4000-539 B.C.: First civilizations advance medicine, part 3

Inanna on the Ishtar Vase
(French museum Louvre)
She was the goddess of love,
war, fertility and lust,
and was associated
with the City of Urek.
(From  Wikepedia)

Everything in ancient Sumeria, Akkadia and Babylonia was created by the gods, even the people.  They were created from the mud of the land, mud that was brought in by the flow of the river, and spread over the land during the floods or inundations.

While the floods were feared, they were needed, because the mud contained the fertilizers necessary to fertilize the land so crops could be grown.  The mud was also fertilizer to mankind, and from this mud grew civilization.  The people were created by the gods with the implicit purpose to perform labor for the gods, and serve the gods. 

Even the king was a servant of the gods. Part of the king's responsibilities was to maintain order among the people, yet his job also was to perform celebrations to the gods.  One such celebration involved the king climbing to a room at the top of the Ziggurat "in which the fertility goddess Inanna lived. The king was married symbolically to a priestess representing the goddess.  Inanna would then see that the king's city prospered." (Foster, page 46)

The king's other job was to make sure each person did his part.  All food and all profits were taken to the temples and belonged to the gods, and in return each person was given whatever food he needed to feed his family.  The people worked hard from sun up to sun down, and in return for all the hard work the people were offered a promise by the god they worshiped of protection.  They made sure the sun rose to begin the day, and the moon came up at night.  They made sure the crops came up, and that the floods or disease did not take them away before they were harvested.  They made sure ideas were created to allow for better methods of taming the land and animals and people. They made sure the year began as expected, and that the floods came to fertilize the land before crops were planted.  He or she kept the people healthy, and gave them new life in the form of healthy children.  

Early chariots on the Standard of Ur, ca. 2600 BC. (from Wikepedia)

So long as the god was fed, clothed, housed, worshiped, and celebrated appropriately, they offered such protection.  When bad things happened, it was because the person, or the society, did something to offend one or another of the gods.  So belief in these gods provided an incentive for the people to be good, and to do what they were told by the ruling classes. This system allowed for the best use of resources.  

With better use of resources, and because crops were so well controlled, some people had time to specialize in things other than producing and preparing food. For this reason, people started to specialize.  Some people became basket weavers, others became potters, some became priests, some became scribes, some became physicians, some became merchants, some became traders.  (Foster, page 43) 

And chances are that whatever family you were born into, you performed the same job as your father or mother; there was very little chance for advancement in society, or change.  The people must have, at times, become overwhelmed by feelings of burnout, apathy and inanition from performing very hard work, and working long hours, usually from sun up to sun down.  

This must have made life very gloomy for the Sumerians.  Their open borders must have made them fear invasion from the north, south, east and west.  They also feared invasion from spirits and demons from the air around them, spirits and demons that were ubiquitous, peering among the trees, the clouds, and even from under the beds in homes, and in the back of dark closets (kind of like what appears in kids' rooms to this day).  They also had to fear the floods, and locusts and other bugs that could destroy crops and kill animals needed to feed themselves and their families.  They also had to fear plagues that killed many of their friends and family, and the fact that eight out of ten infants either died in birth or in the first year of life didn't help matters either.

So they had a very gloomy view of life, and they also had a gloomy view of death. Many of their legends suggest they believed in hell after death, and so they learned to worship their gods for the day, year and life in general to continue.  Perhaps the only solace among these people was worshiping the god, and "hope" that life would continue.  Yet at some point this view of gloom or nothingness after death failed to motivate the people, who took little pride in their lives as a result.  So at some point one member of the ruling classes created a legend of glory and riches after death. This type of mythology must have provided a better incentive to get the people to behave in this life to prosper in the next.

Since all the work was done by the peasants, which were most of the people, some people had time to sit around and think.  One of the first problems they had to think about was how to keep track of crops.  They needed to measure land, and they needed to keep track of who brought in food and who didn't.  They needed to keep track of all sorts of such official records, and they had no means to do it.  This problem was resolved when they invented the cuneiform (wedge-shaped)  system of writing sometime around 3200 B.C., and many believe this was the final requirement for the creation of the world's first civilization.

This page contains IPA phonetic symbols in Unicode. Without proper rendering support,  you may see question marks, boxes, or other symbols instead of Unicode characters. Picture from Wikepedia.com

This page contains IPA phonetic symbols in Unicode. Without proper rendering support,
 you may see question marks, boxes, or other symbols instead of Unicode characters.
Picture from Wikepedia.com

The first form of writing was picturesque, where the picture represented an idea. Yet eventually the writing was created where small wedge shaped pictures, pictograms, were drawn into onto clay with stylus, perhaps a small reed.  The characters were adapted by the Sumerians, Akkadian (Babylonians), and the Persian, according to dictionary.com.

The words were read from right to left.  Yet sometime around 2000 B.C. a group of people called the Phoenicians developed a society at the eastern end of the Mediterranean (what is now Syria, Lebanon and Israel).  They were famous for their ports, such as in Tyre, where other nations sent ships to trade goods and services.  They were also seafarers, and built great ships for traveling the seas looking for people to trade with.

Phoenicians originally lived in the land of Canaan and were called Canaanites, although the ancient Greeks referred to them by a red (phoinos) die they exported, and this is how they obtained the name Phoenicians.  (Kingfisher, page 90-91)

The Phoenicians are believed by many to be the first to create a written language, even before the Sumerians, and even before the Egyptians. (need reference). Although some speculate they adapted their alphabet from Semitic speaking people in Egypt.  Either way, their language used symbols to represent sounds, was read left to right, and consisted of 30 letters (all consonants). (Kingfisher, page 90-91)

Because they were traders, and came into contact with many other nations, they were able to share their culture, including their language.  Perhaps it's for this reason they are often referred to as the inventors of the alphabet and phonics (use of sounds to create speech and words). During the ancient Babylonian civilization the Phoenician language was adapted into Mesopotamian culture.

