By Aisha Abubakar
Modern pharmacy practice is built on several trusted references such as the United State pharmacopoeia, British Pharmacopoeia, European Pharmacopoeia, Internal Pharmacopoeia, Martindale, Remington, etc that ensure drug quality, safety and scientific accuracy, because medication is never dispensed on guess work. Such reference books feel like they weigh more than a bag of IV fluids, but without them, half of us wouldn't survive pharmaceutics or pharmacology.
And so, to better understand where pharmacy is today, we must journey back to where it first began............to the oldest known pharmacy test in the human history.
When historians try to trace the very first written footsteps of pharmacy, they often find themselves standing at a crossroads between two ancient worlds. One path leads to the hot, river-carved lands of Mesopotamia, where as far back as 2400 BC (about 4,425 years ago), healers pressed wedge-shaped marks into clay tablets, recording mixtures of oils, herbs, and minerals in what we now call Sumerian cuneiform. These tablets read like early apothecary notes—simple, direct, and stunningly old, offering a glimpse into a time when medicine was still whispered by priests and prepared in temple courtyards.
The other path carries us west to Ancient Egypt, around 1550 BC (about 3,575 years ago), where the famous Ebers Papyrus unfolds like a long breath of medical wisdom. Unlike the brief clay inscriptions, this papyrus is rich with hundreds of remedies, spells, and therapeutic observations, a treasure so detailed that some scholars call it the first truly comprehensive medical and pharmaceutical document. And so the debate lives on: should we honor the Egyptian text for its depth, or the Mesopotamian tablets for their age? In the end, this article follows the older trail—the one cut by the Sumerian stylus—toward the earliest known written memory of the pharmacist’s art.
The Sumerian Cuneiform Tablet, officially identified by the University of Pennsylvania Museum of Archaeology and Anthropology as B14221 (or CBS 14221). This artifact was discovered in the ruins of the ancient city of Nippur, located in Mesopotamia (modern-day Iraq), during the significant Babylonian Expedition conducted between 1888 and 1900.
The tablet is firmly dated to the Ur III period, often referred to as the Sumerian Renaissance, placing its creation around 2400 BC. Some expert estimates suggest a slightly broader and potentially earlier range, circa 2500 to 2340 BCE. This dating confirms its unparalleled antiquity as a written record dedicated to compounding and therapeutic preparation.
The tablet is inscribed in the Sumerian language utilizing archaic cuneiform script. Its physical form is a clay tablet measuring 15.4 cm in height, 9.3 cm in width, and 2.8 cm in thickness. The material choice—baked clay—is crucial to the document’s survival and subsequent identification.
This tablet details about 15 prescriptions for preparing poultices, salves, and washes using various plant, animal, and mineral ingredients dissolved in substances like wine, beer, or milk. The contents of these tablets suggest a long history of experimentation. Ingredients included myrrh, fig, mustard, snakeskins, and salt, many of which had empirically discovered antiseptic or symptom-relieving qualities (e.g., willow bark for fever, a source of aspirin). Medicine in Mesopotamia was practiced by specialists who underwent extensive training to become scribes first, then medical practitioners. The asu (physician) used these pharmaceutical preparations, working alongside priests. This early Sumerian work laid the foundation for subsequent, more extensive Mesopotamian medical texts, such as the large medical treatise known as the Treatise of Medical Diagnosis and Prognoses, which built upon centuries of accumulated knowledge and included detailed observations and rationales for treatment.
While debates may continue, the Sumerian cuneiform tablets offer an extraordinary window into the earliest documented attempts at pharmaceutical practice. They are not just the remnants of a long-forgotten world, but a testament to the origins of a discipline that has shaped modern medicine. To study them is not merely to explore history, but to return to the very roots of pharmacy.
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