Some Fetal Diseases In Ancient Egypt
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Some Fetal Diseases In Ancient Egypt BY Venice .I .S. Attia
In medical knowledge the Egyptian leaves the rest of the world behind." Homer ( 900 BC)" in his Odyssey
Imhotep reading a papyrus roll, detail of a sculpture in the Egyptian Museum, Berlin .
Ancient Egyptians suffered from a variety of diseases, both congenital and acquired diseases which developed resulting from their life, cultural practices and environment they also had great knowledge about diseases, medicine and medical remedies all this is because they had great idea about anatomy because of the practice of removing human organs during mummification procedures, which was rare and minute and the only sources was those written by Greek historians such as Herodotus who in his books wrote the following concerning Egyptian medicine and physicians:” Their medicine is divided into specialties each doctor attends to one disease and one alone, thus the country is full of doctors, specialists for the eyes, the head, the teeth, the abdomen, or again for diseases of uncertain origin".
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lead them to be so advanced in their understanding of the human body, afflictions and ailments, thus they believed that the causes of body illaments and diseases were due to displeasure of the gods or natural causes . Until the first half of the nineteenth century the knowledge of ancient Egyptian medicine
Herodotus
Diodorus of Sicily (Siculus) also wrote: “They establish the treatment of diseases according to fixed written precepts, 2017
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transmit ted by a great number of famous ancient doctors. If, when following the precepts of the sacred book, they do not succeed in saving the patient, they are declared innocent and exempt of all reproach. If they act contrary to the written precepts, they may be accused and condemned to death.", he also mentioned that "in Ancient Egypt the practitioner was obliged to regulate his conduct, not by his own views, but solely by what was written in the sacred books of Tot (Thoth Hermes)
Diodorus Siculus as depicted in a 19th-century fresco
Another Christian theologian who lived in Alexandria around AD200 called Titus Flavius Clemens claimed that the Early Dynastic Egyptian priests possesed a series of 42 sacred books with them, which they believed that they were written and handed to them by the great god, Thoth (Djehouty) which was later on incorporated into the Greek god Hermes as Hermes Trismegistos (thrice great),then the sacred books was called the "Hermetic Collection.", thus Six of the Hermetic books were supposed to have been devoted to medicine. These books covered the disciplines of Theology, Astrology and Medicine. He mentioned that six of these books contained information concerning
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medicine divided into the following titles: - Constitution of the human body - The diseases - The organs - The medicines - Eye diseases - Women diseases of (Gadalla 1999:305). Unfortunately the original books has never been found although Georg Ebers believed that the papyrus he discovered and named after him was the fourth medical book of the sacred Thoth (Hermetic) Collection.
Clement of Alexandria, from book 1, folio 5 recto of Les vrais pourtraits et vies des hommes illustres grecz, latins et payens (1584) by André Thevet
Also Pliny (XIX, 5) mentioned that the Egyptian physicians examined the bodies after death, to ascertain the nature and of the diseases that caused their death.
Pliny the Elder, as imagined by a 19th-century artist (23- 79 AD).
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In 1822 J.-F. Champollion deciphered the Hieroglyphic language symbols of the Rosetta Stone which made the Egyptian Medical documents as well as other texts easy to understand by its translation knowing its content, thus the German scientist Brugsch began the translation of the medical texts in 1853, followed by others discovering, unveiling and demonstrating the importance of medicine and medical sciences in Ancient Egypt as well as its advanced level.
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offering them their needs of medical treatments and herbs. From the primary sources (mummies& human remains) it is proven that Ancient Egyptians were advanced in their knowledge of the human body, as they did not only mummify bodies but they also had good understanding of internal organs, anatomy and were able to study the body systems, thus the first pharaoh believed to have written a paper on human anatomy was Vizier Imhotep Greek Imouthes- (born in Memphis during the 27th century B.C ) who was a famous doctor, chief minister, vizier, sage, astrologer and architect known for building the famous step pyramid for the Pharaoh Djoser and was honored to be the god of medicine by both Egyptians and Greeks.