The invention of writing is key to our history of asthma and respiratory therapy, because without it there is no way that medical recipes could have been written down and shared from one generation to the next. It made it so that each generation didn't have to start from scratch, and knowledge could be learned and expanded upon.  The accumulation of such knowledge is what has allowed modern asthma experts -- the scientists, researchers, and physicians -- to advance asthma wisdom to where it is today (and it's pretty impressive as far as I'm concerned). Yet it would take a while for this form of writing to be adapted by the main civiliations.

In the meantime, cuneiform was the main form of writing among most of the people of Mesopotamia.  Cuneiform was learned by scribes, who used a stylus, and carved these pictures onto clay tablets that were then heated and sun dried or dried in ovens, and were portable.  This made it possible to record events, such as when the floods occurred, when the sun rose and set. This made it possible to create the first books and the first calendars. This made it possible to monitor the level of the waters.  This made it possible to track the planets and stars, and write down recipes of food and medicine, and myths and legends and  religion.  It made it possible for ideas to grow and mature, and, thus, it made it possible for civilization to begin.

This made it possible to write books, with each stone tablet representing one page.  Each page was marked by the symbol of the god, and this was probably done so the god would protect it and bless the person who used the information inside.  This was essential, because priest/physicians needed the help of the gods in curing their patients.  And each tablet had the last word of the last tablet so the reader knew what sequence to read them, and which tablets went together. (Sigerist, page 383)

So the various tribes of Mesopotamia blended their cultures together in forming the civilization of Sumeria and allowing it to grow and prosper.  For example, the Phoenicians are often credited as being the first to make glass, and they introduced glass making to the Sumerians.  (Hooper, Yahoo.com) The Chaldeans are often credited as being the first sky gazers, and they introduced divination and medicine to the Sumerians.  As Sumerian civilization died out, Sumerian culture was adapted by the Babylonians, Assyrians, and Persians.  

It's also believed that Thales, the first Greek philosopher who lived around 50 B.C., was a Phoenician.  As he traveled Mesopotamia, and later introduced his philosophy to Greece, he must have spread both Phoenician, Sumerian, Babylonian, Assyrian, and Persian culture to Greece. Among the wisdom he would have taught the Greeks was of Mesopotamian medicine.  (Hooper, Yahoo.com)

To be continued...

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

4000-539 B.C.: First civilizations advance medicine, part 2

So with Urek as the capital of Sumeria, its god, the god of the sky, became the chief among all the gods.  He was Lord of the Heavens, Lord of the Constellations, Lord of the spirits and demons. The great legends and myths of Urek became known to all the people of Sumeria.  They all learned of legends and myths such as how the gods created the world from mud, and how a mighty king of Urek by the name of Galgamesh set off on a great adventure with his friend Enkidu to defeat the monsters and demons that were wreaking havoc on the world.  After the gods killed Enkidu, a saddened Galgamesh set off on a quest to find eternal life.

Galgamesh met a man named Utnapishtim who was granted eternal life by the gods after he survived the Deluge with one of all the animals (a story similar to that of Noah).  Utnapishtim told Galgamesh about a magic herb that would grand eternal life that was at the bottom of the sea.  Galgamesh found the magic herb, but it was stolen by a serpent, who then developed the ability of renewed life by shedding it's skin.

Still, there would have been ongoing disagreements among the rules of the other city-states, and at various times one or another of these city-states ruled over Sumeria, with its god moving to the head of the hierarchy of Sumerian gods.  It's legends were learned by the people.  Yet even as this happened, the legends and gods of the previous ruling city-states continued to be worshiped.

In either case, Sumeria started out as a democracy and ended as a monarchy. One person made himself king, ruler of all Sumeria, and he chose his successor when he died (which probably was his son in most cases).  (Foster, page 46) 

An assembly of elders and warriors of the monarchy were required by the gods to make sure all the people did the work of the gods, and so members of the monarchy had time to sit around and think.  They also had time to collect things other than simply food and things that were essential to life.  They learned they could obtain more "things" by taxing the slaves of the gods, who were more than willing to offer the goods they produced because they believed in the myths created by the kings and the king's people.  

Through taxes the kings collected items of pottery and gold.  They collected wood carvings.  They collected an abundance of food.  They made the god's slaves build for them some of the most impressive structures of all the land, and the people did this because they thought they were doing the work of the gods.  So in this way, Sumerians were among the first to amass a collection of material items, many of which have been discovered by archeologists.  The Sumerians and Babylonians worshiped these items as opposed to the gods, and perhaps it was in this way the Biblical story of the Tower of Babel unfolded. 

The writers of the Hebrew Bible made bold predictions regarding the Babylonians, and to the plight of archaeologists and historians, the boldest of these predictions came true.  As noted by Plinio Prioreschi in is 1998 history of medicne:

"The Mesopotamian civilization differed greatly from its contemporary and neignboring Egyptian civilization.  It has been pointed out that whereas the latter was characterized by confidence in the powers of man and by a frontier spirit full of youthful self-reliant arrogance, the 'mood' of the Mesopotamian civilization is well expressed in a quotation from the Galgamesh Epic: 'mere man -- his days are numbered; whatever he may do, he is but wind.' As if to express the same difference, the Egyptian pyramids still stand to proclaim the power of man, whereas the prophecy of Jeremiah (51:37) that 'Babylon shall become heaps' has come to pass, as all that was built in Mesopotamia has crumbled to dust."(Prioreschi, pages 427-8)

So the melancholy nature of the people of Mesopotamia was well known, and this may have played a role in their ruthless nature.  And perhaps this was the reason the various Sumerian city-states created laws,  or codes, that people were required to follow.  Many of these rules were very strict, such as an eye for an eye, a tooth for a tooth, and a hand for a hand.  It was all an experiment, you must understand, because they had no examples to learn from.  This was completely unlike the members of the Constitutional Convention when they got together in Philadelphia around 4,700 years later, who had many examples to learn from as they were creating the U.S. Constitution. The problems faced by the Sumerians had never been faced before, and the solutions were the first solutions.

