628-330 B.C.: Medicine among the early Persians

So we know now what life was like for asthmatics in ancient Mesopotamia and ancient Egypt, now I'd like explain, if only briefly, what life was like for asthmatics in Ancient Iran.  The simple truth of the matter is it really wasn't much better than anywhere else in the world.  If you had asthma, as with any other disease, your best bet was to have someone pat you on the back, provide you with moral support, and to simply allow nature (or spirits or gods) to heal you.

The first people to live in this area, which was not far from Assyria in Upper Mesopotamia, were the Elamites, the Medes and the Persians.  I think these folks were essential to our asthma history because, when western civilization went into a dark ages of medicine after the fall of Rome in 476 A.D., medicine would rise in the east, and mainly in Persia.  This would happen around the 10th or 11th centuries A.D.  So it is essential that we not ignore these folks.

John Hermann Baas, in his 1898 book, "Outlines in the history of medicine,"  explained, that along with the Mesopotamians, the Chaldeans also had a major impact on Persian culture.  The Chaldeans worshiped a series of sacred texts called the Zen Avesta, also referred to as the "Living Word."  This Avesta was put into writing by the Zoroaster (Zaruthustra, Zerdutscht), who was supposedly a Persian prophet.  According to Encyclopedia Britannica, he lived from 628-551 B.C. (3, page 25)

This book, according to Baas, "was subsequently lost, but afterword collected from memory into a book of its present form."  So what is available today is from later copies, of which knowledge of religion, prayers, hymns, origin of the world, and also one section that includes knowledge of physicians and their medicine.
Plinio Prioreschi, in his 1991 "A history of medicine," says this this section was probably copied sometime around 250-200 B.C.  (1, page 488).

The Zen Avesta is among the few sources of knowledge of Persian religion, myths and medicine.  So knowledge of their religion, and their medicine, is scanty. According to Prioreshi:

The religion of the early Iranians, until the sixth century B.C., was similar to that of other Aryan (people who lived in ancient Iran and northern India) populations as, for example, the Vedic Indians.  Their priests were the Magi (wise men); they sacrificed to many gods, among whom Mithra (see below) held a prominent place; and they did not bury their dead but let them exposed to be devoured by wild animals." (1, page 487)

I find this interesting, because Prioreschi also notes that these people have left behind very few monuments, and very few documents, for modern day historians to learn from.  As the bodies of their dead were devoured by animals, their history was devoured by time.  Historians, therefore, have only a few texts to learn about their religion and mythology, and even fewer to learn about their medicine (which, in all essence, was blended into mythology).  So, unless more documents lie unearthed, it is apparent that the ancient Iranians "did not contribute much to world medicine." (that  is, until about the 10th or 11th centuries)  (Prioreschi, pages 487,495)

Yet we can use our imaginations to figure what life was probably like for them, considering, as Henry Sigerist notes in his 1961 "A History of Medicine," most societies pretty much believed sickness and injuries were basically all caused by magic, and healed by magic.  You did not just happen to become dyspneic, or just happen to get bit by an alligator, these things happened because of magical intervention either by enemies, by evil spirts, angry demons, or upset gods or goddesses.  (2)

These people, therefore, paid tribute to the various deities in order to maintain health and order among the civilization.  Some of their most essential deities to our history are:

Ormuzd (Ahuramazda):  Belongs to light, which emanates the good spirits, the supreme Amschaspands.  (3, page 25)

Amschaspand (Ahmeschaepenta):  Decrees diligently executed by their subordinate Izeds (Angels, archangels).  There are 32 angels of Amschaspand, some of these angels are listed here: (3, pages 25-26)

• Korschid:  The sun
• Mithra:  In the middle between the sun and the moon
• The Supreme Diws (Dews, Dewas):  They are the causes of all disease.  The cure will come from Amschaspands through mediation by a priest or priests.  The following emanate from him (Ahriman also belongs to them):  
• Aschmosch: 
• Eghetasch:
• Bochasp:
• Astujad: 
• Tarik:
• Tosius  
• Ahriman (Angramandscha): The evil principle darkness

