Vol.:(0123456789)
HPLS (2025) 47:30
h ps://doi.o g/10.1007/s40656-025-00674-6
ORIGINAL PAPER
In e en ial schema inAkkadian diagnosis: hecase
o Ahh
a
zu
C is inaBa ésGómez1
Recei ed: 8 Janua y 2024 / Accep ed: 17 Ap il 2025
© The Au ho (s) 2025
Abs ac The aim o his wo k is o analyze Akkadian medical diagnosis by exam-
ining he easoning in ol ed in he p ocess. The analysis highligh s he impo ance
o unce ain y in he imeline o in e ence. While p ognosis pe ains o he u u e,
diagnosis conce ns some hing di e en ; i ela es o wha has al eady occu ed. I
is p oposed ha he analysis would be incomple e wi hou conside ing he oles o
bo h he pas and p esen wi hin he in e en ial amewo k. Ancien medical diag-
nosis mus be unde s ood by accoun ing o he en i e easoning s uc u e, which
is no cap u ed in a single ex , o which eason i is necessa y o analyze bo h he
diagnos ic and he apeu ic kind. This wo k d aws on ansla ions o hese ex s by
Assy iologis s. Ancien medical science needs o be s udied om mul iple pe spec-
i es, and he logic and philosophy o science can help o gain a be e unde s and-
ing o i s p ac ice and me hodology.
Keywo ds Akkadian medicine· Abduc ion· Medical easoning· GW model
* C is ina Ba és Gómez
[email p o ec ed]
1 D. Filoso ía, Lógica y Filoso ía de la ciencia, Uni e si y o Se ille, Se illa, Spain
C.Ba és Gómez
30 Page 2 o 25
1 In oduc ion
Akkadian medicine e e s o a collec ion o medical ex s disco e ed a a ious
a cheological si es1, he ea lies ex s da ing o a ound 2000 BC, du ing he Thi d
Dynas y o U (Biggs, 2005). These ea ly ex s a e w i en in Sume ian2, whe eas
se e al la e ancien medical ex s a e w i en in Akkadian. Al hough bo h a e
insc ibed on clay able s, he languages di e and he w i ing signs a y ac oss di -
e en pe iods. Sume ian w i ing is logog aphic, whe eas Akkadian w i ing inco po-
a es Sume ian logog ams along wi h logo-syllabic cunei o m sc ip .
Rega ding he Akkadian medical ex s, he e a e, o example, able s om Nip-
pu da ing o he 18 h cen u y BC (Gelle , 2006), as well as a ange o ex s om
he i s millennium BC, known as he Diagnos ic Handbook (Laba , 1951; Heeßel,
2000;Schmid chen, 2021) (also e e ed o as he Diagnos ic-p ognos ic Handbook,
SA.GIG o Sakikk
u
se ies)3. This handbook, consis ing o diagnos ic-p ognos ic
omens.4 se es as a so o medical guide (S ol 1991-92) ha p edic s he pa ien ’s
u u e a e desc ibing he symp oms o his illness.5 The diagnosis ypically ends
wi h a p ognosis: ei he “he will die” o “he will li e.”
The e a e also se e al ex s ha can be classi ied as ma e ia medica, which lis
plan s, s ones, o diseases, an example o his being BAM 1 (Köche , 1963-2017).
The inal ex ype add essed he e is he mos common in Akkadian medicine, iz.
hose known o Assy iologis s as “ he apeu ic ex s.” (Thomson, 1923),(Köche ,
1963-2017). These ex s, which consis o a combina ion o ecipes, lis s o ma e ia
medica6, and incan a ions, ha e a dis inc i e s uc u e ypically ocusing on symp-
oms and hei ea men , while a ely naming he illness explici ly.
Akkadian medical expe s we e known as as
u
(physician),
a
s
ipu/ma
s
ma
s
s
u
(exo cis ), o b
a
u
(di ine )(Koch, 2015). In ac , he e was no clea dis inc ion
be ween physicians, exo cis s, apo heca ies, and di ine s. E en hough i seems
1 Many o hese ex s can be ound in published wo ks, such as Scu lock (2014) in English. The e is also
a p ojec , BabMed, led by he F eie Uni e si ä Be lin, which publishes online copies o he medical ex s
along wi h hei ansli e a ions (see P ojec ).
2 Fo an analysis and ansla ion o he ea lies diagnos ic ex s o Udug-Hul, see Gelle (1985). I is
impo an o no e ha hese ex s a e no s ic ly medical. F om an in e en ial pe spec i e, howe e , hey
sha e he explana o y s uc u e ound in medical diagnoses, as will be discussed u he on. The Udug-
Hul se ies consis s o magical incan a ions o p oblems ha may o may no be medical in na u e. Fo
he i s known medical p esc ip ion, also w i en in Sume ian, see Ci il (1960).
3 Despi e he ac ha some au ho s call hese ex s a diagnos ic-p ognos ic handbook, ollowing
Heeßel’s and Schmid chen’s ansla ions (Heeßel 2000, Schmid chen 2021), I p e e diagnos ic hand-
book. SA.GIG is he Sume ian e m (li . “sick co ds”), whe eas Sakikk
u
is he Akkadian i le o he ex s
om he Diagnos ic Handbook wi h a meaning akin o “symp oms”.
4 I should be bo ne in mind ha he omen would ha e p ope ly been conside ed as he p ognosis,
whe eas he diagnosis se ed as he explana ion (mo e on which below)
5 I should be s essed ha in his wo k, no dis inc ion is d awn be ween he concep s o disease, illness,
and sickness as is some imes he case in mode n medicine (see Ho mann (2002)).
6 Fo u he de ails on ma e ia medica, see Böck (2014); Bácskay e al. (2024), plus Köche , F. and
Böck, B. The Assy ian-Babylonian D ug Lo e ( o hcoming).
In e en ial schema inAkkadian diagnosis: hecase o … Page 3 o 25 30
ha all hese specialis s app oached medical issues om di e en pe spec i es, he
bounda ies be ween hei oles a e no clea ly de ined o esea che s7.
The s udy o Akkadian medicine has been app oached om a ious pe spec-
i es. A his o y o science and Assy iology app oaches ha e p oduced ema kable
s udies, including ansla ions o ex s (Heeßel, 2004), con ibu ing o b oaden ou
unde s anding o Mesopo amian cul u e, language, and medicine. Ano he impo -
an app oach seeks o unde s and he concep o disease in ancien Mesopo amia
in compa ison o mode n medicine (Scu lock & Ande sen, 2005). In ac , bo h pe -
spec i es ega d Akkadian medicine as a scien i ic p ac ice. Al hough magic is so
deeply ing ained in hese medical ex s ha i canno be decoupled om hem, se -
e al aspec s e lec wha migh be called scien i ic easoning (Gelle , 2010) o an
incipien medical science.
A hi d app oach is aken he e om a logico-philosophical pe spec i e o he
pu pose o unde s anding and acing he e olu ion o science h ough he s udy
o easoning. This epis emological app oach e eals how scien i ic knowledge has
e ol ed by analyzing i s me hodology. Speci ically, he empo al s uc u e o medi-
cal diagnosis, p ognosis, and ea men in ancien Akkadian ex s is examined by
ocusing on he ole o unce ain y in easoning.
