17 FAVISM - FROM THE AVOID FAVA BEANS OF PYTHAGORAS TO THE PRESENT Haema 2004; 7(1): 17-21 Historical review Favism - from the avoid fava beans of Pythagoras to the present John Meletis, Kostas Konstantopoulos National and Kapodistrian University of Athens, School of Medicine, First Department of Internal Medicine, Laiko General Hospital, Athens, Greece Key words: Favism  G6PD deficiency * Correspondence: John Meletis, MD, National and Kapodistrian University of Athens, School of Medicine, First Department of Internal Medicine, Laiko General Hospital, Athens, Greece, Tel.:+30210.7771161, Fax:+30210.7788830, e-mail: imeletis@cc.uoa.gr êõÜìùí áðÝ÷åóèå, kyamon apechesthe be far from the fava beans consumption (Part of Pythagorean consultations) Favism [fabismus, kyamismos (Greece) favismo, fabism] is a reaction to ingested fava plant; beans, pods and, most likely, foliage as well, or to inhalation of fava pollen. It is a hereditary abnormality of the red cell enzyme glucose-6-phosphate dehydrogenase (G6PD), resulting to its sudden destruction (haemolytic anaemia and jaundice) following intake of fava beans, other legumes or various drugs. Favism is common in Mediterranean, Africa and Southern Asia. More than 400 genetic variants are recognized. Fava beans intake originated in the Near East in late Neolithic times; they were afterwards cultivated in ancient Egypt, Greece and Rome. Fava beans are mentioned several times by Homer (8 th to 9 th BC). Greeks apparently associated the little black spot on the hilum with death and although the beans were sometimes offered in sacrifices to Apollo, it was for- bidden to priests to eat or even mention their name. Unlike Egyptians and Greeks, the Romans highly re- spected fava beans among legumes. The beans Pythag- oras is referring to are fava beans (vicia fava, Vica faba vulgaris), which botanically are a large seeded vetch. They are well-adapted to the Mediterranean area because of being very hardy to cold. They grow vigorously during the cool wet months of winter, and they constitute for centuries unique and invaluable part of diet in Mediterranean people. Their history is rife with superstition, prohibition, magic and fear. It is well known that for some people, fresh fava beans can be poisonous. Although common, favism as a genetically transmitted disease was recognized only at the turn of this century. The mechanism was ex- plained only in the last decades. Classic Greece doctors had seen through the im- portance of environment, natural elements and ali- ments for the right balance of organism. Haemolysis due to lack of the enzyme G6PD of red cells was known for many years. It is called favism meaning occur- rence after consumption of fava beans (Greek word êýáìïé, kyamoi, êõáìéóìüò, kyamismos - favis- mus). The observation that the consumption of fava beans causes various disturbances was the first obser- vation of toxic haemolytic anaemia and the rule êõÜìùí áðÝ÷åóèáé, kyamon apechehesthe - be far from the fava beans consumption was a Pythagore- an consultation. This rule constricts a legume that is named Greek fava bean (kyamos Hellenikos, vicia fava, Vica faba) that is cultivated and used in the Medi-