Médecine et médecins au Proche-Orient ancien (review)

Like all collections of articles originating in a colloquium, there is a good deal of variation among various contributions to the present volume, which are generally of a high standard and worth reading.

I would like to focus on the encyclopedic chapter by Marten Stol on digestion of food in Babylonian sources (pp. 103–19). Stol summarizes Greek opinion: although Hippocratic thinking on digestion was vague, Aristotle likened it to cooking. Stol ends his chapter on the same note, explaining that Greek pepsis, denoting ripening and cooking, also meant digestion, whereas the Akkadian equivalent term for cooking does not (p. 116). The impression given is that Greeks actually thought about the problem of digestion and looked for analogies with which to explain it, but Babylonians were simply not interested.

Not all Greek philosophers dealing with medicine believed in theory; the school of Methodists, for instance, rejected any notions of theory in favor of practical remedies that might work to combat disease. It is difficult to determine whether Babylonians developed a theoretical framework for their medical lore, since they never wrote treatises about theory. On the other hand, theory may have been discussed within the scribal schools.

Babylonians had no profound knowledge of internal human anatomy, but neither did the Hippocratics; prior to the third century B.C. no one performed dissection of human corpses. One reason may be that knowledge of anatomy, without microscopes and advanced instruments, does not actually help in curing disease. Stol cites several texts dealing with "lung disease" that mention that the patient has eaten "bewitched food," and infers from this evidence that Babylonian savants associated lungs with digestion (p. 104). Although we cannot be certain that Babylonians understood lungs as organs of respiration, they certainly associated symptoms of cough with "lung disease." It is doubtful that lungs were associated with digestion, since the eating of bewitched food was also marked as a cause of fever and other maladies; the association in some texts between ingesting bewitched food and "lung disease" is simply another example of illness caused by witchcraft. Causes of disease cited in Babylonian texts are always general rather than specific, since there was no real way of establishing causation in ancient medicine. Eating bewitched food could have many bad results.

Other articles: Jean-Marie Durand has solved the meaning of the puzzling Akkadian medical term lipishtu, translating it as "coagulated blood" (pp. 66–71), which fits all the evidence. Frances Joannès's tantalizing discussion of the bit hilsi (house of [oil-]pressing) does not fully prove its case. Although this space in temples in both Uruk and Ur may have served as a storehouse for medicinal plants and aromatics (p. 76f.), the bit hilsi served other cultic functions as well and cannot be exclusively associated with therapy or healing. The question remains whether any temples actually housed "surgeries" or apothecaries. Pierre Villard's tables of healers operating in the Assyrian royal court (pp. 151ff.) do not identify the professional qualifications of each of the practitioners as either exorcist or "physician," nor do the texts themselves always make this clear. Finally, Robert Biggs's article characterizes the exorcist (ashipu) as "sex therapist" (p. 44f.), referring to a corpus of recipes and rituals for alleviating impotence. However, many therapeutic rituals against impotence resemble medical texts and are usually associated with the "physician" (asû) rather than with the exorcist, which makes us wonder whether impotence was treated by more than one type of professional healer.