The Code of Hammurabi, Circa 1,760 BCE, which we left with a mere mention in the last page, lists in crisp and precise terms various offences of those days, by people of different walks of life and also the punishments for them. Hammurabi details the fees chargeable by surgeons for various operations and also the punishments for the surgeons if the operations fail (leaving no room for today’s aphorism, Operation Successful! BUT Patient Died!!”).
Hammurabi conformed with the social inequalities / stratifications prevailing in those ancient eras – [and even in the much later and more recent days of United States Declaration of Independence – adopted by the Continental Congress on July 4, 1776 -Thomas Jefferson, the principal author of the above Declaration, an American Founding Father and the third President of the United States (after George Washington and John Adams) and many of the 56 delegates to the Continental Congress who signed the above Declaration themselves owned slaves who were physically restrained with grades of restraints like handcuffs, fetters, leg irons (shackles), leg cuffs, waist chains, straitjackets, hog-ties, straddle split suspension etc., and whipped and branded with red hot iron (!) so much so that the famous British Abolitionist (Anti-slavery Campaigner),Thomas Day (1748 -1789, co-author of “The Dying Negro”, – his first published work and sole author of “The History of Sandford and Merton”) responded to the hypocrisy in the Declaration by writing, “If there be an object truly ridiculous in nature, it is an American patriot, signing resolutions of independency with the one hand, and with the other brandishing a whip over his affrighted slaves!”!
But you can understand that all of them had to do all this because they had to live with their times, as most of us do now – Do in Rome as Romans do!
Without any more ado, (remember William Shakespeare’s marvelous comedy, “Much Ado about Nothing”?), let us see some quick examples of what Hammurabi did / said in this context:
Hammurabi stratified the recipients of social and professional services / interactions and victims of social and professional negligences / crimes into 3 levels- aristocrat (patrician), commoner (plebeian) and slave and detailed the variegated rewards / punishments for perperators of those acts as in the following examples:
“If a surgeon has operated with the bronze lancet on a patrician for a serious injury, and has cured him, or has removed with a bronze lancet a cataract for a patrician, and has cured his eye, he shall take ten shekels of silver.”
One shekel of silver of Hammurabi’s era is about US $5/- today – that was lot of money in those eras when today’s evils – consumerism (People purchasing goods and consuming materials in excess of their basic needs), its cohort Modern globalization (It’s a small world!) and the resultant inflation (Money value sliding down) – did not exist in such large scale as they do in today’s world!
” If it be a plebeian, he shall take five shekels of silver. If it be a man’s slave, the owner of the slave shall give two shekels of silver to the surgeon.”
Punishments for surgeons also varied according to the social status of the victim!
“If he has removed a cataract with the bronze lancet, ,and made the slave lose his eye, he shall pay half his value. If the surgeon has treated a serious injury of a plebeian’s slave, with the bronze lancet, and has caused his death, he shall render slave for slave. If a surgeon has operated with the bronze lancet on a patrician for a serious injury, and has caused his death, or has removed a cataract for a patrician, with the bronze lancet, and has made him lose his eye, his hands shall be cut off.”!
Apart from socio-economic bios, Hammurabi also was biassed favourably towards the non-operating doctors – physicians – of his times who treated patients with non-surgical means – like potions and magic, as indeed were the cultures of those eras. This was because the illnesses treated by surgeons, such as wounds, were due to direct human error or aggression, and the doctors who treated them by surgery were regarded as merely craftsmen such as a boat builder and by analogy, the penalties for medical negligence were similar to those incurred by a shipbuilder, who manufactured a defective vessel that sank according to the legal code of Hummurabi! Contrarily, internal disorders treated without surgery were believed to be caused by supernatural agents, the physicians who wrestled with such diseases were accountable only to the gods – not to the mortals including Hammurabi!.The physicians, who dealt with problems that would today be called ‘‘internal medicine,’’ were of the priestly class and their professional conduct was not governed by the criminal laws pertaining to assault and malpractice.
Witness the English tradition of addressing physicians with the salutation, “Dr.” while the surgeons are addressed with the less awesome salutation, “Mr.” like the commoners generally are – maybe because today’s surgeons are, historically, the professional descendants of the medieval barber-surgeons who themselves were, historically, the professional descendants of the ancient barbers, who, apart from giving services as tonsorial artists – barbers -, often performed minor operations like removal of corns and callosities from feet and even major surgical procedures in those ancient times.The ancient Society of Barbers grew into The Royal Society of Barbers -> The Royal Society of Barber-Surgeons -> The Royal Society of Surgeons -> ultimately the present prestigious The Royal College of Surgeons!
As a proud Fellow of The Royal College of Surgeons (F.R.C.S.,), I often remember my professional lineage from barbers and offer services like theirs to myself and kids around – hair-cut etc., with awful results, needless to mention!
Hammurabi, the subject of this page, had gender bias too – male chauvinism, again typical of his times and, unfortunately, still not extinct!
That will be an SFAD – Story For Another Day!