Scribes of the Body

Jan 18

Understanding bodies through the lens of ancient practitioners’ medical knowledge and then focusing in on how medical scribes organized and read textualized bodies. The Mesopotamian exorcist is on center stage.

The Scars We Carry (2017)

Eva Camacho-Sanchez

The Surface Design Association

Over the last 20-25 years, a tremendous amount of exciting work has been done to decipher and understand ancient Mesopotamian medicine. As an avid student of this scholarship for over a decade, I have so radically changed my perspective on Hebrew philology that it is now hard to communicate what I “know,” and how I read. Of the several things I hope this website can accomplish, one major goal is to generate briefs as if I was assembling hundreds of fragments of a long shattered glass spectacle. I propose that Babylonian medicine can shed light on topics in Hebrew philology like body language, material religion, the cultural poetics of affliction, first-person distress narratives, medical/psychological discourses, prophetic embodiment, sapiential knowledge, the biblical censure of necromancy/spirits, aspects of the rise of monotheism, several biblical genres, Hebrew narratology, scribal editing, and even canon formation — yeah, not exactly a modest list! In what follows, I plan to free write about medical knowledge — crafting a “what I have learned” essay. This brief is much more like a blue book exam answer than it is a researched article. But I think it could be of value to more than just myself, so I share it publicly.

To trace a through line, I will focus on changes to exorcist medicine. Ultimately, I am interested in the rise of what I call “the scribes of the body” in ancient West Asia during the first millennium B.C.E. To do so, I discuss three types of exorcist knowledge that clunkily follow historical development of the exorcist profession: (1) enacting embodied medical practices, (2) organizing medical wisdom about/with body parts, (3) managing textualized bodies.

Exorcist Knowledge, Type 1: Enacting Embodied Medical Practices

Mesopotamian medicine, known from thousands of Sumerian and Akkadian textual artifacts, is an ancient domain inclusive of diverse knowledge, texts, practices, and practitioners. Modern philologists of Mesopotamian medical texts routinely point to several general categories of practitioner across the long tradition. These categories have provided a useful framework for understanding embodied healers and the kinds of knowledge they each cultivated about the body.

Physicians (Akkadian asû) understood bodily problems and skillfully identified effective plant medicine and other kinds of treatments. Their expertise in prescriptions and prognosis has earned them the modern moniker of “natural” medical specialists. Their profession is legislated in the Code of Hammurabi, and they appear in royal settings in the texts at Mari and the letters from Nippur. The physician begins to fall away and/or blend with the exorcist by the Neo-Assyrian period.
Physiognomists (an eventual knowledge domain of the exorcist; Akkadian, āšipu) observed bodily signs to discern and predict personality and fate. (Barbara Bõck’s work is invaluable here — and I look forward to her editorial work on Alamdimmû.)
Exorcists (Akkadian, āšipu and the largely synonymous Sumerogram MAŠ.MAŠ/Akk, mašmaššu) read bodily symptoms, adduced agents of affliction, understood cosmogonic disease etiologies, and performed incantation therapies (prayers and rituals) directed at the supernatural deity who held the most sway over the patient’s medical drama.

A major distinction between the types of knowledge, indeed perhaps the most important difference in the medical professions were their divergent theories about:

the chain of intermediate causes lying between the gods and the patient. … While āšipu focuses on identifying the divine or supernatural agent responsible for engendering the disease, hence the frequent use of ‘hand’ terminology in The Diagnostic Handbook (e.g., ‘hand’ or agency ‘of a ghost’), Babylonian medicine (asûtu) seeks to identify a chain of intermediate, largely physical causes, leading from the macro-level of heaven and earth to the micro-level of the individual patient. (J. Cale Johnson, “The Stuff of Causation”)

There is some debate about whether these medical professionals read bodily signs as “magical” omens or as “natural” phenomena. Indeed, it would be tempting to consider exorcist knowledge “magical” because of supernatural causation. However, such modern conceptual lines are incredibly unhelpful. For example, exorcist diagnosis involved identifying malevolent spirits, and often the spirit or demon names effectively functioned as disease terms for a consistent set of symptoms which a modern doctor would recognize as a disease. Hence, everything about the knowledge seems empirical, but for the naming convention.

