Is it ever complicated...

Curses cause disease. An Akkadian incantation against sorcery makes the following observation: u2-ša-aṣ-bit-an-ni GIG-su lim-nu ša2 ṣi-bit ma-mit ‘She (the kaššaptu) has imposed on me her evil disease caused by the attack of a curse’. Other texts also show that diseases caused by supernatural agents, which strictly speaking cannot be killed, are readily managed with maledictions. The idea here is to separate and then dismiss both the disease and the supernatural agents to the correct place and make sure that they stay there.... The use of a peg (Sum., gag, line 197) is instructive. According to lines 207/208, this is the vector that will carry the disease into the earth. One suspects that in order to achieve this outcome the peg was nailed into the ground at the conclusion of the ritual.

Due to the verbal shift from the second person (207/208) to the first person (209–10), we may additionally speculate that the closing curse was uttered as the incantation specialist pounded the peg into the earth. Such an act as this would constitute the formal transferral of the disease demon into the ground but not necessarily its departure from the created world. The malediction “May you leave!” still depends on the cooperation of the “great gods” to coerce the diʾiu disease to depart. The reference to KI as the underworld would make an infinite amount of sense because disease demons cannot die. Even so, they can be expelled to the Netherworld, which is of course equivalent to “death” for these supernatural beings. It still remains that, in order for these hostile forces to get there, they must be disengaged from the victim, attached to a vector, and finally dispatched to a place where they will be restricted so that they can no longer do harm. Separation is consequently a necessary intermediate state that must be fully achieved before the harmful powers can even be sent to the underworld.— Cursed Are You!, pages 216-17

<idle musing>
Wow. Talk about complicated. No wonder Jesus said that the truth would set you free! He takes care of all that because he is Lord of all (to borrow from the other book I'm excerpting from, World Upside Down).
</idle musing>