Let me describe some of the difficulties posed by the Mesopotamian medical texts, specifically those concerned with treating women, to a modern reader. These difficulties result to a considerable degree from cultural differences e.g. between ancient and modern concepts of physiology, disease and therapy.

One problem for the modern scholar is to grasp ancient disease concepts and ideas of physiology from symptom descriptions. The gynaecological texts form a small sub-corpus among the majority of medical tablets devoted to diseases which are normally not gender-specific and which use the male body as a general model. Thus, while the latter diagnostic and therapeutic texts begin with the formula “If a man (suffers from ailment X/symptoms X, Y, Z)”, the gynaecological texts begin with “If a woman …”. The gynaecological corpus, not unlike the modern medical discipline, focuses on female reproduction: (in)fertility, complications occurring during pregnancy, birth, and in childbed, but also includes treatments for abnormal vaginal bleeding and other fluxes, as well as renal, rectal and gastro-intestinal ailments in women. Yet, because the perspective of gynaecological texts was restricted to the diagnosis and treatment of abnormal phenomena, they do not contain descriptions and explanations of normal physiological functions, such as menstruation, which have to be inferred from the sparse information gleaned from the medical texts or other text genres.

For instance, Babylonian healers collected treatments “to stop a woman’s blood” in case “a woman’s blood flows and does not stop”, leaving us at loss to decide whether this refers to unusually heavy menstrual bleeding or to abnormal haemorrhage due to other causes. Beside blood, the texts also treat discharge of “fluids” (literally “water”) from the vagina, which depending on the context, refers to phenomena which modern medicine has come to differentiate, like amniotic fluid (premature rupture of the membranes) and vaginal discharge due for instance to leucorrhea. It becomes clear that the Babylonian healers do not share our differentiations of symptoms and diseases, and that progress with the texts will only be made by investigating their system of ideas about what goes wrong in the body when disease occurs.

This undertaking is somewhat hampered by another characteristic of Mesopotamian medical texts, namely that the writers (Babylonian and Assyrian healers and scholars) rarely recorded their theories (e.g. discussions which took place in the classroom and in scholarly discourse). Yet, some of their concepts of the body, health and disease emerge, often implicitly, from disease aetiologies, names, and from metaphors found especially in the incantations that accompanied medical treatments. These characteristic traits of Mesopotamian medical texts form a contrast to Greek and Roman medical writers who often speculated in writing about physiological processes such as menstruation, conception and the nature of female illnesses based on humoral theory.

Another challenge arising from Babylonian medical texts is to understand the “logic” of ancient medical treatments and recipes even though the majority of the drugs are unidentified, and to reconstruct the cultural context in which the texts were used, e.g. how medical consultation and application of treatments actually took place. Thus, it is still debated whether Babylonian (male) healers actually examined women (and applied the prescribed remedies like tampons), or whether the symptom descriptions in the texts stem from what the patients observed themselves and told the doctor. In upcoming posts on fumigation in Mesopotamian and Hippocratic gynaecology, I will illustrate an approach to discover principles of coherence between the use of particular materia medica and specific complaints.