Shigella: Wash your hands of the whole dirty business

I would like to present an anecdotal finding concerning what might be the earliest medical diagnosis in written history. This diagnosis refers to what is probably one of the following infectious diseases that are known today as Salmonella, Shigellosis or brucellosis. In the 24th century B.C., an unknown physician presents us with what might be the first medical diagnosis in history followed by a differential diagnosis.

The diagnosis is described in the following Akkadic text: “…Our knees tremble and our head revolves like a potter’s wheel – and like a kid’s diarrhea. It has long been known that ‘menu’ is the name of the disease; the identification of the disease here is due to the observation that lambs suffer especially from diarrhoea.”1

Now we can compare it to the modern definition of Salmonella, Shigellosis and Brucellosis. Salmonella - the disease which is transmitted from digestion of contaminated food or water. The main symptoms of salmonella infection are: chills, fever, diarrhea and vomit. Brucellosis - the disease which is transmitted from animals to humans via exposure or digestion of contaminated milk products. The main symptoms of brucellosis are: chills, sweats, fatigue, headache, and weight loss. Shigellosis – the disease is transmitted places of low hygiene, poor water supply and contaminated and hands. The main symptoms of shigellosis are: fever, chills, diarrhea and nausea2. This text provides us with an evidence of digestive disease diagnosis 4500 years ago.

Menachem Ben-Ezra, Department of Psychology, Tel Aviv University. Tel Aviv 69978 Israel menbe@freud.tau.ac.il

References

1. Sturtevant EH. Review. Journal of Cuneiform Studies 1947;1:353- 356.

2. Goldman L, Bennett J.C. Cecil textbook of medicine 21st ed. London: Saunders, 2000.