and Sumerian recitations, and the elements that are specific and not specific to ghost rituals. Here the author also provides a typology for the numerous rituals based on whether a recitation or an adjustment to a recitation is present. From here the book proceeds to the ritual praxes involved with curing ghostly afflictions, including offerings, libations, figurines, ritual burial and dispatch, encirclement, amulets, fumigants, bandages, salves, potions, washes, and suppositories. This section is then followed by a brief summary of the many medicaments mentioned in the ritual texts. The introduction ends with a discussion of the problematic natures of the dichotomies that have informed previous works on Mesopotamian medicine (e.g., “sin” versus “sanction,” “divination” versus “diagnosis,” and “magic” versus “medicine”).

The second and largest portion of the book comprises 352 textual editions (A, pp. 161-677). The texts are organized according to their apparitions and the physical ailments that result from hearing and seeing a ghost (i.e., headaches, eye and ear problems, various intestinal pains, shortness of breath and dizziness, fever, neurological and mental disorders, and the appearance of living skeletons). The volume concludes with a useful arrangement of the prescriptions according to the original tablets along with individual text bibliographies, and a concordance that equates the prescription numbers found in the author’s 1988 dissertation (whence this book derives) with the numbers found in this tome. Also provided is a bibliography and series of indices to facilitate reference.

The second tome (B), co-authored with Burton R. Andersen, Professor of Medicine and Microbiology at the University of Illinois College of Medicine, offers a more general treatment of diagnoses in Babylonian and Assyrian medicine. Each of the afflictions discussed is informed by a modern medical taxonomy, e.g., the section on public health practices includes a discussion of environmental hazards such as parasites, bites and stings, river toxins, etc. The authors provide similar treatments for infectious diseases, sexually transmitted diseases, genitourinary tract diseases, gastrointenstinal diseases, metabolic and nutritional diseases, as well as ailments of the heart, circulatory system, lungs, eyes, ears, nose, bones, and joints. Also covered are obstetrics and gynecology, neurology, trauma and shock, poisons, mental illness, dental and oral diseases, ancient etiologies, and prognostics. For each affliction the authors give a brief explanation as well as representative examples from Mesopotamian texts (all cross-referenced). Like the first volume, this book concludes with a number of appendices, notes, and useful indices. Photographs of some of the most important texts also appear in this section.

These two magisterial tomes offer a nearly comprehensive analysis of the medical profession in ancient Mesopotamia.1 The only topic not covered in these volumes, but promised by the authors for future volumes, is that of the medical treatments used (though a preliminary discussion appears in A, pp. 62-71). Both volumes are the result of many years of deep engagement with the subject and both represent the best in interdisciplinary thinking. For the first time, they make the vast learning of the Mesopotamian healing profession accessible to educated laypersons, and to other Assyriologists and medical doctors. Thus, they also provide invaluable comparative materials to those in other disciplines, especially, I would think, Egyptologists, Classicists, and experts in late antique Judaism.2

Both books are filled with fascinating insights on Mesopotamian medical practice. For example, one learns that ghostly apparitions were likely the result of “visual hallucinations accompanying severe abdominal discomfort” (A, p. 10), and that they were not associated with medical symptoms that affect women and children, such as “barrenness, excessive vaginal discharges, difficulty giving birth, puerperal fever and the like, or infantile afflictions, or jaundice, gall bladder, urinary tract problems or DÚR.GIG” (A, p. 19). One also learns that patients were considerably more involved in the application of their own medicaments (and also the recitation of spells) than their modern counterparts, that the physician (âðipu) made house calls, and that his colleague, the asû, who provided the âðipu with materia medica, worked out of his shop. One finds that the diagnostic/prognostic tablets that give us our medical information were used like medical textbooks today. We further learn that autopsies were likely performed, that physicians knew the importance of good hygiene, how to take a patient’s pulse, and how treat some afflictions surgically (e.g., empyema, B, pp. 46-47). When cases looked hopeless, they even practiced euthanasia, albeit rarely. Indeed, the authors provide far too many interesting observations to list here.