Sumerians, Babylonians, and Assyrians created armies and armed them with
knives, swords, spears, and arrows.  This was necessary both to control the
people amid society, but also to protect themselves from enemy nations and,
of course, to fight wars.  (Weaponsandwarfarecom)

Another problem was motivating people to do the work, and to fight wars.  Perhaps the first democracies didn't work because, left alone, people weren't willing to make the sacrifices necessary for the collective. Or perhaps these weren't true democracies, and they weren't formed correctly.  Perhaps a ruler was only chosen during times of strife, and between strife people and city-states were left to do as they pleased, and this was part of the problem, or why problems ensued.

Of course, the founding fathers learned all those years later that democracies never work, because they require every person to stay up on politics, and Lord knows people don't do this.  With most people refusing to vote, or not understanding the need to, or not being interested, one person in power almost always becomes the divine ruler.  This is what happened in ancient Rome, and in ancient Greece, and many times, over and over, throughout history.  Yet the people around Mesopotamia did not know this as they were creating the first governments.

So, perhaps due to the failures of democracies, for whatever reason, monarchies were established.  Perhaps the most powerful king of one of the city-states stood up to the challenge and was accepted as king of the civilization.  It became his job to motivate the people to do the work of the gods, as, after all, they were created by the gods to be servants for those gods.  At least that's what the people were told.  This was the best way, perhaps, for the ruling parties to obtain and maintain order.  This was the best way to make progress.

Picture of Ziggurat in the public domain.

Yet even the king himself was a servant to his god, and this god lived in a temple. Such temples were impressive structures that were built on hills or mounds.  Some of these city-states may have been built around such mounds, although some of the mounds may have been created by human labor. The mighty temples upon them were called Ziggurats. 

Public buildings were built around these temples, and among these buildings were palaces for the ruling class, homes for the priests and even schools and libraries. Wrapped around these mounds were homes made of mud brick and reed sticks that were "closely packed together along narrow, winding streets." (Kingfiisher) 

Surrounding these were many fields where crops were grown (mostly grain) and tamed animals roamed.  Surrounding these were nearby towns, much like today's cities have suburbs. (Foster, 38-39)

The Tower of Babel by Pieter Bruegel the Elder (1563)(from Wikepedia)

The purpose of the Ziggurat was to provide a home for the god or goddess of the city-state to live. These temples were impressive structures, and originally they were made of mud-brick, the same as the individual homes.  When there were floods sometimes the mud would wash away, and the people would  band together to rebuild the temples.  When they did this they made the temples bigger and larger than before, and far more impressive  As greater knowledge and material was obtained, these temples were made of rock, material that did not wash away by the floods.  Many of these structures, although warn by centuries of the rain and sun beating upon them, are still available for modern people to enjoy. Some speculate that the temple built by the people in the city-state of Babylon was the Tower of Babel referred to in the Bible. (Foster, page 39)

To be continued...

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

I

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4000-539 B.C.: First civilizations advance medicine, part 1

To understand how you might have been treated if you were sick in the ancient world, it's important to understand where and how people lived back then, and what people believed.  Medicine was often blended in with mythology, and mythology was based on the culture formed by the land and the people living among it. 

Random and violent flooding of the Tigris and Euphrates rivers created a "fertile crescent" in and around the land between the two rivers.  For over a thousand years groups of people migrated to the area, and ultimately came together to create the world's first civilization.  If you were short of breath, this change would have a significant impact on your life, and your options for a cure.

Mesopotamia was not a civilization; it was a term used by the ancient Greeks in reference to the land between two rivers.  Likewise, since Mesopotamia refers to the land between the two rivers only, "It is, therefore, an inaccurate designation for Babylonia and Assyria, since it does not include the Euphrates Valley."  (15, page 1)

Sometime around 10,000 B.C. people who migrated to the area, and those who continued to migrate into it, found that its rich soils were ideal for the cultivation of plants.  People quickly learned about the various crops in the area:  flax, date palm, leeks, millet, sesame, onions, lentils, wheat and barley.  They also learned about fruit, such as figs and grapes, and various herbs and spices. Around 9,000 B.C. they learned to plant their own crops and tame the animals that lived there. They built huts of reed and mud (clay), and lived amid the landscape which consisted of a plethora of palm and olive trees. 

Scene of Sumerian City-State (http://oxford.library.emory.edu)

They learned quickly that managing the land, and irrigating the crops, took a major effort, and it was nearly impossible to tackle mother nature while working solo.  So it only made sense for the various groups of people in the area to work together for the common good.  They pooled their minds, labor and time and came up with methods of building impressive aqueducts and channels for controlling the flow of water through the land to irrigate the crops. Clans and families turned into villages, which turned into towns, which turned into cities, which, by around 3,500 or 3,000 B.C,. grew into huge cities, each wrapped around a temple on a hill where a god or goddess lived. 

Since the cities each had their own governments, and since there was no government connecting the cities, these cities were referred to as city-states. The largest of these city-states were Ur, Urek, Eridu, Lagash, and Kish. (Kishinger, page 20-21)

Yet as individual clans and families must have realized they could not manage the land alone, so the various kings must have gotten together and come up with some form of treaties.  They must have figured that by working together they could better protect the crops from mother nature and from the plunder of savage people.

Perhaps after a massive flood, or a massive attempt at plunder, one of these kings stepped up as supreme ruler of all Sumeria.  This would have been one of the key moments in the creation of civilization.  The king would have amassed the the armies into one huge military to defeat enemies and protect the nations who volunteered soldiers to the effort.

