Techniques of Mesopotamian medicine

Healing in Mesopotamia was all about utilising substances that nature had provided with or without human intervention. This mainly involved plant-based remedies, where plants of different species were grown in medicinal gardens or acquired from exotic far-away places. Less frequently, other materials were also used alongside the healing plants, such as stones and minerals or various animal products (meat and egg; milk and cheese; wool, bone and sinew). Therapeutic texts extensively discuss the various ways in which all these substances were processed and applied on different parts of the patient's body. With the help of these sources, we can glean some insight into the processes that were in place to produce the most effective medicaments. This also means, however, that we have knowledge only of the working medical recipes, the efficacy of which is sometimes emphasised with labels like "tried and checked (remedy)" or "(tried) eye salve of Hammurabi". The long history of try-and-error that must have led to the discovery of the effective treatments is not recorded in the written sources.

There were two main ways in which medicine could be applied in Mesopotamia -- used externally as bandages, salves and healing baths or taken internally in the form of healing potions, tampons, suppositories and enema. The exact relationship between diseases and healing procedures is still not very well understood, but generally it seems that internal medication mainly involved treating conditions that occurred within the body, including problems with the respiratory and gastro-intestinal tract, as well as renal-urinary and rectal diseases. Medicaments were usually applied externally when a disease affected some external part of the body, such as the skin, the hair or the eyes. However, one can find all forms of medications in connection with all kinds of diseases, without the texts giving us any insights into the motivations for using a bandage in the context of an internal disease or prescribing a healing potion for a patient who suffered from some dermatological problem. Sometimes various forms of medications were used simultaneously to treat a certain medical condition as in the case of a patient who had a piercing pain in their stomach:

You pound nuhurtu ("asafoetida") (and) tīyatu (a plant) (and) he drinks them in beer. You boil down šammu peṣû ("white plant") in oil (and) you pour it into his anus. You heat up leaves from šarmadu (a plant), leaves from ašāgu ("acacia") (and) leaves from baltu ("thorn bush") in water (and) you wash him with it. You pour juice from šunû ("chaste tree") (and) juice from kasû ("tamarind") into his anus. You boil down burāšu (a kind of juniper) (and) kukru (an aromatic) [. . .] using a small copper pot, you smear (the mixture) on a piece of fabric (and) you bandage him with it. (Stomach 2, BAM 575 i 34-36)

In the cited passage, several healing procedures occur alongside each other as complementary ways of treating a single medical condition that affected the gastro-intestinal tract. First, the patient consumed a healing potion made from a mixture of two different healing plants and beer. After the healing potion, another mixture followed as an enema, and it was most likely meant to reach the affected part inside of the patient's body from a different direction. Then, the patient was washed with water containing leaves from various plants, the aim of which presumably was to clean their body and remove all expelled bodily fluid from the scene before the second enema. As the final step, after the affected part inside of the patient's body was reached from all available directions, a bandage was prepared using a mixture of aromatics and some kind of liquid.

Therapeutic texts record an extensive selection of techniques when it comes to preparing medicaments. In the above-cited prescription for stomach ache, these techniques include pounding and mixing drugs in different liquids -- these were the two main groups of ingredients taking place in the manufacturing process, namely, solid drugs with active healing properties (plants, animals and their products, substances of mineral origin) and liquid or semi-liquid carrier substances for administering medicaments (water, milk, vegetable juices, alcoholic drinks, syrup and honey).

Less frequently, the active ingredients did not need any treatment before administration -- herbs, fruit or other plant parts were ingested directly by patients. In the case of more complex manufacturing processes, the solid drugs were treated first, and when they were ready for further processing, they were added to liquid or semi-liquid carrier substances.

Krisztian Simko

Krisztian Simko, 'Techniques of Mesopotamian medicine', The Nineveh Medical Project, The Nineveh Medical Project, Department of the Middle East, The British Museum, Great Russell Street, London WC1B 3DG, 2022 []

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