Potentially deadly dysentery was rife in Old Testament Jerusalem, reveals a new study of ancient toilets.
An analysis of 2,500-year-old samples taken from two latrines in the Holy City, dating back to the biblical Kingdom of Judah, uncovered traces of a single-celled microorganism Giardia duodenalis – a common cause of debilitating diarrhoea in humans.
A team led by Cambridge University scientists say it is the oldest example of the diarrhoea-causing parasite infecting humans anywhere on the planet.
Study lead author Dr Piers Mitchell, of Cambridge’s Department of Archaeology, said: “The fact that these parasites were present in sediment from two Iron Age Jerusalem cesspits suggests that dysentery was endemic in the Kingdom of Judah.
‘Dysentery is a term that describes intestinal infectious diseases caused by parasites and bacteria that trigger diarrhoea, abdominal cramps, fever and dehydration.
‘It can be fatal, particularly for young children.
‘Dysentery is spread by faeces contaminating drinking water or food, and we suspected it could have been a big problem in early cities of the ancient Near East due to over-crowding, heat and flies, and limited water available in the summer.’
The faecal samples came from sediment underneath toilets found in two building complexes excavated to the south of the Old City, which date back to the 7th Century BC when Jerusalem was a capital of Judah.
Judah was at that time a vassal state under the control of the Assyrian Empire, which at its height stretched from the Levant to the Persian Gulf, incorporating much of modern-day Iran and Iraq.
Jerusalem would have been a flourishing political and religious hub estimated to have had between 8,000 and 25,000 residents.
Both toilets had carved stone seats almost identical in design: a shallow curved surface for sitting, with a large central hole for defecation and an adjacent hole at the front for male urination.
Dr Mitchell said: ‘Toilets with cesspits from this time are relatively rare and were usually made only for the elite.’
One was from a lavishly decorated estate at Armon ha-Natziv, surrounded by an ornamental garden.
The site, excavated in 2019, probably dates from the days of King Manasseh, a client king for the Assyrians who ruled for 50 years.
The site of the other toilet, known as the House of Ahiel, was a domestic building made up of seven rooms, housing an upper-class family at the time.
Date of construction is hard to pin down, with some experts placing it around the 8th Century BC.
Its destruction is safely dated to 586 BC, when Babylonian ruler Nebuchadnezzar II brutally sacked Jerusalem for a second time after its citizens refused to pay their agreed tribute, bringing to an end the Kingdom of Judah.
Ancient medical texts from Mesopotamia during the first and second millennium BC describe diarrhoea affecting the populations of what is now the Near and Middle East.
One example reads: ‘If a person eats bread and drinks beer and subsequently his stomach is colicky, he has cramps and has a flowing of the bowels, setu has gotten him’.
The cuneiform word often used in such texts to describe diarrhoea was sà si-sá. Some texts also included recommended incantations for reciting to increase the chances of recovery.
Dr Mitchell said: ‘These early written sources do not provide causes of diarrhoea, but they encourage us to apply modern techniques to investigate which pathogens might have been involved.
‘We know for sure that Giardia was one of those infections responsible.’
The team investigated the 2,500-year-old decomposed biblical period faeces by applying a bio-molecular technique called ‘ELISA’ in which antibodies bind onto the proteins uniquely produced by particular species of single-celled organisms.
Co-author of the study published in the journal Parasitology, Dr Tianyi Wang said: ‘Unlike the eggs of other intestinal parasites, the protozoa that cause dysentery are fragile and extremely hard to detect in ancient samples through microscopes without using antibodies.’
The researchers tested for Entamoeba, Giardia and Cryptosporidium: three parasitic microorganisms that are among the most common causes of diarrhoea in humans, and behind outbreaks of dysentery.
Tests for Entamoeba and Cryptosporidium were negative, according to the findings, published in the journal Parasitology, but those for Giardia were repeatedly positive.
Previous research has dated traces of the Entamoeba parasite, which also causes dysentery, as far back as Neolithic Greece over 4,000 years ago.
Other studies have shown that users of ancient Judean toilets were infected by other intestinal parasites including whipworm, tapeworm and pinworm.