Ancient Medicine

026027

027When an ancient Israelite got a raging bellyache, what did she do? Where could she—or he—go for help?

According to one recent scholarly study, the answer to the first question was “nothing”; to the second “nowhere”:

“In general a sick person had virtually no aids at his disposal worth mentioning, no physicians in the real sense, and no knowledge of medicine…In general he had access to no really recognized or tolerated healing procedures or practices including no ritualistic incantations or exorcism-related manipulations.”¹

A closer look indicates that this negative view is untenable. Both the Bible and archaeology indicate that numerous options were available. Generally, however, cult and healing were closely related.

Of one thing we may be sure: Raging bellyaches—as well as the other infirmities that flesh is heir to—were not uncommon in ancient times. Archaeoparasitologists (archaeologists who study the remains of ancient parasites) have found evidence of intestinal diseases—both tapeworm (taenia) and whipworm (trichuris trichiura) infections—in ancient Israel. Lice infestation was 028doubtless a problem if we may judge from lice combs recovered at Megiddo and elsewhere (see scarred skull from Dimona).^a Numerous other medical problems, from infertility to epidemics, are referred to in the Bible and other ancient literature.

As in modern times, patients usually followed a hierarchy of options, beginning with simple and inexpensive ones, and, if circumstances required, moving to more complicated and expensive ones. Today, our first option for a stomachache might be an antacid from the medicine chest. If the stomachache persists, we seek help from a specialist.

Like modern patients who go to the medicine chest, patients in ancient Israel had some herbal remedies nearby. Rachel and Leah obviously believed that mandrakes could cure infertility (see Genesis 30:14ff. and engraving). Apparently these plants could be collected directly from the field. Balsam (or balm) seems to have been another remedy. A first-century C.E. clay flask discovered in a cave near Qumran contained a thick vegetable oil probably to be identified as balsam based on the proximity of the cave to ancient balsam orchards.^b In Jeremiah’s prophecies against Egypt, he mockingly suggests that when the Lord takes his vengeance, Egypt will look for remedies: “Go up to Gilead, and take balm…In vain you have used many medicines; there is no healing for you” (Jeremiah 46:11). Wounds were dressed and bandaged. Ezekiel, too, prophecies against Egypt: When the Lord breaks Pharaoh’s arm, it will not be “bound up for healing or wrapped with a bandage” (Ezekiel 30:21).

The more common remedies, however, involved the cult. According to the Hebrew Bible, health (in Hebrew, shalom) encompasses a physical state associated with the fulfillment of covenant stipulations; illness results from the violation of those stipulations. Therapy requires reviewing one’s actions in light of this covenant. (Occasionally, as with Job, illness may be rooted in divine plans that are not disclosed; the patient must trust that God’s undisclosed reasons are just.)

Health care associated with the cult of Yahweh was legitimate; health care associated with other gods was not.

The most accessible and inexpensive option was a simple prayer to Yahweh. A number of biblical prayers reflect this viewpoint. When the eighth-seventh century B.C.E. Judahite king Hezekiah fell ill and was near death, he prayed to the Lord, who added 15 years to his life (Isaiah 38:1–5, 16–17//2 Kings 20:1–6).

Another option was to consult a nabi, or prophet. Numerous biblical stories detail the activities of prophets as healers. Elijah and Elisha were consulted for everything from leprosy (2 Kings 5) to even more deadly illnesses. Elisha promised the childless Shunammite woman that she would have son. When the son died, Elisha went to her house, where the boy was laid out dead on his couch. After praying to the Lord, Elisha “mounted [the bed] and placed himself over the child. He put his mouth on its mouth, his eyes on its eyes, and his hands on its hands, as he bent over it. And the body of the child became warm” (2 Kings 4:32–34).^c

When Naaman, the Aramean general, was cured of his skin disease by Elisha (who prescribed immersion seven times in the Jordan River), Naaman declared, “Now, I know that there is no God in all the earth except in Israel” (2 Kings 5:15). The story emphasizes the superiority of Yahwistic health care over non-Yahwistic options. Indeed, it even implies that the land of Israel, because of Yahweh’s favor, is a healthier place to be: Naaman loads a couple of mules with some of Israel’s earth to take home with him (2 Kings 5:17).

