text:
Hezekiah

Hezekiah, or Ezekias (born c. 741 BCE, sole ruler c. 716/15–687/86), was the son of Ahaz and the 13th king of Judah according to the Hebrew Bible.

In the Biblical narrative, Hezekiah witnessed the destruction of the northern Kingdom of Israel by the Neo-Assyrian Empire under Sargon in c. 722 BCE and was king of Judah during the Assyrian siege of Jerusalem by Sennacherib in 701 BCE.

Hezekiah enacted sweeping religious reforms, including a strict mandate for the sole worship of Yahweh and a prohibition on venerating other deities within the First Temple. He is considered a very righteous king in both the Second Book of Kings and the Second Book of Chronicles. He is also one of the more prominent kings of Judah mentioned in the Bible and is one of the kings mentioned in the genealogy of Jesus in the Gospel of Matthew. "No king of Judah, among either his predecessors or his successors, could [...] be compared to him", according to 2 Kings 18:5. Isaiah and Micah prophesied during his reign.

Etymology
The name Hezekiah means "Yahweh strengthens" in Hebrew. Alternately it may be translated as "Yahweh is my strength".

Biblical sources
The main biblical accounts of Hezekiah's reign are found in 2 Kings, Isaiah, and 2 Chronicles. Proverbs 25:1 commences a collection of Solomon's proverbs which were "copied by the officials of King Hezekiah of Judah". His reign is also referred to in the books of the prophets Jeremiah, Hosea, Micah, and Isaiah. The books of Hosea and Micah record that their prophecies were made during Hezekiah's reign. The book of Isaiah records when Hezekiah sought Isaiah's help when Judah was under siege by Sennacherib of the Neo-Assyrian Empire.

Dates
Based on Edwin R. Thiele's dating, Hezekiah was born in c. 741 BCE and died in c. 687 BCE at age 54. Thiele and William F. Albright calculated his regnal years arriving at figures very close to each other, c. 715/16 and 686/87 BCE. However, Robb Andrew Young dates his reign to 725–696 BCE and Gershon Galil to 726–697/6.

Family and life
Hezekiah was the son of king Ahaz and Abijah (also called Abi), daughter of the high priest Zechariah. Hezekiah married Hephzibah and died from natural causes at the age of 54 around 687 BCE and was succeeded by his son Manasseh.

Reign over Judah

According to the biblical narrative, Hezekiah assumed the throne of Judah at the age of 25 and reigned for 29 years. Some writers have proposed that Hezekiah served as coregent with his father Ahaz for about 14 years. His sole reign is dated by Albright as 715–687 BCE, and by Thiele as 716–687 BCE (the last ten years being a co-regency with his son Manasseh).

Restoration of the Temple
According to the Bible, Hezekiah purified and repaired the Temple, purged its idols, and reformed the priesthood. In an effort to abolish idolatry from his kingdom, he destroyed the high places (or bamot) and the "bronze serpent" (or Nehushtan), recorded as being made by Moses, which had become objects of idolatrous worship. In place of this, he centralized the worship of God at the Temple in Jerusalem. Hezekiah also defeated the Philistines, "as far as Gaza and its territory", and resumed the Passover pilgrimage and the tradition of inviting the scattered tribes of Israel to take part in a Passover festival.

2 Chronicles 30, but not the parallel account in 2 Kings, records that Hezekiah sent messengers to Ephraim and Manasseh inviting them to Jerusalem for the celebration of the Passover. The messengers were scorned, although a few men of the tribes of Asher, Manasseh and Zebulun "were humble enough to come" to the city. According to the biblical account, the Passover was celebrated with great solemnity and such rejoicing as had not been seen in Jerusalem since the days of Solomon. The celebration took place during the second month, Iyar, because not enough priests had consecrated themselves in the first month.

Biblical writer H. P. Mathys suggests that Hezekiah, being unable to restore the union of Judah and Israel by political means, used the invitation to the northern tribes as a final religious "attempt to restore the unity of the cult". He notes that this account "is often considered to contain historically reliable elements, especially since negative aspects are also reported on", although he questions the full extent to which it may be considered historically reliable.

Political moves and Assyrian invasion

After the death of Assyrian king Sargon II in 705 BCE, Sargon's son Sennacherib became king of Assyria. In 703 BCE, Sennacherib began a series of major campaigns to quash opposition to Assyrian rule, starting with cities in the eastern part of the realm. In 701 BCE, Sennacherib turned toward cities in the west. Hezekiah then had to face the invasion of Judah. According to the Bible, Hezekiah did not rely on Egypt for support, but relied on God and prayed to Him for deliverance of his capital city Jerusalem.

The Assyrians recorded that Sennacherib lifted his siege of Jerusalem after Hezekiah paid Sennacherib tribute. The Bible records that Hezekiah paid him three hundred talents of silver and thirty of gold as tribute, even sending the doors of the Temple in Jerusalem to produce the promised amount, but, even after the payment was made, Sennacherib renewed his assault on Jerusalem. Sennacherib surrounded the city and sent his Rabshakeh to the walls as a messenger. The Rabshakeh addressed the soldiers manning the city wall, asking them to distrust Yahweh and Hezekiah, claiming that Hezekiah's righteous reforms (destroying the idols and high places) were a sign that the people should not trust their god to be favorably disposed. 2 Kings records that Hezekiah went to the Temple and there he prayed to God.

Hezekiah's construction
Knowing that Jerusalem would eventually be subject to siege, Hezekiah had been preparing for some time by fortifying the walls of the capital, building towers, and constructing a tunnel to bring fresh water to the city from a spring outside its walls. He made at least two major preparations that would help Jerusalem to resist conquest: the construction of the Siloam Tunnel, and construction of the Broad Wall.

Sennacherib was intent on making war against Jerusalem. Therefore Hezekiah consulted with his officers about stopping the flow of the springs outside the city. Otherwise, they thought, the King of Assyria would come and find water in abundance.

The narratives of the Bible state that Sennacherib's army besieged Jerusalem.

Battle with Sennacherib's army

According to the biblical record, Sennacherib sent threatening letters warning Hezekiah that he had not desisted from his determination to take the Judean capital. Although they besieged Jerusalem, the biblical accounts state that the Assyrians did not so much as "shoot an arrow there, ... nor cast up a siege rampart against it", and that God sent out an angel who, in one night, struck down "a hundred and eighty-five thousand in the camp of the Assyrians," sending Sennacherib back "with shame of face to his own land".

Sennacherib's inscriptions make no mention of the disaster suffered by his forces. But, as Professor Jack Finegan comments: "In view of the general note of boasting which pervades the inscriptions of the Assyrian kings, ... it is hardly to be expected that Sennacherib would record such a defeat." The version of the matter that Sennacherib presents, as found inscribed on what is known as the Sennacherib Prism preserved in the University of Chicago Oriental Institute, in part says: "As to Hezekiah, the Jew, he did not submit to my yoke ... Hezekiah himself ... did send me, later, to Nineveh, my lordly city, together with 30 talents of gold, 800 talents of silver, ..."

This version inflates the number of silver talents sent from 300 to 800. In other regards, it confirms the biblical record and shows that Sennacherib made no claim that he captured Jerusalem. However, Sennacherib presents the matter of Hezekiah's paying tribute as having come after the Assyrian threat of a siege against Jerusalem, whereas the Bible states it was paid before.

Herodotus mentions the Assyrian army of Sennacherib being overrun by mice when attacking Egypt. Josephus gives a quote of Berossus that is quite close to the Biblical account.

Death of Sennacherib

Of Sennacherib's death, 2 Kings records:

"'It came about as he was worshiping in the house of Nisroch his god, that Adrammelech and Sharezer killed him [Sennacherib] with the sword; and they escaped into the land of Ararat. And Esarhaddon his son became king in his place.'"

According to Assyrian records, Sennacherib was assassinated in 681 BCE, twenty years after the 701 BCE invasion of Judah. A Neo-Babylonian letter corroborates with the biblical account, a sentiment from Sennacherib's sons to assassinate him, an event Assyriologists have reconstructed as historical. The son Arda-Mulissu, who is mentioned in the letter as killing anyone who would reveal his conspiracy, murdered his father in c. 681 BCE, and was most likely the Adrammelech in 2 Kings, though Sharezer is not known elsewhere.

Assyriologists posit the murder was motivated because Esarhaddon was chosen as heir to the throne instead of Arda-Mulissu, the next eldest son. Assyrian and Hebrew biblical history corroborate that Esarhaddon ultimately succeeded the throne. Other Assyriologists assert that Sennacherib was murdered in revenge for his destruction of Babylon, a city sacred to all Mesopotamians, including the Assyrians.

Hezekiah's illness and recovery

Later in his life, Hezekiah was ill with a boil or an inflammation. Isaiah told him that the Lord said he should put his house in order because he would die. But Hezekiah prayed, and Isaiah returned saying that the Lord had heard his prayer and he would recover. Hezekiah asked for a sign, and Isaiah asked him whether the shadow should go forward ten degrees or go back ten degrees. Hezekiah said it should go back, and the account states, "Isaiah the prophet cried unto the LORD: and he brought the shadow ten degrees backward, by which it had gone down in the dial of Ahaz." The narrative of his sickness and miraculous recovery is found in 2 Kings, 2 Chronicles and Isaiah.

Various ambassadors came to congratulate him on his recovery, among them from Merodach-baladan, son of the king of Babylon, "for he had heard that Hezekiah had been sick". Hezekiah, his vanity flattered by the visit, showed the Babylonian embassy all the wealth, arms and stores of Jerusalem, revealing too much information to Baladan, king of Babylon, or perhaps boasting about his wealth. He was then confronted by Isaiah, who foretold that a future generation of the people of Judah would be taken as captives to Babylon. Hezekiah was reassured that his own lifetime would see peace and security.

According to Isaiah, Hezekiah lived another 15 years after praying to God. His son and successor, Manasseh, was born during this time: he was 12 years of age when he succeeded Hezekiah.

