Quack, Jan Weinhold - The Problem of Ritual Efficacy - Oxford University Press, USA (2010)

The Problem of Ritual Efficacy
Series Editors
Ronald Grimes, Wilfred Laurier University
Ute Hüsken, University of Oslo
Eric Venbrux, Radboud University Nijmegen
Ritual Efficacy
Edited by William S. Sax, Johannes Quack, and Jan Weinhold
The Problem of
Ritual Efficacy
Edited by
william s. sax
johannes quack
& jan weinhold
1
2010
3
Oxford University Press, Inc., publishes works that further
Oxford University’s objective of excellence
in research, scholarship, and education.
Oxford New York

Auckland Cape Town Dar es Salaam Hong Kong Karachi
Kuala Lumpur Madrid Melbourne Mexico City Nairobi
New Delhi Shanghai Taipei Toronto
With offices in
Argentina Austria Brazil Chile Czech Republic France Greece
Guatemala Hungary Italy Japan Poland Portugal Singapore
South Korea Switzerland Thailand Turkey Ukraine Vietnam
Copyright © 2010 Oxford University Press, Inc.
Published by Oxford University Press, Inc.

198 Madison Avenue, New York, New York 10016
www.oup.com
Oxford is a registered trademark of Oxford University Press.
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.
Library of Congress Cataloging-in-Publication Data

The problem of ritual efficacy / edited by William S. Sax, Johannes Quack, Jan Weinhold.
p. cm.
ISBN 978-0-19-539440-5; 978-0-19-539441-2 (pbk.)
1. Ritual. I. Sax, William Sturman, 1957– II. Quack, Johannes. III. Weinhold, Jan.
BL600.R5777 2010
390—dc22 2009012759
9 8 7 6 5 4 3 2 1
Printed in the United States of America

on acid-free paper
Contents
Contributors, vii
1. Ritual and the Problem of Efficacy, 3

William S. Sax
2. Ritual Healing and the Investiture of the Babylonian King, 17

Claus Ambos
3. Jesus and his Followers as Healers: Symbolic Healing

in Early Christianity, 45
Gerd Theissen
4. Healing Rituals in the Mediaeval West, 67

Peter Dinzelbacher
5. Excommunication in the Middle Ages: A Meta-Ritual

and the Many Faces of Its Efficacy, 93
Paul Töbelmann
6. The Work of Zâr: Women and Spirit Possession in Northern Sudan, 113
Janice Boddy
7. Ritual Humility in Modern Laboratories: Or, Why Ecuadorian

IVF Practitioners Pray, 131
Elizabeth F. S. Roberts
vi contents
8. Ritual, Medicine, and the Placebo Response, 151

Howard Brody
9. Bell, Bourdieu, and Wittgenstein on Ritual Sense, 169

Johannes Quack
Index, 189
Contributors
Claus Ambos studied Assyriology, Ancient Near Eastern Archaeology, and

Indology at Berlin, Leipzig, and Heidelberg. He wrote a doctoral thesis on
Mesopotamian building rituals (Heidelberg, 2002) and is currently Research
Fellow in the Collaborative Research Centre Dynamics of Ritual (SFB 619 Ritu-
aldynamik). Since 2008 he has also been active in the Priority Research Field
The Order of Space, Norms and the Law in Historical Cultures of Europe and Asia
at the Heidelberg Academy of Sciences and Humanities. At the present time
he is working on Babylonian royal ideology.
Janice Boddy is Professor and Chair of the Department of Anthropology, Uni-

versity of Toronto. She is a cultural anthropologist interested in gender, ritual
and religion, medical and historical issues, meaning, “the body” and selfhood,
especially in northern Sudan, where she has conducted research since 1976.
Her publications include Wombs and Alien Spirits; Women, Men and the Zar
Cult in Northern Sudan (1989); Aman, the Story of a Somali Girl (with Aman and
Virginia Lee Barnes, 1995); and Civilizing Women: British Crusades in Colonial
Sudan (2007).
Howard Brody received his M.D. and his Ph.D. in philosophy from Michigan
State University, then completed a residency in family practice at the University
of Virginia in 1980. In 2006 he became John P. McGovern Centennial Chair
in Family Medicine and Director of the Institute for the Medical Humanities at
the University of Texas Medical Branch in Galveston, Texas. He is the author
of The Future of Bioethics (2009), as well as books and numerous articles about
medical ethics, philosophy of medicine, and the placebo response.
viii contributors
Peter Dinzelbacher finished his studies in History, Latin, Folklore, and Art
History at the University of Vienna with a Ph.D. in 1973 and a Habilitation in
Ancient and Medieval History at Stuttgart in 1978. He taught at universities
in Germany, Austria, Italy, and Denmark, becoming an honorary professor
at Vienna in 1998. He has published more than thirty-five books, mostly on
mentalities, religion and art in the Middle Ages, and has written numerous
articles in scholarly journals and encyclopedias in nine languages. He is the
founder (1988) and editor of the yearbook Mediaevistik: Internationale Zeitschrift
für interdisziplinäre Mittelalterforschung.
Johannes Quack studied Religious Studies, Philosophy, and Anthropology

at the Universities of Bayreuth, Edinburgh, and Heidelberg. Currently he is
working as a lecturer at the Department of Religious Studies as well as at the
Department of Anthropology of the South Asia Institute at the University of
Heidelberg. His Ph.D. thesis is on “rationalist” and antireligious movements
in India. Further fields of study include popular Hinduism, ritual theory, medi-
cal anthropology (mental health), postcolonial theory, and modes of unbelief.
Elizabeth F. S. Roberts investigates how biotechnologies and their bodily prac-
tice destabilize and remake Enlightenment dichotomies between matter and
spirit, subject and object, love and money, religion and politics, and nature
and culture. She is currently developing these themes in her book manuscript,
God’s Laboratory: Relations and Religiosity in Ecuadorian In Vitro Fertilization, an
ethnographic examination of the experience of women, parents, and medical
practitioners involved with assisted reproduction in Ecuador. Her other proj-
ects include a study of medical migrations—the movement across borders in
search of health and life—and collaborative research on the vast changes in
legal and social practice around reproductive and life politics in Latin America
today.
William S. Sax completed his Ph.D. in Anthropology from the University of

Chicago in 1987. After two years at Harvard University, he fulfilled a lifelong
dream by moving to New Zealand, where he taught Anthropology and Religious
Studies for eleven years before taking up the Professorship in Anthropology at
the South Asia Institute in Heidelberg, Germany. He has published extensively
on popular Hinduism, ritual theater, women and religion, and ritual healing.
He is currently Professor and Head of the Department of Anthropology at the
South Asia Institute.
Gerd Theissen studied Protestant theology and German Literature, complet-
ing his Ph.D. in New Testament Studies in 1968 and his Habilitation on Early
Christian miracle stories in 1973 at the University of Bonn. For several years he
contributors ix
taught at a secondary school. After two years as Professor at the University at

Copenhagen (1978–1980) he taught New Testament exegesis at the University
of Heidelberg. His main areas of interest are Jesus research, the sociology and
psychology of Early Christianity, the history of Early Christan literature, and
the theory of Early Christian religion.
Paul Töbelmann is Research Assistant in the Historical Seminar of the Uni-
versity of Heidelberg. He has studied Chemistry, Philosophy, Political Science,
and History at Heidelberg, completing his M.A. in 2005. His doctoral dis-
sertation on “Staff Symbolism in Mediaeval Ritual” was completed in March
2008. He is currently working on a monograph concerning the ritualization of
political assemblies and early parliaments in mediaeval Europe. His fields of
study include the history of ideas, religious history, and political history in the
Middle Ages.
Jan Weinhold studied psychology at the Humboldt University, Berlin. Since
2002 he has been working as a research psychologist in the Collaborative
Research Centre Dynamics of Ritual (SFB 619 Ritualdynamik) at the Institute
of Medical Psychology, University of Heidelberg. He has published on the rit-
ualized use of psychoactive drugs and on the intercultural aspects of ritual
healing.
This page intentionally left blank
The Problem of Ritual Efficacy
1
Ritual and the Problem
of Efficacy
William S. Sax
Do rituals really work, and if so, then how? This is the question of ritual effi-
cacy, and it provokes a range of responses. Some insist on the efficacy of their
rituals, defending them against skeptics and heretics. Others deny the efficacy
of rituals in the name of science, or modernity, or orthodoxy, asserting that
those who believe in them are victims of ignorance, superstition, or even the
Devil. Some scholars of ritual say that rituals do indeed “work,” but not in the
way the natives think. Others (e.g., Quack, this volume) argue that the very
question of ritual efficacy is misguided. Given all these competing voices, how
should we approach the problem of ritual efficacy? How can we clarify the
issues involved? In June 2007 a conference was held at the University of
Heidelberg in which anthropologists, historians, psychologists, and medical
scientists from Germany, Austria, Canada, and the United States met for three
days to discuss theories of ritual efficacy, in an attempt to clarify the nature of
the problem and the various approaches to it.1 Our deliberations showed that
the question of ritual efficacy, like so many social scientific and historical ques-
tions, is more complicated than it seems at first glance, and that it is made even
more complex by certain cultural assumptions that have profound effects on
both popular and academic ideas about the nature of ritual.
The very idea of ritual efficacy carries a kind of tension, even a contradiction,
which relates to both of the key terms “ritual” and “efficacy.” This contradiction
derives, first, from the fact that most ritual theorists are guilty of the academic
sin of reification. They conduct research on rituals, they teach and write about
them, and after some time they begin to think that “ritual” is something out
there in the world, whose characteristics can be classified, enumerated, and
4 the problem of ritual efficacy
analyzed, rather like a crystal or a virus. In other words, they mistake an ana-
lytic category for a natural kind. A similar mistake is regularly made by political
scientists with respect to “politics,” by economists with respect to “economics,”
by anthropologists with respect to “culture,” and so on.
This point was eloquently illustrated decades ago with respect to the cate-
gory “religion” by the distinguished theologian Wilfrid Cantwell Smith (1964),
who showed how, over the centuries, the term religio, originally an adjective
denoting a kind of mood or attitude, came to be reified as a particular thing out
there in the world. In ritual studies, the point was made by Jack Goody in his
article Against Ritual (1977) as well as by the sociologist Stefan Lukes in his bril-
liant polemic against Shils and Young, and especially their “neo-Durkheimian”
analysis of the coronation of Queen Elizabeth II. Lukes points out that in prac-
tice, the scholar of ritual recognizes his object—ritual—when he sees certain
kinds of activities and beliefs that strike him as nonrational, or certain actions
in which the means seem disproportionate to the ends (1975: 290). Accord-
ing to our meteorological theories, dancing cannot really make it rain, and so
when someone performs a rain dance, we call it a “ritual.” According to our
anthropological theories, one cannot change a person’s fundamental nature by
cutting or tattooing his body, and so when people do such things in the course
of an initiation, we call it a “ritual.” According to our medical theories, disease
cannot be cured by worshiping ancestors, and so when people attempt to do
so, we label it “ritual.” In short, the problem of ritual is the familiar “rationality
problem” in a new guise—old wine in a new bottle.
I have mentioned “our” post-enlightenment theories, according to which
“we” label as “ritual” certain activities that seem to be nonrational. But for those
performing the rain dance, or the initiation, or the healing, these “rituals” do
indeed fit into a cosmology in terms of which they make sense. That is why the
“native” participants typically refer to them not as “rituals” but rather as danc-
ing, or healing, or simply as “work”. In much of North India, for example, the
closest analogue to the term “ritual” would be devakarya, “the work of the gods”
(a term that, incidentally, echoes the title of Raymond Firth’s classic ethnogra-
phy of ritual, The Work of the Gods in Tikopia [1967]). What we see as ritual, they
see as technique. The point is that the term “ritual” is our (post-enlightenment)
term, and it reflects our problem—how to classify a certain set of apparently
nonrational acts. Or perhaps I should say, “apparently ineffective acts,” for, as
I shall argue, the popular understanding of ritual is not so much that it is non-
rational, but rather that it is ineffective.
As one may well imagine, Goody and Lukes’s line of argument has not
found much favor among ritual theorists: after all, if it were widely adopted, it
would mean the end of ritual studies. And although I do not intend to defend
ritual and the problem of efficacy 5
their notion to the death, I do think it important to note that their definition of
ritual as a type of action in which the ends seem disproportionate to the means
has the virtue of being honestly reflexive: that is, it links our intellectual prob-
lem and our definition of terms to our own social and cultural milieu. To do
otherwise is to fall victim to a subtle but common form of positivism, according
to which the cultural assumptions of the observer can and should be bracketed
and held distinct from his or her theoretical and descriptive goals.
How and why has the term “ritual” come to refer to a class of actions that
are purely formal, external, and above all ineffective? To answer this question
adequately would require a book in itself, but parts of the story have already
been told by W. C. Smith, Talal Asad, and J. S. Uberoi. Smith’s book, The Mean-
ing and End of Religion, documents the gradual transformation of the term religio
from an adjective to a noun,that is, from an attribute of persons into a sepa-
rate thing in itself. This process accelerated during the Protestant Reformation
and the Enlightenment, as the doctrinal content of religion slowly came to be
regarded as being of more central importance than religious practices, until
finally “religion” was conceived of as a set of beliefs that can and should be eval-
uated in terms of their internal consistency. How could “ritual” fit into such a
scheme? As Asad shows, for medieval Christians ritual was not an expression
or representation of theological “beliefs,” but rather a disciplinary practice that
aided the cultivation of Christian virtues (1993, chapters 1 and 2). He compares
medieval Christianity’s notion of ritual with the modern, anthropological one
and, quoting St. Victor, writes that in medieval times,
the sacraments are not the representations of cultural metaphors;

they are parts of a Christian program for creating in its
performers, by means of regulated practice, the “mental and moral
dispositions” appropriate to Christians. . . . [But] learning to develop
moral capabilities is not the same thing as learning to invent
representations. (1993: 78–79)
A similar point was made by J. S. Uberoi in his underappreciated clas-

sic Science and Culture (1978), where he argues that the Protestant separation
of humanity from nature, a concept represented most clearly in the writings
of Zwingli rejecting the doctrine of transubstantiation, facilitated the dualis-
tic separation of (mental) “symbol” from (natural) “truth.” This idea further
strengthened the tendency to interpret ritual (e.g., the Christian liturgy) in
terms of what it “symbolizes” rather than what it actually does. The final result
of these various processes is the peculiar, modern theory of ritual—what we
can call the “representational theory”—which seeks to understand or interpret
ritual in terms of the underlying ideas, emotions, structures, or relations that it
“represents,” “symbolizes,” or “expresses,” rather than the ends toward which

it conduces. The real, external world effects of ritual can be recognized only by
the “objective” historian or social scientist and do not correspond its ends as
conceived by the “natives,” since these are by definition nonrational.
To analyze rituals as “expressing” inner states of feeling and emotion, or
“symbolizing” theological ideas or social relations, or “representing” psycho-
physical states of the human organism, is to neglect the question of how they
might be instrumental, how they might actually do things (other than in the
trivial sense of representing ideas, social relations, or inner states more or less
accurately). This question recalls the distinction between expressive and instru-
mental action developed by Talcott Parsons and his followers. Instrumental
action includes things such as scratching an itch, building a house, or invad-
ing a foreign country. It is purposive and goal-oriented and is normally associ-
ated with the “hard facts” of economics, politics, and technology. “Expressive”
action, on the other hand, is associated with art, religion, and of course ritual.
A representational theory of ritual does not merely avoid the problem of ritual
efficacy; it exemplifies it by assuming that rituals are, by definition, ineffective.
One need only go through this week’s newspapers to find statements by public
figures that illustrate the point. Shortly before the conference in Heidelberg,
for example, in speaking of German–French relations, German Chancellor
Angela Merkel said, “Es geht hier nicht um ein Ritual, sondern um die tiefe Über-
zeugung,” in other words, “This has to do, not with ritual, but rather with deep
conviction.”2
To sum up: ritual has come to be thought of in popular discourse as a kind
of action that is ineffective, superficial, and/or purely formal, and this view is
the unexamined premise behind much of ritual studies. This attitude explains
why, even though we cannot agree on a definition of ritual, we “know it when
we see it”—and what we know to be rituals when we see them are acts that are
apparently nonrational, in which the means do not seem proportionate to the
ends, the intended objects of human action are nonempirical beings, or the
theories of efficacy that ostensibly explain the ritual acts are inconsistent with
modern, scientific paradigms. This reaction is similar to what an archaeologist
does when he discovers a structure whose purpose is unclear—he calls it a
temple.
We do not refer to driving an automobile or playing football or taking an
examination as a “ritual,” even though all of these activities involve highly
formal, rule-bound behavior—we only call actions “rituals” when we do not
understand the relation between means and ends, when they do not match
our criteria of rationality, or better yet, when they do not correspond to our
criteria of efficacy. Ritual is assumed to be ineffective, and it is in part this very
ineffectiveness that constitutes the behavior as “ritual” in the first place. That is
why the intellectual task that many students of ritual set themselves consists in
trying to find out ritual’s hidden logic, its principles of efficacy, the things that
it really represents—which must by definition be other than those related to us
by the natives, since these strike us as nonrational.
Nevertheless, the notion that ritual is ineffective is false, and we can show
that it is false. We know that shamanic rituals heal, legal rituals ratify, political
rituals unify, and religious rituals sanctify. Rituals transform sick persons into
healthy ones, public space into prohibited sanctuary, citizens into presidents,
princesses into queens, and according to some, wine into blood. One of our
most important tasks as scholars of ritual is to explain how rituals accomplish
these things (and how they sometimes fail to accomplish them), but it is impor-
tant to remember that in pursuing this task, we are arguing against the grain
of popular understanding.
I have said that ritual exists as an analytic category and not as a natural
kind. If we want to discuss intelligently how it might “work,” we require a
working definition of it, and such a definition must acknowledge its unusual
relation to the modern episteme. Foucault defined this episteme as the condi-
tions of possibility for what counts as scientific. In my view, “ritual” is precisely
the negation of the modern, scientific episteme, which is one of the things that
make it such an interesting category. Further, because ritual is an analytic cat-
egory, one cannot define it in essentialist terms. Instead, one requires a family-
resemblance type of definition: in effect, a list of characteristics that we ascribe
to things we call “ritual.” The idea of family resemblance as developed by Wit-
tgenstein is that, although members of a family are not identical, they do share
enough similar features—manner of speaking, facial shape, eye color, and the
like—that one can recognize them as belonging to the same family.3 Now, what
we call “rituals” clearly are not identical: they consist of different actions and
are performed in different cultures and languages for different purposes. Nev-
ertheless we can observe that certain characteristics are widely shared by that
class of activities that we label “ritual,” and when a particular activity has a suf-
ficient number of them, it “counts” as a ritual, more or less. That is the sense of
the “family resemblance” approach to category definition: membership in the
category is a matter of resemblance and degree, not of essence.
What kinds of resemblances are relevant for the category “ritual”? Here
I draw on Tambiah’s well-known (1979) definition, in which he provides a list
of characteristics that we associate with those actions we label “ritual.” But to
Tambiah’s list of features—“patterned and ordered sequences of words and acts,
often expressed in multiple media, whose content and arrangement are char-
acterized in varying degree by formality (conventionality), stereotypy (rigidity),
condensation (fusion), and redundancy (repetition)” (1979: 119)—I would add

that rituals are “often regarded as ineffective or nonrational.” None of these
characteristics, including apparent nonrationality or ineffectiveness, is essential
for some practice to be regarded as a ritual; however the more of these charac-
teristics a practice has, the more likely it will be regarded as a ritual. This defini-
tion has the advantage of focusing our attention on ritual as a form of practice
rather than a representation of belief. I have criticized representational theories
of ritual above, and so has Bell (1992), who invokes Bourdieu’s insistence that
social theory is weakened by its ongoing attempts to reduce human action to,
or reformulate it in terms of, language and/or “belief.” (These positions are
summarized by Quack, this volume; see also Sax 2002, chapter 1). As Bour-
dieu puts it, practice has its own logic, which is not reducible to propositions
expressed in language. Bell applies these ideas to the study of ritual, which she
refuses to essentialize as an object with a finite set of characteristics, preferring
instead to shift the terms of the discussion by writing of “ritualized actions.”
She argues that such actions produce a “ritualized agent” and that they do so
not by means of representation but rather through embodied practice. This
notion is consistent with the fact (noted by many ritual theorists) that rituals,
with their emphasis on sensory experience (prescribed bodily postures, music,
dance, incense, food, etc.), work primarily on the body and not exclusively by
cognitive means.4
If rituals were purely expressive, then their efficacy could consist only in
the degree to which they adequately expressed beliefs, dogma, and so on. But
Asad, Bell, and Bourdieu, along with many others, argue that in order to under-
stand the efficacy of rituals, we should concentrate on embodied cognition
rather than on symbolic expression. Several of the essays in this volume sup-
port such a focus. Boddy, for example, shows how forms of ritualized “posses-
sion” involve new ways of construing one’s own identity by establishing links
within the kinship system. This is not a cognitive so much as it is a somatic pro-
cess; in other words, the cognitive effects of the ritual are achieved through new
and creative practices of embodied possession. Quack argues that differences
in the attitudes toward ritual at an ashram in North India, between Indians on
the one hand and North Americans and Europeans on the other, can be traced
to their respective, embodied “ritual sense(s).” Ambos suggests that the king’s
bodily experience of imprisonment during his investiture ceremony had pow-
erful effects on his psyche. Roberts shows that a dispute about the use of ritual
in Ecuadoran IVF clinics can be traced to a difference between the ritual styles
of “spiritual” and “material” Catholics, with the former adhering to something
like the Protestant representational theory while the latter exemplify embodied
“faith.” The concept of “faith” is of particular interest in this regard, since it is
often said by ritual practitioners to be indispensable to ritual efficacy. And as

religious persons often remind us, “faith” is not the same thing as “belief.” It
is an attitude toward religious things, not a proposition to which one assents,
so what Bourdieu says of “belief ” is clearly true of “faith” as well: that it “is not
a ‘state of mind,’ still less a kind of arbitrary adherence to a set of instituted
dogmas and doctrines (‘beliefs’), but rather a state of the body” (1990: 68).
This view is also borne out by the essays of Brody and Theissen (both in this
volume), who, despite their very different disciplines (the former is a medical
scientist, the latter a theologian), demonstrate that embodied faith is a prereq-
uisite for ritual healing. For Brody, the patient’s confidence in the healer and/
or his methods has positive, measurable effects on the likelihood of the treat-
ment’s success; while for Theissen, the historical Jesus himself recognized and
proclaimed that his healing rituals were successful because of the faith of those
whom he healed.
Indeed, ritual healing provides the most interesting as well as the most
problematic example of the problem of ritual efficacy. From the point of view
of biomedicine, it is based on non- or even anti-scientific theories and prac-
tices, while biomedicine guarantees its own efficacy by systematically exclud-
ing “ritual” from its therapeutic techniques. Medical journals do indeed use the
term “ritual,” but they define it as a practice that lacks therapeutic efficacy and
should therefore be eliminated.5 Although the World Health Organization has
encouraged “traditional medicine” in recent years (WHO 1978, 2002),6 this
recognition does not extend to ritual healing but is limited to nonritual tech-
niques such as bonesetting, herbal remedies, massage, and dietary practices.
Evidently, the idea that ritual healing might be therapeutically effective is not
thinkable for the WHO.7
But what exactly is efficacy, and how should we define or measure it? The
answer depends on the standards against which it is measured, and these vary:
the biomedical doctor has one set of standards, the Ayurvedic doctor another,
and the shaman still another. The patient has his own set of standards, but that
of his family may be different. The missionary has one set of standards, and
the anthropologist a different one.8 It is highly questionable whether one can
or should evaluate the effectiveness of one system by the criteria of another, but
we do this all the time when we evaluate ritual healing in terms of biomedical
criteria. Ritual healing may well be ineffective according to such criteria, but
the opposite is also true: in a great many cases, modern medicine is ineffective
in meeting those needs that are addressed by ritual healing.
Surveys of “patient satisfaction” show that most of the time, sick people
are more satisfied with treatment by ritual healers than by medical doctors.
This issue was the topic of an early paper by Kleinman, who argued that “in
most cases, indigenous practitioners must heal,” because they treat the human
experience of illness, whereas “in most cases modern professional clinical care
must fail to heal,” because modern clinicians usually limit themselves to dis-
ease, defined in strictly biological terms (1979: 24). And that is why, says Klein-
man, “healing” is an embarrassing word for the medical sciences, which prefer
the term “cure.” Like the assertion that ritual is merely expressive and therefore
inherently nonefficacious, the biomedical critique of ritual healing is strongly
linked to the discourse and practices of modernity. Biomedicine is associated
with “development” and “rationality,” while ritual healing is associated with
lack of development and “superstition” (Kendall 2001, Lee 1982, Dole 2004,
n.d., Pigg 1995, Ram 2001: 13). But “superstition” and “modernity” are not
natural categories either. Rather, they are relational entities, mutually defined
and strategically invoked.
During my own fieldwork on ritual healing (Sax 2008) I encountered
numerous examples of the “modernist” critique of ritual healing. The first
time I ever spoke about the topic was at the Institute for the Study of Human
Behavior and Allied Sciences in Delhi, where I had been invited to give a talk
to a group of medical professionals. I told my learned audience of doctors and
psychologists about the system of oracles and healers, showed them a brief
video clip, and proposed that ritual healing sometimes “works” by addressing
the social causes of stress-related disorders. After my talk I expected an enthu-
siastic round of applause and a stimulating discussion. What I got instead was
outrage. “How dare you conduct research on such a topic?” they asked. “This is
nothing more than primitive, superstitious nonsense! You should be spending
your time stamping it out, not conducting research on it!”
Perhaps I should have expected such a reaction. After all, these were
men of science, and the idea that ritual healing might have therapeutic ben-
efits comparable to those of biomedicine seemed ridiculous to them, perhaps
even insulting. They reminded me of the Nepali doctors discussed by Adams,
who were exposed for such a long time to modern critiques of ritual healing
(particularly by exponents of “development”) that they began to regard such
practices as evidence of backwardness (1998: 12). Such a scenario is hardly
limited to South Asia. Mullings has shown how in Ghana, family-based ritual
therapy gave way to individual therapy under the modernizing influences of
capitalism and Christianity as well as the transformation of villages into towns
(1984: 121, 133–185). To be “modern” and scientific is to reject the theories and
practices associated with ritual healing, because they lie outside contemporary
paradigms of science, modernity, and development. Those who seek to defend
or preserve ritual healing thus risk marking themselves—and perhaps even
coming to understand themselves—as “nonmodern and deviant” (Nandy and
Visvanathan 1990; cf. Pigg 1995), and this is as true of the “modernizing”
cultures of Africa and Asia as it is of Europe and North America. Perhaps it is
even truer there, since local elites in such places are surrounded by the prac-
tice of ritual healing and must therefore work even harder than their Western
counterparts to distinguish themselves from those who engage in it. Kendall
cites cases from Cypress and Sri Lanka that illustrate
the middle class’s identification with “science” or with more

“rational”-seeming religious practices as a means of asserting and
naturalizing class domination. . . . . The point here is not that the new
elites’ posture toward popular religion is an inevitable consequence
of “modernity” so much as it represents the self-conscious inhabiting
of new class positions. (2001: 30)
Meanwhile, my friends back in the village where I was conducting my

research kept asking me a simple, three-word question: “Yaham kuch hai?”
Literally, this means, “Is there something here?” but there is more to the ques-
tion than meets the eye, and I would paraphrase it as follows: “You are a highly
educated person and have been investigating these things for years. So tell me:
is there some special religious power here? Is there such a thing as miraculous
healing? Have you seen it?” After I had been asked this question several times,
I found myself wondering if the skepticism it implied was something new.
Was there ever a time when local peasants accepted the efficacy of ritual heal-
ing without a doubt? Were the modest doubts implicit in this question a result
of modern education? Would they grow?
I observed plenty of skepticism in other contexts as well. Particularly mem-
orable was the family settled in Delhi who returned to their ancestral village for
a major healing ritual but whose father was so dismissive of the whole affair
that he refused to participate in key rituals, while the teenage children found
the possession ridiculous and laughable and were unable to participate in it
properly.9 Then there were the educated persons I knew, especially those in the
medical profession, who condemned the practices of the gurus as unscientific
and superstitious but who surreptitiously visited them at night when their own
problems could not be solved by modern medicine. As I write this introductory
chapter in the Himalayas, I have just concluded interviewing local medical pro-
fessionals about their views regarding ritual healing, Most of them responded
to my initial questions by dismissing outright the possibility that it might be
effective. But with a little patience and perseverance on my part, they began
to talk about successful cases of which they know, and to affirm that, as good
Hindus, they would not deny the power of religious rituals to heal the sick.
As a result, I have come to share Adams’ view that the overt rejection of ritual
healing is not so much a statement of disbelief in its efficacy as it is an assertion

of one’s social position: modern, educated, and scientific.
Discourses of modernity are also to be found in the religious realm, where
local ritual practices, often involving bloody sacrifice, are challenged by those
who wish to replace them with modern, high-caste, vegetarian practices. Once
I met a local ritual healer just after he had successfully treated a client, and he
shook with rage as he told me how a group of satsangis (the followers of a local
religious leader) had harassed him as he walked through the bazaar They had
shouted that people like him, along with their knowledge, should be stamped
out. “I was coming here last night,” he said,
and they started giving me a hard time, shouting “Down with the
gurus! Down with the gurus’ knowledge!” So I said to them, “You
mother-fucking satsangis, a girl is in trouble! You go there! You heal
her! Take (your) satsangi doctors!” What do doctors do here? They
give injections. The needle might break and kill the girl! I put the
mark on her forehead and forced the god to identify himself and to
become present. And once he was there we got the whole decision
{faisla}: “I live at such and such a place, and so forth; worship me
and I will be satisfied, otherwise I will definitely eat this girl {kha hi
lunga}.” Can the satsangis do that?
He said that the satsangis were making quite a stir and that so many people had
joined them that they had multiplied like a bitch’s pups. He accused them of
hypocrisy, of pretending to be satsangis on the outside but continuing to prac-
tice the old rituals behind closed doors. And he linked their “modern” rejection
of ritual healing to an equally modern refusal to uphold traditional norms of
ritual reciprocity.
Just let them come here, and we’ll beat them with our shoes! On the
outside, those bastards are saying that they’re satsangis, but indoors
they’re making all the Brahmans dance [i.e., become possessed].
They worship [the demon] Masan in their houses, and the gods dance
there, but on the outside they are all satsangis. But they don’t do puja!
The god comes hungry, and he leaves hungry.
The healer’s companion reinforced his accusation that the satsangis were behav-
ing in a thoroughly modern, individualistic way: “Whatever rice they get, they
eat by themselves. They’re doing well, but what is the goddess eating? She left
as hungry as she came, but their own stomachs are full.”
Some “modern” local healers even pursue their calling without ritual,
thus making their practice appear more “scientific” and less “religious”—to
themselves as well as to their clients (cf. Press 1971). S. B. Sati was the senior
postman in Joshimath at the time of my research, and he was also an oracle—
but with a difference. Partly because of his own education and professional
status, and partly because of his location at a major stopover on the most prom-
inent pilgrimage routes in India, he had developed an elite clientele consist-
ing of politicians, educators, doctors, and similar persons from all over India.
Sati was well known to the learned classes and professionals of his district,
many of whom had consulted him, and his style was radically different from
the usual oracular style of the area, the most striking difference being the total
absence of ritual. Whereas most oracles began their sessions with various ritual
techniques intended to induce possession, so that the following consultation
is conceived to be one between client and deity, Sati recited no prayers, lit no
incense, and did not become possessed. His clients did not even remove their
shoes when they visited him! His sessions resembled medical or psychological
consultations more than oracular ones. He would begin by drawing a map or
a sketch of the client’s home and then proceed to diagnose the cause of their
problems. The causes he would diagnose (cursing, familial strife, demonic
affliction, supernatural “poisoning”) were very similar to those diagnosed in
other, more typical consultations, as were his therapeutic prescriptions: mostly
rituals of a familiar sort, but also the wearing of amulets (which he himself
made) and other sorts of astrological and gem therapy. I believe that his highly
unusual practice reflected the needs and expectations of his modern, educated
clientele. Clearly there is a kind of struggle occurring in Garhwal over ritual
healing; but it has little to do with the question of efficacy per se and much to
do with “modernity” and one’s attitude toward it. People may well regard ritual
practices as efficacious but still refuse to participate in them because to do so is
to stigmatize themselves as pre-modern and nonscientific.
Similar examples are to be found in many of the essays in this volume.
Brody begins his essay by pointing out that the term “placebo,” like the term
“ritual,” is a “term of suspicion” for medical scientists, even though it may
work in similar ways. Although he asserts that “[m]edicine would lose a good
deal of whatever efficacy it possesses, were we somehow to eliminate all
its ritual elements and practices,” nevertheless most medical practitioners
would probably “deny that ritual plays any role in their activities” because
of the Cartesian dualism to which they subscribe, with its radical separation
of mind and body. I would suggest that such Cartesianism is a hallmark of
what I am calling “modernity.” Elizabeth Roberts shows how ritual practices
in Ecuadoran IVF laboratories are subject to modernist critiques from the
standpoint of “science” as well as from the standpoint of “religion.” From the
scientific side, many medical professionals in Ecuador reject ritual practices
in the lab because they are felt to be incompatible with modern science. From
the religious side, they are rejected by more modern, “spiritual” Catholics,
who accept the Cartesian separation of spiritual from material and are highly
reluctant to acknowledge God’s intervention in scientific processes, much
less encourage it as “materialist” Catholics do through their rituals. Boddy
mentions the religious critique of Zar cult possession rituals by conservative
Muslim clerics, for whom such practices are inconsistent with Islam. As with
many other religious reformers (e.g., the Hindu satsangis mentioned above),
I would argue that such reformist attitudes are fundamentally modern, even
though they represent themselves as “traditionalist.” Both Dinzelbacher’s
and Töbelmann’s essays describe “orthodox” critiques of ritual that, though
they are medieval and not modern, nevertheless illustrate how the taking of
a position with regard to ritual efficacy is a strategic act, through which one
locates oneself in terms of political, economic, social, and theological dis-
putes. All of this goes to show that the question of ritual efficacy is not just
a question about how rituals work. To pose the question of ritual efficacy—
and more importantly, to answer it in one way and not another—is also to
say something about who one is, to position oneself with respect to a range
of issues, from the relationship between mind and body to the difference
between modernity and tradition, or the alleged conflict between religion and
science. How do rituals work, and if so, how? Once should think twice before
answering that question.
notes
1. The conference was organized by the Collaborative Research Area 619, “The
Dynamics of Rituals”(Sonderforschungsbereich 619 Ritualdynamik), supported by the
German Research Council, to whom we express our deepest thanks.
2. http://www.sueddeutsche.de/deutschland/artikel/961/64897/print.html, last
accessed 28 May 2009.
3. See aphorisms 66–67 in Wittgenstein 2003.
4. Butler 1990, Connerton 1989, Csordas 1994 and 2002, Douglas 1973, Jackson
1983, Mauss 1979 [1935].
5. This position is reminiscent of the Victorian anthropologist E. B. Tylor’s view
that the mission of anthropology was to identify customs that had no utilitarian
function and to root them out.
6. See Dole’s description of the Turkish health worker who says she is “not
modern enough” for the WHO’s new emphasis on traditional medicine (n.d.: 22).
7. One of the WHO’s more recent policy statements (WHO 2002) adds the
category “spiritual therapy” but does not define the term.
8. The complexity of the problem is discussed in a forthcoming paper written by
conference participants Quack and Töbelmann.
9. Eventually, their grandmother saved the day—and the ritual—by vigorously

dancing for more than a quarter of an hour, which was itself a kind of miracle, since
she was more than ninety years old!
references
Adams, Vincanne. 1998. Doctors for Democracy: Health Professionals in the Nepal
Revolution. Cambridge: Cambridge Studies in Medical Anthropology.
Asad, Talal. 1993. Geneaologies of Religion: Discipline and Reasons of Power in
Christianity and Islam. Baltimore: The Johns Hopkins University Press.
Bell, Diane. 1992. Ritual Theory, Ritual Practice. New York: Oxford University Press.
Bourdieu, Pierre. 1990. The Logic of Practice. Cambridge: Polity.
Butler, Judith. 1990. Gender Trouble: Feminism and the Subversion of Identity. New
York: Routledge.
Connerton, Paul. 1989. How Societies Remember. Cambridge: University of Cambridge
Press.
Csordas, Thomas. 1994. The Sacred Self: A Cultural Phenomenology of Charismatic
Healing. Berkeley: University of California Press.
——— . 2002. Body/Meaning/Healing. New York: Palgrave.
Dole, Chistopher. 2004. In the Shadows of Medicine and Modernity: Medical
Integration and Secular Histories of Religious Healing in Turkey. Culture,
Medicine and Psychiatry 28: 255–280.
——— . n.d. Mass Media and the Repulsive Allure of Religious Healing: The Cinci
Hoca in Turkish Modernity. (Unpublished manuscript)
Douglas, Mary. 1973. Natural Symbols. Explorations in Cosmology. London: Barrie &
Jenkins.
Firth, Raymond. 1967 [1940]. The Work of the Gods in Tikopia. London School of
Economics Monographs on Social Anthropology Series. Oxford: Berg.
Goody, Jack. 1977. Against “Ritual”: Loosely Structured Thoughts on a Loosely
Defined Topic. In Sally F. Moore and Barbara G. Myerhoff, eds., Secular Ritual.
Assen and Amsterdam: Van Gorcum, pp. 25–35.
Jackson, Michael. 1983. Knowledge of the Body. Man New Series 18(2): 327–345.
Kendall, L. 2001. The Cultural Politics of “Superstition” in the Korean Shaman World:
Modernity Constructs Its Other. In Linda H. Connor and Geoffrey Samuel, eds.,
Healing Powers and Modernity: Traditional Medicine, Shamanism, and Science in
Asian Societies. Westport, Conn.: Bergin & Garvey, pp. 25–41.
Kleinman, Arthur. 1979. Why Do Indigenous Practitioners Successfully Heal. Social
Science and Medicine 13B: 17–26.
Lee, R. P. 1982. Comparative Studies of Health Care Systems. Social Science and
Medicine 16(6): 629–642.
Lukes, Steven. 1975. Political Ritual and Social Integration. Sociology 9(2): 289–308.
Mauss, Marcel. 1979 [1935]. Body Techniques. In Marcel Mauss, Sociology and
Psychology. London: Routledge and Kegan Paul, pp. 95–123.
Mullings, Leith. 1984. Therapy, Ideology, and Social Change: Mental Healing in Urban
Ghana. Berkeley: University of California Press.
Nandy, A., and S. Visvanathan. 1990. Modern Medicine and Its Non-Modern Critics:
A Study in Discourse. In Frederique Marglin and Steven Apffel, eds., Dominating
Knowledge: Development, Culture, and Resistance. Oxford: Clarendon Press,
pp. 145–184.
Pigg, S. L. 1995. The Social Symbolism of Healing in Nepal. Ethnology 34(1): 17–36.
Press, Irwin. 1971. The Urban Curandero. American Anthropologist 73: 741–756.
Quack, Johannes, and Paul Toebelman, n.d. Ritual Theory, Ritual Efficacy.
Forthcoming in Journal of Ritual Studies.
Ram, K. 2001. Modernity and the Midwife: Contestation over a Subaltern Figure,
South India. In Linda Connor and Geoffrey Samuel, eds., Healing Powers and
Modernity: Traditional Medicine, Shamanism, and Science in Asian Societies.
Westport, Conn.: Bergin & Garvey, pp. 64–84.
Sax, William S. 2002. Dancing the Self: Personhood and Performance in the Pandav Lila
of Garhwal. New York: Oxford University Press.
Sax, William S., 2008. God of Justice: Healing and Social Justice in the Central
Himalayas. New York: Oxford University Press.
Smith, Wilfred Cantwell. 1964 [1962]. The Meaning and End of Religion. New York: The
New American Library (a Mentor Book).
Tambiah, Stanley J. 1979. A Performative Approach to Ritual. Proceedings of the British
Academy 65: 113–169.
Uberoi, J. P. S. 1978. Science and Culture. Delhi: Oxford University Press.
Wittgenstein, Ludwig. 2003. Philosophical Investigations: The German Text, with
a Revised English Translation 50th Anniversary Commemorative Edition.
G. E. M. Anscombe, trans. Oxford: Blackwell. (First published in 1953)
World Health Organization. 1978. The Promotion and Development of Traditional
Medicine. Technical Report No. 622. Geneva: WHO.
World Health Organization. 2002. WHO Traditional Medicine Strategy 2002–2005.
Geneva: WHO.
2
Ritual Healing and the
Investiture of the
Babylonian King
Claus Ambos
Introduction
The political implications of ritual healing will be discussed in this chapter

with an example from my field of research, Assyriology, which deals with the
civilizations of the Ancient Near East.1 I hope here to build a bridge between
two seemingly different topics: the efficacy of healing rituals and the efficacy of
political rituals. The essay focuses on some important elements of Babylonian
royal ideology, as attested on cuneiform tablets which were inscribed in the
first millennium BCE but which belong to a much older tradition reaching back
into the second and even third millennium BCE.
Mesopotamian techniques of ritual and divination were believed to have
been transmitted to man by the gods themselves (Lambert 1998), and they
could never work against the will of the gods nor force them to perform an
action merely because it was desired by the ritual’s human participants. The
reason is that ritual was not effective in itself but depended upon the gods’
collaboration. This concept could also account for occasional ritual failure: the
gods simply were refusing any communication with the human sphere and
were not inclined to accept a prayer or a ritual (Ambos 2007a). Ritual and cultic
texts and prayers were transmitted over centuries or even millennia in the so-
called “stream of tradition” (Oppenheim 1977 [1964]: 13) until the end of the
traditional Mesopotamian culture.
It should be noted that in the languages of the Ancient Near East there was
no specific term for “ritual.” In Akkadian (Babylonian-Assyrian), for example,
words for ritual are derivatives from the verb epēšu—“to act, be active, proceed.”2
The noun epi/uštu means in general “act, activity, achievement, accomplish-

ment” and can designate in a concrete sense acts we would call “ritual.” The
term, however, has additional meanings, such as “handiwork, agricultural
work, construction (as process), manufacture, finished structure, construc-
tion, plan, nature, situation.” Another frequently attested term we translate as
“ritual” is nēpešu, which means “activity, undertaking, doings, procedure.” In
a concrete sense, this word also designates a “ritual (procedure).” It can also
mean, however, “tools, utensils, implements.” So for the Mesopotamians, a
“ritual” was rather a technique or procedure.
All of this confirms Sax’s remarks in chapter 1, as does the fact that ritual
was conceived as instrumental action. Countless rituals with diverse aims have
been transmitted from the Ancient Near East. These include rituals of the regu-
lar temple cult and rituals for special occasions such as rituals of building, ritu-
als to avert the consequences of a bad omen, to prevent slaves from running
away, to gain the favor of a high-ranking dignitary, along with love charms,
healing rituals, and many more, covering every field of private and public life.3
A ritual was not merely a symbolic or expressive action. When, for example,
a house or a temple was built or reconstructed, the craft of the ritual expert
was as important as the craft of the builder in leading the construction pro-
cess. Designing buildings, constructing them, and performing the associated
rituals were all considered as complementing each other: While the builder
was responsible for the realisation of the technical aspects of the work, ritual
experts guaranteed that the building process was performed under the protec-
tion and with the agreement of the gods (Ambos 2004; 2007b).
The purpose of a ritual was usually specified in the introduction of a cunei-
form ritual handbook. These handbooks tersely describe the sequence of ritual
events and give directions for the participants. Although they cite the titles of
prayers, they seldom explain how the ritual was actually performed, or give
any hints about Mesopotamian theories of ritual efficacy.4 It is therefore dif-
ficult for modern researchers to understand the inherent logic according to
the Mesopotamian worldview. Although there is some evidence of skepticism
regarding the efficacy of ritual, this was never developed into a coherent cri-
tique, and we can say that in general the efficacy of ritual was considered as
axiomatic (Ambos 2007a).
Our knowledge of ritual in the long-dead cultures of the Ancient Near
East is based not only on ritual handbooks, but also on numerous texts from
daily life. Of extraordinary importance for the study of Ancient Near Eastern
ritual and religion are various extant corpora of letters and reports written
by ritual experts, diviners, and priests. I refer here very briefly to the corre-
spondence of diviners and various officials with the kings of Mari in the first
ritual healing of the babylonian king 19
half of the second millennium BCE, and to the correspondence of the Assyr-
ian kings Esarhaddon and Ashurbanipal with ritual experts and scholars at
their court in Nineveh in the seventh century BCE.5 Through these letters and
reports, we can obtain a rather vivid picture of ritual and religious life in the
Ancient Near East.
My case study is centered on a ritual featuring the Babylonian king in a
prison. This prison was a ritual structure of reeds in the steppe, where the
king stayed every year for one night, in order to procure legitimation of his
rulership. The stay in prison fostered the king’s bodily and mental health and
ensured his material resources. This was evidently a very efficacious prison,
because it promoted the king’s political power along with his material and
physical well-being. So why is a prison used as both a hospital and the site of
royal legitimation?
The prison features prominently in a large cluster of rituals to be per-
formed for the Babylonian king every year just before the autumn equinox in
the month of Tashritu. At first glance, this cluster seems to be comprised of
incommensurate rituals: healing rituals that could be performed by everybody
including private persons, together with royal investiture rituals. The cluster
begins with a ritual to heal pains in the joints as well other symptoms and ends
with the ritual of investiture of the king with his regalia. For us today, to heal
a man from an illness or to crown him king seem to be two totally different
matters. The key to understanding their association there is the Mesopotamian
notion of “illness,” which differs greatly from our own concept. In fact, the
ancient Mesopotamians had a much wider concept of illness—encompassing
the loss of bodily and mental health but also the loss of material resources and
social standing. I propose to discuss healing rituals and royal rituals together
rather than separately, thereby focusing on the efficacy of the various ritual
acts and prayers as attributed to them by the Babylonians according to their
worldview.
The Semiannual Reinvestiture of the Babylonian King

during the New Year’s Festivals
According to Mesopotamian royal ideology, the king was created by the gods as
a being who, while not a god, was nevertheless superhuman, and far superior
to ordinary men in his bodily and intellectual faculties. Already before birth and
even conception, the future ruler was selected by the gods to one day become
king of his country (Stol 2000: 83–89; Wilcke 2002: 70–83; Polonsky 2006:
308 f.). Thus the ruler did not acquire his royal status by the act of coronation
or enthronement at the beginning of his reign, but rather this investiture was
the fulfilment of a destiny decreed by the gods.
After the gods had kept their promise and made their chosen one king,
the Babylonian ruler had to obtain divine confirmation of his rule twice a year
during the New Year’s festivals at the spring and autumn equinoxes. Royal
legitimation was therefore not a unique act, but rather a constant process dur-
ing the king’s reign. The sequence of events in both New Year’s festivals reflect
each other. On the eighth day of the month of Nisannu in spring and on the
eighth day of the month of Tashritu in autumn the most important gods of the
pantheon decreed the fate of the king, for example Marduk in the city of Baby-
lon or Anu in the city of Uruk. Then the gods, accompanied by the king, left
their temples and moved in procession to their so-called akitu-houses outside
the city.6
The spring festival in particular has received much attention in the last
100 years, not only in Assyriology but also in the History of Religion, such
as in the writings of James George Frazer.7 Interest in the spring festival has
usually focused on a peculiar ritual sequence of status reversal: The Babylo-
nian king entered the temple of the god Marduk and was divested of his royal
insignia by the high priest. The priest slapped the king’s face and made him
recite a negative confession of his sins, that is, that he had not neglected the
rites and the temples of the gods or the privileges of the citizens of Babylon.
Only then did the priest present the insignia to the king, again slapping his
face until the tears ran. A temporary status reversal including the removal
of the king’s insignia also took place during the autumn festival, and it was
then that the king stayed in the prison of reeds. Until now, however, little was
known about this ritual.8
Problems in Performing the New Year’s Festivals:

Absent Gods and Kings
The performance of the two New Year’s festivals was constantly in danger
of being impeded by various problems that could lead to the cancellation of
these two most important events in the cultic calendar. The festivals required
the presence of the gods in the form of their statues, as well as the king, who
escorted the gods on their procession. But the festivals could not take place
if either the king or the gods were absent. This meant that under certain cir-
cumstances the New Year’s festivals might not take place for years or even
decades.
The presence of the king, a necessary precondition for the performance of

the New Year’s festivals, could unfortunately not be taken for granted. When
the Neo-Babylonian king Nabonidus (reigning from 555 to 539 BCE) stayed far
from Babylon for years in the town of Tema (in present-day Saudi-Arabia),
these festivals could not take place, even though the crown prince was present
in the capital and performed other royal functions. Various strategic or eco-
nomic reasons have been suggested to explain the king’s long stay in Arabia.
According to contemporary sources, Nabonidus was prevented from returning
to Babylon because he became afflicted by an illness caused by the estrange-
ment and alienation of the gods who had turned away from him. Only when
his personal god Sîn became reconciled did the king recover and return to
Babylon, where the angry gods again turned with favor to him.9
Human beings were protected by personal deities, who guaranteed their
physical and material well-being, success, and luck. These gods constantly kept
watch over humans, walking as guardian angels at their side and staying inside
their body. A person who was abandoned by his or her personal god or gods
suffered illness, financial losses, social exclusion, and a disturbed communi-
cation with the divine sphere because of failed rituals and ineffective oracles.
As the Babylonians saw it, losing money and having shivering fits were not
unrelated events, but rather two different symptoms deriving from the same
source, namely estrangement from one’s protective deities. This was a terrible
situation for any individual, since he or she could no longer occupy his or her
previous social position. Under such circumstances, a king was no longer able
to rule.
In fact, Nabonidus’ absence from Babylon eventually had important
political consequences. By staying far from Babylon and not participating in
the New Year’s festivals, he weakened his legitimation as king. During his
reign, Nabonidus had made enemies among the leading circles of Babylon.
The accusations of his opponents are described in a propagandistic poem
(Schaudig 2001: 563–578). According to his enemies, Nabonidus had done
harm to the cult of Marduk, the city god of Babylon and lord of the other
gods. He was accused of introducing the cult of a foreign god and disregard-
ing Marduk’s status as lord of gods by elevating this new god to an equal
rank. Furthermore, Nabonidus is said to have deliberately cancelled the New
Year’s festivals. In the end, Nabonidus lost the support of the elite of Baby-
lon and played into the hands of his adversary, King Cyrus of Persia. Cyrus
conquered the Babylonian empire and (at least according to one of his own
royal inscriptions) was greeted with joy by the people of Babylon (Schaudig
2001: 550–556).
Healing, Protection, and Reconciliation with the Divine Sphere
The fate of Nabonidus leads us back to the main topic of this chapter, the king
in a prison of reeds. Nabonidus was expected to participate in his annual rein-
vestiture and legitimation by the gods during the New Year’s festivals but was
unable to do so because he was estranged from his protective gods. Therefore,
according to Mesopotamian ideas, he became susceptible to “illness,” which
in their view involved political as well as bodily misfortune. When a healthy
king was not present at the New Year festivals and they had to be cancelled, the
processions did not take place and the gods simply stayed in their temples. This
situation must have greatly weakened the king’s legitimation and may well have
led to negative political consequences, as the case of Nabonidus suggests.
The ritual cluster featuring the king in the prison of reeds served precisely
to secure his presence at the New Year’s festival in autumn. The sequence
of rituals leads to the eighth day of the month of Tashritu, the date when the
king received his legitimation by the great gods and led the deities in proces-
sion to their akitu-houses outside the city. These rituals were performed as a
preventive measure, even when divine anger did not actually threaten to harm
the king. This precaution was understandable, because the anger of the gods
could be aroused easily even without one’s intending to do so. Even if the king
had behaved in a manner that he conceived to be pious and pleasing to the
gods, no one could know with certainty whether they would accept this behav-
ior or would consider it a transgression. This does not mean that pious deeds or
god-fearing behavior was not effective, but it does illustrate the Mesopotamian
belief that humans had no real insight into the intentions of the gods (Ambos
2007a). Therefore rituals were performed prophylactically in order to avoid
even the smallest disturbance between the human and the divine sphere.
The ritual cluster presented here consisted of at least two rituals: House of
sprinkling water and If the death-spirit seizes a man. The performance of these
rituals covered the first week of the month of Tashritu, preparing the king for
his appearance at the New Year’s festival on the eighth day of that month:10
In performing the rituals of this cluster, the ritual expert acted as both
lawyer and healer, employing various, legal, social, magical, and psychological
strategies to bring about a reconciliation between the king and his gods. The
mechanisms of Ancient Near Eastern ritual were in general deeply influenced
by forms stemming from legal procedures. If one felt oneself treated unjustly
by a higher authority (for example, one’s personal gods), one could go to court
to appeal. A ritual performance had, in other words, the characteristics of a trial
(Maul 1994). This similarity can be made clear if one looks at the role of the
1–3. Tashritu: If the death-spirit seizes a man

Dealing with SYMPTOMS: protecting the person of the king
against disease-causing agents (conceptualized as demons),
4–8. Tashritu: House of sprinkling water

