From so far in the future, the medicine of ancient Mesopotamia looks strange. After all, it’s easy to dismiss the therapeutic use of an eagle’s head as not even qualifying as medicine. One unique and perhaps unexpected way in which Mesopotamian medicine differed from our conceptions of medicine is in its use of astrology. We don’t typically expect modern doctors to consult horoscopes or look to the heavens to determine and measure cures, so at face value it seems that this astral medicine only contributes to its strangeness. While it’s true that this medicine often differed from our modern expectations of what constitutes medicine, it’s not fair to write the whole thing off as “strange.” In fact, looking at Mesopotamian astral medicine, we can often find moments of surprising familiarity and common ground.
During the first millennium BCE, the āšipu, “healer-seer,” or the asû, “physician,” practiced general Mesopotamian medicine as described in David Brown’s article on astral divination in the Mesopotamian context. These practitioners passed down knowledge of ailments (and omens related to the treatment or prognosis of ailments), which over time formed the records of the practice of medicine in this culture. A. Leo Oppenheim describes Mesopotamian medicine as “typical folk-medicine on the level of that described by the early English leech-books.” Those seeking the advice of healers could expect the application of herbs, minerals, and some animal products prepared by mixing, soaking, boiling, and grinding, and delivered by smearing, swallowing, or even as suppositories.
Folk medicine like this is common in many cultures, where oral traditions of medicinal plants and prayers form a parallel course of medical treatment, if not the main one. There is a sense, then, that practices from Mesopotamia mirror common practices of other cultures, practices like the application of herbs that, while not in use today, are certainly recognizable as early medicine. We can also look to the records of Mesopotamian medicine as an early example of the modern medical records we are used to today. While we don’t find patient histories and charts of illnesses, the idea of writing down methods and techniques is critical — and therefore familiar — to the modern practice of medicine.
Astronomy and the Calendar
Where Mesopotamian medicine becomes less familiar is when it integrates astronomy. One form this took was the application of the calendar and time to medicine. Mesopotamian calendars were based on lunar and solar cycles, and new months began when the first crescent of the new moon was observed.1 The hour of the day was also determined by the movement of the sun or constellations in the sky. Medicine that involved specific timing required the patient or doctor to be aware of the cycles of these celestial bodies. John Wee describes Mesopotamian therapeutic tablets that required setting medicine out under the stars overnight before applying it to patients. This not only gave the medicine direct exposure to the night sky, but required the timed creation and application of the cure.
At a fundamental level, any medicine based on timing or dating, based on the calendar, is inherently astronomical. But calling this an application of astral medicine is fairly mundane, or at the very least, familiar. Our calendar, too, is based on cycles of the moon and sun, and taking a pill every morning suggests some familiarity with the day/night cycle. We don’t think of this as associated with astronomy because we don’t look at the zodiacal constellations or height of the sun in the sky to figure out the time of the year or day anymore; we only have to look at our phones. While the ties between the calendar and astronomy were perhaps deeper in Mesopotamian medicine than in present day, this relationship doesn’t necessarily feel strange to the modern mind.
A more interesting and more unusual way in which Mesopotamian medicine incorporated astronomy is by letting astrology dictate part of the cure. Centuries of accurate observational records of the position of astronomical bodies allowed Mesopotamians to generate complex predictive models. Eventually these observations and predictive models led astronomers to standardize the zodiac, or a group of constellations around the ecliptic that could serve as reference points for astronomical events and contribute to astrological interpretation of omens. Later medicine made use of this zodiac to determine cures.2 In the fifth century BCE, we start seeing evidence of practitioners selecting medicine according to the zodiacal constellation associated with the timing of the illness.3 This is, in a sense, a continuation of the role that the calendar played on medicine, only much more vividly associated with the placement of astral bodies. During this period, there is evidence of treatment influenced by zodiacal principles, where doctors treated a malady that developed under a particular constellation of stars based on the principles of that zodiacal sign.4
John Steele’s article on astronomy and culture in the city of Uruk discusses a particular example of this: the kalendartexte tablets of the exorcist priest Iqīšâ. These tablets describe the constellations of the zodiac associated with particular ingredients used for anointing a patient. The ingredients parallel the animal of the zodiacal sign with which they’re associated. The ram constellation Aries, for example, required anointing with sheep’s blood, fat, and hair, while Leo required ingredients from a lion. Sheep’s blood seems like a strange medicine, and it appears even stranger to select this as a cure based not on a patient’s symptoms but rather the organization of stars in the sky.
But this association between cures and zodiac signs could have been weirder. The traditional Akkadian zodiacal constellation that we would call Taurus was called MUL.MUL, or “the stars” (a reference to the close grouping of stars we call the Pleiades). It is hard to find a medical corollary to such a constellation, however — how would a physician find hair or blood of “the stars”? As Steele describes, in the kalendartexte we find instead of “the Stars” a reference to a nearby constellation called “the bull of heaven,” an animal for which it is easier to find earthly correlation. But this requires the writer or compiler to be aware of the nearness of “the stars” and “the bull of heaven,” to have some familiarity with the layout and organization of stars in the sky and not just a vague sense of the zodiac. Interestingly, we can use this as evidence that these cures must have been associated with some knowledge of the stars and not just a general idea of the zodiac.
Of course, it is also unlikely that the ingredients specified in the kalendartexte were meant to be applied literally. While some animals — the Taurus bull or the Capricorn goat, for instance — were available in Mesopotamia, they were expensive and not available to the average patron of the medical arts. More worrisome were animals like eagles and lions, which were even less available. While the association between the suggested cures and the stars is undeniable, it is likely that the named ingredients served other purposes. Perhaps they were theoretical, never intended for actual medical practice, or perhaps they were coded references to other, more common and available components. We have some examples of other tablets that list unpleasant ingredients like excrement, semen, and leper’s blood, which were a code for less offensive, real ingredients, to keep the medical knowledge a secret. Lion’s blood, crab’s fat, and eagle’s head could serve a similar purpose in this kalendartexte. In fact, there are other references to “lion’s blood” that actually referred to the juice from the middle of the tamarisk.5 So although this astral medicine may appear strange, it may ultimately just be encoded knowledge for more mundane, traditional medical treatments.
We could also think of matching medicine ingredients to the zodiac as resembling homeopathy — a sort of “like cures like,” where it’s not small doses of the ailment but small doses of the environment. While homeopathy and Mesopotamian astral medicine are certainly very distinct, they do share this appeal to the same as a way of identifying a cure. In this sense, Mesopotamian medicine is not so unfamiliar.
Is Mesopotamian Astral Medicine Really That Weird?
Ancient Mesopotamian medicine had an association with astronomy that, initially, seems very strange to modern sensibilities. That the patterns of the stars or placement of the moon could affect the treatment of disease appears far-fetched. Yet there was logic in how astronomy was applied, from the association of names of constellations to the code-names of ingredients. Indeed, we could look for remnants of these ideas in many modern practices, making the “strange” even more familiar. And in an era where influencers are pushing drinking bleach and urine for their purported medicinal properties, it is clear that humans have certainly done stranger and less scientific things in the name of medicine.
- Sacha Stern, Calendars in Antiquity: Empires, States, and Societies (Oxford: Oxford University Press, 2012), 78. Return to text.
- Markham J. Geller, Ancient Babylonian Medicine: Theory and Practice (Wiley-Blackwell, 2010), 23. Return to text.
- Geller, Ancient Babylonian Medicine, 123. Return to text.
- Geller, Ancient Babylonian Medicine, 163. Return to text.
- Geller, Ancient Babylonian Medicine, 157. Return to text.