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Over the last 25 years, we have drawn attention to Babylonian descriptions, understanding and treatment of neurological and psychiatric disorders.1–5 Although the Babylonians had no understanding of brain or psychological function, they were remarkably observant describers of many medical disorders and behaviours which we see today and for which they had their own interpretations and treatments. We began with the neurological disorders of epilepsy1 and stroke, including so-called Bell's Palsy,2,3 and more recently we discussed psychiatric disorders, including psychoses of epilepsy4 and obsessive compulsive disorder, phobias and psychopathic behaviour.5 We turn our attention now to depression and anxiety in Babylon.

We appreciated the historical review by Pearce (2015) on early observations of facial palsy, beginning with the fragmentary descriptions of the Greco-Roman period, amplified by the later Persian-Ar...

Background The history of obsessive compulsive, phobic and psychopathic behaviour can be traced to the 17th century AD. Methods and results We draw attention to these behaviours in a Babylonian cuneiform medical text known as Shurpu . These three categories were united in the Babylonian mind around the concept of the māmīt ‘oath’ idea, the behaviour habits being so unbreakable it appeared that the subject had sworn an oath to do or not to do the action involved. The behavioural accounts were entirely objective, including what we would call immature, antisocial and criminal behaviour, and obsessional categories of contamination, aggression, orderliness of objects, sex and religion. They do not include subjective descriptions of obsessional thoughts, ruminations or the subject9s attitude to their own behaviour, which are more modern fields of enquiry. Conclusions The Babylonians had no understanding of brain or psychological function but they were remarkable describers of medical disease and behaviour. Although they had both physical and supernatural theories of many medical disorders and behaviours, they had an open mind on these particular behaviours which they regarded as a ‘mystery’ yet to be ‘resolved’. We are not aware of comparable accounts of these behaviours in ancient Egyptian or classical medicine. These Babylonian descriptions extend the history of these disorders to the first half of the second millennium BC.

We have previously published translations of Babylonian texts on epilepsy and stroke, which we believe to be the oldest detailed accounts of these neurological disorders from the second millennium BC. We now present a short Babylonian text, which clearly describes what are today known as interictal or schizophrenia-like psychoses of epilepsy. The text includes many of the classical symptoms of the syndrome, for example, paranoid delusions, hallucinations and mood disorders, as well as religiosity and hyposexuality, which have only been crystallized in the twentieth century. The Babylonians were remarkably good observers of human disease and behavior but had little or no understanding of pathology or brain function. Although they recognized many natural causes of disease, epilepsy and behavior disorders were attributed to supernatural, usually evil forces, the forerunner of the Greek concept of the Sacred Disease.

The history of stroke begins with the ancient texts of Greece and Rome, from the Hippocratic writings of the fifth century BC to the doctrines of Galen in the second century AD. We identified and translated 2 Babylonian medical texts concerned with stroke from the British Museum, London, and the Louvre, Paris, France, so we could present and discuss excerpts that illustrate Babylonian accounts of stroke and to discuss a Babylonian literary text that includes reference to a stroke-like condition. The Babylonians recognized the unilateral nature of stroke involving limbs, face, speech, and consciousness, and they distinguished the facial weakness (mouth paralysis) of stroke from the flaccid paralysis of Bell palsy, as it is known in modern terminology. They were aware of the variable prognoses of stroke, from rapid recovery to disability and death. Difficulties were encountered in separating transient strokes from epileptic seizures, as still occurs today. Unlike epilepsy, not all paralysis was viewed as supernatural, and various physical treatments, poultices, and polytherapy were tried to stimulate the paralyzed muscles. There is also a reference to rehabilitation. These studies extend the history of stroke to the first half of the second millennium BC. The Babylonians were keen observers in all branches of medicine but had no concept of pathology in the modern sense.