Dealing with the CAUSE: reconciliation of the king with his
personal gods. Temporary reversal of status: During the night of
the eighth day the king stays without insignia in a prison made of
reeds in the steppe. The king leaves the prison on the morning of
the eighth day, receives his insignia, and returns to the city.
8. Tashritu: The RESULT: legitimation of the king. The major gods
of the pantheon decree the king’s fate in the assembly of the gods.
Procession of the gods, accompanied by the king, to their akitu-
houses outside the city.
human and divine participants. There was a “judge”—the sun god, who pro-
nounced the concluding verdict—and there was a “lawyer”—the ritual expert—
acting on behalf of his royal “client.”11 Since ritual could not work against the
will of the gods, it would have been regarded as pointless to perform one when
the gods were angry and had turned away. In that case the king had to produce
other deities as powerful intermediaries, who interceded on his behalf with his
own angry personal gods.
Within the general framework of this legal setting, various basic ritual
sequences were performed, which were aimed at physically removing every
kind of “illness” from the body of the king. Many of the techniques employed
by the expert would be termed “magic” by modern Westerners. The cosmos
was considered a kind of clockwork mechanism. According to the Ancient
Near Eastern worldview, there existed a relationship between matter, phenom-
ena, processes, events, and actions. The mechanisms of this relationship were
based on such principles as sympathy and antipathy. Ritual techniques could
make use of these mechanisms to attain a certain aim.12 One very important
technique was the use of magic analogy, and several examples will be discussed
in this chapter. If someone wanted to manipulate persons (whether humans or
supernatural beings), substances, matter, or states, all of which were beyond of
his or the ritual expert’s scope, it was possible to magically equate or identify
the said persons, substances, matters, or states with materia magica (organic or
unorganic, living or dead) used in the actual ritual performance. This materia
magica was then manipulated in such a way to cause an effect on it that corre-
sponded to the effect desired on the real targets which were in the client’s focus.
Thanks to the magic identification established by the ritual expert, the effects
achieved on the materia magica would also be achieved on the targets—at least
if the gods complied, because they could not be forced by magic or ritual.
Let’s consider some important key-actions from the various ritual sequences
of the cluster. The first ritual, If the death-spirit seizes a man, was a kind of broad-
spectrum healing ritual which had no specific connection to royal ideology and
could be performed by any individual. This ritual is directed against various
diseasecausing agents conceptualized as demons. Its aim is clearly expressed
in the introduction (ll.1–2): “If a death-spirit seizes a person and continually
pursues him or the evil alû-demon seizes him or (the demon) ‘Supporter of
evil’ seizes him, or ‘Anything evil’ seizes him—in order to tear them from
his (the afflicted person’s) body ( . . . ).” The demons mentioned here produced
many different kinds of symptoms: shivering fits, paralysis, dizziness, dis-
eases affecting the joints of the body, and mental derangement.13 In order to
“tear them from” the sick person’s body, the ritual expert fashioned a figurine
representing the demons and evil forces which had produced or threatened
to produce the symptoms on the patient, in this case the king. The sun god,
the judge, was asked to bring about a speedy decision in this case, to tear the
disease-causing agents from the patient’s body and take them with him to the
netherworld, which he traversed during the night. The figurine was touched by
the patient and then disposed of by being buried in wasteland.
The key concept behind the fashioning and the use of the figurine was basi-
cally that of establishing a magic identification which then could be exploited
by the exorcist to the disadvantage of the demons and for the benefit of his
patient: Demons and evil forces were harassing humans in various states and
were therefore difficult to deal with.14 But because the exorcist had identified
the figurine with the demons and disease-causing agents, there now existed
magic sympathy between this statuette and the evil forces. Thus the demons
and disease-causing agents had become comprehensible and manipulable by
the human participants according to the needs of the ritual. In the form of the
statuette, the demons could be forced to be present at the trial in front of
the sun god. In the form of the statuette, the king could touch them and by
doing so he could return to them the evil with which they had affected him,
because the evil was believed to be a kind of physical matter attached to the
afflicted person’s body. Thus the king got rid of his symptoms. And finally,
in the form of the statuette, the demons and disease-causing agents could be
disposed of by being buried at some distant place.
This ritual against complaints caused by the malevolent death-spirit and
other demons could protect the king against various disease-causing agents
(as understood by the Mesopotamians) and evil forces, but such protection was
not sustainable if a person had been abandoned by his or her personal gods. So
after dealing with the symptoms and the evil forces which had produced them,
the cause of the “illness” still had to be treated. This was the aim of the next
ritual of the cluster, House of sprinkling water.
This ritual began with an action of magic analogy: The king took in his
hand birds of a species called marratu in Akkadian and released them into the
sky. The analogy was of twofold character, based both on the act of releasing
and on the name of the birds in question: Just as the king had granted life to the
birds given into his hand and just as he had released them, likewise he wanted
to be granted life by the gods and to be released from their anger. The choice of
the specific animals was not based on chance: The Akkadian name of this spe-
cies of birds meant “bitter thing,” so the king got rid of all kinds of bitter things
oppressing him by making the birds of this species fly away from him. Then a
watercourse was dug into the courtyard of the palace, and a miniature boat was
placed in it and sent away, carrying all evil away from the palace and the king.
During the day before the king’s appearance at the New Year’s festival,
an exorcist had erected in the steppe a building complex made of reeds, con-
sisting of a prison and a reed hut in a courtyard surrounded by a reed fence.
The prison was very small, measuring only three cubits square. On the begin-
ning of the eighth day, that is, in the previous evening, at sunset, the king and
the ritual experts entered this reed building by the western door.15 The king
was not wearing his royal insignia. During the night he stayed in the prison
and recited prayers to various heavenly bodies and to the gods of the cities Nip-
pur and Babylon, the two cities of Babylonian kingship. These were the very
gods who had granted rulership to him. The king asked them to intercede on
his behalf with his personal gods, who had turned away from him.
In the morning at sunrise, after the gods of Nippur and Babylon had inter-
ceded on his behalf, the king left the prison and entered a reed hut, where he
offered sacrifices for and recited prayers to Ea, Shamash, and Asalluhi, the
gods who brought about the success of a ritual performance. Shamash, the
sun god, was the divine judge. Ea was the god of wisdom, whose son Asalluhi
had communicated the knowledge of ritual to man. These three gods were the
decision-making body deciding on the case of the person who performed a
ritual, in this case the king. Thanks to the intercession of the gods of Nippur
and Babylon, the king’s personal gods had calmed their anger and the sun god
could prove the king not guilty of any willful transgression against the divine
sphere. Next, the king addressed his personal gods directly with prayers. It
seems that in the reed hut the king also underwent an ablution, stripped off the
clothes he had worn in prison, and put on his royal garment. Then he placed
himself in the eastern door of the complex of reed buildings. Two exorcists
stood to his left and right and by means of conifer cones they sprinkled him
with holy water.16 The royal insignia were also sprinkled with water, and finally
the king was invested with his regalia in front of the rising sun. Immediately
afterwards, he returned to his palace, and there he directed a short prayer to
the beer god in his capacity as “the one who relaxes god and man.” This prayer
implied a kind of magic analogy: just as alcohol had a “relaxing” effect on the
body, so the king wanted to be “released” from his sins and impurity. The
Akkadian (Babylonian-Assyrian) word used here means both “to relax” and “to
release.” After pleading with the beer god for release, the king performed a
beer-related act which would indeed release him from all physical remnants
of sin and impurity attached to his body. He touched a fermenting vat and by
doing so transmitted all that remained from his “illness” into this vessel, from
which it could not escape and where it would be fermented. This was the con-
cluding act of House of sprinkling water, and the king was now able to take part
in the events of the New Year’s festival.
Like many Mesopotamian rituals, the nocturnal ritual sequence in the
reed buildings had the characteristics of a courtroom trial (Maul 1994). In this
case, however, the king claimed his capability to execute his rulership, which
he had lost because his personal gods had turned away from him. This point
is not explicitly stated in the ritual handbook but can deduced from the con-
tents of the prayers the king recited during the night. Whereas earlier scholars
focussed on the final ritual act of the investiture of the king with his royal
insignia, it can be shown that in general terms the ritual cluster was conceived
by the Babylonians as a “healing” of the king in the broadest sense of the word.
It protected him from illness and, much more important, from its cause: his
alienation from the divine sphere and his estrangement from his gods, all of
which led to loss of health, resources, status, and power. By being reconciled
with the gods who guaranteed his health, luck, prosperity and success, the king
was confirmed in his rule and enabled to fulfill his duty as a ruler, which in
this case was to lead the procession of the gods at the New Year’s festival at
the autumn equinox. This aim is implicitly alluded to in the introduction to
the ritual handbook House of sprinkling water, with the words “When you per-
form the ritual of ‘House of sprinkling water’ in the month of Tashritu.” The
connection with the New Year’s festival in autumn becomes clear only by the
date of the performance specified in the handbook: it was to be performed in
the period from the fourth to the morning of the eighth day of the month of
Tashritu, ending immediately before the king’s appearance in the assembly of
the gods in the temple and the ensuing procession during the eighth day.
The rituals of the cluster of the New Year’s festival in autumn are clearly
“rites of passage” (van Gennep 1999 [1909]) which consist of three parts: rites
of separation, a marginal state, and finally rites of aggregation. The state of
being forsaken by his gods is a marginal state for the king, who has lost (or is
in danger of losing) his bodily and mental health and his economic and social
position. Various rites of separation are performed at all stages of the rituals.
It is evident that the “illness” that affected the king was considered a physical
“thing” that had entered his body from the outside and could be removed phys-
ically through washing it away with water, stripping it off with the old clothes,
transmitting it to a figurine and into a fermenting vat or sending it away in a
miniature boat. It is interesting that according to Ancient Near Eastern belief
it was not possible to annihilate evil matter, which could only be removed and
sent away with a carrier or vehicle, or fermented into some other state.17 Rites
of separation also involved what we might consider the use of magic analo-
gies: The king released birds called “bitter thing” into the sky in order to be
released from the anger of the gods and of “bitter things” oppressing him,
or he addressed the beer god as the one who “relaxes” in order to be himself
“released” from sin and impurity. Recovery of the status of a king that he had
temporarily lost was likewise obtained in a physical way by his putting on royal
garments and insignia. Separation from evil and impurity and aggregation to
the status of a king were often connected. Conspicuous ritual acts included the
ablution of the king and the change of clothes in the reed hut, as well as sprin-
kling him with water and investing him with his regalia in the eastern door of
the complex of reed buildings in front of the rising sun. The concept of a rite of
passage is particularly useful in regard to the second ritual of the cluster, House
of sprinkling water, and its interesting ritual space: the complex of reed build-
ings in the steppe consisting of a prison of reed and a reed hut.
The reed hut and the eastern door of the complex of reed buildings are
clearly places of rites of aggregation, where the king regains his position as a
ruler by reconciling with his personal gods and being invested with his regalia.
Reed huts are well attested in many Ancient Near Eastern rituals. They were
regarded as pure and apotropaic places of life and well-being, but they also had
a legal aspect as the place where the decision-making body—Ea, Shamash and
Asalluhi—decided the case of the person who performed a ritual.18 A prison

as a place of a ritual performance, however, is quite unique and attested to
only twice, one attestation being the prison of reeds in House of sprinkling
water. The other ritual prison features in a “private” version of the royal House
of sprinkling water, with the aim of reconciling an individual and his personal
gods. So a prison as a ritual device to calm the anger of the gods was effective
not only for a king, but also for normal people, without, however, the conclud-
ing act of investiture. The prison in this case was not constructed of reeds
but rather was drawn on the floor of a reed hut with flour. The patient sat
on a brick in this “prison” and recited prayers to bring about a reconciliation
with his angry personal gods. After the ritual performance, the expert grasped
the hand of the patient/prisoner and led him out of both the prison and his
miserable state.19 As will be shown below, the prison as a ritual structure was
a liminal space which had the characteristics of a reversed world. While the
king stayed in this prison, he was in a liminal state and subject to a temporary
loss of status.
Ritual Efficacy: The Prison as a Ritual Device
The cuneiform ritual handbooks seldom explain why a ritual action is per-
formed or a prayer recited. The manifold and very complex meanings of the
prison as a ritual structure have to be decoded through the consulting of other
sources. Like the reed hut, the prison erected in the steppe was made of reeds,
so the building possessed an inherently pure and apotropaic quality. While
staying there, the king would not be in contact with any kind of impure or
evil matter. It seems strange, then, that this structure is designated with the
term bῑt ṣibitti, which also serves to designate a normal prison with no ritual
connotations. Why should a prison serve as a place for a ritual performance,
anyway? From a strictly legal point of view, a prison sentence was not usual in
the Ancient Near East. Condemned criminals were fined or were sentenced to
a punishment affecting their life or body, such as death or mutilation. A prison
was for people who were awaiting trial or execution or who were unable to pay
their debts. If we leave aside other religious and ideological meanings, which
will be discussed shortly, the king would appear to be a prisoner awaiting trial
and he could leave the prison after one night, after being judged not guilty by
the decision-making body, the gods Ea, Shamash, and Asalluhi.
The Ancient Near Eastern prison did not have the advantages of a modern
penal system. In a hymn to Nungal, the Mesopotamian goddess of prisons, the
archetypal prison is described—a house of horror:20
House, furious storm of heaven and earth, battering its enemies!

(...)
Its interior is evening light, dusk spreading wide, its awesomeness
is frightening. ( . . . )
House, a pitfall waiting for the evil one, it makes the wicked
tremble. ( . . . )
House, whose foundations are laden with great awesomeness,
Its gate is the yellow evening light, exuding radiance,
Its stairs are a great open-mouthed dragon lying in wait for men,
Its doorjamb is a great dagger whose two edges cut in two (?) the evil
man,
Its architrave is a scorpion which quickly dashes from the dust, it
overpowers everything.
Its projecting pilasters are lions, no one dare rush into their grasp.
The Prisoner-King in Prison as a Criminal Individual
While staying in the prison of reeds during the night, the king was not dressed
in his royal garment and did not wear his regalia. It is consistent with this non-
royal attire that all the prayers the king recited in prison were the prayers of a
suffering individual. During his nocturnal stay there the king addressed various
heavenly bodies and the gods of the cities Nippur and Babylon, asking them
to act as intermediaries with his personal gods. The prayers or incantations
directed to these deities were classified by the Mesopotamians as “(prayers) of
raised hands,” because of the gesture that accompanied their recitation. Prayers
of this genre are not specific to the king and can best be defined as a plea of
an individual private supplicant.21 In these prayers the sufferer attributes his
miserable state to the anger of his personal gods. The following excerpt is from
a prayer to the moon god Sîn:22
After my god has become angry with me (and)

My goddess has stepped back from me,
I ever endure (the following problems): (My gods) have imposed
against me murder, bribe, and violence;
Expenses, losses, privation, and diminution have very severely been
inflicted upon me, and
My heart has become distraught, my life has become short.
The affected person had become a social outcast who lived in continuous
fear and despair, until the interceding deities had managed to calm the anger
of his personal gods. The status and social position of the praying person were
irrelevant for the divine acceptance of the plea, since the gods helped even the
weakest members of society, as we learn from another passage in the same
prayer (ll. 44 f., 51–55):
You take the destitute, who has become weak, by his hand.
You let the weak one attain and receive a verdict of truth and justice.
(...)
The unskilled person you endow with ability,
You have compassion for him who turned to you,
You bring together again the family [lit.: living quarters] of him
whose (family) is scattered,
You remove the sin of him who bears a sin,
You reconcile with him whose god is angry.
The divine intermediaries are asked to intercede with the supplicant’s personal
gods. The following lines are an excerpt from a prayer addressed to the goddess
Gula (Foster 1993: 582 f.):
O Gula, most great lady, merciful mother, who dwells in the great
heavens,
I call upon you, my lady, stand by me and hear me! ( . . . )
Because judging the case, rendering the verdict,
Because reviving and granting well-being are yours (to grant), ( . . . )
O my lady, I turn to you, I am heedful of you.
Accept of me my flour offering, receive my plea,
Let me send you to my angry (personal) god, my angry (personal)
goddess,
To the god of my city who is in a rage and furious with me. ( . . . )
O Gula, most great lady, with the utterance of your sublime
command, which is greatest in Ekur,23
And with your firm assent, which cannot be changed,
May my angry (personal) god return to me, may my angry (personal)
goddess relent to me,
May the god of my city who is in a rage and furious with me,
Who is angry, calm down; he who was vexed may he be soothed!
(...)
Toward the gods whom he asks to act as mediators, the king behaved as a
person from a lower social level behaves toward a higher-ranking person. The
performance of a “prayer of raised hands” and the accompanying ritual acts
were arranged like an audience during which a petitioner requested a mark of
favor of a higher-ranking authority (Zgoll 2003).
After having left the prison and addressing his personal gods, the king
recited individual prayers of the sort that might be recited by any private per-
son. These prayers belonged to the category of “incantation for appeasing an
angry god” (Lambert 1974). In these prayers addressed to his personal gods the
king argued not unlike someone accused in court, at first negating any acts of
transgression and misdemeanor, then admitting that he did commit these acts,
but only unintentionally. Finally, he put forward the point that we are all sin-
ners and that nobody is perfect. The transgressions mentioned in the prayers
are of a vague, unspecified kind with no specific connection to the particular
case. The following is a prayer addressed to a personal god (Lambert 1974:
274–277; cited here is Foster 1993: 641):
My god, I did not know (how) harsh your punishment would be!
I have sworn lightly a solemn oath by your name,
I have disregarded your rites, I went too far,
I have skirted (?) your duty in difficulty,
I have trespassed far beyond your limits.
I certainly did not know, much [ . . . ].
My crimes being (so) numerous, I do not know all I did.
O my god, clear, forgo, dispel your ire,
Disregard my iniquities, accept my entreaties,
Transmute my sins into good deeds.
Your hand is harsh, I have seen your punishment.
Let him who does not revere his god and goddess learn from my
example.
O my god, be reconciled, o my goddess, relent!
Turn hither your faces to the entreaty of my prayer.
May your angry hearts be calmed,
May your feelings be soothed, permit me reconciliation,
Let me ever sing your praises, not to be forgotten, to the numerous
peoples.
Specific royal misdeeds are not mentioned in these “private” prayers. What
the Mesopotamians considered to be royal crimes can be seen, for instance, in
the composition Advice to a prince, a work listing in a casuistic style misdeeds of
kings and the divine wrath that is their consequence (Foster 1993: 760–762).
A characteristic crime of a king is disrespect for the privileges of the venerable
cult centers of Babylonia and their inhabitants. Specific royal crimes are also
mentioned in a kind of negative confession of sins that the Babylonian king
delivered in the temple of Marduk during the New Year’s festival in spring. The
king assured the god that he had not disregarded his royal duties toward the
gods and their temples, that he had not torn down the city walls of Babylon, and
that he had not disregarded the privileges of the citizens. Nothing of this kind is
mentioned in the king’s prayers to his divine mediators or his personal gods.
The Prison as the Material Representation of the Anger of the Gods

The prison of reeds in the steppe was the material representation of the anger
of the personal gods of the king. Interestingly, in the so-called wisdom litera-
ture and other literary genres, the state of a person forsaken by his or her gods
is described as a state of inability to act, of captivity, and is comparable to a
stay in prison. Wisdom literature is a literary genre treating the question of the
place of man within in the cosmological framework, the relationship between
man and god, and ethical questions. In the so-called Poem of the righteous suf-
ferer, the protagonist, who is subject to the anger of his gods, describes his situ-
ation in the following words:24
I take to a bed of bondage; going out is a pain;

My house has become my prison.
My arms are stricken—which shackles my flesh;
My feet are limp—which fetters my person.
Very similar is the concept attested in bilingual Sumerian-Akkadian prayers,

that the person who suffers from the anger of his or her gods has become a
“prisoner” in his or her own house.25
Clearly a person alienated from his or her gods had become inert, had lost
his or her agency and ability to act. During the ritual performance, the king
experienced this god-forsaken state physically by staying in a prison.
The Prison as the Netherworld

During the performance of House of sprinkling water the king moved through
the ritual space from west to east. During the night he stayed in the prison of
reeds, which he left in the morning in order to enter the reed hut and finally to
receive his regalia in the eastern door of the complex of reed buildings in front
of the rising sun. By moving from west toward east, the king obviously followed
the path of the sun during the night. And according to Mesopotamian ideology,
the king was the likeness of the sun on earth among the people. It was certainly
no accident that the king embodied the sun directly before the autumn equinox,
when the New Year’s festival in autumn took place. During the night, the sun
passed through the netherworld. Interestingly, the prison also had the aspect
of the netherworld. The goddess of prison, Nungal or Manungal, belonged to
the circle of netherworld deities and the temple of the deity bore the Sumerian
name Ekur, which is also attested as a designation of the netherworld and was
translated by the Babylonians as “prison.”26
So the king’s nocturnal stay in prison should be seen in analogy with the
stay of the sun in the netherworld during the night. If the prison had a neth-
erworld aspect, we may ask ourselves whether the king actually “died” when
entering the prison in the evening and was “reborn” when leaving it at sun-
rise. It is perhaps relevant that the emergence of a baby from the womb of the
mother was seen by the Mesopotamians as analogous to the sun’s emergence
from the dark netherworld, that is, its rising in the morning (see in general
Polonsky 2006). The same verb is used in Sumerian and Akkadian for both the
emerging of the sun from the netherworld and for the emerging of the child
from the womb. As the sun rises at the horizon to continue its journey across
the sky, so is the birth of a child described as a journey starting at the horizon
in the mother’s womb. The unborn baby is characterized as the dweller in the
darkness of the mother’s womb who has not yet seen the rise or the light of
the sun (Farber 1989: 149–151). The sun god is one of the gods assisting the
woman in labor. In order to introduce newborn boys and girls to their future
gender roles, there were rituals performed on them before the sun. Birth or the
cutting of the umbilical cord was the time when the fate of the newborn was
decreed by the gods. Likewise was sunrise a time when destiny was determined
when the other gods joined the sun god to render judgment and verdict.
The goddess of prison, Nungal or Manungal, according to the abovemen-
tioned hymn, assisted the mother-goddess Nintur in cutting the umbilical cord
of the newborn child and determined his or her fate (Black et al. 1998–2006:
ll. 71 f.):
I assist Nintur at the place of child-delivery;

I know how to cut the umbilical cord and know the favourable words
when determining fates.
Moreover the prison, as described in the hymn to Nungal, had the aspect of
a place of death and rebirth, as is clear in the following excerpt:27
Its brick walls crush evil men and give rebirth to just men. ( . . . )
When the time arrives, the prison is made up as for a public festival,
The gods are present at the place of interrogation, at the divine river
ordeal,
To separate the just from the evildoers; a just man is given rebirth.
(...)
My house gives birth to a just person but exterminates a false one.
The death of the criminal and the rebirth of the just person have been
understood at least by modern researchers as a kind of metaphor of rehabili-
tation or reformation of the prison’s inmates: By staying in prison, the crim-
inal dies and is reborn as a just and honest man (Cavigneaux & Krebernik
1998–2001: 616 f.).
The king left the prison in the morning in order to be invested with his
regalia in front of the rising sun. It is also possible that the act of investiture
was understood by the Mesopotamians as the “death” of the not-yet-crowned
person and “(re)birth” of the crowned person (Wilcke 2002: 82 f.). As is men-
tioned above, a person was made king not by an act of investiture, but rather
because he had been created by the gods to become ruler of his country. The
actual investiture of the king at the beginning of his reign may have been a
reenactment of this creation by the gods. There are attestations that the mother-
goddess herself performs the investiture of the king. The following excerpt is
from a Sumerian hymn to the temple of the mother-goddess Nintu (Sjöberg,
Bergmann & Gragg 1969: 46 f. ll. 500–503):
Mother Nintu, the lady of . . .,

Within your (the temple’s) dark place performs her task:
The (new)born king, she binds the headgear (around his head),
The (new)born lord, she sets the crown (on his head), he is (secure)
in her hand.
The dark interior of the temple of the mother-goddess is clearly to be

seen as an analogy to the dark womb of the mother (indeed the womb is
attested in Mesopotamian incantations and rituals performed for babies as
an archetypal place of darkness: Farber 1989: 149–150). Thus the ruler’s
coronation by the mother-goddess in the dark interior of her temple can bee
seen as analogous to birth (Krebernik 1993–1997: 513 f. § 6.5). We may there-
fore ask if the prison of reeds represented the womb of the mother-goddess
and if the investiture of the king was understood as birth? The ritual hand-
book describing House of sprinkling water does not refer explicitly to birth
and investiture of the king by the mothergoddess. However the king names
himself a “creature of Ninmenanna” in a short prayer at the beginning of
the ritual. Ninmenna or Ninmenanna is one of the names of the mother-
goddess meaning “Lady of the crown” (Krebernik 1993–1997: 505 f. § 3.23).
The royal self-designation “creature of Ninmen(an)na” is no peculiarity of
the ritual House of sprinkling water but is also attested in royal inscriptions of
Babylonian kings.
This reference to the mother-goddess may well be a kind of framing: At the
beginning of the ritual performance the king names himself a creature of the
mother-goddess in her aspect as lady of the crown. During the night of the last
day of the ritual performance he stayed in a small and dark prison, which may
have represented the womb of the mother-goddess, among other things. The
king leaves the prison/womb at sunrise to be invested with his regalia, which
may bear the association of birth. It is noteworthy that the different and seem-
ingly incommensurable situations of staying in a prison and of undergoing
an investiture have very similar associations of death and rebirth. Moreover,
in the ritual House of sprinkling water both these situations are combined and
there is a further link between them by their connection to the path of the sun:
The king leaving the prison at sunrise to be invested with his insignia is to be
seen in analogy to the sun leaving the netherworld, the sunrise bearing again
the metaphor of birth.
The Reversed World
The various connotations of the prison where the king stayed for one night
have one important aspect in common. In literary texts, the prison, the state of
being forsaken by one’s gods, and the netherworld are all described as reversed
worlds, where the normal world order was turned upside down. So the king
was no longer king during this single night, and in fact he did not wear his
royal insignia. It is also noteworthy that none of the prayers the king recited in
prison were specifically royal prayers, but rather prayers that could be recited
by any private person. They dealt with the problems and concerns of an indi-
vidual, but not with those of an empire and its king. They obtain their relevance
for kingship only when seen as a cycle addressed to the gods of the royal cities
Nippur and Babylon.
In the hymn to the goddess of prison, Nungal, the prison is explicitly
described as a place where normal conventions are reversed. The inmates
behave in a way opposite to that of normal people, as can be seen in the follow-
ing excerpt from this composition:28
Brother counts for brother the days of misfortune, but their

calculations get utterly confused.
A man does not recognize his fellow men; they have become
strangers.
A man does not return the password of his fellow men, their looks
are so changed.
Similarly is the netherworld a world of reversal. It is a topos in Mesopo-

tamian epics and myths that all living beings traveling to the netherworld, be
they humans or gods, are advised to behave there in a way exactly opposite
to the way they would behave on earth, so that they will not be recognized as
strangers. A famous example is from the Gilgamesh Epic. Gilgamesh’s friend
Enkidu travels to the netherworld to recover two objects that have fallen into
the realm of the death. Gilgamesh advises Enkidu to behave in the netherworld
exactly opposite to the way he would behave on earth. For example, he should
not behave in the proper way toward his dead relatives:29
You must not kiss the wife you love,

You must not strike the wife you hate,
You must not kiss the son you love,
You must not strike the son you hate.
As we learn from the myth “Nergal and Ereshkigal,” similar advice is

offered to the god Nergal by the god of wisdom, Ea, when he travels into the
netherworld (Foster 1993: 410–428, esp. 420 and 422).
So it becomes evident that the prison where the Babylonian king stayed
during the night of the eighth day of the month of Tashritu in autumn is asso-
ciated on various levels (state of the god-forsaken person prison nether-
world) with the concept of a reversed world.
This reversed world mirrored the treatment of the king during the New
Year’s festival in spring. Then the king did not stay without his insignia in
prison, but he was divested of his insignia and slapped in the face by the high
priest, as described earlier.
The deeper meanings of the prison of reeds in the steppe were not just
symbolic connotations but rather a means to an end: Because the ritual expert
had made the prison corresponding to the state of being forsaken by the gods
as well as to the netherworld, he could deal with the problems the king had
to face: the anger of the gods and endangered kingship which was its conse-
quence. When the king passed through the ritual space of the prison endowed
with the qualities discussed above, his movement was not just movement,
but rather an action of analogy which would cause the desired feedback: By
leaving the prison, the king also left behind him the state of being forsaken
by the gods. Likewise the king, when he went out of the prison, embodied the
sun rising from the netherworld. And since, according to a concept commonly
attested in the Ancient Near East, the king was regarded as the sun of his
subjects, the ruler virtually exerted and confirmed his kingship by embodying
the sun.
Taking into account these various connotations of the prison of reeds in
the steppe, we may assume that this stay had a deep psychological impact upon
the ruler.30 After a night in a dark and extreme narrow prison, which he had
entered as a poor sinner suffering from the anger of the gods, he left both
the prison and his miserable state, going in the direction of the rising sun to
receive his regalia and to turn again into a king.
By mentioning psychological effects on the king, we should note, however,
that during the ritual performance there was not much time to express indi-
vidual repentance. As we have seen, during the ritual performance the king
recited dozens of prayers to his divine intermediaries, his personal gods, and
the decision-making body Ea, Shamash, and Asalluhi. These were stereotyped
prayers with a fixed wording, which were pronounced for the king by the ritual
expert. It was precisely the power of these prayers, stemming from the so-called
stream of tradition, the traditional lore of Mesopotamian scholarship revealed
by the gods themselves, that accounted for the efficacy of ritual.
Conclusion
It was a characteristic mechanism of Babylonian kingship that the ruler was

subject to a semiannual reinvestiture during the two Near Year’s festivals, at
the equinoxes in spring and autumn. This chapter dealt with some aspects of
the autumn festival. The appearance of the king at this important event was in
danger of being impeded by various problems caused by the anger of the rul-
er’s personal gods. This anger led to “illness” as the Mesopotamians conceived
it, that is, the loss of physical and mental health and of economic and social sta-
tus. The anger of the personal gods and the “illness” resulting therefrom could
prevent the king from appearing at the New Year’s festival to be confirmed
in his office and so lead to political consequences. A cluster of various rituals
presented in this chapter were aimed at guaranteeing the king’s presence at
the autumn festival by healing all symptoms of “illness” and eliminating their
cause by reconciling the ruler with his personal gods. In terms of efficacy, the
ritual acts and prayers were perceived by the Babylonians as fulfilling their
respective aim and thus were effective in enabling the ruler to appear at the
festival.
Ritual efficacy can be observed on various mutually dependent levels. The
confirmation of the king’s status is attained after a temporary loss of status,
a mechanism that can be observed worldwide in many rituals of investiture
(Turner 2000 [1969]: 94 ff., 162 ff.).31 During the period of his loss of status,
the king was in a marginal state, staying in a marginal space with the char-
acteristics of a reversed world, the prison of reeds in the steppe. There are
several basic rites of separation and aggregation in the true sense of the word.
Evil, illness, and impurity were physically removed from the body of the king
by being transmitted to other objects, by being washed away with water, by
being stripped off together with the old clothes, or by being sent away in a
miniature boat. The king was reintroduced into his royal status by putting on
his royal garment and his insignia. In principle, each of these basic ritual acts
was effective—not on its own, however, but only when performed in a broader
legal context within a ritual. The king faced a trial before a divine decision-
making body and he had to win over powerful gods as intercessors. If the gods
accepted his acts and prayers, then these basic ritual sequences were effective.
Even a single ritual was not effective on its own, but only as part of a cluster of
several rituals, the respective rituals of the cluster being mutually dependent.
Step by step the king was protected against disease-causing agents such as
demons, reconciled with his personal gods, and then confirmed as ruler by the
major gods of the pantheon during the New Year’s festival in autumn. Thus
the performance of the various rituals of the cluster brought about physical
health, reconciliation with the divine sphere, and confirmation of social and
political status.
In passing we note that in general terms the king’s confirmation in his
office after a temporary loss of status during the autumn festival is mirrored in
the spring festival, when the king was divested of his insignia, was slapped in
his face by the priest of the god Marduk, delivered a report in front of the deity,
and was then reintroduced in kingship.
The participation in the New Year’s festivals was of the utmost importance
for the legitimation of the Babylonian king, and so it is not surprising that he
was prepared for his appearance at this important cultic and political event in
the way as I have described. Religious legitimation of a ruler is attested every-
where in the Ancient Near East, but especially in Babylonia of the first mil-
lennium, where a dynastic concept was only weakly developed. Of course, the
first-born son of a king would expect to follow his father to the throne, but
simply being the oldest son was not sufficient to guarantee one’s succession.
This situation is in marked contrast to Assyria, where even the last rulers of the
empire in the seventh century BCE claimed to be members of a dynasty founded
by a distant ancestor well over 1000 years earlier. But if we look at the state of
the Babylonian monarchy in the first half of the first millenniumBCE, there was
hardly any effective means to guarantee the well-being of the kings or a well-
ordered succession. During 200 years from the ninth to the seventh century
BCE, for example, only once did a son follow his royal father on the throne (leav-
ing aside Assyrian rulers reigning over Babylonia in personal union). This son,
by the way, was murdered after only two years of reign, and his murderer, who
followed him to the throne, was himself killed after only one month (Brinkman
1984: 16). This trouble, however, never raised any question among Babylonian
scholars about whether this form of government and the rituals connected with
it were effective.
Indeed, the ritual featuring the king in prison was considered effective by
both kings and scholars, and it was also used by Assyrian kings ruling Assyria
and Babylonia in personal union in the seventh century BCE. The ritual had a
long-range efficacy, being performed in Babylonia for kings residing in Assyria,
hundreds of kilometers away. The Assyrian kings were informed about the per-
formance of the ritual by letters from their agents in Babylonia. The ritual was
transmitted even long after Babylonia was no longer an independent kingdom
and had become part of the Persian empire. The New Year’s festivals were still
attended in Hellenistic times by Seleucid rulers, but we do not know if a Seleu-
cid (or before then an Achaemenid) ruler was ever slapped in the face during
the New Year’s festival in spring or stayed in a prison in the New Year’s festival
in autumn.
notes
1. The ritual lore of the cuneiform cultures of Mesopotamia will be the focus of
this essay. For Hittite Anatolia and its rich ritual tradition in cuneiform, see Haas
(2003). Special characters are used sparsely and Akkadian words or names are
presented in a simplified way. I am grateful to William Sax for reading an earlier
draft of this article, improving my English and commenting on the contents.
2. For the following discussion of Akkadian words for “ritual,” I made use of the
Assyrian Dictionary of the Oriental Institute of the University of Chicago (Chicago Assyrian
Dictionary).
3. For more on ritual techniques and the materia magica used in rituals see Maul
(1994) and Haas (2003).
4. For explanatory commentaries on ritual and religious texts in Mesopotamia,
see Livingstone (1986).
5. See Pongratz-Leisten (1999) on the role and position of the ritual experts and
scholars and their lore of knowledge at the courts at both Mari and Nineveh. For an
edition of the correspondence of the Assyrian scholars, see the series “State Archives
of Assyria” (Helsinki), especially Parpola (1993). For the letters from Mari, I refer to
the series “Archives royales de Mari” (Paris), especially Durand (1988).
6. For the New Year’s festivals, see Bidmead (2004), Cohen (1993), Linssen
(2004), and Zgoll (2006).
7. For a critical appraisal of Frazer’s treatment of the New Year’s festival, see
Fontenrose (1966: 5–8).
8. I discovered the evidence only recently in the British Museum, while working
on yet unpublished or not correctly identified cuneiform tablets.
9. Schaudig (2001: 18 ff., 26, 493 with note 704 and p. 498; 494 and 499 l. 1 III
11–12; 566 and 573 col. I 18 f).
10. The ritual If the death-spirit seizes a man is edited by Scurlock (2006: 530–535
and 712 f.). Scurlock, however, did not recognize that this ritual is closely connected to
the ritual House of sprinkling water and was part of a cluster to be performed at the
New Year’s festival in autumn.
Fragments of the ritual House of sprinkling water were edited by Meier (1937–1939)
and Berlejung (1996). Neither of these authors, however, identified the ritual correctly
as House of sprinkling water, nor did they recognize that this ritual is connected to the
ritual If the death-spirit seizes a man, nor did they recognize that both rituals were part
of a ritual cluster to be performed at the New Year’s festival in autumn.
I have prepared a new edition of both rituals, and they will be published, along
with a discussion of their context, as a monograph in the near future.
11. With regard to the Mesopotamian view of “illness” and the role of the patient
and the ritual expert, Howard Brody drew my attention to the concept of the “Sick
role” of Talcott Parsons (Parsons 1968 [1951]: 428–479; see also Cockerham & Ritchey
1997: 117 f. and Quah 2005 [2001]: 33–35). According to this concept, society
considered sickness to be a deviant behavior (Parsons 1968 [1951]: 467 f.), the patient
being dependent on the help of an expert; in our Western world that expert would be
the physician (1968 [1951]: 441). Interestingly, Parsons sees the role of the physician as
that of a “court of appeal” (1968 [1951]: 436 f.).
12. A concise explanation of the principles of “magic” as attested in the Ancient
Near East based on examples from Hittite rituals is given by Haas (1987–1990).
13. On the description of symptoms and methods of diagnosis in Mesopotamia,
see in general Scurlock & Andersen (2005). For Hittite Anatolia, see Haas (2003:
55–62).
14. Incantations offer vivid descriptions of how demons in various states slip,
sneak, blow, waft, drip, and flow into the houses of humans (Schramm 2001: 22 f.;
Geller 1999: 51).
15. In the Ancient Near East, the day began at sunset, not at sunrise in the
morning, as in our culture.
16. Representations of the king with two supernatural sages, the archetypal ritual
experts, who stay at his left and right sprinkling water by means of conifer cones are
well attested in Assyrian art: Magen (1986: 73–81).
17. For this concept, see in general Maul (1994: 85–93) and Haas (2003: 68 ff.).
18. On reed huts as ritual structures, see in general Taracha (2001) and Seidl
& Sallaberger (2005/2006). Reed was considered a pure and apotropaic building
material, connected to the cosmic subterranean ocean, the apsû. The reed’s place of
origin, the reed bed, was the epitome of life and well-being, because in marked
contrast to the desert it was a place abundant in water, teeming with fish, birds,
and other animals.
19. Edition of this ritual by Ebeling (1931: 114–120).
20. Cited here are lines 1, 3, 5, and 12–17. The most recent edition of the hymn is
by Attinger (2003) (with French translation). This English translation follows the one
offered by Black et al. (1998–2006) in the “Electronic Text Corpus of Sumerian
Literature” at http://etcsl.orinst.ox.ac.uk.
21. To the problems of distinguishing between “prayer” and “incantation,” see

Mayer (1976: 7 ff.), dealing also with the various attested Mesopotamian categories of
prayers and incantations.
22. Mayer (1976: 495–502 ll. 56–60). In this English translation I also made use
of the citations of the passages in the Assyrian Dictionary of the Oriental Institute of the
University of Chicago (Chicago Assyrian Dictionary).
23. Ekur is the temple of the god Enlil at Nippur.
24. Lambert 1996 [1960]: 44 f., tablet II ll. 95–98. It is interesting that also
Nabonidus, the Babylonian king abandoned by his personal god, quotes a passage from
the Poem of the righteous sufferer to describe his god-forsaken state: Schaudig (2001: 493,
498), referring to Lambert (1996 [1960]: 32 f. tablet I ll. 52 and 54). The passage quoted
by Nabonidus does not refer to the state of a prisoner but alludes to the fact that the
godforsaken person is without protection against inauspicious omens like evil dreams
and that even the diviners and ritual experts can do nothing to help this person as long
as the gods are not inclined to accept oracular queries and rituals.
25. Lambert (1974: 289 f. ll. 15 f.; 292 ll. 15 f.; 293 ll. 12 f.; 301).
26. For the goddess of prison, see Cavigneaux & Krebernik (1998–2001). For the
Akkadian (Assyrian-Babylonian) translation of the temple’s name as “prison,” see
Maul (1988: 263–266 rev. 6 f.).
27. Cited are lines 56, 58–60, and 103, following Black et al. (1998–2006).
28. Cited here are lines 52–54, following Black et al. (1998–2006).
29. A. R. George (2003: 728 ff. ll. 10 ff. and 31 ff.; 749 ff. ll. 181 ff. and 771 f. ll.
181 ff.). Cited here is George (2003: 728 ll. 23–26 and 751 ll. 195–198).
30. Ancient Near Eastern ritual experts were well aware of the psychological
impact of their rituals upon their patients and clients and were using
psychotherapeutic effects deliberately. This fact is clearly attested in Hittite ritual texts;
see the evidence collected by Haas (2003: 67 f.).
31. William Sax drew my attention to rituals of status reversal and rebellion in
southeast Africa analyzed by Gluckman (1963). It should be noted, however, that
there is no evidence that the temporary status reversal of the Babylonian king was
accompanied by ritualized rebellion. On rituals of status reversal and inversion, see
in general Babcock (1978); for more specific discussion of rituals of reversal and
inversion in cultures of the Ancient World, see Auffarth (1991) and Versnel (1993).
references
Ambos, C. 2004, Mesopotamische Baurituale aus dem 1. Jahrtausend v. Chr. Mit einem
Beitrag von A. Schmitt, ISLET, Dresden.
——— . 2007a, “Types of Ritual Failure and Mistakes in Ritual in Cuneiform Sources,”
in When Rituals Go Wrong: Mistakes, Failure, and the Dynamics of Ritual, ed. Ute
Hüsken, Brill, Leiden, pp. 25–47.
——— . 2007b, “Ricostruire un tempio per nuocere al re: Rituali mesopotamici di
fondazione, il loro posto nel culto e il loro impiego come arma politica,” in Kaskal:
Rivista di storia, ambienti e culture del Vicino Oriente Antico 4, 297–314.
Attinger, P. 2003, “L’Hymne à Nungal,” in Literatur, Politik und Recht in Mesopotamien.

Festschrift für Claus Wilcke, ed. W. Sallaberger, K. Volk, & A. Zgoll, Harrassowitz
Verlag, Wiesbaden, pp. 15–34.
Auffarth, Chr. 1991, Der drohende Untergang: “Schöpfung” in Mythos und Ritual im
Alten Orient und in Griechenland am Beispiel der Odyssee und des Ezechielbuches,
de Gruyter, Berlin.
Babcock, B. A. (ed.) 1978, The Reversible World: Symbolic Inversion in Art and Society,
Cornell University Press, Ithaca, N.Y.
Berlejung, A. 1996, “Die Macht der Insignien. Überlegungen zu einem Ritual der
Investitur des Königs und dessen königsideologischen Implikationen,” Ugarit-
Forschungen 28, pp. 1–35.
Bidmead, J. 2004, The Akitu Festival: Religious Continuity and Royal Legitimation in
Mesopotamia, Gorgias Dissertations Near Eastern Studies vol. 2, Gorgias Press,
Piscataway. N.J.
Black, J. A., Cunningham, G., Ebeling, J., Flückiger-Hawker, E., Robson, E., Taylor,
J., & Zólyomi, G. 1998–2006, The Electronic Text Corpus of Sumerian Literature,
available at: http://etcsl.orinst.ox.ac.uk.
Brinkman, J. A. 1984, Prelude to Empire: Babylonian Society and Politics, 747–626 B.C.,
Occasional Publications of the Babylonian Fund 7, Philadelphia.
Cavigneaux, A., & Krebernik, M. 1998–2001, “Nungal,” in Reallexikon der Assyriologie
und Vorderasiatischen Archäologie vol. 9, ed. D. O. Edzard et al., Walter de Gruyter,
Berlin, pp. 615–618.
Cockerham, W. C., & Ritchey, F. J. 1997, Dictionary of Medical Sociology, Greenwood
Press, Westport, Conn.
Cohen, M. 1993, The Cultic Calendars of the Ancient Near East, CDL-Press, Bethesda,
Md.
Durand, J.-M. 1988, Archives épistolaires de Mari I/1, Archives royales de Mari vol. 26,
Editions Recherche sur les Civilisations, Paris.
Ebeling, E. 1931, Tod und Leben nach den Vorstellungen der Babylonier, Walter de
Gruyter, Berlin.
Farber, W. 1989, Schlaf, Kindchen, Schlaf! Mesopotamische Baby-Beschwörungen
und -Rituale, Mesopotamian Civilizations vol. 2, Eisenbrauns, Winona Lake, Ind.
Fontenrose, J. 1966, The Ritual Theory of Myth, Folklore Studies vol. 18, University of
California Publications, Berkeley.
Foster, B. 1993, Before the Muses: An Anthology of Akkadian Literature, CDL Press,
Bethesda, Md.
Geller, M. 1999, “Freud and Mesopotamian Magic,” in Mesopotamian Magic: Textual,
Historical, and Interpretative Perspectives, ed. T. Abusch & K. van der Toorn,
Ancient Magic and Divination vol. 1, Styx Publications, Groningen, Netherlands.
49–55.
Gennep, A. van. 1999 [1909], Übergangsriten (Les rites de passage), German translation
by K. Schomburg and S. M. Schomburg-Scherff, Campus Verlag, Frankfurt.
George, A. R. 2003, The Babylonian Gilgamesh Epic, Oxford University Press, Oxford.
Gluckman, M. 1963, “Rituals of Rebellion in South East Africa,” in Order and Rebellion
in Tribal Africa, ed. M. Gluckman, Cohen & West Ltd., London, pp. 110–136.
Haas, V. 1987–1990, “Magie und Zauberei. B. Bei den Hethitern,” in Reallexikon der
Assyriologie und Vorderasiatischen Archäologie vol. 7, ed. D. O. Edzard et al., Walter
de Gruyter, Berlin, pp. 234–255.
——— , with the collaboration of D. Bawanypeck. 2003, Materia Magica et Medica
Hethitica. Ein Beitrag zur Heilkunde im Alten Orient, Walter de Gruyter, Berlin.
Krebernik, M. 1993–1997, “Muttergöttin. A.I. In Mesopotamien,” in Reallexikon der
Assyriologie und Vorderasiatischen Archäologie vol. 8, ed. D. O. Edzard et al., Walter
de Gruyter, Berlin, pp. 502–516.
Lambert, W. G. 1960, Babylonian Wisdom Literature, Oxford University Press, Oxford.
(Reprint 1996 Eisenbrauns, Winona Lake, Ind.)
——— . 1974, “Dingir.šà.dib.ba Incantations,” Journal of Near Eastern Studies 33,
pp. 267–322.
——— . 1998, “The Qualifications of Babylonian Diviners,” in Festschrift für Rykle
Borger zu seinem 65. Geburtstag am 24. Mai 1994. tikip santakki mala bašmu . . .,
Cuneiform Monographs vol. 10, ed. S. M. Maul, Styx Publications, Groningen,
Netherlands, pp. 141–158.
Linssen, M. 2004, The Cults of Uruk and Babylon. The Temple Ritual Texts as Evidence
for Hellenistic Cult Practice, Cuneiform Monographs vol. 25, Brill & Styx, Leiden.
Livingstone, A. 1986, Mystical and Mythological Explanatory Works of Assyrian and
Babylonian Scholars, Clarendon Press, Oxford.
Magen, U. 1986, Assyrische Königsdarstellungen—Aspekte der Herrschaft: Eine Typologie,
Baghdader Forschungen vol. 9, Verlag Philipp von Zabern, Mainz.
Maul, S. M. 1988, “Herzberuhigungsklagen”: Die sumerisch-akkadischen Eršahunga-
Gebete, Harrassowitz Verlag, Wiesbaden.
——— . 1994, Zukunftsbewältigung. Eine Untersuchung altorientalischen Denkens
anhand der babylonisch-assyrischen Löserituale (Namburbi), Baghdader
Forschungen vol. 18, Verlag Philipp von Zabern, Mainz.
Mayer, W. 1976, Untersuchungen zur Formensprache der babylonischen
“Gebetsbeschwörungen,” Studia Pohl Series Maior vol. 5, Biblical Institute Press,
Rome.
Meier, G. 1937–1939, “Die Ritualtafel der Serie ‘Mundwaschung’, ” Archiv für
Orientforschung 12, pp. 40–45.
Oppenheim, A. L. 1977 [1964], Ancient Mesopotamia: Portrait of a Dead Civilization,
rev. ed. completed by E. Reiner, University of Chicago Press, Chicago.
Parpola, S. 1993, Letters from Assyrian and Babylonian Scholars, State Archives of
Assyria vol. 10, The Neo-Assyrian Text Corpus Project, Helsinki.
Parsons, T. 1968 [1951], The Social System, The Free Press, Toronto & Collier-
Macmillan Limited, London.
Polonsky, J. 2006, “The Mesopotamian Conceptualization of Birth and the
Determination of Fate at Sunrise,” in If a Man Builds a Joyful House. Assyriological
Studies in Honor of E. V. Leichty, ed. A. K. Guinan et al., Cuneiform Monographs
vol. 31, Brill, Leiden, pp. 297–311.
Pongratz-Leisten, B. 1999, Herrschaftswissen in Mesopotamien: Formen der Kommunikation
zwischen Gott und König im 2. und 1. Jahrtausend v. Chr., State Archives of Assyria
Studies vol. 10, The Neo-Assyrian Text Corpus Project, Helsinki.
Quah, S. 2005 [2001], “Health and Culture,” in The Blackwell Companion to Medical
Sociology, ed. W. C. Cockerham, Blackwell Publishing, Oxford, pp. 23–42.
Schaudig, H. 2001, Die Inschriften Nabonids von Babylon und Kyros’ des Großen samt
den in ihrem Umfeld entstandenen Tendenzschriften. Textausgabe und Grammatik,
Alter Orient und Altes Testament vol. 256, Ugarit-Verlag, Münster.
Schramm, W. 2001, Bann, Bann! Eine sumerisch-akkadische Beschwörungsserie,
Göttinger Arbeitshefte zur Altorientalischen Literatur vol. 2, Seminar für
Keilschriftforschung, Göttingen.
Scurlock, J. A. 2006, Magico-Medical Means of Treating Ghost-Induced Illnesses in
Ancient Mesopotamia, Ancient Magic and Divination vol. 3, Brill & Styx, Leiden.
——— , & Andersen, B. R. 2005, Diagnoses in Assyrian and Babylonian Medicine:
Ancient Sources, Translations, and Modern Medical Analyses, University of Illinois
Press, Urbana.
Seidl, U. & Sallaberger, W. 2005/2006, “Der ‘Heilige Baum,’ ” Archiv für
Orientforschung 51, pp. 54–74.
Sjöberg, A. W., Bergmann, E., & Gragg, G. 1969, The Collection of the Sumerian Temple
Hymns, Texts from Cuneiform Sources vol. 3, J. J. Augustin Publisher, Locust
Valley, N.Y.
Stol, M. 2000, Birth in Babylonia and the Bible: Its Mediterranean Setting, Cuneiform
Monographs vol. 14, Styx Publications, Groningen.
Taracha, P. 2001, “Hethitisch Ékippa- und das Sumerogramm (É.)GI.PAD
mesopotamischer Texte,” Altorientalische Forschungen 28, pp. 132–146.
Turner, V. 2000 [1969], Das Ritual: Struktur und Anti-Struktur, German translation of
The Ritual Process, Structure and Anti-Structure, by S. M. Homburg-Scherff,
Campus Verlag, Frankfurt.
Versnel, H. S. 1993, Inconsistencies in Greek and Roman Religion II: Transition and
Reversal in Myth and Ritual, Studies in Greek and Roman Religion vol. 6, Brill,
Leiden.
Wilcke, C. 2002, “Vom göttlichen Wesen des Königtumes und seinem Ursprung im
Himmel,” in Die Sakralität von Herrschaft. Herrschaftslegitimierung im Wechsel der
Zeiten und Räume. Fünfzehn interdisziplinäre Beiträge zu einem weltweiten und
epochenübergreifenden Phänomen, ed. Franz-Reiner Erkens, Akademie Verlag,
Zgoll, A. 2003, “Audienz—Ein Modell zum Verständnis mesopotamischer
Handerhebungsrituale. Mit einer Deutung der Novelle vom Armen Mann
von Nippur,” Baghdader Mitteilungen 34, pp. 181–203.
——— . 2006, “Königslauf und Götterrat: Struktur und Deutung des babylonischen
Neujahrsfestes,” in Festtraditionen in Israel und im Alten Orient, ed. E. Blum &
R. Lux, Veröffentlichungen der Wissenschaftlichen Gesellschaft für Theologie
vol. 28, Gütersloher Verlagshaus, Gütersloh, pp. 11–80.
3
Jesus and His Followers as
Healers: Symbolic Healing
in Early Christianity
Gerd Theissen
My so-called habilitation thesis on Early Christian miracle stories (Theißen

1974)1 more than thirty years ago was a rehabilitation of these small but
very popular stories. I defended them against their interpretation as texts
with a hidden theological message concerning a spiritual salvation. The
telling of these stories appeared to me as a kind of “symbolic action” coping
with concrete predicaments of life such as sickness and danger, despair and
anxiety, isolation and oppression. Telling miracle stories was a rebellion
against the hardness of the struggle for life—with the effect of reducing
anxiety and creating confidence. Whether these miracles had really hap-
pened was not my point. When I was about to finish the book, I met a
cultural anthropologist who was familiar with exorcisms in the Ethiopian
church (Theißen 1974, p. 248 n. 51). She told me that possession by demons
is widespread among Ethiopian women of the lower classes. Priests are able
to free these women from demons who actually endanger their health and
life. The exorcisms are performed according to patterns and scripts compa-
rable to the New Testament stories. During the exorcism the congregation
surrounds the priest and the possessed woman. The priest threatens the
demon, the demon opposes the exorcism by violently shaking the body of
the possessed, but in the end it is forced to leave the woman’s body. She
seems to be dead but is reanimated after a while. I must have listened with
a very skeptical look on my face, for she finished her report by saying: “And
if one of the bystanders looks as skeptical as you, the demon will immedi-
ately enter you.”
To be sure, no demon entered my mind, but rather certain doubts concern-

ing whether I had written the book with adequate knowledge of exorcism and
healing. Since then I have been increasingly convinced that symbolic healing
throughout the world, and above all in traditional societies, is the best anal-
ogy to the exorcisms and healings of Early Christianity. And I asked myself
whether there is perhaps more life-reality in the background of the miracle
stories in the Gospels than we had imagined. It is true that the telling of miracle
stories is a symbolic act opposing real problems, but these stories describe real
healings that were performed with the help of symbols and rituals and may
have had therapeutic effects.
This chapter applies established theories of symbolic and ritual healing
from cultural anthropology to the miracles of Jesus. It does not aim to develop
a new theory on the efficacy of ritual healing, though it will add some new
elements to these theories. But our first aim is to show that applying these
theories is justified and will help us to understand better the healing activi-
ties of Jesus and his followers. Whereas historical critical research tended to
interpret traditions of healings and exorcisms as literary constructions and to
diminish their historical reality, conservative research defended their historic-
ity, not because they could be explained by our knowledge of symbolic heal-
ing, but rather because they were regarded as true “miracles.” To understand
Jesus and his followers as symbolic healers is therefore a new approach in
biblical studies, developed within the last decades and influenced by insights
from cultural anthropology. This new understanding of Jesus’ healings is no
relapse into premodern hermeneutics that considered miracles as proof of
Jesus’ uniqueness. If we consider charismatic healers throughout the world as
analogies to Jesus, this uniqueness cannot be maintained. Using these analo-
gies is a hermeneutical progress, because they may give us a better under-
standing of the miracles of the Gospels. We discover more life in these stories.
We may even discover individual features that are not absolutely unique but at
least particular to their historical context. Still, there is a problem that makes
historical-critical scholars reluctant to interpret the healings of Jesus in this
way: a story is not history. There is a gap between text and historical reality.
Therefore, I will first discuss the historicity of Jesus’ healings. Second, I will
deal with the question of whether it is justified to classify them as symbolic
and social healings. Third, I will treat the efficacy of Jesus’ healings and exor-
cisms, applying the common theories on symbolic and ritual healing to them.
We shall see that we must modify these theories in some regard so that they
fit the evidence. Therefore our second aim is to suggest some modifications
of established theories.
jesus and his followers as healers 47
1 The Problem of Historicity of Jesus’ Healings and Exorcisms
Let’s consider three theses of historical skepticism with regard to miracles in

the New Testament. The messianic propaganda thesis says that the miracles were
told and invented in order to proclaim Jesus as the Messiah; a specific Jewish
hope produced them. This argument was elaborated by David Friedrich Strauß
in the nineteenth century (1808–1874). The miracle pattern thesis says that the
miracles were told and invented according to general patterns of miracle stories
in antiquity. This argument was developed by the form historical school at the
beginning of the twentieth century. The thesis of a late origin of the miracle sto-
ries says that within Christian traditions the miracle stories originated relatively
late and were added to layers containing no miracles. This outsider thesis was
developed in the last few decades (Schmithals 1997).
1.1 The Messianic Propaganda Thesis