Yet all this good came as a result of destruction. People migrated to this area because food was plentiful, yet this was only possible due to the flooding of the rivers, which, unlike those of the Nile, were completely random and unpredictable.  As waters quickly spread across the land it wiped out everything in its path, including homes, crops, animals, and humans.  Yet it was by living through this chaos for many years that the men and women of the region learned to manage the waters and perhaps the people as well.

So if civilization grew out of chaos, we can also say that learning how to manage civilization also grew out of chaos.  At first the various groups of people would have worked independently, perhaps even fighting among another.  Some would have been fortunate to beat the floods and prospered, while others would have failed and either perished or forced to start anew.  Those who failed would have been eager to learn the methods of those who succeeded, and this in and of itself may have been the seed of the more advanced civilization that rose from the lands around Mesopotamia.

Perhaps one of the first problems of all these people coming together was the inability to agree on what to do and how to do it.  Plus there would have been the natural yearning to greed and lust, and perhaps this drove some people to fight their peers for power and glory.  There would have been disagreements, and sometimes all out fights, some perhaps to the death.  There would have been fights as to who would be king of Ur, or Urek, or Eridu, or Lagash, or Kish.

Regardless of who won these inner-city battles, the leaders of each of these city-states must have gotten together for a massive blending of their minds. It must have been agreed upon early on that some form of government was needed.  So each city-state initially agreed to vote for a leader, or governor, or king, who served a term.  This governor made rules for the city-state, perhaps with the permission of a group of elder sages and a group of warriors.  With their guidance and permission they decided how to get the people to work together for the common good.  Then the king's term ended and another ruler was selected for that city-state. (Foster, page 46)

They put their ideas together and this resulted in a series of discoveries and inventions that made it easier to manage the lands.  They invented better tools for tilling the land and building structures.  They invented the potters wheel so making pottery was easier and quicker.  They learned how to build aqueducts and channels to manage the floods and flow of water through the land, and temples to house the gods and the people (the god's slaves).

Yet their would have been the development of individual pride and envy, and greed and lust, among the rulers of the people.  Then there would have been continuous disagreements among the assembly of elders. There would have been all out fights, sometimes to the death.  At some point there must have been a massive flood that destroyed all that had been made by the Sumerians, and one of these kings stepped forward to be the supreme ruler of all the land. Or perhaps there was an increase in the number of ox stolen by savages who were trying to feed their own families.

Regardless, one of these kings was granted supreme power over all the city states to get over some crisis.  After the crisis was over he probably gave back his power.  Yet there must have been one king whose ego grew so huge that he believed he could remain king forever.  He wanted to rule all of the then known world.  He refused to give back his power.  The gods and legends of his city-state became known to all of Sumeria, and the main god of his city-state moved to the head of the hierarchy of Mesopotamian gods.

The king of one of the other city-states was unhappy about being controlled by this one ruler, and his pride grew.  Perhaps this was the king of Urek.  He surreptitiously gathered his asspembly of elders, and he petitioned them to attack the ruling city-state, and defeat the supreme king.  But the assembly of elders, perhaps, refused to grant the king this power.  Yet the king refused to give in, so he had his men murder the members of the assembly who disagreed with him, and he sent his troops to war anyway.  He won battles in stunning fashion, perhaps surprising the ruling party.

To be continued...

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

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4004 B.C.: The beginning of Time?

At some point early on in human existence men and women grew curious about the their surroundings, and they began to ask questions. In essence, as the Biblical allegory says, they ate from the tree of knowledge.

Thus, as noted by Alexander Wilder in his 1901 "History of Medicine:"

By such eating of the Tree of Knowledge, the eyes become open, and the man is as a god. He makes “the divinest conquest of the human intellect." (1, page 2)

When was this tree of knowledge planted, no one knows for sure.  According to the Bible, God created Adam and Eve, and they lived in the Garden of Eden, and this was the beginning of time.

According to Patricia D. Netzley, in her 1998 book "The Stone Age," "some editions of the King James Bible even offered the date of Creation: as 4004 B.C. This date was developed by a religious scholar, an Irish archbishop named James Usher, who used time reference in the bible to construct a system of biblical chronology."  (5, page 18)

This actually makes sense, considering a written language was supposedly invented in Mesopotamia around 3200 B.C., and subsequently, this language made its way to Egypt.  This means it was at about this time when all the information from the past was written down for the first time, information such as:

• Myths
• Legends
• Religions
• Laws
• Recipes for foods
• Recipes for remedies

Prior to this time, this information was relayed by word of mouth, probably by words turned into lyrics and relayed by poems recited or songs sung around the fires late in the evening under the moonless sky, or somewhere on a cold and snowy evening in a cave around a warm fire.  Chances are these stories were altered each time they were told.

The creation of a written language allowed for these stories to be recorded for all of history, assuring that they would no longer be altered when retold.    

Since there was no ability to write prior to about 3200 B.C., each generation had to start from scratch, and so it's probable the information relayed must have been kept very simple, as can be noted by some of the early Biblical stories.  The stories of creation, of Adam and Eve, and of the Tower of Babylon are all very pithy stories, mere summaries of true events.

For most of us, history begins from the time we were born.  So it only makes sense that events that occurred 800 years before you were born, if not shared with you, did not exist.  Yet this all changed sometime around 4004 B.C, or when written language was available.

Interestingly enough, this date was believed to be accurate well into the 19th century, and even into the 20th century for some.  Many of the history books I read in preparing to write this history referred to the Bible for the earliest evidence of our history.

According to the people who wrote the Bible, this history was 100 percent accurate, and this was given the limited knowledge of human history at that time.

Now, I'm not implying that Biblical stories aren't true, I'm merely saying they are but summaries of true events.  Biblical stories were, in essence, allegorical.  This is not a knock on the Bible, as this was simply how stories were told during Biblical times.