Ardibehescht:  He is another god who might provide a cure through mediation of the priests, or a priest, on your behalf or on the behalf of the society.  (3, page 26)

Ainyama:  God of healing (3, page 26)

Thrita:  Physicians were his disciples.  To them he was highly esteemed.  He was the god of physician. (3, page 26)

There is much more detail in their mythology than I mention here, and probably enough to entail an entire book.  Still, if you had asthma in ancient Iran, these are the basic deities most relevant to you.
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So if you lived in ancient Iran, did you have other options besides simply worshiping deities?  Perhaps, although, due to the scanty writings from this era, it's difficult to know for sure.  Although, there may be evidence that there were physicians available to assist you with their enemas, salves and potions.

Prioreschi said that there were essentially three types of physicians in ancient Iran: internal priests who used herbal remedies, surgeon priests who used the knife, and incantation priests who used magical words.  (1, page 490).

Baas said these priests were not paid very well, and this may be a sign of disrespect for physicians, because all other professionals were paid very well.  Likewise, he suspected physicians may have occupied a low position, as only Egyptian and Greek physicains were known to be used as court physicians.  (3, page 27)

Baas notes how Cyrus II, who conquered the Babylonians and created the Persian Empire around 530 B.C., surrounded himself with military physicians, although there are many descriptions of Egyptian and Greek physicians coming to the Persian courts.  (3 page 26)

Prioreschi lists a few quotations where Egyptian or Greek physicians were called upon to treat members of the monarchy.  Prioreschi quotes the great Greek historian Herodutus as explaining how Darius hurt his foot while hunting, and even after seven days of Egyptian physician therapy "the king could get no sleep for the pain."  On the eighth day Democedes of Croton was summoned, and he "applied Greek remedies and used gentleness instead of the Egyptian's violence; whereby he made the king able to sleep and in a little while recovered him of his hurt..." (1, pages 496-7)

Of this, Prioreschi explained:

"This could mean that Persian physicians did not enjoy a great degree of professional respect.  On the other hand, it is difficult to assess the accuracy of Herodutus in this matter as it may simply reflect an opinion held among Greeks in his time (that is, in the fifth century B.C.)  (1, pages 496-7)

Persian physicians may have been disrespected mainly because few people survived the surgeries that were performed.  This may have been true despite the fact the the patient may have died anyway.  Yet because the physician acted, he (or she) would probably get blamed.  The same was true of their medicine, which, when the patient died, must have been blamed.  Herbal remedies, by an ignorant populace, must have been viewed as nothing more than poisons.

So Persian physicians were known for their "poisons," and for this reason, you may have been scared to seek out one.  However, if you did, they might have had a potion or two that might have allayed your nerves enough to take the edge off your suffering.  Or, maybe not.
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The following chart should explain how ancient Iranians commingled with other nations in the area, and it is by this means that ideas and culture (including medicine) were shared.

Ancient Iran
Elam:  2850-640 B.C. Sumerian control: 2850-2180 B.C. Elamites regain control: 2180-1830 B.C. Aryan invasions: 1800 Elams invade Babylon: 1176 B.C. Elams plunder temple of Akkad: 1150 B.C. Assyrians defeat Elams: 721-640 Elam civilization ends: 640 B.C.	While under control of the Sumerians they picked up much of their culture. The Aryans invade around 1800 and bring with them knowledge of medicine.  Before this time, ancient Iranian medicine probably mostly involved magic and religion.  (1, page 496)
Medes:  835-550 B.C. Attacked by Assyria: 835-705 B.C.  Assyrian Rule: 705-625 B.C. Median Empire founded: 625-585	Together with the Babylonians, the Medes destroy Nineveh, the capital of Assyria in 612 B.C. Medes declined, and in 550 B.C. was absorbed by Persian Empire.
Persia:  600-330 B.C. Persian Empire formed: 550-530 B.C. Egypt Conquered: 530-521 B.C. Unsuccessful war with Greeks …Battle of Marathon: 490 B.C. Xerxes I defeated by Greeks: 480&489 B.C Decline of Empire:  465-338 B.C. Conquered by Greece: 336-330 B.C.	Cyrus II conquers Babylon, Lydia and Medes to form the Persian Empire.  His son, Cambyses, conquers Egypt.  Darius extends borders of Empire beyond Indus Valley between 521-486 B.C. but cannot conquer Greece. Persia abandons plans to conquer Greece.  They were ultimately conquered themselves by Alexander the Great of Greece between 336-330 B.C.

