“My tooth aches so much”

CDLB 2014:3

Cuneiform Digital Library Bulletin (ISSN: 1540-8760)

Published on 2014-08-31

© Cuneiform Digital Library Initiative

Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License except when noted otherwise and in the case of artifact images which follow the CDLI terms of use.

Nicholas Reid

Reformed Theological Seminary

Klaus Wagensonner


Yale University

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
  i 1. ki-ma e-eš-te-ne-mu-u2
    2. ˹a˺-na ši-ip-ri-im šu-a-ti
  ii 1. aš-tap-ra-kum
    2. ni-di a-ḫi-im
  iii 1. la ta-ra-aš-ši
    2. ši-in-ni ma-di-iš {UŠ}
  iv 1. uš-ta-am-ri-ṣa-ni
    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.



1  Martin Worthington stated recently, “There are many aspects of professional healing on which the medical corpora are largely or completely silent” (Worthington 2009: 50). To a great extent, Worthington’s article deals with information gleaned from Old Babylonian letters.

2  For the role of the physician in comparison to the diviner, see Geller 2010: 43-55.

3  All dates in this article are B.C. unless otherwise stated.

4  See CAD P, 204-205, c.

5  We thank the Trustees of the British Museum for allowing us to study these letters.

6  Since a full edition is forthcoming, these texts are only partially cited.

7  Gimillia and Etel-pî-Marduk are two well-known correspondents mentioned frequently in an epistolary corpus relating to Kiš. While the new letters in the British Museum make up the larger portion of this “artificial archive,” letters relating to the corpus are scattered in various museums around the world, with the second largest group being housed in the John Rylands Library, Manchester, UK.

8   BM 103143a was split by a spade during the excavation. The tablet was incorrectly associated with BM 103143b and stored in the same box.

9  See PSD B, 126-127 s.v. bar-si A.

10  See, for instance, BE 6/1, 101, in which the ˹tug2˺ bar-siḫi-a are listed among items given as a bridal gift (nudunnû, line 13). The text adds the remark ezub ša aprat, “in addition to the one she is wearing on her head” (see also CAD P, 203, 3' for this and further attestations). See also the letter AbB 2, 142 rev. 13', where pa-ar-ši-ga is part of a gift sent to the daughter-in-law.

11  In a popular volume on the history of dentistry, James Wynbrandt makes the following claim about ‘toothache scarves’: “Archaeological records indicate Babylonians sometimes recited incantations seeking relief from toothworms while wearing such bandages around their heads. The purpose of this dressing is unknown–perhaps to ward off spirits, hold a poultice in place, or keep the cheek warm, dental historians have suggested” (1998: 224). Unfortunately, Wynbrandt does not provide any documentation to substantiate his claims. The authors are unaware of any evidence of the application of ‘toothache scarves’ in ancient Babylonia other than the letter partially cited above.

12  The letter is written by a certain Bēlessunu and addressed to a non-specified awīlum. Obv. 9-10 read: ṭe4-em si-li-iḫ-ti-˹ka / šu˺-up-ra-am, “send me a report about your illness.” For siliḫtu in Old Babylonian sources, see Stol 2009.

13  The attestations of the paršīgu known to us from Mari do not provide sufficient detail to determine if these are being used for a medical purpose.

14  See Paulissian 1993: 109-111. Scurlock & Andersen 2005: 419 state: “in general the cause of the pain is not clear.”

15  The Kuyunjik collection provides a fragmentary therapeutic series with the incipit: “If a man’s teeth hurt” (diš na zu2-šu2 gu7-šu2).

16  Consult CDLI for photo documentation of the tablet.

17   CAD B, 307 refers to AMT 65, 5 obv. 10, which is now joined to several further fragments in the Kuyunjik collection. In this text, the verbal form tu-ba-ḫar is preceded by the ingredients ḫimēta (i3-nun) and ṭābta (mun), “ghee and salt.” For a related text which includes a verbal form of buḫḫuru, see KAR 188 rev. 2 (Heeßel 2009: 24 with comments pp. 27-28). This text also refers to the heating of various ingredients to treat a headache. In light of these texts, it is likely that K 8160 (= AMT 4, 6) originally included some type of ingredient to be heated and applied using the tug2bar-si. The specific ingredient(s), however, cannot be supplied with any certainty due to the nature of the break and unless more data becomes available. For this reason, a reconstruction is not attempted here.

18  Cited following Geller 2007: 162, 239.

19  See Böck’s comments relating to this passage (2014: 16 no. 54).

20  R. Campbell Thompson cites K 7656+, that refers to a treatment of an aching tooth. The cure involves wool that is rolled up, sprinkled with oil and put into the ear on the aff ected side of the patient’s face; see Thompson 1926: 75: 10.

21  Cited following Geller 2010: 61.



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  2009 “‘To Be Ill’ in Akkadian: The Verb salā’u and the substantive sili’tu.” In A. Attia & G. Buisson, eds., Advances in Mesopotamian Medicine from Hammurabi to Hippocrates. Proceedings of the International Conference “Oeil malade et mauvais oeil,” Collège de France, Paris, 23rd June 2006. CM 37. Leiden, Boston: E. J. Brill, pp. 29-46.
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Version: 31 August 2014  

Cite this Article
Reid, Nicholas, and Klaus Wagensonner. 2014. “‘My Tooth Aches so Much.’” Cuneiform Digital Library Bulletin 2014 (3). https://cdli.mpiwg-berlin.mpg.de/articles/cdlb/2014-3.
Reid, Nicholas, & Wagensonner, Klaus. (2014). “My tooth aches so much.” Cuneiform Digital Library Bulletin, 2014(3). https://cdli.mpiwg-berlin.mpg.de/articles/cdlb/2014-3
Reid, Nicholas and Wagensonner, Klaus (2014) “‘My tooth aches so much,’” Cuneiform Digital Library Bulletin, 2014(3). Available at: https://cdli.mpiwg-berlin.mpg.de/articles/cdlb/2014-3 (Accessed: April 22, 2024).
	note = {[Online; accessed 2024-04-22]},
	address = {Oxford; Berlin; Los Angeles},
	author = {Reid,  Nicholas and Wagensonner,  Klaus},
	journal = {Cuneiform Digital Library Bulletin},
	issn = {1540-8760},
	number = {3},
	year = {2014},
	publisher = {Cuneiform Digital Library Initiative},
	title = {``{My} tooth aches so much''},
	url = {https://cdli.mpiwg-berlin.mpg.de/articles/cdlb/2014-3},
	volume = {2014},

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