King Ariarathes IV of Cappadocia: coins reveal enlarged thyroid (188 BC)

King Ariarathes IV Eusebes (“The Pious”) ruled Cappadocia, a province of central Asia Minor (modern Turkey), between 220 and 163 BC. He supported his father-in-law Antiochus III, the King of Syria, in his war against the Romans. However, after the battle of Magnesia in 189 BC, he became an ally of the Romans. Ariarathes IV also moved the capital of his kingdom to Mazaca (modern-day Kayseri), founded on the outskirts of Mount Erciyes, a snow-capped volcano with an altitude of around 4,000 m. On the obverse of the coins struck in Mazaca in the 33rd regnal year of Ariarathes IV, his diademed head with enlarged thyroid is represented. The reverse features his name (ΒΑΣΙΛΕΩΣ APIAPAΘOY EYΣEBOYΣ) together with monograms and Athena holding Nike in her right hand. This might be one of the earliest artistic representations of goiter, presumably associated with endemic iodine deficiency which is especially common in mountainous area.