When stone tools were discovered from time to time, they were usually classified as things like "petrified thunderbolts, fairy arrows, exhalations of the clouds," said Netzley.  By the 1600s, however, "scholars suggested that these ancient items might somehow be related to human activity."  (2, page 17-18)

When dinosaur bones were discovered, they were thought to be bones of the animals kept on the arc, or animals that were killed by the great flood.  

Historians have proven that the stories in he Old Testament really did happen, and provide us with an accurate depiction of human history.

However, there is evidence that human activity persisted long before the beginning of Biblical times.  There is also evidence of knowledge, diseases, remedies, and even doctors prior to 4004 B.C.

References:

1. Wilder, Alexander, "History of Medicine, a brief outline of medical history and sects of physicians, from the earliest historic period; with an extended account of the new schools of the healing art in the nineteenth century, and especially a history of the American eclectic practice of medicine, never before published," 1901, Maine, New England Eclectic Publishing Co.
2. Netzley, Patricia D, "World History Series: The Stone Age," 1998, San Diego, CA, Lucent Books

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4000-539 B.C. Mesopotamian gods may heal you

Each Mesopotamean city-state had its own god to worship.
The Sumerians build large Ziggurat's for their gods to live,
and these were located on hills in the center of each city-state.

Long before the creation of the first civilization in Sumer, the people living among and around Mesopotamia rationalized life by speculating it was made possible by all the spirits of dead people that were ever present in the world around them.  These spirits guided them through life, and so to assure happiness and productivity, to assure life would continue, the people must keep these spirits happy.

At some point some of these spirits became gods.  These gods lived in the heavens, and lived just as they did: they ate, drank, slept, fell in love, got married, celebrated, enjoyed life, worried about life, fought, had wars, killed, and died.  It was even more essential people satiate the needs of these gods, to provide them with food through sacrifice, with water through the wells, and through rituals and celebrations.  In return the gods would offer protection from disease and injury, and they would assure that life would continue to the best interest of the people.  

Originally each of the city-states in ancient Babylonia and Assyria worshiped their own gods (or goddesses), although as time progressed some of these gods gained power, and they were worshiped by most people throughout Mesopotamia. These gods probably gained power as one or another city-state gained power, and so now all or most of the people would be aware of that god, and be forced to worship that god. 

Mesopotamian religion was polytheistic,
consisting of over 3,600 gods and demigods.
The gods were also anthropomorphic, or human in form.
They were immortal and all powerful.
mssuna.com

Once again, whether or not you were healthy, sick or injured was completely determined by the happiness of these gods. They created the earth and everything in it, including humans, by the mud of the Tigris and Euphrates Rivers.  They made the sun rise and fall.  They made the crops grow and kept them safe.  They gave the animals life and kept them safe.  

Yet at the same time they could make it all end just as easy.  If you got sick, it was probably because you angered one of them, or did not satiate their needs well enough.  (3, page 433)

It was for this reason that priests held rituals at the large temples where the gods lived.  The largest of these were on a hill or mound situated in the middle of each city-state, and these temples were called Ziggurats.  However, there were also various smaller temples and shrines where commoners could worship various gods for health and healing. 

Many of these gods had the ability to create good and bad demons, and many of these demons were also responsible for health, disease and injuries.  Many of these demons also had temples built for them to live in, and either the priests or commoners held rituals for health and healing. The ultimate goal was to keep these demons and gods happy in order for life to continue.  This was especially important to the ancient Sumerians who did not believe in life after death (at least according to most legends).  Worshiping the gods was the only thing that gave them solace in an otherwise dark and gloomy world. 

Generally speaking, each city-state, each society, each person, had a particular god or goddess or demon or spirit they were responsible for keeping happy.  It was the responsibility of the priests, as well as each individual person, to keep this god or goddess or demon or spirit happy.  In return, this deity watched over you.  If you sinned -- purgery, lied, cheated, stole, killed, had an impure thought, etc. --against this god, then there was a chance the god (or spirit guardian) no longer watched over you, and this made you "easy prey" to the demons.  (10, page 426)

The following are the most common of these gods and demons who had an influence over health and healing during the period of Ancient Mesopotamia between the years of 3500 and 539 B.C. These gods had various cult followings at different times during this period, and were characters in the various myths that evolved.  If you were sick, or had a relative or friend who was sick, you'd worship one of these gods. You worshiped these gods even in good times and in good health in order to maintain this order.  You were at the mercy of these gods. 

Apsu:  He was the god of fresh water.  He mingled with Tiamat and Mumma to form the gods

Tiamat:  She was the goddess of salt water; she was "primeval chaos."  She mingled with Apsu and Mumma to form the gods.(17, page 430)

Mumma:  He was the son of Apsu and Tiamat, and represented the mist and clouds.  He mingled with Apsu and Tiamat to form the gods. 

Anu:  Lord of the Heavens. He was worshiped throughout ancient Mesopotamia, from the Sumerians all the way through to the Persians. The same was true of Enlil, Nintu, and Inki. Gods like Marduk and Ashur were usually identified with them, although the various civilizations and societies may have different names for them. (10, page 410)  As with most gods, he is the son of Apsu. 

Antu:  She was goddess of the earth, and by her relationship with Anu was formed the gods and goddess of the underworld that were called the Anunnaki. They also created the seven demons (utukki).  In later mythology Antu was replaced by the Babylonian Ishtar (Sumerians called her Innana) as wife of Anu. 