Please note that these are approximate dates according to Plinio Prioreschi. (1, pages 485-487)

If you have any further questions about what life might have been like in ancient Iran, you might have to step into our time machine and take a ride. Or, you can wait and hope some more ancient Iranian documents are unearthed by archaeological expositions.

References:

1. Prioreschi, Plinio, A History of Medicine: Primitive and Ancient Medicine," Volume I, 1991, UK, The Edwin Mellen Press
2. Sigerist, Henry, "A History of Medicine," volume 2, 1961, Oxford University Press, page 202; also see Plinio Prioreschi, "A History of Medicine: Primitive and Ancient Medicine," Volume I, 1991, UK, The Edwin Mellen Press, page 490
3. Bass, John Hermann, translated by H.E Handerson, "Outlines in the history of medicine and the Medical Profession," 1889, New York, J.H. Vail and Company

2000-539 B.C.: Babylon had help giving birth to Medicine

The Babylonians are often said to have advanced medicine.  While this is true to a certain degree, it would not have happened if not for other groups of people who migrated to the region, particularly the Chaldeans and the Phoenicians.

While the Chaldeans are sometimes credited with introducing astrology, divination, and poisons to Babylon, this knowledge would have gone nowhere if not for the assimilation of Phoenician wisdom, particularly their system of writing. This allowed medical wisdom to be shared from generation to generation, and civilization to civilization.

The Phoenicians invented writing even before the Sumerians invented Cuneiform and before the Egyptians invented hieroglyphics. Even while their written language was primitive, it created a basic system that people could later advance and improve upon.  The Phoenician writing system, therefore, was the basic model for letters of all later people. (1, page 29)

The Phoenicians must have influenced the Sumerians, who influenced the Akkadians, who formed an empire around their capital Akkadia.  Over time, this allowed all the various groups of people emigrating to or rising from the fertile soils of Mesopotamia to learn the same language.  This, perhaps, allowed for the assimilation of all the wisdom from all the cultures that emigrated into the region.

Thus, it might have been due to the wisdom of the Phoenicians that even gave medicine a chance to evolve around the Tigris, Euphrates and Nile Rivers.  So it was the assimilation of the Phoenicians, and not just the Chaldeans, who helped the Babylonians advance medicine.

There, chomp on that wisdom while you wait for my next post.

References:

1. Baas, Johann Herman, author, Henry Ebenezer Sanderson, translator, "Outlines of the history of medicine and the medical profession," 1889, New York, page 29

2500-539 B.C.: Chaldeans create system of medicine

Originating with the Chaldeans was the Zend Avista, or the Living Word.  This was a compilation of all the Chaldean knowledge accumulated around 2500 B.C. by Zarathustria (Zerdutscht Zoroaster), who was a "priestly lawgiver who lived around 2500 B.C.  

As the most educated Chaldean, he was probably a member of the priesthood. His writings were lost to time, although they were ultimately rewritten into a book consisting of: (Baas, page 25)

• Yanza -- A liturgy
• Vispered -- Prayers (this would include the medical portions)
• Jesch -- History of Chaldeans
• Bundehesch -- Cosmology

Priests were educated at the world's first universities, some of which were created amid the Sumerians, and included locations in Urikh (Erech), Akkad, Nipur, Kutha, Larsa, and Borsippa.  The various branches of learning were not separated as they are today, so if you attended one of these universities you were pretty much educated in all wisdom, which included literature, writing, mythology, religion, medicine, science, mathematics, astronomy, cosmology, weights and measures, magic lore, divination, and astrology. (wiley, page 20)(Garrison, page 54)

