CHAPTER TWENTY SEVEN

THE CIRCULATION OF MEDICAL

PRACTITIONERS IN THE ANCIENT NEAR EAST:
THE MESOPOTAMIAN PERSPECTIVE

M. ERICA COUTO-FERREIRA
UNIVERSITY OF HEIDELBERG

Abstract
This paper deals with the flow of medical practitioners within the international
diplomacy system in the Ancient Near East during the Late Bronze age, with a
special focus on those references regarding cuneiform evidences. The references
made to Mesopotamian ass and ipus in Egyptian and Hittite contexts, as well as
the adoption of these Akkadian terms to refer to non-Mesopotamian healers in the
international correspondence by the Egyptian and the Hittite rulers will provide an
excellent example to explore the symmetrical and asymmetrical linguistic and
cultural translations of healing professions among Ancient Near East cultural
entities.

Keywords: history of ancient medicine, healers and healing professions,

ancient Near East, transmission of knowledge, Late Bronze Age.

Resumen
El presente artculo analiza, a partir de las fuentes textuales cuneiformes, la
circulacin de profesionales mdicos dentro del marco del sistema de diplomacia
internacional en Oriente Prximo en el periodo final de la Edad del Bronce. Las
referencias a ass y ipus mesopotmicos presentes en contextos egipcios e hititas
as como la adopcin de estos dos trminos acadios para designar a sanadores no
mesopotmicos en las fuentes cuneiformes egipcias e hititas constituyen un

The results presented in this paper derive from my current research for the project
Medical systems in transition. The case of the Ancient Near East of the Cluster
of Excellence Asia and Europe in a Global Context, University of Heidelberg.
Abbreviations used follow the Chicago Assyrian Dictionary.
402 Chapter Twenty Seven

excelente ejemplo para explorar los mecanismos de traduccin cultural de la

terminologa relativa a las profesiones mdicas en el Prximo Oriente antiguo.

Palabras clave: historia de la medicina antigua, sanadores y profesiones

mdicas, Prximo Oriente antiguo, transmisin de conocimiento, Edad del
Bronce final.

1. The historical context

The intense net of international relations developed during the second
half of the second millennium B.C. in the Ancient Near East has left us a
number of interesting, although challenging, evidences regarding
medicine.1 Within a much larger frame of diplomatic connections2 that
included the sending of letters and messengers, the establishment of pacts
and treaties, the military assistance (when not the declaration of war), as
well as the exchange of goods, women (through marriage contracts),3 and
skilled professionals, both healers and healing devices were submitted to
the same patterns of circulation.4
The el-Amarna period (ca. 1550-1200 B.C.) is characterized by the
constitution of a new equilibrium among a great number of political and
territorial powers within the Ancient Near East. The operational area will
expand so as to engage the regions of Babylon, Assyria, Egypt, Hatti,
Mitanni, and other Anatolian entities, Alashiya, Palestine, Syria, Phoenicia,
1
I dont intend to use here a modern biomedical definition of the term, which I
find to be too restrictive when applied to ancient times. I understand medicine as
the discipline and body of knowledge regarding the treatment and prevention of
disease, taking all treatments as equal in importance and without favouring one for
sake of the other. I therefore avoid such dichotomies as magic/medicine. For
further discussion, see my forthcoming A historical approach to healing in
Mesopotamia. The transmission of cuneiform medical knowledge in the Ancient
Near East (in preparation).
2
For different aspects of the political and diplomatic relationships in the Ancient
Near East and Eastern Mediterranean of the period, see Liverani (1994); Mayer
(1995: 67-116, 167-249); Jakob (2003: 51-52, 287-309). With regard to commerce
and exchange of goods, the Uluburun shipwreck provides a good example of the
nature and provenience of the objects exchanged (Pulak 1998).
3
For examples of letter exchange concerning the traffic of brides, see Edel (1994:
90-167 [Akkadian], 214-219 [Hittite]). The exchange and contact operates,
therefore, at various levels and concerning many different realities.
4
The perspective given by historical materialism frame of interpretation emphasizes
the element of professional exchange as a matter of prestige and exotic appeal that
turned healers and other craftsmen into luxury goods. For further discussion, see
Zaccagnini (1983); Liverani (1994: 13-21, 183-260).
 The Circulation of Medical Practitioners in the Ancient Near East 403