The “messianic propaganda” thesis says that since people expected the
Messiah to perform unique miracles, these were ascribed to Jesus, either being
transferred from other miracle workers to him or being invented or shaped
according to messianic expectations. Jesus was said to have fed the crowd in
the wilderness like a new Moses. However, there are some problems with this
thesis. In Judaism there is not an expectation that the Messiah performs mir-
acles. In the Psalms of Solomon, dating from the first century BCE, he does not
perform any miracles (cp. PsSol 17 and 18). At the turn of the new century mes-
sianic pretenders appear in Palestine as popular kings, but nothing is reported
about miracles. During the entire first century CE many charismatic prophets
and other figures appeared in Judaism—John the Baptist and some proph-
ets—but none of them attracted miracle stories, although John the Baptist was
regarded as a new Elijah and Elijah had performed miracles according to the
Old Testament. In the second century CE Bar Kochba was proclaimed the Mes-
siah without miracles being ascribed to him. We do, however, hear of a charis-
matic healer Chanina ben Dosa in Galilee, a contemporary of Jesus, but he did
not claim to be the Messiah or a prophet at all. We may therefore conclude that,
although miracle stories are not associated with all charismatic figures in those
days, the great number of miracle stories associated with Jesus may be due to
his historical activity. But there is a grain of truth in the idea that expectations
created them. In some biblical and other Jewish texts there is the expectation
that God will perform miracles in the last days (Jes 61:1; 29:18 f; 35:5 f; 42:18;
4Q521). Inspired by this expectation, the imprisoned John the Baptist sent mes-
sengers to Jesus asking whether they should wait for another one. Jesus did not
answer by saying, “Look, I am doing miracles,” but rather he said: “Go and tell
John what you hear and see: the blind receive their sight, the lame walk, the
lepers are cleansed, the deaf hear, the dead are raised, and the poor have good
news brought to them.” He states, with many allusions to old eschatological
expectations, that miracles are occurring but does not attribute them to himself
(Mt 11:2–6). He regarded God as the actual author of these miracles, which are
performed either through him or through his disciples or even through other
miracle workers. Indeed eschatological expectations may have produced some
miracle stories as signs and symbols of an eschatological fulfillment.
1.2 The Miracle Pattern Thesis (of the So-Called Formgeschichte

or “Form History”)
The second argument of historical skepticism is based on the fact that the mir-
acle stories in the Gospels contain many recurrent motifs of miracle stories
in antiquity. This argument refers not to specific Jewish expectations but to a
general ancient belief in miracles among both Jews and Gentiles. Some typical
motifs include the approaching of the sick person, his or her difficulties get-
ting in contact with the miracle worker, specific healing manipulations, and the
amazement of the crowd. The stories are told according to traditional patterns.
Therefore, they probably reflect the competence of storytellers more than they
do real history. Nevertheless, this form-historical skepticism is less convinc-
ing if we really take into regard all forms of the miracle tradition; miracles are
described in three forms: in words, stories, and summaries.
In the word tradition, we encounter the typical features of Jesus’ message.
He speaks of repentance which may be expected from those who experienced
miracles (Lk 10:13–15), he states that the kingdom of God is realized by his exor-
cisms (Lk 11:20), and he underlines the power of faith to move trees (Lk 17:5 f).
In the narrative tradition, miracle stories lack most of these motifs. Jesus never
addresses God as father, he never calls others to follow him or to repent, and
he never speaks of the kingdom of God. The eschatological framework of his
message is nearly totally absent (except in Mt 8:29). There is only one com-
mon denominator: the motif of faith is present in both traditions. Therefore, it
deserves special attention, as we will see. The third form of miracle stories,, the
summaries,, speak of healings and exorcisms without mentioning other kinds
of miracles such as walking on water or multiplying bread. One summary of
Jesus’ life is even a non-Christian document, the testimonium Flavianum of
Josephus. It says that Jesus was a “performer of miraculous deeds” (Jos. ant
18:63 f ). We may infer from this that in the first century the rumor of Jesus’
miracles reached people who, like Josephus, were not his adherents.
In my view, this is the key to understanding the difference between word
and miracle tradition. The “word tradition” indicates the tradition of Jesus’ dis-
ciples, who agreed with his message. In contrast, the miracle tradition lacks
individual features of Jesus’ message because they were spread throughout
the people in Palestine and its neighborhood. Here Jesus was experienced and
shaped according to the general patterns of miracle workers in antiquity. He
was enhanced and idealized, and fantastic stories were told of him that could
never have happened. But in spite of this popular “shift” from history to story,
there is a historical core behind these stories. Why do I say this?
Even in their popular present shape we find individual features. Jesus does
not heal broken legs or wounds or the bite of a snake. Traditional societies
often have specialists for such “violations” by external factors (Bichmann 1995,
p. 61), and Jesus was not such a specialist. In the Jesus tradition we exclusively
hear about two forms of healings: “therapies” for sickness from internal causes,
and exorcisms of possession by external spiritual beings: the two overlap. There
are sicknesses caused by demons, but they can be distinguished from posses-
sions, the substitution of a human ego by a demon. Therapies often presup-
pose a magic “healing power” that fills the sick person through contact with the
healer, whereas exorcisms presuppose a struggle between the healer and the
demons. Therapies fill the sick person with power, exorcisms empty the pos-
sessed of the demon. Therapies use contagious magic, exorcism antagonistic
magic. There is an opposite dynamic at work in the two forms.
Moreover, in both kinds of healing, Jesus does not use all the means that
we find among his contemporaries. He never prays in order to heal a person (as
Chanina ben Dosa did, cp. bBer 34b), and he never uses material substances
in order to drive out a demon (as the Jewish exorcist Eleazar did, cp. Jos. Ant
8:46–48). We may conclude that, since not all kinds of healings and not all
motifs of typical miracle stories are found in the Jesus tradition, the accounts
are probably based on actual activities of the historical Jesus. Instead of being
assimilated into general patterns, his figure has an individual profile within
the miracle tradition.
1.3 The Thesis of a Late Origin of the Healing Stories

A third argument of historical skepticism, developed by W. Schmithals, claims
that since the miracles of Jesus are absent in the letters of Paul, the earliest
writings of Early Christianity, and also missing in the Gospel of Thomas, a
Gospel that some consider as being independent of the canonical Gospels,
therefore the first writer of the oldest Gospel may have invented these miracle
stories. But the reconstruction of an early stage without miracles is not pos-
sible. Paul says that he himself has effected the “signs” of an apostle, that is,
that he worked those miracles that are expected of a true apostle (2 Cor 12:12),
but he does not report any miracles performed by Jesus. In fact, Early Chris-
tian letters do not mention any miracles of Jesus at all, in spite of the fact that
they knew some of them. The second letter of Peter shows acquaintance with
at least one synoptic Gospel, the first letter of John knows the Gospel of John,
and the letters of Ignatius know the Gospel of Matthew (cp. also Barn; 2 Clem).
None of these letters says anything about miracles, but they are familiar with
the miracle tradition of the Gospels. And the Gospel of Thomas is a composi-
tion of sayings that includes no stories at all. But even this Gospel refers to
healings of the disciples (ThomEv 14). The silence of Paul and the Gospel of
Thomas are no arguments for a late origin of the miracle tradition.
Positively, we may say that the historicity of Jesus’ miracles is based on
their multiple attestations in independent traditions: in the Logia source and
in the Gospel of Mark, in the special tradition of Matthew and of Luke, and
also in the Gospel of John as far as it is an independent witness. If, according
to form history, all small miracle stories are basically independent traditions
shaped according to standard narrative patterns, we have many more such
sources. As a whole, they are no invention. Besides, we encounter some fea-
tures that could not have been invented. The exorcisms provoke the question
whether Jesus is acting on behalf of Satan (Mk 3:21 ff). This charge against
Jesus must be authentic. Mark states that Jesus was unable to perform healings
in his hometown because of the lack of belief in Jesus there (Mk 6:1 ff).
To summarize my considerations concerning the historicity of the mira-
cles: the miracle tradition is no late invention produced by Jewish messianic
expectations and a general ancient belief in miracles. But there is a “popular
shift” that transformed the historical memory of Jesus as a healer and exorcist
according to general patterns of ancient beliefs in miracles and according to
specific Jewish messianic expectations. However, the tradition undoubtedly
has a historical core. Jesus was a healer and an exorcist.
2 The Problem of Classifying Jesus’ Healing Activities
Our next question is, “May we compare Jesus with other healers and exor-
cists?” Is his healing activity “charismatic and symbolic healing” or “ritual
and social healing”? The four labels “charismatic,” “symbolic,” “ritual,”
and “social” refer to different aspects of traditional healings, to psycho- and
sociotherapeutic effects (Bichmann 1995, p. 46). I think it is appropriate to

apply all of them to Jesus.
The term “charismatic healing” refers to the personal relationship between
a charismatic healer and his adherents. Charisma is an interaction between a
charismatic person and his adherents characterized by confidence and faith.
This is expressed by the formula, “Your faith has saved you.” This faith or
confidence is created by the rumor of Jesus’ miraculous deeds. Healing stories
are therefore not merely secondary with regard to their underlying healings.
On the contrary, they often play a constitutive role in healings from the out-
set. They trigger expectations among the people. We sometimes read in the
Gospels that the rumor of Jesus’ healings is spreading (Mk 1:28.45; 5:14.20;
7:37) or that people come to Jesus after having heard this rumor (Mk 7:24 f.).
This rumor is the origin of the miracle stories in Jesus’ lifetime. They func-
tioned as faith-generating stories.
The second term, “symbolic healing,” refers to the cognitive imaginations
working in the healer and his clients. We encounter two symbolic concepts in
therapies and exorcisms: the imagination of a magic power filling the client,
and the imagination of an antagonistic struggle freeing the possessed from
the demon. Neither the healing energy nor the demons are physical realities;
instead, they are powerful symbols working within the brains of the sick per-
son and the healer. Other powerful imaginations are less frequent: forgiving
sins (Mk 2:1–12) and a declaration that a leper is ritually clean (Mk 1:40–45).
Furthermore, we find the conviction that the transformation of a sick person is
part of an eschatological transformation of the whole world—a conviction that
is above all active in the miracle workers; we find this symbolic conviction only
in the “word tradition,” which probably was transmitted by itinerant follow-
ers of Jesus who performed miracles (Mt 10:7–8), whereas this eschatological
expectation is absent in the narrative tradition which probably was transmitted
also among the people of Palestine who were not itinerant followers of Jesus.
Both charisma and symbols constitute the psychosomatic or psychosymbolic
dimension of healings and exorcisms. But they also have an external aspect
supporting and reinforcing these internal psychic processes.
The third term, “ritual healing,” refers to this external aspect, namely the
visible performance of healing manipulations according to traditional patterns,
which can be repeated again and again: the laying on of hands or the use of saliva
(Mk 7:33; 8:23; Joh 9:6). These ritual devices triggered a tradition of healing in
Early Christianity, which is somewhat different from the one associated with
Jesus. According to the letter of James 5:13–16 the elders shall come together
if a member of the congregation is sick. Then they are to pray for him (though
prayer was no part of Jesus’ healings), anoint him with oil (though oil was never
used in the healings of Jesus), and heal in his name (though Jesus never used
his or God’s name in his healings). The prayer probably substitutes the elders
for Jesus, the oil for his saliva, and his “name” for his personal presence.
The fourth term, “social healing,” refers to the community in which the
ritual acts are performed. Jesus’ healing activates social support in favor of the
sick and thereby reintegrates them into their community. At the end of each
miracle story the healed people are sent back to their houses and families. Some
symbols refer directly to social peace: the forgiveness of sins may reconcile a
group. The declaration of cleanliness returns the leper to social life, because
being regarded as unclean had caused his isolation. But there is a problem: the
healings of Jesus provoke conflicts as well. Forgiving sins and declaring a leper
clean were the privileges of priests, and Jesus acts in their place. This process
provokes protest and stress. The theory of social healing as reducing social
stress must therefore be modified if it is to be applied to Jesus’ healings.
In conclusion, we can say that it is justified to categorize Jesus’ healing
activity as charismatic, symbolic, ritual, and social. Charismatic and symbolic
healing both refer to its psychosomatic dimension, ritual and social healing to
its sociosomatic dimension. Healing acts are facilitated by personal charisma
and mediated by internal symbols; they are ritually embodied and socially
embedded.
3 The Efficacy of the Healings of Jesus and of the

First Christians
If Jesus’ healing acts can be categorized as symbolic and social healing, their
efficacy is above all due to faith. Faith is based on a charismatic relationship
between the sick person and the healer. In the stories of Jesus’ healing, faith
includes also the faith of those who support the sick. The efficacy of faith is our
first point. But a problem remains: the healings of Jesus not only create social
harmony but also provoke conflicts. The significance of social conflicts is our
second point. Our last point is the significance of the ritual aspects of Jesus’
healings. “Faith” in our miracle stories is sometimes visible. When the sup-
porters in Mk 2:1 ff remove the roof of a house and let down the mat on which
a paralytic lies in order to bring the sick person to Jesus, the story says, “When
Jesus saw their faith” (Mk 2:5). What the supporters do does not seem to be a
repetitive act, although sometimes it is construed as such: an apotropaic rite to
avoid the threshold of the house in order to increase therapeutic efficacy. In folk
belief, the threshold is sometimes believed to be the place of demons who pre-
vent people or supernatural powers from entering the house. The supporters
of the paralytic avoid the threshold and thereby outsmart the demons. But this
idea is disputed. With ritual elements of healings we understand all visible and
repetitive acts with a symbolic meaning, whose performance is believed to have
a physical impact on human beings. Also in this regard we come across a spe-
cial problem: along with an increase in social conflicts, we also find a reduction
of ritual elements. Our third point is therefore the efficacy of ritual elements in
the healings of Jesus.
3.1 The Efficacy of Faith: Jesus as Charismatic and Symbolic Healer

Concerning the efficacy of faith, the same can be said of all symbolic and social
healers (but also of a good modern biomedical physician). What is striking with
Jesus is that he consciously reflects this efficacy through faith: He has discov-
ered the power of faith and coined the formula: “Your faith has saved you!” As
it stands, this formula is unique in antiquity but not without analogies.
In Epidauros in Greece, for example, in the healing cult of the god Ascle-
pius, visitors were confronted with inscriptions reporting many healings and
with votive tablets of those who had been cured by the god. These inscriptions
had the same function as the rumor of the miracles of Jesus in Palestine; they
instilled confidence. One of the first inscriptions reflects the “faith” implicit in
these inscriptions, but does so in a different way than in the Jesus tradition:
A man who could move only one finger of his hand came to the god as a sup-
plicant, and when he saw the votive tablets in the sanctuary he did not believe
in the cures and made fun of the inscriptions. In his sleep (in the sanctuary) he
had a vision. It seemed to him that as he was playing dice in the room under
the temple and was about to throw, the god appeared, jumped on his hand, and
stretched out his [the man’s] fingers. When he [the god] stepped off [the man’s
hand], he saw himself bend his hand and stretch out each finger on its own;
when he had stretched them all out straight, the god asked him whether he still
did not believe the votive tablets. And he said no. “Because before you had no
faith in them, though they were worthy of belief, your name in future shall be
Apistos,” said the god, and when the night ended he emerged from the sanctu-
ary cured (Epidauros Nr. 3).
This miracle story is a metastory referring to other miracle stories in the
temple of Asclepius. Faith in Epidauros means belief in the miracle stories.
This faith does not produce miracles but reacts to them. In the Jesus tradition,
faith is more than such a receptive faith, it is an active faith producing miracles.
Jesus says that faith is able to move mountains (Mk 11:22 ff ). This active faith is
attributed to three human roles in the miracle stories and we may derive three
theses from these texts.
1. First of all it is the faith of those who are healed. It is the faith of the woman
with the issue of blood who approached Jesus from behind in the crowd, hop-
ing “If I touch his clothes, I will be made well.” Jesus said to her after she told
her story, “Daughter, your faith has saved you, go in peace, and be healed of
your disease” (Mk 5:34). It is the faith of the blind Bartimaeus and the two
blind men (Mk 10:52; Mt 9:29). It is the faith of the Samaritan who returned
to Jesus in order to thank him (Lk 17:19). His faith saved him. This motif cor-
responds with the word on faith: “If you had faith of the size of a mustard seed,
you could say to this mulberry tree, ‘Be uprooted and planted in the sea,’ and
it would obey you” (Lk 17:6). This motif is probably an authentic trace of the
historical Jesus—preserved on the one hand in the word tradition of the Logia
source (Lk 17:6) and Mark (Mk 11:22 f ), and on the other hand in many narra-
tive stories. The motif surpasses ancient analogies and can scarcely be a later
Christian retrojection, since “faith” in Christian tradition is primarily faith in
Christ, his death, and resurrection. The faith of the miracle stories is much
more general. How are we supposed to evaluate this faith motif ? Its point is the
causal attribution of effective healing to the faith of the healed persons. This
causal attribution is not at all a matter of course. We must remember that the
sick people come to Jesus expecting help. They attribute the healing power to
him. But the healer reattributes this power to their own faith—contrary to their
expectations. In premodern times we encounter a remarkable consciousness
of the power of confidence and faith. Today we know quite well—by experi-
ence and experiments and explanations through theoretical models—that faith
and confidence can support healing processes on the side of both the patient
and the physician. But it seems that Jesus has already discovered the healing
effect of faith intuitively. His “discovery” is basically in harmony with modern
research on the so-called placebo effect (Brody, chapter 8 of this volume). It
is true that Jesus worked without medication, except saliva as a kind of folk
medicine. But we may apply a theoretical model that explains the efficacy of
placebos to his healings; that is the expectancy model. A deep-rooted expecta-
tion that a therapeutic practice will be effective (even if it is an inert medicine)
enhances its efficacy, especially if this expectation is shared by patient and phy-
sician (Brody, chapter 8, this volume). This expectation activates the body’s
own physical and chemical substances. In addition the meaning of the illness
experience is changed for the patient. He feels the care and compassion of the
healer and experiences mastery over his illness. Thus we have in our brains a
wonderful drugstore that offers no manufactured medicine; rather, symbols
and other cognitive convictions activate the body’s healing potential and in this
way support the healing process. Healers work with this “symbolic medicine”
by faith and expectation. It is true that these therapeutic means often do not
directly cure disease, but they improve the general conditions of health and
thereby make it easier to live with an illness. Also most biomedical treatment
in our days does not cure illness but rather helps us to live better and longer
with our diseases or handicaps. Premodern healers did the same—and in light
of the short life expectancy in premodern societies, they were sometimes as
successful as modern physicians.
2. In a second group of evidence, faith is the faith of those who support the
sick person—a kind of vicarious faith. It is the faith of those who carried the
paralyzed man to Jesus and approached him through the roof of the house.
This story states that Jesus saw their faith. He saw their confidence in his
healing power (Mk 2:5). It is the faith of the father Jaïrus, who asked Jesus
for help and was told, “Do not fear, only believe” (Mk 5:36). It is the faith of
the Syrophoenician woman, who asked for help for her demonized daughter
(Mt 15:28). It is the faith of the father of the epileptic boy, who brought his son
to Jesus. Jesus said to him, “All things can be done for the one who believes.”
The father answered, “I believe, help my unbelief ” (Mk 9:23 f ). It is also the
faith of the centurion of Capernaum, who asked Jesus to heal his servant, to
which Jesus replied, “Truly I tell you in no one in Israel have I found such
faith” (Mt 8:10).
The faith of the supporters has been an argument against the psychoso-
matic explanation of the healings. At first glance, it seems improbable that the
supporters’ faith could help the sick person; it is easier to imagine that the sick
person’s faith helps him. In two cases the sick persons were not even present
and Jesus performed a healing from a distance. In both cases non-Jewish, Gen-
tile people were healed. This is often explained as a symbol for the “miracle”
that the Christian message spread to non-Jews. The miracle is said to be a
symbol of overcoming the distance between Jews and Gentiles. But this vicari-
ous faith—and even the faith working from a distance—may be effective. Are
faith and confidence effective only in the faithful persons themselves? Here, we
may apply the theory of social healing. The sick persons are embedded in their
social group. The healer is activating social support for them. Therefore, the
faith of the supporters is important for the efficacy of healing. The shared faith
may have positive effects, reducing social stress and conflicts.
But what about healing from a distance? I think this can also be explained
by faith.2 In the 1950s a physician in Hamburg cooperated with a healer in
Munich, who was a lawyer by profession (Rehder 1995). The healer was con-
vinced that he was able to cure persons from a distance by sending them mes-
sages at certain times. The physician asked him to treat three patients who
were seriously ill, but he did not inform the patients of this treatment. He
and his patients did not notice any relief after the hours when the spiritual
healer sent his message to Hamburg. After this failure the physician informed
his patients of the healer in Munich and of his extraordinary power to heal
from a distance. He gave them writings of the healer and announced a spiri-
tual treatment at a particular time. The healer himself was not informed, and
he certainly did not send any healing messages in this particular moment.
He did not know anything of this “experiment.” All three patients noticed a
remarkable relief after the fictive time and hour. Their health was significantly
improved, at least for a while. Therefore, in order to explain the distant heal-
ings of Jesus we must presuppose only that the Syrophoenician woman told
her little daughter that she was looking for help from a famous Galilean healer,
and the servant of the centurion of Capernaum had knowledge of his master’s
attempt to meet this healer in order to ask him for help. This may explain why
the daughter and the servant felt better. We need not claim that these concrete
miracle stories really happened. It is enough to assume that such distant heal-
ings occurred and that the miracle stories were shaped according to such real
experiences. This second aspect of faith-cures in the New Testament is also in
harmony with modern research: the theory of social healing (cp. Sax 2007 and
Sax, chapter 1, this volume) says that premodern healers activate social help
for the patients and dissolve social conflicts. The reduction of stress by the
overcoming of deep-rooted conflicts in families, tribes, or a village facilitates
the healing processes.
3. In two texts the lack of faith explains the failure of healings. When the
inhabitants of Jesus’ hometown heard of his miracles, they were astounded
and said, “What deeds of power are being done by his hands!” (Mk 6:2). But
Jesus realized that he was without honor in his hometown and therefore the
story notes: “And he could do no deed of power there. Except that he laid his
hands on a few sick people and cured them. And he was amazed at their unbe-
lief ” (Mk 6:5 f ). When the disciples failed to heal the epileptic boy, Jesus com-
plained, “You faithless generation, how much longer must I be among you?”
(Mk 9:19). Jesus then healed the boy, but instructed his disciples: “This kind
(of demon) can come out only through prayer” (Mk 9:29). Moreover, a unit in
the word tradition also deals with the failure of exorcisms—without explaining
it by a lack of faith. The logion of the returning spirit says, “When the unclean
spirit has gone out of a person, it wanders through waterless regions looking
for a resting place, but it finds none. Then it says, ‘I will return to my house
from which I came.’ When it comes it finds it empty and put in order. Then it
goes and brings along seven other spirits more evil than itself, and they enter
and live there, and the last state of that person is worse than the first. So will it
be also with this evil generation” (Mt 12:43–45).
All three texts explain the failure of healings and exorcisms. There is no
doubt that Jesus and the early Christians had to cope with failure. One explana-
tion was a lack of faith—not only in the sick person but also in his social envi-
ronment. Healing charisma is the product of a healer and of expectations in a
group. If Jesus’ hometown has no confidence in the healing power of Jesus,
he cannot perform deeds there. Psychosomatic and sociosomatic healing is
nearly impossible under these circumstances. The logion about the return of
the demon corresponds to experience. After a relief through symbolic healing,
the relapse is all the more disastrous. If even the great healer fails, psychic
depression must be even worse. If we make a distinction between illness and
disease (Kleinman 1980; Pilch 2000) or in the German tradition of psycho-
somatic medicine a similar (though not identical) one between “Kranksein”
and “Krankheit,”3 we may say that the symbolic healing of Jesus and his fol-
lowers treat illness, they transform the social role, the self-estimation, and
the confidence of the sick persons, independent of the organic disease. On
the one hand, there is bottom-up causality from organic disease to the illness
of the whole person. But on the other hand, there is also top-down causality
from the improvement of the psychic and social situation of an ill person to
organic disease.
3.2 Healing and Social Conflict: Healing Efficacy in Spite

of Increasing Conflicts
So far, Jesus’ healing activity fits into the general pattern of symbolic and
social healing. But there is an unresolved problem concerning its sociosomatic
dimension. The healing efficacy of Jesus (and his followers) is certainly due
to in part to the reduction of social stress, but no doubt this healing activity
also increased social stress: some healings provoked conflicts. Jesus and his
message as well as the first Christians were disputed. Therefore, we cannot
say that Jesus’ activity generally reduced social conflicts and stress. On the
contrary, Jesus says to his followers, “Do you think that I have come to bring
peace to the earth? No, I tell you, but rather division! From now on five in one
household will be divided. Three against two and two against three, they will
be divided: father against son and son against father, mother against daughter
and daughter against mother, mother-in-law against her daughter-in-law and
daughter-in-law against mother-in-law” (Lk 12:51–53). Social healing means
that the healer reconciles conflicts in the family and the village, and this may
contribute to an improvement of health. But Jesus also created conflict and
stress. Must we therefore work without the theory of social healing if we try
to explain the healing activity of Jesus and the first Christians? Or must we
enlarge and modify the theory? Let me try to give two answers.
The first answer is that the words concerning a conflict in the families con-
cern those who follow Jesus on his wanderings. Jesus is addressing them when
he says, “Whoever comes to me and does not hate father and mother, wife and
children, brothers and sisters, yes, and even life itself, cannot be my disciple”
(Lk 14:26). These followers provoked conflicts at home. But in the miracle sto-
ries nobody—with the exception of the beggar Bartimaeus—is allowed to follow
Jesus. The healed are sent home. The antifamily ethos of the “word tradition”
is absent. Therefore, we should distinguish two social relations during Jesus’
lifetime: on the one hand, discipleship, which increased conflicts with home
and family; and on the other hand, healed persons, whose life in home and
family was restored (Onuki 2004). The words of Jesus are often addressed to
his disciples, who have experienced a break with home and family. The healing
activity is above all addressed to people in the villages who come to Jesus as a
famous healer.
But this answer does not explain everything. There are conflicts visible
not only within the “word tradition” but also within the “narrative tradition” of
healing immediately connected with the healing process. Jesus’ healing activity
sometimes violates norms. The second answer is therefore that the violation of
rules does increase the value of the healing—the value of both the healer and
the healed person.
First of all, violating norms increases the authority of the charismatic healer.
This effect can be observed in the texts. Jesus says to the paralytic: “Son, your
sins are forgiven”(Mk 2:5). The scribes protest: “Why does this fellow speak in
this way? It is blasphemy! Who can forgive sins but God alone?” (Mk 2:7). To
declare forgiveness is the privilege of God and his priests. Jesus’ authority is
divine authority. The same is true for the violation of the Sabbath. In John 5
Jesus legitimizes his healing on the Sabbath with the argument: “My Father is
still working and I also am working” (Joh 5:17). Presupposed is the conviction
that God continues to work on the Sabbath in order to preserve the creation.
His adversaries object that he is “making himself equal to God.” A third exam-
ple is the healing of the leper. Jesus says to him, “Be made clean!”(Mk 1:41). He
declares him clean and sends him to the priest for an official declaration. But
Jesus has already given this declaration. Therefore the healed leper does not
visit the priest. The implicit logic in these examples is that the person who is
justified in violating rules must have the same authority as the source of those
rules, that is, God. This enhancement of the authority of a charismatic healer
supports confidence and faith in him, and if his enemies refuse him, his adher-
ents will experience this increase in value and authority all the more.
The same is true for the healed person. If the charismatic healer risks a
conflict in order to help a person, his doing so sends a strong message, which
is that helping and healing are so important that even the violation of norms
is justified. Therefore the increase of value also concerns the healed person.
When Jesus breaks the Sabbath norms in order to heal or because his disciples
are hungry, he is demonstrating that the interests of human beings are more
important than the Sabbath. “The Sabbath was made for humankind, and not
humankind for the Sabbath” (Mk 2:27). The positive significance of violating
norms may be even stronger if the respective norms are causing stress. Intol-
erant norms increase psychic anxiety, normative intolerance provokes social
conflict. Hence breaking norms may sometimes be liberating and reconciling.
So we may say that social healing does not always reduce conflicts and
stress. Reducing conflicts and stress in a certain social reference group may
coincide with an increase of conflict and stress in a different social reference
group. We must take into account that Early Christianity as a whole not only
reduced social conflicts but also increased them for its members. They enjoyed
some healing charisma within their small congregations, but they had to toler-
ate discrimination within the society as a whole.
3.3 Healing and Ritual Elements: Healing Efficacy in Spite of

a Reduction of Ritual Elements
Social healing occurs by perceptible signs, by words, gestures, and material
means. All these signs may be understood as ritual elements. Jesus himself
used such ritual gestures, but he reduced them in comparison with contempo-
rary healers. Josephus writes on the exorcism of Eleazar, another first -century CE
Jewish exorcist:
I have seen a certain Eleazar, a countryman of mine, in the presence

of Vespasian, his sons, tribunes and a number of other soldiers, free
men possessed by demons, and this was the manner of the cure:
he put to the nose of the possessed man a ring which had under
its seal one of the roots prescribed by Solomon, and then, as the
man smelled it, drew out the demon though the nostrils, and, when
the man at once fell down, adjured the demon never to come back
into him, speaking Solomon’s name and reciting the incantations
which he had composed. Then, wishing to convince the bystanders
and prove to them that he had this power, Eleazar placed a cup or
footbasin full of water a little way off and commanded the demon,
as it went out of the man, to overturn it and make known to the
spectators that he had left the man. And when this was done, the
understanding and wisdom of Solomon were clearly revealed.
(Josephus ant. 8:46–49)
The means of healing are ring and roots, in addition to some magic for-
mulas and the name of the mighty king Solomon. In the stories of the Jesus
tradition such ritual elements are absent, but others are present. Sometimes
the public is excluded, as if Jesus tried to hide some magic practices (Mk 5:40;
7:33; 8:23; cp. Acts 9:40). Many healings occur by his touching the sick, as if a
mysterious power were transmitted (Mk 5:30). The most important means of
healing is the miraculous word. Sometimes it is said in Aramaic (as so-called
rhe-sis barbarike-) and transmitted like a charm (Mk 5:41; 7:34). We encounter
also saliva or a paste made of saliva and earth (Mk 7:33; 8:23; Joh 9:6 f). The
apotropaic significance of spitting is not totally absent: When a “chain of his
tongue” is salved with saliva (in the healing of the deaf man in Mk 7:35), it must
be that the demons have caused a “chained tongue.” But no name of a great
master is conjured, no prayer is said, no magic formula is cited from an old
powerful book. We encounter in the Jesus tradition only a minimum of ritual
gestures and elements, and these are surrounded by a magic aura.
But are such gestures rituals (see Dinzelbacher, chapter 4 of this volume)?
To be sure, they are not elaborated rituals, but rituals in statu nascendi. Never-
theless we may speak of rituals, because they are visible and repetitive acts with
a symbolic meaning, whose performance is believed to have a physical impact
on human beings. We must also take into account that the few ritual elements
in the healings of Jesus are only a selection out of a much larger repertoire of
ritual elements in the Jewish culture of those days. And they differ also from
the elaborated rituals of the old church as the early Christian Eucharist differs
from the Catholic mass. They are only rituals under development.
This selection of ritual elements is important. It conveys a message. In the
healings of Jesus, those ritual elements that underline the personal relation-
ship between the healer and the sick person prevail. Taking the sick person
aside focuses the healing on personal contact. Healing words are at the center.
The contact by words is enhanced through contacts by touching. By the lay-
ing on of hands, a person is given a special status as successor or the gesture
conveys blessings (Lang 1995, pp. 27 f ). The most intensive contact occurs by
means of saliva. In antiquity, saliva is a drug against diseases of the eyes (Epi-
dauros W 4; 9; Tac. hist. 4:81). Therefore it is unique that Jesus cures by saliva
not only blind people but also a deaf man with an impediment in his speech
in Mk 7:33 f: “He took him aside in private, away from the crowd, and put his
fingers into his ears, and he spat and touched his tongue. Then looking up
to heaven, he sighed and said to him, ‘Ephatha,’ that is, ‘Be opened.’ ” Does
the story say that Jesus put his fingers into the ears but then took them out of
the ears and brought the saliva with his fingers to the tongue? The grammar
does not exclude such an interpretation. But it is much more probable that
Jesus grasped the head of the deaf man with his hands, put his fingers into his
ears and at the same time touched the deaf man’s tongue with his own. This
was a ritual gesture similar to a kiss—a symbol of care and love! Recall that
Early Christianity knew the ritual gesture of the “holy kiss” (Rom 16:16; 1 Cor
16:20; 2 Cor 13:12; 1 Thess 5:26; 1 Petr 5:14).
Nevertheless we must acknowledge a poverty of ritual gestures in the Jesus
tradition. This “poverty” is symbolically very significant, because the few ritual
gestures, which are all selected from a larger repertoire of ritual elements, sig-
nify an increasing proximity to the sick person—by words, touching, and finally
a “kiss.” Such ritual acts correspond to the character of Jesus’ healings as cures
by faith, if we understand by faith the personal confidence of the sick person in
the healer. But this reduction of ritual elements and the concentration on some
symbolic acts does not at all mean that the magic aura disappears in favor of
a personal relationship. Both aspects of the ritual elements are crucial for the
healing process and its efficacy. The healing efficacy of both aspects, the magical
and the personal, can be explained by the two main psychological hypotheses
proposed to explain the placebo effect, namely, conditioning and expectancy
(Brody, chapter 8 of this volume). Jesus approaches sick persons by means of
communicative interactions, which all people are familiar with, because they
recur in many everyday situations. We all know by “conditioned learning” that
words can give comfort, that contact with hands and mouth express love and
care. Such elements trigger a feeling of security and acceptance. The efficacy of
the personal aspects of the ritual elements is partly based on such conditioning
by very frequent acts.
The efficacy of the magic aura, on the other hand, is based on the expec-
tancy that is aroused by very rare phenomena. Such an aura raises cognitive
expectations that a powerful healer is at work. Therefore Jesus arranges myste-
rious acts: taking the sick person aside, speaking mysterious words, and using
saliva. The magic surplus that transcends everyday communication supports
the healing effects in the following way: If people perceive the healer as a pro-
fessional and powerful healer in an adequate setting—this is in antiquity a
magic aura—they have more confidence in him.
Therefore neither the magical nor the personal aspect of these ritual
elements should be neglected. The efficacy of ritual acts with such a double
internal and external aspect may be explained by the Zielbezogenheits Hypoth-
ese of I. Rösing. This theory comprises three hypotheses concerning (1) the
correspondence between healer and the sick person, (2) the correspondence
between internal and external processes, and (3) the correspondence between
different spheres of cognitive knowledge (Rösing 1990, pp. 714–727).
1. The correspondence between healer and the sick person requires a
consensus between them on the target of their acts, so that both can activate
those aspects of their symbolic worlds that can be referred to the target. In this
regard, there is a correspondence between Jesus and the sick persons. Jesus
has an understanding of himself as a powerful healer, and the people attribute
to him such healing power.
2. According to Rösing’s Konvergenz Hypothese, the correspondence
between internal and external processes supports the efficacy of internal cog-
nitive symbols. Symbolic healing is more effective if internal processes are
accompanied by external acts. We have seen that all external ritual elements
underline an internal personal relationship: all other relationships disappear.
Jesus does not pray to God, traditional knowledge of healing does not legiti-
mize his healings, he does not use a powerful name like “Solomon.”
3. According to Rösing’s Wissens-Kreis Hypothese, the correspondence
between knowledge of our own life, of the community, and of the cosmos fur-
ther supports the efficacy of healing. For Jesus and the first Christians, their
healing activities were embedded in the transformation of the whole world. The
transformation of human beings was only a part of a much greater transforma-
tion of the world. But we find this view only in the tradition of Jesus’ words.
In the tradition of the miracle stories, the view prevails that Jesus is the crucial
figure in the history between God and human beings. He is the Son of God.
The development from Jesus to early Christianity changed the practice of
healing and its understanding: The healing rite in James 5:13–16 does not hap-
pen apart from the public, but occurs in the assembly of the elders at the bed of
the sick person. The healing rite activates not only the confidence between the
elders and the sick patient, but also confidence in third figures: in God through
prayer, in Jesus by calling his name. Saliva is substituted for oil. The charisma
of Jesus is reified; it becomes independent of the personal quality of the par-
ticipants. The collective act of forgiving of sins demonstrates in a ritual way the
basic condition of all symbolic healing: the restitution of social harmony within
the community.
Summary
My first aim in this chapter was to apply established theories on symbolic and
ritual healing to the healing activity of Jesus and his followers. Using such
theories in historical studies often means modifying them to make them fit the
evidence. Therefore I underline some new elements in the theories on sym-
bolic and ritual healing that I want to suggest.
First, Jesus and the first Christians performed symbolic healings and are
in this regard comparable to other healers in the world who activate faith and
confidence even if they do not know they are doing it. But Jesus (and the first
Christians) consciously discovered the healing power of faith, an understand-
ing that partly accounts for the efficacy of all symbolic healing. Faith according
to them was the crucial factor for the efficacy of symbolic healing. This point
is less trivial than it may seem. As a rule, the efficacy of faith works uncon-
sciously. People believe that magic, drugs, or rituals help them, and they are
not aware of the power of their own confidence. Placebos no longer function if
everyone knows that they are placebos. But in the Jesus tradition it is said: Your
faith has saved you. It is not the (etic) statement of a neutral observer, but the
(emic) statement of the healer.
A second element is that the symbolic healing of Jesus and the first Chris-
tians was social healing, but the support they activated and the reduction of
stress they achieved was limited to their adherents and congregations, who at
the same time had to tolerate increased social stress and tension in their broader
social environment. Social tension around healing activities may sometimes
increase the value of healings, of the healer, and of the healed person, and it
may thereby contribute to the efficacy of healing. Therefore we suggest adding
to the theory of social healing the fact that the efficacy of healing is due to the
reduction of conflicts,, and we stress a new element. There is also the pos-
sibility that an increase of conflict and stress may in some cases enhance the
efficacy of healing. There is a common denominator for both possibilities: the
intensity of care and help is increased in both cases. Basically the theory of
social healing is substantiated.
Third, Jesus and the first Christians performed acts of ritual healing.
Jesus gives traditional ritual elements and gestures a special accent. He
underlines the immediate personal contact between healer and the sick
one. The relationship to all other figures diminishes but is reactivated in
Early Christianity, through performing rituals by prayers to God and heal-
ing in the name of Jesus. At all events Jesus supports internal confidence by
external ritual acts in his healings. He supports such a confidence even by
reducing external ritual elements, because their reduction underlines imme-
diate personal contact by laying on of hands and by gestures comparable to
a kiss. This element fits into the theory that all therapies—in both premod-
ern and modern times, in psychotherapies based on different theoretical
foundations—have “common features” that explain their efficacy: personal
contact, care and attention, confidence in the competence of the healer and
control of anxiety.
To sum up: The healing activity of Jesus and his followers can be explained
as the activity of a charismatic healer in premodern times. This activity fits
the theories that cultural anthropology has developed to explain the efficacy of
symbolic and ritual healing. Some special features in the Jesus tradition—the
significance of faith, increased conflict, and the reduction of ritual elements—
necessitate some minor modifications of the theories of symbolic and ritual
healing, but they do not contradict the (etic) theories of modern observers and
cultural anthropologist; rather they show that elements of their (etic) theories
already have been a part of the (emic) communication of human beings in pre-
modern times.
notes
1. The present state of research is represented by B. Kollmann, 1996, 2002;
Theissen 2007. A new approach is offered by P. F. Craffert 2008. I am grateful to
P. Craffert for giving me the chapter on “Jesus Shamanic Functions: Healing,
Exorcism, and the Control of Spirits” before its publication.
2. The following analogy concerns the possibility of healing from a distance. The
cultural framework is in both cases very different. The comparison between Jesus in
the first century CE. and a German healer in the twentieth century will demonstrate
only one common feature: healing from a distance is no more miraculous than
healings with immediate contact, so long as we agree that faith and confidence are the
crucial factors.
3. The differentiation between “Krankheit” and “Kranksein” can be derived from
a famous dictum of the German physician Georg Groddeck (1866–1934), one of the
founders of psychosomatic medicine: “In der Wirklichkeit gibt es gar keine
Krankheiten, es gibt nur kranke Menschen.” In Caius (Pseudonym of Georg Groddeck),
“Krankheit,” Hygieia 7 (1893–1894), pp. 17–19, reprinted in: Georg Groddeck,
“Krankheit als Symbol. Schriften zur Psychosomatik,” ed. Helmut Siefert, Frankfurt a. M.
1984, pp.24–26 (italics in the original text). Cp. Greifeld 1995, pp. 16 f.
references
Bichmann, Wolfgang, 19952, “Medizinische System Afrikas,” in B. Pfleiderer,
K. Greifeld, and W. Bichmann (eds.), Ritual und Heilung, Eine Einführung in die
Ethnomedizin. Berlin: Dietrich Reimer Verlag, pp. 33–65.
Craffert, P. F., 2008, The Life of A Galilean shaman: Jesus of Nazareth in Anthropological-
Historical Perspective. Eugene, Ore.: Cascade Books.
Greifeld, Katarina, 19952, “Einführung in die Medizinethnologie,” in B. Pfleiderer,
K. Greifeld, and W. Bichmann (eds.), Ritual und Heilung, Eine Einführung in die
Ethnomedizin. Berlin: Dietrich Reimer Verlag, pp. 11–31.
Groddeck, Georg, 1984 [1893/94], “Krankheit,” in Helmut Siefert (ed.), Krankheit als
Symbol. Schriften zur Psychosomatik.” Frankfurt a. M.: Fischer Verlag 1984,
pp. 24–26.
Kleinman, Arthur, 1980, Patients and Healers in the Context of Culture: An Exploration
of the Borderland between Anthropology, Medicine, and Psychiatry. Berkeley:
University of California Press.
Kollmann, Bernd, 2002, Neutestamentliche Wundergeschichten, Biblisch-theologische
Zugänge und Impulse für die Praxis, Urban Tb 477. Stuttgart: Kohlhammer.
——— , 1996, Jesus und die Christen als Wundertäter. Studien zu Magie, Medizin und
Schamanismus in Antike und Christentum, FRLANT 170. Göttingen: Vandenhoeck
& Ruprecht.
Lang, Bernhard, 1995, Art, Handauflegung, Neues Bibellexikon 2, pp. 27 f.
Onuki, Takashi, 2004, “Urform und Entfaltungen der Heilungswundergeschichten
Jesu. Zur formgeschichtlichen Verortung der ‘Semeia-Quelle’ des
Johannesevangeliums,” in Heil und Erlösung. Studien zum Neuen Testament und
zur Gnosis, Wissenschaftliche Untersuchungen zum Neuen Testament 165.
Tübingen: Mohr, pp. 20–59.
Pilch, John J., 2000, Healing in the New Testament. Insights from Medical and
Mediterranean Anthropology. Minneapolis: Augsburg.
Rehder, Hans, 1955, “Wunderheilungen, ein Experiment,” Hippokrates 26,
pp. 577–580.
Rösing, Ina, 1990, 19953, Dreifaltigkeit und Orte der Kraft: die weisse Heilung. Nächtliche
Heilungsrituale in den Hochanden Boliviens, Mundo Ankari 2, vol. 2. Frankfurt:
Zweitausendeins.
Sax, William, 2007, “Heilen Rituale?” in Axel Michaels (ed.), Die neue Kraft der
Rituale. Heidelberg: Winter, pp. 213–236.
Schmithals, Walter, 1997, “Vom Ursprung der synoptischen Tradition,” Zeitschrift für
Theologie und Kirche 94, pp. 288–316.
Theißen, Gerd, 1974, 19987, Urchristliche Wundergeschichten. Ein Beitrag zur
formgeschichtlichen Erforschung der synoptischen Evangelien, StNT 8. Gütersloh:
Mohn = G. Theissen, The Miracle Stories of the Early Christian Tradition.
Edinburgh: T&T Clark 1983.
——— , 2007, “Die Wunder Jesu. Historische, psychologische und theologische
Aspekte,” in W. H. Ritter and M. Albrecht (eds.), Zeichen und Wunder.
Interdisziplinäre Zugänge, Biblisch-theologische Schwerpunkte 31. Göttingen:
Vandenhoeck & Ruprecht, pp. 30–52.
4
Healing Rituals in the
Mediaeval West
Peter Dinzelbacher
Dedicated in friendship to Prof. Werner Gerabek
Since the terms “rite” and “ritual” are not used in the same way in every branch
of the humanities and by every scholar, it is important here to note how they
are to be understood in this chapter. By healing rituals—and these are the sole
concern in the present context—I mean repeatable, communicative acts that
are generally accompanied by words and are aimed at influencing nonhuman
powers or beings, with the actions not being directly aimed at a practical effect.
Administering a medicinal plant to a sick person, for instance, is not a rite,
even though its medicinal preparation may have been conducted while certain
blessings were uttered, or it may have been gathered at a particular time to the
accompaniment of certain formulae, certain gestures, the use of certain imple-
ments,1 and the like. We are talking of a performative form of expression with
a stereotypical structure that permits people to communicate with nonhuman
powers. I see no reason to restrict rituals to collective actions (see for instance
Hahl and Fricke, 2003); the individual can also act ritually on his or her own,
and even when deliberately excluding the public.
Mediaeval Theories of Illness
The “master narrative” of that epoch of a thousand years that we imprudently

like to refer to with the periodizing concept “Middle Ages” was, beyond doubt,
constituted by the Christian religion in the form expounded by the Catholic
Church, at that time a most formative force in people’s thoughts and deeds in
all areas of life. For this reason the characterization of the Middle Ages as an
“age of faith” is fully justified (even when instances existed of disbelief if not
atheism) (cf. Dinzelbacher, 1999). This is not to say that other conceptions of
the universe did not exist alongside it, such as those in the Early Middle Ages
hailing from pagan Antiquity or of Germanic, Celtic, Slavic provenance, or the
new deviant developments in the High Middle Ages in response to Oriental
religions (Catharism) or philosophies (Averroism). These became intertwined
with Christianity in every imaginable way, or entered into direct competition
with it.
Since the principal holy book, the Bible, repeatedly depicted the founder
of the new religion as a healer and combater of illness, despite Christianity’s
pronounced orientation to the world beyond and its strong devalorization of
everything that had to do with the body, it was quite legitimate for even the
faithful to concern themselves with bodily health. This meant that, in principle,
a coexistence was possible between medicine based on natural observation and
religion based on faith.
Turning specifically to its etiology, in retrospect a number of parallel dis-
courses may be distinguished in the Middle Ages, which in practice also mani-
fested in a variety of combinations:
1. The medical discourse in the present-day sense, in which somatic dys-
functions are explained solely in terms of physical, chemical, or biological
causes—as prevailed in the medicine of Antiquity and Islam. Part and par-
cel of this was also the teaching of the four temperaments, which was central
for doctors of both Antiquity and the Middle Ages, and which viewed disor-
ders as the outcome of an imbalance (dyscrasy) in the body’s four vital humors
(Keil, 2005).
2. The iatromathematical discourse, as applied to astrology in Antiquity
and the Orient, which relates physical disorders to the effects of cosmic occur-
rences, because the human body as microcosm was deemed to be unshakably
bound to the macrocosm. This discourse was represented in Western Europe
from the tenth century onward and entered university medicine in the four-
teenth century. The constellations of the stars (and above all the moon) were
regarded as representing the causes of ailments, as well as indicating their prog-
noses and therapy, particularly since the individual limbs and bodily organs
were assigned to the seven planets or twelve signs of the zodiac (Horchler,
2005; Weisser, 2005).
3. The religious discourse, which attributed such disorders to the direct or
collateral effect of invisible powers from the religious domain, such as deities,
demons, elves, and intermediate beings, or in monotheism to the one god. Its
healing rituals in the mediaeval west 69
pathophoric effect was grasped as punishment for either breaking a taboo or

for sinning (as with King Uzziah of Judah in the Old Testament), or as a test for
the chosen (as with Job in the same work [2 Chronicles]). There is no end to the
available evidence that in the Middle Ages, illnesses, accidents, and death were
also frequently regarded as direct punishments by God (see for instance Esser,
1997). Such evidence is, however, rarely from the specialist medical literature,
being mainly the preserve of devotional, hagiographical, theological, and poetic
texts, as well as healing formulas and visual sources.
Since this etiology is particularly characteristic of the Middle Ages, it is
worth casting more light on it by means of a few examples. The words of the
poet Thomas Hoccleve (1368–1426) may be taken as our motto:
All myghty god as lykethe his goodnes,

visytethe folks alday as men may se,
with lose of good and bodily sikenese,
and amonge other he forgat not me. . . . (Complaint 36 ff., cited in
Esser, 1997)
An example of God as a direct deliverer of illness is to be found, for instance,

in the Revelationes of Birgitta of Sweden (†1373): She tells of hearing that a
renowned priest refused to believe in her revelations. With that she entered
into prayer, during which Jesus appeared to her, compared the arrogance of the
man with having “dung in [his] mouth,” and promised He would deliver the
man a slap in the face by His hand. . . . Whereupon the priest was humbled by
affliction and died of the gout (St. Birgit of Sweden, Revelationes 6 ). The priest’s
sickness and death were thus the consequence of the saint’s prayer in response
to his negative attitude toward her, effected directly by God in person.
As was true of her Lord, it was also possible for His saints not only to
heal but also to inflict ailments. “We worship saints for fear . . . Who dare deny
St. Anthony a fleece of wool for fear of his terrible fire, or lest he send the
pox among our sheep?” (cited in Wilson, 1983). The English reformer William
Tyndale (†1536) was only repeating here the popular opinion that saints also
inflicted the illnesses that they specialized in relieving, in this case St. Anthony
with ergotism, called St. Anthony’s Fire. Paracelsus was critical of this super-
stition: “St. Vitus’s Dance” (chorea), “St. Quirin’s Penance” (phlebitis), or
“St. John’s Revenge” (St. Vitus’s Dance) had, in his view, natural and not supra-
natural causes (Meier, 1993).
There was no disputing the notion that demons—those rebellious angels
whom Michael had cast along with Lucifer from heaven into hell—could also
make people sick, but in practice they were rarely named as the cause of ill-
ness, even in the anthologies of miracles (Finucane, 1977). Not even epilepsy
(Wittmer-Butsch and Rendtel, 2003) or raging epidemics were attributed pri-

marily to diabolic causes. Isolated cases do, however, crop up from time to
time, such as the report of a carpenter who had a fall that resulted in such
alarming fits of insanity that the only explanation his acquaintances could offer
was that a demon had entered him (ibid., 125). Or the miniature, say, of the
evil spirits that sowed the plague from the air in the Chronicle of Giovanni
Sercambi (c. 1400), or the illumination in the autobiography of the Dominican
Friar Heinrich Seuse (†1366), in which an evil spirit belabors him with a drill
to give him toothache (Dinzelbacher, 1996). The image we constantly encoun-
ter from the Middle Ages is above all of a disease projectile fired by some super-
natural or netherworldly being, which might be used to explain lumbago (Hall,
2007) or the plague (Dinzelbacher, 1996).
In theological writings the transcendental hierarchy was naturally upheld
by the qualification that the action of demons occurred only with God’s sanc-
tion. Demons of sickness do appear, but more in the notions of popular belief
than in those of the educated, aside from the mentally ill, who were often des-
ignated as possessed (demoniaci, demoniati). But this possibility was often not
even touched on in medical treatises, although sometimes it was admitted to,
so the spectrum of opinions regarding madness, say, ranged from its being
outside of a doctor’s jurisdiction to a consideration of the merits of scientific
explanations (Beek, 1969). Note that evil spirits play no important role in the
miracle collections (Wittmer-Butsch and Rendtel, 2003) (where we would have
expected them).
Here is an example of one of those intermediary beings that were named
particularly often in popular religion as inflicting illness:
In Anglo-Saxon and Nordic mythology the elves were ambivalent creatures
that could cause great mischief, such as lumbago (English: elfshot). Here they
assumed the role of the sickness demons (Dinzelbacher, 1996; Hall, 2007).
Since the time of Wolfram von Eschenbach (early 13th cent.) at latest, the Bilwis
was often testified to in Germany as being a misanthropic creature that fires
arrows of disease (Handwörterbuch d. deutschen Aberglaubens [HDA] 1; Lecou-
teux, 1988). His name is clearly a euphemism: “the well-wisher”; toward the
end of the Middle Ages he was refashioned as an anthropomorphic monster or
witch. Apparently it was also said that the souls of unbaptized children would
transform into Bilwises and cause illness with their darts (Grimm, 1981; Güting,
1974). A favorite indictment at witch trials in the Later Middle Ages was that
the accused had used sorcery in order to cause gout—Luther named “shooting
the shanks” as the chief occupation of witches and accused them of imperiling
his brother’s life in this manner; Molitor’s Hexenbuch from 1489 contains a
woodcut with the motif of the “Hexenschuss”—lumbago, but literally “witch’s

shot”—showing the act with a clarity that omits nothing.
These etiologies corresponded to various therapies, to wit medico-scientific
and/or magico-religious. It was also not uncommon to combine these in prac-
tice; in Late Mediaeval plague tracts, for instance, religious, astrological, and
medical etiologies and therapies are listed one after the other. The common
opinion was that it was beyond human ability to know whether in concrete
cases the illness had been inflicted from heaven as a punishment for sins, or
had its origin in the constellation of the stars or other natural circumstances
(Esser, 1997).
Healing Rituals
Generally speaking, rituals were probably more a part of everyday life in the
Middle Ages than in the epochs before and after. Formalized, that is, tradi-
tionally prescribed actions can be found in mediaeval religion, above all in the
liturgy and paraliturgy, and otherwise in social communications, especially in
the field of law. There is, however, a prevailing tendency in current Mediaeval
Studies to interpret even spontaneous behavior—such as rulers and heroes
weeping in public—as mere ritual stagings. To my mind this view is not only
indemonstrable but contradicts the sources (Dinzelbacher, in press).
In the context of illness, rituals seem to have been of importance only when
magical healing was attempted. Although they always seemed appropriate in
the realm of high religion when people turned to God and His saints, they
were scarcely central; as any number of testimonies divulge, a mere prayer or
visit to a church brought about supernatural healing without any special ritual
actions. If one analyzes, for instance, the weighty miracle book of St. Walburga
of Heidenheim from the late ninth century, it is noticeable that prayer and pil-
grimage were the order of the day, while rites, such as touching the stretcher in
a reliquary shrine or the stave of a saint or a lamp in a church, are named only
once each (Bauch, 1979). Much the same can be said of other, similar texts.
Expanding the concept of ritual to include the mere act of visiting a living
thaumaturge or a saint’s grave seems to me as erroneous as subsuming a visit
to the doctor, shopping at a pharmacy, or taking the cure at a spa under the
heading of rituals. Basically, pilgrimages are concerned purely and quite practi-
cally with visiting the person or places from which one expects help, even if it
is transcendental help. That ritual elements also entered the situation, such as
the general practice of votive offerings or special ceremonies at specific places,
alters nothing in the fact that this was not the heart of the issue, not at least
according to contemporary reports.
But neither should making an offering at the altar, which practically
always preceded events, be characterized as a ritual, for in keeping with the
Do-ut-des principle of mediaeval Catholicism (Dinzelbacher, 2000), it was sim-
ply a payment for the anticipated or received help. A glimpse at Middle High
German poetry reinforces this impression: sickness and healing procedures
are described soberly according to the scholarly-medicinal tradition, or are
connected with astrology, which was regarded then as a true science (Haage,
1992), while not a word is to be found on special rituals.
So if the outbreak of epidemics led to veritable floods of penitential ritu-
als—whether unspectacularly in the form of ordering a mass, or sensationally
as in the processions and societies of the flagellants (Angel, 1996)—these are
not healing rites but rather prophylactic actions aimed at nipping the disease
in the bud. One could speak of panic being bridled by the use of auto-aggres-
sive rites. In the simultaneous collective attacks on lepers and Jews (Graus,
1994), aggressions were directed outwardly and the primary aim was to mete
out revenge on a scapegoat.
Religious Healing Rites
Both the official and parallel belief systems (Parallelglaube is the term used
today by German folklorists instead of Aberglaube) offered methods to fight
illness by preternatural means. These were often linked with the performance
of rituals, but not exclusively so—unless one wishes to extend the concept of
ritual to include simply praying for health, or to mere vows.
Ecclesiastical rituals refer to behavior that conforms to religion préscrite
(regarding the terminology see Dinzelbacher, 2003), in other words, that is cus-
tomarily recommended, enforced, or tolerated by the hierarchy. In first place—
necessarily so in a monotheistic faith—rituals are addressed directly to God.
Viewed theologically, every ritual or prayer is actually directed to God, who is to
be moved to clemency by the intercession of a saint, while in the imagination
of popular religion it was the saint himself or herself who healed—or made
one ill.
Communication with God is performed chiefly by means of prayer and
liturgy. So it goes without saying that those who could afford to do so would
have celebrated masses for their health. We have numerous examples from the
ranks of the nobility. For example, in 1463, after a sleepless night in pain, the
Archduke of Austria, Albrecht VI of Habsburg, summoned not only his doctor
but also a priest and, surrounded by numerous courtiers, had the mass said
while his valet massaged his hands and feet. His dictum, “But, God willing,
‘twill turn out well,” allows the mass to be interpreted as a liturgical plea to
God for convalesce, and not as a death ritual (Hayer, 1998). Similarly, people
resorted to public prayer and rogations when, for instance, the Emperor Fred-
eric III had a leg amputated after suffering a stroke (Lipburger, 1993).
It should be noted at least that apart from bestowing the holy sacrament,
the utmost importance was attached to the prophylactic nature of the sacra-
mentals, that is, to the holy water, consecrated salt, palm branches, and other
implements. The oil for anointing the sick, for instance, was deemed so pow-
erful that a woman who was restored to health by its use was allowed to wear
only black for twelve months after, and she had to abstain from dancing and
physical love during that time (Burger, 1990; Klingner, 1912). It is clear that
phenomenologically the church sacramentals could not be distinguished from
magical actions but were white magic that was elevated only post facto by theo-
logical explanations (Dinzelbacher, 2000).
One example of direct prayer connected with a healing gesture can be seen
once again in the case of Birgitta of Sweden: While she was on a pilgrimage to
a shrine on Monte Gargano accompanied by the Bishop of Wexiö, he fell from
his horse and broke two ribs. So as not to delay their journey, he asked the saint
for a miracle. After uttering a humility formula, she knelt down to pray and
touched the bishop’s side with the words: “May the Lord Jesus Christ heal you!”
The pain vanished in an instant; the bishop got up and followed the woman
throughout her entire journey (St. Birgit of Sweden, Revelationes 3).
People also turned collectively to God when sickness loomed: time and
again processions were held not as regular features of the church year, but as
specific reactions to crisis situations. The flagellants, for instance, in the middle
of the fourteenth century inflicted themselves with wounds that were supposed
to keep the Black Death at bay, while singing in couples in a procession, as is
customary, around the church with banners, candles, and crosses (Limburger
Chronik, quoted in Bartels, 1997).
There can be no doubt that cures from sickness were the main function
expected from the saints or their relics (Kolmer, 1993; Sigal, 1985). Without
being able to back this statement statistically, the impression is very strong that
petitions were more frequently addressed to the saints in heaven or to their
relics than to the Lord Himself. Prominent saintly remains in the keeping of
a church could even become the center of a cult comparable only to that of the
sanctissimum: the head of John the Baptist, for instance, was liturgically wor-
shipped day and night in twelfth-century Angely by a hundred monks: caput
sanctissimum a centeno monachorum choro die noctuque veneratur (Liber iiiius
S. Iacobi 8, 1978). Conversely it was the custom in the humiliatio to subject

