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“My tooth aches so much”

Nicholas Reid <>

Klaus Wagensonner <>
(University of Oxford)

Akkadian, letters, medical, toothache

§1. Introduction
Not unlike most approaches to healing throughout world history, medical practices in ancient Babylonia consisted of a fascinating amalgamation of “medicine and magic” (see the discussion in Geller 2010: 1-10), where the religious intersected with practical steps for treatment. While much remains unknown about ancient Babylonian medicine,[1] the application of cloths as bandages to wounds appears to have been one important treatment applied by the physician, the asû.[2] In fact, after surveying evidence from pertinent Sumerian literary texts and healing incantations of the 1st millennium,[3] Barbara Böck concludes, “... it does not come as a surprise that bandaging turned into the synonym of healing, namely the healing of the asû ‘physician’ whose patron deity was the [goddess] Ninisina / Gula” (Böck 2014: 17). Two important terms referring to the cloths being used as bandages that feature in medical contexts are the ṣimdu (tug2nig2-la2) and the paršīgu (tug2bar-si). By providing new evidence, we hope to isolate one medical function of the “cloth,” paršīgu, and further substantiate our understanding of the application of bandages by the physician, asû.


§1.2. The Chicago Assyrian Dictionary (hereafter CAD) names the following applications for paršīgu:[4]

  • as apparel for goddesses and (rarely) gods
  • as apparel for figurines in a ritual
  • as a bandage

§1.3. For the instances in which paršīgu refers to a bandage, the recently published volume P only provides 1st millennium attestations. However, in the course of publishing a group of Old Babylonian letters,[5] we identified two new occurrences of paršīgu, demonstrating that these cloths were used as bandages as early as the 2nd millennium. Further, these letters offer new evidence about one function of such bandages and the role of the “physician,” asû, during the Old Babylonian period.


§2. Text apparatus[6]
§2.1. Text 1: BM 103081

Letter sent to Gimillia by Etel-pî-Marduk[7]


 left edge e-eš-te-ne-mu-u2
  2. ˹a˺-na ši-ip-ri-im šu-a-ti
  2. ni-di a-ḫi-im ta-ra-aš-ši
  2. ši-in-ni ma-di-iš {UŠ}
  2. 1(diš) tug2bar-si šu-bi-lam
Since I hear constantly (about this matter), I wrote (immediately) to you regarding this task. Do not be negligent. My tooth aches so much. Send a bandage!

§2.2. Text 2: BM 103143a[8]

Although the second occurrence unfortunately appears in a broken context, the mention of an asû, “physician,” as well as the inclusion of the verbal root √MRṢ indicate that the cloth was requested for medical purposes.


Letter sent to Gimillia by Etel-pî-Marduk


  rev. 1. 2(diš) bar-siḫi-a šu-bi-lam-ma!
    2. lu2a-su-um li-iṣ-mi-˹da-an˺-[ni]
    3. ma-di-iš nam-ra-ṣa-am a-ta-ma-˹ar˺
Send two bandages, in order that the doctor may bind them on me. I am greatly distressed.

§3. Commentary
In both examples above, paršīgu, a Sumerian loan word well-attested in Old Babylonian letters, is written logographically with the Sumerogram tug2bar-si.[9] Many of the instances of this word imply that the paršīgu is used as a type of head-gear, occurring quite frequently in passages relating to dowries or marriage settlements.[10] Despite this, the function of the paršīgu is not usually specified, and the contexts in which the term occurs often lack sufficient detail to gain further insight into the function of these cloths.[11] The same cannot be said of texts 1 and 2, however, since these references made to the paršīgu occur in contexts in which the letter writer complains about an ailment, clearly indicated by the √MRṢ. The above texts, however, are not the only Old Babylonian letters that mention the paršīgu in a possible medical context.


§3.2. JRL 912 (AbB 10, 28)


 25. 2(diš) tug2bar-si-ig uš-ta-bi-lam
 26.šu-lu-um-ka li-ra-˹ḫa˺-[am]
I sent two bandages/sashes. Let (a message of) your wellbeing come quickly.

While JRL 912 fits within the wider epistolary corpus of texts 1 and 2, this letter belongs to the collection housed at the John Rylands Library, Manchester. The letter mentions an illness (siḫiltum), but unfortunately the tablet is extensively damaged.[12] Here it is unclear whether the mentioned paršīgu’s refer to sashes donned as normal head-gear or to cloths used to ease the recipient’s ailment.[13] This is not the case with our texts 1 and 2. Aided by the more specific contexts included in these British Museum texts, each example provides its own contribution to the study of medical practices in ancient Babylonia.


