Diagnoses in Assyrian and Babylonian Medicine: Ancient Sources, Translations, and Modern Medical Analyses

12. Obstetrics and Gynecology

chapter 12 Obstetrics and Gynecology If (in) a woman of childbearing age, pus is continually produced from (the womb)’s mouth, she will die together with her fetus. —DPS XXXVI A 83 = TDP 208:83 Women’s illnesses, including gynecological and obstetrical problems, received considerable attention from ancient Mesopotamian physicians. Treatments were prescribed for most of them, and the patients were followed as closely as their male counterparts. Judging from the clinical texts, there did not appear to be any reluctance on the part of the patient to be examined by the physician, including palpation of the abdomen during pregnancy to ascertain the size of the uterus (and therefore the fetus). The external genitalia also were examined and described. Although the ams hipu is unlikely to have performed a regular pelvic (vaginal) exam in pregnant or nonpregnant women, he apparently had an instrument to spread the vagina open in order to see the cervix. We have this impression because in the references below there are what appear to be descriptions of the cervix. 12.1 DISHMUNUS ti-ik-pi ina ARHRUSH-shá i-tak-kip . . . (SpTU 5.253 r. 1) **If a woman becomes spotted with spots on her womb (cervix) . . . 12.2 DISH TU SHÀ.SUR11-sa sa-a-mu/pe-lu-ú NITA ir-hri (DPS XXXVI A 100–101 = TDP 210:100–101) **If a woman of childbearing age’s womb(?)1 is red/bright red, she was impregnated with a male. 12.3 DISHTU SHÀ.SUR11-sa nam-ru NU SI.SÁ ir-hri (DPS XXXVI A 102 = TDP 210:102) **If a woman of childbearing age’s womb(?) is shining, she was impregnated with a child that will not do well. Gynecology amenorrhea (absence of menstruation) The references listed below document amenorrhea and recommend treatment, but there is no information available to determine a cause. The second reference is curious because it appears to consider both the absence and the presence of menstruation to be a “trouble.” The ancient physician was certainly aware that menstruation was a normal process. 12.4 DISHMUNUS MÚD-shá TAR-ma MÚD-s há NU [IGI] . . . (SpTU 1.59:14⬘) **If a woman’s blood is cut off so that her blood is not [seen] . . . 12.5 NÍG GIG NÍG NU im-mar ana shá GIG s há i[m]-mar . . . (SpTU 1.59:12⬘) **[To turn?] trouble that one does not see into trouble that one sees . . . menhorrhagia (excessive menstruation) Irregular bleeding (nahrs hamtu)2 was known to be a problem. Blood loss would have been an obvious concern in ancient Mesopotamia. Again, there is no information available to determine the cause. 12.6 mash-qit shá MÚD MUNUS TAR-si . . . (SpTU 4.153:17)3 **Potion to stop a woman from bleeding . . . 12.7 DISH MUNUS MÚD.MESH-s hú DU.MESH-ma la ip-par-ra-su ana pa-ra-si . . . (SpTU 4.153:1) **If a woman’s blood flows and does not stop, to stop it . . . 12.8 Ú MUNUS shá na-ahr-shá-a-ti GIG . . . (BAM 381 iii 24)4 **Plant for a woman who is sick with nahrs hamtu (menorrhagia) . . . infertility Female infertility has many causes, among them advancing age. A letter sent by Ramses II to HRattushili III in the mid-second millennium b.c.e. chides the Hittites for supposing that Egyptians had some sort of “miracle cure” that would enable a sixty-year-old woman to have children.5 Medicines, recitations, and charms were available to treat infertile women. 12.9 (DISH) MUNUS a-la-da TAR-sà-[at] . . . (BAM 241 iii 3⬘; BAM 243:5⬘) **(If) a woman is past childbearing age . . . 12.10 Ú MUNUS NU Ù.TU . . . (BAM 381 iii 20//BAM 380:27; cf. BAM 421 i⬘ 25⬘)6 **Plant for a woman who is unable to give birth . . . 260 Obstetrics and Gynecology 12.11 NA4.MESHMUNUS NU PESH4 ana PESH4 . . . (BAM 250:3–4)7 **Stones to enable a woman who is not pregnant to get pregnant . . . Although it was realized that infertility could be the man’s fault (see Chapter 5), we are probably safe in presuming that the solution to a childless marriage was first to treat the woman for barrenness, then to have the man try other partners, and only when that failed would the amshipu worry about the man’s infertility. A section of HRammurapi’s...