According to the Talmud, the disease came about because of a dispute between him and Isaiah over who should pay whom a visit and over Hezekiah's refusal to marry and have children, although in the end he married Isaiah's daughter. Some Talmudists also considered that it might have come about as a way for Hezekiah to purge his sins or due to his arrogance in assuming his righteousness.

Extra-biblical records

Extra-biblical sources specify Hezekiah by name, along with his reign and influence. "Historiographically, his reign is noteworthy for the convergence of a variety of biblical sources and diverse extrabiblical evidence often bearing on the same events. Significant data concerning Hezekiah appear in the Deuteronomistic History, the Chronicler, Isaiah, Assyrian annals and reliefs, Israelite epigraphy, and, increasingly, stratigraphy". Archaeologist Amihai Mazar calls the tensions between Assyria and Judah "one of the best-documented events of the Iron Age" (172). Hezekiah's story is one of the best to cross-reference with the rest of the Mid Eastern world's historical documents.

Archaeological record

A lintel inscription, found over the doorway of a tomb, has been ascribed to his secretary, Shebnah.

Storage jars with the so-called "LMLK seal" may "demonstrate careful preparations to counter Sennacherib's likely route of invasion" and show "a notable degree of royal control of towns and cities which would facilitate Hezekiah's destruction of rural sacrificial sites and his centralization of worship in Jerusalem". Evidence suggests they were used throughout his 29-year reign.

There are some bullae from sealed documents that may have belonged to Hezekiah himself. In 2015, Eilat Mazar discovered a bulla that bears an inscription in ancient Hebrew script that translates as: "Belonging to Hezekiah [son of] Ahaz king of Judah." This is the first seal impression of an Israelite or Judean king to come to light in a scientific archaeological excavation. While another, unprovenanced bulla of King Hezekiah was known, this was the first time a seal impression of Hezekiah had been discovered in situ in the course of actual excavations.

Archaeological findings like the Hezekiah seal led scholars to surmise that the ancient Judahite kingdom had a highly developed administrative system. In 2018 Mazar published a report discussing the discovery of a bulla which she says may have to have belonged to Isaiah. She believes the fragment to have been part of a seal whose complete text might have read "Belonging to Isaiah the prophet." Several other biblical archaeologists, including George Washington University's Christopher Rollston have pointed to the bulla being incomplete, and the present inscription not enough to necessarily refer to the biblical figure.

Increase in the power of Judah
According to the work of archaeologists and philologists, the reign of Hezekiah saw a notable increase in the power of the Judean state. At this time Judah was the strongest nation on the Assyrian–Egyptian frontier. There were increases in literacy and in the production of literary works. The massive construction of the Broad Wall was made during his reign, the city was enlarged to accommodate a large influx, and population increased in Jerusalem up to 25,000, "five times the population under Solomon." Archaeologist Amihai Mazar explains, "Jerusalem was a virtual city-state where the majority of the state's population was concentrated," in comparison to the rest of Judah's cities (167).

Archaeologist Israel Finkelstein says, "The key phenomenon—which cannot be explained solely against the background of economic prosperity—was the sudden growth of the population of Jerusalem in particular, and of Judah in general" (153). He says the cause of this growth must be a large influx of Israelites fleeing from the Assyrian destruction of the northern state. It is "[t]he only reasonable way to explain this unprecedented demographic development" (154). This, according to Finkelstein, set the stage for motivations to compile and reconcile Hebrew history into a text at that time (157). Mazar questions this explanation, since, she argues, it is "no more than an educated guess" (167).

Siloam inscription
The Siloam Tunnel was chiseled through 533 meters (1,750 feet) of solid rock in order to provide Jerusalem underground access to the waters of the Gihon Spring or Siloam Pool, which lay outside the city.

The Siloam Inscription from the Siloam Tunnel is now in the Istanbul Archaeology Museum. It "commemorates the dramatic moment when the two original teams of tunnelers, digging with picks from opposite ends of the tunnel, met each other" (564). It is "[o]ne of the most important ancient Hebrew inscriptions ever discovered." Finkelstein and Mazar cite this tunnel as an example of Jerusalem's impressive state-level power at the time.

Archaeologists like William G. Dever have pointed at archaeological evidence for the iconoclasm during the period of Hezekiah's reign. The central cult room of the temple at Arad, a royal Judean fortress, was deliberately and carefully dismantled, "with the altars and massebot" concealed "beneath a Str. 8 plaster floor". This stratum correlates with the late 8th century; Dever concludes that "the deliberate dismantling of the temple and its replacement by another structure in the days of Hezekiah is an archeological fact. I see no reason for skepticism here."

Lachish relief

Under Rehoboam, Lachish became the second-most important city of the kingdom of Judah. During the revolt of king Hezekiah against Assyria, it was captured by Sennacherib despite determined resistance (see Siege of Lachish).

As the Lachish relief attests, Sennacherib began his siege of the city of Lachish in 701 BCE. The Lachish Relief graphically depicts the battle, and the defeat of the city, including Assyrian archers marching up a ramp and Judahites pierced through on mounted stakes. "The reliefs on these slabs" discovered in the Assyrian palace at Nineveh "originally formed a single, continuous work, measuring 8 feet ... tall by 80 feet ... long, which wrapped around the room" (559). Visitors "would have been impressed not only by the magnitude of the artwork itself but also by the magnificent strength of the Assyrian war machine."

Sennacherib's Prism of Nineveh

Sennacherib's Prism was found buried in the foundations of the Nineveh palace. It was written in cuneiform, the Mesopotamian form of writing of the day. The prism records the conquest of 46 strong towns and "uncountable smaller places," along with the siege of Jerusalem where Sennacherib says he just "shut him up ... like a bird in a cage," subsequently enforcing a larger tribute upon him.

The Hebrew Bible states that during the night, the angel of YHWH (Hebrew: יהוה) brought death to 185,000 Assyrians troops, forcing the army to abandon the siege, yet it also records a tribute paid to Sennacherib of 300 silver talents following the siege. There is no account of the supernatural event in the prism. Sennacherib's account records his levying of a tribute from Hezekiah, a payment of 800 silver talents, which suggests a capitulation to end the siege. However, inscriptions have been discovered describing Sennacherib's defeat of the Ethiopian forces. These say: "As to Hezekiah, the Jew, he did not submit to my yoke, I laid siege to 46 of his strong cities ... and conquered (them). ... Himself I made a prisoner in Jerusalem, his royal residence, like a bird in a cage."

He does not claim to have captured the city. This is consistent with the Bible account of Hezekiah's revolt against Assyria in the sense that neither account seems to indicate that Sennacherib ever entered or formally captured the city. Sennacherib in this inscription claims that Hezekiah paid for tribute 800 talents of silver, in contrast with the Bible's 300, however this could be due to boastful exaggeration which was not uncommon amongst kings of the period. The annals record a list of booty sent from Jerusalem to Nineveh. In the inscription, Sennacherib claims that Hezekiah accepted servitude, and some theorize that Hezekiah remained on his throne as a vassal ruler. The campaign is recorded with differences in the Assyrian records and in the biblical Books of Kings; there is agreement that the Assyrian have a propensity for exaggeration.

One theory that takes the biblical view posits that a defeat was caused by "possibly an outbreak of the bubonic plague". Another that this is a composite text which makes use of a 'legendary motif' analogous to that of the Exodus story.

 * Where the 2 Kings account explains giving 300 talents of silver, Sennacherib's prism records 800 talents. "This discrepancy may be the result of differences in the weight of Assyrian and Israelite silver talents, or it may simply be due to the Assyrian propensity for exaggeration" (558).

Other records
The Greek historian Herodotus (c. 484 BCE – c. 425 BCE) wrote of the invasion and acknowledges many Assyrian deaths, which he claims were the result of a plague of mice. The Jewish historian Josephus followed the writings of Herodotus. These historians record Sennacherib's failure to take Jerusalem as "uncontested".

The Talmud (Bava Batra 15a) credits Hezekiah with overseeing the compilation of the biblical books of Isaiah, Proverbs, Song of Songs and Ecclesiastes.

According to Jewish tradition, the victory over the Assyrians and Hezekiah's return to health happened at the same time, the first night of Passover.

Rabbinic literature
Abi saved the life of her son Hezekiah, whom her godless husband, Ahaz, had designed as an offering to Moloch. By anointing him with the blood of the salamander, she enabled him to pass through the fire of Moloch unscathed (Sanh. 63b).

Hezekiah is considered as the model of those who put their trust in the Lord. Only during his sickness did he waver in his hitherto unshaken trust and require a sign, for which he was blamed by Isaiah (Lam. R. i.). The Hebrew name "Ḥizḳiyyah" is considered by the Talmudists to be a surname, meaning either "strengthened by Yhwh" or "he who made a firm alliance between the Israelites and Yhwh"; his eight other names are enumerated in Isa. ix. 5 (Sanh. 94a). He is called the restorer of the study of the Law in the schools, and is said to have planted a sword at the door of the bet ha-midrash, declaring that he who would not study the Law should be struck with the weapon (ib. 94b).

Hezekiah's piety, which, according to the Talmudists, alone occasioned the destruction of the Assyrian army and the signal deliverance of the Israelites when Jerusalem was attacked by Sennacherib, caused him to be considered by some as the Messiah (ib. 99a). According to Bar Kappara, Hezekiah was destined to be the Messiah, but the attribute of justice ("middat ha-din") protested against this, saying that as David, who sang so much the glory of God, had not been made the Messiah, still less should Hezekiah, for whom so many miracles had been performed, yet who did not sing the praise of God (ib. 94a).

Menachot 109b tells of Hezekiah encouraging others to keep their faith:

"לאחר מפלתו של סנחריב יצא חזקיה ומצא בני מלכים שהיו יושבין בקרונות של זהב הדירו שלא לעבוד עבודת כוכבים

'After the fall of Sancheriv, Hezekiah encountered princes sitting in golden wagons [presumably the rich folks getting out of town] he made them promise not to worship stars [i.e., not to engage in idolatry]'."