etc. in a complex network of relations marked by hierarchy, that will

determine the patterns of reciprocity and exchange (Liverani 1999: 311-
338). In our analysis we will mainly resort to the correspondence
maintained by the different political powers of the period, with special em-
phasis in those examples coming from the Hittite capital Boghazky
(roughly the 13th century), since they provide the most relevant and
significative elements of analysis. Other sources we have taken into
account are constituted by the el-Amarna letters (ca. 1385-1355 B.C.),5 as
well as substantial sections of the corpus of cuneiform texts with healing
or prophylactic functions that have been excavated outside Mesopotamia.
These textual and archaeological evidences reveal two main streams of
movement or exportation with regard to medical goods and expertise
during this chronological period:6 from Babylon towards the North and
North-West, and from Egypt towards the North and North-East.
Nonetheless, it is worth mentioning that there are evidences that prove a
flow, weak as it may seem, in the reverse direction in the form of sporadic
traces of textual use of West Semitic healing references in Egyptian
papyrus.7 Besides, the presence of intermediary powers that manage the
in-between steps of exchange makes the picture much complex, revealing
a multi-directional profile of circulation.8

2. The circulation of texts and objects related to healing

Writing played a fundamental role in the task of allowing
communication and interaction among the different political leaders of the
time. Cuneiform was the script internationally adopted, and Akkadian, the
preferred language for this purpose. The import and learning of cuneiform
writing by non-Mesopotamian entities entailed the adoption of certain
practices and uses beyond the process of learning a logophonetic system

5
See Liverani (1998: 9-62) for an analysis of the el-Amarna material; Edel (1976
and 1994) for the Boghazky letters.
6
Examples of contact and exchange can already be traced in the previous Old
Babylonian period, but at a different scale and with a reduced number of political
powers in play. See Charpin (2004: 25-480).
7
Steiner (1992); Ebers Papyrus 422 in Bardinet (1995: 313): Autre remde pour
les deux yeux, qua rvl un Asiatique de la ville de Byblos.
8
See as an example the role of Turatta, the king of Mitanni, as the intermediary
who allows the statue of Itar of Nineveh to be sent to Egypt. See Zaccagnini
(1983: 254-255); EA 23.
404 Chapter Twenty Seven

itself,9 e.g., the use of clay, the shaping of tablets, the distribution of the
text in a certain manner, the use of certain formulas and patterns of
expression, the dealing with texts from the Babylonian tradition, etc. But it
also required the translation and (re)interpretation of foreign terms into the
own semantic categories as well as the reformulation of local terms and
concepts so as to be able to codify them using the cuneiform writing
system.10
In this frame of reference we find that cuneiform tablets on various
topics travel together with human agents as an indissoluble part of writing
teaching and learning.11 Together with, or parallel to, the circulation of
healers there are, then, other goods of medical character that travel along
the Ancient Near East. Clay tablets of medical content are, perhaps, the
most obvious of them all, and they may have had a double purpose: the
education and training of local scribes in both cuneiform writing and
textual tradition (a kind of acculturation in Mesopotamian genres); and
the actual use for practice and education of healers and scholars. The texts
preserved, although often badly damaged, have revealed a certain number
of medical conditions including impotence, fever, jaundice, paralysis,
diseases affecting the skin, the internal organs, the head, the eyes, as well
as infirmities derived from witchcraft and the action of evil creatures.12

9
The process of teaching and learning of cuneiform writing as well as of the two
main Mesopotamian languages (Sumerian and Akkadian) associated with it
implied the mobility of Mesopotamian teachers to other areas of the Ancient Near
East. For the educational process outside Mesopotamia, see Beckman (1983
[Hattua]), van Soldt (1995 [Ugarit]) and Cohen (2004 [Emar]), with previous
bibliography. For an analysis of the cuneiform archives and libraries in periphery
areas, see Pedersn (1998: 61-80).
10
There are a good number of examples of Akkadian texts adapted to and used in
Hittite contexts, or even translated into Hittite. Just as an example of this, we will
mention the texts 68 to 96 published in KBo XXXIX that were reviewed by Goetze
(1964: 94-96), and that pertain to what he calls the b-bi-li-li rituals, that is, to the
rituals with charms in Babylonian (Goetze 1964: 94).
11
The processes that fuelled the adoption of cuneiform writing as well as the
policies followed by the different non-Mesopotamian political powers in order to
implement it are not at all clear, although we do have some specific examples that
help us gaining at least a first impression on how it functioned. See n. 9 above for
bibliographical references on the topic.
12
For the Hittite case, a list of texts can be found in CTH 800-813; see Arnaud
(1987 nr. 694-695 and 729-738) for the texts found at Emar, and Arnaud (2007:
60-99) for those coming from Ugarit. It is interesting to see how the series Udug-
hul / utukk lemntu evil udug constitutes one of the most widespread cuneiform
set of incantations through time and space within the Ancient Near East.
 The Circulation of Medical Practitioners in the Ancient Near East 405

