Book Review: Babylonisch-assyrische Diagnostik Diagnoses in Assyrian and Babylonian medicine: ancient sources, translations, and modern medical analyses (original) (raw)

Abstract

Mesopotamian medicine is a burgeoning field of research which deserves, and will reward, increased attention by medical historians. Both books under review are well suited to promoting this. They both vaunt an excellent command of primary sources and secondary literature, offering thorough coverage of the topics studied, and exhibit high standards of philological accuracy. They both enshrine substantial advances in knowledge and understanding of Mesopotamian medicine, and present themselves in a fashion which is accessible to non-specialists. They deserve to be widely read and consulted. Despite the similarity in titles, the two volumes are very much complementary rather than overlapping. They approach the ancient evidence with different questions (the primary orientation of Heesel is cultural, that of Scurlock and Andersen medical), and the textual corpora which they study are not conterminous. Heesel's book, originally a Heidelberg PhD thesis, specifically studies “diagnostic” tablets (not diagnoses or symptoms on “therapeutic” tablets). The great majority of currently known diagnostic tablets are manuscripts of a 40 tablet series known today as the Diagnostic Handbook, redacted by a Babylonian scholar in the eleventh century BCE. This work, last edited in full by the French scholar Rene Labat in 1951, is the primary concern of Heesel's book. After the introduction (chapter 1), the discussion embraces the structure of the Diagnostic Handbook and its division into sub-series (ch. 2), the composition and logic of entries on diagnostic tablets (ch. 3), the function of the Diagnostic Handbook and its actual use in medical treatment (ch. 4), and the diachronic development of the genre of diagnostic tablets (ch. 5), with particular attention to the redactorial activity of Esagil-kīn-apli (ch. 5.2). Chapters 6 and 7 are devoted to textual reconstruction. They list all the manuscripts of the Diagnostic Handbook known to Heesel in 2000 (a sizeable number having been identified by himself), and present an exemplary edition (comprising score transliteration, translation and philological commentary) of tablets 15–33. Throughout, the discussion skilfully interweaves existing knowledge with new insights. The introduction of the distinction between Ursache (cause/reason) and Verursacher (instigator) of a disease, and the observation that diagnostic tablets are usually concerned with identifying the latter not the former (ch. 4.1.2), are especially welcome. One might dissent from the level of significance accorded in the same section to the fact that the basic meanings of verbs used to express affliction by disease (“to strike, to grasp, to seize, to touch” and the like) imply physical contact: a figurative dimension is possible, and it is questionable whether disease was always thought to presuppose physical contact with a supernatural being (whatever “physical” contact might mean in such a context). But quibbles and philological trivia (discussed by earlier reviewers) aside, Heesel's book has established itself as the standard work on diagnostic tablets. The volume by Scurlock and Andersen (an Assyriologist and a medical doctor) draws on all known therapeutic and diagnostic tablets, and to a lesser extent even other textual genres. The authors have collected from them all the symptoms, diagnoses and prognoses, and arranged them in separate chapters according to the type of disease. Thus, after introductory discussions of ‘The ancient Mesopotamian context’ and ‘General health and public health practices’, the chapter headings resemble those of a modern medical textbook: infectious diseases, sexually transmitted diseases, genitourinary tract diseases, gastrointestinal diseases, metabolic and nutritional diseases, heart+ circulatory system+lungs, eyes+ ears+nose, skin and hair, bones and joints, obstetrics and gynaecology, neurology, trauma and shock, poisons, mental illness, paediatrics, dental and oral diseases. There are also chapters on the naming of ancient disease patterns and prognostics, a general conclusion, and a number of appendices. The ancient sources are accompanied by a detailed commentary which seeks to identify the conditions described (retrospective diagnosis). Along the way, a large number of exciting suggestions are made, for example, that Mesopotamian physicians knew of peristalsis (p. 118). The combination of philological and medical expertise, coupled with the generous amount of translations, render this volume outstandingly rich in precious details and indispensable for anyone interested in Mesopotamian medicine. In a work of this size and scope there is inevitably room for dissenting interpretation (the authors modestly disavow definitiveness on p. xvii). The cogency of the medical identifications varies from case to case (for example, the identification of “If a woman gives birth and (the child) rejects its mother” as “autism”, p. 407, is dubious). Chapter 19, one of the most innovative sections…