Jean-François Champollion, by Léon Cogniet 1790- 1832
Although therapeutic options were limited in ancient Egypt, the texts in various medical papyri confirms and proves that ancient Egyptian physicians practiced medicine and medical care in an extremely caring, passionate and supportive manners towards their patients, thus patients were not mistreated and their pain, complaints and feelings were not neglected as well as their disorders were not to be ridiculed, making sure that dying patients should to be treated with great compassion and care, Thus their ultimate advice, recommendation, reprimand and warning was decisive, quintessential and insightful, repetition: "Do not abandon him", it is also important to know that physicians (priests) used to visit the patients and disease victims as part of their duty, following up their situation, reading sacred incantations and
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Symbol of physician (swnw)
Symbol of male doctor symbol of female doctor (adapted from Nunn 1996:115).
Early medicine in Egypt was practiced by chief magician and healers who also served as priests at the temples and the two most famous temples associated with healing and curing of various body ailments were Imhotep’s Chapel at Saqqara and Temple of Deir el Bahri.
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Saqqara-StepPyramidComplex
Vizier Imhotep Oganization of the Medical Corps by Venice I Attia (After Ghalioungui P)
Relief of a Doctor
Peseshet first known female physician
One of the important proofs of the advanced level of Egyptian medicine is the domestic medicine chest found in the Pharaoh Mentuhotep wife tomb (eleventh dynasty, 2500 B. C) containing six cases, one of alabaster and five of serpentine, containing dried remnants of drugs, two spoons, a piece of linen cloth and some roots, enclosed in a basket made of straw.
“Overseer of the female physicians”
Knowing that the highest level a healer could reach in Ancient Egypt was known as Wabau where the Wabau is the healer specialized in curing, treatment and healing of specific areas or parts of the human body.
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Stone case in which medicine chest was found in queens tomb
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Cosmetic box of queen Mentuhotep, from Abu el-Naga' Burial Sixteenth Dynasty of Egypt, Berlin, Neues Museum.
Egyptians used a combination of scientific, superstition and magic based cures, for example for treatment of skin injuries, including fall and cut, they used splints and bandages but for diseases, where the diagnosis was uncertain, they believed the gods were the cause of the illness, also magic based cures were used to treat and combat unexplained and unknown causes and reasons of illnesses, they also believed that demons caused other ailments that afflicts their bodies and in such cases patients were given concoctions (remedies) that helps to drive the demons away, such remedies contained various animals blood, fats mixed with ground up horns, bones and hoofs all dissolved in water, milk, wine or beer and sweetened with honey, it is also important to know that there were five methods of patients medicine administration: oral, rectal, vaginal ( females), external application and fumigation, taking in consideration that Egyptian physicians were trained to diagnose various diseases and ailments through information taken from the patient, accompanied with examination that included probing of wounds by fingers, investigation of the sputum, urine, feces, and other body secretions and emanations and as they recognized the pulse they carefully checked it in various body parts, thus the medical
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papyri written by master physicians and expertise healers explaining many wise , smart observations helped practitioners to make their decisions and their curing remedies concerning various body ailments announcing their decision concerning the patient according to the diagnosis which was one of three announcements: 1. I can treat this condition 2. I can contend with this condition 3. I can do nothing for this condition Ancient Egyptians also had great idea of remedies for treatments of diseases, thus senatorial treatment was well known as a treatment various diseases, knowing that the sanatorium was a building where patients were quarantined and partially or completely immersed in healing holy water where certain basins were supplied with water from the sacred lake, which in some cases were planed curatively by allowing the water to flow over healing statues of various deties and certain texts, thus the effect of the sacred water was also obtained by drinking it (Dunn 1997).
The first sanatorium in the world Deir el-Bahri
Certain temples were dedicated as quarantine, incubation or temple sleep, where the patients were allowed to live in the temple hoping of receiving cure from deities (Quirke 1992), thus senatorial treatment was practiced in the great temples such as Hathor and Dendera temples. 2017
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Edwin Smith Papyrus General view of Dendera Temple complex
Hathor temple
From mediated sources (depictions and manuscripts), thus the only avai lable written sources are the medical papyri , most of which are written in priests Hieratic writing such as the Ebers Papyrus, Edwin Smith Surgical Papyrus, Kahun papyrus, Herst papyrus, ….etc., depections are clearly depected in the ceiling of the hypostyle room of the temple of Denderah, which provide some details with respect to the knowledge of Egypt ian physicians, as well as in some mural paintings.
