The responsibility of surgeons and their fees b.c. 2300

BMJ 2003; 327 doi: (Published 13 November 2003) Cite this as: BMJ 2003;327:1143

In the time of Hammurabi, King of Babylon, who lived 2,300 years b.c., the laws regulating the practice of surgery seem to have been rather uncomfortable. According to the code of laws of this monarch, discovered at Susa in 1902 by M. de Morgan, and transcribed and translated by Father Scheil, a surgeon who operated on any one with a bronze stylet or removed a film and saved an eye, was entitled to receive 10 shekels of silver. In the case of a noble the surgeon received 5 shekels, and for a slave 2 shekels. For setting a fracture in the case of a freeman he received 5 shekels, for the son of a noble 3 shekels, for a slave 2 shekels. These fees are doubtless large; but, on the other hand, the surgeon had to bear a somewhat onerous responsibility, for if, when operating with the stylet, he killed a freeman or caused the loss of an eye, his hands were to be cut off; if the slave of a noble died after a similar operation, the surgeon had to give a slave in return; if he caused the loss of a slave's eye, he had to pay half his value. Apparently the surgeon was charged with the duty of marking slaves; if a surgeon marked a slave as “inalienable” without the knowledge of his master, his hand was to be cut off; but if he was induced to do this by the deception of a third person, that person was to be killed and buried in his house, while the surgeon was set free on swearing that he did not perform the act knowingly. It is somewhat difficult to understand how it would be possible to exercise the profession of a surgeon under such laws. And yet the civilization in which they were enacted was one of long date and far removed from the primitive organization of society. Perhaps, like some legislation nearer home, they were not so formidable in reality as they appear on the statute book. In England a hundred years ago the law punished sheep stealing with death; but we know the result was not to hang sheep stealers, but to make it impossible to get a conviction.

BMJ 1903;ii: 211)

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