Like an alien in a strange old world – Reading Mesopotamian medical texts on women’s healthcare

By Ulrike Steinert

Decoding medical cuneiform texts often makes you feel a bit like a detective who has entered a mysterious, foreign world of words and ideas. Not few of my Assyriologist colleagues would probably favour other topics, rather than studying Mesopotamian medical texts, because they are hard to understand, full of strange disease names and unknown drugs, and because these texts have a reputation of being technical, monotonous and boring.

Not surprisingly then, Mesopotamian medical texts remain a poorly known corpus, and few scholars have worked on the subject or published books for a general audience.[i] Although the majority of the texts are still unavailable in proper editions and translations, the situation is steadily improving. Beside a growing number of publications every year, cuneiform medicine is becoming an increasingly recognised topic, and a few research projects are currently investigating these texts, preserved on thousands of fragments of clay tablets and scattered in various museums.[ii] The fragmentary nature of the corpus, consisting of diagnostic and therapeutic texts as well as handbooks on materia medica, written during the 2nd and 1st millennium BCE, and the difficulty of decoding them connected with the cuneiform writing system and the genre (especially the use of many multivalent logograms) have contributed to the lagging behind of research in this field, compared e.g. to Egyptological research on medical papyri.

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.

A Babylonian tablet with medical prescriptions for women, ca. 7th cent. BCE. Source: Cuneiform Digital Library Initiative (http://cdli.ucla.edu/dl/ photo/P238756.jpg)
A Babylonian tablet with medical prescriptions for women, ca. 7th cent. BCE. Source: Cuneiform Digital Library Initiative (http://cdli.ucla.edu/dl/photo/P238756.jpg)

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.


[i] A real primer presenting a comprehensive overview of Mesopotamian medicine is Markham J. Geller’s Ancient Babylonian Medicine. Theory and Practice. Malden / Oxford, 2010.

[ii] The most ambitious of these projects in terms of scope is “BabMed”, a project at Freie Universität Berlin, consisting of a small research team led by Markham Geller. An overview of publications about Mesopotamian medicine can be found in the regularly updated bibliographies in Le Journal des Médecines Cunéiformes (http://www.ames.cam.ac.uk/jmc/de.html).

Cold, dry and bald

By Laurence Totelin

A few months ago, I read with fascination – and surprise – a post by Jennifer Evans on the treatment of baldness in the early modern period. According to one of her sources (William Drage, a physician and apothecary from Hitchin) anything drying, and in particular sexual intercourse, would be detrimental to he who is thinning on top; women and eunuchs, for their part, rarely went bald because of their moist nature.

I was fascinated to find that the early-modern recipes and remedies listed by Jennifer were very similar to those preserved in texts from Graeco-Roman antiquity. Thus recommendations to cut the hair short; to use a laudanum unguent; to anoint the head with juice of onions/leeks, or with radish oil are all to be found in one of the earliest medical treatises preserved in Greek: the Hippocratic Diseases of Women 2 (chapter 189, 8.370 Littré). Some early modern treatments of baldness that presented, such as Mary Glover’s recipe involving cow’s piss and stinking old shoes, were rather unsavoury, but they pale in comparison with pigeon dung (also listed in Diseases of Women 2.189) or the following recipe, excerpted from Cleopatra’s Cosmetics by Galen:

Deer hunt on a fourth-century BCE mosaic from Pella. Source: Wikipedia
Deer hunt on a fourth-century BCE mosaic from Pella. Source: Wikipedia

Another [remedy against alopecia]. The power of this [remedy] is better than that of all the others, as it works also against falling hair and, mixed with oil or perfume, against incipient baldness and baldness of the crown; and it works wonders. One part of burnt domestic mice, one part of burnt remnants of vine, one part of burnt horse teeth, one part of bear fat, one part of deer marrow, one part of reed bark. Pound them dry, then add a sufficient amount of honey until the thickness of the honey is convenient, and then dissolve the fat and the marrow, knead and mix them. Place the remedy in a copper box. Rub the alopecia until new hair grows back. Similarly, falling hair should be anointed everyday. [Galen, Composition of Medicines according to Places 1.2, 12.404 Kühn]

So how is this supposed to work? Ancient recipes do not come with explanation as to their functioning. One must turn to more theoretical texts to find out more. The philosopher Aristotle devoted a long passage of his treatise Generation of Animals to baldness, stating that this affliction is linked to sexual intercourse:

The reason is that the effect of sexual intercourse is to cool, as it is the excretion of some of the pure, natural heat, and the brain is by its nature the coldest part of the body; thus, as we should expect, it is the first part to feel the effect. [Aristotle, Generation of Animals 5.3, 734b. Translation: A.L. Peck]

He went on to explain that children and women do not go bold because they are incapable of producing seminal secretion. Thus, for Aristotle, the cause of baldness is a loss of vital heat through sexual intercourse. Galen, for his part, sees dryness as the cause of the affliction, explaining that women and eunuchs have moist heads, while bald people have dry ones [Galen, Commentary on Hippocrates’ Sixth Book of Epidemies, 17b.5  Kühn]. The physician’s explanation is closer to that found in early-modern treatises: it is through loss of moisture that the hair thins on top.

