Warts and the kings of Parthia: An ancient representation of hereditary neurofibromatosis depicted in coins

Department of Medicine, University of Queensland, Brisbane, Australia
drtodman AT optusnet.com.au

This study of the portraiture on coins of Parthian Kings demonstrates the feature of a nodule or wart on several monarchs. Evidence will be presented that these lesions may represent the cutaneous tumours of hereditary Neurofibromatosis. Examples of coins from several monarchs will be illustrated in this paper as well as coins of Phraates IV for examination.

The Parthians were a nomadic people originally from central Asia who moved into the region of Persia (Iran) in the 3rd century BC and established an eastern superpower that rivalled Rome's hegemony in the west. Parthian coins depict what has been described as a wart on the face of the king. The wart is first seen in the image of Orodes II (57-38BC) though an earlier coin of Mithradates II (123-88BC) shows a nodule below the left eye. The wart is shown on the foreheads of succeeding kings including Phraates IV (38-2BC), the son of Orodes II. They appear on the faces of many but not all of the subsequent kings up to Vologases I (51-78AD) and Vardases II (55-58AD).

The nodules do not appear on all the coins of a particular monarch though they were evident in different parts of the face suggesting a notable facial characteristic. It is unlikely that they were purely symbolic. The familial occurrence in successive generations suggests a hereditary condition. Such rounded nodules are of a size and shape which resemble hereditary Neurofibromatosis type 1(NF-1, von Recklinghausen's Disease). Multiple cutaneous and subcutaneous tumours are the principal feature of this disease. The cutaneous lesions are situated in the dermis and form discrete nodules ranging in size from a few millimetres to a centimetre or more (molluscum fibrosum). The disfiguring lesions may number in the hundreds and  being visible at a distance would constitute an identifying characteristic on coin portraiture.

Poster Session
Saturday, 24 June 2006, 11.00 am - 12.30 pm

11th Annual Meeting of the International Society for the History of the Neurosciences (ISHN)

Pavia, Italy, 2006