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c. 1050 BCE (Diagnostic Handbook)Reputable source · 2 sourcesWell documented

Mesopotamia Splits Healing Between the Physician and the Exorcist

A Babylonian handbook teaches diagnosis by symptom and by omen, with neither ranked above the other

On the timeline · around c. 1050 BCE (Diagnostic Handbook) · Ancient MedicineAncient MedicineMesopotamia Splits Healing Between the Physician and the Exorcist1,750 BCE1,500 BCE1,250 BCE1,000 BCE750 BCE500 BCE250 BCE

Quick facts

Two kinds of healer
Asu (empirical) and asipu (magical)
Key figure
Esagil-kin-apli, Babylonian physician
Text
The Diagnostic Handbook, edited by multiple authors
Method
Inspect symptoms to reach diagnosis and prognosis

What happened

In ancient Mesopotamia a sick person could turn to one of two healers: the asu, a doctor who treated illness or injury empirically with drugs and dressings, or the asipu, who relied on what we would call magic. There is no sign in the ancient texts that one path was considered more legitimate than the other. The Babylonian physician Esagil-kin-apli made additions to the Diagnostic Handbook, a medical treatise compiled by various authors, and organized it around a logical idea: that one should inspect a patient's symptoms to arrive at a diagnosis, and could use those symptoms to judge cause and likely outcome. Alongside symptom reading, diagnosis leaned heavily on omens; one entry warns that if the healer sees a black dog or black pig on the way to a patient, the sick man will die.

Why it matters

The Diagnostic Handbook is one of the earliest attempts to systematize diagnosis, to move from a single symptom to a prognosis by rule rather than by intuition, and its logic of observe-then-conclude anticipates a method medicine would keep refining for millennia. The equal standing of the empirical asu and the magical asipu shows, as in Egypt, that early medicine drew no firm line between the two.

How we know

The Diagnostic Handbook and the roles of the asu and asipu are reconstructed from cuneiform tablets recovered from Mesopotamian sites, read by Assyriologists who can trace Esagil-kin-apli's edits and the omen-based diagnostic entries in the surviving text.

Sources

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Part of a timelineHistory of Medicine24 events · From surgical papyri and the balance of four humors to a Babylonian handbook of omens, an alphabet of the human body, and the day two scientists learned to edit genesView all →
Mesopotamia Splits Healing Between the Physician and the Exorcist · History of Medicine · SourcedStory