Early toilets reveal dysentery in Old Testament Jerusalem

Newswise — A fresh study of aged excrement collected from two Jerusalem lavatories originating from the biblical Kingdom of Judah has revealed remnants of Giardia duodenalis, a microscopic organism responsible for severe diarrhea in people.

According to a publication in the journal Parasitology, a group of researchers, spearheaded by the University of Cambridge, claims that this occurrence represents the earliest known instance of humans being infected with the diarrheal parasite anywhere in the world.

Dr. Piers Mitchell from Cambridge's Department of Archaeology, the lead author of the study, stated that the presence of these parasites in the sediment of two Iron Age Jerusalem cesspits indicates that dysentery was widespread in the Kingdom of Judah.

"Dysentery refers to gastrointestinal infections caused by parasites and bacteria, leading to symptoms such as diarrhea, abdominal cramps, fever, and dehydration. It can pose a significant risk, especially for young children, and has the potential to be fatal."

Mitchell explained, "The transmission of dysentery occurs when feces contaminate drinking water or food. Given the crowded conditions, heat, presence of flies, and limited water availability during the summer in early cities of the ancient Near East, we speculated that dysentery could have been a significant issue."

Mitchell explained, "The transmission of dysentery occurs when feces contaminate drinking water or food. Given the crowded conditions, heat, presence of flies, and limited water availability during the summer in early cities of the ancient Near East, we speculated that dysentery could have been a significant issue."

At that time, Judah existed as a vassal state under the dominion of the Assyrian Empire, which extended from the Levant to the Persian Gulf and encompassed a substantial portion of present-day Iran and Iraq. Jerusalem, serving as a thriving political and religious center, was estimated to have housed a population ranging from 8,000 to 25,000 inhabitants.

Both latrines featured intricately carved stone seats that were remarkably similar in design. They consisted of a gently curved surface for sitting, a prominent central opening for defecation, and an adjacent hole at the front specifically intended for male urination. Mitchell noted, "Toilets equipped with cesspits from this era are quite uncommon and were typically reserved for the privileged few."

One of the latrines originated from a lavishly adorned estate situated in Armon ha-Natziv, encompassed by an ornamental garden. This particular site, which was excavated in 2019, is believed to have originated during the reign of King Manasseh, a vassal ruler for the Assyrians who held authority for approximately fifty years during the mid-7th century.

The second latrine was discovered within the House of Ahiel, a residential structure comprising seven rooms, which served as the residence of an affluent family during that era. The precise date of construction is challenging to determine, with some estimates suggesting it was built around the 8th century BCE.

Nevertheless, the destruction of the House of Ahiel can be confidently dated to 586 BCE. During this time, the Babylonian ruler Nebuchadnezzar II ruthlessly sacked Jerusalem for the second time, as the city's inhabitants refused to fulfill their agreed tribute. This event marked the culmination of the Kingdom of Judah, bringing it to an end.

Medical texts from ancient Mesopotamia, dating back to the first and second millennium BCE, contain descriptions of diarrhea affecting populations in what is now the Near and Middle East. One such example states: "If an individual consumes bread and beer and subsequently experiences stomach cramps, abdominal pain, and a persistent bowel movement, it is likely that they have been affected by a condition known as 'setu'."

In these ancient texts written in cuneiform, the term commonly employed to describe diarrhea was "sà si-sá." Additionally, some of these texts included prescribed incantations that were advised to be recited to enhance the likelihood of recovery from the condition.

Mitchell remarked, "While these early written sources do not explicitly outline the causes of diarrhea, they inspire us to employ contemporary techniques to examine the potential pathogens involved." He continued, "However, we can confirm with certainty that Giardia was one of the infections responsible for the observed cases of diarrhea."

To examine the ancient decomposed feces from the biblical period, the research team utilized a bio-molecular method known as "ELISA." This technique involves the use of antibodies that specifically attach to proteins produced by specific species of single-celled organisms. By employing ELISA, the team could analyze the proteins in the samples that were over two and a half thousand years old.

"Co-author and Tianyi Wang, a PhD candidate from Cambridge, stated that distinguishing the delicate protozoa responsible for dysentery in ancient samples, without relying on antibodies, is a challenging task as they lack the visibility afforded by microscopes, unlike the eggs of other gut parasites."

The scientists conducted examinations specifically for Entamoeba, Giardia, and Cryptosporidium: three types of microscopic parasites known for frequently triggering human diarrhea and contributing to dysentery outbreaks. While the results for Entamoeba and Cryptosporidium came back negative, the tests consistently showed positive for Giardia.

Traces of the Entamoeba parasite, responsible for dysentery, have been dated in previous studies to exist even during the Neolithic period in Greece, approximately 4,000 years ago. Additionally, earlier research has revealed that individuals who utilized ancient Judean toilets were afflicted by various gut parasites such as whipworm, tapeworm, and pinworm.

The collaborative research involved the participation of the University of Cambridge, Tel Aviv University, and the Israel Antiquities Authority.