Illness and Health Care in the Ancient Near East: The Role of the Temple in Greece, Mesopotamia, and Israel

Illness and Health Care in the Ancient Near East: The Role of the Temple in Greece, Mesopotamia, and Israel

Simkins, Roland A

HECTOR AVALOS, Illness and Health Care in the Ancient Near East: The Role of the Temple in Greece, Mesopotamia, and Israel (HSM 54; Atlanta: Scholars, 1995). Pp. xxvi + 463. $49.95.

This monograph is a revised and expanded form of Avalos’s dissertation (Harvard University, 1991). His purpose is to analyze the role of the temple in ancient Israel’s system of health care in relation to those of Greece (with focus on the asclepieia) and of Mesopotamia (with emphasis on the role of the temple of Gula during the Kassite period). Whereas previous scholars have failed to integrate the insights of medical anthropology into their research, A. builds on these insights by emphasizing the systemic nature of health care and by using the system of health care as the basis for comparison. In particular, A. addresses this primary question, “How does a socioreligious conceptual framework affect and interact with the type of health care that a society devises for its members?” (p. 22). For each society A. investigates the presuppositions regarding the causes and diagnosis of illness, the options available to the patient, the modes of therapy administered, the accessibility of treatment, the state’s role in health care, the role of health practitioners, and the society’s attitude toward the patient.

To aid his investigation, A. employs a heuristic typology of the possible functions of the temple in the system of health care and several heuristic models of the society’s socio-religious conceptual framework. The temple of the healing deity may have a petitionary, a therapeutic, or a thanksgiving function. The diagnosis and treatment of an illness may be utopian (an illness has a known cause and is curable) or realist (an illness has many causes which may not be known, and it is not necessarily curable). The role of divine instrumentality in an illness may be utopian (an illness serves the just purposes of the deity) or realist (an illness may serve an unknown, malevolent, or arbitrary purpose of the deity). Finally, in the system of health care the state may take a responsibility that is maximalist (a full range of benefits are provided) or minimalist (no benefits are provided, and the ill are a burden).

Avalos devotes the least attention to the asclepieia, but he nevertheless provides a discerning collection of information that can be used in comparing the systems of health care in Mesopotamia and in Israel. The cult of Asclepius was utopian in its manner of diagnosis and treatment, and it assigned a maximalist role to the state in the health care system. Although the asclepieia had a petitionary and a thanksgiving role, their most prominent feature was their therapeutic role. In Greece, illness was generally not identified with moral impurity, so the sick were welcome in the temples. The asclepieia were communities of ill people who received treatment from legitimate health consultants under the patronage of a god who specialized in the personal care of the ill.

In contrast to Greece, numerous deities were associated with illness and healing in Mesopotamia. Gula was prominent as a healing deity, but at times she simply interceded with other deities or acted in concert with them. Although Gula’s temple had the three main functions of the asclepieia, the Mesopotamian temples were not places for long-term treatment. Because in Mesopotamia many illnesses were connected with impurity, patients were not admitted into the temples, and treatment for illness was generally administered in the home. Moreover, illness often stemmed from sin and was thus a divine punishment. The primary task of diagnosis was to identify the divine agents responsible for the illness. The Mesopotamian medical theology, therefore, was realist in its diagnosis and treatment, and it assigned a minimalist role to the state. The Mesopotamian healing temples also served as repositories for medical records which were of help to healing practitioners in diagnosis and treatment.

Avalos treats Israel’s system of health care in great detail. He analyzes the different traditions in the Bible, briefly commenting on Sirach and the texts from Qumran, and he discerns a diversity of concepts of health care preserved in the Bible. Overall, the Israelite system of health care was similar to the Mesopotamian system, but the Israelite system distinguished between legitimate and illegitimate consultative options. In Israel, Yahweh was the only legitimate healing deity, and the most important consultant was the prophet. The main illegitimate consultant was the rope ; but with the decline of prophecy the rope was legitimated. The centralized system of worship and the rise of a priestly hierarchy also served to exclude the ill from the temple. Eventually, the temple in Israel served only a thanksgiving function, contributing only minimally to health care.

Avalos provides a wealth of insightfully presented information on the systems of health care in the ancient Near East. He exhaustively and judiciously treats every facet of Israel’s system, especially the “medical theology” of the priestly tradition. His analysis of the systems of Greece and Mesopotamia is understandably selective. His work is thoroughly documented. This study will be a great asset for all who are interested in the role of illness and health care in the ancient Near East.

Ronald A. Simkins, Creighton University, Omaha, NE 68178

Copyright Catholic Biblical Association of America Jan 1998

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