Murduk:  The god of the Akkadians and son of Ea (or Enki, depending on what mythology was followed).  He was the lord of magic who lived in the Ziggurut of Babylon, and he became a prominent god who was worshiped all over Babylonia. He was identified with Enlil.  (Sigerist, page 385) Once the Babylonians obtained control of most of southern Mesopotamia, Murduk became one of the most prominent gods in the area around 2,000 B.C.  He essentially rose to the head of the Babylonian pantheon of gods and goddesses. He gained his power because he "imposed a new world order after a fight among the gods that climaxed with a battle that saw Marduk on one side and Tiamat and her second husband, Kingu, on the other. Marduk challenged Tiamat in a single combat; as she opens her mouth to swallow him, he sends a terrible wind right in her mouth, to distend her like a balloon, and then slays her with an arrow.  He binds Kingu, takes from him the Tablets of Destiny (which contain the Code of Hammurabi), and splits the body of Tiamat into two parts.  One he lifts up as the sky, the other he puts down as the ocean below.  After his victory over the forces of chaos, Marduk proceeds to set the universe in order and each of the great gods, Anu, Enlil and Ea, was assigned a portion of the heavens." (17, page 433)

Ea (Enki):  He is the son of Anu and that father of the Babylonian god Marduk. He is the god of wisdom and arts and crafts.  He is a part of the Great Triad that consists of Ea, Anu and Enlil. (about.com) Some considered him "Lord of the Water... Physicians worshiped him as their ancestor." (10, page 433) He separated the earth from the sky to create the world. (14, page 41) Lord of the water. (10, page 410) He was also Lord of the earth, of the rivers, lakes, streams, wells.  Since you drank his water you may want to pray to him that he keeps you healthy by his water, and doesn't infest you with poisons. Azu (physician-priests) may worship him, because the Azu were experts in turning water into medicine.

Enlil:  He was the chief deity of the Sumerian and Akkadian people, although his home was in Nippur.  He was adapted by the Babylonians, Assyrians, Hittites, etc. He was the son of Ashar and Kishar. He was Lord of the Storm. He was identified with Enlil (10, page 384, 388) He was the god of air and agriculture. (about.com)

Damkina:  According to about.com, she was " the Babylonian earth mother goddess, the wife of Ea and mother of Marduk."

Nergal:  Mesopotamian god of disease and death (3, page 56). He was the god of pestilence. (10, page 399)

Baal-Zebul (the Beelzebub of the Bible):  Phoenician god of medicine.  He was interrogated by even the Jews as an oracle of health and disease, although the writers of the Bible preached against it.  (2, page 29)

Esmun:  A special god worshiped by the Phoenicians as the god of medicine. (2, page 29)

Bel:  Tutelary deity of the capital (5, page 37)

Hea:  He was worshiped by the Akkadians and Syrians.   He was “the mysterious Rite, the formula, the all-powerful secret word, which would thwart the efforts of the formidable powers of the Abyss.”  He was "emphatically the god of healing; who had revealed medicine to mankind."  His symbol was usually on one side of the door of an invalid, with the symbol of Merodakh on the other. It was also common to "hang sacred texts about his room and head, in order to exorcise the evil spirits that had caused the disease." Incantations like the following were also said:  (wilder, page 18)

Merodakh:  He was the Bel of Babylon, son of divinity, revered as the "Prince of light," the conqueror of the dragon, the redeemer of kind and bestower of life. He was also the divinity of the planet Jupiter.  His symbol is often found at the beginning of medicine and magic formulas."  An incantation to him would be as such: (1, page 18-19)

“Merciful one among the gods, Generator who brought back the dead to life, Silik-mulu-khi,§ the king of heaven and earth, * ,_. May the invalid be delivered from his disease, Cure the plague, the fever, the ulcer." (1, page 18)

Incantations like this were very important to Babylonian medicine, as they comprised all the healing powers of the priests (also called physicians, wise men, iatroi, magoi).  "They taught the convalescing patients to believe their cure to have been wrought by the divine operation itself."  (1, page 18-19)

“Disease of the bowels, disease of the heart, The palpitation of the heart;
Disease of the vision, disease of the head,
Malignant dysentery ;
The humor which swells, -
Ulceration of the veins, the micturition which wastes,
‘Cruel agony which never ceases,
Nightmare'
Spirit of the heavens, conjure it,
Spirit of the earth, conjure it."

Ainyama:  God of healing. (2, page 26)

Thrita:  Physicians were his disciples.  He was the "good physician," and he was highly esteemed by physicians.  He was the god that they worshiped. (2, page 26)

Baalti:  Supreme god of Akkadians (2, page 27)

Assur:  The god of Assyrians, and the god where from their name is derived.

Nintu:  She was the wife of Anu and the mother of all gods who created humans from clay. She is also the goddess of childbirth. (about.com) She was Lord of the earth. (10, page 410)

Kingu:  The second husband of Tiamat.  In her quest to destroy the other gods, she created a mighty army and set Kingu as its head, according to britannica.com, "Kingu."  He fled when he saw Marduk coming against him.  When Tiamat was defeated, he was taken captive and executed. The god Enki created humans from his blood. 

Naram-Sin:  The moon god. (10, page 385)

Ninib:  A god worshiped by physicians. He was Enlil's son, and he was a healing deity. He was also worshiped by patients for healing. (10, 433)

Gula:  A god worshiped by physicians.  She was a "consort" to Ninib, and she was also a healing deity. "She was a physicians who resurrected the dead by touching them with her pure hands. She was the goddess of potions and poisons and the dog was her emblem. "(10, page 433)

Ninazu:  He was the "Lord of Physicians," and another great healing deity. (10, page 433)

Shamash:  The sun god from whom Hummarabi received the laws. (10, page 387, 399)

An:  Lord of the sky and his main temple was at Uruk.  He was a chief god but had little influence over human life. (14, page 39)

Dumuzi (Tammuz): He was brother of Marduck and god of vegetation, flocks, cattle and food. You might worship him in hopes that your food will be plentiful, but also that it will be safe and not be infected with poisons that have the potential to cause disease and suffering.  He was married to Inanna

Ishtar (Innana, Inanna):  She was the goddess at the side of Murduk, and was the goddess of love. (10, 385-6) She became prominent as early as 4,000 B.C., and was born out of the minds of the people of Urek.  She ultimately became one of the most powerful of all the goddesses of ancient Mesopotamia.  She presided over sexual fruitiness and regeneration.  She was married to Dumuzi, and at the beginning of each year the king of each city-state would climb to the top of the main temple in his city-state (a ziggurat), enter a special room, and perform a celebration in honor of the marriage of Dumuzi and Inanna.  This would keep their marriage strong, for it was this marriage that allowed for the year to continue, and also this marriage that ensured health and productivity of the land and all the people of the city-state and all of Mesopotamia.

