been attributed to supernatural causes, such as demonic attack ultimately resulting
from the patient’s guilt of sin.
There is much to be said in favour of such a scenario, although some refinements
are required to make this scheme workable. First, it is generally agreed that, within
Mesopotamian cosmology, disease can be caused both by immediate and more remote
(or higher) factors; the patient can be ill because he was bitten by a rabid dog and
because he angered the gods, who control all aspects of human destiny (see Stol). The
question, then, is one of focus. Medical incantations tend to be addressed to the more
immediate causes of illness, such as a draught or bile, while more formal magical
texts concern themselves with the ultimate causes of demonic attack and divine
disfavour. All incantations, however, can be assumed to have a psychological dimension
(Stol 1999 ; Geller 1999 ), and hence the question is how these incantations were
designed to be effective within the contexts in which they were used.
One immediate question which arises in medical incantations is why they were
used at all. With other types of incantations, rituals accompanied the incantation to
reinforce the magic, such as the peeling of an onion to symbolise breaking the spell,
as in Shurpu incantations. Other rituals might include the burning of incense, etc.
Medical incantations occurring within a medical text obviously serve some ancillary
function, to increase the effectiveness of the recipes themselves, added for good measure.
On the other hand, the great majority of medical texts have no incantations, nor is
it easy to determine the reason why a spell would appear within one medical text and
not within another. From a modern perspective, we might think that although a spell
may or may not help, it would not do much harm either, although such a sceptical
approach to magic or medicine is unlikely to be found in our ancient sources. Another
— Incantations within Akkadian medical texts —Figure 27. 1 Seal impression showing an incantation priest at work on a patient (Teisser, B.
Ancient Near Eastern Cylinder Seals from the Marcopli Collection 231 ) (courtesy of the Trustees of the
British Museum).