The ropheim, usually translated physicians or doctors, were viewed as an illegitimate option by at least some biblical authors. In 2 Chronicles 16:12, Asa, king of Judah, is condemned for turning to a physician instead of to the Lord to cure an acute foot ailment. On the basis of this passage, some scholars have suggested that the ropheim were secular healers. More likely, however, the ropheim, like most healers in the ancient Near East, were sponsored by another deity, or included prayers to another deity or deities in their healing proceedings. In Mesopotamia the asû, one of the main healing specialists, was sponsored by the goddess Gula, among others.

030

If we make non-supernaturalism the hallmark of a “physician,” then there were also virtually no physicians in the ancient Near East. In Egypt, as well as in Mesopotamia, most healers made supernatural assumptions. Even in Greece, naturalistic assumptions mixed with supernatural ones; Greek healers were often sponsored by the god Asclepius.

Yet archaeology also reveals quite sophisticated healing techniques. Trephination, a procedure by which the skull was opened, was successfully performed on numerous patients, as we know from trephinated skulls that have healed, found from the Neolithic period (8000–5000 B.C.E.) through the Arab period (see scarred skull from Dimona).² Although we cannot be absolutely sure that trephination was a medical procedure, it may have been used to treat people with chronic headaches who sought liberation from some evil force believed to be inside their heads.

Clay liver models inscribed with omens, found at Hazor and Megiddo and dating to the Late Bronze Age (1550–1200 B.C.E.), may also have been used in medical consultations (see clay liver model).³ The models were compared with actual animal livers, and the omens were judged to be good or bad depending on the shape, color and other features of the animal liver. Some of these liver models and other devices may have been used to provide medical prognoses.

The implantation of a bronze wire in a tooth found at Horvat En Ziq, a small Nabatean fortress in the northern Negev, suggests the probable existence of dental specialists in the Hellenistic era (see bronze wire found in tooth).⁴

Bone spatulas found at Tell Jemmeh, near Gaza, are thought to have been used to clean debris from the eyes.⁵

In short, healing specialists or “physicians” probably were available in ancient Israel, but not all of them were regarded as legitimate by Yahwistic healing consultants.

Another important health care consultant was the midwife (meyaledah), who regularly assisted women during labor and probably helped with post-natal care as well. In Exodus 1:15, Pharaoh instructs the Hebrew midwives to kill infant boys they deliver. In the Bible, midwives provide psychological as well as medical support to women during childbirth. Just before Rachel dies giving birth to Benjamin, a midwife encourages her, “Have no fear, for it is another boy for you” (Genesis 35:17; see also 1 Samuel 4:20).

The ill could also go to the Temple for a cure, especially during the pre-Exilic period. In 1 Samuel 1, the childless Hannah attends the temple at Shiloh, where 031she prays for the Lord to make her pregnant. Infertility was one of the most serious afflictions for women. In the Hebrew Bible, a woman’s social status depended on her fertility, which often determined whether the family line would continue. Sculpted images of the Canaanite mother goddess Asherah (1 Kings 14:15; 2 Kings 23:4ff.) may have played a role in fertility rituals.^d

According to 2 Kings 18:4, the Jerusalem Temple contained a bronze serpent made by Moses in the wilderness. During the Exodus, anyone bitten by a snake could simply “look at the bronze serpent and recover” (Numbers 21:9). Until Hezekiah (715–687 B.C.E.) destroyed the serpent and threw it out, “the people of Israel had burned incense to it” at the Jerusalem Temple (2 Kings 18), apparently with hopes of receiving a cure. Archaeology corroborates the use of bronze serpents for healing: A first-century C.E. bronze serpent has been discovered in the temple of Asclepius, the Greek god of healing, at Pergamum, in modern Turkey.⁶ Late Bronze Age (1550–1200 B.C.E.) serpents have been found in Israel at Tel Mevorakh, Timna and Gezer, where they were likely used for healing.