D awing om p e ious wo ks app oaching he ma e om he wo a o emen-
ioned pe spec i es and in oducing his hi d app oach, he aim is no o classi y
medical ex s om he s andpoin o mode n medicine o o s udy Mesopo amian
cul u e om a pu ely his o ical pe spec i e. Ra he , he in en ion is o analyze he
easoning used in medical p ac ice, which should p o ide new insigh s in o Assy o-
Babylonian cul u e and i s unde s anding o disease—o , mo e p ecisely, o science,
pa icula ly he medical kind.
In wha ollows, p e ious wo ks on he s uc u e o medical diagnosis a e
app oached om a logical pe spec i e, analyzing abduc i e in e ence in Akka-
dian medical diagnosis (Ba és Gómez, 2018). The spo ligh is hen placed on he
concep s o unce ain y and he u u e wi hin he in e en ial schema by examining
examples o Akkadian medical diagnoses, p ima ily ocusing on he p ognosis.
While he s uc u e o diagnosis la gely ela es o he u u e, in he ou h sec ion he
ole o he pas wi hin he in e en ial schema is explo ed by explaining he “ ill-up”
and “cu -down” p oblems in abduc i e in e ences (Magnani, 2015b, 2001). These
concep s pe ain o wha is called selec i e abduc ion (commonly used in diagnos-
ic easoning, which in ol es selec ing c i e ia om a numbe o possibili ies) and
7 This deba e is no en e ed in o he e, as i has no immedia e bea ing on he ma e a hand. Fo a discus-
sion on as
u
as a physician and
as
ipu as an exo cis , see Biggs (2005). Some schola s, such as Scu lock
and Ande sen (2005) conside
as
ipu o be he p ac i ione s men ioned in he Diagnos ic Handbook,
whe eas as
u
a e ega ded as apo heca ies. In ac , esea che s s ill know li le abou how he Diagnos ic
Handbook was used. Fo mo e on he p ac ical applica ion o hese ex s and he ac ha some as
u
also
pe o med diagnoses, see Robson (2008),p. 474 and . I appea s ha he bes -known exo cis s om
he Neo-Assy ian pe iod made no e e ence o he Sag-gig se ies, which is also absen om he lib a y
o Kiṣi -A
ss
u (A bøll, 2019), p. 64. Al hough “ he connec ion in Kiṣi -A
ss
u ’s able s o Sag-gig is e i-
den ,” he co ela ion be ween Sag-gig and he apeu ic ma e ial seems inconsis en o some au ho s, as
no ed in A bøll (2019),p. 64. A bøll also sugges s ha “Kiṣi -A
ss
u migh well ha e been augh acco d-
ing o p inciples di e ing om hose appea ing in he Sa-gig se ies”, p. 65.
C.Ba és Gómez
30 Page 4 o 25
c ea i e abduc ion (which o mula es hypo heses, including new ones)(Magnani,
2015b, 2001)8
The in en ion he e is o unde s and he empo al s uc u e o medical diagnosis
h ough an analysis o he in e ences unde lying scien i ic easoning. I is con ended
ha his easoning is associa ed wi h ac ion and he e o e ela es o u u e p ognosis.
Howe e , i is also ancho ed in he pas because, e en in he absence o e idence, i
is linked o hypo heses o mula ed in ela ion o pas e en s. The ques ion ha ig-
ge s he in e ence is si ua ed in he p esen , a p ocess known as diagnosis igge ing.
This kind o analysis should help o unde s and how he empo al s uc u e o
scien i ic easoning de elops and i s epis emological ole. Se e al Akkadian exam-
ples a e p esen ed below o illus a e he in e en ial s uc u e. In he inal sec ion, he
concep o p ac ical easoning and how he empo al s uc u e is c ucial o igno-
ance-p ese ing in e ence a e explained. Unce ain y is a undamen al aspec o
such in e ences, pa icula ly in Akkadian medical diagnosis.
2 Akkadian ex s andin e ences
Be o e analyzing in e ences in Akkadian medicine, i is essen ial o explain wha
an in e ence is and how i has been s udied in Akkadian ex s. An in e ence is sim-
ply a ela ionship be ween a p emise and a conclusion, ypically ep esen ed as one
be ween
𝛼
( he p emise) and
𝛽
( he conclusion). Gene ally, when e e ing o a logi-
cal ela ionship, his signi ies a deduc i e ela ionship ha mus be a necessa y con-
nec ion be ween
𝛼
and
𝛽
. This ela ionship is some imes exp essed in na u al lan-
guage h ough a condi ional s uc u e, such as “i
𝛼
, hen
𝛽
.” Following Rochbe g
(2010), his is he ela ionship ound in Akkadian omens. As she co ec ly explains,
in he s a emen , “I Jupi e becomes s eady in he mo ning, enemy kings will be
econciled,” he ela ionship— ega dless o how i a ises (whe he h ough analogy
o o he wise)—cons i u es a s uc u e o a deduc i e p ocess. Thus, when we ha e
𝛼
,
we necessa ily ha e
𝛽
.
𝛼
→
𝛽
𝛼
——-
𝛽
This is a common deduc i e s ep known as modus ponens. In ac , his s uc u e
ela es o he u u e and has he o m o a p edic ion. I is ce ainly a a ional s ep,
as Rochbe g (2010) no es, which o en appea s in scien i ic easoning. O cou se, i
is bold o asse ha p e-logical hinking exis s when he e a e p edic ions ha unc-
ion as comple ely logical deduc i e p ocesses.
Ne e heless, deduc ion is jus one way o ela ing p emises and conclusions ha
seems o appea in omens, bu no he only way easoning occu s. The e a e o he
8 These concep s, in oduced by Magnani (2001), a e con ex ual and also ake in o accoun he pas om
an eco-cogni i e pe spec i e. Fo de ails, see Magnani (2015a),p. 290 and . I wa an s no ing ha a
c i e ion o plausibili y, minimali y, o consis ency is no necessa y o he hypo hesis o be he bes o
e en adequa e.
In e en ial schema inAkkadian diagnosis: hecase o … Page 5 o 25 30
ypes o in e ence, such as he induc i e and abduc i e kind. When discussing p e-
dic ions (as seen in omens), deduc ions a e usually pe o med, whe eas he expla-
na ions ound in medical ex s a e associa ed wi h o he kinds o in e ence, wi h
abduc ion being he mos p ominen . Howe e , hese can in e wine wi h o he ypes
o in e ence,9 as will be explained below.
Re u ning o medical easoning in Akkadian ex s, as al eady men ioned, he e
a e se e al kinds. Ne e heless, p ide o place should be gi en o he Diagnos ic
Handbook (Laba , 1951Heeßel, 2000 ;Schmid chen, 2021), an impo an compen-
dium o medical diagnoses om An iqui y. The s uc u e o Akkadian medicine is
di ided in o signs/symp oms, diseases, p ognoses, and ea men s. The Diagnos ic
Handbook p ima ily add esses signs/symp oms, illnesses, and p ognoses, while
some imes e e ing o ea men s as well. These ex s discuss he causes o diseases
o he names o illnesses. Al hough in mos cases he causes appea o be a ib-
u ed o supe na u al en i ies—such as he well-known “Hand o he God”— he e a e
ins ances in which he ocus is mo e on he symp oms.10 They ypically ollow his
s uc u e11:
I (in his o ha ame o e e ence) symp om A (B-Z) is p esen :
diagnosis (disease name and/o disease causa i e agen ) - jus i ica ion o
disease -
ins uc ion o exo cis - p ognosis(es)
The i s sen ence o he s uc u e in Akkadian medicine co esponds o wha
Schmid chen (2021) calls he “ opicalisa o .” I exp esses he p eceding ci cum-
s ances ha lead o he diagnosis, which is e e ed o in abduc i e easoning as he
“su p ising ac / ac s.” This s uc u e is now examined while conside ing he medi-
cal easoning amewo k and se ing aside he p ognosis o he momen . The s uc-
u e o a diagnosis in Akkadian medical ex s can be a ionally econs uc ed as an
in e en ial s uc u e known as “abduc ion”,12 which is an in e ence ha is nei he
induc ion no deduc ion. I s i s comple e analysis can be ound in Pei ce (1931)
[CP 5.189] and is schema ized as ollows:
The su p ising ac C is obse ed.
