To the Editor: Although evidence for symptoms of posttraumatic stress disorder (PTSD) in antiquity is scarce, I discuss evidence of trauma 4,000 years ago that has medical significance since it is, to my knowledge, the first description of PTSD symptoms in recorded history. This evidence extends the period of known PTSD symptoms from 350 years to 4,000 years ago (1).
Between 2027 and 2003 B.C., during the third dynasty of Ur, under the regime of King Ibisin, the Elamites from the east and the Sumerians from the west attacked the city of Ur and destroyed it (2). Reactions to the raid, plunder, slaughter, and the actual attack were recorded in cuneiform writing. The following verses describe psychiatric symptoms that resemble those of PTSD as presented in DSM-IV:
The Sumerians and the Elamites, the destroyers, made of it thirty shekels.
The righteous house they break up with pickaxe; the people groan.
The city they make into ruins; the people groan.
Its lady cries: "Alas for my city," cries: "alas for my house." (2, verses 242–245)
In its lofty gates, where they were wont to promenade, dead bodies were lying about;
In its boulevards, where the feasts were celebrated, scattered they lay.
In all its streets, where they were wont to promenade, dead bodies were lying about;
In its places, where the festivities of the land took place, the people lay in heaps. (2, verses 214–217)
At night a bitter lament having been raised unto me,
I, although, for that night I tremble,
Fled not before that night’s violence.
The storm’s cyclone like destruction—verily its terror has filled me full.
Because of its [affliction] in my nightly sleeping place,
In my nightly sleeping place verily there is no peace for me. (2, verses 95–99)
These verses describe documented exposure to the atrocities of war followed by the appearance of psychiatric symptoms 4,000 years ago. This evidence gives us the first glimpse of traumatic reactions in antiquity. These verses were written after exposure to a traumatic event, which was followed by characteristic symptoms, such as sleep disturbances, one of the most common PTSD symptoms (DSM-IV).