But there are also other kind of healing and healthcare-related goods
that are used in diplomatic exchange, such as perfumes (EA 269, Milki-Ilu,
king of Gezer, asks for myrrh), ointments (EA 48, from Ugarit), and even
drugs, as it can be seen in the lists of gifts exchanged between royal
houses.13 In the letter KUB III 51 rev. 2-11, the pharaoh informs the
Hittite king Hattuili about the sending of presents (gold, silver, copper,
textiles, etc) that include the dispatching of certain remedies to treat the
eyes:
[And I] let all the [good] drugs [for my brothers eyes] to be sent, [and] let
a charioteer go together [with Pirihnawa], and this one went to [Benteina,
the prince of the land of Amurru, with my messenger] Pirihnawa, and he
(Pirihnawa) gave hi[m (Benteina) all the drugs which he had brought,
and] he (Benteina) let a sargu-officer [go to my brother wi]th the drugs,
that the king, your brother, let to be brought to my brother [quic]kly,
quickly [through Pirihnawas hand. And] I wrote a letter to the prince of
the land of [Amurru that goes: I have allowed] drugs for the eyes to be
sent to my brother (as well as) [good gold, silver (and) go]od coloured
[linen clothing from Byssos].14

In some cases even the statues of deities especially known for their
healing properties are sent outside the own country, as the letter EA 23
proves: the statue of Itar of Nineveh is sent to Egypt for healing purposes
through the mediation of Turatta, the king of Mitanni.
It is in this frame of mind that we will try to clarify the linguistic and
cultural translations of terms referring to healing professions from and into
Akkadian done by these different political entities.

3. ipu-as: a definition from the Mesopotamian sources

Before we can put ourselves to the task of dissecting the use of the
words for healer within the Ancient Near East, we should make an

13
See Edel (1994: 269) for a table that synthesises the medical information on the
Bhogazky letters sent by the pharaoh, and where reference to drugs as part of the
gifts are included; See Edel (1994: 16-19, 53-57, 70-73, 80-85, 112-123, 134-137,
170-175, 200-201). Examples of containers with medicines for the eyes can be
found in the texts 122/e(+)2644/c+412/d rev. 12-13; 177/b+1756/c+343/e: 20-
21 and KUB III 63 rev. 8.
14
It is worth mentioning here that most medical references in the letters dealt with
the disease of the Hittite king Hattuili II. In those few instances where the nature
of his disease is partially revealed, we found out that he suffered from an affection
of the eyes. Curiously enough, a good number of the medical texts preserved in
Hattua deal with the treatment of ocular diseases, as CTH 809 reveals.
406 Chapter Twenty Seven

assessment on the two main Akkadian terms with regard to healing

practices used in the international documents of the period we are dealing
with. The two kind of healing professionals that are mentioned in
international correspondence are the as and the ipu, and they already
show problematic features for their interpretation in Mesopotamian
contexts. Assyriology has dealt with the problem by mostly taking into
account the numerous first millennium evidences, just to apply afterwards
the conclusions drawn from this material to the rest of Mesopotamian
chronological periods. Generally speaking, assyriologists have identified
the as with the physician (and sometimes with the pharmacist or even the
nurse),15 and the ipu with the conjurer, exorcist or magician. The
distinction has been formulated from different angles and using various
parameters, which we summarize here for the sake of reference:

a) Duality or opposition, that sees them as two separate but

complementary disciplines, or as two separate and independent disciplines,
or even attributes a dependence relationship of the as with respect to the
ipu (Ritter 1965; Herrero 1984: 22; Avalos 1995: 167; Scurlock 1999;
Attinger 2008: 2-3, and passim).
b) Technical-based division of approaches, usually focusing on the
debate of medicine (identified by most scholars with the practice of
healing through the use of plant and mineral-based remedies) against
magic (incantations and ritual performances, medical divination), empiricism
against rationality, etc (Herrero 1984: 24; Ritter 1965: 299; Finkel 2000;
Schwemer 2007: 1; Goltz 1974: 12; Attinger 2008: 2-3).
c) The way of understanding the aetiology of disease, usually
expressed by the clear-cut division between natural and supernatural
categories (Herrero 1984: 24-25).
d) Other principles for division of roles between the two experts have
taken into account the access to experimentation (Stol 1991-1992: 59);16
the number of professional experts active in everyday life (Labat 1952:
130);17 the selection of medical cases (Scurlock 1999)18 or the moment