Ebers Papyrus
Edwin Smith (1822-1906) Plates vi & vii
George Ebers (1837-1898)
A range of diseases were known from ancient Egypt taking in consideration that some diseases leave no trace even in wellpreserved bodies, and thanks to modern science which helped in analyzing Egyptian mummies by endoscopes, science of DNA, X-rays, autopsies and extracting tissues revealing different diseases that ancient Egyptians suffered from such as tuberculosis, Chlamydia trachomatis, arthritis, bronchitis, genital herpes, , gonorrhea, pneumonia; parasites such as malaria, tapeworm, cystercercosis, trichinella spiralis, skin diseases, haemorrhoids, artificial calcification, Malaria etc.
Kahun Gynaecological Papyrus Flinders Petrie1903- 1942 (Petrie Medical Papyrus, UC32057) pages1,2 CT scanning of an Egyptian mummy
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probable case of tuberculosis in ancient times was detected in a human remains of a Neolithic skeleton discovered near Heidelberg in Germany.
Excellent preservation of tissue structures in skin from an Egyptian mummy (MSB staining).
Mycobacterium tuberculosis showing serpentine cords (Ziehl Neelsen stain. (After Meylan, 1993)
Ancient Egyptian skin, Nerve tissue rehydrated
Some recorded diseases: Tuberculosis – Poliomyelitis (polio) Malaria - Smallpox- Bilharzia (schistosomiasis)- Heart diseases- Cancer tumors- Kidney stones and other diseases are believed to be some of the fetal diseases that agonized Ancient Egyptian population.
Tuberculosis: Tuberculosis (TB)was and is still a major predator of humankind, causing many deaths, it is caused by Mycobacterium tuberculosis which is a kind of a rodshaped bacterium species most probably older than the human race age, different species of the genus Mycobacterium causes disease in mammals, birds, reptiles and fish ¹. Tuberculosis in human race and other animals may have been caused by Mycobacterium ancestor many years ago, it is an infectious disease that basically affects the lungs (pulmonary TB), thus other parts of the body may be effected also, the earliest reported
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Tuberculosis (TB) is an airborne highly infectious transmittable disease spreading when infected individuals cough, spit and sneeze, caused by a species of bacillus bacteria called mycobacterium tuberculosis, it is diagnosed through chronic cough with 'blood-tinged sputum', weight loss and fever. Tuberculosis primary effect and damage is on the lungs (pulmonary) and may involve effects on other parts of the body (extra pulmonary), for example Potts disease develop due to tuberculosis, causing the vertebral column to become soft and collapse eventually leading to excessive curvature in the sagittal plane (Kyphosis), and in some cases, there is excessive curvature in a lateral direction, a condition known as Scoliosis. Tuberculosis disease existed thousands of years ago in Egypt and Nubia and it was discovered through the study, investigation and use of modern scientific techniques and medical instruments applied on mummies, human remains and skeletal material, thus analysis of ancient DNA extracted from mummies, skeletons and human remains provided a lot of 2017
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information about diseases in ancient Egypt, also there is a lot of evidence has been offered through the molecular examination and amplification of mycobacterial DNA which contributed to the elucidation, verification, classification and definition of TB as well as other diseases in ancient Egypt.
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similar complications, that is why representations of humped-back statues, carvings and wall painting found in various tombs are difficult to distinguish between Pott's disease and other diseases with similar deformities and symptoms. Ruffer (1910) reported the presence of tuberculosis of the spine in Nesparehan, a priest of Amun of the 21st Dynasty, as it shows the typical features of Pott's disease with collapse of thoracic vertebra, producing the angular kyphosis (humpback).
Cultured bacterial colonies
Hump back and chest deformation due to Pott's disease Mycobacterium tuberculosis under scanning electron Mag 15549X. CDC.
