The biblical story of Hannah, the mother of the prophet Samuel, may describe the first documented case of anorexia nervosa and its associated infertility. In an article in the January issue of Fertility and Sterility, Isaac Schiff, MD, chief of the Vincent Memorial Obstetrics and Gynecology Service at Massachusetts General Hospital (MGH), recounts the story of Hannah and notes how the writer mentioned several times that Hannah was so unhappy at her inability to conceive that she did not eat. After praying at the Temple of Shiloh and receiving reassurance from the High Priest, Hannah regained her spirits and resumed eating. Within a few months, Hannah conceived the son she had prayed for.
Schiff explains that his rabbi had asked him to give a talk on the story, which appears in the first book of Samuel. "When I read the account carefully and noticed how many times the writer noted that Hannah did not eat, it suddenly occurred to me that she probably had anorexia," he says. Schiff co-wrote the article, entitled "The biblical diagnostician and the anorexic bride," with his brother, Morty Schiff, a professor of Creative Writing at the College of Staten Island of the City University of New York.
The story tells of Hannah, one of two wives of Elkanah. The other wife, Penninah, had several children and constantly tormented Hannah because of her childlessness. Even when her husband reassured her that he loved her best, Hannah continued to "weep and not eat." During an annual visit to the temple in Shiloh, Hannah was so distressed that she approached the temple in tears, praying for a son and promising to dedicate him to God's service. The High Priest Eli, seeing her apparently talking to herself, at first thought her unusual behavior was caused by drunkenness and scolded her for her unseemly actions:
"Not so, my lord, Hannah replied. I am a woman distressed in spirit; I have had neither wine nor beer, but have been pouring out my soul before the Eternal. Do not take your servant for a wicked woman. All this time I have been speaking out of my abundant sorrow and torment. Then Eli replied: Go in peace; and may the God of Israel grant your request. May your maidservant find favor in your sight, she said. So the woman went on her way. She ate and was downcast no longer." (1 Samuel 1: 15-18).
The story goes on to tell how Hannah conceived and gave birth to Samuel and brought him back to Shiloh when he was weaned, giving him over to the service of God in gratitude for the granting of her request.
"This story has a lot to tell us about things that are still very true today," Schiff says. "It very explicitly describes the pain of infertility and how truly unhappy Hannah was, in spite of her husband's love. It also reflects the patriarchal nature of the society both in the importance of bearing a son and in how the burden of infertility fell most heavily on the woman, something we now know is unjustified.
"We also see that anorexia -- which we think of as a very contemporary problem -- might have existed 2,500 years ago," he adds. "While Hannah apparently had trouble conceiving even before she became so depressed, the many times that the biblical writer mentions that she did not eat suggests that it was a remarkable problem. Since we now know that extreme weight loss causes infertility, it is logical to conclude that anorexia either caused or contributed to Hannah's inability to conceive."
Schiff adds that the reassurance Hannah received from Eli and perhaps from her own prayers could be regarded as a form of therapy that helped her recover from her anorexia and eventually conceive her much-desired son. "In a mere 28 verses the very perceptive biblical writer has included enough detail for us to diagnose Hannah's problem 25 centuries later," he says.
Journal
Fertility and Sterility