Although, the priesthood was ultimately broken down by the Jews/ Hebrews as follows: (Garrison, page 58)

• Priest: Used words to create heal and prevent sickness and injuries. Hebrew priest were the "hygiene police" There is no mention of Biblical priests acting as physicians. (Garrison, page 57)
• Prophets: Had the ability to heal using knowledge they obtained at the universities.  Both Elijah and Elisha had the ability to cure and raise people from the dead. There are various references to them "making medicine" in the bible. 
• Physicians:  Used various herbal remedies and surgeries to heal
• Pharmacists: Created various herbal remedies and poisons to be used in healing

So most of the medicine was contained in the vispered, and it was all theurgic in character, meaning that it was based on mythology and divination.  These priestly magicians were the most excellent physicians, and they cured by their words, and thus they were: (Baas, page 26)

• Word doctors: They healed with their charms, incantations, and prayers. 
• Herb doctors: They healed with their potions
• Knife doctors: They performed surgery, which mainly consisted of blistering, bleeding, or operating on eyes, castration, etc. It rarely consisted of internal surgery.

According to Wiley, they were familiar with the following: (Wiley, page 20)

• Astrology:  Mainly consisted of using astronomy, the alignment of stars, planets, comets, etc. to determine the words of the gods to predict the future. (Wiley, page 20)
• Divination: Mainly consisted of determining the words of the gods by reading the alignment of internal organs, mainly the liver (called hepatoscopy). Garrison notes that the liver was important because it was the source of blood and the seat of the soul.  He says, "to inspect the liver was to see into the soul of the sacrificed animal, and the mind of the gods." (Garrison, page 55) This also involved palmistry (reading palms) and astrology (reading stars, planets, comets, etc.)
• Herbs: They had poisonous and healing properties, and worked by powers invested in them by gods. Herbal recipes were used as medicine, both internal and external (Wiley, page 20)
• Words: Included magical incantations, conjurations, spells and charms that were disgusting to evil spirits and demons, and remedied and cured ailments 
• Amulets: Their magical powers were able to suck out demons and spirits to cure ailments
• Talisman: Warded off evil demons and spirits
• Pharmacy: Medicine kept in vases and jars (Wiley, page 20)(Recipe page 21)

Garrison said priests or physicians would use one or more of the above in the following fashion: (Garrison, page 54-57 )

• Aetiology: Blaming demons (similar to modern physicians blaming germs)
• Diagnosis:  Based on inspection of patient
• Prognosis: Based on the following: 
• Divination or augury from liver of sacrificed animals:
• Abnormally large organ: token of future power and success
• Abnormality on right side of organ: token of future power or success
• Abnormally small organ: token of weakness or failure
• Abnormality on left side: token of weakness or failure
• Divination of astrological signs
• Birth omens, which determined whether person was going to be a super power or a failure.  These were based on augury of liver of sacrificed animals, astrology and palmistry.  They also studied fetal abnormalities.
• Disease omens:  Inspection of the body, abnormalities, studying liver of sacrificed animals, astrology, and palmistry. 
• Palmistry:  foretelling future through study of palms
• Therapy:  The goal of various remedies was to "disgust demons inside the body." (Garrison, page 56)
• Exorcisms by special ritual.  May be performed by the sick at home or at one of the smaller temples, or by the priests at your home, or as part of the regular rituals held at the larger temples. 
• Herbal remedies 
• Words: incantations, charms, spells, prayers, or conjurations
• Prophylaxis:  Prevention
• Incantation
• Talisman
• Charms (may place seal of gods on both sides of door of invalid) (Garrison, page 56)
• Good behavior
• Good hygiene (this was later perfected by Egyptians and Hebrews, although there is evidence of Babylonian drains, indicating they made the link between feces and disease) The Babylonians did wash their hands before meals, however, mainly because they ate with their fingers. They usually only washed the rest of their bodies only once a week. It was a sin to urinate in canals. (Sigerist, page 402)

In this way, it was the Chaldeans who created the first system of medicine. After the fall of Sumeria in 2000 B.C., their medical wisdom would be assimilated into Babylonian culture. 

