A gastric sarcoma from 3000 years ago: paleopathological diagnosis at the field

OBJECTIVE

Ancient remains tell a lot to those who can solve their mysteries. Mummified remains of individuals have the potential to tell their life stories. Pathological conditions in mummies are identified, commonly, thorough macroscopic inspection and radiological techniques.

PATIENTS AND METHODS

In 2017, a hypogeum tomb was excavated close to the courtyard of Djehuty's tomb (TT11) at the archaeological site of the Spanish Djehuty Project in Luxor (Egypt). In Sector 10, a set of at least 10 mummies were recovered. All showed clear signs of plundering and were found scattered at the site. Wrappings and associated goods indicated that the individuals were from the first half of the 20th dynasty (922 to 888 BCE).

RESULTS

All the individuals were male and from a high social status. Upon removing the individuals for study, two dried stomachs were found. There were clear macroscopic differences. A field histological analysis was performed which revealed that the stomach that showed no alterations, at first glance, presented a pathological pattern that was compatible with gastric sarcoma.

CONCLUSIONS

Malignant diseases are seldom described in Paleopathology; to our knowledge, this is the oldest and most unique case of this type of pathology in mummies worldwide.

Postmortem changes in ancient Egyptian child mummies: Possible pitfalls on CT images

OBJECTIVE

To identify and interpret computed tomography (CT) findings of postmortem changes in ancient Egyptian child mummies.

MATERIALS

Whole-body CT examinations of 21 ancient Egyptian child mummies from German (n = 18), Italian (n = 1), and Swiss museums (n = 2).

METHODS

Conspicuous CT findings from prior evaluations with various research questions that were assessed as postmortem changes were classified, and special cases were illustrated and discussed.

RESULTS

Postmortem changes were classified into several categories. From these, individuals with evidence of invasion of resin/oil/tar into bone, dried fluid-levels within bone most likely due to natron, probable interaction of natron with soft tissues and bone, as well as insect infestation were demonstrated.

CONCLUSIONS

One challenge of paleoradiology is to differentiate between intravital and postmortem changes, which can be multifarious. These changes can be obvious, but also subtle, and can mimic diseases.

SIGNIFICANCE

The provided classification of postmortem changes, as well as the demonstrated cases, may serve as models for further paleoradiological investigations. The dried intraosseous fluid levels in two mummies, most likely due to natron, suggests that these children were immersed in a liquid natron bath, in contrast to the current scientific view that natron for mummification was routinely applied in the solid form.

LIMITATIONS

CT was used as the only examination method, as sampling of the mummies was not possible.

SUGGESTIONS FOR FURTHER RESEARCH

The awareness that postmortem changes on CT images of ancient Egyptian mummies might mimic pathology should be raised to reduce or avoid incorrect interpretation.

Two cases of pelvic trauma with survival in the necropolis of Qubbet el-Hawa (Egypt)

OBJECTIVE

To evaluate the presence of a trauma that results in pelvic ring disruption and its clinical implications in two individuals from ancient Egypt.

MATERIALS

Two complete skeletons of adult women, dated to the Middle Kingdom (c. 1980-1760 BCE), from two tombs in the necropolis of Qubbet el-Hawa (Aswan, Egypt).

METHODS

The anatomical elements were examined macroscopically in Egypt.

RESULTS

Unilateral sacroiliac luxation with disruption of the pubic symphysis was detected in both individuals. The presence of an overlapped symphysis was evident in female QH34aa. A healed fracture of the iliopubic ramus are present in female QH122. Antemortem bone alterations in the pelvis demonstrate that they survived the trauma.

CONCLUSIONS

Pelvic trauma due to a lateral compression was detected in the os coxae. Both women survived but probably had severe sequelae that impaired their quality of life. At least one of them might have received some type of medical treatment.

SIGNIFICANCE

Both cases shed light on pelvic fractures, their mechanisms of production, and their effects on bone and its functionality, as well as revealing possible associated lesions of soft tissues and vital organs.

LIMITATIONS

The pelvis, or at least the pubic symphysis, must be well preserved to allow the correct diagnosis of this type of lesion.

SUGGESTIONS FOR FURTHER RESEARCH

Studies are warranted on the detection of this type of fracture, focusing on the subtle bone changes that indicate its presence. There is also a need to develop methodologies that combine the study of bone and soft tissue alterations.

Metagenomic analysis of Ancient Egyptian canopic jars

Ancient Egyptian remains have been of interest for anthropological research for decades. Despite many investigations, the ritual vessels for the internal organs removed during body preparation-liver, lungs, stomach, and intestines, of Egyptian mummies are rarely used for palaeopathological or medical investigations. These artifacts, commonly referred to as canopic jars, are the perfect combination of cultural and biological material and present an untapped resource for both Egyptological and medical fields. Nevertheless, technical challenges associated with this archeological material have prevented the application of current ancient DNA techniques for both the characterization of human and pathogenic DNA. We present shotgun-sequenced metagenomic profiles and ancient DNA degradation patterns from multiple canopic jars sampled from several European museum collections and enumerate current limitations and possible solutions for the future analysis of similar material. This is the first-ever recorded evidence of ancient human DNA found in Ancient Egyptian canopic jars and the first associated metagenomic description of bacterial taxa in these funerary artifacts.

