A new analysis of ancient feces from two Jerusalem toilets dating back to the biblical Kingdom of Judah has revealed traces of the single-celled microorganism Giardia duodenalis – a common cause of debilitating diarrhea in humans.
This is the earliest example we have of this diarrheal parasite affecting humans anywhere on the planet, says a research team led by the University of Cambridge. The study has been published in the journal Parasitology.
Lead author of the study, Dr Pierce Mitchell, from Cambridge’s Department of Archeology, said: “The fact that these parasites were present in sediments from the two Iron Age Jerusalem pits suggests that dysentery was endemic in the kingdom of Judah.”
“Dysentery is a term describing gastrointestinal diseases caused by parasites and bacteria that cause diarrhea, abdominal cramps, fever, and dehydration. It can be fatal, especially to young children.”
“Dysentery is spread by feces contaminating drinking water or food, and we suspected that it might have been a major problem in the ancient cities of the ancient Near East because of overcrowding, heat, flies, and limited water available in the summer,” said Mitchell.
The stool samples came from sediment under toilets in two building complexes excavated to the south of the Old City, dating back to the seventh century BC when Jerusalem was the capital of Judah.
During this time, Judea was a vassal state under the control of the Assyrian Empire, which at its height stretched from the Levant to the Persian Gulf, and included much of modern-day Iran and Iraq. Jerusalem was a thriving political and religious center with an estimated population of between 8,000 and 25,000.
Both toilets have carved stone benches that are nearly identical in design: a shallow curved surface for sitting, with a large central opening for defecation and an adjacent opening at the front for male urination. “Spit toilets from this time are relatively rare and were usually made only for the elite,” said Mitchell.
One was from the lavishly decorated estate of Armon Hantziv, surrounded by an ornamental garden. The site, which was excavated in 2019, most likely dates back to the days of King Manasseh, King Zabun of the Assyrians who ruled for fifty years in the mid-7th century.
The site of another toilet, known as the House of Ahiel, was a house-building of seven rooms, which housed an upper-class family of the time. It is difficult to date the construction, as some place it in the eighth century BC.
However, its destruction is safely dated back to 586 BC, when Babylonian ruler Nebuchadnezzar II brutally sacked Jerusalem for the second time after its citizens refused to pay the agreed-upon tribute, bringing the kingdom of Judah to an end.
Ancient medical texts from Mesopotamia during the first and second millennium BC describe diarrhea afflicting the inhabitants of what is now the Near and Middle East. An example says, “If a person eats bread and drinks beer and after that his stomach becomes colic, he has cramps and he has a flow in the intestines, he has setu.”
The cuneiform word often used in these texts to describe diarrhea was sà si-sá. Some texts also included incantations recommended for recitation to increase chances of recovery.
“These early written sources do not provide causes of diarrhoea, but they do encourage us to apply modern techniques to investigate pathogens that may be involved,” said Mitchell. “We know for sure that giardia was one of those infections responsible.”
The team investigated the feces of the two-and-a-half-year-old decomposing biblical period by applying a biomolecular technique called “ELISA,” in which antibodies uniquely bind to proteins produced by certain types of single-celled organisms.
“Unlike the eggs of other intestinal parasites, the parasites that cause dysentery are fragile and very difficult to detect in old samples through microscopes without the use of antibodies,” said the co-author and Cambridge PhD. Tianyi Wang candidate.
The researchers tested Entamoeba, Giardia, and Cryptosporidium: three parasitic microorganisms that are among the most common causes of diarrhea in humans, and the cause of outbreaks of dysentery. Entamoeba and Cryptosporidium tests were negative, but Giardia tests were repeatedly positive.
Previous research has dated the effects of the Entamoeba parasite, which also causes dysentery, to Neolithic Greece over 4,000 years ago. Previous work also showed that users of ancient Judean toilets were infected with other intestinal parasites including whipworms, tapeworms, and pinworms.
This research was conducted through a collaboration between the University of Cambridge, Tel Aviv University, and the Israel Antiquities Authority.
Giardia duodenalis and dysentery in Iron Age Jerusalem (7th-6th centuries BC), Parasitology (2023). DOI: 10.1017/S0031182023000410
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