Wounded bear. Mosaic from Pompeii. Source: Wikipedia
Wounded bear. Mosaic from Pompeii. Source: Wikipedia

Where do remedies fit within shifting systems of explanation? The burnt ingredients in the Cleopatra remedy could be interpreted as both warming and drying, while deer marrow and bear fat would have been emollient (moistening). But I would argue that these explanations are too simplistic. One needs to go further and look at what brings cold, dry and baldness together.

In ancient humoural theory, cold and dry were associated with the Autumn season. (Clearly the theory was not devised in the UK!) It is in the Autumn of life that man loses his hair. There is no real solution to the problem, but ‘fertilising’ ingredients such as ashes could perhaps help. Fats from animals born in the spring and hunted in the autumn might also add to the efficacy of the remedy.

Sounds too far-fetched and less ‘rational’ than humoural explanations? Consider the following: Aristotle himself compared hair loss to shedding of leaves, and poets sometimes drew an analogy between lush greenery and animal hair (see for instance Columella, On Agriculture 10.71).  Ancient recipes can always be read in many different ways!

Garlic and fertility testing in the Greek world

By Laurence Totelin

In my last blog post, I discussed some ancient gender tests. This month, I turn to Greek fertility tests. In the Greek world, women only entered full womanhood upon conception and delivery of a child, preferably a boy. Infertility seriously damaged a woman’s status in her community. It is therefore no wonder that one of the treatises of the Hippocratic Corpus (a collection of some sixty texts written in the fifth and fourth centuries BCE) was devoted to the issue of barrenness: On Sterile Women. This tract includes a few fertility tests, aimed at predicting whether a woman will become pregnant or not.

Representation of garlic in the famous 'Vienna Dioscorides' manuscript (512 CE)
Representation of garlic in the famous ‘Vienna Dioscorides’ manuscript (512 CE)

Tests by means of which you will know whether a woman will be pregnant. If you want to know whether a woman will be pregnant: give to drink butter [or a plant called boutyron] and the milk of a woman who has borne a male child, whilst she is fasting. If she vomits, she will be pregnant; if not, she will not.

Another: Let her wrap some oil of bitter almonds in wool and apply as a pessary. Check in the morning whether she smells of it through the mouth; if she smells, she will be pregnant, if not, she will not.

Another test for the same purpose: apply pessaries that are not particularly strong. If she has pains in the joints, suffers from clattering teeth, dizziness, and yawning, there is more hope that she will pregnant than if she who does not suffer from any of these afflictions.

Another: Having washed and peeled a head of garlic, apply it to the womb, and see the next day whether she smells of it through the mouth; if she smells, she will be pregnant, if not, she will not.

If you want to know whether a woman will be pregnant, let here drink finely pounded anise in water, then let her sleep. If she itches around the navel, she will be pregnant; if not, she will not. [On Sterile Women 214]

Every single one of these tests would deserve a long explanation, especially since possible Egyptian parallels exist for some of these recipes. Here, however, I will focus on the second and fourth tests, the almond oil and garlic tests. Both rest upon the assumption that women have a sort of tube (a hodos) that runs through their bodies, with two openings: the mouth of the face and the mouth of the womb (=the vagina). In a healthy woman, whose tube was not obstructed, a smell could travel easily from the lower to the upper mouth – hence the use of such smell test.

The smells used here were not chosen at random. Perfumes, such as that of bitter almond, were associated with Aphrodite, love making and marriage ceremonies. Garlic too was associted with sexuality and fertility, although the links are not particularly easy to interpret. In Aristophanes’ comedy, The Women at the Thesmophoria (a festival in honour of Demeter), women use garlic to conceal the smell of wine after a night of drinking and sex with their lovers (v. 495). Garlic masks the smells associated with sex and pleasure. Similarly, according to the historian Philochorus (third century BCE), at the festival of the Skirophoria (a festival in honour of Athena and Demeter), ‘women ate garlic in order to abstain from sex, so that they would not smell of perfume’ (FGRH 328 F 89). Thus, Philochorus presents garlic as an-aphrodisiac, a clear opposite to those perfumes used in sexual foreplay.

The sceptic will no doubt say that garlic was chosen simply because it is a strong smelling, ‘windy’ plant, whose scent would travel easily through the body. Yet, there seems to be something that links it to women and sex in the ancient world. An admittedly much later document, a sacred law from the sanctuary of the healing god Men at Sounion in Attica (IG II2 1365) informs men that they should cleanse if they have been in contact with garlic, pigs and women — a rather puzzling combination unless you know that ‘piggy’ was Greek slang for the vulva.