It is also not entirely clear to what extent the professionals worked in tandem or separately or how/when their practices and knowledge conflicted. Professional medical practices took place in numerous social and political situations. Medical contexts were not static or uniform, and medical knowledge is not an essence one can extract from historical context. Attending to various social, institutional, and geographical contexts (royal court, temple, elite specialization in the Neo-Assyrian period, socio-political institutions of the Achaemenid period) would allow for much thicker description. For example, Arbøll’s recent study of the texts of exorcist Kiṣir-Aššur offers a local medical history that might shed light on the rise of the exorcist in Neo-Assyrian royal power centers as well as on whether exorcist, Esagil-kīn-apli’s famous Diagnostic Handbook represents a break with the medical establishment in Aššur. (See Nils P. Heeßel, 154ff).

Even accounting for how those discussions develop, it remains relatively clear that observation of the body and its changing manifestations and assemblages was basic to the knowledge of the physician and physiognomist, and it became central to the exorcist in the first millennium. And as we will discuss below, it is also clear that the exorcist became the more expansive profession, claiming the knowledge domains of the other two during the first millennium.

[For quick reading about medical professionals, see especially Markham Geller’s field-defining monograph (review).]

“The human body was an important canvas for the ancient divination artist. Signs on the human body, sounds, utterances, and behaviours featured diversely in the extant omen literature. The boundaries between physiognomy and the registration of symptoms are blurred to a great extent.”

~Klaus Wagensonner, “If His Chin Is Constantly Slack…

Exorcist Knowledge, Type 2: Organizing Medical Wisdom with Textual Bodies

Text-making was always part of the medical professions as Sumerian incantations attest. Markham Geller helps us appreciate the text-making practices and scribal medicine in these earlier millennia:

Medical texts, like literary texts, were consistently copied throughout the second and first millennia and as a result there are duplicates of most medical texts. However, unlike literary texts, the medical corpus is unique in two aspects. First, medical compositions were rarely copied in whole, but rather a medical text comprised selections from numerous texts to create a unique edition. Thus, the individual prescriptions and recipes of a medical text were semi-autonomous and duplicates can be found in very different contexts, such as in either large medical compendia or in a small prescription. (Geller, 89-117; see the review for quoted text).

Overlooking the important (vast) body of medical writing referenced by Geller — the first millennium did produce two consequential medical texts that can help us shift our attention away slightly from the various embodied healers (briefly described above) and towards scribes as editors of first millennium medical knowledge: the Exorcist Manual and the Diagnostic Handbook. In what follows, I sketch the case that the scribes responsible for these two corpora centered “the body” as an organizing principle for their textual traditions of medical wisdom. This is more obvious for the Diagnostic Handbook, which is the earlier of the two works.

The first consequential text, the Diagnostic Handbook (Sa-Gig/sakkiku), internally claims it is the result of exorcist Esagil-kīn-apli’s editorial work (circa 1100 B.C.E.). This influential medical compendium stands out for its comprehensive scope, its innovative arrangement of traditional medical knowledge, and because its exorcist author makes an important statement about his principles of editing, affording tremendous insight into how the Diagnostic Handbook was built.

The Diagnostic Handbook’s most important innovations involve body parts.

Medical scribes had organized diagnostic omens by body part already (Couto-Ferreira, “From Head to Toe” and Wagensonner, “If His Chin Is Constantly Slack…”), but the Diagnostic Handbook (DH) took this principle and went big. DH gathers a vast trove of diagnostic omens for specific body parts and arranges them from head to foot across the tablets, putting the symptomatic human body at the heart of text-building logic. Then, DH does it again with the physiognomic omens (Alamdimmû).

Indeed, as Jonathan Wee states, “Esagil-kīn-apli made two major innovations to Mesopotamian medical literature: i) the introduction of head-to-foot order; and ii) the intellectual realignment that conceived of human diagnosis and physiognomy as complementary disciplines, and that therefore presented their representative works, “Sa-gig” (i.e., the Diagnostic Series) and “Alamdimmû” as companion volumes.” (Jonathan Wee, 2011, 28).

In the Diagnostic Handbook, we have a parade example of how exorcism begins to expand its scope. It was very likely a work of prestigious, elite scribes who made the human body central to medical text-building logic. The fact that the Diagnostic Handbook generated an active commentary tradition speaks to its significance among centuries of cuneiform scribes. Put another way, the textualized body remained important across several centuries of medically trained or at least medically curious scribes.

Focalizing the human body twice (diagnosis and physiognomic observation) raises a huge question for me about whether DH signals new knowledge about the body — does DH newly theorize the symptomatic and the sign-making body? Does DH initiate a new configuration of corporeal causation? Does DH initiate new practices of physical observation and interpretation?

The Exorcist Manual (KAR 44) confirms some impressions just presented and opens other new questions. Most of the copies of the Exorcist Manual are dated a few hundred years after DH (the 7th-5th centuries BCE, Geller, 296). Eckart Frahm describes The Exorcist Manual as the medical “metatext par excellence.”

