Before the ancient physician could treat his patient he had to know what was wrong with him. The problem presented by the divine language of medical signs and symptoms was to determine which combinations of animal products, minerals, and plants and which recitations were effective for which medical problems. To answer this question, the ancestor of theāšipubegan by carefully observing his patients and deriving a vocabulary to describe their signs and symptoms so that any treatments that might subsequently be devised could be applied consistently, past successes reproduced, and repetition of past failures avoided.

As in our own...

1. [anaG]IGinaTE-kaEN É[NanaNÍ-ka] ŠUB-ú anaG[IG NU TE-ḫi]

2. DIŠanaIGI GIG A.MEŠ ŠUB-maNU ⸢MUD⸣ [uZU-šú l]a ú-ád-daŠ[U? …] ⸢NU⸣ D[IN]

3. DIŠanaUGU-šúA.MEŠ ŠUB-maGABA-su uSAG ŠÀ-šú i-nar-⸢ru⸣-[buDIN]

4. DIŠanaKA-šúA.MEŠ ŠUB-maA.MEŠina[K]A-šú ú-kal[DIN]

5. DIŠ UGU-šúKÚM-em u⸢SAG⸣.KI^II-šú ne-eḫ-aU₄.1.KÁM GIG-[ma…]

6. DIŠ UGU-šúKÚM-em uSAG.KI^II-šúKÚMla-aḫ-ḫa-ḫa-šáU₄.1.KÁM GIG-[ma…]

7. DIŠ [U]GU-šúKÚM-em uSAG.KI^II-šúKÚM-maUM₄.2.KÁM GIG-ma[…]

8. DIŠ [UG]U-šúKÚM-em uSAG.KI^II-šúKÚMuIRú-kal-laU₄.3.⸢KÁM⸣ GIG-ma[…]

9. DIŠ [UG]U-[šú] KÚM-emSAG.KI^II-šú u bir-tiÁ^II-šúKÚMuIR...

Pharmacological knowledge was kept “in order not to be forgotten” in a number of forms including vademecum texts (pharmacist’s companion); two dedicated series with descriptions and uses of medicinal plants and stones:Šammu šikinšu(“the nature of plants”) andAbnu šikinšu(“the nature of stones”); and the ancient plant glossary, URU.AN.NA. Vademecum texts are laid out in a chart format, and give the name of each plant to be discussed, its primary use, and the method of preparation. Organization is by usage. These texts were presumably primarily designed so that the pharmacist presented with a patient with an easily or...

In order to be able to treat his patients with symptoms or symptoms complexes diagnosed by means of the Diagnostic Series, the ancient physician needed to be able to find the known treatments matching his diagnosis among the thousands that were available. For this purpose, a reference work was generated, known to us as UGU, an abbreviation of its ancient title, which was also the incipit (first line) of the first tablet.

Although much is missing, the general outlines and parts of the original composition can be reconstructed using the UGU Catalog, copies of individual UGU tablets identified by incipit,...

Text commentaries in general formed an advanced stage of the pedagogic process also attested in the Hippocratic corpus. Writing such commentaries was the manner in which a student could fully demonstrate the extent of his knowledge, as is explicitly stated in the colophon to text 4: “Commentary (based on) oral tradition and questions from the mouth of an expert in it.” It is also noteworthy that, not only are all commentaries unique, but we actually possess three different commentaries on the same exact original text.¹ Moreover, this particular format really separated the poor student, whose commentary carefully belabored the obvious...

Ancient Mesopotamian eyes were treated for loss of vision, dryness, tearing, abnormal redness and bleeding, conjunctivitis, flashes, night blindness, corneal opacities, and glaucoma. For more on this subject, see Fincke 2000 and Scurlock and Andersen 2005, 185–202. Treatments consisted of daubs, drops, plasters, washes, salves and bandages. There were also, even more rarely, potions, pills and aliments—in the case of night blindness, the patient was to eat a piece of liver. The pharmacist could be applied to for eye ointments which were called “spoons,” apparently because a tiny lead spoon was used to apply them. Surgery with a...

The ancient Mesopotamian physician recognized five grades of temperature (including normal), and made careful note of fever patterns. For more details, see Scurlock and Andersen 2005, 27–34. Fevers were most commonly treated with salves and bandages, but potions, fumigants, baths, and, more rarely, daubs, washes, and enemas are also attested. There were also specialized treatments for specific fevers, as for examplediˀu(text 4) andṣētu(texts 5–6).

BAM 147 consists of salves (obv. 1–20), amulets (obv. 21–24), and a potion (obv. 24) for high fever. This is followed by a ritual (obv. 25–33) for...

Ancient Mesopotamian patients complained ofekketu(itchiness),¹kiṣṣatu(hairless patches),rišktu(dry patches) andrišūtu(redness) on their heads. The ancient physician was also prepared to treatkibšu(favus),kurāru/guraštu(ringworm) and sores, not to mention the ubiquitous head lice. For more details, see Scurlock and Andersen 2005, chapter 10 and Fincke 2011b, 169–87. The most common treatments were salves, daubs and plasters. The ancient physician also shaved the head and bandaged it, or used medicated shampoo.