Hezekiah and Isaiah
Hezekiah's dangerous illness was caused by the discord between him and Isaiah, each of whom desired that the other should pay him the first visit. In order to reconcile them God struck Hezekiah with a malady and ordered Isaiah to visit the sick king. Isaiah told the latter that he would die, and that his soul also would perish because he had not married and had thus neglected the commandment to perpetuate the human species. Hezekiah did not despair, however, holding to the principle that one must always have recourse to prayer. He finally married Isaiah's daughter, who bore him Manasseh.

However, in Gen. R. lxv. 4, as quoted in Yalḳ., II Kings, 243, it is said that Hezekiah prayed for illness and for recovery in order that he might be warned and be able to repent of his sins. He was thus the first who recovered from illness. But in his prayer he was rather arrogant, praising himself; and this resulted in the banishment of his descendants. R. Levi said that Hezekiah's words, "and I have done what is good in thy eyes" (II Kings xx. 3), refer to his concealing a book of healing. According to the Talmudists, Hezekiah did six things, of which three agreed with the dicta of the Rabbis and three disagreed therewith.

The first three were these: (1) he concealed the book of healing because people, instead of praying to God, relied on medical prescriptions; (2) he broke in pieces the brazen serpent (see Biblical Data, above); and (3) he dragged his father's remains on a pallet, instead of giving them kingly burial. The second three were: (1) stopping the water of Gihon; (2) cutting the gold from the doors of the Temple; and (3) celebrating the Passover in the second month.

The question that puzzled Heinrich Ewald and others, "Where was the brazen serpent till the time of Hezekiah?" occupied the Talmudists also. They answered it in a very simple way: Asa and Joshaphat, when clearing away the idols, purposely left the brazen serpent behind, in order that Hezekiah might also be able to do a praiseworthy deed in breaking it.

The Midrash reconciles the two different narratives of Hezekiah's conduct at the time of Sennacherib's invasion (see Biblical Data, above). It says that Hezekiah prepared three means of defense: prayer, presents, and war, so that the two Biblical statements complement each other. The reason why Hezekiah's display of his treasures to the Babylonian ambassadors aroused the anger of God was that Hezekiah opened before them the Ark, showing them the tablets of the covenant, and saying, "It is with this that we are victorious".

Notwithstanding Hezekiah's immense riches, his meal consisted only of a pound of vegetables. The honor accorded to him after death consisted, according to R. Judah, in his bier being preceded by 36,000 men whose shoulders were bare in sign of mourning. According to R. Nehemiah, a scroll of the Law was placed on Hezekiah's bier. Another statement is that a yeshibah was established on his grave—for three days, according to some: for seven, according to others; or for thirty, according to a third authority. The Talmudists attribute to Hezekiah the redaction of the books of Isaiah, Proverbs, Song of Solomon, and Ecclesiastes (B. B. 15a).

Chronological interpretation
Understanding the biblically recorded sequence of events in Hezekiah's life as chronological or not is critical to the contextual interpretation of his reign. According to scholar Stephen L. Harris, chapter 20 of 2 Kings does not follow the events of chapters 18 and 19 (161). Rather, the Babylonian envoys precede the Assyrian invasion and siege. Chapter 20 would have been added during the exile, and Harris says it "evidently took place before Sennacherib's invasion' when Hezekiah was "trying to recruit Babylon as an ally against Assyria.' Consequently, "Hezekiah ends his long reign impoverished and ruling over only a tiny scrap of his former domain.'

Likewise, The Archaeological Study Bible says, "The presence of these riches' that Hezekiah shows to the Babylonians "indicates that this event took place before Hezekiah's payment of tribute to Sennacherib in 701 BC" (564). Again, "Though the king's illness and the subsequent Babylonian mission are described at the end of the accounts of his reign, they must have occurred before the war with Assyria. Thus, Isaiah's chastening of Hezekiah is due to his alliances made with other countries during the Assyrian conflict for insurance. To a reader who interprets the chapters chronologically, it would appear that Hezekiah ended his reign at a climax, but with a scholarly analysis, his end would contrarily be interpreted as a long fall from where he began".

Other chronological notes
There has been considerable academic debate about the actual dates of reigns of the Israelite kings. Scholars have endeavored to synchronize the chronology of events referred to in the Hebrew Bible with those derived from other external sources. In the case of Hezekiah, scholars have noted that the apparent inconsistencies are resolved by accepting the evidence that Hezekiah, like his predecessors for four generations in the kings of Judah, had a coregency with his father, and this coregency began in 729 BCE.

As an example of the reasoning that finds inconsistencies in calculations when coregencies are a priori ruled out, dates the fall of Samaria (the Northern Kingdom) to the 6th year of Hezekiah's reign. Albright has dated the fall of the Kingdom of Israel to 721 BCE, while Thiele calculates the date as 723 BCE. If Abright's or Thiele's dating are correct, then Hezekiah's reign would begin in either 729 or 727 BCE. On the other hand, 2 Kings 18:13 states that Sennacherib invaded Judah in the 14th year of Hezekiah's reign. Dating based on Assyrian records date this invasion to 701 BCE, and Hezekiah's reign would therefore begin in 716/715 BCE.

This dating would be confirmed by the account of Hezekiah's illness in chapter 20, which immediately follows Sennacherib's departure. This would date his illness to Hezekiah's 14th year, which is confirmed by Isaiah's statement that he will live fifteen more years (29 − 15 = 14). As shown below, these problems are all addressed by scholars who make reference to the ancient Near Eastern practice of coregency.

Following the approach of Wellhausen, another set of calculations shows it is probable that Hezekiah did not ascend the throne before 722 BCE. By Albright's calculations, Jehu's initial year is 842 BCE, 120 years earlier, but between that and Samaria's destruction, the total number of years of the kings of Israel in II Kings, is 143 7/12. For the kings of Judah, the number is 165. This discrepancy, amounting in the case of Judah to 45 years (165–120), has been accounted for in various ways. Every one of those theories must allow that Hezekiah's first six years fell before 722 BCE. That Hezekiah began to reign before 722 BCE, is entirely consistent with the principle that the Ahaz/Hezekiah coregency began in 729 BCE.

Nor is it clearly known how old Hezekiah was when called to the throne, although 2 Kings states he was twenty-five years of age. His father died at the age of thirty-six. It is not likely, that Ahaz at the age of eleven would have had a son. Hezekiah's own son, Manasseh, ascended the throne twenty-nine years later, at the age of twelve. This places his birth in the seventeenth year of his father's reign, or gives Hezekiah's age as forty-two, if he was twenty-five at his ascension. It is more probable that Ahaz was twenty-one or twenty-five when Hezekiah was born, and suggesting an error in the text, and that the latter was thirty-two at the birth of his son and successor, Manasseh.

Since Albright and Friedman, several scholars have explained these dating problems on the basis of a coregency between Hezekiah and his father Ahaz between 729 and 716/715 BCE. Assyriologists and Egyptologists recognize that coregency was a practice both in Assyria and Egypt. After noting that coregencies were only used sporadically in the northern kingdom (Israel), Nadav Na'aman writes, "In the kingdom of Judah, on the other hand, the nomination of a co-regent was the common procedure, beginning from David who, before his death, elevated his son Solomon to the throne. When taking into account the permanent nature of the co-regency in Judah from the time of Joash, one may dare to conclude that dating the co-regencies accurately is indeed the key for solving the problems of biblical chronology in the eighth century BC.'"

Among the numerous scholars who have recognized the coregency between Ahaz and Hezekiah are Kenneth Kitchen in his various writings, Leslie McFall, and Jack Finegan. McFall, in his 1991 article, argues that if 729 BCE, that is, the Judean regnal year beginning in Tishri of 729, is taken as the start of the Ahaz/Hezekiah coregency, and 716/715 BCE as the date of the death of Ahaz, then all the extensive chronological data for Hezekiah and his contemporaries in the late eighth century BCE are in harmony. Further, McFall found that no textual emendations are required among the numerous dates, reign lengths, and synchronisms given in the Hebrew Testament for this period.

In contrast, those who do not accept the Ancient Near Eastern principle of coregencies require multiple emendations of the Scriptural text, and there is no general agreement on which texts should be emended, nor is there any consensus among these scholars on the resultant chronology for the eighth century BCE. This is in contrast with the general consensus among those who accept the biblical and near Eastern practice of coregencies that Hezekiah was installed as coregent with his father Ahaz in 729 BCE, and the synchronisms of 2 Kings 18 must be measured from that date, whereas the synchronisms to Sennacherib are measured from the sole reign starting in 716/715 BCE.

The two synchronisms to Hoshea of Israel in 2 Kings 18 are then in exact agreement with the dates of Hoshea's reign that can be determined from Assyrian sources, as is the date of Samaria's fall as stated in 2 Kings 18:10. An analogous situation of two ways of measurement, both equally valid, is encountered in the dates given for Jehoram of Israel, whose first year is synchronized to the 18th year of the sole reign of Jehoshaphat of Judah in 2 Kings 3:1 (853/852 BCE), but his reign is also reckoned according to another method as starting in the second year of the coregency of Jehoshaphat and his son Jehoram of Judah (2 Kings 1:17); both methods refer to the same calendrical year.

Scholars who accept the principle of coregencies note that abundant evidence for their use is found in the biblical material itself. The agreement of scholarship built on these principles with both biblical and secular texts was such that the Thiele/McFall chronology was accepted as the best chronology for the kingdom period in Jack Finegan's encyclopedic Handbook of Biblical Chronology.

title: Hezekiah


text:
Haemophilia

Haemophilia (British English), or hemophilia (American English), is a mostly inherited genetic disorder that impairs the body's ability to make blood clots, a process needed to stop bleeding. This results in people bleeding for a longer time after an injury, easy bruising, and an increased risk of bleeding inside joints or the brain. Those with a mild case of the disease may have symptoms only after an accident or during surgery. Bleeding into a joint can result in permanent damage while bleeding in the brain can result in long term headaches, seizures, or an altered level of consciousness.