Perhaps the most important contribution of these volumes is that they offer a healthy corrective to many long-held assumptions concerning the Mesopotamian medical profession. For example, they illustrate that disease was only rarely viewed as a punishment for personal action (A, pp. 73-74)—indeed, “sin” (especially in the Christian sense), is a concept that would have been wholly foreign to ancient Mesopotamians. In addition, the âðipu, often regarded as a “conjurer” or “magician” because of his connection to performative incantations and his knowledge of ritual texts, is shown in these volumes to be an astute and rational observer whose profession was built upon millennia of inductive medical testing. Though he attributed afflictions to the “hands” of gods, demons, and ghosts, these attributions only registered his inability to see the source of the affliction in much the same way that bacteria are invisible to us without a microscope. Moreover, as the authors explain, it is impossible to label such diagnoses as “supernatural,” because the Mesopotamians did not recognize a category “supernatural.” While the polytheistic world in which the âðipu lived encouraged him to equate certain ailments with particular gods and demons, there is no evidence of a higher theory that served as a basis for medical treatment (unlike the often wildly unsuccessful theories of Hippocratic physicians [A, p. 81]). As Scurlock observes: “the ancient Mesopotamian âðipu tailored his understanding of the demoness to fit what he observed to be happening to his patients, and not the other way around” (A, p. 77). Indeed, his belief in gods, demons, and ghosts did not prevent him from providing a rational treatment for illnesses. Moreover, in many cases, his powers of observation led him to correct conclusions.

“…it is now clear that many of the apparently disparate symptoms attributed by the âðipu to various trouble causers, including ghosts, are, in fact, related. For example, the âðipu was not entirely mistaken in attributing what appear from the descriptions to be meningitis and otitis media to “hand” of ghost. These can indeed be attributed to the same cause, not, admittedly, ghosts, but other assailants equally invisible to the patient, namely bacteria such as haemophilus influenzae”(A, pp. 77-78).

What becomes patently clear from reading these volumes is that the Mesopotamian medical profession was extremely sophisticated.

It is no exaggeration to say the skill of ancient Mesopotamians in diagnosis and therapy was only surpassed in the late nineteenth century C.E., a starling tribute to the potential of the human mind to reason, if armed with an observation-based approach and an attitude of “use whatever works” (B, p. 12).

These volumes are a veritable goldmine of information on the Mesopotamian medical profession. They are encyclopedic, copiously documented and cross-referenced, and provide all the relevant Sumerian and Akkadian medical terminology. They will undoubtedly serve as indispensable reference works for many years. I eagerly await the anticipated volumes on Babylonian and Assyrian medical treatments.

[1] Due to circumstances beyond the author’s control, the publication of Magico-Medical Means of Treating Ghost-Induced Illnesses in Ancient Mesopotamia was delayed by eight years. Consequently, as the author notes (p. x), studies published in the last eight years, including the other book under review here, have not been integrated, nor has Nils Heessel, Babylonisch-assyrische Diagnostik (AOAT 43; Münster: Ugarit Verlag, 2000).

[2] I note, for example, that the use of unbaked fermenting vessels to trap ghosts and prevent them from breathing air (A, p. 51) might be fruitfully compared to the so-called “magic bowls” of late antique Iraq, and that the drainage hole as a place to deposit performative figurines (A, p. 52), has a similar counterpart in the Greco-Roman world. The instruction to avoid looking behind oneself after receiving medical treatment for ghostly affliction (A, p. 217), is reminiscent of the Odyssey, X: 526-530: “But when with prayers you have entreated the glorious hordes of the dead, then sacrifice one ram and one black female (ewe), turning them toward Erebos, but yourself turn away from them and make for where the river runs, and there the numerous souls of the perished dead will come and gather about you.” Many similar comparative observations could be made with reference to Egyptian documents.