the relics—as if they were living persons—to humiliating punishments if they
failed to help.2
Of immense importance to pious feelings in this epoch, and also recom-
mended by the established church, was the veneration of holy remains3. Quite
simply any substance that had come from the body of the thaumaturge or been
in contact with it was regarded as a relic. For instance, the hair of Hildegard of
Bingen helped to soothe labor pains and to allay mental illness when applied to
the body, and the soil in which the bones of the blessed Gerlac of Valkenberg
rested, when dissolved in water and drunk, would make throat ulcers disappear
(Vita Hildegardis 3).
It was essential that seekers of help visit the shrines in person and, if pos-
sible, touch them so that the virtus, the magical power of the dead, was trans-
mitted to them. It is for this reason that many of the reliquaries or shrines in
churches were slightly raised, or the graves fitted with openings that enabled
a person to crawl inside, that is, that accommodated the desire for the most
intense possible physical proximity (a further component of this custom was
the notion that illnesses could be “wiped off ” in this manner). The life of the
Alsatian saint Morand (†1115) describes how people could stick their head
through holes set in his tomb slab in order to be freed of their pains. Yet this
activity should still not be characterized as a healing ritual, because the way
in which this indirect contact (the holy bones remained untouchable in their
casket) was sought with the healing object was no different than when today’s
patient goes to be treated with physiotherapy massage apparatus in order to
alleviate pain.
A contemporary illustration of this type of tomb can be found on an illu-
minated page from the thirteenth century depicting the shrine of Edward the
Confessor (Jordan, 2004), or on the tomb of St. Osmund, which is still pre-
served in Salisbury, England (Finucane, 1977), or on that of Otto of Bamberg
in St. Michael’s Minster in the city of Bamberg (dated about 1430) (Beck, 1962).
In the case of smaller relics, the pilgrim would be touched with them by the
priest. A handbook for pastors printed in 1506 indicates that while displaying
the shrine, one should say: “Come here with piety and let you be touched with
the reliquary, so that the dear saint may be your good intercessor and advocate”
(cited in Beissel, 1892). Here too—irrespective of the theological “rectification”
in the closing words—a simple healing mana is transmitted to the sick person,
not unlike modern day radiation therapy.
In the case of the incubation (Beek, 1969; Saintyves, 1931), the healing
sleep in a temple or church, one might wonder whether or not this was a
direct form of therapy or a rite. This practice was well known to Antiquity and
continued to be observed in christianized form. When, for instance, Gerald

of Wales (1147–1223) reports how a raving youth first returned to his senses
after being chained in irons to the tomb of Hugo of Lincoln for a week (Groß,
1990), one could draw a parallel to a comparable stay in a hospital. The “hall”
crypts of the eleventh and twelfth centuries were designed with many aisles
for droves of pilgrims; the sick would regularly spend the night there and a
possessed person was tied up until a miracle occurred or the patience of his
wards ended (Beek, 1969; Finucane, 1977; Saintyves, 1931; Wittmer-Butsch
and Rendtel, 2003).
Yet there are also numerous instances in which instead of the incubation
resulting in healing, the local patron saint merely appeared to the invalid in a
dream and told him or her how to achieve some aim. An example can be found
in the eleventh-century miracle book of St. Fides of Conques, who is famed to
this day for her cult statue: One Gerbert, who had already once been granted a
miracle, spent no less than three months supplicating night after night before
the martyr’s altar. At last she visited him in a dream and commanded that next
day he join the monks’ procession to the shrine of St. Michael; only then would
his blindness be cured (Robertini, 1994).
The best means of availing oneself of the saint’s power was to ingest their
bodies. The central rite of Catholicism was and is theophagy, the physical
ingestion of the incarnate god during the solemn rite of communion (Hoff-
mann, 1891). A more sensual relationship to God is hard to imagine (Bynum,
1987; Walter, 1992),4 however much theologians have constantly attempted to
undermine such concreteness through sublime interpretation. Much the same
was true of the grave of certain wonder-working saints, where it was not uncus-
tomary to break or rub off pieces of the stone slab; sometimes, as was the case
of the stigmatic Elisabeth of Reute (†1420), this act led to the pious destruc-
tion of the tomb slab (Schurer, 1962). More harmless was “taking along” the
miraculous power by drawing a Paternoster cord across the face of a deceased
person of saintly repute, or pouring oil, water, or wine over the bones of a dead
saint so as to drink it or use it as a rub.
A large number of pilgrimage sites possessed skull relics from particu-
lar saints, and the skullcap could be removed and used as a beaker for wine
(Legner, 1995). This may be a christianized form of a largely Celtic custom, in
which the skull of the vanquished foe was fashioned into a goblet. Here indeed
we may speak with confidence of a rite—accepted by the Church—which, in
addition to summoning the saint, also transmitted the orenda to the sick per-
son through contact with the sainted relic. The oldest Christian reference is to
be found in the Itinerarium de locis terrae sanctae of Pseudo-Antoninus Placenti-
nus (c. 570), who drank from the gold-rimmed skull of St. Theodata.
But not infrequently neither such a brief physical contact, nor an often
lengthy incubation, nor the ingestion of reliquial medicine, but a multipartite
sequence of actions was required. And thus a rite was performed.
Only some thaumaturges—by no means all—demanded such a rite. Ritu-
als can be seen in the Middle Ages and Early Modern era in the not infrequent
offerings in kind made to a saint or church the quantity was determined by
weighing the sick person’s body (Franz, 1960). This procedure corresponds to
buying off one’s own body, which is actually doomed to death, by an “exactly
equal” substitute offering. Analogously, one could also have a candle made to
exactly the same length or weight as the patient and donate it to the saint, or a
wax figure of the ailing limbs, or similar trading (Bacci, 2000). And naturally
the rich could court the saint’s favor by means of votives made of precious met-
als such as gold and silver. A well-known example that has been preserved is
the kneeling wax figure of Margrave Leonhard of Görz (in the same size and
of the same weight as the nobleman) dating from the late fifteenth century
(Philippovich, 1965; Waldmann, 1990).
Admittedly this procedure is dominated somewhat by the aspect of
exchange or trade: a healthy body or body part is given in return for the proxy
offering: the saint accepts the form cast in gold, wax, iron, or other costly mate-
rial and repays it with the unscathed member in flesh and blood. This proce-
dure is especially clear when children are desired, such as when in the 1180s
Prince Ladislaus of Poland sent a delegation with the golden statue of a child to
St. Aegidius (French: Gilles) in Saint-Gilles to receive an heir in exchange. His
wish was heard (Girault, 2007).
Rites focused on demons are found particularly in the Orthodox-Catholic
milieu in connection with possession, a state that nowadays, like its positive
counterpart, enthusiasm, is almost always viewed as a schizoid disorder. The
familiar rite for this condition is exorcism (Dinzelbacher, 1996; Dinzelbacher,
2000; Scheidegger, 2002)5—the “classic” evocation of Christianity for driving
out evil spirits. From the Antique and Mediaeval viewpoint, the evil ghosts
could have lodged themselves almost anywhere, in objects, animals, or people.
Consequently exorcism was (and is) a central part of every Christian baptism:
“Depart unclean spirit and make way for the Holy Ghost!” to quote Luther’s
Taufbüchlein or Little Book on Baptism of 1523.
For adults exorcism is used mainly in cases of possession, and in practice
it consists not merely in holy words and impressive gestures, such as holding
up the crucifix, but also can consist of physical injury. The Devil is unable to
withstand the rod (Klingner, 1912), and so a good caning was often part of the
process. Even placing the stole around the patient’s neck seems to be little
less than an act of throttling when one studies Grünewald’s realistic depictions
on the Heller Altar in the Staedel in Frankfurt. A natural element in exor-

cism was spraying the person with holy water and less often immersion; in
1402 a patient was drowned in this way by the Egmond monks. The Franciscan
monk Thomas Murner (†1537) described the rite in St. Anstett at Wittersdorf
as follows: “They are exorcised there, thrashed with scourges and immersed in
cold water” (Beek, 1969). In this form, Catholic exorcism may be described as
“sacral antidemonic therapy” (Nola, 2004).
Magic Healing Rites
Even the magia naturalis, which consisted of arcane knowledge drawn from
natural history, was viewed most critically by the Church and obviously was
banned when it was employed for black magic. Scholarly ritual magic only
became more common, though, in the fifteenth and sixteenth centuries through
the Humanists’ keen interest in Neoplatonism, and it too was used for heal-
ing purposes. Natural forces and angels were seen as the active powers here,
and less so demons. Forbidden on principle was magia supranaturalis, which
operated with angelic or more frequently demonic powers. In the Late Middle
Age both forms6 came to be associated with the belief in and the persecution of
witches (Zambelli, 1991).
If one takes not a theological but a phenomenological definition of the con-
cept, one must regard countless paraliturgical and related actions performed by
the clergy as magical, including those conducted for healing purposes. When,
for instance, a page choked on a chicken bone while eating, Bishop Hartmann
of Brixen (†1164) took a slender candle, twisted it around the youth’s neck,
and ordered him to attend his Holy Communion the following day, when the
candle would be lit. Further augmented by the bishop’s invoking the relevant
saint, St, Blaise the martyr, the anticipated effect did not fail to manifest (Spar-
ber, 1957). St. Thomas Aquinas in his Summa Theologiae wrote that it is legiti-
mate to “hang relics for protection around one’s throat or elsewhere.”7 Another
learned Dominican priest, Heinrich Seuse, had no scruples about scraping off
paint from portraits of saints with his own hands and rubbing them into a
patient’s injured eyes in the name “of God’s power and the holiness of these
old fathers” in order to effect a healing miracle (Bihlmeyer, 1906).
Still preserved in the parish Church of St. Grat in Valhourles is the early
mediaeval bell that was placed over the heads of the mentally ill for healing
purposes, a rite that was also practiced at St. Fillan’s in Scotland (Beek, 1969).
Another healing rite was performed in the Late Middle Ages in the chapel of
St. Louis of Toulouse, in Palermo, in which a piece of Cyprus wood was touched
to the portrait of the saint and dipped in burning oil before being placed on the
tongue of the person soliciting help (Goodich, 2004). In the Middle Ages the
ailing who wished to know whether they could be cured or were destined to
die would go on a pilgrimage to St. Erminold in Prüfening or St. Quirinus in
Tegernsee, to St. Leonhard in Inchenhofen or to the Holy Blood in Wilsnack.
In all these places of pilgrimage (as well as a number of others) the monks used
scales (which one had to mount up to thirty times) the deflection of which was
regarded as an oracle for the course of the ailment. One could ask the saint
for a cure or a speedy end. The fact that even high ecclesiastical dignitaries
submitted to this rite, such as Archbishop Konrad of Mainz in 1200, demon-
strates the legitimacy it enjoyed (before later being abolished) (Franz, 1960;
Pietsch, 1884). More frequent was the procedure testified to from the Carolin-
gian period, at latest, until modern times, of weighing the miraculously healed
person with food or wax (Bauch, 1979).
An unusual rite (apart from incubation and swallowing dust from a saint’s
grave) also had to be undergone at St. Hubertus’s in the Ardennes: it is known
that from the eleventh century onward a sick person would be given a silk
stole—the Sainte Étole that had fallen from the heavens—to wear around his
or her head, and that a thread from it would be sewn into the person’s forehead
after a small incision had been made. This relic remained for nine days in
the person’s body, during which time he also had to observe a wealth of other
ceremonies and taboos, such as reciting particular prayers a certain number of
times, or enduring a proscription against combing himself, and the like. The
disease that St. Hubertus specialized in was rabies. It is so dreadful that despite
all the Christian prohibitions in the Middle Ages, the sufferer would often
be smothered out of compassion. That people persisted for a long time in their
belief in the Hubertian rites can be explained by the fact that the disease fails to
erupt in roughly a third of all those bitten by rabid animals. This escape from
the disease would be regarded as a miracle. And given that God was almighty,
all miracles were possible. “Which is why He is called the Almighty, because
He can bring about anything!” as we read in the Vita Quarta of St. Patrick
(Bieler, 1971).
In keeping with this practice, Caesarius of Heisterbach (†1240) admitted
quite openly that the Church simply offered the better magic: “Whoever has-
tens to the Church in sickness not only has health restored to their body but
simultaneously the forgiveness of their sins. So if a double gain lies waiting for
us in the Church, how can these wretches be so foolish as to look for cures from
enchanters, from springs and trees, from amulets, magicians, and augurs. . .”
(J.-C. Schmitt, 1993). But the Church did not always help. In such cases,
as Michael Scot, a vaunted and notorious scholar from the circle of Kaiser
Friedrich II of Staufen, recommended, “Where medicine fails, the physi-

cian should advise the patient to go to diviners and enchantresses, although
this may seem wrong [inhonestum et nephas], or contrary to the Christian
Faith—but true nevertheless” (Finucane, 1977). Sometimes there was also the
possibility—exclusively for the privileged—of legally obtaining help from a
witch. The following case would deserve little credence had it not been reported
by the fiercest guardians of the orthodoxy, the Dominican inquisitors who
wrote the Hexenhammer (Malleus Maleficarum or literally Hammer of Witches).
According to them, Nicholas V. (1447–1455) had permitted a German bishop
to charge a witch to cast the same illness on his spell-casting lady love that she
was using to torment him. The Prince of the Church was promptly healed, and
his mistress struck down. But from the perspective of the phenomenology of
religion, as was already remarked, the paraliturgical actions of the priests were
often nothing more than magic licensed by the Church.
The magic condemned by the Church was as much a part of daily life as
the tolerated form, and yet it was viewed as heresy, a break with God and the
One True Church, and was consequently hounded. Famous, for instance, is
the rite that the Inquisition attempted to wipe out in the middle of the thir-
teenth century in a grove in the Dombes near Lyon—a ceremony by which the
women of the vicinity attempted to give strength and health to weak and sickly
children through the aid of St. Guinefort. This saint, however, happened to be
a greyhound that had been unjustly killed after defending a child in its crib.
The rite was no less bestial than the saint and was conducted by an enchantress
together with the baby’s mother (J.-C. Schmitt, 1982): After offering salt and
other items and spreading out the afflicted child’s nappy close to Guinefort’s
grave, the women tossed the child nine times from one person to the next
and beseeched the fauns to exchange it for the healthy child they had allegedly
stolen—the notion of the changeling which even a person like Martin Luther
firmly believed in (Grisar, 1912; Shahar, 1991). The baby was then left between
two lit candles, where it sometimes died of its burns (the purificatory power
of fire was also enlisted medicinally when children were drawn to the hearth
to fight “consumption” [Schönbach, 1900] ). Sometimes wolves would arrive
and rend the child. If it survived, it would be immersed nine times in a nearby
river; if it survived this ritual also, it was regarded as the original, healthy child
returned.
We know of a large number and wide variety of magic rites from the Mid-
dle Ages, which either came from local customs or were of scholarly origin;
their consummation also depended on certain spells that have been handed
down to us in their scores, in both Latin and the vernacular. A group of such
incantations was aimed directly at the cause of illness, a creature that evidently
was only later identified as a demon by the Christian system. Originally an evil
hybrid creature must have been pictured raging in the body, often in the form
of a worm. In the Old High German Wurmsegen (blessing against worms) it
was called nesso and its children nessiklinon (Schulz, 2003); the notion of the
“toothworm,” which also belongs to this complex, remained widespread right
into the modern era (Gerabek, 1993).
But many of the spells were aimed directly at the ailing body part, above all
the blood, and treated it as a being in its own right: “So do it, Blood!” Doubtless
one recognizes here the memory an even older (and otherwise latent) zone of
mental representations, here admittedly connected with the exemplar of the
healed Christ in illo tempore, that is, with the “myth” belonging to the rite (Trier
Blood Blessing, Saxon, tenth century):
Christ had been wounded, then he became again whole and sound
That blood stood still, so shall you do, blood!
Three Amens, three Pater Nosters. (Holzmann, 2001)8
Apart from uttering or singing or shouting out the blessing or incantation, we

also find various operative rituals. These include, of course, making the sign
of the cross, writing down magical names, blowing and spitting on the appro-
priate spots, and others (Schulz, 2003). Turning to a more detailed account,
a fourteenth-century manuscript not only prescribed for epilepsy the recital
of the Our Father and other prayers, but also stated that one should “take a
buckskin strap and bind it around the throat, as long as he is in pain, and
say. . . .” The strap was later to be placed under the shoulder of a dead per-
son at his or her funeral, thus burying the illness until the Day of Judgment
(Holzmann, 2001).
The operative element could certainly enjoy great prominence in a ritual.
Thus a fifth-century Latin pharmacopoeia chiefly containing folk remedies
gives “A highly useful spell against gripe: Press the thumb of the left hand into
the belly and say: ADAM BEDAM ALAM BETUR ALAM BOTUM. After say-
ing this nine times, touch the earth with the same thumb, spit, say it another
nine times, and then nine times more, touching the ground and spitting in
between each set of nine” (Marcellus Empiricus 28, 72, cited in Dinzelbacher
and Heinz, 2007). In the Lacnunga, an eleventh-century collection of old Eng-
lish texts somewhere between medicine and white magic, one finds the fol-
lowing remedy for diarrhea: A parchment amulet is to be inscribed with the
words from a heaven’s letter that an angel brought to earth in Rome. The size
of the parchment is measured to fit the girth of the sick person’s head and
then it is attached around his neck (Skemer, 2006). In a rite known from the
Late Middle Age, a sick person is renamed by means of exstinccio or extraccio
candelarum: a number of candles were inscribed with names, and the patient
was given the one on the candle that burned the longest in order to deceive
the sickness demon with the “false” name. Occasionally one encounters magic
prescriptions that demand absolute silence: According to an Anglo-Saxon leech
book, an inflammation of the finger will depart if one scratches the name of
the patient into a piece of wood, pours blood over the letters, and throws the
wood over one’s shoulder into flowing water, without uttering a word (Olsan,
644–650).
So in these instances rites are an integral part of magical therapy. Without
them the black arts would also cease to function, as an evil spirit personally
informed its conjurer when the latter complained to him about his lack of suc-
cess. “He justifies himself and says that it is not his fault, but the ceremonies
lack something, and for that he requires a scientifically trained person. . . .”
Erasmus of Rotterdam reported on the matter, with which he had completely
familiarized himself, in a letter dated 14. I. 1501.
Medical Rituals?
Did the doctors of that epoch also use rituals in the pursuance of their profes-
sion? Even if the term is taken very broadly, one could scarcely name here
such repetitive and purely functional actions as inspecting urine samples or
feeling a person’s pulse. And what of the customary consultation of the horo-
scope and the heavenly constellations, or the choice of the right day (avoiding
the unpropitious “Egyptian days,” as they were called [see for instance Mauch,
2006])? Not from the perspective of the Middle Ages, because in the eyes of
those academically trained doctors they were dealing with a serious scientific
technique.
Moreover, a link with faith-bound religious operations is scarcely enough
to qualify something as a healing ritual. After all, mediaeval medicine did not
exist in a vacuum free of worldviews, but like any other profession, was essen-
tially under Church supervision. The clergy sought to exercise control by means
of Canon Law. Thus, for instance, in the canon 22 of the Lateranum IV the
medical profession was bound to advise the patient on all accounts to “call the
physician of the soul” (Foreville, 1970). In practice this meant, for instance, that
(according to the regulations issued in 1328) the hospital in Munich refused
to administer help before a patient had confessed (Dirr, 1934). And obviously
there were also highly devout doctors who took it upon themselves not to give
a consultation before the patient had rued his or her sins, as Nikolaus of Bibra
proudly noted around 1283 with regard two Erfurt doctors (Mundhenk, 1997).
Although surgeons in particular evinced a comparatively large number of skep-

tics and agnostics in the Middle Ages (Dinzelbacher, 1999), the large majority
would have been devout in the normal sense of that time, as attested to by
numerous biographies. After all, no lesser authority than Galen had agreed to
have an abscess cured by the god Asclepius (Mullin, 1979).
The sequence of behavior sketched out here in regard to sickness was
instilled in the people accordingly, such as by the much read lawyer poet Sebas-
tian Brant:
Illness often comes from sins,

And sin great days of sickness brings.
So he who wants to avoid disease,
Should ensure he God doth please,
See to it he goes to confess,
Before he imbibes remedies,
And that his soul is fit and thrives,
E’er the body’s physician arrives. . . .
(from “Narrenschiff,” in Lemmer, 1986)
Admittedly religious aspects do not appear to have had any bearing on the
practice of administering therapy as a doctor. The specialist literature was by
and large indebted to a tradition hailing from pre-Christian Antiquity, which as
a rule continued to remain free of Christian influence and reinterpretation. It
cannot be assumed that religious ceremonies were a regular part of the agenda
of the Mediaeval medical profession.
Doubtless due to their small numbers compared with the overall popula-
tion, the doctors only occasionally found themselves competing with the saints
(Dinzelbacher, 1994); despite the strikingly large number of religious skeptics
already found in this profession in the Middle Ages (Dinzelbacher, 2009), the
majority were pious and many of them did not scoff at praying for supernatural
help—or receiving the same through magic.
Who Performed the Healing Rituals?
Magical and religious healing rituals were not performed primarily by “ritual
experts,” such as healers or priests, but chiefly by the sufferers themselves. This
is suggested because there were a great many forms of blessing and incanta-
tion that were generally designed for self-administration. One can think of such
words as Niem ain wurzen . . . mach ein kränzlin davon. . . . [Take a spice, make a
garland of it] or (making the sign of the cross and repeating the Pater Noster):
Ich hab mich verruckht vnnd hab mich verrenckht,

Got den herren hat mann gehenckht.
Schadt jme sein henckhen nichts,
so schadt auch mir mein verrenckhen nichts.
I’ve cricked myself, put myself out of joint
But God the Lord has been hung.
Yet for him the hanging does not hurt
So my crick will do me no wrong.
The poem clearly implies that the incantation and the accompanying rituals
are to be performed by the afflicted person. Obviously other evidence exists. A
narrative example, as it were, is the story of Deacon Walfroy given by Gregory
of Tours (second half of the sixth century): After the destruction of a Temple
dedicated to Diana in the course of Christianization, his entire body began to
be covered with pustules. “I went alone into the church and stripped myself
before the holy altar. Now I had there a jar full of oil which I had brought from
Saint Martin’s church. With this I oiled all my body with my own hands and
soon lay down to sleep. I awoke about midnight and rose to perform the service
and found my whole body cured as if no sore had appeared on me. . . .” (Tours,
1916: 8, 15). Or: The celebrated doctor Arnaldus de Villanova tried out a modi-
fied Pater Noster prayer on himself by requesting that he be freed of warts and
by plucking and burying glasswort during three repetitions; by the time the
plant had rotted, the warts had disappeared (Löhr, 1943).
Of course, there were also professional and semiprofessional healers—
ranging from ecstatic shamans to herbalists to quacks—who practiced Chris-
tian or non-Christian healing rites. Even the clergy could clearly work as magical
healers, as for instance a certain priest of Ramsholt in Suffolk, who tried to
cure his sick daughter with “charms and medicines” before it occurred to him
to summon St. Thomas à Becket (Finucane, 1977). In emergencies neighbors
or other helpful people would step in, such as the five widows who attempted to
help a drowned man by reeling off nine Our Fathers (Finucane, 1977).
Even when they had none of their own, priests possessed the charisma
of their position, which now and then seems to have been helpful with the
sick; saints, on the other hand, always distinguished themselves by their per-
sonal charisma. The mediaeval Vitae are full of descriptions of successful exor-
cisms; one famous case is the exorcism of a possessed noblewoman in 1169 by
Hildegard of Bingen, which fills many pages of her biography. After Sigewize
had been taken unsuccessfully to a succession of relics over a period of eight
years, the demon revealed that only Hildegard could dispel him. For this the
saint drew up an exceptionally elaborate ritual: after fasting and scourging
themselves, followed by prayer and communion, seven priests as embodi-

ments of the Seven Gifts of the Holy Ghost were to surround the possessed
woman with rods. Using various formulas of exorcism, the woman was to be
beaten repeatedly on the head, back, breasts, navel, kidneys, knees, and feet.
The ritual produced only momentary respite. Not until the afflicted noble went
on a pilgrimage to Hildegard in her convent and was exorcised by her in person
did the evil spirit leave via her private parts (Radimersky, 1957; Schipperges,
1985). Admittedly this great efficacy on the part of the abbess (who according
to Church law was not entitled to perform exorcism), compared with that of
the consecrated holders of office, presents a most unusual case in the annals
of demonology.
No doubt a major function of the saints was essentially to aid the faithful in
their illnesses as “heavenly doctors.” This applies not only to medical specialists
such as Cosmas and Damianos, but, according to the anthologies of miracles,
to virtually all the venerated. As a rule, such living charismatics as Hildegard
saw themselves as nothing more than mediums of grace, whose intercessions
simply motivated God to perform a miracle. Against this belief, the healers and
magi on society’s margins believed in part that their powers issued from their
own selves, while others believed they acquired them by banning evil spirits or
signing themselves away to the same in a pact.
Rulers could also possess a certain healing power: it sufficed to secretly cut
off the fringes of the cloak of Merovingian King Guntram (sixth century) and
dissolve them in water to create a draft that instantly restored health to those
with fever (see in this connection Erkens, 2005). This royal unction “worked”
in this archaic world every bit as well as the mana in the saintly garments kept
as relics. Unexpectedly, however, this incident appears to be the only exam-
ple from the first half of the Middle Ages. Not until the later epochs did a
celebrated tradition emerge of wonder-working kings—in both England and
France (Bloch, 1924; Boureau and Ingerflom, 1992; Cardini, 2005). In par-
ticular scrofula, also known as the “King’s evil,” could be healed by the touch
of a sovereign in an act that could be termed a rite, not least because it was
performed at specific times (Le Goff, 1988).
Possibilities for Interpreting Efficacy
Depending ultimately on the type of text involved, the sources of the epoch
refer both to healing successes due purely to medicine from this world, as well
as to successes due to transcendental intervention. Proofs would seem to obvi-
ate themselves here. Did people in the Middle Ages ponder on the efficacy of
rituals in this regard? As a rule the sources do not broach this subject, and it
is likely that those who employed healing rituals generally proceeded on the
assumption of a power (virtus) that resided in the word, gesture, or charm itself
and that was not questioned. Nor was there any discussion in the many phar-
macopoeias as to why certain medicinal plants had this or that effect. Other
healers, however, took their guidance from the ancient tradition that medicinal
plants had qualities corresponding to the bodily humors. Naturally some medi-
cal texts also noted that medicines consisted of natural substances created by
God and that even medicinal healing is due to God, the prime cause (Esser,
1997; Haage, 1999), as was already written in the Old Testament (Ecclesiasti-
cus 38:2–4). The first of these explanations concurs with our own understand-
ing of the world, the second with the dominant worldview of that epoch, which
stands in contradiction to the general knowledge of our time and above all
to historical method, which recognizes on principle only structures that are
immanent in the world.
In regards to magic, certain intellectuals since Antiquity have in fact con-
sidered giving a rational explanation for it. Among Christian authorities we
see that St. Augustine developed a theory of signs that remained influential
throughout the Middle Ages (Markus, 1994). According to him, signals may
be discerned in magical rites by which the demons are invited to employ their
powers according to the wishes of the magus. Therefore unlike other authors
of Antiquity, he did not qualify magic as a neutral exercise of hidden natu-
ral powers, but recognized it as an evil action per se, because Christianity did
not acknowledge the existence of benign demons, so the possibility of white
magic was ruled out. The performance of such rites in secret was seen by the
Church fathers as a basic indication of evil intentions. The structural similari-
ties between the operations of the saint and those of the magus were not lost on
Augustine, but since he assumed that the two had totally different purposes—
on the one hand the glorification of God, on the other that of man—they had
to be judged differently. It should be noted that such models sought to explain
magical operations as a whole, and not simply or especially those of healing
magic.
As for the possible efficacy of rites in healing terms, from the current scien-
tific perspective the same possible explanations should be applied to the Middle
Ages as to other cultures with healing procedures that are coupled with rites:
• Mental aspects, especially autosuggestion, whether autonomous or

introduced by a healer;9 suggestion or hypnosis; also a placebo effect.
Remarkable in this connection is the fact that the majority of successful
healings that are ascribed to mediaeval saints relate to mental or
psychogenetic physical disturbances, such as epilepsy, passing

blindness, paralysis and the like.10
• Parapsychic aspects, that is, effects produced solely by the mental
influence of the healer.
• Medicinal aspects, when drugs or manipulations of the patient’s body
in the company of rites produce biologically comprehensible effects.
• Spontaneous healing that is inexplicable from the present standpoint.
Be that as it may, evidence that “rituals transform sick persons into healthy ones”11
must be deemed lacking for the Middle Ages, because in no single instance of heal-
ing do we know all of the environmental factors that existed. This point may be
underlined if we look at an autobiographical text that describes a recovery through
the ritual of incubation: As a child, reports the subsequent Benedictine Abbot
Guibert of Nogent (†1124), he succumbed for several days to a fever and was not
even able to eat. Thereupon his mother instructed the boy’s teacher and the chap-
lain to spend the night with him before the altar of their own church. At around
midnight they were awakened by an appalling din—and the next morning Guib-
ert was fully restored. Although the report is written by the person concerned, and
it brings us as close to what Clifford Geertz terms the “first order” of evidence as
is possible for the Middle Ages, one cannot definitely conclude that the doubtless
impressive experience during the incubation had produced a cure through a men-
tal shock. The illness could have reached its natural term by then, or unmentioned
medicines could have been administered—there is simply no information one
way or the other in the source, so these possibilities cannot be excluded. Guibert,
writing many years later as an abbot, clearly believed in this religious explanation,
in keeping with his world picture, and he propagated it accordingly.
Now that rituals have long attracted the attention of cultural anthropology,
religious studies, and sociology, in recent years the topic has also gained a place
in the areas of Mediaeval history and literary studies. This attention can be seen
in publications dedicated to the topic, although as a rule they are concerned
not with healing rituals but withrituals in politics, communications, literature,
and other fields (e.g. Althoff, 1994, 1997; Classen, forthcoming; Harth and
Schenk, 2004; Leyser, 1993). Although undoubtedly rituals could be of great
importance in a culture centered chiefly on oral communication, this was far
less true of the specific realms of sickness and healing than it was of religion
or the exercise of power (J.-C. Schmitt, 1999). Furthermore, in many cases
the ritual was doubtless merely the form that cloaked the actual agents. These
might be the blows administered during an exorcism that broke through a
psychosomatic block, or an herb given amidst incantations and gestures, for
example. When, for instance, a cure for mental disturbances in an Anglo-Saxon
leech book recommends that beer be mixed with herbs and lichen and drunk
from a church bell over which seven masses have been sung (Olsan, 2000,
650), there is a distinct possibility that it is primarily the medicinal plants that
trigger the physical and mental reaction. This was exactly the opinion that Doc-
tor Johannes Hartlieb expressed in 1455–1456 in his treatise on superstition
regarding the “forbidden arts.” He wrote that the blessings performed with
holy water had no power of their own and that the effect came from the herbs
and roots dissolved therein, from “that power that things have of which they
be made. This be however quite natural and has nothing to do with blessing or
words” (Hartlieb, 1989). This process can clearly be seen when a thaumaturge
such as Franceso di Paola, whose cures were always ascribed by his contempo-
raries to divine grace, regularly administered an herb or some other substance
when giving his patients “spiritual” treatment (Addante, 1988).
As always when reframing a topic, scholars of the Middle Ages have suc-
cumbed to the danger of overestimating the relevance of the freshly “discovered”
to their own discipline. Seductive in this case is perhaps the unconscious long-
ing for the stability allegedly provided by rituals; more than a few historians in
our ritually barren times have been led to interpret early procedures along these
lines, although the sources do nothing to substantiate this hypothesis. A glaring
example is the interpretation of the public weeping by rulers as a political ritual
(Dinzelbacher, in press). It is with this phenomenon in mind that I call here for
the significance of ritual behavior in the spiritual and worldly healing arts of the
Middle Ages to be given only as much weight as is justified by the sources. And
this, as I hope could be seen, lies almost exclusively in the realm of white magic,
whether performed by the Church, outside the Church, or by its opponents.12
acknowledgments
My heartfelt thanks to Bernhard Haage for his Argus-eyed reading of the first draft of
this chapter. The translation by Malcolm Green has been authorized by the writer.
notes
1. It goes without saying that there are libraries of books on the controversial
theoretical discussions surrounding each of the main concepts such as religion, rite,
ceremony, magic, etc. I have used the terms as they appear in my Handbuch der
Religionsgeschichte im deutschsprachigen Raum II (Dinzelbacher, 2000). A good, brief
overview is given by S. Tschopp and W. Weber (2007, 113 ff., 147 ff.). Not yet available
by the time this article was concluded were Ambos et al. (2005) and Althoff
et al. (2007).
2. See Geary (1983), who gives examples from the 11th and 12th centuries, and
of a ban on this custom in the 13th century.
3. See Dinzelbacher (2003) for a summary and list of sources.
4. “En communiant à la messe, le chrétien mange donc la chair d’un homme et
celle d’un dieu” (Walter, 1992: 145).
5. The literature in Lexikon für Theologie und Kirche, Lexikon des Mittelalters,
etc., is by and large unusable for Medieval practice. The best informed is still Franz
(1960).
6. This distinction seems first to establish itself after 1200 (Kieckhefer, 1992).
7. “collo suspendere vel qualitercumque portare ad suam protectionem”
(Aquinas: 2, 2, q. 96, a. 4, 3). See also Siebert (1907).
8. “Ich beser dich wurm vnd wyrmin . . .” (Holzmann, 2001).
9. Introduced autosuggestion is the term used in W. Seabrook, Witchcraft. Its
Power in the World Today (1968), to explain the psychosomatic efficacy of black magic
(this only functions when the victim is informed that magic is being used on him, to
which he or she responds with anxiety fantasies leading to physical illness).
10. The findings of Sigal (1985) must in principle apply to Germany and the late
Middle Ages, too. See for instance Busse-Wilson (1939) and Ohler (1985). For modern
examples of miracle cures and their explanation from the worldly perspective see for
instance Nickell (1993).
11. See William Sax in the introduction to this volume.
references
Addante, P. 1988. San Francesco di Paola. Cinisello Balsamo.
Althoff, G. 1994. Ritual und Demonstration in mittelalterlichem Verhalten. In
B. H. Helmut Brall and Urban Küsters (eds.), Personenbeziehungen in der
mittelalterlichen Literatur, 457–476. Düsseldorf.
Althoff, G. 1997. Les rituals. In J.-C. Schmitt and O. G. Oexle (eds.), Les tendances
actuelles de l’histoire du Moyen Age en France et en Allemagne. Actes des colloques de
Sèvres, 231–242.
Althoff, G., et al. 2007. Die neue Kraft der Rituale. Sammelband der Vorträge des Studium
Generale der Ruprecht-Karls-Universität Heidelberg im Wintersemester 2005/2006.
Stuttgart.
Ambos, C., et al. (Eds.). 2005. Die Welt der Rituale. Darmstadt.
Angel, H.-F. 1996. Der religiöse Mensch in Katastrophenzeiten. Frankfurt.
Bacci, M. 2000. Votive Offerings. In C. Lindahl et al. (eds.), Medieval Folklore,
1021–1025. Santa Barbara.
Bartels, K. 1997. Musik in deutschen Texten des Mittelalters. Frankfurt.
Bauch, A. (Ed.). 1979. Quellen zur Geschichte der Diözese Eichstätt II: Ein bayerisches
Mirakelbuch aus der Karolingerzeit. Regensburg.
Beck, G. 1962. Der heiligen Otto von Bamberg. Bamberg.
Beek, H. H. 1969. Waanzin in de middeleuwen: Beeld van de gestoorde en bemoeienis met
de ziecke. Nijkerk.
Beissel, S. 1892. Die Verehrung der Heiligen und ihrer Reliquien während der zweiten
Hälfte des Mittelalters. Freiburg i. Br.
Bieler, L. (Ed.). 1971. Four Latin Lives of St. Patrick. Dublin.
Bihlmeyer, K. (Ed.). 1906. Heinrich Sense, Deutsche Schriften. Stuttgart.
Bloch, M. 1924. Les rois thaumaturges. Paris.
Boureau, A., and Ingerflom, C. (Eds.). 1992. La royauté sacrée dans le monde
chrétien. Paris.
Burger, C. 1990. Volksfrömmigkeit in Deutschland um 1500 im Spiegel der Schriften
des Johannes von Paltz OESA. In P. Dinzelbacher and D. R. Bauer (eds.),
Volksreligion im hohen und späten Mittelalter, 307–328. Paderborn.
Busse-Wilson, E. 1939. Die Wunder am Grabe der hl. Elisabeth von Marburg. Beiträge
zur hessischen Kirchengeschichte 11: 184–209.
Bynum, C. W. 1987. Holy Feast and Holy Fast: The Religious Significance of Food to
Medieval Women. Berkeley.
Cardini, F. (Ed.). 2002. Per me regnes regnant. Geneva.
Classen, A. (forthcoming). Rituale des Trauerns als Sinnstiftung und ethische
Transformation des eigenen Daseins im agonalen Raum der höfischen und
postheroischen Welt. Zwei Fallstudien: Mai und Beaflor und Diu Klage. LiLi.
Zeitschrift für Literaturwissenschaft und Linguistik.
Dinzelbacher, P. 1994. Christliche Mystik im Abendland. Paderborn.
Dinzelbacher, P. 1996. Angst im Mittelalter. Paderborn.
Dinzelbacher, P. 2000. Handbuch der Religionsgeschichte im deutschsprachigen Raum II:
Hoch- und Spätmittelalter. Paderborn.
Dinzelbacher, P. 2003. Mentalität und Religiosität des Mittelalters. Klagenfurt.
Dinzelbacher, P. 2008. Warum weint der König? Mittelalterliche Herrscher und Helden in
Tränen.
Dinzelbacher, P. 2009. Unglaube im Zeitalter des Glaubens. Badenweiler.
Dinzelbacher, P., and Heinz, W. in print. Europa in der Spätantike. Darmstadt.
Dirr, P. (Ed.). 1934. Denkmäler des Münchner Stadtrechts I. Munich.
Erkens, F.-R. (Ed.). 2005. Das frühmittelalterliche Königtum. Berlin.
Esser, T. 1997. Die Pest: Strafe Gottes oder Naturphänomen? Zeitschrift für
Kirchengeschichte 108: 32–57.
Finucane, R. 1977. Miracles and Pilgrims: Popular Beliefs in Medieval England. London.
Foreville, R. 1970. Lateran I–IV. Mainz.
Franz, A. 1960. Die kirchlichen Benediktionen des Mittelalters. Graz.
Geary, P. 1983. Humilation of Saints. In S. Wilson (ed.), Saints and their Cults, 2nd ed.,
123–140. Cambridge.
Gerabek, W. (1993). Der Zahnwurm. Geschichte eines volksmedizinischen Glaubens.
Zahnärztliche Praxis 44: 162–165; 210–213; 258–261.
Girault, M. u. P.-G. (Ed.). 2007. Livre des Miracles de saint Gilles. Orléans.
Goodich, M. 2004. Lives and Miracles of the Saints. Aldershot.
Graus, F. 1994. Pest—Geißler—Judenmorde, 3rd ed. Göttingen.
Grimm, J. 1981. Deutsche Mythologie III. Frankfurt.
Grisar, H. 1912. Martin Luther. Freiburg.
Groß, A. 1990. “La folie.” Wahnsinn und Narrheit im spätmittelalterlichen Text und Bild.
Heidelberg.
Güting, E.-D, and Beheims, M. Gedicht gegen den Aberglauben und seine lateinische
Vorlage. In Forschung und Berichte zur Volkskunde in Baden-Württemberg
1974–1977, 197–218.
Haage, B. 1999. Alchemistische Arzneimittelherstellung vor Paracelsus. Nova Acta
Paracelsica 13: 217–236, 229.
Haage, B. D. 1992. Studien zur Heilkunde im “Parzival” Wolframs von Eschenbach.
Göppingen.
Hahl, W., and Fricke, H. (Eds.). 2003. Ritual: Neubearbeitung des Reallexikons der
deutschen Literaturgeschichte, vol. 3. Berlin.
Hall, A. 2007. Elves in Anglo-Saxon England. Woodbridge.
Harth, D., and Schenk, G. (Eds.). 2004. Ritualdynamik, Kulturübergreifende Studien zur
Theorie und Geschichte rituellen Handelns. Heidelberg.
Hartlieb, J. 1989. Das Buch der verbotenen Künste: Aberglauben und Zauberei des
Mittelalters, aus dem Mittelhochdeutschen, übersetzt, kommentiert und mit einem
Glossar versehen von Falk Eisermann und Eckhard Graf. Munich.
Hayer, G. 1998. Krankheit, Sterben und Tod eines Fürsten. In M. Wenninger (ed.), du
guoter tod, 31–50. Klagenfurt.
Hoffmann, J. 1891. Geschichte der Laiencommunion bis zum Tridentinum. Speier.
Holzmann, V. 2001. Ich beser dich wurm vnd wyrmin. . . . Bern.
Horchler, M. 2005. Die Alchemie in der deutschen Literatur des Mittelalters. Baden-Baden.
Jordan, W. C. (Ed.). 2004. Dictionary of the Middle Ages, Suppl. I. New York.
Keil, G. 2005. In W. Gerabek et al. (eds.), Enzyklopädie der Medizingeschichte, 641 ff.
Berlin.
Kieckhefer, R. 1992. Magie im Mittelalter. Munich.
Klingner, E. 1912. Luther und der deutsche Volksaberglaube. Berlin.
Kolmer, L. 1993. Heilige als magische Helfer. Mediaevistik 6: 153–175.
Lecouteux, C. 1988. Der Bilwiz: Überlegungen zu seiner Entstehungs- und
Entwicklungsgeschichte. Euphorion 82: 238–250.
Legner, A. 1995. Reliquien in Kunst und Kult: Zwischen Antike und Aufklärung.
Darmstadt.
Le Goff, J. 1988. Le mal royal au moyen âge: du roi malade au roi guérisseur.
Mediaevistik 1: 101–113.
Leyser, K. 1993. Ritual, Zeremonie und Gestik: Das ottonische Reich.
Frühmittelalterliche Studien 27: 1–26.
Lindahl, C., et al. (Eds.). 2000. Medieval Folklore. Santa Barbara.
Lipburger, M. 1993. Zum Tod Kaiser Friedrichs III. In L. Kolmer (ed.), Der Tod des
Mächtigen, 125–135. Paderborn.
Löhr, H. 1943. Aberglauben und Medizin. Leipzig.
Markus, R. 1994. Augustine on Magic: A Neglected Semiotic Theory. Revue des Études
Augustiniennes 40: 375–388.
Mauch, U. 2006. Der frühneuhochdeutsche Traktat über die verworfenen Tage.
Mediaevistik 19: 213–240.
Meier, P. 1993. Paracelsus. Zürich.

Mullin, R. 1979. Miracles and Magic. London.
Mundhenk, C. (Ed.). 1997. Occultus Erfordensis. Weimar.
Nickell, J. 1993. Looking for a Miracle. Amherst.
Nola, A. d. 2004. Der Teufel, Wesen, Wirkung, Geschichte. Munich.
Ohler, N. 1985. Alltag im Marburger Raum zur Zeit der heiligen Elisabeth. Archiv für
Kulturgeschichte 67: 1–40.
Olsan, L. 2000. Medicine. In C. Lindahl et al., Medieval Folklore. Santa Barbara.
Philippovich, E. v. 1965. Kuriositäten—Antiquitäten. Braunschweig.
Pietsch, P. 1884. “Kleine Beiträge zur Kentnis [sic] des Aberglaubens des Mittelalters.”
Zeitschrift für deutsche Philologie 16: 185–196, 190.
Radimersky, G. W. 1957. Magic in the Works of Hildegard von Bingen (1098–1179).
Monatshefte für deutschen Unterricht, deutsche Sprache, deutsche Literatur 49:
353–359.
Robertini, L. (Ed.). 1994. Liber miraculorum S. Fidis 2, 1. Spoleto.
Saint Bridget of Sweden. Revelationes 6. Retrieved from http://saintbridget.fiberia.
com/vol1_book1/b1_b1_ch6.htm
Saintyves, P. 1931. En marge de la Légende Dorée: Songes, miracles et survivance. Paris.
Scheidegger, G. 2002. Das Neugeborene und der Teufel. Archiv für Kulturgeschichte
84: 259–291.
Schipperges, H. 1985. Heilung einer Geisteskranken im hohen Mittelalter. Zeitschrift
für klinische Psychologie 33: 58–64.
Schmitt, J.-C. 1982. Der heilige Windhund. Stuttgart.
Schmitt, J.-C. 1993. Heidenspaß und Höllenangst, Aberglaube im Mittelalter.
Frankfurt.
Schmitt, J.-C. 1999. Rites. In J. Le Goff and J.-C. Schmitt (eds.), Dictionnaire raisonné
de l’Occident médiévale. Paris.
Schönbach, A. E. 1900. Studien zur Geschichte der altdeutschen Predigt II: Zeugnisse
Bertholds von Regensburg zur Volkskunde (SB Wien 142/7). Vienna.
Schulz, M. 2003. Beschwörungen im Mittelalter. Heidelberg.
Schurer, P. 1962. Die selige Gute Betha von Reute. Reute.
Seabrook, W. 1968. Witchcraft: Its Power in the World Today. New York.
Shahar, S. 1991. Kindheit im Mittelalter. Munich.
Siebert, H. 1907. Beiträge zur vorreformatorischen Heiligen- und Reliquienverehrung.
Freiburg.
Sigal, P.-A. 1985. L’homme et le miracle dans la France médiévale (XIe–XIIe siècle).
Paris.
Skemer, D. 2006. Binding Words: Textual Amulets in the Middle Ages. University
Park.
Sparber, A. 1957. Leben und Wirken des seligen Hartmann, Bischofs von Brixen,
(1140–1164). Vienna.
Tschopp, S., and Weber, W. 2007. Grundfragen der Kulturgeschichte. Darmstadt.
Waldmann, S. 1990. Die lebensgroße Wachsfigur. Munich.
Walter, P. 1992. Mythologie chrétienne: Rites et mythes du Moyen Age. Paris.
Weisser, C. 2005. In W. Gerabek et al. (eds.), Enzyklopädie der Medizingeschichte,