There are two main types of haemophilia: haemophilia A, which occurs due to low amounts of clotting factor VIII, and haemophilia B, which occurs due to low levels of clotting factor IX. They are typically inherited from one's parents through an X chromosome carrying a nonfunctional gene. Most commonly found in men, haemophilia can affect women too, though very rarely. A woman would need to inherit two affected X chromosomes to be affected, whereas a man would only need one X chromosome affected. It is possible for a new mutation to occur during early development, or haemophilia may develop later in life due to antibodies forming against a clotting factor. Other types include haemophilia C, which occurs due to low levels of factor XI, Von Willebrand disease, which occurs due to low levels of a substance called von Willebrand factor, and parahaemophilia, which occurs due to low levels of factor V. Haemophilia A, B, and C prevent the intrinsic pathway from functioning properly; this clotting pathway is necessary when there is damage to the endothelium of a blood vessel. Acquired haemophilia is associated with cancers, autoimmune disorders, and pregnancy. Diagnosis is by testing the blood for its ability to clot and its levels of clotting factors.

Prevention may occur by removing an egg, fertilising it, and testing the embryo before transferring it to the uterus. Human embryos in research can be regarded as the technical object/process. Missing blood clotting factors are replaced to treat haemophilia. This may be done on a regular basis or during bleeding episodes. Replacement may take place at home or in hospital. The clotting factors are made either from human blood or by recombinant methods. Up to 20% of people develop antibodies to the clotting factors which makes treatment more difficult. The medication desmopressin may be used in those with mild haemophilia A. Studies of gene therapy are in early human trials.

Haemophilia A affects about 1 in 5,000–10,000, while haemophilia B affects about 1 in 40,000 males at birth. As haemophilia A and B are both X-linked recessive disorders, females are rarely severely affected. Some females with a nonfunctional gene on one of the X chromosomes may be mildly symptomatic. Haemophilia C occurs equally in both sexes and is mostly found in Ashkenazi Jews. In the 1800s haemophilia B was common within the royal families of Europe. The difference between haemophilia A and B was determined in 1952.

Signs and symptoms

Characteristic symptoms vary with severity. In general symptoms are internal or external bleeding episodes, which are called "bleeds". People with more severe haemophilia experience more severe and more frequent bleeds, while people with mild haemophilia usually experience more minor symptoms except after surgery or serious trauma. In cases of moderate haemophilia symptoms are variable which manifest along a spectrum between severe and mild forms.

In both haemophilia A and B, there is spontaneous bleeding but a normal bleeding time, normal prothrombin time, normal thrombin time, but prolonged partial thromboplastin time. Internal bleeding is common in people with severe haemophilia and some individuals with moderate haemophilia. The most characteristic type of internal bleed is a joint bleed where blood enters into the joint spaces. This is most common with severe haemophiliacs and can occur spontaneously (without evident trauma). If not treated promptly, joint bleeds can lead to permanent joint damage and disfigurement. Bleeding into soft tissues such as muscles and subcutaneous tissues is less severe but can lead to damage and requires treatment. Children with mild to moderate haemophilia may not have any signs or symptoms at birth, especially if they do not undergo circumcision. Their first symptoms are often frequent and large bruises and haematomas from frequent bumps and falls as they learn to walk. Swelling and bruising from bleeding in the joints, soft tissue, and muscles may also occur. Children with mild haemophilia may not have noticeable symptoms for many years. Often, the first sign in very mild haemophiliacs is heavy bleeding from a dental procedure, an accident, or surgery. Females who are carriers usually have enough clotting factors from their one normal gene to prevent serious bleeding problems, though some may present as mild haemophiliacs.

Complications
Severe complications are much more common in cases of severe and moderate haemophilia. Complications may arise from the disease itself or from its treatment: Haemophilic arthropathy is characterised by chronic proliferative synovitis and cartilage destruction. If an intra-articular bleed is not drained early, it may cause apoptosis of chondrocytes and affect the synthesis of proteoglycans. The hypertrophied and fragile synovial lining while attempting to eliminate excessive blood may be more likely to easily rebleed, leading to a vicious cycle of hemarthrosis-synovitis-hemarthrosis. In addition, iron deposition in the synovium may induce an inflammatory response activating the immune system and stimulating angiogenesis, resulting in cartilage and bone destruction.
 * Deep internal bleeding, e.g. deep-muscle bleeding, leading to swelling, numbness or pain of a limb.
 * Joint damage from haemarthrosis (haemophilic arthropathy), potentially with severe pain, disfigurement, and even destruction of the joint and development of debilitating arthritis.
 * Transfusion transmitted infection from blood transfusions that are given as treatment.
 * Adverse reactions to clotting factor treatment, including the development of an immune inhibitor which renders factor replacement less effective.
 * Intracranial haemorrhage is a serious medical emergency caused by the buildup of pressure inside the skull. It can cause disorientation, nausea, loss of consciousness, brain damage, and death.

Genetics

Typically, females possess two X-chromosomes, and males have one X and one Y-chromosome. Since the mutations causing the disease are X-linked recessive, a female carrying the defect on one of her X-chromosomes may not be affected by it, as the equivalent dominant allele on her other chromosome should express itself to produce the necessary clotting factors, due to X inactivation. Therefore, heterozygous females are just carriers of this genetic disposition. However, the Y-chromosome in the male has no gene for factors VIII or IX. If the genes responsible for production of factor VIII or factor IX present on a male's X-chromosome are deficient there is no equivalent on the Y-chromosome to cancel it out, so the deficient gene is not masked and the disorder will develop.

Since a male receives his single X-chromosome from his mother, the son of a healthy female silently carrying the deficient gene will have a 50% chance of inheriting that gene from her and with it the disease; and if his mother is affected with haemophilia, he will have a 100% chance of being a haemophiliac. In contrast, for a female to inherit the disease, she must receive two deficient X-chromosomes, one from her mother and the other from her father (who must therefore be a haemophiliac himself). Hence, haemophilia is expressed far more commonly among males than females, while females, who must have two deficient X-chromosomes in order to have haemophilia, are far more likely to be silent carriers, survive childhood and to submit each of her genetic children to an at least 50% risk of receiving the deficient gene. However, it is possible for female carriers to become mild haemophiliacs due to lyonisation (inactivation) of the X-chromosomes. Haemophiliac daughters are more common than they once were, as improved treatments for the disease have allowed more haemophiliac males to survive to adulthood and become parents. Adult females may experience menorrhagia (heavy periods) due to the bleeding tendency. The pattern of inheritance is criss-cross type. This type of pattern is also seen in colour blindness.

A mother who is a carrier has a 50% chance of passing the faulty X-chromosome to her daughter, while an affected father will always pass on the affected gene to his daughters. A son cannot inherit the defective gene from his father. Genetic testing and genetic counselling is recommended for families with haemophilia. Prenatal testing, such as amniocentesis, is available to pregnant women who may be carriers of the condition.

As with all genetic disorders, it is also possible for a human to acquire it spontaneously through mutation, rather than inheriting it, because of a new mutation in one of their parents' gametes. Spontaneous mutations account for about 33% of all cases of haemophilia A. About 30% of cases of haemophilia B are the result of a spontaneous gene mutation.

If a female gives birth to a haemophiliac son, either the female is a carrier for the blood disorder or the haemophilia was the result of a spontaneous mutation. Until modern direct DNA testing, however, it was impossible to determine if a female with only healthy children was a carrier or not.

If a male has the disease and has children with a female who is not a carrier, his daughters will be carriers of haemophilia. His sons, however, will not be affected with the disease. The disease is X-linked and the father cannot pass haemophilia through the Y-chromosome. Males with the disorder are then no more likely to pass on the gene to their children than carrier females, though all daughters they sire will be carriers and all sons they father will not have haemophilia (unless the mother is a carrier)

Severity
There are numerous different mutations which cause each type of haemophilia. Due to differences in changes to the genes involved, people with haemophilia often have some level of active clotting factor. Individuals with less than 1% active factor are classified as having severe haemophilia, those with 1–5% active factor have moderate haemophilia, and those with mild haemophilia have between 5% and 40% of normal levels of active clotting factor.

Diagnosis
Haemophilia can be diagnosed before, during or after birth if there is a family history of the condition. Several options are available to parents. If there is no family history of haemophilia, it is usually only diagnosed when a child begins to walk or crawl. Affected children may experience joint bleeds or easy bruising.

Mild haemophilia may only be discovered later, usually after an injury or a dental or surgical procedure.

Before pregnancy
Genetic testing and counselling are available to help determine the risk of passing the condition onto a child. This may involve testing a sample of tissue or blood to look for signs of the genetic mutation that causes haemophilia.

During pregnancy
A pregnant woman with a history of haemophilia in her family can test for the haemophilia gene. Such tests include:
 * chorionic villus sampling (CVS): a small sample of the placenta is removed from the womb and tested for the haemophilia gene, usually during weeks 11–14 of pregnancy
 * amniocentesis: a sample of amniotic fluid is taken for testing, usually during weeks 15–20 of pregnancy

There is a small risk of these procedures causing problems such as miscarriage or premature labour, so the woman may discuss this with the doctor in charge of her care.

After birth
If haemophilia is suspected after a child has been born, a blood test can usually confirm the diagnosis. Blood from the umbilical cord can be tested at birth if there's a family history of haemophilia. A blood test will also be able to identify whether a child has haemophilia A or B, and how severe it is.

Classification
There are several types of haemophilia: haemophilia A, haemophilia B, haemophilia C, parahaemophilia, acquired haemophilia A, and acquired haemophilia B.

Haemophilia A is a recessive X-linked genetic disorder resulting in a deficiency of functional clotting Factor VIII. Haemophilia B is also a recessive X-linked genetic disorder involving a lack of functional clotting Factor IX. Haemophilia C is an autosomal genetic disorder involving a lack of functional clotting Factor XI. Haemophilia C is not completely recessive, as heterozygous individuals also show increased bleeding.

The type of haemophilia known as parahaemophilia is a mild and rare form and is due to a deficiency in factor V. This type can be inherited or acquired.

