The Natural Aspect of “Fever”

The empirical aspect of Mesopotamian diagnostics was limited to what could be observed on the external surface of the patient's body, e.g. temper­ature, colour, deformation or dysfunction.

We still need a systematic analysis of the symptomatology of the various terms for “fever”, but we can define one well-known complementary symp­tom. As Stol observed, the term ememu “to be hot” is often contrasted with the phrase kasu “to be cold”.3^[90] The diagnostic term immim u ikassa “he is hot then cold” probably refers to the patient shivering and thus represents an empirical observation within Babylonian medicine. But we could connect this opposi­tion to other aspects of Babylonian diagnostics. In some therapeutic prescrip­tions against seta hamit and li’bu “disease”, the hot and cold state is linked with human anatomy^[91] In the letters of Marduk-sakin-sumi, the chief exorcist of Assurbanipal, we read the following: “My arms and feet (= legs) are without strength. I cannot open my eyes; I am scratched and lie prostrate, (all) that is because this fever (huntu) has lingered inside the very bones”^{[92] [93] Based on this passage, the term “his bone is inflamed below” could refer to hot legs, and the opposition of flesh and bone to the trunk and legs of the human body.42 Furthermore the opposition of “above” and “below” probably refers to the difference between symptoms appearing on the surface or inside the patient's body.}

In Mesopotamian medicine the hot and cold state is related also to day and night^[94] or to midday and shadow.^[95] The identification of the hot state with midday, for instance, testifies to the use of natural phenomena to refer to illnesses^[96]

The various verbs used in therapeutic prescriptions for healing a hot patient are common in the medical corpus: nasahi “to release”; sulu or sahatu or susl “to remove”^[97] The therapeutic treatments for “fever” are not specific and are also well attested for curing other illnesses. The most frequent thera­peutic treatments are napsaltu “ointment”, nasmattu “bandage”, marhasu “rinse or clisma” and masqitu “drink”. It appears that the consistency (solid, liquid or semi liquid) and method of application depend mainly on part of the body to which with medical treatment is to be applied. Generally, bandages or ointments were used for external treatment, while enemas or drinks were used for internal treatment. For example:

If a man's head is continually hot, you shave (his head), knead emmer in the water of kasu-plant, bandage (him) for 15 days.

If [ditto] you crush and sieve mud (which) has been overwhelmed by heat-radiance, you knead (it) in the water of kasu-plant, bandage (him) for 3 (or) 15 days. You pound tarmus-plant, knead (it) in the water [of kasu-plant and do not untie for three days.

In order to release the heat of the head, you knead potsherd from an oven (and) isququ-flour in the water of kasu-plant, you bandage his head (bam 480 ii 61-65 // BAM 3 ii 36-39).^{[98] [99]}

If a man's feet are hot and full of munu-sore: (You crush) together sahlu-cress, cedar tree, cypress tree, juniper aromatic [kukru?]-aromatic seed of kamantu-plant, (mix) with hiqatu-beer, (then) you close (it) in an oven. Lift (it) out and rub his feet, then you mix old oil with these plants, and salve it on his feet, then he will recover (bam 120 iii 1-5).

If a man's belly is hot, (in order) to take off “the heat of the belly”, you crush together cucumber, baluhhu-aromatic, nuhurtu-plant, hasu-plant, put (them) into beer, leave (it) out over night (lit. under the stars), in the morning you cook (and) sieve (it) (and) put date syrup and pressed oil into it. When it is hot (lit. in its boiling condition), you pour (the medi­cine) into his anus, (his inner part) will be normal and he will recover (bam 168 = bam 7, 34 Ms. hh).

Although our sources rarely directly mention the cooling of the patient^⁸ the application of liquid or semi liquid medicine (namely drinks, bandages or lotions) often occurs in cures for hot temperature. The Babylonian scientific background of this praxis is probably based on the opposition between hot/ dry and cold/wet.

Although the therapeutic prescriptions and diagnostic texts do not mention any medical-theoretical cause of “fever”, we can find cause-effect connections between heat and other physical forms of suffering in the sources. The follow­ing letter was written by Nabu-nasir, an exorcist of Assurbanipal, about the cause-effect connection of teething problems:

To the king, my lord: your servant Nabu-nasir. May Nabu and Marduk bless the king, my lord!...As to what the king, my lord, wrote to me: “Write me truthfully”—I am speaking the truth to the king, my lord. The burning wherewith his head, arms, feet were burnt was because of his teeth: his teeth were (trying) to come out. Because of that he felt burnt and transferred it to his innards. Now he is very well and has fully recov­ered. (saa X, no. 302 obv. 11-rev. 7).

In this letter, Nabu-nasir explains to the king that the inflamed state of his body originated from teething. A similar idea can be found in diagnostic texts:

If the infant has no fever (but) his head is hot, his teeth are coming out.

For twenty-one days the woman will see hardship but he will recover.^[100]

We can conclude that the conception and treatment of “fever” probably did not have the kind of theoretical or scientific system that we can observe in respect of epilepsy or paralysis. This is perhaps because a patient's high body temperature was conceptualized simply as a medical complaint, similar to physical pain,^{[101] [102] [103] hence the occurrence of references to this affliction not only in scientific texts but also in letters written by court healers.}