15
See Avalos (1995: 167): [] the as is more akin to a combination of a modern
pharmacist and nurse.
16
According to him, the as would have a wider access to experimentation and,
therefore, to innovation.
17
Labat believed that ass were small in number with respect to ipus.
18
Some scholars sustain that the as would have always treated the patient or that
he would have engaged in the treatment of simple cases, while the ipu would
have dealt with difficult stages of disease.
 The Circulation of Medical Practitioners in the Ancient Near East 407

of intervention in the course of disease (Avalos 1995: 158);19 the relation

of both practitioners with the textual medical corpus (the ipu would have
held the role of the intellectual, according to Frahm 2002: 83; Verderame
2004: 33-34, II.2.2; Attinger 2008: 2); the effectiveness of treatments
(physical versus psychosomatic efficacy, in Goltz 1974: 13); the social
status of the practitioners, with the ipu gaining a higher status from the
Late Bronze period onwards (Attinger 2008: 3), etc.
The definition of healing professional duties and profiles given by the
scholars depends heavily on the sources selected,20 with notable
differences of judgement whether the sources considered are documentary
texts, hymns to healing deities or learned sources, just to name a few. The
division between magical healing or magic (ipus sphere) and
medical healing or medicine (ass sphere) has been adopted as a
device to smooth the obvious difficulties in working with cuneiform texts,
but it has inevitably hampered the development of epistemological trends
and methodological procedures designed for the specificity of Mesopota-
mian sources. With regard to textual evidences on healing, there is an area
where both practices (iptu and astu) seem to have overlapped or at
least shared certain elements. It is this apparently grey area concerning the
knowledge on manipulation and use of drugs what tends to fuel confusion
among the scholars. The conflict arose when Assyriology began to deal
with healing texts, mainly from the first millennium B.C., that combined
treatments based in incantations and rituals with remedies based on drugs
within the same tablet. These medical texts bore mainly ipus names in
the colophons, what raised the question of what the competences of the
ipu were, how he interacted with the as, and what was left for the as
to do in healing processes if the ipu was the one to apply all kind of
known remedies. The fundamental problem here is related, I would say, to
actual access to (and uses of) literacy as seen in first millennium sources.
From my viewpoint, the limited amount of texts bearing ass names in
the colophon could be indicative of a practical and technical learning
carried out mainly through direct practice and oral teaching. At some

19
Taking anthropological studies as reference, Avalos points out that as and
ipu may have intervened at different stages of disease. He quotes the textual
example of CT 23,44a 8 that indicates that qt eemmi may be treated by both the
as and the ipu, though one may find only one of these consultants at different
stages of the illness.
20
Scholar studies have focused the debate of medical professions and health-
related activities mainly around these two figures, leaving aside many other
typologies of workers. Because of evident restrictions of time and space, we have
preferred not to deal with the topic here, although it will be treated elsewhere.
408 Chapter Twenty Seven

point, a learned interest in bringing together the totality of the healing lore
(or perhaps in documenting practices outside the written tradition) would
have arisen. This doesnt mean that: a) ass were illiterate or that they
didnt use writing in their education or daily practice; b) (some) ipus
couldnt have learned and applied those techniques that Assyriology has
traditionally linked with astu the art of the as.
The information regarding the activities of the ipu and as in late
Bronze Age within Mesopotamia is quite puzzling and considerably less
numerous than the references we have for the first millennium.21 Generally
speaking, and taking into account the relevant sources from the period
considered, we see that the ipu was a cultic performer who was
responsible for executing recitations together with acts (dicenda and
agenda) in a number of ceremonies of both public and private dimensions.
These performances were based on the need of keeping the relations be-
tween men and deities in good terms, in such a way that the ipu could be
considered an intermediary between the human and the divine realms.
This, of course, implied that they had to take responsibility on a large
amount of activities, which would have also included the restoration of
health and the prevention of disease, and most probably, also the
preservation of texts as a lore directly linked to divine knowledge and
command.22 As for the as, he had a more immediate influence on the
patients body, since he manipulated it and physically interacted with it in
the treatment of wounds, broken bones, haemorrhages, abscesses, etc.23
According to some authors (Waschow 1936), he may have been directly
related to the temple of the healing goddess Gula, although further
evidence on the matter is still badly in need.
This very basic and somehow general definition obviates many of the
synchronic and diachronic problematic features of the differentiation
between the two disciplines, but it does so for the sake of helping in the
analysis of how the terms were adopted and adapted by non-native users of
Akkadian and cuneiform writing.
21
We must rely on letters as those coming from Nippur (Waschow 1936), on
administrative texts reporting distribution of goods among both the ass and the
ipus in order to perform their duties, and on specialized texts gathering cultic
performances and healing remedies with sporadic references to these professionals.
See Jakob (2003: 528-537) for references.
22
The subject has been treated mainly taking into account 1st millennium
references, specially the neo-Assyrian text KAR 44 and duplicates, which gather
the titles of all the works an ipu should master. The most recent re-edition of the
text can be found in Jean (2006), with previous bibliography. For the perspective
given by neo-Assyrian letters, see Verderame (2004), with previous bibliography.
23
This is clear in the Mari letters from the Old Babylonian times.
 The Circulation of Medical Practitioners in the Ancient Near East 409