Bu i A we e ue, C would be a ma e o cou se.
Hence, he e is eason o suspec ha A is ue.
9 Fo a de ailed desc ip ion o abduc ion as an explana ion and deduc ions as p edic ions o p ognoses in
medicine, see Ba és Gómez and Fon aine (2022) and he ollowing sec ions.
10 The e a e also se e al examples ha e e o illnesses, such as “Sick Lungs,” bu o he bes o my
knowledge, hey a e no o en ound in he Diagnos ic Handbook (mo e on his aspec below).
11 This is a e o mula ion o he A alos s uc u e p oposed by Heeßel 2000,p. 41. The English ansla-
ion is my own. See also Schmid chen (2021),p. 54 and .
12 Fo a comple e analysis o Akkadian medical diagnosis as an abduc i e in e ence, see Ba és Gómez
(2018).
C.Ba és Gómez
30 Page 6 o 25
This easoning in ol es he p o isional adop ion o a hypo hesis and i s applica-
ion in u u e ac ions.13 This can be illus a ed wi h an example o medical diag-
nosis om an Akkadian ex . The ollowing pa ag aph comes om he Diagnos ic
Handbook14. Table 33 is he only one in he Diagnos ic Handbook ha uses he
co ec name o he illness. I should be conside ed ha in ancien medical ac s,
signs/symp oms and names a e o en mixed. Ne e heless, he exis ence o a able
wi h a speci ic name indica es he e is a clea e in e en ial schema ha di e en ia es
be ween hese aspec s. Taking a b oade pe spec i e is a good s a ing poin when
he idea is o explo e he schema o easoning. Thus:
Example 1 Diagnos ic Handbook: possible jaundice. SA. GIG/Sakikk
u
33/9315
T ansla ion: “[I his ace] is yellow and he inne pa o his eyes is yellow (and)
he base o he ongue is black, [i is called], [ahh
a
zu]”.
I he signs/symp oms a e conside ed as
𝛽
and he illness as
𝛼
, a s uc u e simila o
he ollowing migh be ob ained16:
The pa ien has he signs/symp oms
𝛽
([his ace] is yellow and he inne pa o
his eyes is yellow (and) he base o he ongue is black)
I he pa ien has illness
𝛼
([ahh
a
zu])
→
hen he will ha e he signs/symp oms
𝛽
( [his ace] is yellow and he inne pa o his eyes is yellow (and) he base o
he ongue is black)
___________________________
I can be concluded ha he pa ien has illness
𝛼
([ahh
a
zu])
This in e en ial s uc u e is equen ly exp essed by a condi ional in Akkadian (
s
umma), usually wi h DIŠ ollowing a lis o symp oms (i he pa ien has any...)17
13 I should be aken in o accoun ha he e ha e been many p oblems in de ining abduc ion, while
some au ho s ha e conside ed i o be a o m o induc ion. He e, abduc ion is ega ded as a ype o in e -
ence di e ing om induc ion and deduc ion, as no ed in Ba és Gómez and Fon aine (2022); Gabbay
and Woods (2005); Hin ikka (1999); Magnani (2001, 2015a, 2015b, 2017, 2019a); Pa k (2015); Woods
(2013). Fo u he in o ma ion on he p oblems associa ed wi h abduc ion and i s in e p e a ion in he
philosophy o science, see Plu ynski (2011).
14 See Heeßel 2000; Scu lock 2014.
15 The ex is om he Diagnos ic Handbook, able 33, line 93. The English ansla ion is om Scu lock
(2014). p. 239. See also AOAT 43.357, he abb e ia ion AOAT de i ing om Heeßel 2000, p. 357
and . The AOAT ansla ion is “[Wenn sein Gesich gelb - g ]ünlich wi d, das Inne e seine Augen
gelb-g ünlich wi d und seine Zungenwu zel schwa z wi d:[a] hh[
a
-zu is ih Name].” Simila ly in Laba
(1951), TDP 9/13: “Si son isage es jaune, l’in é io de ses yeux, jaune, e la acine de sa langue, noi e:
(c’es ), le démon Ahh
a
zu.” See also chap e 3 in Scu lock and Ande sen (2005); Schmid chen (2021),p.
415. and BAM 578, IV, 43-45 and 26. Usually, his demon is associa ed wi h jaundice, namely, a symp-
om o jaundice o a demon pe soni ying he disease i sel , as discussed in Adamson (1993) and he inal
chap e o his wo k.
16 See also Magnani (2001).
17 Some imes he e is also DIŠ GIG... ( i he ill pe son...).
In e en ial schema inAkkadian diagnosis: hecase o … Page 7 o 25 30
in he p o asis and a diagnosis in he apodosis18. The physician has he signs/symp-
oms o an sick pe son (ma ṣu) in he p o asis, along wi h some con ex ual da a ha
igge he in e ence and se e as he p emises. In logical e ms, hey a e ypically
e e ed o as he an eceden and consequen o a condi ional. Ne e heless, his na -
u al language condi ional e e ses he deduc i e in e ence. The s uc u e consis s o
p emises (p o asis) and a conclusion (apodosis).
F om a logical pe spec i e, i is necessa y o analyze he ela ionship be ween
hese p emises (signs/symp oms) and his conclusion (diagnosis/cause).19 This is no
a deduc ion because, in he na u al language condi ional, he an eceden is no mally
he consequence o an illness. In ac , a diagnosis— he cause—comes i s and he
signs/symp oms a e he consequence o he cause, as shown in he schema p esen ed
abo e. Con e sely, in he linguis ic condi ional, i s he e a e he signs/symp oms
and hen he consequence as he cause. This in e ence is no a deduc ion because,
om a deduc i e poin o iew, backwa d easoning is in ol ed.
3 Abduc i e in e ence indiagnosis: G‑W schema
In Akkadian he condi ional demons a es a backwa d in e ence in sea ch o he
cause. I is no a modus ponens s uc u e because i does no in ol e o wa d eason-
ing ypical o an omen, bu backwa d easoning in he ques o an explana ion, e en
hough hese wo ypes some imes employ he same condi ional in he Akkadian
language. Indeed, i his s uc u e— he one in he Akkadian medical condi ional
ha seeks he causal agen (diagnosis) is accep ed—i could be claimed ha his is
a deduc ion; howe e , his in e ence is in alid. The u h o he p emises does no
imply he conclusion. Since A is o le, his has been e e ed o as he “ allacy o
a i ming he consequen ,” esembling modus ponens, bu in e e se. When exam-
ined om a deduc i e poin o iew, i is possible o iden i y an e o in easoning.
This is no a alid a gumen schema in deduc i e logic.
