possibility is that the healer may have thought that an appeal to Gula, the goddess
of healing, or even a meaningless mumbo-jumbo Sumerian charm, may have had a
desirable psychological impact on the patient, to enhance the placebo effect of the
drugs, although again there is not a single Mesopotamian text which recognises drugs
as placebos. Unfortunately, we have no manuals of medicine or instruction manuals
explaining when such incantations were to be used by healers, and when not.
The use of medical incantations can be viewed from the perspective of the ancient
physician or patient as a means of altering certain realities. The belief was that similar
causes can stimulate similar effects, which is the essential principle behind sympathetic
magic. Hence, diarrhoea is seen in one incantation as analogous to an overflowing
canal. If damming the canal solves one problem, then medications acting in the same
way will staunch the flow of diarrhoea. The incantation draws the patient’s attention
to the sympathetic power of the analogy, with the psychological by-product of creating
greater confidence in the herbal remedies and prescriptions.
One thing, however, is clear, and that is that the medical incantations are not
useful as diagnostic statements about the medical state of the patient or the perceived
or real cause of his disease (paceCollins). The analogies within medical incantations
are intended to portray the disease to the patient in a graphic way, but not as actual
explanations of ‘cause’. A few examples will illustrate the point.
Painful toothache is depicted in an incantation within medical prescriptions as
the work of a tooth-worm (tultu) who gnaws away at the patient’s teeth and jaws.
The incantation explains that the tooth-worm was one of the primordial creatures
of creation, who complained before the gods Shamash and Ea that he had nothing to
eat, i.e. no raison d’être. When offered fruit as his host, the worm declined and
replied, ‘what are a ripe fig and an apple to me? Set me to dwell between teeth and
jaw, that I may suck the blood of the jaw, that I may chew on the bits (of food) stuck
in the jaw’ (Foster 1993 : II 878 ; Collins 1999 : 262 f.). The incantation is hardly a
diagnosis, but a way for the patient to visualise his toothache in a non-abstract form.
In addition to medical remedies applied to the tooth and jaw, the incantation serves
to help the patient cope with the pain by imagining the incantation’s power forcing
the worm out of the tooth. No such illustration is offered by the medical prescription
itself. A similar ontological myth accompanies the ‘ergot’ incantation, which describes
a tiny ergot (mirhu) entering a lad’s eye, at the very beginning of creation when the
gods Shamash and Sin first learned to reap and harvest (Foster 1993 : II 854 ; Collins
1999 : 95 f.). The incantation offers a way of explaining a sty in the eye as by-product
of the natural order of things, rather than as a demonic invasion.
In some cases, the medical incantation incorporates a simple ritual, in addition to
the complex prescriptions which are applied to the patient to alleviate the symptoms
of disease. In another ‘eye-disease’ incantation, the spell opens with a statement that:
the lad’s eye is sick, the maiden’s eye is sick. Who will heal the eye of the lad
and maiden? You send (for ones who) take for you the pure heart of the date palm.
You break it up in your mouth and roll it in your hand, you bind it on the
foreheads of the lad and maiden and the eye of the lad and maiden will get better.This leads us to the central difference between ‘classical’ incantations, best attested
in either Sumerian or as Sumerian–Akkadian bilinguals, and medical incantations
— M. J. Geller —