4. The borrowing of the terms ipu-as

Lets turn now to the use that of the terms as and ipu is made in the
diplomatic letters concerning healing matters sent between the different
political powers of the Late Bronze Age. The group of texts taking into
account come mainly from the archives of the Hittite royal capital,
Hattua, where a number of letters addressed to the Hittite king from the
Egyptian pharaoh and the Babylonian king, among other political leaders,
were preserved. As the main focus of this presentation, we will analyse the
use that of the terms ipu and as was made by the Hittites and the
Egyptians. At this point a remark on the specific relation of these two
powers with the cuneiform writing should be advanced: while the
Egyptians adopted the cuneiform script for international communicative
aims while still using hieroglyphic and hieratic for internal purposes, the
Hittites took up cuneiform to write down their native language.24 It seems
more than plausible that the Egyptians learned cuneiform writing from the
Hittites (Beckman 1983: 112-114) and adopted it as a way of favouring
political, military and economic interaction with West Semitic populations.

4.1. The as
The Hittite textual sources use the term in two ways: a) in Akkadian
texts from the Mesopotamian tradition as well as in letter exchange
conducted in Akkadian; b) in their own language, the Hittites took up the
akkadogram A.ZU to refer to a type of practitioner in their mother tongue
whose roles only partially match those we find attested among the
Mesopotamian ass. The Hittite reading of the Akkadogram is unknown.
According to Kammenhuber (1976: 137-138), the lA.ZU would have
treated bodily injuries and different diseases as well, including epidemics,
cases of divine punishment due to transgression, etc (see also Haas 2003).
Therefore, the Hittite lA.ZU would have often recurred to or taken part in
the performance of prayers, offerings, and rituals in order to cure or
prevent disease.25 This means that the professional figure behind the
l
A.ZU would have differed from the as of the Mesopotamian sources
and would therefore have been used to allow writing down the name of a
specific Hittite expert. Whether the different populations understood the

24
On the use of other writing systems different from cuneiform within Anatolia,
see Gelb (1969) and Hawkins (1986).
25
For textual examples that mention the as taking part in different types of
performances, see Kammenhuber (1976: 137-142); Pecchioli-Daddi (1982: 119-
120); Haas (2003: 6-10).
410 Chapter Twenty Seven

as to be a specific type of healer, with more or less different competences

in comparison with the Babylonian equivalent, its hard to say. As for the
concrete competences of the as in this international context, the
correspondence doesnt usually make explicit references to the methods
employed by the practitioners. Only occasional references to the
preparation of specific remedies (.ME epu to make drugs) or to the
performance of rituals by one or the other are included.
How about the Egyptian use of the term? When writing in Akkadian,
we find that the Egyptians employed both the terms as and ipu to refer
to their own practitioners when their political partners ask them to send
professional healers to them. What did the pharaoh mean by as when he
applied the term to an Egyptian type of healer? The most frequent term
found in the medical papyrus and inscribed steles is swnw, which is
translated as doctor, physician by egyptologists in the sense of an expert
who cures through the three-stage process of examination of the patient,
diagnosis of the disease, and treatment.26 The rich variety of Egyptian
terminology to refer to different medical specialties and healing
administrative charges27 seems not to be reflected in all its complexity in
the Akkadian international correspondence, though.
An example that serves to illustrate the nature and purpose of these
letters can be found in the following passage, where the pharaoh reports
the sending of the physician scribe28 Pareamah to Hattuilis wife, the
queen Puduhepa, so he can prepare all the remedies (.ME) requested by
her (presumably for the sake of his husband):

