The first case of pagophagia: the Byzantine Emperor Theophilus.

The Byzantine Emperor Theophilus (829-842 AD) died from dysentery, the exact nature of which is unknown. However, based on the original Greek texts of the Byzantine historians and chroniclers of that era, the possible cause of death may be connected to Theophilus' pagophagia (snow eating), in order to relieve the symptoms of gastric inflammation. Additionally to the symptoms from the gastro-intestinal system, the Emperor seemed suffering from depress after the defeat of his army and the loss of territories, among whom his native town, Amorion. The current study supports the theoretical possibility that the case of pagophagia in the 9th century AD, so well described by a great number of historians because of the sufferer's royal identity, extends in the past the knowledge on pica, still attracting the medical interest.