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From the Late Achaemenid city of Uruk comes a single cuneiform document described here as a Systemic Etiology, which attributes to various sicknesses their origins ‘from’ four ancient organ systems – psychic, alimentary, respiratory, and excretory-reproductive – that bear remarkable resemblance to classifications in modern biology. Features of such a functional holism may already be detected, in varying degrees, elsewhere in the Mesopotamian medical literature. The striking manner in which the Etiology re-categorizes certain sicknesses, nonetheless, illustrates how holisms do not organize their constituents in a disinterested fashion, or group them together merely on the basis of previously known characteristics, but can also reframe perspectives in ways that impose new meanings on individual constituents’ identities.