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Status: Finished  |  Genre: Historical Fiction  |  House: Booksie Classic

The Medical fees were relatively high, the practice produced a good income, and the business grew in the new clinic.
Nevertheless, Marduk-zer was unhappy with the medical stele in the place and asked his partner,
"What is this shaqlu anyway?"
"You mean how the silver coin has replaced cereals as monetary value?" Abil-ili replied, thinking that he was asking about the fees it conferred for services.
"It is not only the list value; I have a bad feeling about the practice code as a whole; how I am supposed to work under such stringent penalties?" Marduk-zer explained.
"Don't think about it; the code is not enforced to the letter", his partner responded.



A year earlier, in ancient Babylonia, Abil-ili decided to build and operate a new clinic. He was an Asu, which is a medical doctor from the nobility classes.

He asked his friend Marduk-zer to partner with him since he was an Asipu, a healer who relied upon magic.

The Asu and Asipu were also Surgeons, Dentists and Veterinarians as that time tradition necessitated.

Abil-ili was the herb and knife doctor, whereas Marduk-zer was the psychiatrist or spell doctor since the basic concepts of medicine were primarily religious.

In the remedial school associated with the temple, they studied the mythical causes of diseases, interpretation of dreams, and anatomy of sacrificed animals.

There were clay models of hepatic divination as the liver was considered the seat of life because it is the collecting point for blood.

They also studied old prescriptions written in cuneiform on tablets since 2100 BC.

To practice their profession, they had to seek the permission of Awil-nannar, the supreme Baru, a diviner in charge of prognosis in health and other general calamities for the city.

At the time of the great Hammurabi, the sixth King of the First Babylonian Dynasty, who reigned from 1792 to 1750 BC, medical practice and other professional activities were regulated by well-defined laws


The two doctor's new clinic was located in a three storey-house built from cut sandstone blocks and mud bricks, with the entrance covered in a layer of red clay.

The flat-roofed first storey had four walls for privacy.

The other storeys were covered in grape arbours to provide shelter from the sun.

Inside the front door was a small garden with rocky bench seats.

The clinic was situated within a cluster of houses around the massive ziggurat in which a temple was housed.

That same ziggurat was the famous Tower of Babel built initially between 3500 and 2400 BC for defence and flood avoidance.

The Tower was a waterproof construction of burnt bricks and mortar of asphalt manufactured from local mineral deposits.


 To complete the suite of services they offered, the two practitioners recruited the beautiful midwife, Shala.

The Asipu Marduk-zer assisted her deliveries by reciting prayers against Lamashtu, the daughter of the supreme deity Anu, who killed or carried off infants.

The Asu, Abil-ili, on the other hand, provided a mixture of herbs and dates to assist in the labour pains.

Inside the clinic, a sizeable finger-shaped basalt stele was installed, setting forth in cuneiform the ten medical practice codes extracted from the 282-law Code of Hammurabi.

The King's name means "the kinsman is a healer", and his medical codes read as follows;

215. If a physician makes a large incision with an operating knife and cure it, or if he opens a tumour over the eye and saves it, he shall receive ten shaqlu in money.

 216. If a patient is a freedman, the practitioner receives five shaqlu.

217. If the patient is the slave of someone, his owner shall give the physician two shaqlu.

218. If a physician makes a large incision with the operating knife and kills the patient or open a tumour and cut out the eye, his hands shall be cut off.

219. If a physician makes a large incision in the slave of a freedman and kills him, he shall replace the slave with another slave.

220. If the practitioner had opened a tumour and put out his eye, he shall pay half his value.

221. If a physician heals a man's broken bone or diseased soft part, the patient shall pay the physician five shaqlu.

222. If he were a freedman, he shall pay three shaqlu.

223. If he were a slave, his owner shall pay the physician two shaqlu.

224. If a doctor of oxen or asses has treated either ox or ass for a severe wound and cured it, the owner of the ox or ass shall give the doctor one-sixth of a shaqlu of silver as his fee.

The Asipu Marduk-zer was named after Marduk, the most influential deity in Babylonian worship. His father, Ea, was the lord of water and the cosmic ancestor of physicians, whereas his son, Nabu, was a deity over science, including medicine.

A temple was raised to Nabu, where the medical school developed.


They had established a small library containing cuneiform texts with all the Forty-four then-known old Babylonian publications mentioning diseases. From their clinic experience, the two doctors added prescription clay tablets to the library and a series of essay tablets about medical diagnoses and prognoses.

They also added clay tablets that list drugs and their appropriate uses. Hundreds of plants, minerals, and animal substances were the therapeutic agents they used.

With the help of Shala, the doctors organized the essay tablets in head-to-toe order with separate subsections covering disorders, reflecting their accurate observations of patients' symptoms to estimate their seriousness. Their experience and active documentation established their reputation as authorities in medicine.

Regular cases in their clinic included Osteoarthritis syndromes due to frequent heavy lifting, Headaches, Eye and Ear problems, Chest pain, Coughs, Cramps, Vomiting, and Diarrhea.

Persistent teeth diseases were also common, probably associated with the spread of date palms consumption, which was not surprising, given that date cultivation began between 5530 and 5320 BC.