References:  See post "2000 B.C.:  Assyrian physicians will treat your dyspnea"

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2000 B.C.: Chaldeans introduce physicians to Babylon

Chaldeans introduced astronomy/ medicine to ancient Mesopotamians?

Various groups of people continued to emigrate into Mesopotamia even as the Sumerian civilization was fading. Among these were the Syrians, Babylonians, Hebrews, Phoenicians, Akkadians and Arabs. Some of these matured to form villages, towns, cities, empires and even civilizations. Yet it was another group of people who had the greatest impact on medicine: the Chaldeans (Chaldees). (Baas page 25)

No one knows when they emigrated into the area, although many speculate they came from the north. The Hebrew Bible says they came from the "extremities of the earth," which may be Armenia, Cephenin, and Arrapachitis. Job mentions gold, and Jeremiah the iron of the north. It's also believed they left their homeland (and nobody knows why) over a century before they landed in Babylonia and Persia, or "before they besieged Jerusalem." (Asiatic Journal, page 36-37)

As time went by they were assimilated into Babylonian and Persian society to the point that they were often referred to as Babylonians and Persians, as opposed to Chaldeans. (Asiatic Journal, page 36-37) 

The dominant element of their way of life "consisted of servants to the deity," (Baas, page 25) and they are even referred to in the Bible as the "Magi" or the "Wise men," or "haruspices."  (Asiatic Journal, page 37)(Baas, page 25)

Magi or wise men were magicians, priests who were proficient in all the knowledge of the universe.  They specialized in mythology, religion, and medicine.  They were, perhaps, the most well educated people among society, and they were, in essence, magicians.

Haruspices, according to Britanicca.com, refers to the study of organs, such as the liver, and astronomical phenomenon, such as thunderstorms, lightning, alignment of stars, planets, comets, etc.  This was all done for the purpose of divination, or predicting the future.

The Chaldeans were known for their knowledge of mathematics, astronomy, astrology, interpretations of dreams, and medicine. Some referred to them simply as "skygazers."

Perhaps by gazing at the stars they developed the first calendars based on the phases of the moon.  Perhaps they are the ones who introduced Babylonians and Persians to a numerical system based on the number 60.  This system included the 360 degree circle, 60 seconds in a minute, 60 minutes in an hour, and so forth. They are also sometimes credited as helping the Babylonians advance mathematics, astronomy, astrology and medicine. 

Henry Sigerist, in his 1922 history of medicine, said that ancient societies did not study the sky because they were interested in the alignment of the planets, stars, comets, etc. What they were interested in was interpreting the words of the gods, and this alignment, so they thought, was how the gods communicated. It was the job of the Chaldean priests, and later the Babylonian priests, to interpret astrological signs. (Sigerist, page 392)

Or, as William Osler wrote in his history of medicine:

A belief that the stars in their courses fought for or against him arose early in their civilizations, and directly out of their studies on astrology and mathematics. The Macrocosm, the heavens that “declare the glory of God,” reflect, as in a mirror, the Microcosm, the daily life of man on earth. (Osler, page 24)

As they themselves were, their knowledge and culture were assimilated into Babylonian culture, and this is how medicine evolved into a science of divination through astrology and hepatoscopy in ancient Babylonia, or so it is believed. (Baas, page 25)(Sigerist, 392)

Actually, not only were the Chaldean Priest known for their astrology and hepatoscopy, they were also known for their herbal remedies and incantations. In fact, it was probably due to the Chaldean Priests that the Babylonians became well known for their poisons. (Baas, ?)

Babylonian medicine was initially referred to as poison because it was used for its poisonous effects, which sometimes included killing people who were not wanted.  It was this effect, some believe, that gave Babylonian medicine, at least initially, a bad name.  Perhaps for this reason most physicians were seen as bad people, and for this reason they worked behind the scenes.

Perhaps this was among the reasons that when the Greek historian Herodotus traveled through Mesopotamia, he wrote that "they have no physicians."  Various historians have noted ample evidence that there were, especially after the assimilation of the Chaldeans.

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