𝛽
𝛼
⟶
𝛽
———
𝛼
Bu is i eally an e o ? While i may no be classi ied as one, he in e es ing
poin he e is he ac ha his is no longe a deduc ion bu a he an abduc ion, which
is mo e complex han he allacy o a i ming he consequen . The e o e, he o -
maliza ion p esen ed abo e is a simpli ica ion o he ac ual easoning in ol ed.This
o m o easoning does no use he same s anda ds o alidi y as deduc i e eason-
ing, while i s co ec ness esides in i s p agma ic i ue.
18 Al hough his is he usual o m, he e a e also o he s, as seen in example 1. Fo a comple e analysis o
he e bs and o ms, among o he hings, see Heeßel 2000 and Schmid chen (2021).
19 Usually, his cause—whe he i be a punishmen , illness, o di ine sende —appea s as he “Hand o
he God.” Fo an analysis, see Heeßel (2007).
C.Ba és Gómez
30 Page 8 o 25
The GW model, de eloped by Do M. Gabbay and John Woods in Gabbay and
Woods (2005); Woods (2013), is use ul o analyzing his s uc u e. This model o
abduc ion is concei ed in e ms o in e ac i e cons uc ions and d aws om con-
cep ual insigh s (Magnani, 2017) de i ing om he ecen e i al o he Pei cean
p agma ic iew. Tha is why he models p oposed by Gabbay and Woods (2005),
Woods (2013), and Magnani (2017), which unde s and abduc ion in e ms o cogni-
i e, economic, and ecological conside a ions, se e as a s a ing poin o p ac i-
cal easoning in medicine. Woods ((Woods, 2013), p. 376) de ines abduc ion as an
“igno ance-p ese ing” in e ence, which a ises in esponse o an igno ance p oblem.
A ques ion o which an agen has no answe ac s as a cogni i e i i an , p omp ing
he o mula ion o a hypo hesis ha may se e as he basis o new ac ions, despi e
he pe sis en s a e o igno ance.
Le us b ie ly conside he a o emen ioned example in a GW model (Gabbay &
Woods, 2005; Woods, 2013) o abduc ion, which cap u es mo e ea u es han he
schema p esen ed ea lie :
1.
T!Q(𝛼)
This co esponds o a T ( a ge ) esul ing om a Q (ques ion) ha will
be answe ed by
𝛼
, which means ha he e is an ini ial ques ion ha needs o be
answe ed, which is as ollows: om which disease is he pa ien su e ing? In
his s a e o igno ance he e is a ac ( ha he pa ien is unwell) and i is essen ial
o know wha has igge ed hese signs/symp oms20.
2.
∼(R(K,T))
[Fac ] This su p ising ac o he signs/symp oms is no in ela ion
R o a ge T ha will answe he ques ion and he cu en s a e o knowledge K.
In o he wo ds, he eason behind he pa ien ’s sickness is unknown.
3.
∼(R(K∗,T))
[Fac ] The e is no successo o knowledge
K∗
in he physician’s
cu en backg ound knowledge. No is he e any ela ion R be ween he succes-
so o knowledge
K∗
and a ge T. The e is no hing in he physician’s cu en
knowledge ha di ec ly indica es wha disease he pa ien has.
4.
H∉K
[Fac ] In o de o answe he ques ion, a hypo hesis H ha does no o m
pa o backg ound knowledge K is equi ed. In o he wo ds, he physician’s
hypo hesis abou he illness is no o be ound in his cu en knowledge o he
pa ien ’s s a e.
5.
H∉K∗
[Fac ] Hypo hesis H is no in a successo o backg ound knowledge
K∗
. No can he physician encoun e he hypo he ical disease in a successo o
his cu en knowledge.
6.
∼R(H,T)
[Fac ] So, he e is no ela ion R be ween hypo hesis H and a ge T.
No is he e any p e ious ela ion be ween he illness and he answe o he
ques ion.
7.
∼R(K(H),T)
[Fac ] The e is no ela ion be ween backg ound knowledge K,
hypo hesis H, and a ge T. No is he e a eal link be ween he illness, he physi-
cian’s cu en knowledge, and his answe .
20 The ac ha he is no in a s a e o wellbeing de i es om he con as be ween he concep o illness
and wellbeing, o which eason medical ex s usually desc ibe bo h. In Akkadian he e a e physiognomic
omens, Alamdimm
u
. Fo hese ex s, see Böck (2000).
In e en ial schema inAkkadian diagnosis: hecase o … Page 9 o 25 30
8.
H
⇝
R(K(H),T)
[Fac ] A hypo hesis H is conjec u ed which has a subjunc i e
ela ion
⇝
in o de o in e ela e backg ound knowledge K, hypo hesis H, and
a ge T. Tha is, i he physician we e amilia wi h he disease, he migh be
able o answe he ini ial ques ion, o i would allow him o explain he signs/
symp oms.
9. H sa is ies condi ions
S1, ..., Sn
[Fac ] This hypo he ical disease needs o ul ill
some condi ions o be plausible o he ime and place and so o h.
10. Then, C(H) [Sub-conclusion, 1-7] The physician conjec u es he hypo he ical
disease. A his poin , in medicine he hypo hesis is usually clinically es ed.
The e a e subsequen ly h ee possibili ies. The i s is ha he hypo hesis is
con i med, signi ying ha a pa ial abduc ion has been pe o med because he
esul is no longe a hypo hesis21. The second is ha his is no he case, signi y-
ing ha he physician has o s a om sc a ch. The hi d is ha nei he has he
hypo hesis been con i med no has i been clinically es ed. Ra he , he physician
ac s in consequence, ea ing he pa ien in o de o cu e he disease ha he has
hypo hesized. The las possibili y leads o s ep 11.
11. Then,
HC
[Conclusion 1-8] The physician uses he hypo hesis in an igno ance-
p ese ing way. He does no p o e i , bu ac s in consequence by ea ing he
pa ien . This s ep, which is equen ly achie ed in gene al clinical medicine
because ma e ial esou ces a e limi ed, also occu s in eme gency si ua ions
(Ba és Gómez & Fon aine, 2021). In Akkadian medical diagnosis, his s ep is
linked o a p ognosis.
The main poin ha should be highligh ed in his schema o abduc ion is ha i is
igge ed by a su p ise; i is an ac o guessing, an inkling a he han knowledge.
I is also a ma e o cou se22 and leads o ac ion. “Abduc ion su p ises a e agenda-
mo i a ing cogni i e i i a ions,” in Woods’ wo ds (Woods, 2013, p. 366).
To his G-W schema should be added he concep s o selec i e and c ea i e
abduc ion, as in oduced by Magnani in Magnani (2001), which co espond o s eps
8 and 9. These ypes o abduc ion a e qui e impo an o diagnosis because selec ion
in ol es choosing be ween hypo heses used in a diagnosis o di e en ia e among ill-
nesses in a compendium. C ea i e abduc ion, on he o he hand, occu s when a new
hypo hesis is o mula ed. These cases a e explo ed below wi h Akkadian examples.
