My fascination with Hindu mythology dates back to my early childhood. Evenings then were generally dull, as we had no television in those days. One evening, however, I found one of my grandaunts telling stories from Hindu mythology to her grandchildren, and I was entranced.
By the age of 6, I knew the whole of Bhagavatha, which is the story of Krishna, an incarnation of the Hindu god Vishnu. When I was 7 years old my dad bought me an abridged version of Mahabharatha, one of the greatest epics of Hindu mythology. I read the whole book in a few days. I was intrigued and enchanted by all the stories in it, but one stood out in particular.
It is the story of a fisherman's daughter. She was very beautiful, but unfortunately she smelt of fish. One day a sage came along and fell in love with her. During their short lived affair the sage blessed her, which made her odour-free.
Years later, while reading Nelson's textbook of paediatrics, I came across the condition called trimethylaminuria. This condition is caused by a deficiency of the liver enzyme trimethylamine oxidase. Trimethylamine is formed in the intestine from choline in eggs, liver, and nuts, and trimethylamine oxide in fish. The enzyme converts the trimethylamine thus formed to its oxide, which is odourless. In the absence of the enzyme trimethylamine accumulates in the body and is excreted in the urine, and people with this condition smell of rotten fish. Treatment is simple dietary advice to avoid all foods that are a source trimethylamine. Obviously, our sage in the story knew the condition and its treatment.
I had never before looked at the Hindu myths with a medical eye. They were just flights of imagination, not true life stories. However, I now tried to make some sense out of them from a medical viewpoint. I found many other examples in Mahabharatha, such as infertility treatment, test tube babies, intrauterine surgery, and even neonatal resuscitation, but the story of the girl with trimethylaminuria remains my favourite.