A non-genetic form of haemophilia is caused by autoantibodies against factor VIII and so is known as acquired haemophilia A. It is a rare but potentially life-threatening bleeding disorder caused by the development of autoantibodies (inhibitors) directed against plasma coagulation factors. Acquired haemophilia can be associated with cancers, autoimmune disorders and following childbirth.

Management
There is no long-term cure. Treatment and prevention of bleeding episodes is done primarily by replacing the missing blood clotting factors.

Clotting factors
Clotting factors are usually not needed in mild haemophilia. In moderate haemophilia clotting factors are typically only needed when bleeding occurs or to prevent bleeding with certain events. In severe haemophilia preventive use is often recommended two or three times a week and may continue for life. Rapid treatment of bleeding episodes decreases damage to the body.

Factor VIII is used in haemophilia A and factor IX in haemophilia B. Factor replacement can be either isolated from human plasma, recombinant, or a combination of the two. Some people develop antibodies (inhibitors) against the replacement factors given to them, so the amount of the factor has to be increased or non-human replacement products must be given, such as porcine factor VIII.

If a person becomes refractory to replacement coagulation factor as a result of high levels of circulating inhibitors, this may be partially overcome with recombinant human factor VIII.

In early 2008, the US Food and Drug Administration (FDA) approved an anti-haemophilic drug completely free of albumin, which made it the first anti-haemophilic drug in the US to use an entirely synthetic purification process. Since 1993 recombinant factor products (which are typically cultured in Chinese hamster ovary (CHO) tissue culture cells and involve little, if any human plasma products) have been available and have been widely used in wealthier western countries. While recombinant clotting factor products offer higher purity and safety, they are, like concentrate, extremely expensive, and not generally available in the developing world. In many cases, factor products of any sort are difficult to obtain in developing countries.

Clotting factors are either given preventively or on-demand. Preventive use involves the infusion of clotting factor on a regular schedule in order to keep clotting levels sufficiently high to prevent spontaneous bleeding episodes. On-demand (or episodic) treatment involves treating bleeding episodes once they arise. In 2007, a trial comparing on-demand treatment of boys (< 30 months) with haemophilia A with prophylactic treatment (infusions of 25 IU/kg body weight of Factor VIII every other day) in respect to its effect on the prevention of joint-diseases. When the boys reached 6 years of age, 93% of those in the prophylaxis group and 55% of those in the episodic-therapy group had a normal index joint-structure on MRI. Preventative treatment, however, resulted in average costs of $300,000 per year. The author of an editorial published in the same issue of the NEJM supports the idea that prophylactic treatment not only is more effective than on demand treatment but also suggests that starting after the first serious joint-related haemorrhage may be more cost effective than waiting until the fixed age to begin. Most haemophiliacs in third world countries have limited or no access to commercial blood clotting factor products.

Other
Desmopressin (DDAVP) may be used in those with mild haemophilia A. Tranexamic acid or epsilon aminocaproic acid may be given along with clotting factors to prevent breakdown of clots.

Pain medicines, steroids, and physical therapy may be used to reduce pain and swelling in an affected joint. In those with severe hemophilia A already receiving FVIII, emicizumab may provide some benefit. Different treatments are used to help those with an acquired form of hemophilia in addition to the normal clotting factors. Often the most effective treatment is corticosteroids which remove the auto-antibodies in half of people. As a secondary route of treatment, cyclophosphamide and cyclosporine are used and are proven effective for those who did not respond to the steroid treatments. In rare cases a third route or treatment is used, high doses of intravenous immunoglobulin or immunosorbent that works to help control bleeding instead of battling the auto-antibodies.

Contraindications
Anticoagulants such as heparin and warfarin are contraindicated for people with haemophilia as these can aggravate clotting difficulties. Also contraindicated are those drugs which have "blood thinning" side effects. For instance, medicines which contain aspirin, ibuprofen, or naproxen sodium should not be taken because they are well known to have the side effect of prolonged bleeding.

Also contraindicated are activities with a high likelihood of trauma, such as motorcycling and skateboarding. Popular sports with very high rates of physical contact and injuries such as American football, hockey, boxing, wrestling, and rugby should be avoided by people with haemophilia. Other active sports like soccer, baseball, and basketball also have a high rate of injuries, but have overall less contact and should be undertaken cautiously and only in consultation with a doctor.

Prognosis
Like most aspects of the disorder, life expectancy varies with severity and adequate treatment. People with severe haemophilia who do not receive adequate, modern treatment have greatly shortened lifespans and often do not reach maturity. Prior to the 1960s when effective treatment became available, average life expectancy was only 11 years. By the 1980s the life span of the average haemophiliac receiving appropriate treatment was 50–60 years. Today with appropriate treatment, males with haemophilia typically have a near normal quality of life with an average lifespan approximately 10 years shorter than an unaffected male.

Since the 1980s the primary leading cause of death of people with severe haemophilia has shifted from haemorrhage to HIV/AIDS acquired through treatment with contaminated blood products. The second leading cause of death related to severe haemophilia complications is intracranial haemorrhage which today accounts for one third of all deaths of people with haemophilia. Two other major causes of death include hepatitis infections causing cirrhosis and obstruction of air or blood flow due to soft tissue haemorrhage.

Epidemiology
Haemophilia frequency is about 1 instance in every 10,000 births (or 1 in 5,000 male births) for haemophilia A and 1 in 50,000 births for haemophilia B. About 18,000 people in the United States have haemophilia. Each year in the US, about 400 babies are born with the disorder. Haemophilia usually occurs in males and less often in females. It is estimated that about 2,500 Canadians have haemophilia A, and about 500 Canadians have haemophilia B.

Scientific discovery
The excessive bleeding was known to ancient people. The Talmud instructs that a boy must not be circumcised if he had two brothers who died due to complications arising from their circumcisions, and Maimonides says that this excluded paternal half-brothers. This may have been due to a concern about hemophilia. The tenth century Arab surgeon Al-Zahrawi noted cases of excessive bleeding among men in a village. Several similar references to the disease later known as hemophilia appear throughout historical writings, though no term for inherited abnormal bleeding tendencies existed until the nineteenth century.

In 1803, John Conrad Otto, a Philadelphian physician, wrote an account about "a hemorrhagic disposition existing in certain families" in which he called the affected males "bleeders". He recognised that the disorder was hereditary and that it affected mostly males and was passed down by healthy females. His paper was the second paper to describe important characteristics of an X-linked genetic disorder (the first paper being a description of colour blindness by John Dalton who studied his own family). Otto was able to trace the disease back to a woman who settled near Plymouth, New Hampshire, in 1720. The idea that affected males could pass the trait onto their unaffected daughters was not described until 1813 when John F. Hay, published an account in The New England Journal of Medicine.

In 1924, a Finnish doctor discovered a hereditary bleeding disorder similar to haemophilia localised in Åland, southwest of Finland. This bleeding disorder is called "Von Willebrand Disease".

The term "haemophilia" is derived from the term "haemorrhaphilia" which was used in a description of the condition written by Friedrich Hopff in 1828, while he was a student at the University of Zurich. In 1937, Patek and Taylor, two doctors from Harvard, discovered anti-haemophilic globulin. In 1947, Alfredo Pavlovsky, a doctor from Buenos Aires, found haemophilia A and haemophilia B to be separate diseases by doing a lab test. This test was done by transferring the blood of one haemophiliac to another haemophiliac. The fact that this corrected the clotting problem showed that there was more than one form of haemophilia.

European royalty
Haemophilia has featured prominently in European royalty and thus is sometimes known as 'the royal disease'. Queen Victoria passed the mutation for haemophilia B to her son Leopold and, through two of her daughters, Alice and Beatrice, to various royals across the continent, including the royal families of Spain, Germany, and Russia. In Russia, Tsarevich Alexei, the son and heir of Tsar Nicholas II, famously had haemophilia, which he had inherited from his mother, Empress Alexandra, one of Queen Victoria's granddaughters. The haemophilia of Alexei would result in the rise to prominence of the Russian mystic Grigori Rasputin, at the imperial court.

It was claimed that Rasputin was successful at treating Tsarevich Alexei's haemophilia. At the time, a common treatment administered by professional doctors was to use aspirin, which worsened rather than lessened the problem. It is believed that, by simply advising against the medical treatment, Rasputin could bring visible and significant improvement to the condition of Tsarevich Alexei.

In Spain, Queen Victoria's youngest daughter, Princess Beatrice, had a daughter Victoria Eugenie of Battenberg, who later became Queen of Spain. Two of her sons were haemophiliacs and both died from minor car accidents. Her eldest son, Prince Alfonso of Spain, Prince of Asturias, died at the age of 31 from internal bleeding after his car hit a telephone booth. Her youngest son, Infante Gonzalo, died at age 19 from abdominal bleeding following a minor car accident in which he and his sister hit a wall while avoiding a cyclist. Neither appeared injured or sought immediate medical care and Gonzalo died two days later from internal bleeding.

Treatment
The method for the production of an antihaemophilic factor was discovered by Judith Graham Pool from Stanford University in 1964, and approved for commercial use in 1971 in the United States under the name Cryoprecipitated AHF. Together with the development of a system for transportation and storage of human plasma in 1965, this was the first time an efficient treatment for haemophilia became available.

Blood contamination
Up until late 1985 many people with haemophilia received clotting factor products that posed a risk of HIV and hepatitis C infection. The plasma used to create the products was not screened or tested, nor had most of the products been subject to any form of viral inactivation.

Tens of thousands worldwide were infected as a result of contaminated factor products including more than 10,000 people in the United States, 3,500 British, 1,400 Japanese, 700 Canadians, 250 Irish, and 115 Iraqis.

Infection via the tainted factor products had mostly stopped by 1986 by which time viral inactivation methods had largely been put into place, although some products were shown to still be dangerous in 1987.

Gene therapy
In those with severe haemophilia, gene therapy may reduce symptoms to those that a person with mild or moderate haemophilia might have. The best results have been found in haemophilia B. In 2016 early stage human research was ongoing with a few sites recruiting participants. In 2017 a gene therapy trial on nine people with haemophilia A reported that high doses did better than low doses. It is not currently an accepted treatment for haemophilia.