Ancient Egyptians most probably got tuberculosis bacillus bacterium from close contact with livestock existed after the Neolithic revolution, around 3300 B.C, the earliest cases detected of spinal tuberculosis returns back to the pre dynastic era and was found at Adaima south Esna through excavations. Spinal tuberculosis (Pott's disease) is abundantly found in an archaeological context, but pulmonary tuberculosis is less detected, as the bacilli bacterium (mycobacterium tuberculosis) causing the disease disappears directly after death, thus the discovery of lung collapse and or pleuritic adhesions found in some mummies proved its existence, despite of confusion where other conditions cause
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(Old kingdom statue in Cairo Museum)
A gardener with a spine appears to have Pott's disease irrigating a garden with a "shadouf". scene from the tomb of Ipwy, 19th dynasty, Deir el-Medinah
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Eviscerated cadaver shows marked scoliosis
There are several cases of TB in ancient Egypt from several dynasties, the most famous case of ancient Egyptian TB is the case of the mummy of lady Irtyersenu, who died in Thebes around 600 BC, aged about 50 Known as (Dr Granville’s mummy) which was the first mummy to be subjected to a scientific autopsy, and Dr Granville concluded that she died of ovarian cancer, but recently Dr Donoghue and colleagues from the University of Birmingham, UK, combined DNA amplification with a recently developed technique to search for a short repetitive section of DNA from Mycobacterium tuberculosis, they identified the organism in tissue from the lungs, bone and gall bladder of the mummy of Irtyersenu, they also found biomarkers specific to the cell wall of the mycobacterium tuberculosis in the lungs and bones, these results proved that that TB infection had spread from her lungs to the rest of her body causing death (disseminated TB).
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A documented death case due to TB infection is an Egyptian mummy of an infant found in the tomb of Nebuenenef (TT 157) . Zimmerman, 1979: 604-608. A case of skeletal tuberculosis, from the 21st dynasty is of the mummy of a 25 to 30-year-old Egyptian priest of Amun called Nespaheran found near Thebes. A mummy of a girl of a 4- 6 year old from the Ptolemaic period, in the Bolton Museum, appears to have suffered from Pott's disease.
Nespaheran, a priest of Amun from the 21st dynasty. The side view shows marked kyphosis of the spine.
Case TT183-8. The mummy of a newborn male child without any sign of evisceration. After careful opening of the chest wall, fine Pleural adhesions of the lung indicated a tuberculosis infection.
Dr Granville’s mummy The Trustees of the British Museum
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Opened thorax of an Egyptian mummy showing adhesions of right lung and destruction of lumbar vertebral bones L4 and L5
Despite the fact that tuberculosis existed no doubtly in ancient Egypt, many authors (Ortner and Putschar 1981; Steinbock 1976) believe that nothing in the medical papyri can be directly related to the disease, as the medical papyri do not contain any direct or clear descriptions of tuberculosis but other authors referred to TB and believed to have been mentioned in the Ebers Papyrus (Ebbell 1937) and Kamal 1964) and they mentioned that there is a description of two cases with tuberculosis of the cervical lymph nodes and the text is translated as follows: 1- The first case is described in section 860, column 195 (if you examine a man having an enlarged cystic node in his neck, and you find it like the thymus(?) gland because of its softness at palpation and its white discharge ... (empty space), you shall then say concerning him he has enlargement of the cystic node in his neck,( Diagnosis) an ailment I will treat by surgery to protect the vessels, you shall prepare medicines to treat him by a bandage that makes the cyst open through the skin: acacia seyal, pea, fruit, animal blood, insect's blood, honey, common salt (and other things), grind, mix together and bandage (Treatment).
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2-The second case is described in section 861 information about enlarged infected node in the neck of a man, if you examine an enlarged infected node in the neck of a man, after it is enlarged and removed the skin that covered it, and caused suppurating granulation for many years and months, it discharges a secretion like the seminal fluid of synodontis (a type of fish) (Examination), you shall then say concerning him he has an enlarged infected node. An ailment I will treat (Diagnosis), you shall prepare the medicines for him: wax or fat, As(?), ink, salt, goose fat, fruit(?) galena, Heat and bandage the neck (Treatment), the following image is the description of a chronic tuberculous node in the neck inscribed Part of paragraph861 of Ebers papyrus. Translated to Arabic by Kamal (1964) curtsy of Tuberculosis in Ancient Egypt by SALEH A. BEDEIR
Part of paragraph861 of Ebers papyrus, describing a chronic tuberculous node in the neck. Arabic translation by Ahmad Kamal bey (1964) curtsy of Tuberculosis in Ancient Egypt by SALEH A. BEDEIR
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Pott's disease is well presented in ancient Egyptian art especially clay statuettes of men depicted with humped spines that suggests tuberculosis, dating to the Presynaptic period, as well as other representations of humped-back servants in the tomb chapels.