There are over 3000 other Mesopotamian gods, although this is enough for our medical history.  I just wanted you to have an idea of what it would be like if you lived during this era of mankind.  You'd spend all your days worshiping these gods, and even fearing them.  

These gods even spoke to the people through the gentle breeze, through the chirping of the birds, through the  position of these birds in relation to your house, through the position of the stars and planets, through the position of bumps and scars on your body, through the size of internal organs (particularly the liver) of sacrificed animals, through the location of abnormalities on organs, and by dreams.  Often a priest or priestess was summoned to interpret these voices, or what we more commonly refer to as omens. 

Ironically, some believe mythology of other civilizations copied, to some extent, Mesopotamian mythology.  The Egyptian Isis and the Greek Aphrodite are very similar in nature to Ishtar. Enlil might have been copied in the creation of the Egyptian God Re and the Greek god Zeus.  Or, perhaps, all of these gods were one and the same, with unique names depending on where you lived.

The blessing of the gods for health was often sited by the people in their regular talk, and in their letters. As we often sign our letters with words such as "be well," or "best wishes," or "keep the faith," the ancient Mesopotamians might use words such as "May Shamash and Marduk give thee health," or "May Ninib and Gula give to the king my lord happiness and health."

May all the gods be with you. 


References: See post "4000-539 B.C.: First civilizations advance medicine, part 4""

4000-2000 B.C: The birth of artificial breathing and tracheotomy

Perhaps as far back as 4,000 years before the birth of Christ some mother grappled for something to do as she watched her child gasp for air.  She had already chanted incantations, and even called the medicine man, so she placed her mouth over the boy's mouth, and exhaled.  As she did so she saw that his chest expanded.

Unknowingly, she became the first person ever to perform mouth to mouth breathing.  Her attempt probably failed, and amid her anguish as she grieved for her child she made no effort to reveal to others what she had done.

Similar efforts were made from time to time, and mostly by mothers making panicked efforts to save their children.  Most of these efforts probably failed, although each would have at least given a child a chance to go on living.

And, lo and be hold, one of these efforts must have resulted in the child gasping and opening his eyes, and this would have been reported to a medicine man who made note of it deep in the back of his mind.  Several years later he was called to a young patient who appeared to be dead.  He breathed three times into the child's mouth and the child breathed life.

Such success would have brought great joy to the parents and family members, and the medicine man hailed as a hero.  This hero would have shared this wisdom with his sons, one of whom shared it with an ancient Mesopotamian messenger, who shared it with a prophet, who shared it with his scribe, who recorded it in some ancient medical texts.

For the first time ever, instead of being relayed from word of mouth, it was privy wisdom shared with the select few who were privileged to attend the few schools that then existed.

This wisdom was used from time to time by ancient physicians, magi, and profits. More often than not such attempts failed to bring people back from the dead, but from time to time it worked.  And with each success some new wisdom was learned.

One day, after a failed attempt at mouth to mouth breathing, a young physician took a sharp knife and created an opening into a suffocating man's neck.  This would have been the first tracheotomy.  Such knowledge would have been recorded by scribes and taught at schools.  This would have been done sometime around 4,000 B.C. (1, page 222)

In 2000 B.C. Ancient Hindu medicine mentioned "throat incision," and about 1500 B.C. the ancient Egyptian architect, scribe and physician Imhotep became the first mention the procedure in writing. While his original works are lost to history, we learn about his thoughts by later writers who would have had access to his original works.  (1, page 222)

The rare patients brought back to life by mouth to mouth breathing were probably merely revitalized by the efforts.  The rare patients who survived early tracheotomies probably died later on due to the unintentional introduction of pathogens to the blood stream during the operation.

References: 

1. Szmuk, Peter, eet al, "A brief history of tracheostomy and tracheal intubation, from the Bronze Age to the Space Age," Intensive Care Medicine, 2008, 34, pages 222-228
2. Price, J.L., "The Evolution of Breathing Machines," Medical History, 1962, January, 6(1), pages 67-72; Price references The Bible, Kings, 4: 34 
3. Fourgeaud, V.J, "Medicine Among the Arabs," (Historical Sketches), Pacific medical and surgical journal, Vol. VII, ed. V.J. Fourgeaud and J.F. Morse, 1864, San Fransisco, Thompson & Company,  pages 193-203  (referenced to page 198-9)
4. "Biographical Dictionary of the society for the diffusion of useful knowledge," Longman, Brown, Green and Longmans, volume III, 1843, A. Spottingwood, London, page 124-5
5. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company
6. Lee, W.L., A.S. Stutsky, "Ventilator-induced lung injury and recommendations for mechanical ventilation of patients with ARDS," Semin. Respit. Critical Care Medicine, 2001, June, 22, 3, pages 269-280
7. Tan, S.Y, et al, "Medicine in Stamps:  Paracelsus (1493-1541): The man who dared," Singapore Medical Journal,  2003, vol. 44 (1), pages 5-7
8. Ball, James B, "Intubation of the Larynx," 1891, London, H.K. Lewis
9. Hill, Leonard, Benjamin Moore, Arthur Phillip Beddard, John James Rickard, etc., editors, "Recent Advances in Physiology and bio-chemistry," 1908, London, Edward Arnold

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5,000 B.C. -1500 A.D.:The first inhalers

Like the discovery of fire, the first inhaler was probably the product of an accident, or mere coincidental reaction of thinking man.