21 As Ba és and Fon aine ha e a gued in Ba és Gómez and Fon aine (2022), he e is eally no such hing
as a pa ial abduc ion in medical easoning. In any case, as ac ion is aken—e en clinically es ing i is an
ac ion—so he hypo hesis is always used in s ep 11. In his connec ion, I would like o hank one o he
anonymous e e ees o sugges ing he ole o ex ispicy in Akkadian medical hinking Heeßel 2018. The
s udy o he li e and o he animal o gans as a o m o di ina ion seems o ha e se ed as a kind o e i-
ica ion some imes unc ioning as induc i e p oo and some imes as a p ognosis as a o m o pos -abduc-
ion e i ica ion. O cou se, his is no a e i ica ion in mode n scien i ic me hodology, bu does occupy a
place in he in e en ial s uc u e. This poin should be analyzed mo e comp ehensi ely in u u e s udies.
22 Fo a comple e analysis, see Woods (2013),p. 364 and .
C.Ba és Gómez
30 Page 16 o 25
dis inc ion seemingly becoming blu ed as mo e is lea n abou Mesopo amian
medicine. Ne e heless, he mos impo an aspec ha should be unde sco ed is
he p ac ical p oo o he emedies, namely, he ial-and-e o aspec o empi ical
medicine om a me hodological pe spec i e, speci ically conce ning pha macologi-
cal ea men 48. The magical elemen s o he diagnos ic ex s appea o all ou side
scien i ic me hodology.
Howe e , om an in e en ial and philosophical s andpoin in medicine, he en i e
in e en ial s uc u e is equi ed o discuss p ope scien i ic me hodology. O he wise,
he i s aspec , associa ed wi h he diagnos ic ex s, only p o ides semio ics (sys-
ema ic obse a ion, which is he mos empi ical componen o medical easoning)
in some able s and pu e specula ion in o he s (such as he diagnos ics associa ed
wi h he “Hand o ”). In he second case, he he apeu ic ex s, wi hou he Sakikk
u
,
a e me ely symp oma ic ea men s de i ing om ial and e o , lacking any scien-
i ic planning. To ully unde s and medical easoning in Akkadian ex s, hese ex s
mus be conside ed as a cohesi e whole.
Ano he aspec ha me i s conside a ion is ha , e en hough he e m “ he apeu-
ics” is no mally used when e e ing o he he apeu ic ex s, in he Sakikk
u
e e -
ence is also made o he apy.
Example 7 Diagnos ic Handbook: SA.GIG/Sakikk
u
31/1-249
T ansla ion “[I ṣē u bu ns a pe son] and on he day (you see he pa ien ), he has
chills, ha pe son has been sick o h ee days; [in o de ha ] [his] [ill-
ness] no be p olonged, i you epea edly ub him gen ly wi h ho oil
and i s quali y bee , he should eco e .”
This is a p ope p ognos ic ex in ancien medicine indica ing a speci ic numbe o
days, which comes om he
s
umma ṣē u ihmussuma o he Diagnos ic Handbook,
no he he apeu ic ex s. Once again, in e ms o scien i ic medical easoning, he e
is a mo e comple e schema in he diagnos ic ex s han in he he apeu ic ones. Simi-
la o G eek medicine, he medical easoning has he s uc u e o signs/symp oms
(semio ics), which is es ablished in empi ical medicine h ough sys ema ic obse a-
ion, as emphasized by Hippoc a es. In ac , se e al Assy iologis s, such as Heeßel
(2024a), ecognize ha i is likely ha he Diagnos ic Handbook has an empi ical
basis ha he his o ical omens lack. The medical omens seem o be based on eal
48 This may also be why some esea che s claim ha he as
u
was mo e akin o a pha macologis han a
doc o . In his espec , see Scu lock (2014)
49 The ex is om he Diagnos ic Handbook, able 31, line 1-2. The English ansla ion comes om
Scu lock (2014),p. 227. Ano he ansla ion in Ge man SA.GIG 31/1-2, AOAT is om Heeßel 2000,p.
342 and .
In e en ial schema inAkkadian diagnosis: hecase o … Page 17 o 25 30
obse a ions o signs/symp oms, ep esen ing he igge ed aspec o he easoning
and he empi ical ounda ions o scien i ic easoning.50
When examining he subsequen pa o he easoning—speci ically, he cause o
he disease—which in G eek medicine is p ima ily ound in Galen and he heo y
o humo s, a simila elemen in Akkadian medicine can be obse ed. This cause
o hypo hesis embodies he expe imen al idea, in Be na d’s wo ds (Be na d, 1966),
leading o ial and, subsequen ly, a p ognosis.51 Empi ical medicine, as science, is
de eloped h ough Hippoc a ic p ognosis and some imes bypasses he unde lying
cause.
The mos impo an aspec is he de elopmen o sys ema ic obse a ion and
he p ognosis ha a ises om i , because i is g ounded in empi ical ac s, whe eas
he causes in Galenic medicine a e o en less clea . The lack o emphasis placed on
he causes o illness in Hippoc a ic medicine is equen ly discussed, as i ends o
es ablish a gene al pa hology. E en when compa ed o G eek medicine, he Diag-
nos ic Handbook con ains wha is clea ly empi ical medicine—as in he las ex
men ioned abo e—whe eas o he ex s ocus on he causes o illnesses desc ibed in
Galenic medicine.
E go, elemen s o scien i ic medicine can be obse ed in bo h adi ions, speci i-
cally, empi ical medicine and he explo a ion o causes. The c ucial ac o in de el-
oping scien i ic medical me hodology is no he andom ial and e o p esen in
he apeu ic ex s, bu a he he sys ema ic obse a ion ha leads o hypo heses and
p ognoses. T ial and e o is ine ec i e wi hou a guiding hypo hesis. These hypo h-
eses eme ge om an in e en ial s ep (abduc ion), ansi ioning om a se o empi i-
cal ac s (sys ema ic obse a ion: signs/symp oms) o he hypo hesis (cause/illness)
and subsequen ly ac i a ing ea men h ough ac ion.
These a e he scien i ic ounda ions o medical easoning, as e lec ed in he
Diagnos ic Handbook. Mo eo e , he e a e also able s, such as no. 31, which
include ecipes, indica ing a comple e s uc u e ha inco po a es ial and e o in
he ea men p ocess. In ac , as men ioned ea lie , in Akkadian medicine, ea men
is associa ed wi h a posi i e p ognosis, as e idenced by able Sakikk
u
31/1-2. In he
Diagnos ic Handbook, ea men is adminis e ed o cases o o e hea ing wi h he
aim o p e en ing a p olonged illness.
T ea men plays an impo an ole in he schema. The e is a ull abduc ion wi h
pos -con i ma ion (con i ma ion ollowing ull abduc ion) i he p ope ea men
o he illness is de e mined. In any case, he unce ain y o igno ance s emming
om he hypo hesis pe sis s when deciding on a cou se o ea men . This igno ance
is only pa ially esol ed a e he hypo hesis is employed and he eac ion can be
obse ed ollowing he p ognosis and ea men , bu he hypo hesis mus be used o
achie e his.
50 Fo a de ailed analysis o his obse a ion as a scien i ic cha ac e is ic o medical easoning in Akka-
dian medicine, see Heeßel (2024a). The medical omens no only in ol e he p ognos ic-omens, bu also
he abduc ion-explana ion s ep. Besides, hey a e g ounded in empi ical ac s wi h a sys ema ic obse a-
ion co esponding o he su p ising ac / ac s.
51 This aspec o he comple e in e en ial s uc u e could explain sugges ions, such as ha made by Böck
(2014), o whom he de ini ion o a disease also in luences ea men . Once he hypo he ical disease has
been de e mined as he a lic ion o a god X, he plan s associa ed wi h ha di ini y a e used.