Whereas non-spiritual causes for illness were Abil-ili's responsibility to find and heal, other diseases were attributed to pre-existing spirits and supernatural forces.

Each spirit was held responsible for only one disease in any one part of the body.

For instance, the Nergal spirit gives fever, Ashakku debilitates consumption, Tiu gives a headache, Namtaru spirit causes throat illnesses, etc.

These disorders were the responsibility of Marduk-zer to cure and tackle the curses and illnesses caused by violating the moral codes.

Recitations, ceremonies, prayers, and sacrifices were his preferred procedures in these instances.

The application of medications was made strictly according to rituals.

For example, if vegetable oil for open wounds, tendons and broken bones were not sufficient, additional surgical treatment in their clinic was also utilized.


Marduk-zer was made happier due to his developing relationship with Shala.

After work, they used to walk through the city of Babel that was surrounded by a broad and deep water-filled moat, behind which rose a wall fifty royal cubits in width and two hundred in height.

One of their favourite settings as their love affair grew was walking through the twenty-five gates on each side of the Tower of Babel built of 2,000 kg cubic meter bricks.

The doors of these enormous gates were cast in bronze, adding to the glory of the Tower where it was wider than it was in height, making it seem more like a mountain than a tower.

The two lovers, Marduk-zer and Shala, ascended the wide spiral path that contained lodgings for workers and animals.

On one of their romantic walks along the deep-water moat, Marduk-zer felt lucky that he didn't have to pick a bride from the Babylonian marriage market.

Women were gathered up there in the market, and an auctioneer would parade each woman one by one, putting her up for sale. Of course, they were being sold to be wives, not slaves.

At that moment of satisfaction, he proposed to Shala, saying,

"I am the son of nobles, silver and gold shall fill thy lap, thou shall be my wife, and I will be thy husband".

That was a big move for Marduk-zer. Even though it was a contract to be man and wife together, every marriage begins with a legal agreement and retains the form of purchase.

Engagements and marriages were serious matters in Babylonia and were strictly regulated by the Hammurabi codes numbered 128- 153.

For example, if a man changed his mind, he would forfeit his entire deposit and bride price.

Such codes were meant to encourage responsible decisions and orderly social behaviour.


Since the wedding ritual had to include a feast in order to be considered legitimate, Marduk-zer and Shala started to discuss their marriage contract, payment of the families of the bride and groom to each other, and the required ceremony.

They planned their wedding feast to coincide with Akitu, commonly known as Res sattim, the festival of the barley sowing, which was celebrated in the first months of the year (March/April) or what they called it Nisannu.

The New Year's festival was still a few months ahead of them.

Things were usually smooth except for an outbreak, indirectly due to a minor war with an eastern tribe.

The doctors faced plagues of some kind and fevers, during which Shala contracted shaking chills, profuse sweating, headache, nausea and vomiting.

The doctor's first response was based on religio-magical reasoning, but this didn't work.

They isolated their partner, Shala, suspecting the flu epidemic. The first cases of Influenza among humans are known to be 6000 years old.

Next, they suspected Variola might be the diagnosis after consulting one of their clay documents dating back to 3000BC but excluded that as there were no Smallpox lesions.

Their final diagnosis was suspected Malaria, which was reasonably known. The first clay descriptions of malaria date from 2700 BC.

They noticed breathing problems attributed to the accumulation of fluid in her lungs and organ failure.

Shala's condition deteriorated further, and she could not breathe through the windpipe or trachea. Marduk-zer knew that the hollow tube was bolstered by rings of cartilage to prevent it from collapsing.

He decided to take a risk out of his love for her.

His magic knowledge inspired him to insert a hollow metal tube in her throat down as far as the trachea to help her breathe.

He was thinking about what is known today as endotracheal intubation using plastic tubes into the air passages.

However, his action choked Shala, and she died.


The requirements of the Law and justice are rigorous aspects of the Babylonian way of life.

Despite his deep sorrow and before his tears had even dried, Marduk-zer found himself facing trial in court before the high priest.

That day morning, he rode into the court with the sun going down, and his mind wasn't so calm.

After listening to his and Abil-Ali's testimony, the priest judge said:

"I will read to you code 218 of our King Hammurabi:

"If a doctor has treated a man with a metal knife for a severe wound and has caused the man to die, his hands shall be cut off".

"Citizen Marduk-zer, consider yourself lucky, cutting off your hands is not that severe punishments if matched against the penalties imposed by the code on ordinary citizens; an eye for an eye, a tooth for a tooth and life for life, the priest judge summoned.

Image from


Submitted: October 28, 2021

© Copyright 2021 Ali Al-Zaak. All rights reserved.

Check out Ali Al-Zaak's Book

The Immortal Mesopotamian: A novelette of the rise of moral authority Kindle Edition

(I was surprised to know that the classy woman in the crowd next to me was King Hammurabi's sister, offering date cakes for the masses of Babylon). A historical fiction set in a time that seems to be overlooked by historical writers. It follows a righteo

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Another visit to the great ancient world of Mesopotamia brought to life by your knowledable hand and fervent imagination.

I found it an enjoyable and educational read.

Sun, November 21st, 2021 8:29am


Thanks for your kind words. Wish you the very best.

Wed, November 24th, 2021 2:52pm

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