652 ff. Berlin.
Wilson, S. (Ed.). 1983. Saints and Their Cults. Cambridge.
Wittmer-Butsch, M., and Rendtel, C. 2003. Miracula: Wunderheilungen im Mittelalter.
Cologne.
Zambelli, P. 1991. L’ambigua natura della magia. Milan.
5
Excommunication in the
Middle Ages: A Meta-Ritual
and the Many Faces of Its
Efficacy
Paul Töbelmann
1 Introduction
Being excommunicated was for many centuries one of the most dreadful things
that could happen to a Christian. Throughout late Antiquity and the early and
high Middle Ages, excommunication was a powerful means to reform a sinner,
as well as being a severe social, economical, and political hazard. It would be
wrong to call excommunication a ritual, although there was a specific liturgical
ritual associated with it. Far more than that, it was also a juridical instrument
of discipline, a sociological as well as spiritual phenomenon (Logan 1968;
Vodola 1986).
The character of excommunication in the Middle Ages will serve as an
excellent example for demonstrating that ritual efficacy is a highly complex
thing. A ritual—much like any other social activity—can and will impact many
different objects at once. These can often be separated into distinct spheres or
levels of efficacy. In the case of excommunication, one of these is the sphere
of ritual itself: excommunication affected not only the excommunicate’s ability
to participate in the community’s religious rituals, but also every other com-
munity member’s ritual experience. Thus excommunication was a meta-ritual;
that is, a ritualized system of actions and ideas that influenced other rituals.
In this chapter I will first give an overview of the development and historical
dynamics of excommunication in the Middle Ages. Next I will analyze the sol-
emn rite of excommunication, what I call the candle ceremony. Finally, I will
interpret medieval excommunication in terms of its complex threefold effi-

cacy and will develop the notion of meta-ritual in more detail. I aim to foster a
deeper understanding of the difficulties and intricacies involved with analyzing
ritual efficacy, and to further the notion that understanding ritual efficacy is a
cornerstone of understanding why rituals are performed at all. I also hope that
this presentation of a phenomenon right on the brink of what can still be called
a ritual will nurture the idea that ritual is not a phenomenon sui generis, but
rather just one class of complex social activity among many—even though it is
set apart in its intentional logic (Humphrey and Laidlaw 1994).
2 History
In the year of the Lord 878, Pope John VIII wrote to his colleague archbishop
Athanasius of Naples to congratulate him: “Your holiness has, with faithful
devotion, taken care to gladly sacrifice and cut off a limb of your body that is
putrid with great infection” (Kehr 1928: 72 f.; cf. Lohrmann 1968). This ampu-
tation referred to the excommunication of Athanasius’ brother Sergius, the
Neapolitan duke who had snubbed the pope time and again. Sergius had made
alliance with the Saracen pirates who had been scouring the coasts of Italy
for decades (Rizzitano 1965; Daniel 1975: 55). This alliance was an unbear-
able sin in John’s eyes, and since Sergius was unwilling to change his foreign
policy, he was found guilty of contumacy, the refusal to bow to the authority of
the Church. This was the “infection” referred to in John’s letter, a contagious
affliction that might, John feared, spread to endanger the Church’s whole body
(Engreen 1945). Athanasius had removed the limb in the manner prescribed
in Matthew 5:30: “If thy right hand causeth thee to stumble, cut it off, and cast
it from thee: for it is profitable for thee that one of thy members should perish,
and not thy whole body go into hell.”
But what kind of body was this? John was referring to the ancient Christian
notion of ekklesía, the community in Christ (Struve 1978). According to Paul’s
first letter to the Corinthians, this is the community of the Eucharist. By taking
part in the bread and wine that are the flesh and blood of God’s son, all Chris-
tians also take part in the Holy Spirit that suffuses the body of Christ. Christ
himself, according to Paul’s letter to the Colossians, is “the head of the body,
that is, the congregation.” The ritual of the Eucharist, performed by individual
Christians who undergo the ritual of baptism, ties them together and fuses
them in one mystical body (Gommenginger 1951: 4 f.). Therefore, the commu-
nity of Christians everywhere was endangered if a member contracted a (spiri-
tual) disease. In the case of Duke Sergius, this disease consisted in trafficking
excommunication in the middle ages 95
with the Saracens, for these were, according to Pope John VIII, an “impious
people,” “enemies of the cross” and “odious to God.” Good Christians should
never take refuge with these “limbs of the devil, who are the children of forni-
cation, and vessels of wrath.” Instead, they should work “for peace and unity
among the faithful,” so that “the body of God’s holy church is not wounded
in its members.” Apparently, there existed a body of the devil that opposed
the mystical body of Christ at every turn, intent on wounding its members or
afflicting them with disease (Vismara 1974: 21 ff.).
While this idea was not wholly new in Pope John VIII’s time, he was cer-
tainly one of the more consequential pursuers of bodily hygiene, so to speak.
Not many popes before or after him made use of excommunication against
princes and monarchs as often as he. And his is also one of the earliest exam-
ples of excommunication used solely for political purposes—for all the talk of
Christian unity, simile and metaphor could not disguise the fact that John’s
ends were highly political in nature (Engreen 1945). He tried to create a league
of independent Italian principalities and baronies, with himself at the summit.
He put pressure on his political enemies, especially those who worked with
the Saracens, by employing the most severe penalty the Church could inflict:
excommunication. In this chapter I will study this penalty from several differ-
ent angles, with special attention to its efficacy. When finally I return to this
starting example, I hope to have clarified some general ideas about Christian
ritual in the Middle Ages.
In the early days of Christianity, excommunication was understood as a
state of being rather than as a sentence (Logan 1989: 536). Closely interwoven
with the broader concepts of sin and penance, it referred to the state sinful
persons were in. The state of excommunication meant that they were no longer
part of the community in Christ, they were set apart from God. Until about the
fifth to sixth century A.D. sinners were understood to have left this community
of their own accord, by their own doing, without interference by the Church
(Gommenginger 1951: 29). Even if their sin was secret and they still attended
the Eucharist, partaking in the bread and wine no longer held sacramental
power for them and did not bring them any closer to God.
Once a mortal sin had come to be known publicly, though, this private
state of excommunication before God was also transformed into a public mat-
ter. Sinners were separated from the congregation in that they were no longer
allowed to take part in the sacraments, especially the Eucharist. They were com-
manded to show regret and do penance, even after they were readmitted to the
Eucharist (Gommenginger 1951: 30, 32 f.). In many ways, penance was similar
to Jewish methods of discipline (Hill 1957: 1 f.; Hein 1975: 3–12, 412–414). It
could consist in wearing specific penitent garb and hair, in prayer, almsgiving,
fasting, abstinence from sexual intercourse, and pilgrimages. As van Gennep

has noted, these rites of penance not only resembled Jewish disciplinary rites,
but also made heavy use of Jewish mourning imagery (1960: 93–97; cf. Vodola
1986: 9 f.). The penance was to be undertaken in a state of excommunication
from the Church, as part of the hardships penitent sinners had to endure. In
no way did it exclude them from the social community at large, however: only
the sacraments were forbidden to them (Gommenginger 1951: 28). The most
hardened heretics and schismatics were sometimes punished by the denounce-
ment of a synod and set apart from the social community as well, because they
were deemed a danger to other Christians. This denunciation was known as
anathema and was well nigh irreversible (Gommenginger 1951: 44).
But even in ancient Christianity the excommunication of penance was
reserved for severe cases, namely, contumacy (Gommenginger 1951: 42 f.).
Only sinners for whom simple penance—that is open confession of their
wrongdoing and the promise to make amends—did not seem to be effective
were held to be in a state of excommunication, so as to increase the pressure.
Excommunication must first and foremost be understood as an instrument
of Church discipline, whose aim was always to correct the excommunicate by
pressuring him to return to the fold (Hill 1951: 215). Being prohibited from the
sacraments must have been a severe blow to any Christian’s confidence, for it
carried the danger of dying without confession and extreme unction—mak-
ing the soul highly susceptible to eternal damnation. Thus it was a powerful
reminder of the dangers of sinfulness, and of the therapeutic worth of penance,
and was applied mostly medicinally (Reynolds 1987: 433; Logan 1989: 537 f.).
Small wonder, then, that only the highest-ranking and therefore presumed wis-
est Church personnel, namely bishops, archbishops, cardinals, and of course
the pope, were charged with excommunicating unrepentant sinners (Hill 1951:
213; Logan 1968: 25 ff.).
In ancient Christianity, penance was still very much a public matter. Con-
fessions were made, penance was performed, and absolution was granted in
front of the whole congregation (Reynolds 1987: 433). Consequently, excom-
munication from the church was firmly anchored in the public as well, since
it excluded the excommunicate from the rituals a congregation performed
together. But until the seventh century A.D., public penance gradually came
to be reserved for notorious sinners only. Private sins could be confessed pri-
vately, and the priest could administer private penance for them (Gommengin-
ger 1951: 35, 39). Publicly known sins, on the other hand, increasingly came to
be regarded as crimes to be judged in court. Penance and excommunication
were separated into private and public; penance no longer excluded the peni-
tent from the Eucharist, and excommunication was no longer understood as a
state being incurred by sinning, but as a sentence handed down in court. This
was the beginning of the distinction between the interior and exterior forums.
God was the sole judge of the imagined court of the interior forum. He judged
secret sins, thoughts, and lack of faith, and his decisions were executed by
priests. However, the court of the exterior forum was staffed by ordinary men
(Mörsdorf 1957).
Naturally, actions such as heresy and blasphemy were considered crimes
in the Middle Ages, to be punished by the ecclesiastical courts. But minor sins
such as adultery, incest, perjury, or simply working on a holiday were handled
much the same way as these, though perhaps less harshly. The ecclesiasti-
cal courts could also judge a sinner to be notorious, or contumacious, and
proclaim him excommunicate. Thus excommunication was firmly attached
to the juridical procedures of the courts and would be incurred by anyone
foolish enough to stick to his crimes or otherwise deny the courts’ authority
(Hill 1951: 214; Logan 1989: 536). Since ecclesiastical courts were not lim-
ited to bishops, they were in practice often headed by other clergymen, espe-
cially abbots and archdeacons (Logan 1968: 33 f.). In the High Middle Ages,
many were even headed by laymen, who consequently gained the power of
excommunication when they acted as judges. The secular powers also began
to reinforce the sentences of ecclesiastical courts with fines, imprisonment,
confiscation, and even exile. Excommunicates were often not allowed to hold
public office or to participate in warfare; they could not be plaintiffs or judges
and could not swear oaths, a restriction that made legal defense very difficult
(Vodola 1986: 70 ff.).
Around A.D. 1140, Gratian’s Decretum compiled the canon law of the time
and served as a sturdy fundament of judgment in ecclesiastical courts. The
Decretum also contains Gratian’s understanding of excommunication. It insti-
tutionalized excommunication as the most severe punishment to be handed out
by ecclesiastical courts. Contumacy was still the prerequisite for this ultimate
instrument of Church discipline. But whereas in late antiquity contumacy was
“deliberate and obstinate opposition to the very authority of the Church,” by the
twelfth century it had come to mean merely disobedience to ecclesiastical law
(Logan 1968: 44). Thus excommunication could be, and was, incurred much
more easily and frequently.
A more severe form of excommunication, what Gratian called excommu-
nicatio totalis, later generally known as major excommunication, was a viable
threat to the stiff-necked. An excommunicate who did not seek reconciliation
could be judged incorrigible and proclaimed anathematized. Not only did this
judgment ban them from the sacraments of the Church, it also imposed on
every Christian the obligation not to traffic with the anathematized under
any circumstances, be they social, political, or economic. Anybody who dared

infringe on this obligation was put under the sanctions of minor excommuni-
cation, that is, exclusion from the sacraments. This excommunicatio totalis was
similar to, though less severe than, anathema, and the sources often treated the
two as if they were the same.
Excommunicates were often forced to reconcile quickly with the ecclesi-
astical authorities; otherwise additional penalties were inflicted by the secular
arm. In England and the Empire, the period of warning was forty days and six
weeks, respectively, after which the obstinate excommunicate was threatened
with imprisonment in England, and the imperial ban in the Empire (Logan
1968: pass.). This kind of regulation became very common in Europe in the
Late Middle Ages, as the Church pressed lay authorities to lend their weight to
the salvation of souls. After excommunication had been proclaimed against a
sinner, there was no more the Church could do, after all. The excommunicate’s
soul was then in great danger of being lost, a fate that meant defeat not only for
the sinner but also for the Church. This danger, together with the more com-
mon use of excommunication as a sentence, made it necessary to employ the
secular arm to enforce compliance by excommunicates.
One special form of excommunication, excommunicatio latae sententiae,
was institutionalized in the twelfth century as well (Huizing 1955; May 1980:
173 f.; Vodola 1986: 28 ff.). Without our going into this matter too deeply, suf-
fice it to say the following. Certain crimes, such as striking a priest, preaching
heresy, and desecrating or robbing a church, were said to carry a sentence of
excommunication in themselves. No further act was necessary on the part of
the Church authorities: The moment a crime punishable by excommunication
latae sententiae became known, the offender was excommunicated. This con-
struction contributed to excommunication’s becoming more and more imper-
sonal and technical, as we shall see.
3 Ritual
As a ritual of exclusion, excommunication made use of a few distinctive forms,

although the most important part was arguably the words spoken. Ritual actions
signifying exclusion could include spitting or closing doors. They always bore
the marks of a curse segregating the excommunicate by making him sacer; that
is, putting him as an individual in a spiritual rather than social category (Vod-
ola 1986: 3 ff., 45 f.). One ceremony became most prominent. The following
ritual prescription was originally compiled in the eleventh century in Burchard
of Worms’ Decretum, as caput 3 in the eleventh book. Gratian copied it a century
later as c. 106 of the third quaestio in the eleventh causa: “Twelve priests must
stand around the bishop in a circle holding burning candles in their hands,
which in conclusion of the anathema or excommunication they must fling to
the ground and extinguish with their feet; after this, letters are sent through
the parishes, containing the names of the excommunicated and the reasons
for the excommunications.” These are the words to be spoken (ibid.: c. 107):
“Following the canonical institutes and the examples of the Holy Fathers, we
eliminate the violators of God’s churches N. from the bosom of Holy Mother
Church and from community with all Christianity, by the authority of God and
the judgment of the Holy Spirit, until they come to their senses and satisfy
God’s church.”
This prescription invokes powerful imagery: A church lit only by twelve
candles; a bishop in full regalia speaking the condemning words in a sol-
emn voice; twelve priests in a circle around him, at all points of the clock;
the bishop reaching the end, the candles being tossed to the ground; twelve
heels crunching down, smothering the light, darkening the church. A bishop
for Christ proclaiming the sentence, twelve priests for twelve apostles as wit-
nesses, candles for the light of salvation, extinguished like the light of faith in
the excommunicate.
Gratian does not go into specifics concerning the setting of this ceremony.
In fact, today we do not know whether this procedure was actually much used
at all, for no sources survive that explicitly say so. In the case of England, a study
of over 15,000 excommunicates has not revealed one case in which this ritual
is reported to have been performed (Logan 1989: 537). This kind of source dif-
ficulty is no news to historians, of course: it is one of the main difficulties, or,
if you like, challenges of the trade. The most common elements of daily social
life are sometimes the hardest to ascertain from the sources, simply because
medieval authors thought them too common to waste parchment by mention-
ing them. Some logical assumptions may thus be in order, even though there is
little direct evidence for the performance of the candle ceremony. It is quite fea-
sible to surmise that the thousands of monks and clerics who copied Gratian’s
work thought of the prescribed procedure as the primary, correct, and proper
way to go about an excommunication. It may be that the candle ceremony was
not performed all the time, or even with any great frequency, yet in medieval
contemporary thought it remained the “proper” method. Gratian’s Decretum
had soon achieved such a status that it became almost unheard of to copy only
part, and not all, of it. As a result, the candle ceremony was guaranteed a dedi-
cated space in what people knew about excommunication. We cannot be sure
that the described form was actually used in everyday practice, but neither can
we dismiss the evidence of this source out of hand. Let us simply assume for
the moment that the candle ceremony was a distinct possibility, a very solemn
way of excommunicating an obstinate sinner.
In day-to-day affairs, especially in court, excommunication cannot have
taken the form described. For instance, it was not always a bishop who excom-
municated a culprit. As was mentioned, even a layman could hand down the
sentence, acting as judge in an ecclesiastical court. It might be assumed that
the candle ceremony still needed to be performed to act upon the findings and
sentence proclaimed by the court. If this were the case, the bishop and his
candle-bearing clerics would have been the executing organs of the court, little
more than spiritual henchmen, if you will. However, this does not seem to have
been the case. Gratian and the Decretists all agreed that the moment the sen-
tence of excommunication was declared, it took effect. Even an unjust sentence
of excommunication was believed to be valid and fully as binding as the most
justified one (Hilling 1905: 253 f.). No appeal, no injunction, even if it were
granted later by higher authority, could save the excommunicate from feeling
the full effects of the excommunication the second the sentence was declared.
So we cannot assume that the candle ceremony was needed, because the court
sentence itself was sufficient. The actual excommunication, then, seems to
simply have been the bishop’s (or court official’s) speech declaring it.
Why, then, the candle ceremony? What further use could it possibly serve?
Again, the answer may lie in Gratian’s own writings. He usually does not dis-
tinguish clearly between excommunication and anathema, but in one instance
he tells us that excommunication “separates from the society of brothers”
while anathema “cuts off from the body of Christ itself, that is the Church.”
The words spoken in the candle ceremony aim at exactly this latter action, the
cutting off or elimination from the Church. So while the words “in conclu-
sion of the anathema or excommunication they must fling [the candles] to
the ground . . . ” hold that the ceremony could be used for either anathema or
excommunication, they probably referred mostly to the former. Anathema held
much greater power of condemnation, since it was usually all but irreversible,
except through great persistence of penitence. Although Gratian was far from
precise concerning this distinction, his contemporaries were much clearer, in
at least some cases. Thus the candle ceremony might have been the form spe-
cific to anathema, or major excommunication. This is actually the opinion of a
few of the Decretists, most prominently Hostiensis, and has attracted modern
scholars as well (Logan 1968: 14 nn. 4–6; Vodola 1986: 44 ff.).
For further consideration of the ritual itself, let us turn to the form in which
excommunicates could obtain absolution. Gratian prescribes the following pro-
cedure: “If some excommunicated or anathematized man, led by penitence, asks
forgiveness and promises emendation, the bishop who excommunicated him
shall come before the church, and twelve priests with him, who shall stand around
him on all sides. And if he asks forgiveness prostrated on the ground, and vows to
be watchful in the future, then the bishop shall lead him into the church, taking
his right hand, and give him back to the communion of Christ, and sing the seven
penitential psalms, together with these prayers. . . .” Then follows the bishop’s ora-
tion: “We beseech thee, Lord, grant this your servant the proper fruit of penitence,
so that to your holy church, from whose integrity he deviated through sin, he be
given back without sin by seeking forgiveness of his crimes.”
The ritual described here is in many respects the mirror image of the can-
dle ceremony of excommunication. Again, a bishop is necessary as the main
actor. Again, twelve priests accompany him, “surrounding him on all sides.”
The bishop’s declaration is now a prayer, the antithesis of the curse-like pro-
nunciation of excommunication. The ritual is performed outside the church
proper, which is still closed to the still excommunicate, penitent though he may
be. Only after it is performed may the absolved enter the church and take part
in the singing of psalms and speaking of prayers. But first of all, he must show
obedience to the clergy’s authority by prostration and asking for forgiveness.
This ritual of reconciliation effectively annuls the ritual of excommunication by
putting right the wrongness of the excommunicate’s former behavior. In cer-
tain pontificals (manuals for episcopal ceremonies) there can be found a fur-
ther stipulation that supports this view: those the excommunicate has wronged
must be compensated and must testify to their full and proper compensation.
All this is intended to remove the conditions that made the excommunication
necessary in the first place. Only when this is done may the prayer that effects
reconciliation be spoken and may the absolved enter church, sing psalms, and
pray. This ritual too was very likely performed only when an anathematized
person was reconciled. By canon law, the spoken formula of absolution suf-
ficed to offset minor excommunication. Again, it was the speech act, in practice
often limited to the famous ego te absolvo, that was effective.
Structurally and morphologically, these two rituals do not offer much to
study in regard to ritual efficacy. It would be desirable to perform an analysis
of the form of the excommunication ritual described above as related to its
efficacy; however, the simple fact that the excommunicate was probably never
present at his own excommunication makes it hard to believe that the form
of the rite would affect him much. It was more likely the knowledge of a per-
son’s state as an excommunicate rather than the specific ritual performed that
brought about all the effects. Moreover, a strict liturgy such as that of the candle
ceremony is not easily adapted to specific circumstances. I am therefore quite
certain that the form of the excommunication ritual, fascinating though it may
be, will not help us much in establishing its efficacy.
4 Efficacy
The role of excommunication in the Middle Ages, as well as its dynamics,

depended to a large degree on its efficacy as perceived by contemporaries. Cath-
olics in the Middle Ages did not ask whether the Eucharist or the excommuni-
cation was efficacious. To them, the efficacy of such rituals was axiomatic (so
long as certain conditions were met). But when I, as a modern historian, raise
the question of the efficacy of such rituals, I consider effects that may have
been peripheral to or entirely absent from the understandings of those who
were involved in them. I may, for example, adopt a sociological viewpoint and
understand the Eucharist to form a seed of collective identity, to build social
coalitions, or to reproduce and ensure the dominant position of the clergy.
Thus, “did it work?” is a completely different question from my perspective
than from the medieval Catholic’s. Nevertheless, and primarily out of neces-
sary respect for my source materials, I wish to propose an account of efficacy
that does not contradict the understanding of those who participated in or were
affected by the rituals.
These considerations lead us to the following conclusion. According to
Gratian and the Decretists, the role of excommunication was to separate a sin-
ner from the “fraternal community,” that is, from the congregation of the faith-
ful, the community of the Eucharist. Thus, the ritual of excommunication was
efficacious if it successfully separated a sinner from the community. This end
was achieved by prohibiting his participation in the Eucharist. According to the
opinions held and stipulations made in canon law and early scholastic theol-
ogy, the effect was automatic. Excommunication excluded the contumacious
sinner from the sacraments by its very pronouncement.
But the question is not to be dealt with so easily. After all, if the “native
point of view” (in this case, that of the believer) is the only one that counts, then
there is little scope for sociological or historical analysis. I would like to develop
a perspective that sees ritual efficacy as a problem but that is still close enough
to the contemporaries’ view of the ritual that it does not blatantly contradict
them. Let us step back and take a more encompassing look at the efficacy of
excommunication.
It seems that in the case of excommunication in the Middle Ages, there
are three spheres of effect, that is, three levels on which it was effective: the ritual
sphere, the sociological sphere, and the spiritual sphere. These spheres, while
heavily interrelated, can still be analytically separated and varying efficacy can
be ascribed to each. This type of analysis implies that there may be several layers
to every ritual’s efficacy, depending on perspective and the spheres it takes into
consideration. But it also prevents us from any clear-cut conclusions regarding

the efficacy of excommunication—and perhaps of any other ritual as well.
The immediate aim of excommunicating someone was directed toward
the ritual sphere: the desired effect was the excommunicate’s exclusion from
the community of the sacraments. But it also had a more comprehensive
range of effects—the application of pressure by way of exclusion from the
community-as-society—which occurred primarily in the social sphere. Not
only was the excommunicate forbidden to enter church or receive benefit from
the sacraments; he was also forbidden to undertake any action to which sacra-
mental power still clung. The most important of these was the oath, the basis
of civil law, and thus of public life. It regulated all kinds of legal as well as social
relations and had an important impact on the political and economic spheres.
Forbidding oaths in itself must have been a significant hindrance to any legal
act the excommunicates wished to undertake. Furthermore, they could not
function as judges or plaintiffs, they could not hold public office, they could not
take part in elections, and in the case of excommunicated clerics, they could not
say mass or perform other sacerdotal functions. In legal matters, excommuni-
cates were faced with severe handicaps (Vodola 1986: 70 ff.). The constraint
put on their public life went so far as to necessitate a papal decree stating that
money owed an excommunicate must still be paid back (Vodola 1986: 129 ff.)!
The excommunicates’ private life was also disturbed by the repeated insistence
that everybody communicating with them risked excommunication them-
selves; Gratian himself treated this particular point with utmost distinction,
dedicating a full seventeen chapters to it. So, did even the excommunicate’s
family turn away from him? And what about friends, colleagues, and vassals?
Although Pope Gregory VII decreed as early as 1078 that an excommunicate’s
familia—meaning parents, spouse, children, servants, and thralls—was still
allowed to interact with him as usual, it took until the thirteenth century before
this adjudication was generally recognized (Vodola 1986: 24 ff.).
Therefore the sociological effects of excommunication were much more
encompassing than the ritual effects, although it is important to remember
that the former were derived from the latter. Excommunication deprived the
individual of social and business contacts to a greater or lesser degree, it ham-
pered him severely in court, and it could estrange vassals and even families.
These social, political, and economic consequences may even have been what
individual clerics aimed to do when they performed an excommunication.
But there was also much criticism to the effect that excommunication should
not be undertaken frivolously and for personal gain. It was argued that in too
many cases, excommunication was obviously intended to achieve certain social
effects, and that this was against the spirit of the institution.
The ostensible end of excommunication lay in the spiritual sphere. This

end was not exclusion but rather reformation of obstinate sinners, their read-
mittance to the sacraments, and ultimately the salvation of their souls through
the punishing liturgical and sociological consequences of excommunication.
In fact, the excommunication ritual’s spiritual effect was not limited to the
excommunicate’s soul, but had to do with the whole Christian community. As
the opening quotation indicates, a powerful conviction that sin is ultimately
contagious held sway in medieval Christian discourse. By establishing excom-
munication as one of its most threatening instruments for dealing with those
who did not care about the rules, early Christianity took a page from the Tal-
mud. For in early Christianity, rituals of penance were not only similar to Jew-
ish rituals of grief; they also incorporated Jewish notions of purity, especially
where excommunication is concerned (Hein 1975). In Christianity, the great-
est impurity arises from the rejection of Christ and the Holy Spirit. While the
exclusion of those who rejected Christ by defying his church might chasten
them on the one hand, on the other it also safeguarded their fellow community
members against their impurity. The spiritual end of excommunicating some-
body was thus twofold: to reform them through chastening, and to protect the
noncontaminated from contagious, sinful notions.
So excommunication had effects in at least three spheres: the ritual, the
sociological, and the spiritual. It could be said to be effective in that it excluded
sinners from participation in ritual, that it separated and degraded them socially,
or that it spiritually reunited them with the Church and led to their salvation.
Depending on perspective, any one of these effects might be declared to be
decisive. Although from the perspective of the “inventors” and practitioners of
excommunication the soul was its final object, the sources show that in prac-
tice it often aimed at one of the other two spheres (Hill 1951). Every use of
excommunication could therefore potentially be styled an abuse. This was all
the more the case as the emphasis shifted from the ritual to the sociological
sphere over the course of centuries.
5 Use, Misuse, Abuse
At the beginning of this chapter stood an example from the ninth century A.D.,
in which excommunication was used for mostly political ends by Pope John
VIII. While John certainly had a powerful vested interest in politics, he prob-
ably did not distinguish between the ritual, sociological, and spiritual spheres.
His understanding of the body of Christ was holistic; therefore, any politi-
cal opposition to what the pope regarded as salutary policy was punished or
constrained just the same as more common forms of sin. John VIII was not
much concerned with duke Sergius’s individual salvation. He would probably
have argued that Sergius’s excommunication was conducive to the salvation of
many thousands of others, but there is no doubt that he stressed what today we
call the political as opposed to the spiritual. Although this kind of amalgama-
tion of the political and the spiritual is unthinkable today, it was typical of the
Middle Ages. In A.D. 1076 Pope Gregory VII excommunicated king Henry IV,
and although they were famously reconciled at Canossa the following spring,
only three years later the pope saw fit to renew the excommunication in his
ongoing struggles with the king. Henry died without obtaining reconciliation.
In A.D. 1160 Pope Alexander III and his schismatic rival, Victor IV, excom-
municated each other; Emperor Frederick I Barbarossa, who supported Vic-
tor, was excommunicated as well, but the emperor also had his own bishops
excommunicate the city of Milan, which had supported Pope Alexander. In
A.D. 1209 Pope Innocent III excommunicated his former ally Emperor Otto IV
for treachery. His successor, Emperor Frederick II, was excommunicated no
less than three times and died an excommunicate—though this circumstance
did not stop him from embarking on a (successful) crusade to the Holy Land
in 1229!
The list goes on, and it should be obvious that excommunicating a king did
not guarantee his submission. It was much more likely that he would simply
ignore the excommunication; it would not have been hard for him to find or,
if necessary, create a bishop who would still read mass for him. Furthermore
an excommunicated king’s total exclusion from society was quite difficult to
bring about, and so excommunication as a political instrument was not ter-
ribly effective. Also the church often contented itself with the mere threat of
excommunication so far as the powers-that-be were concerned: It simply would
not do to anger individuals of authority any more than necessary, and it would
probably endanger the ongoing work of the Church (Hill 1951: 216, 221; Hill
1957: 7 f.). Moreover, secular authorities were understood to reign according to
God’s mandates, as in Paul’s letter to the Romans (13:1 f.). There are no fewer
than twenty-one clauses in Gratian’s Decretum, taken from synodal rulings,
that condemn priests who still communicated with excommunicates and bish-
ops who absolved them without proper legitimation (all contained in C. 11,
q. 3). The fact that these directives were deemed necessary suggests that even
contumacious sinners could still find some friends among the clergy, and that
excommunication was not always an impediment to their participation in the
sacramental rites.
In the late Middle Ages, excommunication was routinely used as a means
to enforce obedience from the direct subjects of a church, to coerce debtors to
repay borrowed money, and, in England, even to enforce the political and legal
provisions of the Magna Carta (Howland 1901: 22; Hill 1957: 9). In fact, the
use, or abuse, of excommunication became so widespread and indiscriminate
that some scholars hold this development to be an important factor in bringing
about the Reformation (Anker 1919). The efficacy of excommunication can-
not be said to have been concentrated in the sphere of ritual or spirituality:
its social ramifications came to be its most telling aspect. Leaving behind the
archaic rituals of penance and the powerful imagery of the candle ceremony,
excommunication became a mere judicial sentence with well-defined ramifica-
tions and corollaries. More and more during the waning of the Middle Ages, its
ritual efficacy took second place to its juridical and political efficacy.
6 Meta-Ritual
We now have a general overview of the ritual in question. We have seen how
it was performed and how it could be ritually repealed. We have gained a gen-
eral insight into its historical development and changing significance, and have
identified three different levels of its efficacy. We have seen that the excommu-
nication ritual itself is not very illuminating structurally or morphologically, at
least where its efficacy is concerned. In practice, it consisted mostly of a speech
act. The candle ceremony may or may not have been performed much, and
if it was at all important, its purpose was to lend a visual and spatial quality
to the speech act performed by the excommunicating bishop. Yet the excom-
municates would never have witnessed this ritual themselves, and the simple
sentence, “I declare thee excommunicate,” spoken by any authorized person,
was apparently sufficient to bring about all the consequences mentioned so
far. If we left it at that, excommunication could be dismissed as just another
instance of illocutionary acts: the performance of the excommunication ritual,
that is, the central speech act all by itself, brought about the “conventional con-
sequences” discussed above (Austin 1962).
Yet for me the fascinating dimension of excommunication is not the ritual
per se but rather what I would like to call its meta-ritual character. I have argued
that the soul was the final object of this rite, and the soul’s salvation its end.
Obviously, the soul and its salvation are central to many rituals of the Catholic
Church. Because the priesthood had been given the power to bind and loose by
God, it was capable of performing feats that touched the domain of the soul,
called sacraments. These were usually liturgical in nature, so as to be set apart
from other necessary priestly functions such as preaching and counseling. But
the soul is ultimately the property of the individual, and individuals can, by
sinning, decide to withhold their souls from being affected by the sacraments.
Unable to affect (and thus save) the souls of such individuals, the Church can
only try to touch on the sphere that is closest to the soul. For early and medieval
Christianity, this was the ritual sphere. By restricting or downright prohibiting
access to the Christian ritual sphere, in which medieval communities were
above all grounded, the Church could still hope to affect an excommunicate’s
soul, albeit in a mediated way.
This proximity of ritual to the soul is hard to understand without one’s tak-
ing for granted the truth of Catholic Christian teachings. The secularized scholar
of Western modernity struggles with the notion. Still, the “structure” of the soul,
if I may call it that, must have been hard to grasp even for Gratian and the Decre-
tists, as it still is for contemporary theologians. As St. Augustine saw it, the soul
is the ultimate perceiver of every Christian’s environment, and the arbiter of the
perceived in moral terms (Wienbruch 1971). It can perceive through the body’s
sensory organs and immediately “know” the right and wrong about the perceived,
because God has invested in the soul certain fundamental truths, which illumine
the outer world and its significance for the Christian individual. This is also why
(Church) ritual is so powerful and so close to the soul: because God informs each
Christian that this is so in a subliminal, preinterpretive way.
Pierre Bourdieu’s habitus (2002), already well established by the writings
of Catherine Bell (1992) as an integral part of ritual studies, could be said to
work much the same. Although of course it is not God who effects immediate
understanding and emotive reaction in Bourdieu’s concept, the habitus con-
sists of “structured principles of the generation and structuring of practices
and representations” (Bourdieu 2002: 72). Because habitus is not God-given,
it is not eternal and unchanging, but “transposable” (ibid.). Yet in any instance
of habitus-informed practice, the action performed and its perception are struc-
tured on a level once removed from conscious interpretation.
This analogy between soul and habitus might seem rather crude. Yet it may be
helpful to imagine—from the modern scholar’s perspective—excommunication
as an effort to make a direct impact on the habitus. The aim was not only to
influence the sinner’s habitus, to touch on deeply held convictions and practical
knowledge and implant the certainty of impending doom. Excommunication of
one community member also changed the ritual sphere of all other members.
Not only were excommunicates simply not present in church anymore—a fact
that must have reminded everybody else of their state—but their names were
also proclaimed in church, to make them public and to remind the community
that they must not traffic with these persons nor mimic their misbehavior. The
exclusion of excommunicates modulated Christian ritual in a way that demon-
strated several things to all participants: the clergy’s power to bind and loose;
their authority not only to provide but also to negate the benefits of the sacra-
ments to good and bad Christians; the purity and unity of the Christian com-
munity; its inviolability by bad influences; and finally its responsibility to remain
pure, united, and inviolable by excluding obstinate sinners.
Excommunication in the Middle Ages shows that there is no such thing
as a singular ritual. It cannot be stressed enough that individual ritual acts are
part of the ritual sphere as a whole. I dare not call them a system, since doing
so would imply more regularity than the evidence warrants. Yet it seems clear
that rituals not only draw on a socially common body of symbols and interpre-
tations thereof, being concerned mainly with “signification and communica-
tion” (Singer 1984: 30). Nor do they simply take a set of “building blocks” or
elements particular to time, place, and culture, rearranging these in order to
produce sense (Michaels 2007: 242 ff.). Rather, rituals also interpret, reinter-
pret, and otherwise influence each other. For every ritual of inflicting damage
on one’s enemies, there is one to mitigate damage taken; for every ritual of
exclusion, there is one of readmittance; for every ritual of bonding, there is one
of separation. Many rituals are meta-rituals, in that they affect the ritual sphere
as such. Seen this way, even such a straightforward ritual as a wedding can be
understood as having a meta-ritual component. Under modern law in Western
countries the wedding ritual commonly may be performed only once. A wed-
ding is self-referential insofar as its performance precludes its being performed
again. Divorce, on the other hand, can be performed only after a wedding has
already been performed.
While these rituals aim at being efficacious in spheres outside of ritual,
they have a certain meta-ritual character. Excommunication, which restricted
participation in many other rituals of the same community, was much more
strongly geared toward this meta-ritual aspect. At least originally, its primary
area of efficacy was the ritual sphere, and its broader political, legal, social, and
economic effects were added only to reinforce this element. It was thus a meta-
ritual in the purest sense.
The sociological and spiritual effects of being excommunicated were, origi-
nally, only derivatives of its effects on the ritual level. The reason can tentatively
be sought in the recursive relationship between ritual practice and the habitus
that informs it: ritual practice structures activity in a way that produces, repro-
duces, and manipulates the fundamental dispositions that make up the habitus
(Bell 1992). Anything that impacts ritual practice as massively as excommuni-
cation must therefore be of the utmost importance in the shaping of the ritual
habitus. This is what I mean by calling excommunication a meta-ritual. Other
typical meta-rituals include inaugurations and depositions, consecrations, ini-
tiations, and basically all rituals that are tied into a more encompassing ritual
system. All these represent a huge “encroachment” on “normal” ritual practice,

in that they make possible or impossible large areas of ritual activity. Thus their
impact on the ritual habitus is much greater than that of rituals concerned pri-
marily with a more, shall we say, “practical” end, such as healing rituals, ritual
curses, or ritual thanksgiving.
In the case of medieval excommunication, however, this meta-ritual char-
acter was lost over time. Medieval society’s grounding in ritual ensured that the
further effects, which stemmed from the meta-ritual effects of being excom-
municated, would increase the pressure on obstinate sinners. But with grow-
ing literacy and the beginnings of scholasticism came a growing juridification
of religious and social life. The social, political, economic, and juridical effects
of excommunication became more and more unhitched from its meta-ritual
character. Over time, their significance grew, while that of exclusion from the
sacraments lessened. Thus the meta-ritual character of excommunication came
to have less and less of a telling impact on its efficacy—although it never ceased
to be its defining characteristic.
7 Conclusion
In the early days of Christianity the efficacy of excommunication lay first

and foremost in the ritual sphere. Excommunication was a meta-ritual, for
it restricted or outright forbade participation in the sacraments, most impor-
tantly, the Eucharist. This restriction shaped the ritual sphere, in which not
only the excommunicate but all members of the community were embedded.
The Christian community was in many ways grounded in this ritual, so exclu-
sion from it could, and did, lead to social isolation. But in the first centuries
after Constantine made the Christian faith his state religion, excommunication
was but one of many rituals of penance and was reserved for the most obstinate
of sinners. Only after the seventh century did it affect the juridical sphere, and
social and even economic and political consequences became an integral part
of its effects. These were “naturally” derived from the effects excommunication
had on the ritual sphere, but over time they became institutionalized by canon
law as typical effects of excommunication, in lieu of its meta-ritual efficacy.
Thus, the social, economic, and political effects were increasingly considered
to be the most important ones.
The distinction between minor and major excommunication, though
never more than tenuous, became more widespread. With the advent of Gra-
tian’s Decretum in the twelfth century, and the annotation and continuation of
his work by the Decretists in the next century, excommunication was finally
institutionalized and well-defined. However, it had lost much of its ritual, as

well as its salutary character, which deteriorated even further in the late Middle
Ages. Now it was based mostly on the legal fixation of consequences in spheres
outside the Church. What had been a ritual became a juridical sentence. While
theologians still upheld its basic meta-ritual character, misuse, abuse, and over-
use for political and economic ends diluted the original qualities of the excom-
munication ritual. The growing gap between its basic meta-ritual character and
the utilitarian way in which it was used aroused a lot of criticism, but this
went mostly unheeded by Church and lay authorities. Lessening faith in the
intentions of the excommunicators, as well as a dramatic rise in the number
of excommunicates for all kinds of reasons, led to the deterioration of excom-
munication’s overall efficacy, on all levels. Growing literacy, education, and
rationality finally brought about the Reformation. When in 1520 Martin Luther
publicly burned the papal bull Exsurge Domine, which declared him excommu-
nicate, he lent expression to a historical development that no longer accepted
the unfettered power that excommunication had held in earlier times.
I might put forward two theses culminating in a third: One is that excom-
munication must exist as a threat to be efficacious. As it was overused, it lost
its value to qualitative as well as quantitative inflation. Two, excommunication
was too potent not to use, because of the three quite different levels on which
it was effective. It entailed so many and so powerful consequences that its use
promised success for any ends one might have in mind. Three, the fundamen-
tally meta-ritual character of excommunication, which originally made it so
powerful and its use so potent and widespread, inevitably resulted in its reduc-
tion to a minor technique after the ritual sphere underwent critical re-tailoring
in the Reformation.
references
Anker, K. 1919, Bann und Interdikt im 14. und 15. Jahrhundert als Voraussetzung der
Reformation, Tübingen.
Austin, J. L. 1962, How to Do Things with Words: The William James Lectures delivered at
Harvard University in 1955, ed. J. O. Urmson, Oxford.
Bell, C. 1992, Ritual Theory, Ritual Practice, New York.
Bourdieu, P. 2002, Outline of a Theory of Practice, trans. R. Nice, Cambridge Studies in
Social and Cultural Anthropology 16, 14th ed., Cambridge.
Daniel, N. 1975, The Arabs and Mediaeval Europe, Arab Background Series, London &
Beirut.
Engreen, F. E. 1945, “Pope John the Eighth and the Arabs,” Speculum 20, pp. 318–330.
Fransen, G. 1992 (ed.), Burchard of Worms, Decretorum libri XX ex Consiliis et
orthodoxorum patrum decretis, tum etiam diversarum nationum synodis seu loci
communes congesti, Aalen.
van Gennep, A. 1960, The Rites of Passage, trans. M. B. Vizedom & G. L. Caffee,
Chicago.
Gommenginger, A. 1951, “Bedeutet die Exkommunikation Verlust der
Kirchengliedschaft? Eine dogmatisch-kanonistische Untersuchung,” Zeitschrift für
katholische Theologie 73.1, Wien, pp. 1–71.
Hein, K. 1975, Eucharist and Excommunication. A Study in Early Christian Doctrine and
Discipline, European University Papers XXIII, 19, 2nd rev. ed., Frankfurt.
Hill, R. 1951, “Public Penance: Some Problems of a Thirteenth-Century Bishop,”
History: The Journal of the Historical Association 36, London, pp. 213–226.
——— . 1957, The Theory and Practice of Excommunication in Medieval England,
History: The Journal of the Historical Association 42, London, pp. 1–11.
Hilling, N. 1905, Die Bedeutung der iusta causa für die Gültigkeit der
Exkommunikationssentenz, Archiv für katholisches Kirchenrecht 85, Mainz.
Howland, A. C. 1901, Ordeals, Compurgation, Excommunication and Interdict,
Translations and Reprints from the Original Sources of European History 4, rev.
ed., Philadelphia.
Huizing, P. 1955, “The Earliest Development of Excommunication Latae Sententiae by
Gratian and the Decretists,” Studia Gratiana 3, Bologna, pp. 278–321.
Humphrey, C., & Laidlaw, J. 1994, The Archetypal Actions of Ritual. A Theory of Ritual
Illustrated by the Jain Rite of Worship, Oxford Studies in Social and Cultural
Anthropology, Oxford.
Kehr, P. 1928 (ed.), Epistolae Karolinorum Aevi V, MGH Epistolarum VII, Berlin.
Logan, F. D. 1968, Excommunication and the Secular Arm in Medieval England. A Study
in Legal Procedure from the Thirteenth to the Sixteenth Century, Pontifical Institute
of Mediaeval Studies: Studies and Texts 15, Toronto.
——— . 1989, “Excommunication,” Dictionary of the Middle Ages 4, ed. J. R. Strayer,
New York, pp. 536–538.
Lohrmann, D. 1968, Das Register Papst Johannes’ VIII. (872–882): Neue Studien
zur Abschrift Reg. Vat. 1, zum verlorenen Originalregister und zum Diktat
der Briefe, Bibliothek des Deutschen Historischen Instituts in Rom 30,
Tübingen.
May, G. 1980, “Bann IV.: Alte Kirche und Mittelalter,” Theologische Realenzyklopädie 5,
Michaels, A. 2007, “ ‘How Do You Do?’ Vorüberlegungen zu einer Grammatik der
Rituale,” Der Mensch—Ein “animal symbolicum”? Sprache—Dialog—Ritual, ed.
H. Schmidinger & C. Sedmak, Topologien des Menschlichen 4, Darmstadt, pp.
239–258.
Mörsdorf, K. 1957, “Der Rechtscharakter der iurisdictio fori interni,” Münchener
Theologische Zeitschrift 8.3, Munich, pp. 161–173.
Reynolds, R. E. 1987, “Rites of Separation and Reconciliation in the Early Middle
Ages,” Segni e riti nella chiesa altomedievale occidentale I, Settimane di studio del
Centro Italiano di studi sull’alto medioevo 32, Spoleto, pp. 405–433.
Rizzitano, U. 1965, “Gli Arabi in Sicilia,” L’occidente e l’Islam nell’alto medioevo I,
Settimane di studio del Centro Italiano di studi sull’alto medioevo 12, Spoleto,
pp. 37–63.
Singer, M. 1984, Man’s Glassy Essence. Explorations in Semiotic Anthropology,

Bloomington, Ind.
Struve, T. 1978, Die Entwicklung der organologischen Staatsauffassung im Mittelalter,
Monographien zur Geschichte des Mittelalters 16, Stuttgart.
Vismara, G. 1974, Impium Foedus. Le origini della “respublica christiana,” Milan.
Vodola, E. 1986, Excommunication in the Middle Ages, Berkeley, Calif.
Wienbruch, U. 1971, “signum,” “significatio,” und “illuminatio” bei Augustin, Der
Begriff der Repraesentatio im Mittelalter. Stellvertretung, Symbol, Zeichen, Bild, ed. A.
Zimmermann, Miscellanea Mediaevalia. Veröffentlichungen des Thomas-Institus
der Universität zu Köln 8, Berlin, pp. 76–93.
6
The Work of Zâr: Women
and Spirit Possession
in Northern Sudan
Janice Boddy
To speak of “ritual efficacy,” or ritual-and-efficacy, implies the prospect of

tangible results: sprinkled with holy water, a wheelchair-bound man rises
to walk—a miraculous but obvious cure. Yet much that ritual accomplishes
takes place behind the scenes, at the level of the cognitive and the emotional,
helping to orient participants in social and cosmological space, or, as Rappa-
port (1993) suggests, producing their commitment to it. In this chapter I will
mobilize ethnographic information on Hofriyat, a village of Arabic-speaking
Muslims in northern Sudan, to discuss the potential—not certain—efficacy
of ritual for shoring up the meaningfulness of participants’ everyday world
or reestablishing it when it is under threat. The rites described are zâr spirit
possession ceremonies, practiced by people with whom I have conducted
anthropological fieldwork since the mid 1970s (Boddy 1989). I will examine
zâr rites for their capacity to open up cultural meanings and to enable both
participants and onlookers to adjust their moral compass, sense of self, and
somatic well-being. To the extent that zâr produces effects on and in partici-
pants, it does so, I believe, by calling attention to the ambiguities and conun-
drums of daily life through the simultaneous invocation of otherness and
locally apposite behaviors and ideals. Individuals are propelled into a series
of awkward confrontations from which they claim to emerge transformed.
But before arguing this point, let me sketch some ethnographic context for
the Sudanese zâr.
Zâr
The term zâr refers at once to a type of spirit (plural zayrân), the illnesses such
spirits bring by taking possession of humans, and the rites by which zayrân
can be appeased. Variants of zâr are found in Egypt, Ethiopia, Somalia, Ara-
bia, and Iran.1 In Sudan, zâr rituals and coteries of adherents, mainly women,
were originally modeled on local Sufi brotherhoods or tarîqas, whose zikrs or
“remembrance” rites are largely the preserve of men (Constantinides 1991,
Makris 2000). Today the two are well distinguished, and many who consider
themselves pious Muslims condemn the zâr as unIslamic.
Although religious scholars regard the zâr with disfavor, they subscribe,
as all Muslims do, to the foundations on which the practice rests, for zayrân
belong to the class of beings called jinn, whose existence the Qurcan substan-
tiates.2 Jinn are mischievous ethereal entities who inhabit a world that is both
parallel to our own (they have homelands, ethnic groups, religions, classes,
sex, and age) and contiguous with it (their lands are superimposed on our
own), but who are imperceptible to us most of the time. They are sentient
beings created by Allah and both similar to and different from bani Adam—
sons of Adam, human beings. Whereas humans are composed of water and
earth, jinn are composed of their complements: air and fire. Though jinn
live longer than humans, they are nonetheless governed by natural laws and
bound by social contracts; they are born, have childhoods, grow up, marry,
reproduce, and live in families. Yet vis à vis humans they have a number of
exceptional abilities. They can move unimpeded through walls and doors,
transform themselves into animals, assume human form. They can take
possession of humans at will, signaling their presence by provoking illness,
disturbing visions, or dreams. Some jinn are malevolent, others benign,
but zayrân, also known as red jinn ( jinn al-ahmâr) or red winds (rowhan al-
ahmâr), are capricious pleasure seekers, amoral and ambivalent. Most of the
time they remain “above” ( fôg) their human hosts, exerting constant pressure
on the head or neck, inducing in them specific moods, bodily sensations,
and desires whose import can be deciphered with the aid of zâr specialists,
shaykhat.3
Sometimes, however, a spirit causes its host to feel unwell or exacerbates
an existing complaint. This problem calls for an appeasement ceremony,
in which the troublesome zâr is invited to “descend” into the human realm
and make known its demands, in return for which it should restore its host
to health. On such occasions, zayrân manifest themselves to observers by
the work of zâr 115
entering the bodies of their mediums during trance, displacing their persons,
and acting in their stead. The possessed seldom enter trance spontaneously;
trance is a state one must learn to effect in order to negotiate an appropriate
relationship with intrusive zayrân. As adepts put it, one learns through the
ritual how not to resist a spirit’s attempts to enter the human realm through
the vehicle of her body.
“Trance” here refers to a general human capacity to abnegate wakeful
awareness. Yet how trance is experienced depends not only on universal apti-
tudes but on the culturally specific contexts in which they are invoked. For
Hofriyati it is a period when the quotidian self is in abeyance and an out-
side agent appears to dominate the bodily being. Although Western psychol-
ogy tends to describe trance as an “exceptional” state, in many societies it is
expected and in some even routine; indeed, more exceptional cross-culturally
is the heightened significance attached to rational self-awareness and the
pathologization and avoidance of trance states in much of the west.4 For heu-
ristic purposes we can think of trance as a form of transitory psychological dis-
sociation, or separation of normally connected mental processes, that enables
one to experience an other than socially normative relationship between body
and mindfulness, a suspension of conscious volition and thought. To witness
trance is to witness a transitory shift of the socially normative body–mind rela-
tion in another human being.
I am aware that considerable ink has been spilled over the inadequacies
of Cartesian dualism for capturing non-Western realities and contributing to
their exoticization. Long before the 1987 publication of Scheper-Hughes and
Lock’s seminal article “The Mindful Body,” ethnographers had amassed con-
siderable evidence of monism in cultures around the world: cosmologies and
forms of sociality that do not constitute mind and body as separate entities or
that brook no firm split between self and other, variously defined. Certainly,
northern Sudanese with whom I worked do not see themselves as unique enti-
ties, wholly distinct from others of their group, nor do they experience affective
and physical events as unconnected: a man who, as an infant, consumed his
mother’s milk just when an Ethiopian spirit arrived “above” her finds that he
is plagued by the same spirit in later life, as evidenced by a desire for coffee
on Sundays and the salience in his dreams of the color red. Just as he and his
mother share bodily substance—blood and its nutritional products—so they
share a spirit who was attracted to that bodily substance at a specific time. Per-
sonhood in northern Sudan is relational rather than individualistic; a person is
linked corporeally and morally to kin. More on this point will help make sense
of zâr and the potential efficacy of possession rites.
The Theme of Closure in Hofriyat
During prepubescence Hofriyati undergo ritual alterations of the physical body

that profoundly affect their corporeal sensibilities.5 Genital cutting orients the
mindful bodies of boys and girls to their incompletely shared social world,
establishing differences in their dispositions and their adult perspectives. A
girl’s body is “purified,” feminized, closed by the removal of clitoral tissue and
infibulation of her external labia, then concealed behind courtyard walls, where
she is expected to remain. A boy’s body is complementarily masculinized by
circumcision, uncovered, opened to confront the world with which he must
henceforth engage. Girls thus learn in a visceral way that their future lies in
childbearing and the inside world of the house; boys, that theirs revolves around
provisioning and protecting family and village life. The female body, however,
is both a metonym and an icon of village society, guarded from external threat
by its own scar tissue, household walls, and the defensive efforts of local men.
Enclosure and “covering” also characterize social relations, in that mar-
riage is strongly endogamous in Hofriyat. People are expected to wed cousins,
whose parents are also cousins, and so on into the past. Indeed, I found that
more than two-thirds of first marriages in the village conformed to this pattern
(Boddy 1989). Most people also marry within a tightly circumscribed territorial
range, and genealogical and territoral proximity generally overlap.
Yet villagers recognize that, however valued, enclosure is always relative.
For life to continue, bodies, houses, and families must have openings. The
trouble is that this requirement makes people, and especially women, vulner-
able: to other humans, but also to powerful spirits, some capricious and some
malign, who cannot be kept out by walls, human skin, or closed doors. Illness
results when physical and architectural defenses are breached, for then spirits
are encouraged to intrude. For females, bodily closure is considered not just
normative but healthy, even curative: a young girl who has been ailing for some
time may be prematurely infibulated in order to “be made well.”
Infibulation, by enclosing the womb, contains and safeguards uterine
blood, the source of a woman’s fertility, men’s (and women’s) future descen-
dants, and the village’s well-being. Local concepts of procreation stipulate that a
child’s bones and sinew (hard parts) are formed from the semen or “seed” of its
father, while its flesh and blood (soft parts) are formed from its mother’s blood.
Such contributions are again complementary, if differently weighted: flesh and
blood, after all, are ephemeral, bones relatively enduring. Like the skeleton that
structures the body, patrilineal descent structures human relations in durable,
continuing ways. While patrilineally endogamous marriages are preferred, in

practice marriages traced through close female kin are highly suitable, even
should prospective spouses belong to different local lineages. Indeed, relations
traced through flesh and blood—that is, through women—link the village’s
skeletal descent groups, providing integument that eventually succumbs to
entropy and decay unless renewed by successive intermarriages. The social
body—the endogamous village—is thus homologous with the physical body;
both are moral entities.
There are implications here for daily social relations and a person’s sense
of self. Bodies are at once integral and interdependent, thoroughly and com-
plexly relational. Indeed, one can regard the village as an organism in which
physical substances—flesh, blood, bone—circulate and are shared among
individuals to varying degrees. Likewise, degrees of consubstantiality map
social alignments, official and unofficial, that are realized in a physical way.
Closely related women experience their shared corporeality acutely. It is com-
mon, for example, for a woman whose daughter has died in childbed or from
some other cause to fall gravely ill herself from a malady called du’f, “weak” or
“diminished blood.”
This gendered view of consubstantiality intersects with ideals of harmony,
balance, and purity in bodily constitution. Regardless of one’s sex, a person’s
health can be controlled to some extent by eating foods or smelling odors
described as “pure.” Pure foods are white or enclosed by skins, rinds, jars,
or tins. Consuming these is said to “bring blood” (bijîb ad-dum) and enhance
health, while consuming food or drink defined as “impure” can diminish
blood’s capacity, precipitate illness, and render the body assailable by zayrân.
Breathing impure smells—of human sweat or blood—is idiomatic of physical
openness and signifies spirit intrusion. Because women are deemed less able
to resist invasive spirits than men, a woman who encounters bad smells may
immediately fall ill or enter possession trance. But beyond this possibility, any
untoward event or act, such as walking alone at night through village lanes,
endangers a woman’s health, for bodies out of place are also “open,” vulnerable
to zayrân and other jinn.
Importantly, zayrân, the red jinn, are powerfully attracted to women’s
blood, the exposure of which is thus carefully controlled, for drawing the atten-
tions of a zâr can have serious repercussions for pregnancy and birth. Zayrân
who “seize” a woman’s blood can prevent her from becoming pregnant or can
“loosen” her fetus and precipitate miscarriage. This situation is clearly prob-
lematic, in that women bear the onus for reproduction in Hofriyat; only under
exceptional circumstances will a man be suspected of infertility. A woman who
does not give birth in the first year or two of her marriage or who produces
daughters but no sons risks divorce or co-wifery as her husband continues his
quest for descendants.
A Hofriyati woman is therefore understandably anxious to placate trouble-
some spirits should she experience conditions of “openness” and find herself
possessed. She is under considerable pressure to conform to the specific ide-
als of her sex: to be “closed,” chaste, and modest, to conduct herself with dig-
nity, to marry a close kinsman, and to produce numerous offspring, especially
sons. Not to do so or to experience a setback in these pursuits leads readily to
possession.
Thus, zâr possession is an unfortunate but not unusual condition. Most
consider it a lifelong state, least welcome in its early stages, when a difficult,
unruly spirit is reluctant to release its grip on a woman’s reproductive health
until its demands are met. The purpose of the healing rite is to tame the zâr
and establish a social relationship between it and its human host. But the suc-
cess of this venture requires that the woman and her family recognize the dif-
ference between the two. Establishing this difference is critical to the spirit’s
being accepted as the cause of fertility problems rather than the woman herself.
It is this external responsibility that zâr rites help to accomplish, at the same
time as they grant opportunities for gaining perspective on the bond between
female self and reproductive function that Hofriyati culture enjoins.
Ambiguity, Difference, and the Zâr
I propose that spirit possession in Hofriyat provides a corrective to such cul-