C.Ba és Gómez
30 Page 18 o 25
This unce ain y no only emains ied o he u u e, leading o an unce ain ou -
come, bu also connec s o he pas . While he u u e is e lec ed in he p ognosis and
ea men , along wi h he aspec s o unce ain y ha a ise di ec ly om he hypo h-
esis, he e a e also links o he pas h ough he diagnosis. This leads o he concep s
o selec i e o c ea i e abduc ion as discussed by Magnani (Magnani, 2001, 2015a,
b, 2017, 2019a).
5 The ole o hepas : diagnosis andunce ain y
Medical diagnosis is usually associa ed wi h he u u e because he goal is o cu e
he pa ien o e ime. The medical diagnosis has a easoning s uc u e ha esul s
in u he ac ion o i is a p ac ical easoning aimed a ac i a ing a hypo hesis a a
u u e momen . Ne e heless, a e healing and dea h solely ela ed o he u u e o
does he pas play a ole in hem as well?
The pas is impo an because an a emp should be made o isola e he possible
causes (Chi i, 2021). The essen ial poin he e is ha he in e ence schema used in
medical diagnosis also has links o he pas ega ding he hypo hesis o he illness,
which may in ol e selec ion o c ea ion, as explained by Magnani (Magnani, 2001,
2017, 2019b). Un il now, he ocus has been placed on s ep 11 o he GW model,
which desc ibes he u u e ac i a ion o he hypo hesis. The ime has now come o
u n ou a en ion o he issues associa ed wi h s eps 8 and 9 o he GW model.
• 8.
H
⇝
R(K(H),T)
[Fac ] So we conjec u e a hypo hesis H.
• 9. H sa is ies condi ions
S1, ..., Sn
[Fac ]
Abduc ion is conside ed he e as a way o o mula ing plausible hypo heses ha se e
o mo e o wa d. This ype o o mula ion in ol es choosing o selec ing hypo heses
om hose a ailable. In ac , hei selec ion, a leas in medicine, connec s wi h he
p ac ical aspec s o he ield. The disease is selec ed om a compendium o known
condi ions. When examining Akkadian medical diagnosis, i can be obse ed ha
his is p ecisely he unc ion o some able s om he Diagnos ic Handbook. This is
one o he ea lies compendia in he his o y o medicine, whose impo ance lies in
how he ex s iden i y known maladies and hei signs and symp oms. These ex s,
which migh ha e se ed as manuals o s uden s o app en ices, e lec gene al
p ac ice, a he han a andom and isola ed emedy o soma ic ea men . Ne e he-
less, his s ep, which is no s aigh o wa d, has been a opic o deba e in abduc i e
s udies.
The e a e wo mo emen s in s eps 8 and 9. Fi s , he e is a p ocess ha is e e ed
o as he “ ill-up p oblem,” as desc ibed by Magnani (Magnani, 2001, 2015b,
2019b). I is i s necessa y o de e mine how o ill up he plausible hypo heses and
acco ding o which c i e ia. I belie e he e is no clea ill-up c i e ion o he possi-
ble hypo heses because he usual c i e ia men ioned in his con ex a e nei he su i-
cien no necessa y o o mula ing a sa is ac o y one. In poin o ac , a c i e ion o
plausibili y, minimali y o consis ency is o en men ioned. Howe e , none o hese
c i e ia a e en i ely sa is ac o y because he hypo hesis migh no be minimal, could
In e en ial schema inAkkadian diagnosis: hecase o … Page 19 o 25 30
be con adic o y, o may e en be implausible (Ba és Gómez & Fon aine, 2021).
None o hese could se e as a de ini i e c i e ion o suppo ing he hypo hesis. The
mos impo an scien i ic heo ies equen ly all ou side hese c i e ia.
E en wi hou clea and de ini i e c i e ia, plausible hypo heses can s ill be illed
up, his aspec being linked in medicine o he pas in he sense ha hose hypo h-
eses a e illed up wi h known maladies. Fu u e easoning is based on pas easoning.
Thus, he selec ion p oblems, which a e he ocus o wha is called selec i e abduc-
ion, a ise in he diagnosis when choosing an illness om a compendium o known
maladies, such as he Diagnos ic Handbook in Akkadian medicine.
A e illing he gap, he e a e se e al possibili ies o choose om. This aspec is
e e ed o as he “cu -down p oblem” in abduc ion (Magnani, 2015a, b). Again, he
issue o c i e ia c ops up: a e he e c i e ia o cu down he plausible hypo heses?
The answe is “no”. While possibili ies could be discussed, in some cases he mos
imp obable op ion is chosen due o he associa ed isks.52 The ollowing could be
conside ed as an example o hese mo emen s in Akkadian medicine:
Example 8 Diagnos ic Handbook: SA.GIG/Sakikk
u
13/75-7653
T ansla ion “I he was inju ed on his abdomen (and he has been sick o ) nine
days, ’hand’ o he win gods. I (i is) second (day), ’hand’ o Adad.
I he hi d, ’hand’ o Ea. I he ou h, ’hand’ o Dingi mahh. I he
i h, ’hand’ o Papsukkal.”
In hese ex s, he e a e se e al diseases ha could be conside ed mo e o less likely
based on he signs and symp oms. This p ocess is o en e e ed o as di e en ial
diagnosis54; howe e , i is p ima ily abou choosing among possibili ies, a p ocess
ha is also desc ibed in o he able s. In ac , he ill-up mo emen has al eady been
es ablished, bu he cu -down mo emen is no as clea , and he physician o en
lea es he possibili ies open o a emp s o choose among hem. This aspec also
highligh s he de easible na u e o he hypo hesis and i s me ely conjec u al s a us. I
is a conjec u e ancho ed in he pas bu in ended o use in he u u e.
This kind o selec ion be ween plausible hypo heses is qui e common in medi-
cine. Ne e heless, i implies a b oad knowledge o medical science and disease ca -
ego ies. Ano he ques ion ha should also be posed is wha happens when he dis-
ease is unknown and canno be ound in he handbook. This si ua ion also connec s
52 Fo an analysis o he isks and e alua ion o a eco-cogni i e model o his in medicine, see Ba és
(2021).
53 The ex is om he Diagnos ic Handbook, able 13, lines 75-76. The English ansla ion is om
Scu lock (2014),p. 113. Ano he ansla ion can be ound in Schmid chen (2021) p. 521 and . See also
Laba (1951),pp. 118-119, line 17.
54 O he di e en ial diagnoses a e also men ioned in SA.GIG, Sakikk
u
10/32-33. Howe e , i is no clea
whe he hey a e uly di e en ial o me ely a compila ion o di e en adi ions. See Heeßel 2000,p. 57
and Schmid chen (2021),p. 159.
C.Ba és Gómez
30 Page 20 o 25
wi h he pas , bu in he sense ha he disease was ne e conside ed. This case is
wha is e e ed o as c ea i e abduc ion (Magnani, 2001, 2015b, 2017).