Poliovirus
TEM micrograph of poliovirus
Egyptian statuettes of a humped back man
Poliomyelitis (polio): Called polio, infantile paralysis, is an infectious disease caused by poliovirus (PV), genus Enterovirus, which is a group of RNA virusesthat colonizes the gastrointestinal tract, oropharynx and the intestine, its incubation time ranges from three to 35 days, its structure is very simple, composed of a single (+) sense RNA genome enclosed in a protein shell called a capsid which over few hours to few days results in muscle weakness and inability to move as the viral infection damages central nervous system resulting in muscular weakness and acute flaccid of the anterior horn cells of the spinal cord resulting in paralysis, thus the presence of poliomyelitis virus can only be detected in those who survive its acute stage, the disease spreads from person to person, and is transferred through food, water and human waste.
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Poliovirus bound to a neuron receptor Illustration courtesy of Link Studio
A blockage of the lumbar anterior spinal cord artery due to polio
Polio existed in ancient Egypt where paintings and carvings depicted people with withered limbs, and children walking with canes. Mitchell (Sandison 1980:32) noted the shortening of the left leg, which he interpreted as poliomyelitis, in the early Egyptian mummy from Deshasheh, the club foot of the Pharaoh Siptah (1205– 1187 BCE, Cairo, National Museum CG 61080) mummy which shows a severely deformed Pes equinovarus-like left foot and a shortened left leg, thus the mummy 2017
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of Siptah was unwrapped by Grafton Elliot Smith on August 29th, 1905.
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Carlsberg Museum ÆIN 0134) is the first representations of a polio victim.
The mummy of pharaoh Siptah showing a deformity of the left leg and foot. (1194–1188 BCE) shows a clear deformity of the left leg and foot due to either poliomyelitis, clubfoot deformity Cairo Museum, Cairo.
Another situation also encountered with clearl deformity and propable polio is the clubfoot of Khnum-Nekht (ca. 2500 BCE, Manchester Museum, Inv. No.21471) which may be diagnosed as evidence of neuromuscular disease suggestive of poliomyelitis infection or congenital malformations or produced modifications due to mummification procesdure.
The Doorkeeper Roma with his wife and child (1550–1080 BCE). Courtesy of New Carlsberg Glyptotek, Copenhagen
As well as The famous Berlin relief in (Egyptian Museum Inventory 15000) shows a late Amarna royal couple (ca. thirteenth century BCE) , thus the king is depected as polio victim with a shortened leg using a cane.
Margaret Murray, third from left, and team after unwrapping Khnum-Nakht
Also the ca. 1500 BCE stele of a priest called Ruma who had a shorter leg and holding a stick as a self support (Copenhagen, Ny
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A relief of a royal couple in the Amarna-period style; figures may be Akhenaten and Nefertiti, Smenkhkare and Meritaten, or Tutankhamen and Ankhesenamun; Egyptian Museum of Berlin
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Malaria Malaria is a disease caused by parasites of the genus Plasmodium (a single-celled parasite known as a sporozoa), the infection is transmitted to humans through the bites of mosquitoes of the genus Anopheles which is responsible alone of spreading malaria in nature Anopheles mosquito life cycle , causing malaria epidemic
Anopheles mosquito
Egyptian texts dating from 3,500 to 4,000 years ago refer to fevers and splenomegaly, suggestive of malaria and the disease was attributed to the swamps.
Plasmodium falciparum
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Malaria was an endemic disease in ancient Egypt and investigations of Egyptian mummies proved the presence of malaria (Miller et al., 1994; Nerlich et al., 2008), mummies belonging to the Anthropological and Ethnographic Museum of Turin, Italy dated to 3200 B.C. (from Gebelen, near Assiut, Middle Egypt) has been examined and the results confirmed the presence of malaria antigens using an immune enzymatic assay (Para Sight™ -F test). There are several remedies against mosquitoes that are mentioned in the Ebers Papyrus such as : Fresh palm wine, Protection by planting acacia tree, and house Fumigation with incense and myrrh, as well as traditional herbal remedies was used to treat malaria, thus Herodotus(484–425 B.C.) mentioned that the pyramid builders were given large amount of garlic as a protection against malaria for being known as an insect repellent(Katz et al., 2008). According to Herodotus the ancient Egyptians invented the mosquito net, and it is said that King Sneferu, from the fourth dynasty of (2613 -2589 B.C),and Cleopatra VII(69–30 B.C.), used to sleep under nets hanged covering their beds as a kind of protection against insects including mosquitoes causing malaria for sure. 2017
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laboratory with the most stringent biosafety level.