26
See Nunn (1996: 113-116), with previous bibliography. Cfr. Zucconi (2007: 33-
36) for the discussion and analysis of some problematic features in relation with
the different professions related to healing in Egypt.
27
See Jonckheere (1958: 95-103) as well as Nunn (1996: 117-119, tables 6.1-6.3)
for relevant terminology. The differentiation of level or competence of the as
within the corpus of Mesopotamian medical texts is not self-evident. For the case
of the ipu, the difference is made according to the level of education and
apparently not to the functions performed, although both factors must have been
closely related.
28
The Akkadian term lDUB.SAR lA.ZU used in international correspondence
seems to be the translation of the Egyptian term s3w swnw, which is attested, for
example, in relation to a certain Neb-amun (Nb-j-Jmn) in a stela from the 18th
dynasty (Jonckheere 1958: 51, 101). Other examples in Akkadian can also be
found in the texts KUB III 66 (Edel 1976: 46-50 and 82-91; Edel 1994: 171-173,
nr. 72; and cfr. KUB III 68 in Edel 1976: 50). Other letters refer to the lDUMU
.GAL A.ZU a physician from the palace, as it is the case in the el-Amarna text
EA 49, where the king of Ugarit asks the pharaoh for this kind of professional to be
sent (Liverani 1999: 285-286, nr. 256, with previous bibliography).
 The Circulation of Medical Practitioners in the Ancient Near East 411

So (say): I have sent the scribe (and) as Pariamah now. He has been
allowed to go in order to produce drugs for the king of the land of
Tarhunta (whose name is) Kurunta, and he will allot all, all the drugs
corresponding to what you have written about. And as soon as he gets to
you, redirect him to the king of the land of Tarhunta (whose name is)
Kurunta to produce (medicines). And send the two ass who are with him
(that is, with Kurunta) there and allow them to go (back) to the land of
Egypt. [As soon] as the scribe (and) as Pariamah arrive to him, [i]n that
day they (the ass) should arrange their activity. (KUB III 67 obv. 12-rev.
9)

This document pictures some of the most salient characteristics of

healing professional exchange, that is, the rather general characterisation
of the healing activities to be performed, the mediated nature of the
exchange (professionals of the palace that are sent abroad to other political
leaders to apparently treat the health problems of the elite), the more or
less itinerant tour that lead these professionals from one political power to
the other, and the risk of being detained from going back to their countries
of origin.29

4.2. The ipu

With regard to the use of the term ipu in this international context,
the analysis results more complex. The writing lAIPU appears in a low
number of Hittite references in ritual context, mostly in relation with
Akkadian incantations (Kammenhuber 1976: 143-145; Puhvel 1984: 102
sub apisi-). There is also a Hittite form lapii-, clearly a loanword (with
metathesis) taken from the Akkadian through Hurrian influence, although
it seems that the relevant professional figures involved in cultic
performances in Hatti came from the Anatolian milieu and not from the
Mesopotamian area of influence (see, for example, Haas 2003), a trait that
would explain the use of other professional terminology in Hittite textual
tradition. Some scholars have pointed out that the equivalent role of the
ipu in Hatti would have been that of the SALU.GI,30 lit. old woman,

29
For other examples of healers being retained by their host, check the letter KBo I
10+KUB III 72 together with Oppenheim (1967: 117-118); Zaccagnini (1983: 253-
254); Hagenbuchner (1989: 280-300, nr. 294 and passim). See Heeel (2009) for
the case of the Babylonian as Rab-a-Marduk as an example of this same
occurrence.
30
Kammenhuber (1976: 145); Haas (2003: 16-25). See Haas and Wegner (1988)
for the rituals carried out by her. She performs rituals of birth as well as other
therapeutic and prophylactic acts, and she is one of the oldest professionals in the
412 Chapter Twenty Seven

although an exact match in terms of formation, duties, etc is out of

question.
The ipu is mentioned in the letters a few times to refer to
professionals of Babylonian origin travelling to other areas of the Ancient
Near East,31 but in some cases the term is also employed in the Egyptian
letters sent by the pharaoh, as in the case of 652/f+28/n+127/r (Edel 1994:
178-181). Nonetheless, the exceptional nature of this reference may
respond to the laughing tone of the letter. In this highly quoted text, the
pharaoh answers the request made by the Hittite king of having an expert
that may be able to make her old sister conceive sent by first laughing at
the idea, and then promising to send both an as and an ipu:
Thus to [my] br[other: (Concerning) what my brother] has written [to]
m[e] regarding his [sist]er Mata[n]az[i]: May my brother send to me a
man to prepare a medicine so that she may bear children. So my brother
has written. And so (I say) to my brother: See Matanazi, the sister of my
brother, the king, your brother, knows her. A fifty-year-old!! Never! Shes
sixty! Look, a woman of fifty is old, to say nothing of a sixty-year-old!
One cant produce medicine to enable her to bear children! Well, the Sun
God and the Weather God may give a command, and the order which they
give will then be carried out continually for the sister of my brother. And I,
the king your brother, will send a competent ipu and a competent a[s]
to assist her to produce children.