C ea i e abduc ion occu s when, as in ou medical case, he hypo hesis is no a
known disease. The physician c ea es a new synd ome because he signs and symp-
oms do no ma ch any known illness. As men ioned in Scu lock and Ande sen
(2005), he e a e some synd omes in ancien Akkadian medicine ha we e asso-
cia ed wi h demons. Conside ing he way in which illnesses we e ca ego ized as
gods, ghos s, o demons, he c ea ion o a new synd ome also in ol ed ha o a new
di ine igu e. The e a e se e al examples in Akkadian li e a u e ha migh e lec
his, such as Lama
s
u, ahh
a
zu, mi
s
i u, and al
u
55. Following Adamson (1993), ahh
a
zu is desc ibed as a symp om o jaundice o a demon pe soni ying jaundice i sel . As
men ioned ea lie , he e is ano he e m ha desc ibes jaundice: amu īq
a
nu. Some
ex s a emp o di e en ia e be ween he wo. He e is a inal example om Akka-
dian medical diagnosis o his ahh
a
zu, which some au ho s conside o be a possible
c ea ion56 and, in in e en ial e ms, can be seen as a case o c ea i e abduc ion.
Example 9 Diagnos ic Handbook:SA.GIG/Sakikk
u
3/79-80.57
T ansla ion “I in his head he bu ns wi h e e (and) o e he cou se o a day i
lea es him and hen (la e ) i o e powe s him (and) lows o e him o
wo days (as in) a lic ion by [a ghos ] and he plan a su aces o his
ee ( eel) cold, (and) when ( he e e ) eleases him, his hands and his
ee a e ho as in a lic ion by a ghos ,ahh
a
zu, [i ] ( he cou se o he
e e ) is egula , [he will ge well.]”
This demonahh
a
zu migh ha e e ol ed om an o iginal medical synd ome, as
no ed in Scu lock and Ande sen (2005). The key poin is ha cases such as ahh
a
zu
migh ep esen a c ea i e abduc ion; in o he wo ds, i is a hypo hesis ha does no
co espond o any p e ious synd ome o god. These synd omes, gods, demons, and
55 Fo a de ailed explana ion, see Scu lock and Ande sen (2005),pp. 505-506. I is impo an o no e ha
some o he o igins a e ai ly ho ly deba ed in Assy iological s udies. Fo example, in he case o Lama
s
u, also e e ed o as he “baby-sna ching demon,” au ho s such as Scu lock and Kinnie Wilson sugges
i may be a demon c ea ed om he signs and symp oms o an illness, which could be yphoid o yphus.
O he au ho s belie e i migh be associa ed wi h a di e en kind o illness o e e , such as li e disease,
whe eas o he s con end ha i canno be linked o a single illness. I will no en e in o his deba e; o
u he analysis, see he chap e en i led, Lama
s
u - Agen o a Speci ic Disease o Gene ic Des oye o
Heal h?. W. Fa be in Finkel & Gelle (2007).
56 I is impo an o s ess ha I am no p oposing any heo y ega ding he c ea ion o his demon. F om
an in e en ial poin o iew, an illness can be c ea ed a some poin ; hus, i is possible ha he name o
synd ome was es ablished be o e he compila ion, leading o he demon o igina ing om he synd ome.
This phenomenon occu ed when a new illness eme ged ha had no ye been included in he compen-
dium. This in e en ial s ep could explain why he synd ome became a demon, a he han ice e sa, as is
ypically desc ibed in Akkadian medicine. Ne e heless, he o igins o his synd ome a e some hing ha
Assy iologis mus es ablish using he a ailable da a.
57 The ex is om he Diagnos ic Handbook able 3, lines 79-80. The English ansla ion is om
Scu lock (2014),p. 22. See also Schmid chen (2021), line 68, pp. 253-260.
In e en ial schema inAkkadian diagnosis: hecase o … Page 21 o 25 30
so o h a e no included in he handbook o in he p io knowledge o he physician.
I was i s necessa y o c ea e a new illness as a synd ome, which hen e ol ed in o
a demon due o he es ablished disease ca ego ies in Akkadian medicine. This c ea-
i e abduc ion p ecedes he classi ica ion.
This is no a deba e abou whe he he demon in ques ion, which e ol ed om
such synd omes, is au hen ic o no o his is some hing Assy iologis s should
es ablish and is no he goal o his s udy. I am elying on Assy iological s udies
in his espec . The poin is ha i is no unusual o ind his phenomenon in medi-
cal diagnosis, as i is a ai ly common exp ession o c ea i e abduc ion in medical
easoning. The e o e, i is no su p ising o encoun e such cases in ancien medical
diagnoses. F om a me hodological medical pe spec i e, his is plausible.
As al eady explained, he e is a clea link o he pas in medical diagnosis h ough
he unce ain y o he hypo hesis. This unce ain hypo hesis, o conjec u e, ep e-
sen s he pas aspec o he in e ence. We use medical knowledge posi i ely when
we selec om i , bu we also use i nega i ely o in en when he e a e no op ions
a ailable in ou compendium. Ne e heless, i should be cla i ied ha his does no
imply ha we possess all he necessa y knowledge wi hin ou amewo k. I we
did, we would be engaging wi h a s uc u e o abduc ion akin o In e ence o he
Bes Explana ion (he eina e I BE). Howe e , I am sugges ing is ha i is mo e
closely ela ed o In e ence om he Bes Explana ion (he eina e I BE), in Woods’
e ms,58. In ac , as we do no ha e all he possibili ies a ou disposal, i canno be
“ o he bes explana ion.” The bes answe we ha e a he momen is “ om he bes
explana ion.” In his espec , i is impo an o ecall he somewha ambiguous con-
cep o explana ion as discussed by Hin ikka.
“[...] hese ac s will be [...] unknown a he ime o he abduc ion, and e en mo e
so mus he auxilia y da a which help o explain hem be unknown. Hence hese
u u e, so a unknown explananda, canno be among he p emises o an abduc i e
in e ence” (Hin ikka, (1999,p. 94).
We do no ha e su icien da a because i we did, he e would be no abduc ion;
ins ead, he e would be a deduc ion om he da a. The su p ising ac emains so
p ecisely because i is unknown, jus as he hypo hesis is no an a i ma ion bu an
unce ain y. These poin s indica e ha he link o he pas is es ablished only a e
he ill-up mo emen has been comple ed, no be o e. This does no mean ha he
possibili ies o unknown explananda a e al eady p esen in he p emises; a he , once
he gap has been illed and linked o es ablished knowledge, he empo al s uc u e
connec s wi h pas diagnoses. Connec ions can be made only a e his p ocess has
been comple ed. Ne e heless, e en hough his hypo hesis has been selec ed om a
compendium, i is ne e ce ain. The e is no an a i ma ion, bu a he a conjec u e.
We do no ha e an in e ence o he bes explana ion because we lack all possible
explana ions. This can also be obse ed in he ac ha he e may be bo h selec i e
and c ea i e abduc ions. The only aspec simila o a con i ma ion will a ise la e
58 I should be aken in o accoun ha I do no assume abduc ion o IBE (in his wo k I BE) o o I BE
(Woods, 2013) bu conside I BE migh cha ac e ize some abduc ions. I do no conside I BE o de ine
abduc ion. Fo abduc ions which a e no I BE, see Ba és Gómez and Fon aine (2020); Gabbay and
Woods (2005); Magnani (2001); Woods (2013); Magnani (2017).
C.Ba és Gómez
30 Page 22 o 25
on, once he ea men has been adminis e ed o he p edic ion has been e i ied.
E en in hese cases, howe e , he e a e many a iables ha canno ully con i m he
hypo hesis.