tural identifications of mind and body, self and other, or self and context, that
have or could become stultifying, disenabling—impediments to agency and a
healthful orientation to the world. Zâr rituals in northern Sudan play with the
significance of openness and closure, unsettle accepted canons of morality and
propriety, and in doing so help to establish useful categorical distinctions in
the minds and through the bodies of the possessed. The zâr is a culturally and
historically specific aesthetic; its rites invoke the familiar along with the alien
and ambivalent in ways that are at once intuited and quietly observed. It is, in
this way, therapeutic.
How so? By summoning spirits to enter the visible world through their
human hosts, the rituals confirm two things: the materiality of spirits, and
their power over women’s lives. Asserted afresh with each new or repeat diag-
nosis, the existential distinction between host and spirit enables the possessed
to distinguish between her symptoms and her culturally constructed, socially
monitored self. Where procreation is at issue, for instance, the rites affirm to
others and herself that she is inherently fertile, for zayrân have interfered with
her ability to reproduce. The ritual thus supports her self while providing occa-
sion to reflect on its composition.
Crucial to this process, I think, is the temporal oscillation of experiential
positions during rites. The effiacy of zâr rituals in providing space for con-
fronting the taken-for-granteds of daily life, but also for affirming their worth,
depends on more than undergoing possession trance. It also requires that one
witness trance being experienced by neighbors and kin. To show how this pro-
cess works entails further elucidation of the zâr and thus a return to its ethno-
graphic logic.
According to Hofriyati, there are two levels of existence in the natural
world: one occupied by humans, another by creatures called jinn. The physical
abode of jinn is contiguous with our own but, like the creatures themselves, is
normally invisible to humans. The world of jinn overlies and shares qualities
with the visible world yet exists independently of it; jinn are not the ghosts of
former humans, but existents in their own right. At certain places and times
the boundaries between human and jinn domains are weak, and jinn, who are
less restricted by their physical makeup than humans, can cross over and wreak
havoc with human lives.
Although invisible to humans most of the time, jinn are not supernatural
beings but the physical counterparts of humans in a quadripartite, holistic cre-
ation. Humans are composed of dust and water, jinn, of wind and pure fire.
Humans have form and are diurnal, jinn are formless and most active at night.
The two are obverse entities: each form is the antithesis of its counterpart.
By virtue of their composition, jinn are able to negotiate the human world
with a fluidity that its regular inhabitants lack. Where humans must use doors,
jinn can burst through walls and ceilings when intent on entering a human’s
room. Importantly, jinn can enter a human body and thus temporarily occupy
it; a human wishing to initiate relations with another is constrained to commu-
nicate that desire in less immediate ways, although kin, who share corporeal
substance, may be considered already to “possess” each other in this sense.
As has been noted, the jinn who most often trouble Hofriyati are zayrân,
self-indulgent, gregarious hedonists who live, as humans do, in societies and-
who have occupations, religions, and ethnic identities. Among them are zâr
Europeans, Turks, Ethiopians, and other Africans; kings, slaves, merchants,
herdsmen, prostitutes, nuns, male homosexuals, Coptic priests, Islamic holy
men, Nuer leopard-skin chiefs. Zayrân are either male or female, children,
adults, or elderly. They are born; they marry and reproduce; eventually they
die. They are not wholly good or bad but, like humans, something of both.
Their chief characteristics are ambivalence and caprice, in which they differ
from humans only by excess. A zâr may be the counterpart of a human histori-
cal figure, such as General Charles Gordon or the Virgin Mary. Each is named
and has an individual history, typical behaviors when appearing in the body of
a human host, and kin relations with other zayrân which, in a key departure
from those of Hofriyati, cross-cut kinship as well as ethnic and religious lines.
Zayrân who possess Hofriyati and are the focus of their ministrations
belong only to foreign societies in the parallel world of jinn. Villagers have
no knowledge of zayrân who behave or look like themselves. Indeed, despite
their similarity to humans in some regards, zayrân are quintessential others,
alien physically, socially, and culturally. Even Muslim spirits who exhibit admi-
rable piety and self-restraint ultimately subvert local values by being wed exoga-
mously, to non-kin adherents of other faiths.
The complexities of zayrân become obvious during possession rites, when
spirits are summoned in sequence to show themselves in the bodies of their
human (mainly female) hosts. On the one hand, spirit performances hyper-
bolize village ideals, caricature them in the spirits’ outlandish demands for
human finery: gold, henna, imported soaps, and delicate fabrics, all markings
of femininity in Hofriyat. Here zayrân are analogous to their hosts, but more
extreme. Yet such behaviors belie the deeper disparities between humans and
zayrân. And this aspect, too, receives ceremonial elaboration: a spirit acts in
ways appropriate to its specific but in some way non-Hofriyati ethnic group,
social role, religion, and sex. A zâr may be wanton and undignified, take on
superior airs, beg piteously, dance about wildly, speak in brash tones or coy
ones—behaviors improper for Hofriyati but especially Hofriyati women. When
zâr and villager occupy the same body, the characteristics of each cast those
of the other into relief. Their partial resemblance contributes to the effect by
furnishing a line of bearing that both invites their comparison and illuminates
their contrasts.
To see how the zâr acts as a foil to women’s everyday lives, we need to
consider the Hofriyati wedding, a distilled expression of salient cultural values
and ideals. Clues to this insight can be found in the zâr’s special vocabulary,
which, like subtle transparencies in works of allegorical fiction, serves to orient
novice readers. For example, a woman for whom a zâr is held is referred to as
the “bride of the zâr,” and spirits are likened to husbands in that both have a
penchant for caprice. Certain references are a bit more obscure: during a wed-
ding the groom and his entourage must fight a mock battle with the bride’s kin
at the formal or men’s entrance to her home before being granted admittance;
further, in Hofriyati thought the bride’s vaginal opening, closed by her infibu-
lation, is the symbolic equivalent of this threshold, and the groom has acquired
the right to pass over both of them. In the lexicon of the zâr, a woman’s hus-
band is known as her “doorkeeper” (bowab), a term that links this context to
that of the wedding while also alluding to the fact that since husbands pro-
vide funds to mount spirit rites, they can effectively open or bar the invisible
“door” behind which spirits are said to stand before entering their hosts when
summoned by the ritual drums. For the imaginatively engaged participant in
a possession event, this double entendre explodes as it brings to mind further
associations of doorways, thresholds, keys, and enclosures, symbols ubiquitous
in Hofriyat. Once this line of thought is started, it becomes increasingly clear
that the zâr is, in much of its structure, an elaborate and supple parody of the
wedding and, by extension, of everyday life. As it unfolds, it unlinks routin-
ized associations, extolling as potentially positive what the wedding cautions
against, namely, forging contractual relationships with outsiders. The zâr con-
tains a wealth of potential messages, not least being that the cultural directives
of “closure” and fertility that so rigidly frame women’s lives are neither immu-
table nor utterly determinate.
Zâr symbolism and ritual structure are not the only vehicles for opening
up implicit meanings. During the ritual, spirits are summoned in sequence,
by ethnic affiliation. One by one throughout the night they appear in villagers’
midst, and as they do a catalogue of “others” comes to life, dramatizing a series
of spirit (human) traits. Muslim holy men zayrân display masculine piety and
unctuous religiosity; Ethiopian zayrân display nobility and improper sexuality;
European zayrân show a fondness for drink, material acquisitiveness, and the
soi-disant benevolent exercise of power. Each spirit “scene” provides a back-
drop for values to which villagers subscribe; in each case positive values are
depicted along with negative ones in a context already rife with ambiguity. Zay-
rân embodied in their hosts provide concrete expression of the problems of
human existence in heightened relief.
One of my favorite ethnographic examples will help illustrate this point. It
refers again to the wedding: ideally that ceremony, like the zâr, lasts for seven
days. Its climax comes near dawn of the third morning, when the bride is led
out from seclusion with a shawl of red and gold silk draped over her head,
concealing all of her body but her legs. She is positioned on a mat in the center
of the courtyard, where she stands, barefoot and immobile, until her husband
steps onto the mat and removes the shawl. Now she is revealed in all her fin-
ery and her family’s gold, with elaborately hennaed hands covering her face
in a gesture of timidity. Gently, the groom releases her arms and she begins
the exacting bridal dance: eyes tightly shut, arms extended to the sides, back
arched, feet moving in tiny mincing steps that never leave the mat. Toward the
end of each song she breaks off her dance and shyly recovers her face, then
recommences with the groom’s signal, as before, repeating the sequence until
she has had enough, and her kinswomen lead her away. At no time ought the
bride to have seen her husband or the gathering for whom her dance was the
focus of rapt attention and long anticipation.
In the zâr, Luliya is a female Ethiopian prostitute spirit who demands
that Sudanese wedding incense, jewelery, and a bridal shawl be ready for her
ritual use. When Luliya appears during a zâr, a bridal mat is spread and the
spirit dances as a Hofriyati bride. When the silky shawl is removed, Luliya’s
(host’s) hands cover her face; when these are pulled away she starts to dance
with closed eyes, though far less reticently than the bride and with obvious
pretense at shyness.
What is happening here? On one level a wanton, uncircumcised, nominally
Christian spirit presumes to dance as a chaste, circumcised, Muslim village
woman. In the attempt, the spirit overcompensates, exaggerating the controlled
steps of the bride to the point where simulated Hofriyati drama becomes a
spirit farce. Luliya is not by nature bashful; her timidity must be feigned. The
spirit’s own personality shows through the facade she erects with the aid of her
host, illuminating Hofriyati ideals against a background of patently non-Hofri-
yati traits. But this is not all. What the audience actually observes is a normally
restrained, infibulated Hofriyati woman in the role of a wanton, uninfibulated
foreigner who in turn “plays” a village bride who is the epitome of restraint. In
looking at the other, Hofriyati see the other looking at them; while in looking
at the woman entranced, they see themselves looking at the other looking at
them. The multiple reflection is dramatically sustained . . . then suddenly shat-
ters as Luliya peeks over the hands of her host, giving herself away to the laugh-
ter of her human audience. This densely convoluted episode is more than a
comic discourse on the ambiguities of gender and sexuality, for it raises these
as issues in themselves and points to the somewhat subversive observation (in
Hofriyat) that feminine deportment is not innate but culturally constructed,
and thus perhaps modifiable.
In these and other possession dramas two levels of meaning—that of
everyday life and that of its extraordinary counterface, the zâr—oscillate and
nourish one another, enabling the ritual to accumulate interpretive weight
with each spirit appearance, challenging observers to draw their own conclu-
sions. As an aesthetic genre, the zâr enables a great deal to be implied which
might be too inappropriate, heretical, or politically dangerous to say outright.
Human “authors” entirely disavow their authorship: whatever is said is said
by zayrân, whose existence is thereby reasserted as a matter of fact. Observers
at a zâr are confronted by a series of riddles, a multilayered paradox in which
alien beings are presented as antithetical to Hofriyati, yet more Hofriyati than
villagers themselves, all in the bodies of ordinary women. When inhabited by

a zâr, a woman is literally not who she is—not human, not Hofriyati, not even,
in most cases, female. That said, though the identities of the possessed and her
intrusive zâr are distinct, and it is the aim of the rite to cultivate awareness of
their distinction in the possessed, witnesses may find it difficult to maintain
the separation of entities, and those describing the event sometimes refer to
the woman and her spirit interchangeably. Yet this risk of confusion is what
makes the rite so provocative. Like the grotesque in Western art and literature,
by forcing together incongruous entities and ideas it uncouples naturalized
associations and disturbs assumptions that tacitly guide routine life. And for
any who would push interpretation further, zayrân appear to be none other
than Hofriyati themselves, seen in the mirror of an artfully imagined world.
Thus might Hofriyati women become objects, indeed subjects, to themselves.
This is not the work of trance alone but rather the continuous shifting
back and forth throughout the rite between moments of “absence” (ghaiyba)
and moments of self-aware “presence” (hadra), now seeing your friends and
kinswomen as zayrân, now becoming absent from your self as a zâr takes hold
and you provide that potential for others; this enactment, I think, is what helps
to destabilize cultural embodiment. When a spirit takes over, a woman is said to
experience its social world; released from trance when the drumbeat shifts to
that of another zâr, she witnesses this other world through the bodies of her
friends and kin. Even for those who merely observe, the juxtaposition of own
and other realities is highly suggestive. Zâr trance is not just a subjective expe-
rience; it is also a cultural performance in which implicit cultural knowledge is
brought to conscious attention through parody, inversion, caricature. Women
afterwards say they “see things differently” and “feel better” about their lives.
One might reasonably suggest that the ritual’s method is mimesis, or
simulative representation: the rite “shows,” rather than explicitly “tells,” via a
series of episodes in which familiar women become temporarily alien to others
and themselves. The mimetic faculty is, as Bourdieu (1990) notes, the basis
for human learning; I would argue that zâr rites provide occasions in which
there can take place contextual learning—what Gregory Bateson (1972) called
“deutero-learning” or learning about learning, about what has been learned.
In bringing together the commonplace and the strange in temporally and sys-
tematically circumscribed ways, the rituals open spaces for reflection in which
empathy and insight can emerge. Through her imaginative engagement in
the rite, a participant is enabled to disengage herself from the image of wom-
anhood that she so closely identifies with and that she has come to embody
so completely. She claims a moment of emotional distance from her social
and cultural situation, yet under the cloak of ambiguity that does not demand
renunciation of her self, only contextualizes it. The vacillation of audience and
participant positions, of seeing and feeling, being exposed to satire and the
challenging juxtaposition of contradictory categories and domains, may propel
her to levels of understanding that are foreclosed in everyday life. Possession
inserts a caesura between body and mind, self and context, precisely when the
culturally informed, personal elaboration of their unity has become problem-
atic for health. Along with the issues surrounding fertility, the symptom most
often associated with zâr is zihuj—lassitude, depression, apathy. Periodically
participating in zâr rites, along with fulfilling the everyday tasks that one’s spir-
its impose, are mnemonics, aids for preserving the separation of entities within
oneself, for maintaining insight and adjustment within the relational world.
Social Efficacy
Possession also “works” in quite pragmatic but equally personal ways on the
social plane. Having spirits enables a woman to open up the dense tangle of
relationships in which she is enmeshed, a situation that stems from the high
frequency of endogamous first marriage (Boddy 1989) and the precepts that
ensure its continuity. Village genealogies are extremely convoluted and kin-
ship bonds are multidimensional. A woman’s mother’s sister may also be her
father’s brother’s wife and her own mother-in-law. Paradoxically, because one
is related to almost every kinsperson in several different ways, and each of
these ways carries its own set of obligations, moral allegiance is not just con-
centrated but ambiguous and potentially contradictory. Under such circum-
stances it can be crucial for individuals to map out personal networks of support
within their encompassing group of kin.6 But because women are expected to
be submissive to menfolk’s desires and are responsible for maintaining the
social fabric through continuous mutual visiting, their personal networks may
be less apparent or less readily negotiated than men’s. Moreover, a woman’s
personal identity may be complicated and unclear to others: sisters, for exam-
ple, but also paternal aunts and nieces, are considered social and jural equiva-
lents, expected to assume the other’s place in a marriage when one of them
has died. So thoroughly merged can these women’s identities be that male
genealogists generally fail to note when a man’s children have been borne by
different though closely related mothers, whereas had the mothers not been
closely related the point would have been remarked.7 Though a man may also
replace his deceased brother in the latter’s marriage, the children of that mar-
riage are named for their actual fathers, reflecting the greater individuation of
men’s social identities.8 For women, the point remains that for Hofriyati (as
Karen Brown [1990:13] succinctly notes of Haitians), “human connection is the

assumption; it is separation that requires both effort and explanation.”
Knowledge of maternal kinship that is at risk of being lost in this patrilin-
eal society is partially preserved in informal, narrative genealogies of women’s
spirit afflictions. Because zayrân are attracted to blood, and maternal blood is
the substance that forms a child’s own blood and flesh, offspring are likely to
acquire spirits that have also possessed maternal kin, typically mothers and
maternal grandmothers, though mother’s and grandmothers’ sisters can be
sources of spirits as well. Importantly, members of a rural possession group
not only share a mutual history; it is, in part, because of that history that they
become possessed. During my fieldwork roughly two-thirds of all women in
Hofriyat had acknowledged a spirit affliction at some point in their lives and
almost half of the women over the age of fifteen claimed to be possessed. Since
virtually all of these women had sisters, mothers, aunts, nieces, and neighbors
who were fellow adepts, participants in local zâr ceremonies knew each other
intimately from contexts other than possession. In Hofriyat at the time of my
fieldwork, zâr added layers to existing kin relations rather than, as I. M. Lewis
(1990, 1991) hypothesized for the urban zâr, compensating for their loss.
Whatever understandings zâr might catalyze depend not only on a person’s
kin conundrums but also on characteristics of spirits and humans involved.
When Saida, for instance, was pregnant with Miriam, she became possessed
by the spirit Hakim Basha, a highly placed Western doctor zâr. Thus, when
Miriam fell ill as a married woman and possession was diagnosed, the spirit
responsible was believed to be Hakim Basha. So it transpired: Miriam during
her healing rite went into trance and Hakim Basha emerged to confront the
assembly through her body. But Miriam’s mother’s mother had also been pos-
sessed by Hakim Basha. Being possessed by the same spirit who possessed
one’s deceased maternal grandmother is a way of relating to that ancestor, but
indirectly, not through words or overt acts of allegiance but through embodied
experience. Here too, then, social alignments were being realized through cor-
poreal ones. The few village men who were possessed or in whom possession
had been acknowledged during childhood had all acquired their spirits from
their mothers. Zayrân accentuate “blood lines.” In the complicated tapestry of
local relatedness, specific spirits provide threads of coherence, lines of matri-
lineal continuity. Zâr possession thus provides an embodied counterpoint to
officially articulated kinship; in doing so it activates matri-group understand-
ings and support.
But perhaps it goes even further. From well before the Christian millen-
nium until at least the fifteenth century AD, and possibly for some centuries
after that, matrilineality with preferred endogamy and adelphic succession
were predominant structural principles in the region of Sudan stretching north

along the Nile from Khartoum to the Dongola Reach, in which Hofriyat is
located. There is evidence, too, that royal women, who in some political epochs
may have been sister-wives, governed during their brothers’ absences and
sons’ minorities.9 In late medieval times the Muslim rulers of Egypt frequently
captured important Nubian women (and their sons) in war, holding them at
Cairo to ensure peace along the southern border: letters from Nubian kings
and nobles entreating their sisters’ and mothers’ return attest to these wom-
en’s roles as important state advisors (Vantini 1981: 182). Contemporary head-
stones of commoners’ graves make it clear that this pattern was not confined to
royalty.10 Under leaders of the overtly patrilineal and Muslim Funj confederacy
established in the sixteenth century, the political reality of matrilineal descent
was, in a sense, domesticated though not denied, for the king’s maternal uncle
was assigned a powerful role as superintendent of the palace (literally, the royal
enclosure or hosh) and the status of an heir’s mother was a principal determi-
nant of his succession (Spaulding 1985). As recently as the late eighteenth and
early nineteenth centuries, long after Islam and Arab patrilineality had taken
root in northern Sudan, matrilineal tendencies were evident in the ascendancy
of paramount kings’ sisters’ sons to the local throne in the vicinity of Hofriyat.11
Perhaps, then, zâr plays a role in validating villagers’ archival knowledge and
keeping alive in shadow form an ancient social structure that was historically
eclipsed by Arab influence.
Traces of matrifocality may be seen in the fact that during my fieldwork
a woman was expected to give birth in her mother’s home; she would reside
there for the last trimester of her pregnancy and for several months after deliv-
ery, until she and her baby were declared well and fit to return to her husband.
Such visits, which included younger children, often stretched to a year or more,
particularly if the husband was a migrant laborer, and were repeated with suc-
cessive pregnancies. Thus matrilineal patterns of spirit possession that were
described earlier may articulate pragmatic and emotionally compelling affilia-
tions among sometime co-resident matrikin, whose relationships are officially
secondary, as much as they reflect the matrilineal past and its embodied con-
tinuation. Still, the matrilineal logic of possession constitutes a political parry
to the historical process of Arabization itself.
Possession thus works to index or effect (re)alignments of hegemonically
related kin. More than this: hierarchies of age, sex, and authority are covertly
challenged when spirit relations are mapped onto those of the possessed, as,
for example, when a woman and her mother-in-law are possessed by Muslim
father and daughter spirits, respectively. A person can be latently possessed
by several different spirits at once, spirits of different sexes, ages, and social
estates who hail from various homelands in the spirit world. Thus a woman’s
personal pantheon may present different facets of her social identity or express
her internalization—embodiment again—of domestic stresses and strains. For
full sisters to have no common zayrân might nuance a distinction between
them, where they are otherwise social and substantive equivalents. Likewise,
for a woman and her sororal niece, who is also her son’s wife, to be possessed
by the same zâr would intensify their matrilateral bond while downplaying the
affinal one; if both are possessed yet no common spirit links them, the opposite
emphasis might obtain.
The versatile ambiguities of Sudanese kinship are echoed and braced by
the subtleties of spirit discourse, for only those with a thorough understanding
of local relationships and their tensions, and knowledge of villagers’ possession
histories, are equipped to recognize in specific cases of possession the delicate
reweaving of kinship and the querying, even defiance of established allegiances
that they can imply. And such knowledgeable individuals are, overwhelmingly,
women, whose status limits their social maneuverability and thus may sharpen
their attention to the details of social affairs. Possession, especially in a rural
area such as Hofriyat, helps participants open up thickly layered, politically
significant relationships, separate their strands, assess and negotiate their
respective valences. Importantly, however, it is not the women who initiate this
process, but zayrân.
Conclusion
Zâr, as a ritual complex, works in at least two related ways to alleviate personal
distress. It is, first, an ingenious means for Hofriyati women whose embodi-
ment of feminine cultural images so clashes with the exigencies of their lives
that they have fallen ill, to gain perspective on their circumstances from a posi-
tion ostensibly beyond village truths, through possession trance, the experience
of being temporarily alien to themselves, and by observing such transitions and
alterations in family and friends. As such it locates responsibility for failing
to realize cultural ideals in exogenous agents, preserving a woman’s embodi-
ment of those ideals—her self—while reducing the suffering that it brings.
Second, zâr offers participants a way to open up the dense knot of relationships
in which they are invariably caught, so as to subtly navigate their positioning
and gain insight into the logic that informs their daily lives. The efficacy of zâr
may not be obvious or instantaneous, but implicit and cumulative, developing
gradually and continuously over time. And this may be why spirit possession in
Hofriyat is considered a lifelong affliction, but also a lifelong boon.
notes
1. Constantinides 1972, 1991. Cloudsley (1983: 75) has some evidence that zâr is
practiced in the Maghreb as well.
2. See Suras 6, 17, 18, 34, 37, 46, 55, 72, and 114.
3. Feminine plural of shaykh. There are male zâr specialists too, but they are
less common than female and more typical of zâr tumbura than zâr bori, the form I
describe here. On tumbura, see Kenyon 1991, 2004, and Makris 2000.
4. For further development of this point and a literature review on spirit
possession cross-culturally, see Boddy 1994.
5. This section is drawn from Boddy 1989, 2002, 2007.
6. For discussions of the social implications of endogamy, see Barth 1973,
Bourdieu 1977, Comaroff and Comaroff 1981, Comaroff and Roberts 1981, Comaroff
1985, Peters 1972, Rosen 1982, Solway 1990.
7. Women, however, did remember, and they provided significant information
about maternal relatedness.
8. Thus Hofriyati do not practice a “true” form of the levirate.
9. See Al Hag Hamad Mohammed Kheir 1987, Kronenberg and Kronenberg
1965, Vantini 1981, Adams 1984, Spaulding 1985.
10. Dr. Nicholas Millet, Curator, Royal Ontario Museum, personal
communication, 1992.
11. Burckhardt 1819: 247; Bruce 1813, vol. 4: 509.
references
Adams, William Y. 1984. Nubia: Corridor to Africa. Princeton: Princeton University
Press.
Al Hag Hamad Mohammed Kheir. 1987. Women and Politics in Mediaeval Sudanese
History. In The Sudanese Woman, Susan Kenyon, ed. Graduate School
Publications 19. Khartoum: University of Khartoum Press, pp., 8–39.
Barth, Frederick. 1973. Descent and Marriage Reconsidered. In The Character of
Kinship, J. Goody, ed. Cambridge: Cambridge University Press, pp. 3–19.
Bateson, Gregory. 1972. Steps to an Ecology of Mind. New York: Ballantine.
Boddy, Janice. 1989. Wombs and Alien Spirits: Women, Men, and the Zar Cult in
Northern Sudan. Madison: University of Wisconsin Press.
——— . 1994. Spirit Possession Revisited: Beyond Instrumentality. Annual Review of
Anthropology 21: 407–434.
——— . 2002. Tacit Containment: Social Value, Embodiment, and Gender Practice
in Northern Sudan. In Religion and Sexuality in Cross-Cultural Perspective,
S. J. Ellingston and M. C. Green, eds. New York: Routledge, pp. 187–221.
——— . 2007. Civilizing Women: British Crusades in Colonial Sudan. Princeton NJ:
Princeton University Press.
Bourdieu, Pierre. 1977. Outline of a Theory of Practice, R. Nice, trans.. Cambridge:
Cambridge University Press.
——— . 1990. The Logic of Practice, R. Nice, trans. Cambridge: Polity Press.
Brown, Karen McCarthy. 1990. Mama Lola: A Vodou Priestess in Brooklyn. Berkeley:
University of California Press.
Bruce, John. 1813 [1790]. Travels to Discover the Sources of the Nile. London: James
Robins. v.4.
Burckhardt, John Lewis. 1819. Travels in Nubia. London: John Murray.
Cloudsley, Ann. 1983. Women of Omdurman: Life, Love, and the Cult of Virginity.
London: Ethnographica.
Comaroff, Jean. 1985. Body of Power, Spirit of Resistance: The Culture and History of
a South African People. Chicago: University of Chicago Press.
Comaroff, John, and Jean Comaroff. 1981. The Management of Marriage in a Tswana
Chiefdom. In Essays on African Marriage in Southern Africa, E. J. Krige and J. L
Comaroff, eds. Cape Town: Juta, pp. 29–49.
——— , and Simon Roberts. 1981. Rules and Processes: The Cultural Logic of Dispute in
an African Context. Chicago: University of Chicago Press.
Constantinides, Pamela. 1972. “Sickness and the Spirits: A Study of the ‘Zaar’ Spirit
Possession Cult in the Northern Sudan.” Ph.D. dissertation, University of
London.
——— . 1991. “Ill at Ease and Sick at Heart.” Symbolic Behavior in a Sudanese
Healing Cult. In Symbols and Sentiments, Ioan M. Lewis, ed. New York: Academic
Press, pp. 61–83.
Kenyon, Susan M. 1991. The Story of a Tin Box. In Women’s Medicine: The Zar-Bori
Cult in Africa and Beyond, I. M. Lewis, A. al-Safi, and S. Hurreiz, eds. Edinburgh:
Edinburgh University Press for the International African Institute.
——— . 2004. Five Women of Sennar: Culture and Change in Central Sudan (2nd ed.).
Long Grove, Ill.: Waveland Press.
Kronenberg, A., and W. Kronenberg. 1965. Parallel Cousin Marriage in Mediaeval and
Modern Nubia, Part 1. Kush 13: 241–260.
Lewis, I. M. 1990. Spirits at the House of Childbirth. Times Literary Supplement, June
1–7, p. 590.
——— . 1991. Introduction: Zar in Context, the Past, Present and Future of an African
Healing Cult. In Women’s Medicine: The Zar-Bori Cult in Africa and Beyond,
I. M. Lewis, Ahmed al-Safi, and Sayyid Hurreiz, eds. Edinburgh: Edinburgh
University Press for the International African Institute, pp. 1–16.
Makris, G. P. 2000. Changing Masters: Spirit Possession and Identity Construction among
Clave Descendants and Other Subordinates in the Sudan. Evanston Ill.: Northwestern
University Press.
Peters, Emrys. 1972. Shifts in Power in a Lebanese Village. In Rural Politics and Social
Change in the Middle East. R. Antoun and I. Harik, eds. Bloomington: Indiana
University Press, pp. 165–97.
Rappaport, Roy A. 1993. The Obvious Aspects of Ritual. In Ecology, Meaning and
Religion. Berkeley, Calif.: North Atlantic Books, pp. 173–222.
Rosen, Lawrence. 1982. Bargaining for Reality. Chicago: University of Chicago Press.
Scheper-Hughes, Nancy, and Margaret Lock. 1987. The Mindful Body. Medical
Anthropology Quarterly 1 (1): 6–41.
Solway, Jacqueline. 1990. Affines and Spouses, Friends and Lovers: The Passing of
Polygyny in Botswana. Journal of Anthropological Research 46 (Spring): 41–66.
Spaulding, Jay. 1985. The Heroic Age in Sinnar. East Lansing, Mich.: African Studies
Center, Michigan State University.
Vantini, Giovanni. 1981. Christianity in the Sudan. Bologna, Italy: EMI Press.
7
Ritual Humility in Modern
Laboratories: Or, Why Ecuadorian
IVF Practitioners Pray
Elizabeth F. S. Roberts
Crucifixes and images of the Virgin Mary watch over the microscopes and gam-
ete incubators in several of Ecuador’s in vitro fertilization (IVF) laboratories.
The majority of Ecuadorian IVF clinicians and laboratory biologists pray for
God’s aid when aspirating and transferring gametes, and most would agree
with Dr. Molina, one of Ecuador’s most prominent IVF specialists, when he
exclaimed to me, “God is in the laboratory.” How can we make sense of the
use of these images? Why are these practitioners of modern biotechnology and
medicine invoking God? What do these ritualized actions and declarations do?
Are they efficacious?
Simply put, the answer to the last question is, “Yes.” When IVF practi-
tioners call on divine intervention in their clinics and labs, they are acting to
secure and control an uncertain outcome—pregnancy. Ritual exchange rela-
tionships with God are central to IVF and important for making sense of clini-
cal results. This chapter describes how calling the divine mitigates uncertainty,
but it focuses more specifically on another form of ritual effectiveness. These
rituals also work because by humbling themselves in front of the power of God
and other Catholic intermediaries, Catholic Ecuadorian IVF practitioners effec-
tively neutralize the official Catholic condemnation of IVF. This condemnation
revolves around two primary issues. The Vatican argues that (1) the research,
development, and practice of IVF involve the destruction of embryos, that is,
the “destruction of human life,” and (2) by engaging in assisted reproduction,
humans are technologically interfering with a process that should remain
under God’s dominion (Ratzinger 1987). But if, as these practitioners claim,
God and the Virgin have a hand in determining IVF outcomes, then surely
their clinics have God on their side.
I became aware of these enchanted laboratories in 2000 when I first
began to observe Ecuadorian IVF clinics. In 2002–2003 I carried out a year of
ethnographic research in seven of Ecuador’s nine private IVF clinics (which is
a relatively high number for an extremely poor rural nation of less than 12 mil-
lion), all located in either Quito or Guayaquil.1 While the mechanics of IVF are
roughly the same country-by-country, there are key differences in the practice
of IVF between nations.2 For instance, the optimal number of eggs retrieved
from a woman undergoing an IVF cycle varies with the policies of country and
clinic, depending on costs, drug protocols, the local health care system, and
the existence (or nonexistence) of regulatory institutions. IVF, which might
be seen by some as an “immutable mobile,” an entity that can be moved with-
out a change of meaning (Latour 1988), turns out to be very mutable indeed.
Comparing the problems, debates, and anxieties that may surface regarding
new technological and scientific practices in different sites “provincializes”
(Chakrabarty 2000) scientific and ethical norms, even though some of these
norms, such as the separation of religious and scientific rationalities, remain
globally dominant.
While most northern practitioners of science and biomedicine assert that
their practice is disenchanted, this assertion is not so pressing to Ecuadorian
IVF practitioners. Like other Ecuadorian elites and middle classes, these IVF
clinicians and biologists are heirs to Enlightenment thought, and they experi-
ence themselves as modern in their participation in these high-tech endeavors.
Nevertheless their spiritual approach to laboratory rationality does not trouble
these IVF practitioners’ experience of themselves as moderns. In contesting
the position of the Catholic Church through routine prayer, Ecuadorian IVF
practitioners demonstrate that they are comfortable combining the domains
of spirit and matter in the realm of science. It would be easy enough for north-
ern scientists to dismiss these claims of God’s favor as another example of
the inability of “third world” biologists to purify their labs of spirit. My task,
however, is to explain how and why Ecuadorian IVF practitioners, who are fully
enlisted in a modern project, proudly declare God’s presence in their midst.
Modern Catholic Dilemmas
In detailing the spiritual actions of modern Ecuadorian laboratory practitio-

ners, I am suggesting not an “alternative modernity” (Gaonkar 2001), but
rather a local formulation of the predicament involved in achieving modernity
ritual humility in modern laboratories 133
within a nation marginalized to that process. In Ecuador the urban middle- to

upper-class IVF practitioners with whom I worked could be described as avid
participants in what Talal Asad (1993) calls the “modern project,” for which
elite and professional classes strive. This project aims at institutionalizing civil
equality, industry, consumerism, and freedom of the market, and in Ecuador it
is most often understood as yet-to-be-achieved. In my daily encounters in Ecua-
dor, there was a palpable sense of what has been termed Ecuador’s “national
inferiority complex” (Miles 2003: 123). As a representative of a northern nation
that supposedly functions properly, I was frequently used by Ecuadorians of all
classes to enact a standardized monologue: “What’s wrong with this country?
Why are we so backward?” Depending on the person speaking, the blame, I was
told, rests with the dysfunctional state, corruption, or the superstitious and
insular indigenous groups of Ecuador. To remedy this failure, politicians have
been attempting to “modernize” the mentality of the nation, often by trying to
create a shared sense of being Ecuadorian (Radcliffe and Westwood 1996).3
IVF has been held up as one symbol of pride in Ecuador’s scientific prog-
ress, but Ecuadorian IVF practitioners have engaged in this same failure narra-
tive, constantly lamenting the difficulties of “peripheral” bioscience due to what
they saw as their country’s failure to maintain the infrastructure of a “modern”
nation-state. They had to go elsewhere for training and, on returning, faced
an ongoing “crisis” that they narrated in economic, political, and social terms.
Many of these Ecuadorian technical elites, who hold advanced degrees they
attained elsewhere, are compelled to seek employment in three or four loca-
tions, as clinicians, teachers, or consultants. But even though IVF practitioners
represented their need to travel elsewhere for training as a sign of Ecuador’s
distance from modernity, they were not anxious about how their enchanted
laboratories deviated from modern secular science. While modernity was a key
symbol of attainment for these middle-class Ecuadorians, they did not consider
laboratory mixtures of spirit and matter to be worrisome signs of a premodern
irrationality.
In North America and Europe, by contrast, the laboratory is most often
seen as a modern secular realm that demands the purification of spirit so that
the work of science may proceed (Latour 1993; Shapin and Schaffer 1989). Its
daily operations are imagined to be “secular” in the extreme, with the full exci-
sion of religion from its domain (Hess 1993). It is sometimes easy to forget
that the secular was initially constituted through the creation of religion as a
bounded object constricted to the “private” sphere. Max Weber’s famous thesis
that linked forms of Protestantism to the rise of capitalism (2001) predicated
the modern era on the emergence of a new type of religious subjectivity, not
on the total banning of religion from modernity. But “the secular” has taken
on life of its own, so it is sometimes viewed as having brought about religion’s

demise. Historian Jonathan Sheehan argues that
[a]s an analytical category, secularization plagues the efforts to

connect the Enlightenment and religion, not least because the term
is so crucial to the self-imagination of the modern age, which has,
from the eighteenth century onward, understood itself as surpassing
its religious past. (2003)
However, in Ecuador it is perhaps easier to make the connection between

Enlightenment and modern forms of religious subjectivity, because these mod-
erns do not imagine themselves as “surpassing” a religious past but rather as
living in a fully religious present.
In the past two decades, social scientists such as Bruno Latour (1993;
Latour and Woolgar 1986), Donna Haraway (1991, 1997), and Talal Asad
(1993, 2003) have begun to question this standard narrative of modern disen-
chantment. More recently the unabashed religiosity of the Bush administration
and its supporters has made this narrative even easier to complicate. While
the Bush administration has exhibited little interest in “surpassing” religion,
its move to infuse science with religiosity has perhaps compelled beleaguered
North American scientists to police the boundaries between scientific and reli-
gious epistemologies with renewed vigor. The overt banishing of religiosity
from laboratory practice in the United States appears to conform to what Bruno
Latour (1993) calls the “modern constitution.” Latour contends that modernity
is predicated on the belief that certain domains such as nature, culture, poli-
tics, and the economy can and should be separated from each other. Moderns
are those people who make these separations and who distinguish themselves
from those who do not. Modernity, then, constitutes itself in relation to this
otherness. One of the most basic modern separations, especially within mod-
ern science, is that between animated spirit and inert matter.4 This separation
established the natural material world, the domain of science as uninfluenced
by spiritual forces, which are the domain of religion. In the infancy of Euro-
pean capitalism and colonial expansion, the meaning of the English word “sci-
ence” shifted from “general knowledge” to the “theoretical and methodical
study of nature,” a nature that was newly mechanistic (Williams 1985: 278).
Enlightenment thinkers posited a spiritual order in the universe, where God
was no longer directly involved in the daily operations of the world, epitomized
in Descartes’ argument that “God has so established nature . . . and concluded
His work by merely lending His concurrence to nature in the usual way, leav-
ing her to act in accordance with the laws which He had established” (1996:
26). Mirroring the emerging modern order, the universe became differentiated
into the spiritual, natural, and social realms, parallel to the divisions of church,
science, and the state (Hess 1995: 79). Protestantism, the new religion of a
modern world (in which religion came into being as a separable entity), took to
heart God’s departure from the material world. To be modern was to deny the
possibility of earthly enchantment.
The Catholic response to the Protestant Reformation and its doctrine of
God’s earthly transcendence came in the form of the Council of Trent (1545–
1563), which asserted the divine immanence of God on earth, but only to a point.
Throughout the next several hundred years, this emphasis on God’s earthly
presence served as a means for Catholics to differentiate themselves from Prot-
estants. Simultaneously, this earthly focus became somewhat problematic in
the eyes of Church administration. The declaration of God’s intervention in
human affairs seemed to foster “the natural tendency” on the part of Catholic
peasants “to blur the distinction between genuinely religious activity and super-
stition,” causing Catholicism to appear “premodern,” “backwards,” and “uned-
ucated” (O’Connell 1986). The quandary of how to maintain a clear distinction
between the mainline Protestant separation of God from Earth, and the Catho-
lic belief in the possibility of God’s miraculous intervention on earth, while
at the same time preventing the populist faithful from determining the pub-
lic face of Catholicism, has been termed the “Tridentine dilemma”(O’Connell
1986). Since the early twentieth century, Catholicism has been at work crafting
an image of itself as fully engaged with the enlightened, scientific ethos of the
day, while retaining the possibility of divine immanence.
Materialist Catholicsm
In Europe, modernity was birthed partially though a process of distinguish-

ing between those who made separations between a transcendent (Protestant)
and immanent (Catholic) God. But in Latin America this cosmological battle
took a different form. There, many of these contestations took place among the
Catholic faithful rather than against the non-Catholic outside world. Historian
Pamela Voekel argues that the move toward Enlightenment and modern ideals
came not from elite men who had moved away from the Church, but rather
from elite reformers within the Catholic Church (2002). Referencing Foucault,
Voekel portrays these men as “self ” fashioned into a new form of Catholic sub-
ject heavily borrowed from the Protestant Reformation. These men, whom she
terms “enlightened Catholics,” proclaimed themselves sober, civic-minded,
self-disciplined, and rationally bureaucratic. They objected to what they saw as
the premodern displays of traditional Catholicism, with its outwardly focused,
baroque, and personalistic professions of devotion to God and saints in order

to effect material change on earth.5 Voekel claims that, at least in the late eigh-
teenth century, these men were fighting not for a separation of Church and
state, but instead for a rationalized Catholic state; thus the purifications of
modernity in Mexico and other Latin American nations took place within the
framework of Catholicism.
Voekel’s distinction between forms of Catholic subjectivity is key to my
analysis of God’s invocation in the clinics and laboratories of Ecuadorian IVF.
While she distinguishes between “enlightened” and “baroque” Catholics, I find
it more useful to make a distinction between spiritual and materialist Catholics.
Both subject positions are modern in the sense that both participate in natural-
izing the opposition between the spirit and the material, although it is spiritual
Catholics who have come to be called “modern,” and materialist Catholics who
have come to be called “traditional.” For spiritual Catholics, God is in effect a
Cartesian God. He created the natural world and now as a spiritual presence
has left its daily operations behind to be observed and managed by men. This
spiritual God is bounded, rule oriented, and like Him, the spiritual Catholic is
foremost an individual who is inwardly focused, temperate, and rule-oriented.
Spiritual Catholics are similar to mainline Protestants in many ways, especially
in their distrust of materiality, except that as Catholics they must allow for the
occasional intervention of God on earth, albeit much less frequently than do
materialist Catholics.6
The God of materialist Catholics can and does play an active role in the
daily material affairs of earth and men. He subverts His own natural laws
through these interventions (often known as miracles), because He and His
intermediaries are deeply involved in personal (not individualistic) relation-
ships with materialist Catholics. While spiritual Catholicism requires the cul-
tivation of the self-disciplined individual, materialist religiosity might be most
accurately described as the cultivation of exchange relationships. Many of the
practitioners as well as the patients with whom I worked were enmeshed in
personal exchanges with saints. A materialist Catholic might seem to be a con-
tradiction in terms, since materialism is often portrayed (especially by Marx,
its most ardent champion) as antithetical to enchantment. Thus, materialist
Catholics could be seen as radically nonmodern because of their insistence
that God and His intermediaries can and do transform the material world, but
this reading ignores how the very distinction between modernity and nonmo-
dernity is, as Latour argues, constituted through the purificatory practices of
modernity itself.
Understanding the majority of IVF practitioners and patients in Ecuador as
materialist Catholics explains their argument that their laboratories are God’s
domain. Of the twenty laboratory biologists and clinicians with whom I spent
the most time, fifteen could be categorized as embodying a materialist Catholic
religious sensibility. Of the five remaining, two were atheists, and the other
three I have come to think of as spiritual Catholics. These three denied God’s
influence on clinical outcomes with statements like, “God is not a puppet mas-
ter,” or “Faith does nothing.” These practitioners told me that they have no
dealings with individual saints but only Jesus Christ, mirroring longstanding
Protestant and Evangelical sentiments about the idolatry involved in forming
relationships with the graven (material) images of saints. But when working
with patients, everyone—even the atheist practitioners—would invoke God at
specific moments of the IVF process.
Ritual Expression: Clinic and Lab
My presuppositions about modern medical professionals were challenged in

my first days of observation in Ecuadorian IVF clinics. Initially I assumed that
the Catholic religious imagery hanging on the clinic walls was on display for the
patients, the majority of whom I knew to be religious. My assumption proved
to be wrong when I first entered clinic laboratories and operating rooms and
observed that these images, as well as religious rituals, occupied an integral
position in the practice of many embryologists and clinicians. God, it seemed,
had not been banished from the premises. His will was invoked in two main
areas of clinic life: first, in prayer, during procedures and treatments, and sec-
ond, in practitioners’ reflections on the general state of clinical affairs.
A cycle of IVF consists of many steps or phases, some more dramatic
than others. First the patient is given hormones to stimulate her follicles so
that more than one egg will be released at ovulation. The clinician checks the
patient’s follicles with a sonogram every other day to measure their growth.
When the follicles are large enough (usually around days 12–15), they are vagi-
nally aspirated or harvested in an operating room. Follicular fluid containing
the eggs is suctioned out of the patient’s uterus and deposited into test tubes,
which are delivered to the waiting biologist in the darkened laboratory next
door. From there the biologist empties the contents of these tubes into petri
dishes and examines the fluid for eggs under a microscope.
The next drama, although more solitary, is one of the two most fraught
moments of the process. The laboratory biologist, now alone, prepares the eggs
for insemination. Once she places the sperm in the petri dish, there is nothing
else she can do but hope, until she checks for fertilization 18 to 20 hours later.
It is at this time that she reflects on the quality of the eggs and sperm and prays
for an outcome. At Dr. Padilla’s clinic, the laboratory biologist Linda kissed and
caressed the incubator as she intoned her desire for God to fertilize the eggs. She
would often say a short prayer, addressing God familiarly: “Que Diosito quiera
que los ovulitos fertilicen. [May God want the eggs to fertilize.]” At another lab, the
biologist Dr. Escobar made the sign of the cross before he placed the petri dish
with the ovum and sperm in the incubator. With the gametes safely inside, he
patted the incubator, saying, “Go with God.” In Dr. Leon’s laboratory, when she
finished combining ovum and sperm, she would touch the image of the Virgin
Mary hanging over the principal microscope and then make the sign of the cross.
As she closed the door to the incubator after placing the petri dish inside, Dr.
Leon would touch an attached crucifix, which was hanging in a sterile plastic bag,
and again make the sign of the cross. In addition to these visible acts of devotion,
some biologists told me that they make silent prayers throughout the cycle as
well. Dr. Larea explained that at every aspiration she says “a prayer to God ask-
ing Him to let us get the number of eggs we need and that we get good results.
I say this before I enter the lab before each aspiration so that it goes well. God
help us.” She continued, “I have Christ in the laboratory. Whenever I go to do
a procedure, I ask that he enlighten me to do things well.” The next day, before
checking the eggs for fertilization, the biologist might make the sign of the cross.
If the resulting embryos are bonito (beautiful) instead of feo (ugly) or not fertilized
at all, she might give thanks and make another sign of the cross. After this crucial
check the new embryos are monitored daily for cell division and regularity until
the transfer. Finally, before the transfer, the right embryos must be selected and
another prayer might be offered at this moment: “God permit me to choose good
embryos.”
The transfer of embryos to the patient is also a moment of great conse-
quence. It occurs from 48 to 72 hours after the aspiration. During transfers,
God’s intervention is called for in several ways. At Dr. Padilla’s clinic, the biol-
ogist, Linda, would enter the operating room from the laboratory holding a
tube containing the embryos that were to be inserted into the catheter already
positioned in the patient’s cervix. Dr. Padilla would then say out loud, mostly
for the benefit of the supine woman and her husband, “This is the serious
part.” When he placed the embryo-filled catheter inside the patient’s uterus
for a timed minute, he would twice intone, “God help us, may these implant”
as a nurse guided the patient’s right hand in the sign of the cross. With the
transfer complete, the patient’s legs would be taken out of the stirrups and
laid on the table. She would be covered in blankets and the table was cranked
up so that her legs were higher than her head. When Linda returned to the lab
after checking the catheter, she would often announce to everyone, “This all
depends on God. It’s in the hands of God if they [the embryos] will stick.” She
would then turn to the now inverted patient and say, “There is a high chance
you’ll get pregnant. But you don’t know. If God helps us, all will go well.” As
each practitioner exited the room, he or she kissed the patient on the cheek and
told her and her husband, “God willing, you will be pregnant,” or “We need to
have faith.”
One morning, at another clinic, while holding a catheter in the supine
patient’s cervix, Dr. Quiroga turned to a visiting biologist and remarked,
“Wouldn’t it be great if everyone got pregnant?” Then he mentioned a recent
American study of the hormone selectin, which in the future might allow for
better control of implantation. The biologist replied, “But for now only God can
help us.” Dr. Quiroga nodded in agreement. When he removed the catheter,
he said to the patient, Felicitaciones. Que Dios nos ayude. No podemos hacer mas
hasta la prueba. [Congratulations. May God help us. We can’t do anything more
until the test.]
Throughout my observations, God was evoked at all of these stages but was
summoned most frequently at the moments surrounding the fertilization and
the transfer. These two moments were pivotal in the IVF process. They signaled
times when the clinicians, after preparing as best they could, ceded control
of the gametes to the unknown. Using Victor Turner’s language—the sperm
and eggs, which hopefully will combine into embryos while in the incubator,
are quintessential “entities in transition” (Turner 1969). They are liminal—an
especially apt term, given that liminality frequently involves womb-like spaces,
darkness, and invisibility, all attributes of the incubator where the gametes are
placed for their metamorphosis. They sit in dark, unseeable places and cannot
be manipulated while there. The eggs and sperm are put in a sealed incuba-
tor, where they are not examined for a day. Then the embryos are placed in
a uterus, unseen for two weeks of waiting, a period punctuated by frequent
hormone injections and testing. This stage stands in contrast, to other, more
controllable stages, such as the stimulation, when follicles can be monitored by
ultrasound through the patient’s body every day.7
As Malinowski documented seventy-five years ago, calling for “spiritual
assistance” is a common means of managing uncertain outcomes (Malinowski
1984). Trobriand islanders who venture into deeper waters do so, as do Mexican
potters, Masaii warriors, and American baseball players. Ecuadorian embry-
ologists do it as well, and these embryologists’ calling on the Virgin Mary,
or God, serves as a means to control an unknown future, similar to check-
ing temperature gauges on the incubators, or sterilizing pipettes. This case
is singular, however, because the weight of a presumed scientific modernity
makes the evocation of God in the laboratory different from these other routine
and “material” laboratory procedures. According to the “modern constitution,”
these invocations should not occur because they contradict the basic material-
ist tenets of science and biomedicine. However, while controlling an indefi-
nite outcome is certainly part of what these rituals do, I believe that they also
serve to manage the Church’s disapproval of these practitioners’ livelihoods.
Invoking God does more than manage the future and tilt the odds toward preg-
nancy. By disavowing their own agency and humbling themselves before God,
these practitioners effectively counter the Churches’ claim that IVF is a godless
practice.
About Belief
An understanding of why and how Ecuadorian IVF practitioner’s ritual contes-

tation with the Church is efficacious requires both a consideration of the cat-
egory of belief and a genealogy of ritual itself. When I present this material to
North American scholars they frequently ask, “Just how meaningful are these
evocations of God?” Maybe, they suggest, we should think of these practices as
rote and unconscious actions, like crossing oneself while walking by a church
or regularly exclaiming Dios Mio! to signal dismay—acts that in these scholars’
minds do not signify internalized conviction or belief. For heirs to Enlight-
enment thought, belief is supposed to signal a deeply held conviction of the
essential self.
This understanding of belief is also part of a common refrain heard in
Ecuadorian scholarly and religious literature, and in daily life, which concerns
the shallowness of Ecuadorian Catholic piety. “Look how the churches are
empty.” “Look how hypocritical they are to use birth control.” These “facts”
are repeated not only by those who, like priests, are not satisfied by the level
of institutional and popular support and power that the Church maintains
in Ecuador, but also by the atheist practitioners with whom I worked. Schol-
ars from Weston Le Barre (Le Barre and Mason 1948) to Michael Taussig
(1980) have used these same “facts” to indicate the Church’s failure to effect
internalized piety among Andean peoples. But none of these denigrations or
celebrations of the lack of “true” religiosity in Ecuador describes the palpable
devotion of urban Ecuadorians, who commonly make pilgrimages to Catholic
shrines but rarely attend Sunday mass. In Ecuador, mass attendance is not a
significant marker of Catholicism (although it might be a useful marker of
spiritual versus materialist Catholicism). Indeed, when I asked doctors and
patients in Ecuador, or anyone for that matter, if they were religious, the most
common response was, “I’m Catholic. I’m not a fanatic, though. I don’t go
to Mass.” But avoiding mass does not preclude a Catholic identity. One of
the very few studies of urban religiosity in Ecuador, conducted in the early
1980s, found that Ecuadorians, at least in the Northern Sierra, identified as
Cristianos (Catholics) first, before race or class groupings. Religious belief was
employed as the sign of a true person (Stutzman 1981). And as anthropolo-
gists have demonstrated, belief can be experienced in a variety of local and
historically specific ways.
Thomas Kirsch argues that for contemporary Zambian forms of Christi-
anity, belief is better understood as “the practice of cyclically regenerating a
condition of internalized believing” than as “a stable and perpetual interior
state” (2004: 699). As with Zambian Christians who are constantly “restaging
the will to believe,” materialist Catholic Ecuadorians’ understandings of faith
are not determined by a permanent and internal state of doctrinal belief. Thus
Ecuadorian IVF practitioners’ prayers to God and the Virgin do not appear
shallow or hypocritical to themselves or those around them. Their “beliefs”
and the effectiveness of their rituals are constituted through the performance
of humility and do not necessarily reflect the desire for an internal and per-
manent state of being. As Bourdieu puts it, “[p]ractical belief is not a ‘state of
mind,’ still less a kind of arbitrary adherence to a set of instituted dogmas and
doctrines (‘beliefs’), but rather a state of the body” (1990: 68).
Variability in belief experience is directly linked to variability in ritual acts,
as is demonstrated through Talal Asad’s careful parsing of the genealogy of
ritual. Asad distinguishes between premodern Christian, modern Christian,
and secular understandings of ritual. The earlier view of rite in premodern
Christian monasteries had to do with actively learned skills and instrumen-
tal behaviors that formulated a connection between “outer behavior and inner
motive” (Asad 1993: 58). This view changed in the modern period as ritual
came to be seen as signifying behavior, “classified separately from practical,
that is technically effective behavior” (ibid.). In premodern monasteries the
liturgy, or the routine ritual of mass, was not separated out as a symbolic enact-
ment of Christian faith, but, like copying manuscripts, was for monks a practi-
cal means to develop virtue (ibid.: 64).
Obviously modern Ecuadorian IVF practitioners are not premodern Euro-
pean monks, but nevertheless Asad’s genealogy of ritual allows us to see that
the commonplace anthropological analysis of ritual as “symbolic of ” something
else, or as signifying a deeply held belief, might not adequately match the expe-
rience of those we study. For materialist Catholics, the external presentation
of one’s belief is linked to an emphasis on outward signs rather than on the
internal cultivation of belief. Asad’s work on secular modernity demonstrates
that “belief ” has come to describe an internally “genuine” and deeply felt state.
Permanency and consistency, in addition to internality, became two more
hallmarks of belief, all of which emphasize “the priority of belief as a state of

mind, rather than as a constituting activity in the world” (Asad 1993: 47).
From the point of view of contemporary spiritual Catholics (or anyone who
connects belief with genuine conviction), materialist belief looks suspect, self-
serving, shallow, hypocritical, and erratic. In the case of materialist Catholic
Ecuadorians, prayers to the Virgin can be understood more as a “constituting
activity in the world,” like the disciplinary and external ritual of self-oblation
that IVF practitioners use to make clear to those present—patients, other prac-
titioners, themselves, and God—that the power of life rests in His hands. Thus,
instead of questioning the depth of Ecuadorian IVF practitioners’ conviction or
belief, we might imagine them as engaging in an integral and technical ritual.
In this case the discipline of the ritual instills the virtue of self-oblation—the
constant enactment of humility before God, which differs greatly from the ego-
enhancing presentation of self that I have encountered in my research with IVF
doctors in the United States (Roberts 1998a, 1998b). During the most fraught
moments of an IVF cycle, when the potential for life’s creation hangs in the
balance, these clinicians perform a “divine service” by reminding themselves,
and others, that they are not responsible for the creation of life.
Boundary Disputes
Throughout my fieldwork, practitioners, especially laboratory biologists, shared

with me a litany of reasons for the rate of pregnancy success and failure in
their particular clinics. Laboratory equipment (e.g., the quality of cultivation
media, pipettes, incubators), types of patients (e.g., spates of older or younger
patients), and natural disasters (after a nearby volcanic eruption, the ash cov-
ering Quito infiltrated the labs and was blamed for a month of bad results at
several clinics) are commonly invoked to explain good or bad outcomes. For
most practitioners, God was also part of this scenario. While I would imagine
many of these causal explanations to be common to IVF labs around the world,
it was the unabashed but unreflexive insertion of a divine causality that struck
me as noteworthy for moderns.
One morning the laboratory biologist Linda lamented the fact that most
recent patients had not gotten pregnant. She reminded me of an embryo trans-
fer that I had observed three weeks before. When Dr. Padilla pulled the catheter
out from the patient’s uterus, it was covered with blood. My stomach lurched
as I saw Dr. Padilla and Linda exchange a look. I knew well that clinicians care-
fully maneuver the catheter precisely in order to avoid uterine bleeding. Linda
reflected that in that particular case the blood might have ruined the woman’s
chances, since
blood is invasive and damaging for embryos. For that case it’s the
only explanation we have because we are doing nothing different.
Nothing! God is not giving me a hand. Lately He has forgotten
me. When we transfer the embryos and I see that the embryos
I transferred to this patient were good quality and could give a
pregnancy, and nevertheless it is not given, it’s because unexpectedly
God didn’t want it.
Linda’s invocation of God relates to an implicit boundary debate with the

Catholic Church. Clinical practitioners are keenly aware that the Church finds
IVF objectionable, and this is something with which they as Catholics have
to grapple. Their rebuttals took two basic forms: (1) We are not playing God;
we are only God’s helpers; and (2) God gave us the ability to do this, so it
must be okay. They do not directly respond to the charge that IVF exterminates
life, an objection that both practitioners and patients and even many priests in
Ecuador often overlooked. Rather, they focused their rebuttals on the Church’s
objections to the artificiality of IVF.
Many practitioners had practiced responses to Church condemnation of
IVF’s artificiality. Dr. Molina’s comment that “God is in the laboratory” was
part of a larger statement that he made to reporters when they asked if he was
not “playing God”:
Many times in interviews in radio and television they have asked me

if in the laboratory you are not playing with life, playing God. And
I have answered, “God is in the laboratory.” We are nothing more
than assistants. We are only putting our small grain of sand in to get
results.
With declarations like this, IVF practitioners countered Church claims that IVF
distorts the proper relationship between God and humanity. They positioned
themselves in agreement with the Church: according to them the ultimate
authority over life rests in God’s hands, not their own. Through ritual enact-
ments and declarations of faith they offer a countertheological discourse about
God’s interventions. The practitioners themselves are only assistants. Their sci-
entific workspace becomes God’s space, His laboratory.
This contrast between IVF practitioners’ claiming God’s intervention and
priestly denial of this possibility enacts the centuries-old Tridentine dilemma, a
debate that usually took place between priests and peasants rather than between
priests and scientists. And like peasants, these practitioners also employed sto-
ries of official Catholic hypocrisy to discount the Church’s position on IVF.
When I brought up the Church position directly with clinic directors, they inev-
itably told me how the directors of Catholic hospitals were against IVF—that
is, until their daughters could not have children. On another occasion, when I
asked Dr. Molina if he knew about the miraculous seventeenth-century bench
in the local Convent of Santa Catalina, reputed to help infertile women who
sit on it and pray to get pregnant, he said, “No.” But then, winking at me, he
wanted to know “if the nuns get pregnant too.” He explained that “[t]here are
tunnels under the churches in the old town where the priests and nuns meet,
and they have found the remains of fetuses there.” This was not the first time
I had heard this story, but never from a doctor who might have a specific inter-
est in portraying the Church in a less than flattering light, given his own role
in facilitating a condemned form of virgin birth. Dr. Molina’s jokes about the
sex lives of priests and nuns were similar to the anticlerical humor circulated
among Southern European peasants, which was used to challenge the author-
ity of the priests and the Church hierarchy without rejecting Catholicism as a
whole (Badone 1990). Like Southern European peasants, who object to what
they see as rigid, Church-created boundaries, Ecuadorian IVF practitioners are
not preoccupied with dividing the world into the oppositional spheres of sacred
and profane, spiritual and material. What differs in this case, however, is that
the Church officially vilifies these practitioners’ livelihood, and that the practi-
tioners are not operating from a position of social or educational inferiority to
the priesthood.
Throughout my fieldwork I also spoke with priests in Ecuador about why
the Church is against IVF. Evident in most of these discussions was the tight-
rope walked by institutionalized Catholicism, which diminishes, but cannot
completely extirpate, miraculous displays of personal favors bestowed by God.
When I explained how IVF practitioners called on God in their clinics and
laboratories, the priests denied that God’s miraculous intervention could occur
within territory reviled by the Church. These priests, as spiritual Catholics,
emphasized God’s primary role as the creator of natural laws, not an entity
with a material presence on earth. When I told one priest that IVF practitioners
saw God’s handiwork in IVF clinics, he countered by identifying psychological
forces, such as relaxation, as the “real” causes of “miraculous” clinic results.
Such priests did allow that God does very occasionally intervene on earth. One
priest told me, “God doesn’t break His own natural laws.” Nevertheless, he
had known one infertile woman who had become pregnant from praying on
the miraculous bench at the convent of Santa Catalina. Another priest told me
dismissively that praying to God in an IVF clinic is like Colombian assassins
praying before killing someone, or like doctors praying before performing an

abortion. These comments frame the stakes of this moral contest between IVF
practitioners and the Catholic Church. Are IVF practitioners acting as false
gods and killers, or are they God’s helpers, as they themselves claim? In their
response to Ecuadorian IVF, priests must reign in signs of personalistic Catho-
lic devotion and adamantly critique claims of God’s favor within the context of
an activity the Church condemns.
The Tridentine dilemma is modern in that its tensions enact a boundary
dispute between spiritual and material explanations (e.g., Is it God or is it psy-
chology?), a quintessentially modern preoccupation. To North American scien-
tists and medical professionals, this debate between priests and practitioners of
scientific medicine might appear as what Asad (2003: 10) has described as the
“failure to embrace secularism and enter modernity,” given that the terms do
not presuppose a solely material and disenchanted scientific universe. In this
enactment of the dilemma, however, the modern struggle is about religious
legitimacy in what many have imagined to be a wholly material sphere.
Claims of God’s favor make these practitioners somewhat unusual mod-
erns in yet another way. One of the key facets of modernity as described by
Weber (1991) is the creation of a rationalized, impersonal bureaucracy. The
God of both mainstream Protestants and enlightened Catholics is bureaucratic.
He does not break His own laws, at least almost never. Materialist proclama-
tions of God’s presence in the laboratory, God’s direct effect on clinical preg-
nancy rates, and claims of personal exceptionalism are not bureaucratic or
rationalized. These miracles are signs of personal exchanges with God, which
provide certainty and, more important, undermine Church claims that IVF is
against God’s will.
Conclusion
As these Ecuadorian elite proponents of technomedicine demonstrate, moder-

nity is not always about the “formation of the secular” or the banishment of
enchantment from the realm of natural law. In Ecuador, a nation-state fully
engaged in a modern project, religion has not been relegated to the private
sphere. Modern Ecuadorians are disinterested in the full embrace of secularity
even in settings that are avowedly secular elsewhere. Even though Ecuador is
one of the most officially secular nations in Latin America (Aguilar-Monslave
1984), public spaces, schools, and government offices are filled with Catholic
religious imagery. Although Ecuadorian IVF practitioners are by no accounts
pious, everyday life, even everyday scientific life, is suffused with religiosity.
The examination of bioscience around the world can destabilize conven-

tional assumptions of secularity, prompting us to ask: In what other sites or
nations does religiosity play a role in the laboratories of modern science and
biomedicine? Even scholars such as Bruno Latour (1993), who have done much
to disrupt our received notions of disenchanted science, characterize scientists
as being cleaved to the image of science as rational, disciplined, and, above
all, purified of the spiritual. To be clear, this is not an attempt to expose the
“irrational, religious underbelly” of science and biomedicine: instead, it is a
call to explore how the northern proclamation of God’s banishment from the
laboratory is not the only way that bioscientific workers can understand and
arrange their material and spiritual worlds. Modern Ecuadorians have their
own specific moral landscape where religious evocation does not have to be
separated from scientific medical practice. This example can aid scholars work-
ing elsewhere to reexamine longstanding assumptions about the automatic
separation of religious and material rationalities in scientific settings. The need
to explain why God resides in Ecuadorian IVF laboratories should prompt a
parallel need to defamiliarize the avowed disenchantment of North American
or European labs.
For many Ecuadorian IVF practitioners, there is nothing remarkable about
the evocation of the divine in a high-tech biomedical setting. This possibility
suggests a different construction of the relationship between science and reli-
gion than is often supposed in theories of modernity. When practitioners of
Ecuadorian IVF make appeals to God and the Virgin for the fertilization of eggs
retrieved during IVF, they are operating within a modern project where God’s
intervention does not contradict their identity as Catholics or as practitioners
of modern scientific medicine. These clinicians assert God’s presence in the
laboratory to neutralize Church disapproval, but they see no need to cordon off
the material from the spiritual. Modern boundary tensions are at work in Ecua-
dor, not necessarily over the primacy of science or religion, but over the proper
boundaries of enchantment. Humbly giving over one’s laboratory to God effec-
tively allows these practitioners to stake a claim to legitimate Catholic practice.
These rituals of humility work. In Ecuadorian IVF, God has been appointed the
director of laboratory life.
notes
1. My research took place in IVF clinics, where I observed and talked with
practitioners and patients in waiting rooms, laboratories, operating rooms, and
patients’ recovery rooms. In addition I conducted over 130 formal interviews for
the project, the majority with female infertility patients, and sometimes their male
partners and other family members. I also conducted interviews with IVF
practitioners, physicians, technicians, laboratory biologists, or staff at IVF clinics, as

well as egg and sperm donors, surrogate mothers, priests, lawyers and bio-ethicists.
For an extended discussion of my findings see Roberts (forthcoming).
2. IVF practitioners vaginally remove a woman’s eggs from her hormonally
stimulated ovarian follicles. Laboratory technicians combine these eggs in a petri dish
with sperm. The resulting fertilized eggs, or embryos, are transferred back into a
woman’s uterus in the hopes of implantation and pregnancy.
3. Business groups were behind a recent modernizing campaign. In fall of 2003
these groups organized a ceremony where the nation gathered to synchronize its
watches in order to increase worker productivity.
4. In Latour’s modern constitution, the flip side of purification is the proliferation
of hybrids. This is the logical outcome of the modern belief that entities like nature or
culture exist and thus can be separated. When these supposedly separate realms are
brought together, they are called hybrids (Latour 1993).
5. Coastal liberal reformers have been battling against what they see as the
entrenched patron client relations endemic to Sierran agrarian society that they
understood as preventing the development of free trade.
6. See Webb Keane (2002) for a discussion of Protestant distrust of materiality.
He paraphrases Marx concerning the links between Christianity and capitalism where
the “the concrete comes to be subordinated to the abstract” (Keane 2002).
Ironically, the separation of the material world from the spiritual world is what,
according to Weber, allowed Protestants, who made that separation, a means to
achieve an unimaginable level of material accumulation (Weber 2001).
7. The moments where the lack of control is heightened are linked to God in a
way that other moments of the process that we might expect to be sacred are not. For
example, after the quality of embryos was checked, prayers or thanks to God were
frequently offered. The embryos themselves, though, do not necessarily provoke such
sentiment: after a transfer; when there are “extra” embryos, they are often dumped
unceremoniously into the trash. For further discussion see (Roberts 2007).
references
Aguilar-Monslave, L. A. (1984) The Separation of Church and State: The Ecuadorian
Case. Thought 59, 205–219.
Asad, T. (1993) Genealogies of Religion: Discipline and Reasons of Power in Christianity
and Islam, Baltimore: Johns Hopkins University Press.
——— . (2003) Formations of the Secular: Christianity, Islam, Modernity, Stanford,
Calif.: Stanford University Press.
Badone, E. (1990) Religious Orthodoxy and Popular Faith in European Society,
Princeton, N.J.: Princeton University Press.
Bourdieu, P. (1990) The Logic of practice, Cambridge: Polity.
Chakrabarty, D. (2000) Provincializing Europe: Postcolonial Thought and Historical
Difference, Princeton, N.J.: Princeton University Press.
Descartes, R. (1996) Discourse on the Method; and, Meditations on First Philosophy, New
Haven, Conn.: Yale University Press.
Gaonkar, D. P. (2001) Alternative Modernities, Durham N.C.: Duke University Press.