What kind of healer intended the pharaoh here with the term ipu?
Edel (1994 vol. II: 270) wants to see the Egyptian jry-hb (the lector
priest) as paralleled to the ipu, and although they may have had
equivalent roles in some cases, such an identification is not clear at all,
especially if we take into account the number of Egyptian professionals
involved in healing.32 Scholars like Ghalioungui have quite another idea.
He states that priest-physicians (the wawb or pure priests) would have
been the most high-ranked healers close in form and function to the ipu
(Ghalioungui 1973: 63). On the part of Gardiner, the jry-hb would have
also developed healing functions, and therefore there is a chance that the

service of the palace of Hattua attested. She also practices evil magic and has
knowledge of rituals from different traditions, including Hattian, Luwian, West-
and South Anatolian ones.
31
See for example the letter KUB III 71: 7-11 from the king Kadaman-Turgu of
Babylon to Hattuili III, that informs of the arrival of an ipu to the Hittite court.
The function of this professional regards the performance of rituals (n-pe-a ul-te-
pi-[a] I let him perform the ritual).
32
See Nunn (1996: 98-101) for a brief overview of the professions gathered under
the problematic rubric Magicians; cfr. Zucconi (2007).
 The Circulation of Medical Practitioners in the Ancient Near East 413

term ipu in this context may have referred to the Egyptian lector-priest
(Gardiner 1938: 161, 164). Whether these professional figures were
allowed to travel outside Egypt seems to be a question with no present
answer.

5. Conclusions
Through these pages I hope I have been able to demonstrate how the
use of Akkadian as an international language of communication made the
process of cultural translation mandatory. Besides, the specific case
regarding medical professions raises a series of historical questions. What
made possible the exchange of healing professionals in antiquity? How
were these specialists perceived from the outside? Were their therapeutic
techniques perceived as equal, or even superior, in terms of efficacy with
respect to the local ones? Were there points in common among apparently
different ancient medical systems? Was this circulation of healing goods
and people promoted by personal needs and peculiar circumstances, as it
seems to have been the case of Hattuili? Future research will hopefully
bring some light on these and other question marks.

Bibliography
Arnaud, Daniel 1987, Emar. Textes sumriens et accadiens, vi/4, Paris:
ditions Recherche sur les Civilisations.
. 2007, Corpus de textes de bibliothque de Ras Shamra-Ougarit (1936-
2000) en Sumrien, Babylonien et Assyrien, Sabadell: Ausa.
Attinger, Pascal 2008, La mdecine msopotamienne, Le Journal des
Mdecines Cuniformes 11-12, 1-96.
Avalos, Hctor 1995, Illness and health care in the Ancient Near East. The
role of the temple in Greece, Mesopotamia, and Israel, Atlanta:
Scholars Press.
Beckman, Gary 1983, Mesopotamians and Mesopotamian learning at
Hattua, Journal of Cuneiform Studies 35, 97-114.
Bardinet, Thierry 1995, Les papyrus mdicaux de lgypte pharaonique,
Paris: Fayard.
Charpin, Dominique, Dietz Otto Edzard and Marten Stol (eds.) 2004,
Mesopotamien. Die Altbabylonische Zeit, Fribourg and Gttingen:
Vandenhoeck & Ruprecht.
Cohen, Yoram 2004, Kidin-Gula. The Foreign Teacher at the Emar
Scribal School, Revue dassyriologie et darchologie orientale 98,
81-100.
414 Chapter Twenty Seven