In July 2022 results of a gene therapy candidate for haemophilia B called FLT180 were announced, it works using an adeno-associated virus (AAV) to restore the clotting factor IX (FIX) protein, normal levels of the protein were observed with low doses of the therapy but immunosuppression was necessitated to decrease the risk of vector-related immune responses.

In November 2022, the first gene therapy treatment for Hemophilia B was approved by the U.S. Food and Drug Administration, called Hemgenix. It is a single-dose treatment that gives the patient the genetic information required to produce Factor IX.

In June 2023, the FDA approved the first gene therapy treatment for Hemophilia A, called Roctavian. It was only approved for patients with severe cases, but it has been shown to reduce yearly bleeding episodes by 50%. It works similarly to Hemgenix, being administered by intravenous infusion that contains a gene for Factor VIII.

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Haemophilia


text:
Hickory (disambiguation)

Hickory is a type of tree (Carya species) found in North America and East Asia.

Hickory may also refer to:

Places in the United States

 * Hickory, Alabama, a place in Pickens County
 * Hickory, Kentucky, a census-designated place
 * Hickory, Louisiana, a place in St. Tammany Parish, Louisiana
 * Hickory, Maryland, an unincorporated community
 * Hickory, Mississippi, a town
 * Hickory County, Missouri
 * Hickory, North Carolina, a city
 * Hickory Motor Speedway
 * Hickory, Oklahoma, a town
 * Hickory, Pennsylvania, a census-designated place
 * Hickory, Tennessee, a place in Sevier County, Tennessee
 * Hickory, Virginia, an unincorporated community
 * Hickory Creek (disambiguation)
 * Hickory Mountain (disambiguation)
 * Hickory Township (disambiguation)

Other uses

 * Hickory High School (disambiguation)
 * USCGC Hickory (WLB-212), a United States Coast Guard seagoing buoy tender
 * Hickory, childhood nickname of Mose Solomon (1900–1966), Major League Baseball player
 * Hickory Records, a record label
 * Hickory, a character played by Jack Haley in the 1939 film The Wizard of Oz
 * Foxcliffe Hickory Wind or Hickory, a dog named Best in Show at the Westminster Kennel Club Dog Show in 2011
 * Hickory cloth, a cotton twill used for North American workshirts and coveralls
 * Hickory golf, a form of golf played with hickory-shafted golf clubs
 * "Hickory", a song by Iron & Wine from the album Around the Well
 * Hickory, an early name for Phil Collins's band Flaming Youth

title: Hickory (disambiguation)


text:
Hemicellulose

A hemicellulose (also known as polyose) is one of a number of heteropolymers (matrix polysaccharides), such as arabinoxylans, present along with cellulose in almost all terrestrial plant cell walls. Cellulose is crystalline, strong, and resistant to hydrolysis. Hemicelluloses are branched, shorter in length than cellulose, and also show a propensity to crystallize. They can be hydrolyzed by dilute acid or base as well as a myriad of hemicellulase enzymes.

Composition
Diverse kinds of hemicelluloses are known. Important examples include xylan, glucuronoxylan, arabinoxylan, glucomannan, and xyloglucan.

Hemicelluloses are polysaccharides often associated with cellulose, but with distinct compositions and structures. Whereas cellulose is derived exclusively from glucose, hemicelluloses are composed of diverse sugars, and can include the five-carbon sugars xylose and arabinose, the six-carbon sugars glucose, mannose and galactose, and the six-carbon deoxy sugar rhamnose. Hemicelluloses contain most of the D-pentose sugars, and occasionally small amounts of L-sugars as well. Xylose is in most cases the sugar monomer present in the largest amount, although in softwoods mannose can be the most abundant sugar. Not only regular sugars can be found in hemicellulose, but also their acidified forms, for instance glucuronic acid and galacturonic acid can be present.

Structural comparison to cellulose
Unlike cellulose, hemicelluloses consist of shorter chains – 500–3,000 sugar units. In contrast, each polymer of cellulose comprises 7,000–15,000 glucose molecules. In addition, hemicelluloses may be branched polymers, while cellulose is unbranched. Hemicelluloses are embedded in the cell walls of plants, sometimes in chains that form a 'ground' – they bind with pectin to cellulose to form a network of cross-linked fibres.

Based on the structural difference, like backbone linkages and side groups, as well as other factors, like abundance and distributions in plants, hemicelluloses can be categorized into four groups as following: 1) xylans, 2) mannans; 3) mixed linkage β-glucans; 4) xyloglucans.

Xylans
Xylans usually consist of a backbone of β-(1→4)-linked xylose residues and can be further divided into homoxylans and heteroxylans. Homoxylans have a backbone of D-xylopyranose residues linked by β(1→4) glycosidic linkages. Homoxylans mainly have structural functions. Heteroxylans such as glucuronoxylans, glucuronoarabinoxylans, and complex heteroxylans, have a backbone of D-xylopyranose and short carbohydrate branches. For example, glucuronoxylan has a substitution with α-(1→2)-linked glucuronosyl and 4-O-methyl glucuronosyl residues. Arabinoxylans and glucuronoarabinoxylans contain arabinose residues attached to the backbone

Mannans
The mannan-type hemicellulose can be classified into two types based on their main chain difference, galactomannans and glucomannans. Galactomannans have only β-(1→4) linked D-mannopyranose residues in linear chains. Glucomannans consist of both β-(1→4) linked D-mannopyranose and β-(1→4) linked D-glucopyranose residues in the main chains. As for the side chains, D-galactopyranose residues tend to be 6-linked to both types as the single side chains with various amount.

Mixed linkage β-glucans
The conformation of the mixed linkage glucan chains usually contains blocks of β-(1→4) D-Glucopyranose separated by single β-(1→3) D-Glucopyranose. The population of β-(1→4) and β-(1→3) are about 70% and 30%. These glucans primarily consist of cellotriosyl (C18H32O16) and cellotraosyl (C24H42O21)segments in random order. There are some study show the molar ratio of cellotriosyl/cellotraosyl for oat (2.1-2.4), barley (2.8-3.3), and wheat (4.2-4.5).

Xyloglucans
Xyloglucans have a backbone similar to cellulose with α-D-xylopyranose residues at position 6. To better describe different side chains, a single letter code notation is used for each side chain type. G -- unbranched Glc residue; X -- α-d-Xyl-(1→6)-Glc. L -- β-Gal, S -- α-l-Araf, F-- α-l-Fuc. These are the most common side chains.

The two most common types of xyloglucans in plant cell walls are identified as XXXG and XXGG.

Biosynthesis
Hemicelluloses are synthesised from sugar nucleotides in the cell's Golgi apparatus. Two models explain their synthesis: 1) a '2 component model' where modification occurs at two transmembrane proteins, and 2) a '1 component model' where modification occurs only at one transmembrane protein. After synthesis, hemicelluloses are transported to the plasma membrane via Golgi vesicles.

Each kind of hemicellulose is biosynthesized by specialized enzymes.

Mannan chain backbones are synthesized by cellulose synthase-like protein family A (CSLA) and possibly enzymes in cellulose synthase-like protein family D (CSLD). Mannan synthase, a particular enzyme in CSLA, is responsible for the addition of mannose units to the backbone. The galactose side-chains of some mannans are added by galactomannan galactosyltransferase. Acetylation of mannans is mediated by a mannan O-acetyltransferase, however, this enzyme has not been definitively identified.

Xyloglucan backbone synthesis is mediated by cellulose synthase-like protein family C (CSLC), particularly glucan synthase, which adds glucose units to the chain. Backbone synthesis of xyloglucan is also mediated in some way by xylosyltransferase, but this mechanism is separate to its transferase function and remains unclear. Xylosyltransferase in its transferase function is, however, utilized for the addition of xylose to the side-chain. Other enzymes utilized for side-chain synthesis of xyloglucan include galactosyltransferase (which is responsible for the addition of [galactose and of which two different forms are utilized), fucosyltransferase (which is responsible for the addition of fucose), and acetyltransferase (which is responsible for acetylation).

Xylan backbone synthesis, unlike that of the other hemicelluloses, is not mediated by any cellulose synthase-like proteins. Instead, xylan synthase is responsible for backbone synthesis, facilitating the addition of xylose. Several genes for xylan synthases have been identified. Several other enzymes are utilized for the addition and modification of the side-chain units of xylan, including glucuronosyltransferase (which adds [glucuronic acid units), xylosyltransferase (which adds additional xylose units), arabinosyltransferase (which adds arabinose), methyltransferase (responsible for methylation), and acetyltransferase] (responsible for acetylation). Given that mixed-linkage glucan is a non-branched homopolymer of glucose, there is no side-chain synthesis, only the addition of glucose to the backbone in two linkages, β1-3 and β1-4. Backbone synthesis is mediated by enzymes in cellulose synthase-like protein families F and H (CSLF and CSLH), specifically glucan synthase. Several forms of glucan synthase from CSLF and CSLH have been identified. All of them are responsible for addition of glucose to the backbone and all are capable of producing both β1-3 and β1-4 linkages, however, it is unknown how much each specific enzyme contributes to the distribution of β1-3 and β1-4 linkages.

Applications
In the sulfite pulp process the hemicellulose is largely hydrolysed by the acid pulping liquor ending up in the brown liquor where the fermentable hexose sugars (around 2%) can be used for producing ethanol. This process was primarily applied to calcium sulfite brown liquors.
 * Arabinogalactan

Arabinogalactans can be used as emulsifiers, stabilizers and binders according to the Federal Food, Drug and Cosmetic Act. Arabinogalactans can also be used as bonding agent in sweeteners. The films based on xylan show low oxygen permeability and thus are of potential interest as packaging for oxygen-sensitive products. Agar is used in making jellies and puddings. It is also growth medium with other nutrients for microorganisms.
 * Xylan
 * Agar
 * Curdlan

Curdlan can be used in fat replacement to produce diet food while having a taste and a mouth feel of real fat containing products.
 * beta-glucan

b-glucans have an important role in food supplement while b-glucans are also promising in health-related issues, especially in immune reactions and the treatment of cancer.
 * Xanthan

Xanthan, with other polysaccharides can form gels that have high solution viscosity which can be used in the oil industry to thicken drilling mud. In the food industry, xanthan is used in products such as dressings and sauces.
 * Alginate

Alginate is an important role in the development of antimicrobial textiles due to its characteristics of environmental friendliness, and high industrialization level as a sustainable biopolymer.

