Dental Pathology in Ancient Mesopotamia

Introduction

The study of ancient illness is a difficult task. Semantic confusions, misdiagnosis, and every kind of mistake conspire against the human need to know about our ancestors’ diseases. These problems are most serious when we address the issue of the diseases that existed several millennia ago. This is the case, for instance, in regard to the diseases that were prevalent between the Euphrates and Tigris Rivers, the land of Babylonia and Assur, of Niniveh and many other famous cities. From this culture, which was most vibrant between five thousand years ago and the last half of the first millennium B.C., have survived several thousand small clay tablets with an impressive quantity of cuneiform texts that Assyriologists are still trying to decipher. There are many obstacles to reading these tablets: the cuneiform writing system and the languages used (Sumerian and Akkadian) are difficult to understand; the texts are sometimes too fragmentary to read even a single line; and some of the words used are either completely unknown or else their technical (medical or pharmaceutical) meaning is unclear (or positively misleading).

These cuneiform tablets include many medical texts, which are of great interest for the study of the history of medicine and of disease. More than six hundred medical tablets (or fragments of them) have been partially published in their cuneiform version; ¹ only a few have been translated into modern languages and published, mainly in Assyriological papers. ² Assyriologists who have worked on this material and have tried to translate ancient words and texts into modern medical concepts have too often failed: in the manner of a modern Procrustes, they have attempted to adapt Assyro-Babylonian healing arts to our anatomico-pathological viewpoint. The disappointing results are difficult to accept, and even, sometimes, to understand. It is therefore important for scholars to agree that ancient medical texts must be interpreted not only from a philological but also from a medical point of view. This paper is intended to be an exercise in this kind of comprehensive analysis, making use, as an example, of the study of the teeth and their pathology.

The Evidence from the Ancient Texts

The Akkadian word for “tooth” was sinnu. ³ It is quoted in texts from different epochs, including ancient Babylonian texts (ca. 1950–1530 B.C.). These cuneiform quotations refer to human teeth as well as to the teeth of animals or mythical beings.

Eruption

Various cuneiform texts describe the presence of teeth in the newborn, at the moment of childbirth. One of the most interesting of these is a teratological divinatory treatise, known by its ancient name of Summa izbu . . . (If an anomaly . . .). ⁴ In this text, hundreds of different teratological pathologies are described (and, of course, sometimes imagined) by the diviner, who was in charge of determining their meaning either for the future of the country or for the personal situation of the king or other individuals. Among the prophecies are the following:

If a woman gives birth and at birth [the child] already has one tooth - the land will be disturbed by command of a god.

(S.I. 4.27)

If a woman gives birth and at birth [the child] already has two teeth - the granary of the king will be used up.

(S.I. 4.28)

If a woman gives birth and at birth [the child] already has its teeth - the days of the prince are at an end; the land will experience hard times; troubles for the land; that house will be scattered.

(S.I. 4.30)

If a woman of the Palace gives birth and at birth [the child] already has teeth - the day of the prince is at an end.

(S.I. 4.50)⁵

These are variations on the subject of a child who is born with one, two, or more teeth—a phenomenon that has actually been observed and described. But this phenomenon also is mentioned in the context of more complex (and very probably speculative) anomalies:

If a woman gives birth and [the child] is half a cubit tall, he is bearded, he can talk, he can...