Since the second line of each of the twenty-five couplets above begins with the words: “God Nergal” and, then adds the first word or phrase of the preceding line, it may be called a refrain with variations. Moreover it would seem probable that a priest chanted the longer first line, and a choir the second line in response.

Nergal No. 6 opens with an introductory couplet:

Flood watering the harvest knows any one thy name?

Powerful one, flood watering the harvest knows any one thy name?

This usage of repeating the first line and adding a word to it, suggests that the second line was repeated with greater emphasis, and possibly by a choir in response to a priest. After this introductory couplet there follow eleven couplets with a double refrain, made up of the first half lines of each couplet. Thus:

Powerful one, mighty one, lord of the kingdom of the dead,

Most mighty one, divine scion of Shitlam;

Powerful one, great strong steer,

Most mighty one, lord of Gushidi;

Powerful one, ruler, divine prince of Erech,