Cleopatra relief at Kom Ombo
variola virus
It is a contagious disease thad spread through contact withthose who suffere from the disease or their dead bodies, and its symptoms appear on skin an the form of lesions.
Statue of King Snefru
Smallpox lesions on human hand
Smallpox Smallpox is a is an acute contagious disease infects humans only and is caused by variola virus (a doublestranded DNA virus and a member of the Poxviridae family) which is clinically identified and detected for diagnostic purposes using capabilities Electron microscope, DNA polymerase chain reaction (PCR), and isolation of the virus from a clinical specimen in a
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The first smallpox epidemic recorded was in 1350BC (era of Egyptian-Hittite war), thus the mummy of Ramses v, as well as other mummies from the 18-20th dynasties (1570-1085 BC) shows evidence of typical smallpox scars on their faces.
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Planorbis snail
Mummy of Ramses v
Schistosomiasis (bilharziasis) Schistosomiasis sometimes referred to as bilharzias, bilharziasis, or snail fever is a parasitic disease caused by flukes (trematodes) flatworms of the genus Schistosoma that lives in fresh water snail species called Bulinus, of the three main species of the platyhelminth worm Schistosoma, the most abundant spieces in Egypt are Schistosoma mansoni and S. haematobium.
Male & female Schistosoma
There is a complex life cycle alternating between the two hosts of bilharzia, the humans and the fresh water snail of the genus Bulinus.
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The infection happens to humans who come into contact with the free swimming worm which the snail releases in the water, then the worm penetrates the intact skin and passes to the veins of the human host. The main symptom of the presence of the parasite is haematuria which results in serious anemia, loss of appetite, urinary infection, and loss of resistance to other diseases, thus some complications of schistosomiasis include the following: Gastrointestinal bleeding, Malnutrition, GI obstruction, renal failure, Sepsis, Schistosomal nephropathy, Infertility, Pyelonephritis, Hematuria, hypertension, Hemospermia, Severe anemia, squamous cell bladder cancer, Low ̶ birth-weight babies, Spontaneous abortion, Pregnancy complications, higher risk for pregnancies, Carcinoma of the liver, bladder, or gallbladder, there may also be interference with liver functions. Dr. Theodor Bilharz discovered the schistosome parasites in humans in 1851 in Cairo and Dr. Robert T. Leiper presented the demonstration of their life cycle in Egypt in 1915. The earliest case of human schistosomiasis (S. haematobium) identified using immunodiagnosis (ELISA) was discovered in an Egyptian adolescent over 5,000 years ago (Deelder et al. 1990, ELISA also revealed S. haematobium in two mummies 2017
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3,000 and 4,000 years old (Contis and David 1996 and they were diagnosed by Ruffer (l910) and dated to the Twentieth Dynasty (1250-1000 BC). Ova of this parasite and of tapeworm were found radiologically in the naturally preserved (by desiccation) body of a 14 year old boy of similar archeological age who was a weaver by trade and had liver cirrhosis, a common symptom of chronic schistosomiasis (Lewin 1978). Calcified schistosome ova were identified radiologically in several mummies from later periods by the Manchester Mummy Project (Contis and David 1996). One of the finest archaeological examples for the existence of schistosomiasis in ancient Egypt was the discovery of calcified ova in the unembalmed 21st Dynasty mummy of Nakht. Upon medical examination, the mummy not only exhibited a preserved tapeworm, but also ova of the Schistosoma haematobium and displayed changes in the liver resulting from a schistosomal infection. (Millat et al. 1980:79)
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Schistosoma parasite eggs in human bladder tissue
Schistosoma japonicum eggs in hepatic portal tract.
Swamps in ancient egypt
Egg of Schistosoma hematobium, with its typical terminal spine.
Life cycle of Schistosoma
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