Dogs too were associated with healing in the ancient Near East. Gula, the Mesopotamian goddess of healing, was represented as a dog or had a dog as an emblem, and dogs may have participated in healing rituals at her temple. Dogs also took part in ceremonies at the Greek temples of Asclepius. Archaeologists have discovered the remains of hundreds of dogs in a Persian-period cemetery at Ashkelon. Excavator Lawrence Stager believes that a healing cult associated with dogs may have been centered there, although the corresponding deity remains undetermined.⁷ Perhaps the dog became associated with healing because of the curative powers evident from its licking its sores and wounds.^e

The destruction of the bronze serpent and the other reforms of kings Hezekiah and Josiah (640–609 B.C.E.) may have signaled a significant shift in the use of the Jerusalem Temple for therapy. These kings aimed to centralize worship in Jerusalem by destroying all outlying shrines. Patients could no longer attend their local shrines—whether dedicated to Yahweh or another deity—for therapy. Further, with the removal of the Asherah cult objects and the bronze serpent, the Jerusalem Temple would no longer serve as the same kind of therapeutic center. For many patients, however, a trip to the Jerusalem Temple to pray to Yahweh for healing may have been too long and difficult.

The advocates of centralization apparently recognized the problems for those who lived far from the Jerusalem Temple. First Kings 8:37–39, part of the so-called Prayer of Solomon, suggests how patients could receive from afar the benefits of praying at the Jerusalem Temple: “If there is a famine in the nation…whatever plague, whatever sickness there 032is; whatever prayer, whatever supplication is made by anyone or by all your people Israel, each knowing the affliction of his own heart, and stretching out his hands toward this house, then you shall hear in heaven, your dwelling place.” Patients no longer needed to come to the Temple to be healed. No matter where they were, the afflicted could simply extend their hands toward the Temple for a long-distance cure.

By the post-Exilic period (after the return of the Exiles from Babylon in the late sixth century B.C.E.), official concern over health had greatly expanded. The Priestly Code,^f exemplified mainly in the book of Leviticus and completed in the early post-Exilic era, contains the most complete health care policy in the Hebrew Bible. Its most notable provision is that persons stricken with tzaraath (usually translated as “leprosy”) were banned from the Temple and, indeed, from the community. Priests acted, in effect, as public health officers who diagnosed the condition and decided whether such persons merited expulsion from society.

“Leprosy,” as used by Leviticus, cannot be identified with any single disease known to modern medicine.^g Its key involved chronic discoloration of the skin (or almost any surface, including the walls of houses!). Thus, any of a number of diseases that produce chronic changes in the skin was probably diagnosed as leprosy, including skin cancer, psoriasis and lupus erythematosus, if these diseases existed in any significant form at that time.

The “treatment” for this chronic illness was removal from the community for as long as the disease persisted. From Leviticus 13:45–46, we can deduce the following scenario after the diagnosis had been made:

1) The patient is to shout out “Impure, Impure”;

2) the patient shall live alone;

034

3) the patient shall live outside the camp community;

4) this exile lasts as long as the affliction.

Why this four-step process? The usual response is fear of impurity or contagion. But this is too simple. Recent anthropological studies show that the definitions of contagion and impurity are as much a matter of socio-economic status as they are expressions of the fear of contagion.⁸ In other words, socio-economic status, and not simply fear of contagion, plays a role in deciding who and what is declared impure by those who have the power to define impurity.

The priestly establishment may have sought to classify as “impure” those members of society who posed the greatest socio-economic burden. The blind and the lame (see 2 Samuel 5:8), for example, who should have posed no real threat of contamination or contagion, were excluded from the Temple. In effect, the Priestly Code advocated a health care policy by which the state unburdened itself completely of the care for at least some of the chronically ill. The eradication of chronic illness would be left for a future messianic utopia. Indeed, Ezekiel 47:12 attributes a possible therapeutic function to the future Temple and its garden:

“By the river on both banks (shall be) every type of tree fit for food. Their leaves shall not wither, and its fruit shall never cease. Every month it shall renew its fruit, for its waters spring from the Temple itself; And its fruit shall be fit to eat, and its leaves (shall serve as) medicine.”