Edel, Elmar 1976, gyptische rzte und gyptische Medizin am

hethitischen Knigshof, Opladen: Opladen Westdeutscher Verlag.
. 1994, Die gyptisch-hethitische Korrespondenz aus Boghazki in
babylonischer und hethitischer Sprache, Opladen: Opladen
Westdeutscher Verlag, 2 vols.
Finkel, Irving 2000, On Late Babylonian medical training, in Andrew
George and Irving Finkel (eds.), Wisdom, gods and literature. Studies
in Assyriology in honour of W. G. Lambert, Winona Lake:
Eisenbrauns, 137-223.
Frahm, Eckart 2002, Zwischen Tradition und Neuerung: Babylonische
Priestergelehrte im achmenidenzeitlichen Uruk, in Reinhard Kratz
(ed.), Religion und Religionskontakte im Zeitalter der Achmeniden,
Gtersloh: Kaiser, 74-108.
Gelb, Ignace 1969, A Study of writing, Chicago: University of Chicago
Press.
Ghalioungui, Paul 19732, The House of Life. Amsterdam: Isral.
Goetze, Albrecht 1964, Review of KBo XII; KBo XIV; KUB XXXIX,
Journal of Cuneiform Studies 18, 89-96.
Goltz, Dietlinde 1974, Studien zur Altorientalischen und Griechischen
Heilkunde. Therapie, Arzneibereitung, Rezeptstruktur, Wiesbaden:
Steiner.
Haas, Volkert 1988, Die Rituale der Beschwrerinnen SALU.GI. Die
Texte. Vol. I, Roma: Multigrafica editrice.
. 2003, Materia Magica et Medica Hethitica, Berlin: De Gruyter.
Hagenbuchner, Albertine 1989, Die Korrespondenz der Hethiter. Vol. II,
Heidelberg: Winter.
Heeel, Nils 2009, The Babylonian physician Rab-a-Marduk. Another
look at physicians and exorcists in the Ancient Near East, in Mark
Geller and Irving Finkel (eds.), Advances in Mesopotamian medicine
from Hammurabi to Hippocrates. Proceedings of the International
Conference Oeil Malade et Mauvais Oeil, Collge de France, Paris,
23rd June 2006, Leiden-Boston: Brill, 13-28.
Herrero, Pablo 1984, La thrapeutique msopotamienne, Paris: Recherche
sur les civilisations.
Hawkins, David 1986, Writing in Anatolia: Imported and Indigenous
Systems, World Archaeology 17, 363-376.
Jakob, Stefan 2003, Mittelassyrische Verwaltung und Sozialstruktur.
Untersuchungen, Leiden: Brill.
Jean, Cynthia 2006, La magie no-assyrienne en contexte. Recherches sur
le mtier dexorciste et le concept diptu, Helsinki: Neo-Assyrian
Text Corpus Project.
 The Circulation of Medical Practitioners in the Ancient Near East 415

Jonckheere, Frans 1958. Les mdecins de lEgypte pharaonique. Essai de

prosopographie, Bruxelles: Fondation gyptologique Reine Elisabeth.
Kammenhuber, Annelies 1976, Orakelpraxis, Trume und Vorzeichenschau
bei den Hethitern, Heidelberg: Winter.
Labat, Ren 1952 Review of History of Medicine, Vol. I: Primitive and
archaic Medicine by H. Sigerist, Journal of Cuneiform Studies 6,
128-133.
Liverani, Mario 19942, Guerra e diplomazia nellantico Oriente 1600-
1100 A.C., Roma: Laterza.
. 1998, Le lettere dei piccoli re, Brescia: Paideia.
. 1999, Le lettere dei grandi re, Brescia: Paideia.
Mayer, Walter 1995, Politik und Kriegskunst der Assyrer, Mnster:
Ugarit-Verlag.
Nunn, John 1996. Ancient Egyptian medicine. London: British Museum
Press.
Oppenheim, Leo 1967, Letters from Mesopotamia, Chicago: University of
Chicago Press.
Pedersn, Olof 1998, Archives and libraries in the Ancient Near East,
1500-300 B.C., Bethesda: CDL Press.
Puhvel, Jaan 1984, Hittite Etymological Dictionary. Vol. I, Berlin: De
Gruyter.
Pulak, Cemal 1998, The Uluburun shipwreck: an overview, The
International Journal of Nautical Archeaology 27, 188-224.
Ritter, Edith 1965, Magical-expert (= ipu) and physician (= as). Notes
on two complementary professions in Babylonian medicine, in Hans
Gustav Gterbock (ed.), Studies in honor of Benno Landsberger on His
Seventy-Fifth Birthday, April 21, 1965, Chicago: University of
Chicago Press, 299-321.
Schwemer, Daniel 2007, Rituale und Beschwrungen gegen Schadenzauber,
Wiesbaden: Harrassowitz.
Steiner, Richard 1992, Northwest Semitic Incantations in an Egyptian
Medical Papyrus of the Fourteenth Century B.C.E., Journal of Near
Eastern Studies 51, 191-200.
Stol, Marten 1991-1992, Diagnosis and Therapy in Babylonian
Medicine, Jaarbericht van het Vooraziatisch-Egyptisch Genootschap
Ex Oriente Lux 32, 42-65.
van Soldt, Wilfred 1995, Babylonian Lexical, religious and literary texts
and scribal education at Ugarit and its implications for the alphabetic
literary texts, in Manfried Dietrich (ed.), Ugarit Und Seine
Altorientalische Umwelt, Mnster: Ugarit-Verlag, 171-212.
416 Chapter Twenty Seven

Verderame, Lorenzo 2004, Il ruolo degli esperti (ummnu) nel periodo

neo-assiro, PhD dissertation: Universit di Roma La Sapienza.
Waschow, Heinz 1936, Babylonische Briefe aus der Kassitenzeit, Leipzig:
Harrassowitz.
Zaccagnini, Carlo 1983, Patterns of Mobility among Ancient Near
Eastern Craftsmen, Journal of Near Eastern Studies 42, 245-264.