Haraway, D. J. (1991) Simians, Cyborgs and Women: The Reinvention of Nature, London:
Free Association.
——— . (1997) Modest*Witness @ Second*Millennium. FemaleMan *Meets* Onco
Mouse: Feminism and Technoscience, New York: Routledge.
Hess, D. J. (1993) Science in the New Age: The Paranormal, Its Defenders and Debunkers,
and American Culture, Madison, Wis.: University of Wisconsin Press.
——— . (1995) Science and Technology in a Multicultural World: The Cultural Politics of
Facts and Artifacts, New York: Columbia University Press.
Keane, W. (2002) Sincerity, “Modernity,” and the Protestants. Cultural Anthropology
17, 65–92.
Kirsch, T. (2004) Restaging the Will to Believe: Religious Pluralism, Anti-Syncretism,
and the Problem of Belief. American Anthropologist 106, 699–709.
Latour, B. (1988) The Pasteurization of France, Cambridge, Mass.: Harvard University
Press.
——— . (1993) We Have Never Been Modern, New York: Harvester Wheatsheaf.
——— , and S. Woolgar. (1986) Laboratory Life : the Construction of Scientific Facts,
Le Barre, W., and J. A. Mason. (1948) The Aymara Indians of the Lake Titicaca Plateau,
Bolivia, Menasha, Wis.: American Anthropological Assn.
Malinowski, B. (1984) Magic, Science, and Religion, and Other Essays, Westport,
Conn.: Greenwood Press.
Miles, A. (2003) Healers As Entrepreneurs: Constructing an Image of Legitimized
Potency in Urban Ecuador. In J., Koss-Chioino, T. L. Leatherman, and
C. Greenway (Eds.), Medical Pluralism in the Andes, London: Routledge.
O’Connell, M. (1986) The Roman Catholic Tradition Since 1545. In R. L. Numbers and
D. W. Amundsen (Eds.), Caring and Curing: Health and Medicine in the Western
Religious Traditions, New York: Macmillan.
Radcliffe, S., and S. Westwood. (1996) Remaking the Nation: Place, Identity and Politics
in Latin America, London: Routledge.
Ratzinger, C. J. (1987) Instruction on Respect for Human Life in Its Origin and on the
Dignity of Procreation. Congregation for the Doctrine of the Faith, the Feast of the
Chair of St. Peter, the Apostle. February 22, Rome.
Roberts, E. (1998a) Examining Surrogacy Discourses: Between Feminine Power and
Exploitation. In N. Scheper-Hughes and C. Sargent (Eds.), Small Wars : The
Cultural Politics of Childhood, Berkeley: University of California Press.
——— . (1998b) “Native” Narratives of Connectedness Surrogate Motherhood and
Technology. In J. Dumit and R. Davis-Floyd (Eds.), Cyborg Babies: From Techno-
Sex to Techno-Tots, New York: Routledge.
——— . (2007) Extra Embryos: Ethics, Cryopreservation and IVF in Ecuador and
Elsewhere. American Ethnologist 34, 188–199.
——— . (forthcoming) God’s Laboratory: Mixed Relations in Andean IVF Clinics.
Shapin, S., and S. Schaffer. (1989) Leviathan and the Air-pump: Hobbes, Boyle, and the
Experimental Life, Princeton, N.J.: Princeton University Press.
Sheehan, J. (2003) Enlightenment, Religion, and the Enigma of Secularization:

A Review Essay. The American Historical Review 108, 1061–1080.
Stutzman, R. (1981) El Mestizaje. An All Inclusive Ideology. In N. Whitten (Ed.)
Cultural Transformations and Ethnicity in Modern Ecuador, Urbana: University of
Illinois.
Taussig, M. (1980) The Devil and Commodity Fetishism in South America, Chapel Hill:
University of North Carolina Press.
Turner, V. W. (1969) The Ritual Process: Structure and Anti-Structure, Chicago: Aldine.
Voekel, P. (2002) Alone Before God: The Religious Origins of Modernity in Mexico,
Durham, N.C.: Duke University Press.
Weber, M. (1991) From Max Weber: Essays in Sociology, London: Routledge.
——— . (2001) The Protestant Ethic and the Spirit of Capitalism, London: Routledge.
Williams, R. (1985) Keywords: A Vocabulary of Culture and Society, New York: Oxford
University Press.
8
Ritual, Medicine, and the
Placebo Response
Howard Brody
Definitions and Preliminary Observations
The “placebo response” may most usefully be defined as a change in a person’s

health status that is caused by the symbolic aspects of a therapeutic interven-
tion.1 It turns out to be extremely difficult to give a completely consistent defi-
nition of this phenomenon.2 Some commonly offered definitions are actually
quite misleading. It will not do, for instance, to say that the placebo response
is a change in health produced by an inert medication or other therapy, since
inert remedies cannot, by definition, produce changes. Even in today’s medical
literature, it is common to encounter definitions that characterize the placebo
response as the nonspecific response to therapy, as contrasted with the specific
response that is presumably caused by the treatment’s physical or chemical
properties. This is also incorrect. When a placebo treatment is administered to
patients with asthma, for instance, it generally (if it has any effect at all) reduces
wheezing but does not relieve pain. By contrast, when a placebo is given to
patients with a headache, a certain number are likely to have pain relief but no
improvement in their breathing. How this result makes a placebo more “ ‘non-
specific” than any other therapeutic modality is never explained.
I have offered a definition of “placebo response” without attempting first
to define “placebo.” This approach is important because the most fruitful
accounts of placebo response do not restrict the term solely to circumstances
in which an actual placebo is employed. Today placebos are rarely prescribed in
U.S. medical practice, yet I would contend that virtually any medical encounter
that involves a conscious patient is potentially subject to a placebo response
as one component of the overall therapeutic intervention. Because the discon-

nect between “placebo” and “placebo response” suggests to many that the latter
term has outlived its usefulness, some have proposed that a better term would
be context effect or meaning response.3
The Placebo Response as “Suspect Category”
Let us return for a moment to the unsatisfactory definition of the placebo as

an inert remedy. This definition is offered unblushingly by many expert physi-
cians, many if not most of whom would accept such a definition without objec-
tion. If it were then pointed out to them that it seems illogical to attribute an
effect to something inert, the physicians would be inclined to shrug off this idea
as being of little importance, a mere semantic quibble. On the other hand, if
one offered a similarly flawed, illogical definition of a term such as “diabetes,”
these same physicians would protest loudly.
What does this reaction signify? I would suggest that the placebo response,
within medicine, is a sort of “suspect category,” in some of the same ways that
ritual can be viewed as a “suspect category” according to Sax.4 For example,
starting in about 1950 medicine adopted the double-blind, randomized, con-
trolled trial as the methodological cornerstone of research into new therapies,
in hopes of eliminating the placebo response as an explanation for the efficacy
of any new therapeutic agent. Yet a research program to better understand the
placebo response was inaugurated by the U.S. National Institutes of Health
only within the past half-decade. For much of the twentieth century, “placebo
response” was a wastebasket category for medicine to shift embarrassing phe-
nomena so that they could then be ignored, rather than an explanatory category
for seeking greater insight. When a systematic review, purporting to dismiss
the placebo effect as an important phenomenon in double-blind randomized
trials, appeared in a major American medical journal in 2001, the editorialist
appeared to be highly gratified that at last the overromanticized placebo notion
had been put in its proper place (which, one gathered, was no place at all).5
The placebo response, as I have defined it, is a subset of a larger category
that might be called “mind-body healing.”6 But conventional Western medicine
retains a strongly Cartesian, reductionist tendency that is extremely uncom-
fortable with the idea of mind-body healing—or any significant interaction of
mind and body, for that matter. Montgomery notes that most of the sciences,
especially the social sciences, were addressing postmodern concerns during
the latter decades of the twentieth century and were accepting the breakdown
of the subjective-objective distinction. By contrast, medicine during this period
ritual, medicine, and the placebo response 153
remained steadfastly positivist and Newtonian in its worldview. Montgomery

attributes this medical intransigence to physicians’ (and patients’) extreme
resistance to the acknowledgement of uncertainty.7 Most students of the pla-
cebo response agree that on average, placebos appear to be efficacious roughly
one-third of the time, though this average disguises a considerable variability
depending on context. The inherent uncertainty of the placebo response seems
sufficient to dismiss it from the minds of many physicians.
Many physicians, on being told that at least some of the efficacy of the
treatments they administer to their patients is probably attributable to the pla-
cebo response, would initially at least feel insulted. I believe that this tendency
is lessening, as medicine slowly becomes more accommodated to mind-body
interactions and as placebo phenomena become more widely known. Still, it is
worth noting that to label anything in medicine as a “placebo response” is to
put it in a category that renders it somewhat problematic.
Rituals in Medicine
Many healing activities in conventional Western medicine may helpfully be

analyzed as rituals. Do their ritual elements help to account for the placebo
response? To answer this question we must look at psychological theories of
placebo mechanisms and then assess recently accumulated empirical data on
the placebo response that point toward underlying neural processes. Some pre-
liminary observations may highlight features of ritual that are especially perti-
nent to healing and to the placebo response.
I understand rituals to be conscious, intentional, often repetitive bodily
actions that attempt to impose meaning on one or another aspect of the world.
In performing ritual, the person often relinquishes individuality in favor of a
role that follows specific, prescribed rules. That is, his or her body transforms
itself into something larger than, and external to, individual self. The prescribed
rules that constrain bodily action in ritual often dictate what is socioculturally
believed to be “right and fitting to do in the context of a given situation.”8 The
notion of “right and fitting” helps to elaborate how ritual creates meaning. Rit-
ual is a bodily acting-out of what sort of situation one is in, and what ought to
be done about it. At least according to one theory, rituals are attempts to control
nature. Healing rituals fall within the larger category of restorative rituals—the
sick person is ill or is in a state of disharmony with nature, and the ritual’s pur-
pose is to restore health or harmony. According to Sax, rituals in this category
are transformational.9 Later we will ask whether the fact that a ritual is believed by
its participants to be transformational can itself be a source of ritual efficacy.
Conventional Western medicine, which will largely be the focus in this

chapter, contains a great many rituals.10 Two that are commonly seen in a
teaching hospital are the physical examination performed by the physician,
and the “rounds” during which the examining physician presents to the other
physicians all the findings that have been gleaned for that patient, along with
the diagnosis and the plan of therapy. A sociologist of medicine might be
most interested in the latter sort of ritual. For our purposes I will discuss
only the rituals that involve the patient directly. I will assume that medical
rituals that occur off-stage (as it were) from the patient’s perspective have
much less effect on the meaning that the patient attaches to the illness and
its treatment.
A complication of studying ritual in conventional Western medicine is that
medicine subscribes to a scientific belief system, according to which everything
is done because of the profession’s scientific knowledge. Since to many, “rit-
ual” equates with religion or superstition, medical practitioners might immedi-
ately deny that ritual plays any role in their activities. They may be reluctant to
acknowledge that even if we grant the questionable assumption that everything
in medicine is scientifically based, some practices may have features of ritual in
addition to their scientific content, and that those ritual elements might be inde-
pendently effective in some aspects of healing. The tendency to dismiss ritual as
part of medicine reflects the same Cartesian, reductionist strain in medicine’s
belief system that renders the placebo response a “suspect category.”
By contrast, a medical sociologist or anthropologist would perceive impor-
tant analogies between healing rituals practiced in so-called primitive cultures
and many of those routinely engaged in as part of Western medicine. Jerome
Frank, a psychiatrist, argued in a classic study that most of Western psycho-
therapy works because of elements that it shares with these healing rituals,
with religious faith healing, and with the placebo response.11 To Frank, such
an observation explained rather than denied the efficacy of psychotherapy.
Anthropologists have argued that ritual may be efficacious in an even more
determinative manner. Kleinman, for example, stated that the rituals per-
formed by indigenous healers, in accordance with the rules prescribed by their
culture, “must heal.”12 I believe that he intended to say that the sufferer in such
a ritual has two choices: either he, and all around him, regard him as having
been healed; or he becomes an exile from his community. To regard himself
as not having been healed when all the culturally prescribed rules have been
scrupulously followed is tantamount to adopting a foreign belief system that
would remove him from his culture. This is true even if he keels over dead the
next day. Western medicine has its own version of such an event, even if often
spoken in jest: “The operation was a success but the patient died.”
Psychological Theories: Expectancy and Conditioning
Let us now seek a scientific explanation of how two things might lead to a
sick person’s being healed: taking a sugar pill or similar “inert” medication
within a Western medical context; or undergoing a healing ritual in an indig-
enous community. The scientist would first insist that we somehow exclude
a likely alternative explanation—that the illness resolved because of its “nat-
ural history.” That is, even absent the sugar pill or the ritual, the sick per-
son would have gotten better just as fast. Assuming that we can exclude the
natural-history explanation, we are left with what appears to be a true placebo
response. The explanations then offered would probably involve two psycho-
logical mechanisms—expectancy and conditioning.
According to expectancy theory, the mere belief that something will happen
sometimes produces bodily responses that conform to the expectation. Taking
the sugar pill, or undergoing the healing ritual, the patient expects to improve.
That expectancy involves activation of specific areas in the brain that are in
turn capable of activating other brain areas that alter peripheral physiology,
via neural, hormonal, or immunological mechanisms. The final result is that
alterations in bodily function occur that move the patient in the direction of
restored health.
Through conditioning theory, a placebo response works in accord with clas-
sical Pavlovian conditioning. In the case of the sugar pill, for example, in the
past the patient has been exposed to an unconditioned stimulus (the chemi-
cal content of nonplacebo remedies) and a resultant unconditioned response
(relief of the symptom). Repetitively, the conditioned stimulus (the outward
appearance of the pill) was linked to the unconditioned stimulus (the chemical
content of the pill). After enough repetitions, the conditioned stimulus became
capable of producing the response, even in the absence of the unconditioned
stimulus (that is, a chemically inert pill produces similar relief of symptoms).
There is a good deal of evidence in support of expectancy theory.13 For
instance, patients randomized to receive either acupuncture or massage for low
back pain displayed markedly varied reactions to the two treatments. The appar-
ently random pattern disappeared, however, if one factored in their expectan-
cies. Those who expected to get better with massage and who were randomly
assigned to the massage group did much better at a statistically significant rate;
a similar thing happened for those who expected maximal improvement with
acupuncture.14
The role of expectancy in placebo-induced analgesia has been extensively
studied by Fabrizio Benedetti’s group at Turin, one of the most active groups
of placebo-response investigators. They have shown repeatedly that the expec-

tation of pain relief leads to actual pain relief, and that the neural system that
is implicated in this causal chain releases endogenous opioids, or endorphins.
Naloxone, a chemical that blocks endorphin activity, reliably reverses the anal-
gesia associated with expectancy.15
There is less evidence to link conditioning theory to the placebo response,
yet some data seem strongly suggestive.16 Robert Ader, in classic experiments,
was able to produce a conditioned immunosuppression response in rats. After
rats had repeatedly received a powerful immunosuppressant drug along with
saccharin, the rats demonstrated significant immunosuppression after being
administered saccharin alone.17 Eventually these findings were replicated in
humans.18 Ader also showed that an antihypertensive medicine, atenolol, could
produce a conditioned response such that subjects showed antihypertensive
effects when later given a placebo.19 Asthmatic children were administered
their usual asthma medication in a metered-dose inhaler, and simultaneously
exposed to a vanilla aroma, for fifteen days; the vanilla aroma then was capable
of improving their lung function even when the inhaler was filled with a salt-
water solution.20
In a particularly elegant set of experiments, Benedetti’s group set up a
conditioned response in pain patients to two different analgesics—an opioid,
and a nonsteroidal anti-inflammatory medication. They discovered that the
conditioned response in the subjects who had been conditioned with the opi-
oid could be reversed with naloxone, the chemical that blocks the effect of both
endorphins (endogenous opioids) and extrinsic opioids. Since this group had
previously shown that naloxone could reverse placebo analgesia induced by
an expectancy state, one might imagine that this experiment suggested that
expectancy and conditioning were identical. But when the naloxone was then
administered to the subjects who had been conditioned using the non-opioid
analgesic, no reversal of the response occurred. The investigators concluded
that when an opioid is the unconditioned stimulus, the conditioned response
involves an endogenous opioid pathway and so can be blocked by naloxone;
when a different medication is involved in the conditioning process, a dif-
ferent chemical pathway is activated and so naloxone is no longer effective
in reversing it.21 To put it more fancifully, the conditioned response follows
along the same biochemical trail that was initially blazed by the unconditioned
stimulus.
The naloxone-reversal studies would seem to suggest a lack of overlap
between expectancy and conditioning as placebo-response mechanisms. Yet
such a dichotomy seems unwarranted. Conditioning in the conscious animal,
especially the human, is a form of learning. It seems hard to claim that the
asthmatic children, for instance, did not come to expect that their asthma would
improve when they smelled vanilla. Psychologists studying the placebo response
have demonstrated that some human studies that were initially interpreted to
be “pure” conditioning studies actually were contaminated with a good deal of
expectancy.22 Yet the experiments with naloxone reversal of analgesia would
seem to suggest, by contrast, that the conditioned response is separable from
expectancy effects.
The principal difference between expectancy and conditioning as explana-
tory models is that conditioning requires a previous, repeated exposure to a par-
ticular stimulus. By contrast, I may expect that something will heal me, even
if I have never experienced it or been exposed to it before. Conditioning is a
backward-looking explanation while expectancy is forward-looking.
We might fantasize trying to resolve the apparent dispute between the
expectancy and conditioning models of the placebo response by prying open
the subject’s head and peering into the brain to see just what is happening.
Some of the most promising recent research on the placebo response has
involved neural imaging modalities that promise to do just that.
Neuroimaging Studies of the Placebo Response
In the past decade neuroscientists began to use positron emission tomography

and functional magnetic resonance imaging to study the placebo response. The
bulk of the studies have been done for three medical conditions: pain, Parkin-
son’s disease, and depression. Althought most such data at this point must be
regarded as preliminary and relatively few of these findings have been exten-
sively replicated, some data do seem reasonably robust:23
• When a placebo response can be detected by neuroimaging, it

appears to involve the same anatomic centers as would be active
in a pharmacologic response to the medication that the placebo
mimics. Placebo analgesia seems to involve mostly endogenous
opioid pathways. Placebo responses in Parkinson’s disease involve
the dopamine-secreting cells of brain nuclei. Depression seems to
be an exception; at least some research suggests that brain areas
activated by placebo differ from those involved with pharmacologically
active antidepressants. Specifically, the brain areas activated by
placebo represent only a subset of the brain areas activated by the

pharmacologically active antidepressant.24
• The role of expectancy and of endogenous opioids in placebo analgesia
seems to have been firmly established. The brain regions that become
active during the placebo response in pain correlate quite precisely
with, first, cognitive areas involved in expectancy, and second, areas
known to be involved in endorphin release and responsiveness.
• Placebo responses appear to involve generally a complex interaction
between cognitive and emotional centers. What I think is going to
happen to me, and how I feel about it, refuse to remain in watertight
compartments. Thoughts and emotions interact in complex ways in
producing the typical placebo response.
• Two mechanisms can be postulated for placebo analgesia. Events in the
brain may dampen or shut off incoming pain signals from the body’s
periphery. Alternatively, once the pain signals have been received,
the manner in which the brain processes them may be modulated.
Neural connections are known to exist that are compatible with either
mechanism. Neuroimaging data suggest that both occur to some
degree. It is also possible that one mechanism occurs early in the
placebo response and the other occurs later—although, surprisingly, it
seems to be the inhibition of incoming pain signals that is the later-
occurring phenomenon.25
• The same brain regions that are involved in expectancy-triggered
placebo analgesia appear to be involved in other expectancy states
without pain. One experiment, for example, manipulated subjects’
expectancy to diminish the perception of an aversive taste stimulus.
Many of the same brain centers were activated in this study as would
in placebo analgesia, including the rostral anterior cingulate cortex, an
area known to be richly supplied with opioid receptors. This suggests
to some that there is a general expectancy-sensory-response system in
the brain and that placebo analgesia is only one way that this system
functions.26
• One of the most mysterious elements of the placebo response has
been its unpredictability and variability. Though it is often possible to
predict what percentage of subjects will experience symptom relief, it
has been virtually impossible heretofore to predict which individuals
would respond to placebo. Neuroimaging offers some clues as to how
placebo responders might differ from nonresponders, and it might in
the future do much to elaborate the basis for this significant level of
variation.27
At the same time that these neuroimaging studies have been carried out,
the group at Turin has exploited a useful experimental model—comparing
covert and overt administration of “active” medication or other therapy. Our
basic model assumes that when a conscious patient receives a medication,
chemical and placebo elements are both present. A traditional way to study
which is which is to give a dummy pill that eliminates the chemical element.
The newer studies shine a light on the phenomenon from another angle—
the chemical element is retained, but the symbolic element is removed, since
the subject no longer has any way of determining when and how much of the
chemical has been administered. (For instance, an intravenous infusion pump
concealed behind a screen may be programmed by a computer to adminis-
ter doses of a narcotic painkiller at various intervals.) Initially it was shown
that when open administration of intravenous narcotic for postoperative pain
is contrasted with hidden infusions that are identical, the pain relief in the
hidden situation was about half as great.28 Similar results have been found in
medication for anxiety and in electrical stimulation of the brain for Parkin-
son’s disease. It has also been shown that covert discontinuation of a treatment
leads to less symptom rebound than open discontinuation.29 The discontinua-
tion findings, incidentally, would be viewed by some as evidence in favor of a
conditioning mechanism.
In summary, recent neuroimaging data, combined with other research,
make it difficult to accept the claims that the placebo response is an experimen-
tal artifact or wishful thinking.30 Neuroimaging data suggest that our earlier,
crude model of the placebo response as mind-body healing is correct for condi-
tions so far studied—that a “mental” stimulus leads to a neural response that
closely mimics whatever occurs when a pharmacologically active substance is
administered.
One might harbor concerns that this turn toward neuroimaging data
to explain the placebo response represents an unfortunate reductionism, in
which beliefs, emotions, and social meaning are dismissed as ephemeral and
only data that can be obtained by high-technology brain scanners are seen as
real. Popular responses to reports of these studies readily raise such concerns.
On the other hand, so long as we insist that neuroimaging represents only one
among many tools with which to approach the placebo response, there seems
less danger of such a reductionism. I believe that it is very important to use
neuroimaging to discover what brain centers are activated, and in what order,
in association with the research subjects’ first-person reports of their experi-
ences and thoughts. I think this process is methodologically sound so long as
we grant epistemic primacy to those first-person reports and never presume
that brain imaging data are somehow privileged over or above those reports.
Implications for Ritual
Many if not most of the activities that have been studied in placebo-response
experiments may be construed as rituals. How might an understanding of
these behaviors as rituals further illuminate the placebo response?
One of the simplest and most common rituals in medicine is the repetitive
swallowing of a pill or capsule. A placebo pill administered four times a day is
generally more effective than a placebo pill administered twice a day.31 Other
medical rituals are more complex and novel and could well stimulate enhanced
placebo effects. In one study that compared a real transcutaneous electric nerve
stimulator (TENS) with a dummy machine for back pain, all subjects to whom
the dummy was administered were impressed by the visual and sound feed-
back and claimed to feel the (nonexistent) electrical stimulation.32 In this study,
however, the actual relief of pain attributable to the dummy TENS unit was
not very impressive. Of greater moment was a study comparing acupuncture,
sham acupuncture, diazepam (a tranquillizer and muscle relaxant), and a pla-
cebo pill for chronic arthritis of the neck. Acupuncture, sham acupuncture,
and diazepam were all equivalent in pain relief and were all statistically supe-
rior to the placebo pill.33 That is, the symbolic, ceremonial, or ritual aspects of
acupuncture were more important in producing pain relief than the physical
or physiological effects of inserting and twirling the needles; and the pain relief
produced by this ritual was equivalent to that of a powerful drug.
Very few medical practitioners seem to be aware of the significance of
the studies of overt vs. covert medication administration by Benedetti’s team.
The vast majority of medications now administered conventionally have never
been subjected to this experimental design. If the findings on the analgesic
effects of open vs. hidden infusion of narcotics were to be replicated widely
with other classes of medication, and with the oral as well as the intravenous
route of administration, then we would be faced with the finding that fully
half of the effectiveness of all these powerful medicines—antihypertensives,
cholesterol-lowering drugs, antibiotics, anti-cancer drugs—rely on the ritual of
taking them regularly and knowing that one is taking them. The average prac-
titioner would probably reject this hypothesis out of hand. It is important to
realize that today such a rejection would be an act of faith rather than science.
Plausible claims have already been put forth to demonstrate that the placebo
response probably accounts for the majority of the therapeutic benefit seen
with antidepressants.34
In 1980, drawing on an earlier anthropological analysis by Adler and Ham-
mett, I proposed a “meaning model” of the placebo response.35 The meaning
model offers an empirical hypothesis that a positive placebo response (improve-

ment in the patient’s symptoms) is most likely to occur when the meaning of
the illness experience for the patient is altered in a positive direction. This positive
change in meaning, in turn, depends on several factors:
• The patient feels listened to and attended to by the caregiver.

• The patient is provided with an explanation for the illness that coheres
with his general worldview.
• The patient feels care and compassion from the caregiver and other
helping individuals.
• The patient experiences an enhanced sense of mastery or control over
the illness.
The body of data gathered in the intervening years would, on balance, tend to
support the meaning model. The evidence was at any rate sufficient to prompt
Moerman in 2002 to urge that we replace the term “placebo effect” with “mean-
ing effect.”36
The meaning model assists us in understanding the sense in which ritu-
als can be “meaning-making,” and how in turn those meaning-making ele-
ments of ritual might explain ritual’s efficacy in healing. A local community,
by conducting a healing ritual, offers an explanation of what is happening. To
perform a ritual is to do what one’s society and culture proclaim to be the cor-
rect thing to do under certain circumstances; so the performing of the ritual
is reassuring evidence that those circumstances, and not some others, pertain
to what is going on. In Western medicine the “local community” may be a
shrunken group, compared with indigenous healing ceremonies in which the
entire village participates. The “community” might consist of the patient and
the physician, the physician’s office staff, and the immediate friends and rela-
tives of the patient to whom the patient has confided symptoms and who played
a role in urging the patient to seek medical attention. Even if small in number,
this community can be very powerful in shaping meaning, and the sociocul-
tural authority invested in the role of the physician enhances that individual’s
status as a proclaimer of what events mean.
Sadly, it is not a part of many medical rituals today to listen carefully to
what the patient says and to take that account seriously. International studies
of patient satisfaction with primary medical care highlight “the doctor does not
listen to me” as one of the most common complaints.37 If, however, the physi-
cian does indeed listen carefully to the patient’s account, then the meaningful-
ness of the ritual is enhanced. The patient now has increased confidence that
what is going on is directed at this specific person and her individual, unique
problems.
The ability to offer an explanation, coupled with a display of care and com-
passion, counteract one of the most powerfully demoralizing aspects of seri-
ous illness. The sufferer commonly feels as if no one else has ever suffered
in this way before, that no one else could possibly understand the suffering,
and that therefore the sufferer is effectively an outcast from the community,
cut off from the understanding and sympathy of fellow human beings.38 The
performance of a healing ritual becomes a bodily enactment of reconnection
with the community. Since the community can explain what is happening and
can select the proper ritual for it, it must be known, and so the source of the
suffering cannot be as opaque as was feared. Since the sufferer herself, and her
suffering body, are participants in the ceremony, it must be possible to recon-
nect and to experience human sympathy.
Finally, rituals offer a tool that promises to the community a higher level
of control over the world. The conjoint participation in the medical ritual by all
parties amounts to a common declaration by the community that the natural
events that led up to the illness are open to human mastery. The community
asserts with confidence, “Take this pill four times a day for two weeks, drink
lots of fluids, and get extra rest, and you will get better.” The patient came to the
physician initially because he felt out of control. The performance of the heal-
ing ritual reasserts control and so brings substantial comfort.
Ritual is, for all these reasons, psychologically comforting to the victim of
illness. The psychological comfort derives directly from the manner in which
the ritual alters the meaning of events for the participants. The comfort and
the alterations in meaning seem to be closely allied with the factors that (other
things being equal) would be likely to produce a positive placebo response.
Which of the various elements of ritual meaning, one may ask, contribute
the most to the placebo response? Kaptchuk and colleagues have recently dem-
onstrated a research approach that holds future promise for addressing this
question. They created a design (administering sham acupuncture to patients
with irritable bowel syndrome) that allowed them to titrate different elements—
for example, separating the ritual administration of the acupuncture from the
presence or absence of a warm and attentive relationship with the practitioner.
They showed that each added element contributed to the total reduction in
the severity of the bowel symptoms, with the supportive patient-practitioner
relationship probably accounting for the largest single component.39 Further
studies designed to tease out the precise contribution of individual elements of
ritual and meaning could be quite instructive.
Theissen, analyzing the stories that portray Jesus as healer, calls upon
the placebo-effect literature as a way of explaining the purported efficacy of
these healing ceremonies. It is worth noting that Theissen’s analysis matches

very closely the meaning model I have presented here. First, Theissen stresses
the importance of expectancy, noting the poor success of healing ceremonies
among those lacking faith, and the probable value of the spreading rumors of
Jesus’ healing prowess in ensuring greater success in the future. Next Theissen
emphasizes the dual psychological and social character of these rituals; they
activate important psychosomatic processes but also remain socially embed-
ded and exert some of their efficacy via their ability to alter social relationships.
I would add that Jesus’ standard analysis of his own healing powers, “your
(own) faith has healed you,” might be viewed as an important message of pos-
sible mastery and control over illness. Jesus’ willingness to approach the sick
person to perform the healing ceremony, especially when that person bore
some social stigma, might be seen as a powerful statement of compassion and
social reconnection.40 In sum, Theissen’s analysis recalls Frank’s earlier com-
parison of psychotherapy and religious faith healing, claiming that what mod-
ern Western medicine has in common with such rituals may better explain a
good deal of its healing efficacy than what sets it apart.
A simple way of expressing what we know about the placebo response is
that the human brain seems to be hard-wired to get better in illness, and that
certain sorts of mental stimuli seem capable of turning on this hard-wired sys-
tem to produce symptom relief. The elements that make up ritual seem to be
especially effective in turning on the wiring circuits.41
The preceding account is very general. A more specific implication of ritual
for the placebo response arises from the observation that repetition seems to be
a common element of rituals. We have seen that there has been some dispute
about the extent to which conditioning mechanisms, as opposed to expectancy,
mediate placebo responses. Other things being equal, if rituals truly possess
healing efficacy, and if this efficacy is achieved by neural pathways similar to
those implicated in placebo responses, then conditioning might well play a
larger role in the placebo response than has previously been recognized. Expec-
tancy cannot be eliminated. If, via conditioning, the performance of healing
rituals over time produce positive changes in health, then the person will come
to consciously expect better health outcomes whenever such a ritual is performed
(such as when he swallows pills). Nevertheless, the fact that the operative neu-
ral pathways are strengthened by repetition, and that a newly performed ritual
at a later date appears to reactivate a neural pathway that was previously laid
down and stored in memory, suggests that some sort of conditioning process
may be implicated. At the very least, future research on the placebo response
should attend carefully to the possible role of conditioning.
Conclusion
Besides its implications for further research into the placebo response, what
does a ritual analysis of medicine suggest for the practitioner? The science
writer Nicholas Wade once wrote, “All medicine is a form of theater.” In my
experience, physicians are largely unwilling to equate what they do with a
theatrical performance. They regard acting in theater as fakery, just as they
view the placebo response as disreputable because it seems to depend on a
dummy or fake treatment. They are not reassured by analyses from those
who understand theater, on how acting can be a deeply honest business—
just as they may not be reassured by more expansive definitions of “placebo
response” that try to make clear that this phenomenon does not depend in
any way on administering placebos and may actually accompany almost all
medical encounters.42
If physicians understood that the rituals in medicine themselves have
healing potential, so that the physician’s ability to participate in these rituals
in optimal fashion might make a serious difference in the patients’ health
outcomes, then perhaps physicians might be willing to address the skills they
need to acquire in order to perform in such rituals to the best of their ability.
What does it mean, for instance, for the physician and patient to become
jointly involved in a healing ritual, in an ideally empathic way? Adler, whose
early work on the physician–patient relationship laid the groundwork for
the meaning model of the placebo response, has recently proposed that the
empathic physician can serve in some cases as an external physiological regu-
lator for the distressed patient. “Mirror” neural pathways have been identified
that appear to function in situations of high empathy, by which I can alter
my own autonomic function, such as breathing, heart rate, and blood pres-
sure, in the direction of the functions of the other person who provides the
empathic presence.43
Medicine would lose a good deal of whatever efficacy it possesses were we
to eliminate all its ritual elements and practices. Yet we are far from understand-
ing those ritual elements and their efficacy in any satisfactory way, whether at
the level of brain neural circuits or at the level of clinical practice.
acknowledgment
I am grateful to Robert Rose and to anonymous reviewers for Oxford University Press
for helpful comments on earlier drafts.
notes
1. H. Brody. The placebo response: recent research and implications for family
medicine. J Fam Pract 49:649–654, 2000; A. Harrington (ed.). The placebo effect: An
interdisciplinary exploration. Cambridge, MA: Harvard University Press, 1997.
2. I. Kirsch. Unsuccessful redefinitions of the term placebo. Am Psychol
41:844–45, 1986.
3. Z. Di Blasi, E. Harkness, E. Ernst, et al. The influence of context effects on
health outcomes: a systematic review. Lancet 357:757–62, 2001; D. E. Moerman.
Meaning, medicine and the “placebo effect.” New York: Cambridge University Press,
2002; F. G. Miller, and T. J. Kaptchuk. The power of context: reconceptualizing the
placebo effect. J R Soc Med 101:222–25, 2008.
4. W. S. Sax, chapter 1 (this volume).
5. A. Hrobjartsson and P. C. Gotzsche. Is the placebo powerless? An analysis of
clinical trials comparing placebo with no treatment. N Engl J Med 344:1594–1602,
2001; J. C. Bailar. The powerful placebo and the Wizard of Oz. N Engl J Med 344:
1630–32, 2001.
6. A. Harrington. The cure within: A history of mind-body medicine. New York:
W.W. Norton, 2008.
7. K. Montgomery. How doctors think: Clinical judgment and the practice of
medicine. New York: Oxford University Press, 2006.
8. E. M. Zuesse. Ritual. In: M. Eliade (ed.). Encyclopedia of religion. New York:
Macmillan, 1987:12:408.
9. W. S. Sax. Healing rituals: A critical performative approach. Anthropol Med
11:293–306, 2004.
10. E. M. H. McKinney. Medical error: Overcoming barriers to truthful disclosure.
Ph.D. Dissertation, University of Texas Medical Branch, March 2007:96–100. I am
grateful to Johannes Quack for pointing out to me the recent literature on rituals and
ritualization, according to which many of these medical activities, as well as some to be
addressed later (such as pill-taking), would be viewed as “ritualized actions” rather than
as “rituals” in the full sense. No conclusions in this chapter hinge on that distinction, so
I would lose nothing by substituting “ritualized action” for “ritual” in much of what
follows. Nevertheless I would urge some caution before one concludes that many of
these medical behaviors are not rituals. Rituals, it is noted, are often employed to
demarcate a privileged sphere of activity from the everyday. I would propose that a
similar privileging is a major function of many medical “rituals,” and indeed that that
privileging (setting aside the medical activities as “special”) plays a role in medicine’s
healing efficacy. Furthermore, medical rituals are important in determining
membership in and the boundaries of a social group. A new physician coming from a
distance establishes his credentials with the local medical community (and with patients)
especially through his unhesitating ability to participate in these various rituals.
11. J. D. Frank. Persuasion and healing. New York: Schocken Books, 1974.
12. A. M. Kleinman. Why do indigenous healers successfully heal? Soc Sci Med
13B:17–26, 1979 (emphasis in original).
13. I. Kirsch (ed.). How expectancies shape experience. Washington, DC: American
Psychological Association, 1999.
14. D. Kalaoukalani, D. C/ Cherkin, K. J. Sherman, et al. Lessons from a trial of
acupuncture and massage for low back pain: Patient expectations and treatment
effects. Spine 26:1418–24, 2001.
15. M. Amanzio, A. Pollo, G. Maggi, and F. Benedetti. Response variability to
analgesics: A role for non-specific activation of endogenous opioids. Pain 90:205–15,
2001.
16. F. Haour. Mechanisms of the placebo effect and of conditioning.
Neuroimmunomodulation 12:195–200, 2005.
17. R. Ader. Conditioned immunopharmacological effects in animals:
Implications for a conditioning model of pharmacotherapy. In: L. White, B. Tursky,
and G. E. Schwartz (eds.). Placebo: Theory, research, and mechanisms. New York:
Guilford Press, 1985, 306–23.
18. M. U. Goebel, A. E. Trebst, J. Steiner, et al. Behavioral conditioning of
immunosuppression is possible in humans. FASEB J 16:1869–73, 2002.
19. A. L. Suchman and R. Ader. Classic conditioning and placebo effects in
crossover studies. Clin Pharmacol Ther 52:372–77, 1992.
20. M. Castes, M. Palenque, P. Canelones, et al. Classic conditioning and placebo
effects in the bronchodilator response of asthmatic children. Presented at Research
Perspectives in Psychoneuroimmunology VIII, Bristol, UK, April 1–4, 1998.
21. M. Amanzio and F. Benedetti. Neuropharmacological dissection of placebo
analgesia: Expectation-activated opioid systems versus conditioning-activated specific
subsystems. J Neurosci 19:484–94, 1999.
22. N. J. Voudouris, C. L. Peck, and G. Coleman. Conditioned response models
of placebo phenomena: Further support. Pain 38:109–16, 1989; G. H. Montgomery
and I. Kirsch. Classical conditioning and the placebo effect. Pain 72:107–13, 1997.
23. F. Benedetti, H. S. Mayberg, T. D. Wager, et al. Neurobiological mechanisms
of the placebo effect. J Neurosci 25:10390–402, 2005.
24. H. S. Mayberg, J. A. Silva, S. K. Brannan, et al. The functional neuroanatomy
of the placebo effect. Am J Psychiatry 159:728–37, 2002.
25. T. D. Wager, J. K. Rilling, E. E. Smith, et al. Placebo-induced changes in fMRI
and the anticipation and experience of pain. Science 303:1162–67, 2004; J. K. Zubieta,
J. A. Bueller, L. R. Jackson, et al. Placebo effects mediated by endogenous opioid
activity on mu-opioid receptors. J Neurosci 25:7754–62, 2005.
26. I. Sarinopoulos, G. E. Dixon, S. J. Short, et al. Brain mechanisms of
expectation associated with insula and amygdala response to aversive taste:
Implications for placebo. Brain Behav Immun 20:120–32, 2006.
27. J. K. Zubieta, W. Y. Yau, D. J. Scott, and C. S. Stohler. Belief or need?
Accounting for individual variations in the neurochemistry of the placebo effect. Brain
Behav Immun 20:15–26, 2006.
28. M. Amanzio, A. Pollo, G. Maggi, and F. Benedetti. Response variability to
analgesics: A role for non-specific activation of endogenous opioids. Pain 90:205–15,
2001.
29. L. Colloca, L. Lopiano, L. Lanotte, and F. Benedetti. Overt versus covert

treatment for pain, anxiety, and Parkinson’s disease. Lancet Neurol 3:674–84, 2004.
30. A. Hrobjartsson and P. C. Gotzsche. Is the placebo powerless? An analysis of
clinical trials comparing placebo with no treatment. N Engl J Med 344:1594–1602,
2001; A. Hrobjartsson and P. C. Gotzsche. Is the placebo powerless? Update of a
systematic review with 52 new randomized trials comparing placebo with no
treatment. J Intern Med 256:91–100, 2004.
31. A. J. de Craen, D. E. Moerman, S. H. Heisterkamp, et al. Placebo effect in the
treatment of duodenal ulcer. Br J Clin Pharmacol 48:853–60, 1999.
32. S. Marchand, J. Charest, J. Li, et al. Is TENS purely a placebo effect? A
controlled study on chronic low back pain. Pain 54:99–106, 1993; T. J. Kaptchuck. The
placebo effect in alternative medicine: Can the performance of a healing ritual have
clinical significance? Ann Intern Med 136:817–25, 2002.
33. M. Thomas, S. V. Eriksson, and T. Lundberg. A comparative study of
diazepam and acupuncture in patients with osteoarthritis pain: A placebo controlled
study. Am J Chin Med 19:95–100, 1991.
34. I. Kirsch and G. Sapirstein. Listening to Prozac but hearing placebo: A
meta-analysis of antidepressant medication. Prevention and treatment 1, article 0002a,
http://journals.apa.org/prevention/volume1/pre0010002a.html; B. T. Walsh, S. N.
Seidman, R. Sysko, and M. Gould. Placebo response in studies of major depression:
Variable, substantial, and growing. JAMA 287:1840–47, 2002.
35. H. Brody. Placebos and the philosophy of medicine: Clinical, conceptual, and
ethical issues. Chicago: University of Chicago Press, 1980, 122–23; H. M. Adler and
V. B. O. Hammett. The doctor–patient relationship revisited: An analysis of the
placebo effect. Ann Intern Med 78:595–98, 1973.
36. D. E. Moerman. Meaning, medicine and the “placebo effect.” New York:
Cambridge University Press, 2002.
37. M. Stewart, J. B. Brown, A. Donner, et al. The impact of patient-centered care
on outcomes. J Fam Pract 49:796–804, 2000.
38. J. Berger and J. Mohr. A fortunate man. New York: Holt, Rinehart, and
Winston 1967; E. J. Cassell. The nature of suffering and the goals of medicine. N Engl
J Med 306:639–45, 1982.
39. T. J. Kaptchuk, J. M. Kelley, L. A. Conboy, et al. Components of the placebo
effect: Randomized controlled trial in patients with irritable bowel syndrome. BMJ
336:999–1003, 2008.
40. G. Theissen, chapter 3 (this volume).
41. H. Brody and D. Brody. The placebo response: How you can release the body’s
inner pharmacy for better health. New York: HarperCollins, 2000.
42. E. B. Larson and X. Yao. Clinical empathy as emotional labor in the patient–
physician relationship. JAMA 293:1100–6, 2005.
43. H. M. Adler. Toward a biopsychosocial understanding of the patient–
physician relationship: An emerging dialogue. J Gen Intern Med 22:280–85, 2007.
9
Bell, Bourdieu, and
Wittgenstein on Ritual Sense
Johannes Quack
Introduction
In 2006 at Heidelberg University, the French anthropologist Michael House-

man gave a workshop on divination rituals. Instead of giving a lecture, how-
ever, he presented the participants with a pair of shoes and said that they had
belonged to Marcel Mauss and that the group should try to come up with a
ritual using them. No further instructions were given.
This chapter is concerned with the notion of “ritual sense.” In relation to
this topic it is interesting to note that within a short period of time the partici-
pants found it easy to invent a ritual that seemed appropriate to all of them.
How did they manage to do this? Further I wonder whether, during this pro-
cess, any of them thought of how to make the ritual efficacious (or deliberately
pointless, for that matter)? In order to clarify this problem, I want to raise some
further questions: Does it help to state here that all the participants shared a
“ritual sense”? If so, is the ability to invent rituals based on a universal human
ritual instinct (as Ludwig Wittgenstein suggests) or is it based on a culturally
specific, embodied ritual sense (as Catherine Bell suggests)? And what might
the answer tell us about the notion of ritual efficacy?
In her book Ritual Theory, Ritual Practice Catherine Bell claims that “[i]t is
through a socially acquired sense of ritual that members of a society know how
to improvise a birthday celebration, stage an elaborate wedding, or rush through
a minimally adequate funeral” (1992: 80). The first part of this chapter will deal
with Bell’s argument. It will examine her concept of ritual sense (or “sense of
ritual”) as a “socially acquired” sense, a form of embodied knowledge about
how to perform a ritual. I will then demonstrate how she relates her arguments
to Pierre Bourdieu’s work, and discuss the advantages and disadvantages of her
use of the concept of “ritual sense.” This discussion and critique of Bell will
draw on ethnological fieldwork I conducted in 2005 in Rishikesh, India.
My argument concerning Bell will be that in many cases it is helpful to
look at a socially acquired sense of ritual but is problematic to focus explicitly
on ritual, since Bourdieu’s much broader notion of “habitus” is more impor-
tant here. I will further argue that Bourdieu’s own use of the term “ritual”
also leads in a different direction: not toward a culturally specific ritual sense,
but toward Wittgenstein’s concept of a “ritual instinct.” In his “Remarks on
Frazer’s Golden Bough” (henceforth referred to here as Remarks) Wittgenstein
writes about the invention of rituals as well. He gives the following example:
Recall that after Schubert’s death his brother cut some of Schubert’s
scores into small pieces and gave such pieces, consisting of a few
bars, to his favourite pupils. This act, as a sign of piety, is just as
understandable to us as the different one of keeping the scores
untouched, accessible to no one. And if Schubert’s brother had
burned the scores, that too would be understandable as a sign of
piety. (1993: 126)
The second half of this chapter will focus on aspects of Wittgenstein’s and
Bourdieu’s use of the term “ritual.” Both seem to claim that human beings
are in a certain way “ceremonial animals” (i.e., that they have a ritual instinct).
They also claim that there are limits to the possibility of explaining rituals and
that one should first and foremost acknowledge the ritualistic elements in
one’s own practices. The argument here will be that there are some consid-
erable overlaps in Wittgenstein’s and Bourdieu’s approaches to ritual. Their
central arguments, however, are not about rituals understood as ceremonies,
but rather about ritual understood as a basic element of various human actions.
Nevertheless certain problems of ritual theory—for example, the problem of
efficacy—appear in a different light if one accepts Wittgenstein’s Remarks as
a conceptual basis. Further, we shall be able to identify some of the shortcom-
ings of Bell and Wittgenstein by looking at them in terms of the concept of
ritual efficacy. Hence the question of ritual efficacy will be the vehicle for the
summary of the discussion of the notion of “ritual sense” in the light of Bell’s,
Bourdieu’s, and Wittgenstein’s comments. The general direction of my final
argument here is that the question, “How do rituals work?” either implies the
problematic notion of some of kind of ritual efficacy sui generis, or posits that it
should be reformulated in a much more specific manner. For this discussion,
bell, bourdieu, and wittgenstein on ritual sense 171
the use of the notion of intentionality seems to be unavoidable, whether one

talks about ritual sense or ritual efficacy. But before considering Bell, Bourdieu,
Wittgenstein, and ritual efficacy, I will give an empirical example of the notion
of ritual sense.
Different Performances of Pujas in Sacha Dham

Ashram, Rishikesh
In 2005 I spent several months in Rishikesh, where the holy river Ganges
flows into the north Indian plains as it leaves its Himalayan home. Rishikesh
is famous for it ashrams1 and meditation centers, most of which are located in
one of two neighborhoods of Rishikesh called Ram Jhula and Laxman Jhula.
The precise location of my fieldwork was in an ashram in Laxman Jhula called
Sacha Dham. The Sacha Dham (“abode of truth”) ashram was perched on a
small cliff overlooking the Ganges. Its actual area was about 200 meters long
and 100 meters wide, including five major buildings and a small, beautiful gar-
den. In spring 2005 another large building was under construction to extend
the guest house facilities, all of which are exclusively for Indian disciples who
come to stay in the ashram. Non-Indians were asked to stay in one of the count-
less hotels, guesthouses, and ashrams around Sacha Dham. Older members of
the ashram told me that building and renovation work has been going on in the
ashram continuously for many years. Although a lot has changed and grown in
the last decades, especially since an American woman now called Shanti Mayi
came some twenty years ago to stay with Guru Shri Maharajji, it was always
emphasized that Sacha Dham is a “traditional Vedic ashram.” This means, for
example, that visitors were advised to be particularly careful to observe tradi-
tional rules of dress and behavior, but it also refers to the important lineage of
Gurus to which Shri Maharajji and Shanti Mayi belong, and which is served by
eight additional priests (pandits).
The male Indian Guru Shri Hans Maharajji and the female American
Guru Shanti Mayi were then guiding the Sacha Dham ashram. One of the
peculiarities of the ashram was that many Indians came to visit Shri Maharajji,
while Shanti Mayi is visited almost exclusively by non-Indians, mainly people
from Western Europe, but also from the United States. Both Gurus stood in the
same lineage and their “theological accordance” was emphasized by both sides.
Nevertheless, the daily religious practices—mainly pujas2—were not performed
together by the two groups of disciples. During my stay, Shanti Mayi’s dis-
ciples’ program of activities—which was not compulsory and from which she
herself was usually absent—started generally at 5 A.M. with silent meditation

to greet the dawn. The gayatri mantra,3 which was seen as “a universal prayer
for the awakening of all beings,” was chanted daily at 9:30 A.M. together. Pujas
or devotional rituals were also offered daily in various forms—a Shiva-puja at
6 A.M., the havan-puja4 at 7 A.M., the Durga-puja at 7:30, and two Ganesh-pujas
during the day—usually in the garden right beside Shanti Mayi’s house. Central
to all of them was a variation of the arati-ceremony5; honoring the Sacha lin-
eage of Gurus and “the Guru within.” About four days a week Shanti Mayi
offered satsang6 (also referred to as “Dharma Drum”), an opportunity to ask her
questions about spiritual matters, to talk about personal experiences, and “to
drink in the wisdom of her words and the silence between the words.” Bhajans,
or devotional hymns, were usually sung before the satsang began and were seen
“as a chance to dissolve the thinking mind in the pure joy of singing heartfully,
melting with others.”7
For the Indians by contrast, the day started with a havan-puja in the morn-
ing. Furthermore an arati-puja was performed at the beginning and end of
the day in the temple of the ashram, complemented by the reading of extracts
out of the Ramayana and the singing of bhajans before or after the arati. Addi-
tionally, the statue of Sri Sacha Guru in the main temple of the ashram was
fed, put into bed, woken up, and so on daily, acts that were not, however, part
of a special ceremony one could somehow attend. For arati, the reading of
the Ramayana, and singing, the attendance of Westerners was allowed, and
a few used this opportunity from time to time to listen only to the singing of
the bhajans.
One focus of my fieldwork was to describe the differences between these
performances of what, in principle, were the same rituals. My main focus was
on the performance of the havan-puja, so one day I would perform the havan
and probably some other rituals with the Indians and the next day would do so
with the Westerners. I tried to make sense of these differences in terms that
might be relevant to ritual theory.
The term puja is commonly applied to a combination of rites of worship,
honor, or welcome of a deity in any of its manifestations and in any context in
India, such as in front of the shop, or in large, elaborate temple ceremonies
(cf. also note 2). It is often emphasized that at the center of the phenomenon
of puja lies a transaction between worshiper(s) and the deity(ies) (see Fuller’s
The Camphor Flame). This becomes noticeable through the fact that the pre-
vailing metaphors for puja are hospitality, servitude, service, and blessings.
The aspect of the deity being treated as a guest, and the mutual interaction
between the deity and the devotee, are also mentioned in most scholarly
descriptions of puja.8 Attention is thereby often drawn to the question of to
what degree puja mirrors the hierarchical relationships in Indian society.