§3.3. Text 1 is of particular interest since it states that the condition is a toothache and therefore provides more information about one medical function of these “cloths.” Although toothaches are frequently mentioned in the Mesopotamian sources, references to the causes are comparatively scarce.[14] Whether the toothache was attributed to a “worm” or some other problem, numerous attempts were made to alleviate the pain.[15]


§3.4. While on the basis of text 1 it is secure that toothaches are one condition treated by the application of the paršīgu, these bandages could serve other medical functions. The Kuyunjik text K 8160 (= AMT 4, 6) is the splinter of a large tablet which includes the mention of the tug2bar-si in a medical context.[16] Although the symptoms are missing from the text, line 3 reads:


[...] x tu-ba-ḫar-ma ina tug2bar-si sag-ki-su la2-˹ma?˺ [...]
... you heat up[17] and with a bandage you bind his temple.

This attestation clearly refers to the use of a paršīgu as a piece of cloth to be bound around the temple. A ritual from Sultantepe with incantations against “hand of man,” STT 2, 256 obv. 28, instructs the participant to bind a paršīgu around the figurine’s head (tug2bar-sig sag-du-su keš2-as, paršīga qaqqassu tarakkas). In another text, a red bandage is to be bound around the patient’s head to alleviate a fever (BAM 2, 150 obv. 9). Even when it is not being used in a medical context, the tug2bar-si can refer to a sash that is wrapped around the head, as is shown by a line on the 12th tablet of the canonical series Utukkū lemnūtu:[18]


 98. tug2bar-si maš2-ḫul-˹dub2˺-ba sag-ga2-na u-me-˹ni˺-[keš2] ina par-ši-gu-šu2 ša2 min-e qaq-qas-su ru-ku-us-˹su˺
Bind the sash of the scapegoat on his head.

§3.5. Sumerian literature also provides some further clues about the medical functions of the tug2bar-si. Most revealing is a song of praise to the healing goddess Nin-Isina (Nin-Isina A; cited after Böck 2014: 16 with minor variations;[19] see also ETCSL 4.22.1 and Römer 2001: 111 for different interpretations):


 17. tug2bar-si-ge šu im-ma-an-ti šu im-gur-gur-re
 18. tug2bar-si dig-dig-e im-ma-ak-e
 19. im al-du11-ga im-ku7-ku7-e
 20. mud2 lugud-e šu im-šu2-ur-šu2-ur-re
 21. simx(GIG)-simx(GIG)-ma šu-kum2 mu-na-ak-e
 40. šu še17-da-na nam-ma-an-de6
She takes the bandage and wipes (the wound carefully).
She softens the bandage and makes comfortable the plaster to be put (on the wound).
She cleanses the wound from blood and suppuration and lays (her) warm hand on the severe wound.
She brought (the ghee) along with her soothing hands.

§3.6. None of these late attestations, however, relate this bandage or cloth to toothache. Yet from these texts, it can be established that the paršīgu is a type of cloth that can be wrapped around the head. Although the paršīgu can serve as a normal headdress, these cloths were also utilized as bandages to bring relief from pain, such as fevers and toothaches.


§3.7. Text 2, on the other hand, further establishes the nature of patient-doctor relationships in Babylonia. Among the many mysteries related to the medical corpora, the role of “physicians,” asû, and the extent to which they had actual contact with their patients has remained largely unknown. M. Geller (2010: 51) has highlighted some of the ambiguity about the role of the physician for the 1st millennium evidence when he writes: “We do not know if the asû-physician ever met a patient, except for the occasional reference in the royal correspondence to a court physician visiting his patient. Unlike the exorcist, we cannot place the asû in any designated healing location.” Geller does not exclude house visits by the physician, although it “was the exorcist and not the physician who examined the patient from head to foot and recorded the symptoms” (ibid., 52). While text 2 should not be taken as representative of the practice of physicians throughout ancient Babylonia, it indicates that during the Old Babylonian period, the paršīgu could be administered by an asû, putting the physician in direct contact with the patient, since the physician is the one who treats the patient by attaching a paršīgu to his head.


§3.8. These newly discovered Old Babylonian attestations of the term paršīgu indicate two things in particular. First, they deliver one of the earliest known attestations of the medical application of the paršīgu. It is clear from text 1 that the paršīgu can be bound (around the head) in order to ease the patient’s toothache. Of course, whether the cloth is always treated with specific herbs or substances before applied to the patient’s head remains elusive.[20]


§3.9. Secondly, text 2 provides an important clue for establishing one task of the asû. By stating that the bandage will be bound by a physician, text 2 suggests direct contact between the patient and the physician. It is these physicians who are referenced in relation to the treatment of wounds with bandages in the epilogue of the Codex Hammurapi (rev. xxviii 50-69):[21]

May Ninkarrak (~Gula), daughter of Anu, who speaks in my favor in the Ekur temple, make a serious illness break out in his limbs, a malicious demon or a grievous wound (simmu) that cannot be soothed, that no asû-physician knows anything about nor can treat with bandages (ina ṣimdī), and like the bite of death cannot be eradicated.





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Version: 31 August 2014