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

16. Mental Illness

chapter 16 Mental Illness If a person is well, but his behavior is sick. —BM 64174:9//BAM 326 ii 7⬘ There is a sufficient record in many cultures, regions of the world, and times for us to conclude that mental illness is a problem common to human society. The peoples of ancient Mesopotamia must have shared this problem, and the medical texts discussed in this chapter show that the amshipu had a clear idea of what was normal and what was “sick” behavior. However,sincevirtuallyallofthesignsandsymptomsofpsychiatricdiseasecanbeproduced by organic brain disease or metabolic abnormalities, it is difficult to read a single text and know with certainty whether it is an organic or purely psychiatric problem. There is also a risk in applying modern Western standards of normality, which are embedded in our own culturalnormsandexpectations,toancienttexts.1 Eveninthemodernera,mentalillnesses in different cultures have clinical presentations that do not always fit standard definitions of specific diseases and, where cultural differences are particularly great, there is always a danger of serious misinterpretation. For this reason, we have tried to base our diagnoses on findings that were considered by the ancient Mesopotamians to be abnormal, and to be especially cautious in assigning possible modern equivalents. Signs and Symptoms of Mental Illness AncientMesopotamianphysiciansrecognizedmanyabnormalbehavioralpatternsand emotional responses. In many cases they failed to provide sufficient information for us to reach a diagnosis understandable in modern terms. However, the extent of their observations bears testimony to their concerns about mental illness. gnashing teeth (bruxism) Itisgenerallyrecognizedthatcertainpeoplewhenunderstresswillgnashorgrindtheir teetheitherduringsleeporwhenawake.Thefirstofthereferencesthatfollowindicatesthat the amshipu was aware that worry and bruxism were related. See Chapter 18 for additional discussion. 16.1 [DISHLÚ] i-na s.a-la-li-s hu shi-[i]n-[ni-shu] i-ka-s.a-as. [i-na]-an-zi-iq (Köcher and Oppenheim , AfO 18.64 i 41–42 [physiognomic omens]) **[If a person] gnashes his {teeth} in his sleep, [he is] worried. 16.2 NA4.MESHDISHNA ZÚ.MESH-s hú i-ka-s.a-s.a . . . (BAM 372 iii 5⬘)2 **Stones for cases where a person gnashes his teeth . . . 16.3 KA.INIM.MA DISHNA ZÚ.MESH-s hú i-kas.-s.a-as. . . . (BAM 30:8⬘) **Recitation (for cases where) a person gnashes his teeth . . . 16.4 DISHNAinai-tu-li-s húZÚ.MESH-s húi-kas.-s.a-as...(BAM30:47⬘–48⬘//BAM157obv.6⬘)3 **If a person when he lies down to sleep gnashes his teeth . . .4 stress headache Headaches can occur during periods of mental stress, and the texts below seem compatible with this association. For the personal god and goddess of the patient as causers of stress, see 19.35–19.38, with discussion. 16.5 DISH ina SAG.DU-s h[ú]/SAG.KI-shú DIB-su DIB DINGIR-t[i] (DPS XIX/XX:100⬘ [AOAT 43.232]) **If it afflicts him in his head/temple(s), divine anger. 16.6 DISH SAG.KIII-s hú shá 15 u 150 KÚ.MESH-s hú-ma KÚM-shú mit-hrar SHU DINGIR-s hú DIN (DPS IV B obv. 32//E i 12 = TDP 36:33//SpTU 3.88 i 12)5 **If his left and right temples continually hurt him and his temperature is normal, “hand” of his god; he will get well. nightmares The goddess Ishtar was responsible for nightmares in small children (see Chapter 17). In adults as well as in children, disturbing dreams are a frequent consequence of mental stress. 16.7 NA4.MESHMÁSH.GI6.MESHHRUL.MESHSIG5 . . . (BAM 376 i 30⬘; cf. SpTU 4.129 ii 6)6 **Stones to make bad dreams good . . . 16.8 shá mal-di GISHNÁ.MU it-ti-iq ú-pal-lìhr-an-ni ú-shag-ra-[ra-an-ni] s hu-na-a-tú pàr-da-a-tú úkal -lam-an-ni . . . (SpTU 3.82 iv 12–13//Ebeling, ArOr 21.403:1–2) 368 Mental Illness **(The demon) who crosses the edge of my bed, frightens me makes me roll over and over, shows me troubled dreams . . . 16.9 DISHN[A M]ÁSH.GI6 par-d[a IGI-mar . . .] BÚR-ri-s hú . . . (STT 107:12⬘–13⬘) **If a {person} [sees] a {troubled dream} [. . .], to dispel it . . . 16.10 NA4 MÁSH.GI6.MESHpar-da-te . . . (BAM 377 iii 18) **Stones for troubled dreams . . . One particular sort of bad dream that receives special mention in the texts is having...