The community responsible for the Dead Sea Scrolls was even stricter toward the chronically ill. Certain patients were expressly forbidden to enter the sanctuary city, according to the Temple Scroll (11QT 45:12–13):⁹

“All blind persons shall not enter into it for their entire life, so that they might not defile the city within which I dwell.”

Concerning the “leper,” the Temple Scroll (11QT 45:17–18) states:

035

“Any ‘leper,’ or afflicted (person) shall not enter it [the holy city] until they are purified. Once he is purified, he shall offer…”

These policies, while no doubt causing emotional hardship to the families of the chronically ill, probably did check the spread of many contagious diseases. In contrast, Greek temples of Asclepius, which welcomed the chronically ill, including lepers, may have helped to spread disease by concentrating the sick in small spaces.

The Priestly Code’s hard-line attitude towards the chronically ill may have unwittingly served to provide a springboard for the rise of Christianity. The code was responsible for the growth of chronically ill populations with little access to the Temple. Since Jesus and his disciples appear to target these populations (Matthew 10:8; Mark 14:3), early Christianity can be seen, in part, as a critique of the Priestly health care system.

Early Christianity recognized that illness was not necessarily a sign of God’s disfavor or anger (Matthew 15:22; Luke 11:14; John 9:2). Christianity also emphasized that the cure for illness was available in this world. Yet, while criticizing the Priestly health care system, Christianity preserved many older Hebrew traditions regarding miraculous healings (Acts 5:16, 9:34) and collective health (James 5:16), though the influence of Hellenistic healing cults, including the Asclepius cult, also may be seen: For example, both Jesus and Asclepius were called soter (Greek for “savior”), both stressed the role of faith in healing and both used similar procedures, such as using spit to cure eye ailments. Further, many of the healing testimonies of Asclepius (particularly those written on a fourth-century B.C.E. inscription at a temple of Asclepius in Epidauros, Greece), like the healing stories related in Matthew 9:18–34, consist of a series of short healing stories that sometimes report the specific number of years that a patient has been afflicted.

In short, disagreements about the ideal health care system among Jewish sects may have been one of the prime factors in the development of Christianity.

But let’s return to our original question. What did people in Judah do when they got a raging bellyache or some other illness? Unlike the scholar quoted at the beginning of this article, we would argue that the Israelite patient did have access to a wide variety of healing specialists who might be called “physicians,” if by that term we include practitioners who held supernatural assumptions.

We must also realize that a more precise answer to our question depends on a number of factors. Where the patient went for a bellyache or some other illness depended on the patient’s economic resources and on the historical period, location, length of illness and willingness to use options not sanctioned by the 048authorities. Patients might first collect their own remedies from a field or pray for themselves and, if the results were not satisfactory, call a prophet as a next step.

In the early eighth century, patients may have gone to the Temple of Jerusalem or to a local Yahwistic shrine. But after the reforms of Hezekiah and Josiah, people probably could not use the bronze serpents in Jerusalem or at other Yahwistic shrines. If the patient was a pregnant woman with a bellyache, a midwife may have been the preferred consultant. If the patients were not as devoted to Yahweh as the prophets may have liked, they may have contacted a variety of non-Yahwistic healers or temples. What I hope has become clearer is that the complexity and richness of the options available for patients in ancient Israel and the Near East is only beginning to be explored.¹⁰

27When an ancient Israelite got a raging bellyache, what did she do? Where could she—or he—go for help? According to one recent scholarly study, the answer to the first question was “nothing”; to the second “nowhere”: “In general a sick person had virtually no aids at his disposal worth mentioning, no physicians in the real sense, and no knowledge of medicine…In general he had access to no really recognized or tolerated healing procedures or practices including no ritualistic incantations or exorcism-related manipulations.”1 A closer look indicates that this negative view is untenable. Both the Bible and archaeology indicate that […]