BAM 33 consists of medicated shampoos (1–7, 9–18), salves (8, 15–19), and a plaster (15–18) for hairless patches,...

Ancient physicians observed the heart’s rate and rhythm, observed the pulse, and treated crushing pain in the heart with salves, fumigants, and potions. There are also descriptions of what appear to be congestive heart failure. For more details, see Scurlock and Andersen 2005, 165–77.

BAM 388 column i begins with a fumigant for stroke (i 1–2) and continues with fumigants (i 3–7) and a salve (i 8–11) for a crushing sensation in the chest. All are formatted in such a way as to suggest a pharmacist as the ultimate source. The last treatment of potions and...

The ancient physician had an excellent grasp of the human gastrointestinal tract, and was able to offer treatments for various symptoms of gastrointestinal illness: nausea/vomiting, constipation, diarrhea, abdominal bloating and pain. For more details, see Scurlock and Andersen 2005, chapter 6. Among numerous treatments for unhappy stomachs, a number stand out.

One of the most interesting set of diseases attributed to a single causal agent on symptomatic grounds is the “Hand” of Ghost complex. Diseases involving some combination of severe headache, ringing in the ears, hallucinations, pain, and dehydration were likely to be laid at the door of these unhappy...

Hot dry climates are not kind to the human genitourinary tract. In addition, ancient Mesopotamians seem to have suffered the attentions ofSchistosomiasis hematobium. Ancient physicians examined the urine for color, consistency, and smell and listened to complaints of blood in the urine, discharge, inability to urinate and incontinence. They also had to deal with impotence, priapism, orchitis, and Ishtar’s revenge (venereal disease). For more details, see Scurlock and Andersen 2005, chapters 4–5.

BAM 396 has a unique way of indicating that there is more than one treatment available for a given condition. Instead of the usual repeated KI.MINs...

Neurology occupies its own section of the Diagnostic Series (tablets 26–30), suggesting that it was a subspecialty of theašipu’s craft. Ancient physicians describe grand mal seizures, petit mal seizures, simple partial seizures, and complex partial seizures, as well as the more unusual sensory seizures and gelastic seizures. In addition, they were aware of what we call status epilepticus and phases of seizures including the post-ictal state, narcolepsy, cataplexy, stroke, and coma. They also distinguished between various grades (“hurting,” “afflicting,” “touching”) and qualities (“squeezing,” “pounding,” “burning,” “gnawing,” “jabbing,” “stinging,” “needling”) of pain, described numbness and paralysis (distinguishing between flaccid...

As is still the case today, women were generally treated in the same way and with the same medicines as men but with exceptions. As we know from rare references to dosages, these were adjusted for female patients. It was also unethical to give a woman something which might accidentally cause an abortion if she happened to be pregnant. There were, of course, special problems relating to menstruation and childbirth that only women have, and these occupied a separate section of the diagnostic series, suggesting the possibility of specialization. Certainly specialists were the midwives who attended the typical, unproblematic childbirth....

The ancient physician was a careful observer, who has left to us a very wide description of birth defects. A tablet of the diagnostic series (no. 40) was devoted exclusively to the medical problems of infants. For more details, see Scurlock and Andersen, 2005, chapter 17. Treatments specifically and exclusively designed for infants or toddlers are relatively rare and usually scattered among prescriptions for adults with similar problems. So, for example, BM 78963: 45–46 (see chapter 8, text 3) deals with an infant withsuˀālucough.

Seizures are not uncommon among infants, although not everything that looks like a...

In addition to trying to counteract the real or imagined attempts to hex enemies (using figurines or animal surrogates, examples of which were occasionally found by the distraught victims), ancient Mesopotamians viewed poisoning by sorcerers as the source of a variety of illnesses with prominent salivation or production of phlegm, mucus, or semen. Included are probably cases of actual and deliberate or accidental poisonings with muscarinic mushrooms. For more details, see chapters 15 and 19 in Scurlock and Andersen 2005, 356–58, 500–501, 503 and the “Unsolved Puzzles” appendix, pp. 563–566.

BM 42272 begins with potions (1–9,...

BM 50346 is a typical extract text which records a stone charm to be used in cases of ghost-induced pain. Like many of the stone lists, its focus is on which stones are to be used for what purpose. Other texts allow us to fill in details about the type of cord used and whether or not burls with plants in them were included. For pain, numbness and varicose veins, the practice was to bind the charm onto the affected part suggesting that pressure was intended to be applied, which, in the case of varicose veins at least, is likely...

If there were any doubt that the tooth worm (see Scurlock and Andersen 2005, 420–21) had to do with rotten teeth, this charming series of rituals ought to put it to rest. Lines iii 1–3 describe a transfer rite in which the illness of the tooth is given to a skull by spitting out a mouthful of malt lumps onto it. In lines iii 4–7, the worm’s “wish” was: “Put me among the teeth and set me in the jaw so that I may suck the blood of the tooth and chew up the chewed up (food...