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

17. Pediatrics

The birth process and the early years of life are subject to many risks of morbidity and mortality in the current era, and those risks were even greater in ancient Mesopotamia. Inherited diseases often become evident early in life, and the immature immune system of childrenplacesthematgreaterriskforinfectiousdiseases.Theamshipureservedatabletofthe diagnostic/prognostic series exclusively for diseases of infants and small children (LÚTUR/sherru). A section of the omen series SHumma Izbu also discussed malformations in newbornsandtheirominoussignificance.Thischapterwillcoveronlythoseconditionsthat are unique to childhood diseases; those that have signs, symptoms, and outcomes similar to adult diseases will be included in the relevant sections of other chapters. Birth difficult births 17.1 BE MUNUS Ù.TU-ma ush-tap-s hi-iq . . . (SHumma Izbu IV 45 [Leichty, Izbu 70]) **If a woman is too narrow to give birth . . . Difficult births are caused by many factors, some of which have been discussed in the obstetrics and gynecology chapter (Chapter 12). Some problems specifically relating to the fetus are covered in this chapter. chapter 17 Pediatrics If a mother gives birth to a powerless (child). —SHumma Izbu I 56 stillbirths: the kumbu-demon The Kumbu-demon1 was a ghoulish nuisance whose malevolence was particularly directed at newborn babies (see Chapter 19 with 19.335–19.342) for the simple reason that Kumbu was the demonic manifestation of stillborn children, as may be seen from the following references.2 17.2 **Kumbu who was not buried in a grave . . .3 17.3 **Like Kumbu, never able to suck his mother’s milk . . .4 17.4 **The Kumbu of nadı m tu, qadis htu, kulmashı m tu, and is htarı mtu of Anu (holy women whose duties included supervising childbirth); the little ones who do not know their own names (and) who never saw the sun . . .5 “Seeing the light of the sun” is a typical metaphor for live birth.6 Kumbu is presumably described as “not buried in a grave” because, as in early twentieth-century c.e. Iraq,7 stillbirths were not buried in the cemetery with the adults, but under the threshold of the house orbythedoorofthemother’sroom.Likethelilûfamilyofdemons(seeChapter12),Kumbu’s personality profile falls into a pattern whereby the victim of demonic attack is confronted by the unattractive possessor of unfulfilled desires.8 premature deliveries Premature deliveries are described in medical and omen texts with the terse “she will not bring her fetus to term,” reflecting the fact that this is a problem that is associated with very real fetal risk. 17.5 DISHTU ip-ta-na-ar-ru ul ú-shal-lam (DPS XXXVI A 81 = TDP 208:81) **If a pregnant woman continually vomits, she will not bring (her fetus) to term. 17.6 li-,-bu ina KUR ú-la-,-ib MUNUS.PESH4.MESHs há SHÀ-s hi-na NU SILIM.MESH(RochbergHalton , AfO Beih. 22.243:4) **Infections will infect people in the land; pregnant women will not bring their fetuses to term. With regard to the second quote above, many infections appear capable of inducing premature delivery, but cholera and brucellosis are well documented as having this effect. post mature deliveries The amshipu considered a normal pregnancy to last 10 months rather than 9 months as in themodernera.Thisisduetothepracticeofreckoningtimeusinglunarmonths,measured from new moon to new moon and lasting for an average of 28 days. In both eras, the usual gestation period was 40 weeks. In the text below, periods of 11 and 12 lunar months are marked as abnormal. Since this is an omen text, there is little to suggest the medical significance of this abnormality. Delayed deliveries, however, carry some risk to the fetus, since fetal wasting and other signs of placental insufficiency may be present. Pediatrics 387 17.7 [BE] MUNUS lu ITI.11.KAM lu 12.KAM ú-bi-il-ma Ù.TU-ma [. . .] (SHumma Izbu IV 46 [Leichty, Izbu 70]) **[If] a woman carries (the child) for eleven or twelve months and gives birth and [. . .] footling births The position of the fetus when it passes through the birth canal has a very significant effect on the degree of difficulty in delivering the fetus. Normally the fetus exits head first. When the fetus comes out feet first the delivery is more difficult, and injury to the fetus (especially the brain) is more likely. The examples below mention this problem in twin births.9 17.8 BE MUNUS 2 NITA.MESHs he-pa...