Alongside all the exorcist therapy, which became more and more complex over the centuries, the Mesopotamians elaborated an Empiric Medicine. For example, they established a very meticulous, even finicky, list of symptoms with their appropriate therapies. The Treatise of Medical Diagnoses and Prognoses studied by the French Assyriologist, R. Labat, offers no fewer than five to six thousand lines of text, distributed over forty or so tablets, of which at least half have come down to us. It seems that nothing was left to chance. For the nose alone, Labat draws up an impressive catalogue of infections:
“If the patient’s nose is bleeding […]; If the tip of his nose is wet […]; if the tip of his nose is yellow […]; if the tip of his nose has a red rash […]; if the tip of his nose has a white rash […]; if the tip of his nose has a red and white rash […]; if the tip of his nose has a black rash […]”
The enumeration of the symptoms is followed by the remedies to treat them. They are indicated very briefly. They precede the prognosis which is declared fatal or favourable. The Mesopotamian pharmacopoeia known to us comports no fewer than two hundred and fifty medicinal plants, one hundred and twenty substances of medical origin and a good hundred of animal origin. The remedies are usually absorbed with water, beer or palm wine. Special jars with filters have been found, which were used for macerations or infusions. But the medications were also absorbed or applied in the form of suppositories, enemas, ointments or collyria. Certain illnesses seem to have been very well identified, such as paludism [malaria] with its
“recurring attacks, during which the patient alternatively presents accesses of fever, then chills and perspiration: after which, he feels a sensation of heat in all his members, then is again taken with a strong fever, which then gives place to new chills and new perspiration…”,
or again epilepsy:
“If the person, while walking, suddenly falls forwards, keeping his eyes dilated, without them returning to their normal state, and if he is also incapable of moving his arms and legs: it is the beginning of an attack of epilepsy…”
The medical act which combines the religious ceremony, the prescription and execution of treatment, is imprinted with great solemnity. If it is to treat a high-ranking person, the priest doctor, dressed in ritual clothes, moves in procession in the company of “demons”, a choir and kettledrums, whose sound is supposed to chase away evil spirits; the servants and family of the patient bring up the rear. Once cured, the patient must pay homage to his doctor. With praises formulated like this:
“He made the illness-demon, which was enveloping him in its outspread wings, flee. He dispersed the ill which was hurting him. He changed the man’s sufferings into joy; he placed near him benefactory genies as guardians and tutors.”
Mesopotamian doctors formed a social corps with very high status. They composed a whole hierarchy, at the top of which could be found the First Doctor to the King, himself. Hammourabi’s Code (1750 before the present era) mentions the reglementation imposed on doctors. Assimilating them to priests, it makes them practically untouchable and irresponsible. However, Articles 215 to 240 are a lot stricter for the inferior categories of the medical corps, particularly the galfabu, or barbers, who practised minor surgery on the eyes, teeth, broken bones, war wounds. There, the Code draws up sanctions as well as remunerations:
“If a barber has treated a free man for a serious wound with a bronze lancet, and if the man is cured; if he has opened the cloud of the eye [cataract] of a man with the bronze lancet, and if the eye is cured, he will receive ten sicles of silver…”
What must we conclude about this Mesopotamian Medicine? Good clinical observations, an attempt at classification, an attempt (still awkward though) to establish certain causal relations, an empiric pharmacopoeia which is already very complete. But the Mesopotamians remain attached to a magical and expiatory conception of illness. They attach extreme importance to rituals which have no chance of bettering the patient’s condition.
Despite everything, how can we not admire the contents of the Treatise of Medical Diagnoses and Prognoses which we have already mentioned? This is a document in which the empiric approach supplants magic, and proposes an approach which can be qualified as rational, with no risk of anachronism.
To be continued.