Diagnoses in Assyrian and Babylonian Medicine: Ancient Sources, Translations, and Modern Medical Analyses

7. Metabolic and Nutritional Diseases

Abnormalities in growth, development, and energy production can be caused by acquired or inherited defects in biochemical pathways and by nutritional deficiencies. Hormonal (endocrine) abnormalities may also play a role in growth and development. The signs and symptoms produced by these diseases often do not identify a specific condition, and modern laboratory techniques may be required to establish the diagnoses. There are, however, some metabolic diseases that can be identified with some degree of confidence from the signs and symptoms that they produce. Nutritional Deficiencies1 protein malnutrition When individuals have an adequate calorie intake, but inadequate protein intake, they develop protein malnutrition, sometimes called kwashiorkor. Growing children are especiallypronetodevelopthiscondition.Wehavefoundsixteenreferences(notincluding duplicates) describing changes in the hair of the patient’s head. Twelve of these include the phrase “touched in the steppe.” Two quotes state only that the hair was abnormal, while the others describe hair that is brittle, stands on end, trembles (possibly meaning thin or with loss of substance), is frizzed, can be easily pulled out, and has changed color to red. chapter 7 Metabolic and Nutritional Diseases If he chews his fingers and eats his own lips [. . .] —DPS XI A r. 52 = TDP 98 r. 52 abnormal 7.1 DISHSÍG SAG.DU-shú is-sa-na-la-, ina EDIN TAG KI.MIN (DPS III A r. 22⬘b//C r. 47 = TDP 30:107)2 **Ifthehairofhisheadcontinuallybecomesabnormal,hewas“touchedinthesteppe;” (it is worrisome). brittle 7.2 DISHSÍG SAG.DU-shú is-se-ni-ip-pi ina EDIN TAG-it na-,-id (DPS III A r. 22⬘a//C r. 46 = TDP 30:106)3 **If the hair of his head continually becomes brittle,4 he was “touched in the steppe”; it is worrisome. 7.3 DISHSÍG S[AG].{DU}-shú hra-s hat DIN / DISHSÍG SAG.DU-s hú sa-pat GAM (DPS III A r. 21⬘//C r. 45 = TDP 30:105) **If the hair of his {head} is chopped-looking, he will live. If the hair of his head is brittle , he will die. stands on end 7.4 DISHSÍG SAG.DU-s hú zuq-qú-pat ina EDIN TAG-it [KI.MIN] (DPS III A r. 23⬘//C r. 48 = TDP 30:108)5 **If the hair of his head seems to stand on end, he was “touched in the steppe”; [(it is worrisome)]. trembles 7.5 DISH b[i-rit] SAG.DU-s hú i-sal-li-ihr ina EDIN TAG (DPS III A r. 19⬘//C r. 43 = TDP 30:103) **Ifthe(haironthe){centralareaof}hisheadtrembles,hewas“touchedinthesteppe.” frizzed 7.6 DISHkal-li SAG.DU-s hú sa-hrir : is-sahr-hrar GAM (DPS III A obv. 33//C obv. 23a = TDP 20:23a)6 **If the (hair on the) crown of his head frizzes, he will die. easily pulled out 7.7 DISHSÍG S[AG.DU]-shú i-na x x a ZI-at GAM (DPS III A r. 26⬘//C r. 51//G 7a = TDP 30:110) **If the hair of his {head} [. . .] is (easily) pulled out, he will die. 156 Metabolic and Nutritional Diseases changed to red 7.8 DISHbi-rit SAG.DU-s hú sa-mi ina [EDIN TAG-it] (DPS III C obv. 23b = TDP 20:23b) **If the (hair on the) central area of his head is red,7 [he was touched] in [the steppe]. 7.9 DISHSÍG S[AG.DU-shú] SA5 GAM / DISHSÍG SAG.DU-s hú SA5 u sahr-[rat GAM] (DPS III A r. 28⬘//C r. 53//G 8 = TDP 30:112; cf. Labat, Syria 33.125 r. 2–3)8 **If the hair of [his] {head} is red, he will die. If the hair of his head is red and {frizzes}, [he will die]. These references indicate that the hair changes are associated with a very poor prognosis (worrisome) or a fatal outcome. Another “touched in the steppe” reference does not mention hair abnormalities but describes changes in the patient’s face that clearly indicate a wasted or cadaveric appearance. This patient also will have had a fatal outcome. 7.10 DISHA.SAG-s hú SHÚ-ip ina EDIN TAG-it GAM (DPS IX A 79//B r. 26 = TDP 78:79) **If (his face) falls flat against his skull, he was “touched in the steppe”; he will die. These findings are all highly compatible with protein malnutrition...