6 Conclusion
The s uc u e o a diagnosis will depend on wha ime pe spec i e i in ends o
adop . In ac , i has a p esen -o ien ed ocus when i s pu pose is o acknowl-
edge a clus e o e en s associa ed wi h a disease; i is pas -o ien ed when
i a emp s o isola e possible causes o a disease, and inally u u e- ocused
when i indica es a possible p ognosis and an app op ia e ea men o a gi en
pa ien . (Chi i, (2021,p. 10)
An unde s anding o he empo al s uc u e in ancien medical science allows o gain
insigh s in o he epis emological e olu ion o medical easoning h ough i s p ac ice.
I ha e explained how medical diagnos ic easoning equen ly ea u es he in e ence
s uc u e o abduc ion as an explana ion. This in e ence is a ype o easoning ha
canno be educed o deduc ion o induc ion. I p ese es he schema o igno ance
and is di ec ed owa d u u e ac ion because i in ol es p ognosis and ea men . The
ul ima e goal is o pe o m an ac ion based on a hypo hesis, making i s p ima y em-
po al ocus a u u e e en , whe e he unce ain y o he hypo hesis con inues along-
side ha o he p ognosis and ea men .
This has been exempli ied by se e al Akkadian medical diagnoses and p ima ily
co esponds o s ep 11 o he GW model o abduc ion. The mos signi ican aspec
o he Diagnos ic Handbook is he di ec ion o easoning owa d a p ognosis, which
is al eady an ac i a ion o he hypo hesis unde unce ain y. When he p ognosis is
posi i e, i includes ea men ; con e sely, when i is nega i e, i does no . In bo h
cases, an ac ion is aken in an igno ance-p ese ing way. In his con ex , he ea -
men is also conside ed a u he ac ion.
This aspec is p esen no only in he handbook bu also in he he apeu ic ex s o
Akkadian medicine. I is essen ial o iew medical easoning as a whole, aking in o
accoun he comple e s uc u e: he semio ics, disease, p ognosis, and ea men . In
he handbook, i can be obse ed how he medical ial was planned, whe eas in he
he apeu ic ex s, he ial i sel can be seen.
The signs and symp oms a e assessed in he p esen , which aises a ques ion ha
canno be answe ed wi h he knowledge a ou disposal. These signs and symp oms
ep esen he su p ising ac in he in e ence. This poin se es as he igge o ou
abduc ion and es ablishes he condi ions o s eps o ou easoning. We do no ha e
he answe o ou ques ion in he p esen ; i we did, we would no longe be engaging
in abduc ion bu a he in deduc ion. This aspec is clea ly illus a ed in he Diagnos-
ic Handbook and o ms he basis o diagnosis in Akkadian medicine. Ancien phy-
sicians began wi h he signs and symp oms (semio ics) and conjec u ed a possible
illness, looking o a cause.
The las poin conce ns he ole o he pas , speci ically how i ela es o al eady
known maladies in ou medical compendium. In Akkadian medicine, his is ound in
In e en ial schema inAkkadian diagnosis: hecase o … Page 23 o 25 30
he handbook. Indeed, his aspec has wo di e en b anches. Fi s , i is conside ed
posi i ely when he gap is illed wi h se e al al eady known hypo heses, be o e na -
owing down he possibili ies o selec one. This is he mos common modus ope -
andi in he handbook. Second, i is e lec ed in a c ea i e mo emen ha exp esses
i s ela ionship nega i ely. Examples o his include newly c ea ed demons ha
eme ge om synd omes in Akkadian ex s. When aced wi h a knowledge gap,
some hing is c ea ed o ill i . I he e a e no iable op ions in ou pas knowledge,
we gene a e a new one in a ill-up mo emen . E en i we ill i wi h se e al possibili-
ies, including hose ha a e c ea ed, we will s ill need a cu -down mo emen .
In his wo k, I ha e shown how medical easoning in Akkadian medical ex s can
be unde s ood as a whole when conside ing se e al ex s. Some a e dedica ed o
semio ics, diagnosis, p ognosis, and some imes ea men , whe eas o he s ocus on
ea men alone. Ne e heless, o achie e a comp ehensi e o e iew o medical sci-
ence in he ancien Nea Eas , he e is a need o examine medical easoning om a
b oade pe spec i e, inco po a ing philosophical and logical analyses ha can help
o isualize he s uc u e o his easoning.
Empi ical me hodology is clea ly exp essed in he handbook, alongside medical
heo y ep esen ed as hypo he ical illnesses. T ea men s a e documen ed in bo h he
handbook and he he apeu ic ex s. All o hese elemen s e lec an in e en ial s uc-
u e ha is speci ic o ancien medicine and can be ound simila ly in o he o ms o
ancien medicine. The key is o unde s and how ancien p ac i ione s hough and
easoned, and o his pu pose, I ha e used logic as a ool o s udy human eason-
ing. This me hodology should help us o gain a mo e ho ough unde s anding o he
s uc u e o medical p ac ice and i s e olu ion h oughou he his o y o medicine.
Acknowledgemen s Fi s o all, I would like o hank all he e e ees o hei commen s, which ha e
helped me o co ec and imp o e a ious aspec s o he a icle. I ex end my g a i ude o he o ganize s
and pa icipan s o he “Ma bu g Dialogues on Ancien Healing A s” (“Ma bu ge Gesp äche zu Al en
Heilkunde”) in 2022 and 2023, pa icula ly P o . Tanja Pomme ening, P o . D . Nils P. Heeßel, and Anne
G ons. I am also indeb ed o he o ganize s and pa icipan s o p e ious wo kshops whe e ela ed issues
we e discussed, such as he “In e na ional Wo kshop on Logic, Philosophy, and His o y o Medicine”
(held in Se ille, Spain, in 2022) and “Dioses, Tumbas y Hé oes: De las A enas de Babilonia a las Aguas
de Ta eso,” o ganized by he Cen o de Es udios del P óximo O ien e (CEPO) and he Depa men o
P ehis o y and A chaeology o Se ille Uni e si y. I would like o hank P o . Nils P. Heeßel, P o . John
Woods, P o . Lo enzo Magnani, and D . Ma hieu Fon aine o hei commen s on his wo k and/o on
p e ious wo ks add essing abduc ion. O cou se, any e o s a e my own.
Funding Funding o open access publishing: Uni e sidad de Se illa/CBUA. I ha e ecei ed inancial
suppo om he p ojec “Abducción y Diagnós ico Médico: In e ogación e Hipó esis en la Causalidad
Cien í ica” (US-1381050, P oyec os de I+D+i en el ma co del P og ama Ope a i o FEDER Andalucía
2014-2020, Jun a de Andalucía), led by F. J. Salgue o and mysel , as well as om he p ojec “Mé o-
dos Lógicos y Abduc i os Aplicados a la Semán ica y la P agmá ica de la In e acción Comunica i a”
(PID2020-117871GB-I00, P oyec o del Plan Es a al 2017-2020 Gene ación del Conocimien o - P oyec-
os I+D+i, Minis e io de Ciencia e Inno ación), led by F ancisco J. Salgue o.
Open Access This a icle is licensed unde a C ea i e Commons A ibu ion 4.0 In e na ional License,
which pe mi s use, sha ing, adap a ion, dis ibu ion and ep oduc ion in any medium o o ma , as long as
you gi e app op ia e c edi o he o iginal au ho (s) and he sou ce, p o ide a link o he C ea i e Com-
mons licence, and indica e i changes we e made. The images o o he hi d pa y ma e ial in his a icle
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