Natural functions
As a polysaccharide compound in plant cell walls similar to cellulose, hemicellulose helps cellulose in the strengthening of plant cell walls. Hemicellulose interacts with the cellulose by providing cross-linking of cellulose microfibrils: hemicellulose will search for voids in the cell wall during its formation and provide support around cellulose fibrils in order to equip the cell wall with the maximum possible strength it can provide. Hemicellulose dominates the middle lamella of the plant cell, unlike cellulose which is primarily found in the secondary layers. This allows for hemicellulose to provide middle-ground support for the cellulose on the outer layers of the plant cell. In few cell walls, hemicellulose will also interact with lignin to provide structural tissue support of more vascular plants.

Extraction
There are many ways to obtain hemicellulose; all of these rely on extraction methods through hardwood or softwood trees milled into smaller samples. In hardwoods the main hemicellulose extract is glucuronoxlyan (acetylated xylans), while galactoglucomannan is found in softwoods. Prior to extraction the wood typically must be milled into wood chips of various sizes depending on the reactor used. Following this, a hot water extraction process, also known as autohydrolysis or hydrothermal treatment, is utilized with the addition of acids and bases to change the yield size and properties. The main advantage to hot water extraction is that it offers a method where the only chemical that is needed is water, making this environmentally friendly and cheap.

The goal of hot water treatment is to remove as much hemicellulose from the wood as possible. This is done through the hydrolysis of the hemicellulose to achieve smaller oligomers and xylose. Xylose when dehydrated becomes furfural. When xylose and furfural are the goal, acid catalysts, such as formic acid, are added to increase the transition of polysaccharide to monosaccharides. This catalyst also has been shown to also utilize a solvent effect to be aid the reaction.

One method of pretreatment is to soak the wood with diluted acids (with concentrations around 4%). This converts the hemicellulose into monosaccharides. When pretreatment is done with bases (for instance sodium or potassium hydroxide) this destroys the structure of the lignin. This changes the structure from crystalline to amorphous. Hydrothermal pretreatment is another method. This offers advantages such as no toxic or corrosive solvents are needed, nor are special reactors, and no extra costs to dispose of hazardous chemicals.

The hot water extraction process is done in batch reactors, semi-continuous reactors, or slurry continuous reactors. For batch and semi-continuous reactors wood samples can be used in conditions such as chips or pellets while a slurry reactor must have particles as small as 200 to 300 micrometers. While the particle size decreases the yield production decreases as well. This is due to the increase of cellulose.

The hot water process is operated at a temperature range of 160 to 240 degrees Celsius in order to maintain the liquid phase. This is done above the normal boiling point of water to increase the solubilization of the hemicellulose and the depolymerization of polysaccharides. This process can take several minutes to several hours depending on the temperature and pH of the system. Higher temperatures paired with higher extraction times lead to higher yields. A maximum yield is obtained at a pH of 3.5. If below, the extraction yield exponentially decreases. In order to control pH, sodium bicarbonate is generally added. The sodium bicarbonate inhibits the autolysis of acetyl groups as well as inhibiting glycosyl bonds. Depending on the temperature and time the hemicellulose can be further converted into oligomers, monomers and lignin.

title: Hemicellulose


text:
Hillbilly

Hillbilly is a term for people who dwell in rural, mountainous areas in the United States, primarily in the Appalachian region and Ozarks. As people migrated out of the region during the Great Depression, the term spread northward and westward with them.

The usage of the term hillbilly as a descriptor receives mixed perceptions, often in part due to the nature in which it is used. It may be used in in-groups as a point of pride, while others consider its usage derogatory, especially when used as an insult.

The first known instances of "hillbilly" in print were in The Railroad Trainmen's Journal (vol. ix, July 1892), an 1899 photograph of men and women in West Virginia labeled "Camp Hillbilly", and a 1900 New York Journal article containing the definition: "a Hill-Billie is a free and untrammeled white citizen of Alabama, who lives in the hills, has no means to speak of, dresses as he can, talks as he pleases, drinks whiskey when he gets it, and fires off his revolver as the fancy takes him". The stereotype is twofold in that it incorporates both positive and negative traits: "Hillbillies" are often considered independent and self-reliant individuals who resist the modernization of society, but at the same time they are also defined as backward and violent. Scholars argue this duality is reflective of the split ethnic identities in white America. The term's later usage extended beyond solely white communities, exemplified with the "Hispanic hillbillies of northern New Mexico", in reference to the Hispanos of New Mexico.

Etymology
The term "hillbilly" is Scottish in origin but is not derived from its dialect. In Scotland, the term "hill-folk" referred to people who preferred isolation from the greater society, and "billy" meant "comrade" or "companion". The words "hill-folk" and "Billie" were combined and applied to the Cameronians who followed the teachings of a militant Presbyterian named Richard Cameron. These Scottish Covenanters fled to the hills of southern Scotland in the late 17th century to avoid persecution for their religious beliefs.

Many of the early settlers of the Thirteen Colonies were from Scotland and Northern Ireland and were followers of William of Orange, the Protestant king of England. In 17th century Ireland, during the Williamite War, Protestant supporters of William III ("King Billy") were referred to as "Billy's Boys" because 'Billy' is a diminutive of 'William' (common across both Britain and Ireland). In time the term hillbilly became synonymous with the Williamites who settled in the hills of North America.

Some scholars disagree with this theory. Michael Montgomery's From Ulster to America: The Scotch-Irish Heritage of American English states, "In Ulster in recent years it has sometimes been supposed that [hillbilly] was coined to refer to followers of King William III and brought to America by early Ulster emigrants, but this derivation is almost certainly incorrect. ... In America hillbilly was first attested only in 1898, which suggests a later, independent development."

History
The Appalachian Mountains were settled in the 18th century by settlers primarily from England, lowland Scotland, and the province of Ulster in Ireland. The settlers from Ulster were mainly Protestants who migrated to Ireland from Lowland Scotland and Northern England during the Plantation of Ulster in the 17th century. Many further migrated to the American colonies beginning in the 1730s, and in America became known as the Scots-Irish although this term is inaccurate as they were also of Northern English descent.

The term "hillbilly" spread in the years following the American Civil War. At this time, the country was developing both technologically and socially, but the Appalachian region was falling behind. Before the war, Appalachia was not distinctively different from other rural areas of the country. Post-war, although the frontier pushed farther west, the region retained frontier characteristics. The Appalachian people themselves were perceived as backward, quick to violence, and inbred in their isolation. Fueled by news stories of mountain feuds such as that in the 1880s between the Hatfields and McCoys, the hillbilly stereotype developed in the late 19th to early 20th century.

The term "hillbilly" was used by members of the Planter's Protection Association, a tobacco farmers union that formed in the Black Patch region of Kentucky, to refer to non-union scab farmers who did not join the organization.

The "classic" hillbilly stereotype reached its current characterization during the years of the Great Depression. The period of Appalachian out-migration, roughly from the 1930s through the 1950s, saw many mountain residents moving north to the Midwestern industrial cities of Chicago, Cleveland, Akron, and Detroit.

This movement to Northern society, which became known as the "Hillbilly Highway", brought these previously isolated communities into mainstream United States culture. In response, poor white mountaineers became central characters in newspapers, pamphlets, and eventually, motion pictures. Authors at the time were inspired by historical figures such as Davy Crockett and Daniel Boone. The mountaineer image transferred over to the 20th century where the "hillbilly" stereotype emerged.

In popular culture
Pop culture has perpetuated the "hillbilly" stereotype. Scholarly works suggest that the media has exploited both the Appalachian region and people by classifying them as "hillbillies". These generalizations do not match the cultural experiences of Appalachians. Appalachians, like many other groups, do not subscribe to a single identity. One of the issues associated with stereotyping is that it is profitable. When "hillbilly" became a widely used term, entrepreneurs saw a window for potential revenue. They "recycled" the image and brought it to life through various forms of media.

The comics portrayed hillbilly stereotypes, notably in two strips, Li'l Abner and Snuffy Smith. Both characters were introduced in 1934.

Hillbilly Elegy: A Memoir of a Family and Culture in Crisis (2016) is a memoir by J. D. Vance about the Appalachian values of his upbringing and their relationship to the social problems of his hometown, Middletown, Ohio. The book topped The New York Times Best Seller list in August 2016.

A family of "Hill People", who are employed as migrant workers on a farm in 1952 Arkansas, have a major role in John Grisham's book A Painted House, with Grisham trying to avoid stereotypes.

Film and television
Television and film have portrayed "hillbillies" in both derogatory and sympathetic terms. Films such as Sergeant York or the Ma and Pa Kettle series portrayed the "hillbilly" as wild but good-natured. Television programs of the 1960s such as The Real McCoys, The Andy Griffith Show, and especially The Beverly Hillbillies, portrayed the "hillbilly" as backwards but with enough wisdom to outwit more sophisticated city folk. Gunsmoke Festus Haggen was portrayed as intelligent and quick-witted (but lacking "education").

The popular 1970s television variety show Hee Haw regularly lampooned the stereotypical "hillbilly" lifestyle. A darker negative image of the hillbilly was introduced to another generation in the film Deliverance (1972), based on a novel of the same name by James Dickey, which depicted some "hillbillies" as genetically deficient, inbred, and murderous.

The Texas Chainsaw Massacre and its sequels has Leatherface and his family, the Sawyers, portray a particularly violent "Hillbilly" stereotype that is common in horror films. The Texas Chainsaw Massacre movie series is thought to have paved the way for the countless horror films featuring deranged and often cannibalistic "Hillbillies" that have since become a staple of the horror genre.