After playing with certain herbs, they may have been tossed into the fire, and a brief ease of temperament may have ensued by those who inhaled the fumes.  Upon further study it must have been learned that the herb in question, perhaps opium, could be used for recreation -- a gift from the gods, perhaps.

Experimentation must have ensued with other drugs, perhaps by a medicine man.  It was ultimately learned that inhaling the fumes of dried and crushed herbs such as black henbane, strammonium, and belladonna resulted in relaxation of the mind.  Then one day an asthmatic, coincidentally perhaps, noticed his breathing was eased by such an inhalation.

To better direct the fumes, some unknown tinkerer tossed a brick into the fire, took it out while it was piping hot, and tossed the herbs onto this, crouched down upon his knees, placed his nose up close to the fumes, and inhaled.  This was a technique mentioned by ancient Egyptian scribes.

Such technology must have made it's way to Greece, and physicians fine tuned this discovery so the medicine was placed in a simple pot with a hole in the lid.  A hollow reed was inserted into the hole, and the patient placed his lips to the reed and inhaled the fumes this way.  (1)  The "herbs and resins were boiled with vinegar and oil which were drawn into the lungs" through the tube.  (2)

Such a device was mentioned by the Hippocratic writers, and perhaps even Hippocrates himself.
Various medicines would have been experimented with, and trialed for certain symptoms.  You may have tried it for your asthma, although that's not necessarily what Hippocrates himself would have prescribed.

From Hippocrates onward physicians and philosophers and other interested persons obtained the writings of Hippocrates, and they copied him.  Each successive expert on such devices shared this wisdom through their own writings, often plagiarizing previous authors.  The works of most of these authors have disappeared in time, although shared vaguely through works that still remain.

Experimentation and observation educated men that certain herbs helped certain symptoms quicker when inhaled.  It was learned that patients complaining of certain symptoms showed certain signs.  For example, the child complaining of a stuffy, runny nose and breathing trouble had a red and inflamed nasal passage and throat.  These symptoms were eased by directly inhaling certain herbal combinations.

First by word of mouth, and then by texts, this knowledge traveled through time.  Medicine men, and later physicians, learned that the vapours of certain herbs helped patients experimenting symptoms of breathing difficulty and cough were associated with signs such as red, inflamed nasal passages.  Terms such as dyspnea, cough, catarrh, and coryza are recognized over time, treated with various inhaled herbal preparations.

Found in Valencia circa 800B.C.-1200A.D. (6)

By studying the works handed to them, Greek and Roman physicians experimented on their own and came up with adaptations and theories.  In Ancient India various herbs were stuffed into crude pipes and inhaled. (2)

In Rome Galen wrote about such inhalations by means of devices similar to that described by Hippocrates.  So to did Actius (500-600? A.D.).  And so to did Arabic authors such as Rhases, Aegineta, Avicenna and Haly Abbas.  (3, page 7)  Around 1190 A.D. Mamonides recommended the primitive method of tossing herbs into the fire and inhaling.  (1,2)

The medicinal, or recreational, component varied through time.  In ancient Greece and India it may have been Black Henbane, Strammonium,  Belladonna or Indian Hemp, all of which would have provided some hallucinogenic qualities necessary to ease the mind of the sufferer, and to generate mild relief from breathing difficulties.

One of earliest discovered medicines was opium, and this may also have been inhaled and prescribed by various medicine men in the primitive world and physicians in the ancient world. Opium inhalation was prescribed in ancient China through metal inhalers or incense.  (2)

Arica Inhaler (Northern Chile, Southern Peru, 1500 A.D.)(7)

Other substances, wither herbal or solutions, were experimented on at various times.  Haly Abbas, for example, recommended inhaling vapors of vinegar, camphor, arsenic and other substances.  Avicenna recommended inhalation of pine fruit.  These remedies may also have been recommended for diseases such as asthma, phthisis (tuberculosis of the lung), bronchitis, emphysema and other diseases of the airway (3, page 7)

Paulus Aegineta (930-1037 A.D.) recommended arsenic in "fumigation with resin in chronic cough, when its steam is inhaled by means of a syphon." (5, page 324-5)

Such technology made its way as far as central America by 1500 A.D. as an inhaler of sorts was used in Southern Peru.  It consisted of a small, decorated plate-like device that held a combination of tobacco-like substances that were inhaled through a small, hollowed out wooden mouthpiece.  It may not have been used for medicinal purposes, although it was an inhalation device.  (4)

References:

1. Anderson, Paula J, "History of Aerosol Therapy: Liquid Nebulization to MDIs to DPIs," Respiratory Care, 2005, September, volume 50, number 9, pages 1139-1150 
2. Sanders, Mark, "Inhalation Therapy: An Historical Review," Primary Care Respiratory Journal,  2007, volume 16, issue 2, pages 71-81
3. Scutter, John M, "On the use of medicated inhalations in the treatment of diseases of the respiratory organs," 1867, Cincinnati, Moor, Wilstach, and Baldwin
4. Sanders, Mark, "Arica Inhaler," Inhalatorium.com, page 120,  http://www.inhalatorium.com/page120.html.  Also see  Anderson, Paula J, "History of Aerosol Therapy: Liquid Nebulization to MDIs to DPIs," Respiratory Care, 2005, September, volume 50, number 9, page 1140.  Picture compliments of Inhalatorium.com.  
5. Aegineta, Paulus, translated by Adams, Francis, "The Medical Works of Paulus Aegineta, The Greek Physician, 1834, vo 1, page 325
6. Sanders, Mark, "Ancient Pipes," page 57,  http://www.inhalatorium.com/page72.html, accessed 9/21/12
7. Sanders, Mark, "Arica Inhaler," page 120,  http://www.inhalatorium.com/page120.html, accessed 9/21/12