Further an attempt is often made to describe what happens when the wor-
shiper meets the deity, since the borders between the mundane and the godly
realm, in the context of Indian religiosity, are said to be not as strong as in
other religions.9
If one compares this perspective on pujas to the stance taken by the non-
Indians in the Sacha Dham ashram, it is striking that the emphasis shifts from
metaphors of hospitality, service, and blessings with respect to the relationship
with a deity to the experience of a general “spiritual feeling” that is experienced
in the same way during pujas, satsang, or meditation. One man from England
wrote on my questionnaire:
As I walk across Laksman Jhula towards Satsang, my alignment

has already begun. Almost every time that I have gone to Satsang,
as I begin my walk towards Sacha Dam [sic], my expression calms,
quietude comes, and sometimes I do not even make eye contact on
my way. Often I will not speak, my intention becomes more and
more focused. This is because . . . ? I left Satsang yesterday rich in
Loving Neutrality. Wandering the street for a couple hours I was
open and mostly at peace. . . . Time would pass. I was quite content.
Statements referring to the daily pujas were very similar to this one. None of the
Westerners spoke of a “transaction,” but rather of the “self,” which becomes
“focused,” “at peace,” or “one with everything else.” The following statement
about the performance of pujas is but one example:
I associate [with puja] feelings of openness being connected to

everyone and everything, a sense that there is more to life than just
living, more harmony, peace inside myself, warmth from myself
towards all living beings, and an understanding of people.
In order to discuss such differences, it is necessary to go into more detail.

However, my focus here will be primarily not on “theological interpretations”
but rather on the actual practice of puja.
To summarize my findings, I see the performance of the “Western pujas,”
relative to the “Indian pujas,” as being concerned with “togetherness” as well as
being “closed” and andächtig.10 For example, the Westerners put great emphasis
on each participant’s harmonizing with the others, thereby stressing “together-
ness.” One person, for example, said, “We sing together, in harmony, but [the
Indians] neither have the same melody nor the same rhythm.” Another person
commented, “It is the fact that so many people sing with just one voice which
makes our singing so powerful. Everybody is melting into it.”
Certain aspects of the Westerners’ ritual practice seemed to be “closed”—

for example their sitting in a circle facing inward, and their concern to ensure
that the rite had a clear beginning and end, so that people felt that it was inap-
propriate to come late or leave early. One Swami of Shanti Mayi from the
Netherlands told me that she felt it very disrespectful and disturbing when an
Indian woman performed her own puja right beside her while she was per-
forming her Ganesh-puja. The Indians in the ashram seemed to have a far
more “open” attitude to the performance of pujas. I observed several times how
people performed their own puja at the same time and place where another
public puja was being performed, and that anyone could join or leave the major
performances anytime.
The term that captures the last difference best is the German andächtig,
that is, “devout, prayerful, or pious.” Once again, little incidents are exem-
plary. While performing the fire ritual (havan), one was told not to point the
feet toward the fire. Hence the normal sitting position was cross-legged. Since
I was not accustomed to sitting like this, to do so for about an hour was in
the beginning quite a challenge for me. This was not the case for most of the
other Westerners, some of them having practiced yoga for years. From time to
time I felt that because of the specific andächtig atmosphere of the ceremony,
I was disturbing the others by moving around too much. In contrast, a German
woman said, “In Indian pujas there is a lot of traffic going on. I mean the whole
atmosphere is kind of confusing and chaotic.” A further point of illustration is
the fact that the Westerners performed the arati without blowing a conch shell
or striking a gong or metal plate. A Dutch woman said, “They [the Indians] spill
water everywhere, bang extremely noisy on metal plates while blowing a horn
and ringing a bell, throw rice and flowers everywhere—and in the end it looks
more like a battlefield.”
The Westerners often used the same adjectives in referring both to everyday
life in India and to the Indian pujas: for example, “chaotic,” “noisy,” “strange.”11
None of these qualities are conducive to the kind of atmosphere they saw as
central to their puja—which I call “prayerful” (andächtig). In all these respects
the Indian pujas contrasted with those of the Westerners, and the sum of these
small individual differences makes the two pujas quite distinct from each other.
Accordingly the Westerners were reluctant to join the pujas of the Indians,
claiming, for example, “The Indians’ puja does not work for me.”
Of course, there were other reasons why Indians and Westerners did not
perform the pujas together: for one, the groups were separate in various ways—
not at least due to language and other cultural barriers. But there was no obvi-
ous disharmony between the two groups, so how do we explain such radically
different concepts about what constitutes an appropriate puja? Following Bell,
one could argue that one important reason for the different performances is a
difference in the groups’ respective “ritual senses.” Accordingly one could con-
clude that a common “ritual sense” existed among the Westerners about what
is appropriate in a puja (that is in their puja). Hence the concept of ritual sense
could play an important part in explaining the separate performances.
Bell, Bourdieu, and Ritual Sense
Bell’s opus magnum Ritual Theory, Ritual Practice (1992) begins by arguing
that traditional theories of ritual are based on a problematic hierarchical oppo-
sition between thought and action, an opposition she seeks to avoid by focusing
on the concept of “ritualization,” that is, focusing on ritual practices rather than
on rituals as reified “things.” I will ignore here Bell’s argument that ritualized
actions reproduce power relations, which she sees as implemented in hierar-
chical oppositions constructed through the process of ritualization. I will focus
instead on the very basis of her position: her concept of ritual sense and its
relationship to “ritualization.” Bell writes that “the implicit dynamic and ‘end’
of ritualization . . . can be said to be the production of a ‘ritualized body.’ A ritu-
alized body is a body invested with a ‘sense’ of ritual” (1992: 80).
Having a ritual sense, in her terminology, amounts to having a culturally
specific “ritual mastery” inscribed in one’s body, which generates a feel for
what is or is not acceptable in ritual. A ritual sense is a culturally dependent and
“situational” disposition (1992: 81). Further, we are dealing with a flexible set
of schemes and strategies acquired and deployed by a ritualized agent (cf. 1992:
80), and third, the use of the ritual sense shows how ritual activities generate a
sense of what is or is not acceptable in ritual. In this respect the basic function
of the ritual sense is presented as creating a distinction between ritualized and
nonritualized,—thus, acceptable and unacceptable—ways of doing the task at
hand (cf. 1992: 74). As with Bourdieu’s notion of habitus, such an incorpo-
rated knowledge consists of dispositions that are based on past experiences,
find their expression in the present, and, thereby shape the future.
Hence for Bell, the notion “ritual sense” is not merely classificatory: she
also sees it as a causal-explanatory notion, similar to Bourdieu’s habitus. In a
nutshell, the culturally dependent “ritual sense” produces ritualized agents as
well as new schemes of what counts as ritual. All of these aspects seem to be
at stake in Bell’s remark that one’s ritual sense allows one to “rush through a
minimally adequate funeral.” This idea evokes Clifford Geertz’s famous essay
“Ritual and Social Change” in his The Interpretation of Cultures (1973) on a
failed ritual in Indonesia. His essay is concerned primarily with showing that
functionalism is not able to deal adequately with social change, but Bell wants
to make a different point:
[A] focus on the sense of ritual would shift the emphasis . . . to how
minimal ritual procedures were improvised with sufficient respect
for tradition that the child was considered buried more or less
satisfactorily. (1992: 80)
Bell’s theoretical concepts—like ritual sense, ritual mastery, embodied strate-

gies, and so on—are based implicitly or explicitly on Bourdieu’s work, and in
particular on his central notion of habitus.
For example, scholars from abroad who visit the University of Heidelberg
should not have problems interacting with academics whom they have never
met before, at places they have never seen before. They just “know what one
does” in a particular situation, because they are all representatives of the spe-
cies Homo Academicus. Because of mental and corporal schemes of action that
function as the basis for the generation and ordering of their interactions, they
act like “fish in the water” in a familiar academic milieu. Such an unconscious
mechanism, which enables us to cope with unforeseen and ever-changing situ-
ations, is what Bourdieu (1990, chap. 3) calls habitus. It is the basis of the
“knowledge” of “what one does” in a given situation, a knowledge so deeply
bred into our bones that we do not even think about it—at least as long as we
are in a familiar environment, that is, as long as our habitus fits the milieu,
in this case the university. Returning to Rishikesh, one could say that even
the Westerners who had never performed a puja before were able, without
any problem, to participate in one conducted by the disciples of Shanti Mayi.
I expressly asked those who were participating for the first time, and all of
them told me afterwards either about their “deep” and “powerful” personal
experiences or at least how much they liked it. As for myself, I can say that the
procedure and the singing, indeed the whole style of the “Western puja” felt
somewhat “natural” to me.
However, the pujas performed by the Indians in the ashram were expe-
rienced differently by the disciples from the United States and Europe. Most
Westerners I talked to felt strange and rather uncomfortable during the “cha-
otic” and “noisy” Indian-performed pujas. In line with Bell’s application of
Bourdieu, one can argue that the implicit “ritual sense” of the Westerners,
their ritual habitus, their sense of what “one does” in a ritual did not fit the
milieu of the “Indian pujas” but instead matched the “closed” and andächtig
rituals conducted in the West. So far it seems to be helpful to look at a socially
acquired sense of ritual to explain similarities or differences in the way rituals
are performed. I will argue here, however, that Bell’s limiting her focus to ritual
is problematic for two reasons. First, we lose more than we gain if we limit
Bourdieu’s much wider notion of habitus in such a way. Second—and more
important—Bell’s concept of ritualization is problematic with respect to the
explanation of the differences between ritualized and nonritualized actions.
I hope that my brief account of the pujas in Sacha Dham ashram suffices
to indicate the relevance the concept of habitus might have for ritual activities,
especially with respect to the differences in performances in a cross-cultural
setting. To paraphrase a passage from Bourdieu’s book Distinction:
A [ritual] has meaning and interest only for someone who

possesses the cultural competence, that is, the code, into which it
is encoded. . . . A beholder who lacks the specific code feels lost in a
chaos of sounds and rhythms, colors and lines, without rhyme and
reason. (1984: 2)
My paraphrase involves substituting “piece of art” with the word “ritual,”

indicating that these socially inculcated bodily senses Bell stresses by draw-
ing on Bourdieu are not specific to rituals in any way. A similar point could
easily be made with respect to differences in the choice of clothes, of hotels
and restaurants, of music and schools of art—in Rishikesh and elsewhere.
Indeed, one of the central and most interesting points of Bourdieu’s social
analysis is the linkage he uncovers between apparently different realms of
society. Thus, in Distinction Bourdieu relates—within one theoretical frame-
work—the preferred drink of people with the way they dress, their political
views, their financial background, and other factors. In the ethnographic sec-
tion above I mentioned that in addition to their divergent senses of ritual,
there were other reasons why Indians and Westerners did not perform the
pujas together. These reasons will be lost from view, however, if the theoreti-
cal focus is limited to the ritual sense. The similar descriptions of pujas, sat-
sangs, and meditation practices, for example, point toward a shared “sense”
of the Westerners that is not confined to rituals but extends to other religious
and social practices. Hence, my first point of criticism is that Bell’s applica-
tion of Bourdieu omits one of the most interesting aspects of his theorizing
and thereby misses important connections and interrelations between differ-
ent spheres of social action.
One could of course argue that for a scholar of ritual it is still interest-
ing to limit Bourdieu’s discussion of practical sense to ritual sense. Doing so,
however, brings in the notorious problem of the definition of ritual, which Bell
refigured only as the problem of the conceptualization of “ritualization.” So for
the present discussion, the relevant question is, what are the specific character-
istics of ritualized actions that justify Bell’s focus on the “ritual sense”?
There are two ways in which Bell tries to answer this problem. On the one
hand she describes the terms she uses (ritual sense, ritualization, etc.) in a
way that comes close to defining them, and on the other hand she gives some
examples of how these terms can be applied. In her account, agents possess-
ing a ritual sense are able to ritualize everyday actions in such a way that they
become ritualized actions. The participation in ritualized actions in turn is what
produces and shapes the ritual sense of the people involved. This amounts to
asserting, in a rather circular fashion, that ritual activity is the result of the
practice of ritualization and the other way round. In her words: “Essential to
ritualization is the circular production of a ritualized body which in turn pro-
duces ritualized practices” (1992: 93). Besides the implicit danger of reifying
the process (described by Bourdieu with respect to habitus as a structured and
structuring process) by which individuals acquire their sense of ritual, these
formulations do not explain anything with respect to the specific character-
istics of ritualized actions. Moreover, the few examples Bell does provide of
processes of ritualization do not solve the problems at hand, but instead raise
further questions. She writes:
An even simpler example might contrast the routine activity of

buying some regularly used article of clothing for a spouse or child
(such as gym socks) and the ritualized version of buying a similar but
different article (argyle socks) and giving it as a gift. These activities
are differentiated in the very doing and derive their significance form
the contrast implicitly set up between them. Routine giving plays off
ritualized giving and vice versa; they define each other. (1992: 91)
This might be a good example for the difference of doing something routinely
as opposed to doing it carefully, but not for the ritualization of buying a pair of
socks. Acting with care is characteristic of many different sorts of actions, only
some of which would be considered ritual—learning a new piece on the piano,
for example—leaving aside the question of why one would ritualize the buying
of a pair of socks in the first place.
Clearly she is aware of the problem. She writes that “this is not to say
that ritualization is simply acting differently. Otherwise, buying mismatched
socks at a bargain table . . . would qualify as ritual” (1992: 91). And later she
adds that “ritualization can be characterized in general only to a rather limited
extent since the idiom of its differentiation of acting will be, for the most part,
culturally specific” (1992: 93). So we are left where we started: “strategies of
ritualization” that draw “privileged distinctions” between ways of acting in a
“culturally specific” way. This problem of how to differentiate ritualized from
ordinary actions is only underlined by Bell’s later book, Ritual: Perspectives and
Dimensions (1997), where she again draws attention to how the ritualization
of an activity establishes its own ritualized frame. She states that ritualization,
given a voice, would say: “This is different, deliberate, and significant—pay
attention!” (1997: 160). Yet also here she fails to answer the obvious ques-
tion regarding the difference(s) between ritualized actions and other actions
that are also different, deliberate, and significant—but are not rituals. This is
not merely a problem of terminology and consistency but relates to her use of
Bourdieu as well. Given the similarity of ritual sense to Bourdieu’s practical
sense and habitus, Bell has to somehow “claim” or mark out the ritual field or
respective milieu of the application of the ritual sense, since this is what is at
stake.
Of course, Bourdieu himself uses and discusses the notion of ritual
throughout his writings, but I would argue that when one looks more closely
at such statements, one recognizes that he pursues Wittgenstein’s rather than
Bell’s view of ritual. So I turn now to consider what Wittgenstein had to say
about “ritual instinct” and how this view articulates with those of Bourdieu.
Wittgenstein, Bourdieu, and Ritual Sense
The concept of ritual instinct12 is central to Wittgenstein’s Remarks on Frazer’s

Golden Bough. Wittgenstein had at least two encounters with different editions
of Frazer’s Golden Bough and there are several versions of his Remarks, none
of which he released for publication. Here I refer to the most comprehensive
edition of Wittgenstein’s writings on Frazer (edited by Klagge and Nordmann
in 1993) and to the very interesting interpretation by the French philosopher
Phillip De Lara in his article “Wittgenstein as Anthropologist” (2003).13
A striking claim of the Remarks is that a “ritual instinct lies at the bottom
of all rites,” that “one could almost say that man is a ceremonial animal” (Wit-
tgenstein 1993: 128). But in order to understand what Wittgenstein hints at
with such statements, we first have to differentiate between several intertwined
arguments within his Remarks. I will focus here on two. First, Wittgenstein
holds that there are limits to the explanation of rituals, notwithstanding the fact
that they can be explained in various ways. The second point is a kind of moral
argument developed by Wittgenstein: that one must recognize (as Frazer con-
spicuously did not) that “our” way of thinking and acting is not very different
from that of “the natives.”
Concerning the first argument, Wittgenstein is convinced that the
demand for a full explanation of ritual actions betrays a misunderstanding
about what rituals are.14 But it would be a further misunderstanding to think
that Wittgenstein suggests that reference to an instinct is all one can say with
respect to ritual action. He does not mean that explanations or elucidations of
any sort are impossible. His point is rather that some features of human life
cannot be thoroughly explained, for they are a constitutive part of the human
predicament. “Here one can only describe and say: this is what human life is
like” (1993: 121). In this respect, an example clarifies his point:
Kissing the picture of one’s beloved. That is obviously not based on

the belief that it will have some specific effect on the object which the
picture represents. It aims at satisfaction and achieves it. Or rather:
it aims at nothing at all; we just behave this way and then we feel
satisfied. (1993: 123)
The self-correction here is central to an argument to which I will later return.

In a first step Wittgenstein suggests that the intention to produce causal con-
sequences as well as the intention to express some emotion or desire is not a
primary quality of ritual action. One kisses the picture of one’s beloved neither
because one expects a causal consequence nor in order to express one’s feel-
ings directly. Here Wittgenstein tries to overcome the false dichotomy between
intellectualist and expressive or symbolic accounts of ritual by employing the
concept of “instinct.” But he seems to go one step further. When he writes that
“it aims at nothing at all,” he seems to be suggesting that there are noninten-
tional human actions—such as an involuntary twitch of the eyes—which are to
be understood as more than simple “behavior.”15
According to Wittgenstein, if we want to understand such actions ade-
quately, we have to realize that we simply behave this way; it is an “instinct-like
reaction” to a significant phenomenon. If one compares such statements to
some of Bourdieu’s statements on rituals, one cannot miss the similarities.16
Bourdieu writes on ritual practices:
Rites are practices that are ends in themselves, that are justified
by their very performance; things that one does because they are
“the done thing,” “the right thing to do,” . . . they may have, strictly
speaking, neither meaning nor function, other than the function
implied in their very existence. (1990: 18)
There are also striking similarities between Bourdieu and Wittgenstein with respect
to the second, moral argument, namely that it is wrong to oppose our way of think-
ing to the magical, mystical, ritual thinking of the natives. Bourdieu writes that
the anthropologist would probably give a better account of

rituals or kinship relations if he introduced into his theory the
“understanding”—in Wittgenstein’s sense of the ability to use them

correctly—that is evident in his . . . skill at performing the social
rituals of academic life. (1990: 18)
He claims that there are analogies between the “practical logic of ritual” and
“our way of using the opposition between right and left in politics,” all of which
leads us to discover that “mythological thinking is quite often nothing but the
logic of three-fourths of our actions” (Bourdieu interviewed by Lamaison 1986:
114). Wittgenstein, on the other hand, writes about “our kinship to those sav-
ages” and states that
the principle according to which these practices are arranged is a

much more general one than in Frazer’s explanation and is present
in our own minds, so that we ourselves could think up all the
possibilities. (1993: 127)
All of this goes to show that Wittgenstein’s “ritual instinct” and Bourdieu’s
“practical sense” are parallel concepts and that both are useful for interpreting
ritual practices. The point is that we are dealing with a very basic, prereflective
aspect of human beings, which can be part of various actions. A well-known
example is that of bowlers who see that their bowling ball is heading too much
to the left, and then move their upper body to the right.17 Neither do they seek
to express their feelings to the people around them nor do they think that their
movement has some influence on the direction of the bowling ball. They do it
instinctively.
Hence the concept of ritual instinct is to be seen only as the basic level
of ritual practice. On a second level one could investigate the expressive and
instrumental aspects of any given practice. Such a differentiation of levels is
problematic, however, and at the end of this chapter I will discuss how Wittgen-
stein sets out to differentiate between the two levels, and whether it is helpful to
introduce a level of a basic action that, while not intentional in any way, is still
more than mere behavior.
Coming back to my fieldwork in Sacha Dham ashram, I want to add that
the two arguments outlined above in the name of Wittgenstein would find
agreement among most of the Westerners, including Guru Shanti Mayi—in
particular the claim that there are limits to the explanation of ritual prac-
tices. With respect to my work, they frequently told me that I was searching
for explanations of things where there are no explanations—only experi-
ence. Yet they made this comment with respect to rituals as well as to other
actions. One could argue that their position was akin to Bourdieu’s state-
ment that
the “thinker” betrays his secret conviction that action is fully

performed only when it is understood, interpreted, expressed, by
identifying the implicit with the unthought and by denying the
status of authentic thought to the tacit and practical thought that is
inherent in all “sensible” action. Language spontaneously becomes
the accomplice of this hermeneutical philosophy which leads one
to conceive action as something to be deciphered, when it leads one
to say, for example, that a gesture or ritual act expresses something,
rather than saying, quite simply, that it is “sensible” (sensé) or, as in
English, that it “makes’” sense. (1990: 36–37)
Some problems involved in this statement will be addressed when we turn to

the question of the efficacy of rituals. First, however, I want to conclude my
discussion of Wittgenstein. At first one has to see that a different notion of
ritual is at stake here. When Bourdieu compares ritual actions to the “logic
of three-fourths of our action,” he seems to be thinking in Goffmanian terms
about ritual, rather than in terms of the sorts of ceremonies that puja, mass,
baptism, and the like exemplify. A similar point can be made with respect to
a central problem of Wittgenstein’s account of “ritual instinct.” The example
of the bowler (as well as some of Wittgenstein’s own examples in the Remarks)
makes it more than clear that here we have left the realm of rituals conceived
as ceremonies. If the movement of a bowler exemplifies the ritual instinct at
work, it is hard to argue that we are still talking about rituals as they are usu-
ally conceived in social theory (for example by Bell).18 Rather, Wittgenstein is
reminding us about one aspect of human life and the dispositions it produces,
trying to make us see that there are many aspects of our day-to-day life that have
nothing to do with means and ends as this relationship is usually conceived.
This observation implies that the opposition set up at the beginning of
this chapter between a universal human ritual instinct (as suggested by
Wittgenstein) and a culturally specific, embodied ritual sense (as suggested by
Bell) is only apparently contradictory, since the respective conceptualizations of
“ritual” are on different levels. Hence, it is not problematic for Bourdieu to be
involved in both understandings of ritual sense.
But—to come back to Wittgenstein—it would be silly to suggest that he
did not notice that many of our actions are means to ends. In fact, I expressly
omitted parts of the quotation in this respect. Wittgenstein writes, “One could
almost say that man is a ceremonial animal,” but he immediately adds, “That
is, no doubt, partly wrong and partly nonsensical, but there is also something
right about it” (1993: 218, my italics). What seems right to me is that there
are aspects of human behavior for which what Weber called Zweckrationalität
(“instrumental rationality”) is not an exhaustive explanation. Along these lines

one probably could say with Bourdieu that an action makes sense to the actors
merely because they have an appropriate sense of it, because it “makes sense” to
them. The ritual performed by the Westerners in the ashram makes sense to the
other Westerners because they share a common ritual sense, or better, because
their habitus fits the milieu. But—and here I diverge from Wittgenstein—such
an interpretation does not mean that such actions are not intentional. They
might not be based on Zweckrationalität, but although they are not in this sense
goal-oriented, the point of such actions is still understandable to other people.
Central to such an argument is that “understanding” means to understand the
intentions behind the action.
What Wittgenstein sees as being wrong (about the statement that man is a
ceremonial animal) is to think that this is the case for all human actions. And
he would probably see the attempt to ascribe those features to a distinct class of
actions as nonsensical. The argument of Wittgenstein is therefore against the
category “ritual” as it is commonly used in the social sciences. In a Wittgen-
steinian perspective ritual action must be understood not as a distinct class of
actions or behavior, but as central aspect of some human actions.19
Ritual Sense, Efficacy, and Intentionality
What has all of this is to do with ritual efficacy? To make my point clear I want
to start with a very basic question: Is it helpful at all to talk about the efficacy
of rituals? Does the question, “How do rituals work?” make sense? Some of
the participants at the conference that led to this book seemed to imply that
rituals (whatever we consider them to be) have a special kind of efficacy. To
my mind it is wrong and misleading to suggest that there is something like
ritual efficacy sui generis (cf. Sørensen 2006 for the most recent formulation of
such a position). I do not think that there is one answer to the question of “how
rituals work.” Shamanic rituals may heal, legal rituals may bind, political ritu-
als may resolve difficulties, religious rituals may cleanse or bestow grace, and
so on—or they may not. But how and when they succeed cannot be explained
by a general theory of ritual; nor is the efficacy of such actions, when they are
successful, specific to rituals.20 Speech acts, general causal relations, placebo
effects, catharsis, rhetoric, and luck can and do help explain the efficaciousness
of an action—but this fact does not depend on whether or not the action is ritu-
alized. Such a position regarding ritual efficacy is, for example, underlined by
Howard Brody’s paper on the placebo effect in this volume. Brody could have
written the same article without mentioning ritual at any point. His important
contribution to the topic of ritual efficacy is based not on a general theory of rit-
ual efficacy, but rather on the way in which he shows how ritual performances
might enhance a certain kind of efficacy (placebo effects).
What I have said about Bell and Wittgenstein is intended to underline
this basic point. In her introduction to Ritual Theory, Ritual Practice, Bell
writes that that she wants to provide “potentially more fruitful questions
about the origins, purposes, and efficacy of ‘ritualized actions’ than are acces-
sible through current models” (1992: ix). I am skeptical about whether she
succeeds in this goal. Here again one has to ask what, precisely, she means
by the “efficacy of ritualized actions”—how, for whom, and against what are
they efficacious? I assume that she wants to say that it is fruitful to ask how
ritualized actions are efficacious in the production of a ritual sense (which
in turn is relevant to a reproduction of power relations—misrecognized by
the actors themselves). Recall her earlier quote that “the implicit dynamic
and ‘end’ of ritualization . . . can be said to be the production of a ‘ritualized
body.’ A ritualized body is a body invested with a ‘sense’ of ritual” (1992:
80). I argued that her approach is problematic since she seems to be talking
primarily about the fitting of a ritual habitus to a ritual milieu and that the
mechanisms at work in such an effect are not at all specific to the process of
ritualization. It is telling that Bell herself at decisive points does not speak
about efficacy but rather states that the focus on ritual sense helps to show
how the child from the example of Geertz was “considered buried more or
less satisfactorily.” The notions of adequacy or appropriateness—although
the analytical value of these terms might be even less than that of the notion
“sense” or “instinct”—bring us back to the example at the beginning of this
chapter. I claimed that, while it was no problem for participants in a seminar
on ritual theory to invent, within a short period of time, a ritual that seemed
appropriate to all of us, none of us even thought of the question of how to
make it efficacious.
This observation points in the direction taken by Wittgenstein: the idea
that rituals are not primarily about efficacy. For him, the most basic feature
of rituals is that they are based on an instinct-like reaction to a significant
phenomenon. The belief in causal consequences, like the explicit expression
of emotions or desires, is a secondary quality of ritualized actions, and so
therefore is the question of efficacy. Since the question of efficacy can only
be added to ritual action, any talk about ritual efficacy, and even more so
any talk about an efficacy specific to rituals, is misguided, because these are
properties of human action in general. You would not ask Schubert’s brother
or the man who kisses the picture of his beloved whether their actions were
efficacious.
But Wittgenstein’s observation that instrumental or expressive theories of

ritual are not always sufficient ways to make sense of a ritualized action (they
rather are based on a false dichotomy) does not imply that such actions are
pointless. This is where Wittgenstein’s position (as well as De Lara’s interpreta-
tion of it) that such actions “aim at nothing at all” needs to be discussed further,
primarily since the word “aim” bears much theoretical weight here. I only want
to hint at an alternative approach, one that takes on the problems debated above
but that is not based on the notions of sense, instinct, efficacy, instrumentality,
or expression but rather on the notion of intentionality.21
To use an earlier example, the question is whether an (intentional) basic
action is performed by a bowler by moving the upper part of the body to the
right or by a lover who kisses the picture of his beloved. If one looks at it this
way, one sees that the lack of instrumental rationality as well as the lack of
an intended expression of feelings does not necessarily make the respective
actions “pointless,” nor is it appropriate to say that such actions “aim at noth-
ing at all.”22
I have attempted to show that one must treat the efficacy of rituals on a
case-by-case basis, and must acknowledge that with respect to efficacy, ritual
actions do not differ from other sorts of action. The latter point was exempli-
fied in the discussion of Bell when I argued that one has either to defend a
concept of ritual efficacy sui generis based on a sufficient conceptualization of
ritual/ritualization, or acknowledge that there is no ritual-specific efficacy. The
discussion of Wittgenstein’s position raised the question of whether efficacy
is in any sense a primary feature of ritual activities. This led me to consider
them not only as similar to other actions having multiple relations to the lives
of human beings but also as intentional and, because of this intentionality, as
understandable to other human beings. With respect to all the problems raised
in this chapter concerning ritual sense as well as ritual efficacy, I finally argued
that a discussion of intentionality is unavoidable.
So, although I introduced and discussed the notions of ritual sense and
ritual instinct, I feel that they help us neither to answer “the problem of ritual
efficacy” nor to understand specific aspects of ritual actions in general. Bell’s
formulation of a ritual sense depends on an inadequate conceptualization of
the term “ritual(alization).” Wittgenstein’s idea of a prereflective, instinctive
and unintentional reaction to “significant phenomena” did not explain how to
conceptualize the mental states of the persons performing these actions (ritu-
als). With respect to ritual efficacy, my conclusion is that different rituals call
for different considerations of their efficacy, because they are primarily species
of action. In short, when it comes to ritual efficacy, we must follow another
piece of advice from Wittgenstein and resist our “craving for generality.”
acknowledgment
I want to thank Don Gardner and William Sax for their valuable comments, and the
German Research Council and the German Academic Exchange Service for their
financial support.
notes
1. In our context, the term ashram refers to a more or less secluded residence or
“hermitage” of a religious community gathered around a Guru. There are, however, other
ashram concepts—for example the one propagated by Mohandas “Mahatma” Gandhi.
2. The performance of a puja normally employs the use of a statue or image
(murti). It is often emphasised that pujas bring together the human and the divine worlds
at specific times and places by actualizing the presence of deity in a physical from that in
some way embodies the reality of that deity. In most of the pujas there are at least three
actions involved. The devotee first presents an offering to the murti, then the devotee is
granted the blessed sight (darsana) of the deity and receives the deities’ blessing in the
form of a mark (tilak) as well as a blessed article from the worship (prasad).
3. Gayatri is a name of a goddess as well as the name of a verse of the Rig-Veda.
The gayatri Mantra is uttered by many Brahmins at dawn as well as in the brahmanic
initiation ritual. It is often presented as being a condensed form of whole Veda.
4. In the havan or havan-puja, ritual oblations are offered into a sacrificial fire.
5. Arati is the honorific passing of a flame (lighted lamp, piece of camphor, etc.) in
front of a guest, deity, or statue of a Guru. The essential gesture of arati is that of moving
the object in a circular, clockwise fashion before the statue. In temples, usually a conch
shell is blown, a gong is sounded, or a bell is rung continuously at the same time.
6. Satsang can be translated as “association of the true,” that is, of persons who
are devoted to the truth. The term is used for devotional groups who meet, sing
hymns, listen to sermons, and so forth.
7. All unreferenced quotes in this paragraph are taken from Shanti Mayi’s
homepage “The Un-Spun Web” (http://www.shantimayi.com/ch1/sachadham.html)
on 09.08.05.
8. Cf. Babb (1975: 43), Courtright (1985: 33), Fuller (1992: 60), and Rodrigues
(2003: 35), to mention just a few.
9. The position of Chris Fuller is here most clear. He writes: “Puja, at its heart,
is the worshiper’s reception and entertainment of a distinguished and adored guest. It
is a ritual to honour powerful gods and goddesses, and often to express personal
affection for them as well; it can also create a unity between deity and worshiper that
dissolves the difference between them” (1992: 57). According to Fuller, the aspects of
hierarchy as well as the transgression of borders are “two of the most critical features
of Hindu religion and society” (1992: 3) and he keeps them in mind throughout his
book The Camphor Flame (1992), especially in the chapter on pujas.
10. Lacking a tantamount translation, I used the German term andächtig. It can
be loosely translated as devoutly, prayerful, docile, pious, etc. and in German it is kin
with Andacht (Engl.: devotion, prayer).
11. Cf. on this point one of Fuller’s descriptions of pujas: “Puja in a large temple,
especially in the blackness enveloping the innermost shrines, has a powerful sensual
impact, often amplified by the press of a large crowd of devotees in a hot, confined
space. Frequently there is a deafening and even discordant sound as the music of pipes
and drums combined with ringing bells and the chanting of sacred texts” (1992: 57).
12. For Wittgenstein’s notion of “instinct,” see De Lara (2003).
13. Cf. De Lara (2005) for a more extensive outline of his position.
14. The frame of explanatory reference is here Wittgenstein’s general aversion to
“theories” in philosophy and his view that explanations always come to an end
somewhere. For the point of the argument of this paper it is, however, not necessary to
elaborate on this view.
15. “Intentionality” is to be understood here as a specific state of the mind that
plays a distinctive role in the etiology of actions and not as a kind of “concept” (what
would be called “intension” in the philosophy of mind).
16. It is not surprising that Bourdieu’s position resembles Wittgenstein’s, since
he openly refers to Wittgenstein throughout his writing, most famously on his
discussion of “following a rule.” But in an interview conducted in 1986 by Pierre
Lamaison, Bourdieu gives the impression that he read the Remarks after he formulated
his position on rituals (Lamaison and Bourdieu 1986: 118).
17. Cf. Ahern (1979: 16), where she quotes Piaget, who used the example of the
bowling player to describe “spontaneous magical ideas in the adult” and relates this
example to Wittgenstein’s Remarks.
18. Ahern, in her brief discussion of Wittgenstein, fails to notice the different
concepts of ritual at stake (cf. Ahern 1979: 16).
19. Cf. De Lara (2003), to whom the reconstruction of Wittgenstein’s position
given above owes a lot.
20. Cf. Skorupski’s critical remarks in Symbol and Theory: “What does a term
have which brings together a man shaking hands, a man praying to his god, a
man refusing to walk under a ladder, a man clapping hand at the end of a concert,
a man placing medicine on his crops?” (1976: 171).
21. Not only is the notion “intentionality” well discussed and substantiated in the
pertinent areas of philosophy, but it is further central to the respective debates in the
classical as well as recent debates in ritual theory (cf. Skorupski 1976, Humphrey and
Laidlaw 1994). In my perspective, basic actions in general are expressive of the mental
states that cause them, irrespective of the question whether these actions were
undertaken in order to express these states (they might not even be conscious to the
actor while performing them).
22. De Lara (2003) discusses the notion of “intransitive expressions” where we
do not have to proceed by saying what, for example, a piece of music might be an
expression of. To my mind it is not satisfactory either for a music concert or for a
ritual to say that it is merely expressive (not to mention the grammatical/logical
reasons involved, since expressing is a two-place predicate). Beattie’s “expressivist”
position that ritual activities are better to be compared to a ballet performance (Beattie
1986) seems to loom here still in the back, although De Lara is conscious of some of
the problems involved.
references
Ahern, Emily M. (1979), “The Problem of Efficacy: Strong and Weak Illocutionary
Acts,” Man 14:1–17.
Babb, Lawrence A. (1975), The Divine Hierarchy: Popular Hinduism in Central India.
New York: Columbia University Press.
Beattie, J. H. M. (1986), “On Understanding Ritual,” in Bryan R. Wilson (ed.),
Rationality. Oxford: Blackwell, 240–268.
Bell, Catherine M. (1992), Ritual Theory, Ritual Practice. New York: Oxford University
Press.
——— (1997), Ritual. Perspectives and Dimensions. New York: Oxford University Press.
Bourdieu, Pierre (1984), Distinction, a Social Critique of the Judgment of Taste.
Cambridge, Mass.: Harvard University Press.
——— (1990), The Logic of Practice. Stanford, Calif.: Stanford University Press.
Courtright, Paul B. (1985), “On this holy day in my humble way: Aspects of Puja,” in
Joanne Punzo Waghorne (ed.), Gods of Flesh—Gods of Stone. Chaberburg, Pa.:
Anima, 33–50.
De Lara, Philippe (2003), “Wittgenstein as Anthropologist: The Concept of Ritual
Instinct,” Philosophical Investigations 26(2): 109–124.
——— (2005), Le rite et la raison, Wittgenstein anthropologue. Paris: Ellipses.
Fuller, Chris. J. (1992), The Camphor Flame: Popular Hinduism and Society in India.
Geertz, Clifford (1973), The Interpretation of Cultures. New York: Basic Books.
Humphrey, Caroline, and James Laidlaw (1994), The Archetypal Actions of Ritual. A
Theory of Ritual Illustrated by the Jain Rite of Worship. Oxford: Claradon Press.
Klagge, James C., and Alfred Nordmann (1993), Philosophical Occasions, 1912–1951,
Indianapolis: Hackett.
Lamaison, Pierre, and Pierre Bourdieu (1986), “From Rules to Strategies: An
Interview with Pierre Bourdieu,” Cultural Anthropology 1(1): 110–120.
Rodrigues, Hillary (2003), Ritual Worship of the Great Goddess: The Liturgy of the Durga
Puja with Interpretations. Albany, N.Y.: State University of New York Press.
Skorupski, John (1976), Symbol and Theory, a Philosophical Study of Theories of Religion
in Social Anthropology. Cambridge: Cambridge University Press.
Sørensen, Podeman (2006), “Efficacy,” in Jens Kreinath, Jan Snoek, and Michael
Stausberg (eds.), Theorizing Rituals. Leiden: Brill, 523–531.
The Un-Spun Web, http://www.shantimayi.com/ch1/sachadham.html (accessed on
09.08.2005).
Wittgenstein, Ludwig (1993), “Remarks on Frazer’s Golden Bough (1931–1948),” in
James C. Klagge and Alfred Nordmann (eds.), Philosophical Occasions, 1912–1951.
Indianapolis: Hackett.
Index
Adams,Vincanne, 10–11 as opposed to faith, 9

Africa 11 in miracles, 48, 50, 53
agency, 32, 118, 140 psychological notion of, 155
age of faith, 68 Bell, Catherine, 107, 169–171, 174–179,
Akkadia. See Babylonia 182, 184–185
Allah, 114 Benedetti, Fabrizio, 155–156
America. See Latin America; biblical studies, 46
North America biomedicine, 9–10, 132, 140, 146
anathema. See excommunication Birgitta of Sweden, 69, 73
Ancient Near East, 17–19, 22–23, 27–28, black magic, 77
36, 38 body imagery, 117–118
Anu, 20 Bourdieu, Pierre, 8–9, 107, 123, 141,
Arabia, 21, 114 169–171, 175–183
Asad, Talal, 5, 8, 133–134, 141, 145 bureaucracy, 145
Asalluhi, 25, 28, 37
Asclepius, 53, 82 candle ceremony. See excommunication
ashram, 8, 171–174, 176–177, 181, 183 cartesian dualism, 13–14, 115, 136, 152, 154
Assyria. See Babylonia cartesian separation. See cartesian
assyriology, 17 dualism
astrology, 72 Cartesianism. See cartesian dualism
catholicism, 72, 75, 140, 144
Babylonia materialist vs. spiritual, 135–137, 141–142
kingship in, 17, 19–20, 25, 35–38 charismatic healing. See faith healing
pantheon of, 20, 23, 25, 27–28, 33, 36, 38 Christianity, 45–46, 67–68
baptism, 76, 94, 182 communion, christian, 75, 77, 84, 101.
Bateson, Gregory, 123 See also excommunication
belief conditioning mechanism. See
as bodily state, 9 conditioning theory
christian, 135 conditioning theory, 61, 155–157, 159, 163
as deep conviction, 140–142 context effect. See placebo response
190 index
conventional medicine. See biomedicine and ritual, 98–101, 106–109

coronation ritual. See ritual of coronation and sinning, 94–98
Cyrus, 21 social consequences of, 95–98,
101–102, 109
Decretum. See Gratian excommunicatio totalis. See
demon excommunication
Descartes, 134 exorcism, 26, 45, 59, 76–77, 83
development, economic, 10 expectancy model. See expectancy theory
Devil. See Satan expectancy theory, 54, 61, 155. See also
discourse of modernity. See modernity conditioning theory
disease. See illness
double-blind trial, 152 faith, 46, 48, 81, 84, 109
dualism. See cartesian dualism. christian, 72, 79, 109
dynastic kingship, 38 efficacy of, 63–64
and embodiment, 8–9
Ea, 25, 27, 28, 36–37 healing, 154, 51–58, 61, 63
Ecuador, 13, 133–134,136, 140–141, 143–146 lack of, 97, 99, 110
effectiveness. See efficacy vs. secular science, 137, 139, 141, 143
efficacy fertility, 116–18, 121, 124
complexity of, 93–96 fieldwork, 10, 113, 125–126, 142, 144,
of excommunication, 102–106 (see also 170–172, 181
excommunication) Foucault, Michel, 7, 135
levels of, 102–104, 106 Frazer, James George, 20
and possession, 115, 127
and psychological theory, 54–55, 61, 155 Galen, 82
of ritual performance, 3, 7–9, 17–18, Garwhal, 13
37–39, 46, 53, 59–63, 84–87, 110, Geertz, Clifford, 86, 175, 184
161, 170, 182–185 Gennep, Arthur van, 96
social, 124–128 Gilgamesh Epic, 36
theory of, 101–104 Goody, Jack, 4
Egypt, 114, 126 Gospel, 46, 49
embodiment, 8, 9, 123, 127 Gratian, 97–100, 102–103, 105, 107, 109
as habitus, 170 Greece, 53
of ritual sense, 175–176, 178 (see also Guru, 171–172, 181
ritual sense)
Enlightenment, 5, 132, 134–135, 140 habitus, 107–109, 170, 175–179, 183–184
and post-enlightenment, 4 Haraway, Donna, 134
Epidauros, 53 Hildegard of Bingen, 74, 83
epilepsy, 69, 80, 86 historical skepticism, 47–50
Erasmus of Rotterdam, 81 history of religion, 20
Ethiopia, 114 Hexenhammer, 79
etiology, mediaeval, 68–71 healing ritual, 9, 11, 17, 19, 24, 71, 81–82,
Eucharist, 60, 94–96, 102, 109 85 (see also ritual healing)
Europe, 11, 68, 98, 133, 135, 171, 176 definition of, 67
excommunication, 93 in medicine, 153, 155, 161–62, 164
vs. absolution, 100–101
abuse of, 104–106 illness experience, 54, 161
history of, 94–98 as opposed to disease, 9–10, 57
and meaning of the soul, 104, 106–107 mediaeval theories of, 67–71
as political instrument, 95, 97, in Mesopotamian cosmology, 19,
104–105, 109 21–23, 25–27, 37
index 191
and rituals, 71–72, 74, 79, 86, 161–163 meta-ritual, 93, 106–109
(see also placebo response) Mexico, 136
caused through sinning, 69–71 mimesis, 123
and spirit possession, 114, 116–117 miracle, 75, 77. See also miracle stories
India, 4, 8, 13, 170–174, 176–177 miracle stories, 45–50
infertility, 146 in healing, 50–52, 62
intentionality, 171, 183, 185, 187 modernity, 3, 10–14, 107, 136, 139, 141,
in vitro fertilization (IVF), 8, 13, 131–133, 145–146
136, 140–147 as opposed to religiosity, 131–35
catholic critique of, 131–132, 143 modern medicine. See biomedicine
cycle of, 137–139
Iran, 114 Nabonidus, 21–22
IVF. See in vitro fertilization Nergal, 36
neuroimaging studies, 157–159
Jesus of Nazareth, 9, 53–64, 69, 73, 137, New Testament, 45, 47, 56
162–163 New Year’s Festival, mesopotamian
as exorcist, 46, 47–52 description of, 19–27
Jinn, 114, 117, 119–120 as rite of passage, 27–28
John the Baptist, 47–48, 73 interpretation of, 27
Nineveh, 19
Kleinman, Arthur, 9, 154 Nintur, 33
Nippur, 25–26, 29, 35
Latin America, 135–136, 145 North America, 3, 11, 133–134, 142,
Latour, Bruno, 134, 136, 146 171, 176
legitimation of power. See political ritual North India, 4, 8, 170–174, 175–177
liminality, 27, 28, 32, 139 Nungal, 28, 32–33, 35
Lock, Margaret, 115
Lucifer. See Satan oracle, 10,13, 21,78
Lukes, Stefan, 4
Luther, Martin, 70, 76, 79, 110 Paracelsus, 69
paradigm of science. See scientific
madness. See mental illness paradigm
magic analogy, 24–27 Parkinson’s Disease, 157
magic healing, 71, 85 patient satisfaction, 9, 161
magic identification. See magic analogy Persia, 21
Malleus Maleficarum. See Hexenhammer personal deity, mesopotamian idea
Manungal. See Nungal of, 21–28, 31–39
Marduk, 20–21, 31, 38 personhood, relational, 115
Marx, Karl, 136 pilgrimage, 71, 75, 78
materia magica, 24–26 placebo 13, 54, 63, 151–153, 155–160, 164
matrilineality, 125 placebo effect. See placebo response
meaning model, 160–161, 163–164 placebo response, 151–164
meaning response. See placebo response and biomedicine, 152, 154
medical pluralism, 84–87 definition of, 151–152
medical ritual. See rituals in medicine efficacy of, 153–157, 163–164
mental illness, 70, 74, 77 and faith healing, 54, 63, 154
Mesopotamia and neuroscience, 157–159, 163
cosmology of, 22, 25, 32–33 explained through psychological
concept of illness in, 19, 22, 25, 37 theories, 61, 155–157
rituals in, 17, 18, 26, 28, 34 and ritual, 13, 153–154, 160–164
royal ideology, 19, 29, 31 political ritual, 17, 19, 22
192 index
positivism, 5 theory of, 5, 6, 8, 27, 94, 106–109,

possession, 8, 45, 49, 70, 75–76, 113–115 160–163, 170, 172, 184
and gender, 117–118, 120–121 violence in, 84
and kinship, 116, 124–128 ritual healing, 4, 7, 9–11, 24–27, 50–52
practice theory, 8. See also Bourdieu, and placebo, 13, 61, 152, 160–163
Pierre ritual instinct, 169–170, 179, 181–182, 185
pregnancy, 117, 126, 131, 142–143 ritualization, 175, 177–179, 184–185
prison of reed, mesopotamian 19–27 ritual sense, 8, 169–171, 175–179, 182–185
as ritual setting, 28–29
interpretation of, 32–37 Sabbath, 58–59
Protestantism, 5, 8, 133, 135 saints, role of, 73, 75–84, 136–37
psyche, 8 Satan, 3, 50, 69, 76, 80
psychological theories, 155–157. See also satsangi, 12, 14
expectancy theory; conditioning Scheper-Hughes, Nancy, 115
theory Schmithals, Walter, 49
puja, 12, 171, 176–177, 182 science and religion, relationship
Western vs. Indian perceptions between, 146
of, 172–175 scientific paradigm, 6, 9–10, 81, 164
self-healing process, 54–55. See also
Quran, 114 placebo response
sense of ritual. See ritual sense
rationality, 4, 6, 10, 132 Shamash, 25, 27–28, 37
instrumental, 183, 185 sin. See excommunication
relic, 73–75, 77–78, 83–84 Smith, Wilfrid Cantwell, 4–5
religio, 4, 5 social healing, 50, 52, 55–56, 59, 63
representational theory, critique on 5, 8 social stress, 57–59
reproduction, assisted. See in vitro Somalia, 114
fertilization soul. See excommunication
reproductive medicine. See in vitro speech act, 98–101, 106, 183
fertilization spirit possession. See possession
Rishikesh. See India status reversal, 20
rite. See ritual St. Birgit of Sweden. See Birgitta of Sweden
rite of passage, 27 stream of tradition, mesopotamian, 17
ritual Sufi, 114
in biomedicine, 153–154, 160–164 Sumeria. See Babylonia
of coronation, 19–27 superstition, 3, 10, 69, 87, 154
critique of, 11–14 symbolic healing, 46, 49, 57, 62–63.
defining, 7–8, 51, 53, 60, 67, 71, 74, 94, See also ritual healing
158, 163, 177–178
efficacy (see efficacy of ritual) theophagy, 75
failure of, 17, 20–21, 56, 57 threshold, 52–53
framing of, 34, 102–103, 177–179 trance, 115, 117, 119–120, 122–123, 125,
genealogy of, 141–142 127. See also possession
linguistic analysis of, 4, 17–18 Turner, Victor, 139
as nonrational practice, 4, 7
popular understanding of, 7, 8 Uruk, 20
prophylactic performance of, 22, 26 United States of America. See North
reification of, 3, 4, 175 America.
substance use in, 26, 60 universalism, 63–64, 179
index 193
van Gennep, Arthur. See Gennep, Arthur witchcraft, 70–71, 77, 79

van Wittgenstein, Ludwig, 169–171,
Vatican, 131 179–185
Virgin Mary, 120, 131–132, 138–139, World Health Organisation, 9
141–142, 146
Zambia
Weber, Max, 133, 145, 182 zâr, 14, 113, 122–127
Western medicine. See biomedicine nature of, 114–115, 117–121
white magic, 73 zayrân. See zâr

Quack, Jan Weinhold - The Problem of Ritual Efficacy - Oxford University Press, USA (2010)

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Quack, Jan Weinhold - The Problem of Ritual Efficacy - Oxford University Press, USA (2010)

Uploaded by

Copyright:

Available Formats

The Problem of Ritual Efﬁcacy

Oxford New York

Copyright © 2010 Oxford University Press, Inc.

Published by Oxford University Press, Inc.

Library of Congress Cataloging-in-Publication Data

Printed in the United States of America

1. Ritual and the Problem of Efﬁcacy, 3

2. Ritual Healing and the Investiture of the Babylonian King, 17

3. Jesus and his Followers as Healers: Symbolic Healing

4. Healing Rituals in the Mediaeval West, 67

5. Excommunication in the Middle Ages: A Meta-Ritual

7. Ritual Humility in Modern Laboratories: Or, Why Ecuadorian

8. Ritual, Medicine, and the Placebo Response, 151

9. Bell, Bourdieu, and Wittgenstein on Ritual Sense, 169

Claus Ambos studied Assyriology, Ancient Near Eastern Archaeology, and

Janice Boddy is Professor and Chair of the Department of Anthropology, Uni-

Johannes Quack studied Religious Studies, Philosophy, and Anthropology

William S. Sax completed his Ph.D. in Anthropology from the University of

taught at a secondary school. After two years as Professor at the University at

the sacraments are not the representations of cultural metaphors;

A similar point was made by J. S. Uberoi in his underappreciated clas-

“represents,” “symbolizes,” or “expresses,” rather than the ends toward which

condensation (fusion), and redundancy (repetition)” (1979: 119)—I would add

often said by ritual practitioners to be indispensable to ritual efﬁcacy. And as

the middle class’s identiﬁcation with “science” or with more

Meanwhile, my friends back in the village where I was conducting my

healing is not so much a statement of disbelief in its efﬁcacy as it is an assertion

9. Eventually, their grandmother saved the day—and the ritual—by vigorously

The political implications of ritual healing will be discussed in this chapter

The noun epi/uštu means in general “act, activity, achievement, accomplish-

The Semiannual Reinvestiture of the Babylonian King

Problems in Performing the New Year’s Festivals:

The presence of the king, a necessary precondition for the performance of

Healing, Protection, and Reconciliation with the Divine Sphere

1–3. Tashritu: If the death-spirit seizes a man

against disease-causing agents (conceptualized as demons),

4–8. Tashritu: House of sprinkling water

personal gods. Temporary reversal of status: During the night of

8. Tashritu: The RESULT: legitimation of the king. The major gods

Procession of the gods, accompanied by the king, to their akitu-

houses outside the city.

Asalluhi—decided the case of the person who performed a ritual.18 A prison

Ritual Efﬁcacy: The Prison as a Ritual Device

House, furious storm of heaven and earth, battering its enemies!

The Prisoner-King in Prison as a Criminal Individual

After my god has become angry with me (and)

The Prison as the Material Representation of the Anger of the Gods

I take to a bed of bondage; going out is a pain;

Very similar is the concept attested in bilingual Sumerian-Akkadian prayers,

The Prison as the Netherworld

I assist Nintur at the place of child-delivery;

Mother Nintu, the lady of . . .,

The dark interior of the temple of the mother-goddess is clearly to be

The Reversed World

Brother counts for brother the days of misfortune, but their

Similarly is the netherworld a world of reversal. It is a topos in Mesopo-

You must not kiss the wife you love,

As we learn from the myth “Nergal and Ereshkigal,” similar advice is

It was a characteristic mechanism of Babylonian kingship that the ruler was

21. To the problems of distinguishing between “prayer” and “incantation,” see

Attinger, P. 2003, “L’Hymne à Nungal,” in Literatur, Politik und Recht in Mesopotamien.

My so-called habilitation thesis on Early Christian miracle stories (Theißen

To be sure, no demon entered my mind, but rather certain doubts concern-