Similar "evil hillbilly people"-type have also been seen in a more comical light in the 1988 horror film The Moonlight Sonata, but the 2010 horror comedy film Tucker & Dale vs. Evil even parodies hillbilly stereotyping. More recently, the TV series Justified (2010–2015) was centered around deputy U. S. Marshal Raylan Givens who was reassigned to his hometown in Harlan, Kentucky where he was in conflict with Boyd Crowder, a drug dealer who had grown up with Raylan. The show's plots often included "hillbilly" tropes such as dimwitted and easily manipulated men, use of homemade drugs, and snake-handling revivalists.

"Hillbillies" became a frequent gimmick in professional wrestling, usually portrayed as simple but amiable fan favourites. An early example of this character was Whiskers Savage (born Edward Civil, 1899–1967) who was promoted as a "bumpkin" persona as early as 1928. During the 1960s and 1970s, two superheavyweight wrestlers (and frequent tag team partners) Haystacks Calhoun and Man Mountain Mike both portrayed "country boys" in overalls and carrying lucky horseshoes. In the WWF in the 1980s, Hillbilly Jim, depicted as a protegé of Hulk Hogan, led a faction of "hillbillies" including Uncle Elmer, Cousin Luke and Cousin Junior.

"Hillbillies" were at the center of reality television in the 21st century. Network television shows such as The Real Beverly Hillbillies, High Life, and The Simple Life displayed the "hillbilly" lifestyle for viewers in the United States. This sparked protests across the country with rural-minded individuals gathering to fight the stereotype. The Center for Rural Strategies started a nationwide campaign stating the stereotype was "politically incorrect". The Kentucky-based organization engaged political figures in the movement such as Robert Byrd and Mike Huckabee. Both protestors argued that the discrimination of any other group in United States would not be tolerated, so neither should the discrimination against rural U.S. citizens. A 2003 piece published by The Cincinnati Enquirer read, "In this day of hypersensitivity to diversity and political correctness, Appalachians have been a group that it is still socially acceptable to demean and joke about... But rural folks have spoken up and said 'enough' to the Hollywood mockers."

Music
Hillbilly music was at one time considered an acceptable label for what is now known as country music. The label, coined in 1925 by country pianist Al Hopkins, persisted until the 1950s.

The "hillbilly music" categorization covers a wide variety of musical genres including bluegrass, country, western, and gospel. Appalachian folk song existed long before the "hillbilly" label. When the commercial industry was combined with "traditional Appalachian folksong", "hillbilly music" was formed. Some argue this is a "High Culture" issue where sophisticated individuals may see something considered "unsophisticated" as "trash".

In the early-20th century, artists began to utilize the "hillbilly" label. The term gained momentum due to Ralph Peer, the recording director of OKeh Records, who heard it being used among Southerners when he went down to Virginia to record the music and labeled all Southern country music as so from then on. The York Brothers entitled one of their songs "Hillbilly Rose" and the Delmore Brothers followed with their song "Hillbilly Boogie". In 1927, the Gennett studios in Richmond, Indiana, made a recording of black fiddler Jim Booker. The recordings were labeled "made for Hillbilly" in the Gennett files and were marketed to a white audience. Columbia Records had much success with the "Hill Billies" featuring Al Hopkins and Fiddlin' Charlie Bowman.

By the late-1940s, radio stations started to use the "hillbilly music" label. Originally, "hillbilly" was used to describe fiddlers and string bands, but now it was used to describe traditional Appalachian music. Appalachians had never used this term to describe their own music. Popular songs whose style bore characteristics of both hillbilly and African American music were referred to as hillbilly boogie and rockabilly. Elvis Presley was a prominent player of rockabilly and was known early in his career as the "Hillbilly Cat".

When the Country Music Association was founded in 1958, the term hillbilly music gradually fell out of use. The music industry merged hillbilly music, Western swing, and Cowboy music, to form the current category C&W, Country and Western.

Some artists (notably Hank Williams) and fans were offended by the "hillbilly music" label. While the term is not used as frequently today, it is still used on occasion to refer to old-time music or bluegrass. For example, WHRB broadcasts a popular weekly radio show entitled "Hillbilly at Harvard". The show is devoted to playing a mix of old-time music, bluegrass, and traditional country and western.

Video games
Many video games feature plots, subplots or characters that utilize the Hillbilly stereotype for narrative purposes and cultural signifiers. Some notable examples of this include the Silent Hill video game series, Fallout 3, Fallout 76, Dead by Daylight, Grand Theft Auto V, Red Dead Redemption 2, Resident Evil 4 and Resident Evil 7.

Cultural implications
The hillbilly stereotype is considered to have had a traumatizing effect on some in the Appalachian region. Feelings of shame, self-hatred, and detachment are cited as a result of "culturally transmitted traumatic stress syndrome". Appalachian scholars say that the large-scale stereotyping has rewritten Appalachian history, making Appalachians feel particularly vulnerable. "Hillbilly" has now become part of Appalachian identity and some Appalachians feel they are constantly defending themselves against this image.

The stereotyping also has political implications for the region. There is a sense of "perceived history" that prevents many political issues from receiving adequate attention. Appalachians are often blamed for economic struggles. "Moonshiners, welfare cheats, and coal miners" are stereotypes stemming from the greater hillbilly stereotype in the region. This prejudice has been said to serve as a barrier for addressing some serious issues such as the economy and the environment.

Despite the political and social difficulties associated with stereotyping, Appalachians have organized to enact change. The War on Poverty is sometimes considered to be an example of one effort that allowed for Appalachian community organization. Grassroots movements, protests, and strikes are common in the area, though not always successful.

Intragroup versus intergroup usage
The Springfield, Missouri Chamber of Commerce once presented dignitaries visiting the city with an "Ozark Hillbilly Medallion" and a certificate proclaiming the honoree a "hillbilly of the Ozarks". On June 7, 1952, President Harry S. Truman received the medallion after a breakfast speech at the Shrine Mosque for the 35th Division Association. Other recipients included US Army generals Omar Bradley and Matthew Ridgway, J. C. Penney, Johnny Olson, and Ralph Story.

Hillbilly Days is an annual festival held in mid-April in Pikeville, Kentucky celebrating the best of Appalachian culture. The event began by local Shriners as a fundraiser to support the Shriners Children's Hospital. It has grown since its beginning in 1976 and now is the second largest festival held in the state of Kentucky. Artists and craftspeople showcase their talents and sell their works on display. Nationally renowned musicians as well as the best of the regional mountain musicians share six different stages located throughout the downtown area of Pikeville. Aspiring hillbillies from across the nation compete to come up with the wildest Hillbilly outfit. The event has earned its name as the Mardi Gras of the Mountains. Fans of "mountain music" come from around the United States to hear this annual concentrated gathering of talent.

The term "Hillbilly" has been used with pride by a number of people within the region as well as famous persons, such as singer Dolly Parton, chef Sean Brock, and actress Minnie Pearl. Positive self-identification with the term generally includes identification with a set of "hillbilly values" including love and respect for nature, strong work ethic, generosity toward neighbors and those in need, family ties, self-reliance, resiliency, and a simple lifestyle.

However, the term has also been used repeatedly by outsiders to systematically denigrate Appalachian natives and other rural people. To many native Appalachians, an outsider calling them "hillbilly" is highly offensive and the term is one of the oldest epithets in use in the United States.

title: Hillbilly


text:
Host

A host is a person responsible for guests at an event or for providing hospitality during it.

Host may also refer to:

Places

 * Host, Pennsylvania, a village in Berks County

People

 * Jim Host (born 1937), American businessman
 * Michel Host (1942–2021), French writer
 * "Host", an author abbreviation in botany for Nicolaus Thomas Host

Fictional entities

 * Hosts (World of Darkness), fictional characters in game Werewolf: The Forsaken
 * Hosts, alien invaders and overlords in the TV series Colony
 * Avenging Host, a group of characters in Marvel Comics' Earth X series of comic books
 * Rutan Host, fictional aliens from Doctor Who

Film

 * Host (film), a 2020 horror film directed by Rob Savage

Literature

 * Host, the third novel in the Rogue Mage series by Faith Hunter
 * Host, a 1993 book by Peter James
 * Hosts (novel), a 2001 book written by American author F. Paul Wilson

Music

 * H.O.S.T., an influential hip-hop group in Azerbaijan
 * Host (Critters Buggin album), 1996
 * Host (Paradise Lost album), 1999
 * Host (Cults album), 2020
 * "Host", a song from the b-side of the 1999 single "Cave" by Muse

Computing and technology

 * Host (network), a computer participating in a computer network
 * hosts (file), mapping hostnames to IP addresses
 * host (Unix), a command
 * Internet hosting service
 * Virtual host, hosting multiple domain names on a single server
 * In hardware virtualization a host machine runs a virtual machine
 * UOL HOST, a webhosting service

Groups or formations

 * Cossack host, military formations of Eastern Europe
 * Hueste, or host, a type of military force in the Iberian Peninsula and France during the Middle Ages
 * Furious Host or the Wild Hunt, a European folk myth

Religion

 * Heavenly host, an "army" of good angels in Heaven
 * Lord of hosts, a common epithet of the God of the Old Testament
 * Sacramental bread, called the host or hostia, used in Christian liturgy

Roles

 * Host (radio), the presenter or announcer on a radio show
 * Television presenter, the host or announcer on a television show
 * Casino host
 * Host, a paid male companion at a host club offering conversation and entertainment, primarily in East Asia
 * Maître d'hôtel (Maître d') or head waiter of a restaurant or hotel
 * Master of ceremonies
 * Talk show host, a presenter of a TV or radio talk show

Science

 * Host (biology), an organism harboring another organism or organisms on or in itself
 * Host (psychology), personality as emphasized in treating dissociative identity disorder
 * Host (astronomy), the interactions and analysis of a star-planet relationship

title: Host