Medicine in Mesopotamia

During the history of Mesopotamia the practice of medicine was considered a sub-specialty of the scribal arts. The goddess concerned with healing was Ninkarrak whose city was Isin, famous for its medical school. Most of the medical texts were written in Akkadian and many of them were found in Assurbanipal's library in Nineveh. Internal evidence points to origins in the Old Babylonian period. Only one text from the earlier Sumer period has been found, but it shows that the Sumerians had quite a large arsenal of medicines used to treat illness.

It was generally thought that illness was caused by angering the gods, by demon possession and the like. To treat this kind of sickness the asipu was called in to pacify the gods or drive away the demon. The asipu was skilled in divination and the interpretation of omens. His treatments included conjurations, magical rituals and incantations.

In contrast, another kind of physician, the asu, attempted cures with truly medical preparations, which included herbals, beer, wine, poultices and oil massage. As an example, a Sumerian tablet from the end of the 3rd millennium BC, probably the first pharmacopeia in the world, prescribes the following:

Pour heated water over a dried and powdered watersnake, the amamashumkaspal-plant, roots of the thorn plant, powdered naga (an alkali-yielding plant), powdered turpentine and faeces of bat. After having lathed the affected area, rub with oil and cover with shaki(?)

As we've seen healing took off into two directions: the asu, dating back to Sumerian times, and the asipu, arising later from Akkadian and Amorite sources. The asu's Materia Medica included:

• Herbs

Plants were so closely associated with healing, that the word for plant, sammu, also meant medicine. Several narcotics were known, like opium, hemp, belladonna, madragore and the water-hemlock. Camomile was prescribed for upset stomach and mustard seed as a laxative.

• Animals

For the most part these were not effective and probably were used for their magical properties, like dried watersnake, powdered tortoiseshell and the like.

• Minerals

It is doubtful that minerals had any influence on a cure, but they were included for their magical properties. Examples of minerals included powered copper and lapis lazuli, salt and bitumen.

• Liquids

Frequently specific liquids were prescribed as the medium for other ingredients, like milk, honey, wine and beer. Oil was often used for enemas.

Social Position

In spite of the number of medical texts that have been discovered, it is doubtful that physicians enjoyed the exalted position they did in either Egypt, Greece or in our own time. Of course, the status of the clients they managed to attract rubbed off on the doctor. Consequently court physicians were held in high esteem and were sometimes sent to foreign courts on special missions. Fees, as now, varied with the status of the client and with the kind of service rendered. Members of the upper class were expected to pay from 5 to 10 shekels while commoners might pay from 3 to 5 shekels. In those days the asipu visited the home of the patients and quite likely also the asu.

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Reference

Hawkes, Jacquetta. The first great civilizations. 1973, Knopf, NYC.

After Anu had created heaven,
Heaven had created the earth,
The earth had created the rivers,
The rivers had created the marsh,
And the marsh had created the worm -
The worm went, weeping, before Shamash,
His tears flowing before Ea:
"What will you give me for food?
What will you give me to suck on?"
"I will give you the ripe fig and the apricot."
"What good is the ripe fig and the apricot?
Lift me up, and assign me to the teeth and the gums!
I will suck the blood of the tooth,
and I will gnaw its roots at the gum!"
Because you have said this, O worm,
May Ea strike you with the might of his hand!

- An incantation against toothache found on a cuneiform tablet in Nineveh

The ancient peoples of Mesopotamia were pretty big on dental health. Evidence suggests that starting with the Sumerians of the 5th and 4th millennia B.C., the Mesopotamians cared about the health of their teeth and gums and even the freshness of their breath.

Ancient Mesopotamian dental care

As benedicat describes above, health in Mesopotamia was maintained through a combination of medicine and magic, and the same was also true of dental health specifically. The surviving records lay out hundreds of recipes and recommendations written by Akkadian, Babylonian and Assyrian physicians.

One of these physicians provides us with one of the first recorded recommendations of a gum massage to treat gingivitis:

If a man's teeth are all lose and decay sets in... thou shalt rub... on his teeth until blood comes out, and he shall recover.

Another tablet gives us a method to dispel "mouth-trouble" (possibly referring to inflammation):

If a man's mouth has mouth-trouble, with gall-apples, ammi, mustard he shall cleanse his mouth and drink them in kurunnu-beer and shall recover. (I wish my dentist would order me to drink beer as a part of my dental hygiene routine.)

But Mesopotamian dentists were also concerned with more cosmetic dental issues. The same records contain recipes for mouthwash and stain-removal mixtures that include such ingredients as salt, pine turpentine, honey, oil, beer, lupin and turmeric, plus a feather to induce vomiting at some point in the procedure.

Despite not having the benefits of Oral-B toothbrushes or Colgate, some people in Mesopotamia seem to have practiced dental hygiene on a regular basis. Archaeological searches have revealed toothpicks made of gold, silver and bronze, sometimes as parts of vanity kits.

Dentistry and religion

As with most other facets of ancient Mesopotamian life, religion played an active role in medical practice. Certain incantations were sometimes prescribed to work alongside a medical remedy, the idea presumably being that one or more of the gods would help the medicine do its job.

The toothache-related text found at Nineveh in interesting in this respect. Many ancient and medieval peoples believed that toothaches were caused by a worm that ate at the gums and gnawed through the teeth, boring holes and causing decay. Recounting the story of the creation of the worm and asking Ea to smack him down with the might of his hand suggests a magical element to dental care that no longer exists in modern dentistry (depending on your dentist, anyway.)

Try it at home!

If you're tempted to try out some ancient dental techniques, you can start with this toothache remedy, to be used together with the incantation against toothache copied above:

Second-grade beer, the plant sa-kil-bir and oil thou shalt mix together; the incantation thou shalt recite three times thereupon and put the medicine upon the tooth.

So if you have some second-grade beer and sa-kil-bir in the back of your fridge, this is always an option. It certainly beats going to the dentist's office and paying for the privilege of getting nagged at by your dental hygienist.

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Forrai, Judit. "The Beginnings of Dental Caries and its Treatments." Archives of Oral Research, May 2009. pp. 187-192.

Paulissian, Robert. "Dental Care in Ancient Assyria and Babylonia." Journal of the Assyrian Academic Society, Nov. 1993. pp. 96-116.

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Note: I've reposted this here: http://waxtablets.wordpress.com/2014/12/11/ancient-mesopotamian-dental-care/. This message is just here to assure anyone who happens across both posts that I'm not a word-thief.