The treatise provides information on two key issues: the corpus of magical texts that Babylonian and Assyrian āšipus, i.e., exorcists, of the first millennium B.C.E. considered fundamental to their craft; and the origins of these texts—or at least what the scribes of the first millennium thought about these origins. In several respects, the Manual can be considered the metatext par excellence on the Assyro-Babylonian art of āšipūtu (Frahm, Exorcist Manual).

The manual presents two curricula of texts that the exorcist scribe must master, both of which frankly stretch the modern imagination. The first includes numerous known and some unknown medical collections, from magical gems to witchcraft (e.g., Maqlu), from the Diagnostic Handbook to temple rituals (e.g., mîs-pî, the mouth-washing incantations for purifying divine statues). As if this wasn’t a wide enough scope, the second curriculum is even more scintillating than the first — this second compendium of study is introduced as “secret” (niṣirtu) knowledge about “the totality of sources of wisdom, the secrets of the art of incantations, the sources of the plans of heaven and earth, the secrets of the Lalgar (abyss), and non-canonical (ahû) incantations (KAR 44: 30-31). The emphasis here is on ‘sources’ or ‘springs’ of knowledge, based on the metaphor of the Apsû or subterranean sweet water” associated with Ea, the god of wisdom (Geller, 294).

This medical-exorcist curriculum goes well beyond the symptomatic and signifying human body that we saw in the Diagnostic Handbook. Can we even claim that the human body was a central organizing value in this knowledge? Was human health the central concern? Was this all “medical” knowledge? I am not going to delve into a deep discussion of cross-cultural medical study. That is an important discussion, and scholars who are disoriented by this nexus often default to the categories “magical” and “medical” to navigate the “strange” domain of knowledge. However, I prefer to call all of this knowledge medical to the extent that any of it is medical. But regardless, the question I am asking now is how central the human body was to this manual. This is not a simple question to answer.

I submit that we can consider bodies as the focus of this curriculum, if you will first allow me to expand what we mean by “body.” Certainly, Esagil-kīn-apli centered a new textualized human body in DH. The Exorcist Manual cast a much wider net, gathering texts about the powers at work in diverse “bodies.” From gems as treatments to temple statues indwelled by gods in need of purified mouths, to the types of houses that draw malevolent force, the curriculum in the Exorcist Manual presents a broad spectrum of “material” bodies in/around whom circulated the forces that cause or relieve human suffering.

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Pause in my writing — notes to be integrated below….

Even its second curriculum fits this theme — encompassing knowledge about the “hidden” nature of the underworld, earth, and heaven, which is knowledge put beside two examples of incantational knowledge. Stop right there! —> Incantations are among the oldest Sumerian medical genres, carried forward for millennia by practitioners and scribes. Incantations are medical/exorcist genres for human healing. I am going to connect a dot that a modern scholar would most likely miss: exorcists were experts in disease etiologies, which means they studied all the agents in the cosmos involved in affliction. When the Exorcist manual juxtaposes incantational knowledge with knowledge about cosmic geography — we are still in the domain of human health and the vast assemblages of corporeal agents, patterns, signs, symptoms, and manifestations coursing through the cosmos. I propose this connection, thanks to something I learned from J. Cale Johnson’s work. An article he wrote helped me understand how important “minor cosmogonies” were to the exorcist’s incantational practices and tablet-making. (For a full scope, see his discussions of cosmogony in both the incantation medical and political domains.)

The connection between cosmognonic genres and medical scribalism has gone underappreciated. (At some point, I want to come back to this, to engage Mircea Eliade who proposed a medical function for cosmogonic myths. Eliade viewed cosmogonic myths as explanations of the origins of medicine and visions for the shaman/healer’s practices of regenerative time; Myth and Reality and Sacred Time and Myths).

In short, the Diagnostic Handbook centered the human body as an organizing principle for exorcist knowledge. This focus was more or less developed by the Exorcist Manual — where traditions of material/medical/magical knowledge were brought together and framed by advanced exorcist knowledge of cosmic geography and the correlated power of inscribed incantations. And you can cite me on that. :-)

Exorcist Knowledge, Type 3: Managing Textualized Bodies

…to be continued in a follow-up brief, “Managing Textualized Bodies”

Addendum: For the sake of a complete picture in Exorcist Knowledge, Type #2, two other major types of medical texts produced in the first millennium were medical lists (diseases and therapeutic substances, aka, material medica), and therapeutic texts which combined recipes, therapeutic substances, and incantations. (Geller, 2010, 89-117).