OBJECTIVES

In this study, our objectives were to characterize the metagenomic profile of the Ancient Egyptian funerary vessels known as canopic jars to retrieve endogenous ancient human DNA, reconstruct ancient microbial communities, and identify possible pathogens that could shed light on disease states of individuals from the past.

METHODS

We applied ancient DNA techniques on 140 canopic jars to extract DNA and generate whole-genome sequencing libraries for the analysis of both human and bacterial DNA. The samples were obtained from museum collections in Berlin (DE), Burgdorf (DE), Leiden (NE), Manchester (UK), Munich (DE), St. Gallen (CH), Turin (IT), and Zagreb (HR).

RESULTS

Here we describe the first isolated DNA from the Egyptian artifacts that hold human viscera. No previous work was ever conducted on such material, which led to the first characterization of human DNA from Ancient Egyptian canopic jars and the profiling of the complex bacterial composition of this highly degraded, challenging, organic material. However, the DNA recovered was not of enough quality to confidently characterize bacterial taxa associated with infectious diseases, nor exclusive bacterial members of the human microbiome.

DISCUSSION

In summary, we present the first genomic survey of the visceral content of Ancient Egyptian funerary artifacts and demonstrate the limitations of current molecular methods to analyze canopic jars, such as the incomplete history of the objects or the presence of uncharacterized compounds that can hamper the recovery of DNA. Our work highlights the main challenges and caveats when working with such complicated archeological material - and offers sampling recommendations for similarly complex future studies, such as incrementing the amount of starting material and sampling from the less exposed parts of the jar content. This is the first-ever recorded evidence of ancient human DNA found in Ancient Egyptian canopic jars, and our results open new avenues in the study of neglected archeological artifacts.

Suicidal Depression in Ancient Egypt

OBJECTIVE

To evaluate the oldest record of a depressed individual contemplating suicide.

METHOD

A directed review of ancient Egyptology literature of translations and discussion regarding a papyrus that is approximately 4,000 years old.

RESULTS

The content of the document is consistent with a man going through a severe depression and is contemplating suicide. However, this does not appear to be a suicide note, but more of an ancient example of 'journaling' or working through the thoughts of suicide and its possible consequences to the man's eternal life in the afterworld.

CONCLUSIONS

Presentation of depression, the reasons for considering suicide, and the process by which an individual works through those thoughts have not varied significantly over the past 4,000 years.

Congenital kyphosis due to a body agenesis from Ancient Egypt

In Paleopathology, total lack of a vertebral body is a rare finding, mostly due to infectious diseases or tumors. We report the case of an adult male from the necropolis next to "Temple of the Millions of Years" of Thutmose III dated to the Late Old Kingdom and First Intermediate Period (2345-2055 BCE). He showed a fracture of T12, more than 50%, associated with the complete disappearance of the body of L1 and bilateral transverse process. Infection and tumor involvement were ruled out due to the morphology of the spinal segment. The most likely diagnosis was complete body agenesis. Congenital kyphosis related to vertebral agenesis has been described as a possibility in paleopathology, but it had not been reported until now.

Ancient Egypt and the geological antiquity of man, 1847-1863

The 1850s through early 60s was a transformative period for nascent studies of the remote human past in Britain, across many disciplines. Naturalists and scholars with Egyptological knowledge fashioned themselves as authorities to contend with this divisive topic. In a characteristic case of long-distance fieldwork, British geologist Leonard Horner employed Turkish-born, English-educated, Cairo-based engineer Joseph Hekekyan to measure Nile silt deposits around pharaonic monuments in Egypt to address the chronological gap between the earliest historical and latest geological time. Their conclusion in 1858 that humans had existed in Egypt for exactly 13,371 years was the earliest attempt to apply geological stratigraphy to absolute human dates. The geochronology was particularly threatening to biblical orthodoxy, and the work raised private and public concerns about chronological expertise and methodology, scriptural and scientific authority, and the credibility of Egyptian informants. This essay traces these geo-archaeological investigations; including the movement of paper records, Hekekyan's role as a go-between, and the publication's reception in Britain. The diverse reactions to the Egyptian research reveal competing ways of knowing the prehistoric past and highlights mid-Victorian attempts to reshape the porous boundaries between scholarly studies of human antiquity.

The earliest known case of frontal sinus osteoma in man

Frontal sinus osteoma is a relatively common finding in the modern clinical setting. Although, its paleopathological record is not in dispute, its presence in Ancient Egypt has never been clarified. The aim of this article is to contribute to the debate. An Egyptian mummy head from the Musée d'Éthnographie de Neuchâtel (Switzerland) was studied radiologically and the obtained evidence was contextualized in the wider frame of multidisciplinary paleopathology. A 128-slice CT scanner was used for further investigation; datasets were processed with OsiriX-64 bit (version 5.8.5), and multiplanar (MPR) and volumetric reconstructions were performed. A small hyperdense and well-defined structure, most likely an osteoma, was identified in the right frontal sinus. Frontal sinus osteoma definitely existed in Ancient Egypt. Finally, this represents the oldest case in anatomically modern humans so far reported. Clin. Anat.32:105-109, 2019. © 2018 Wiley Periodicals, Inc.

First-time complete visualization of a preserved meningeal artery in the mummy of Nakht-ta-Netjeret (ca. 950 BC)

The preservation of the meningeal artery in ancient mummified bodies, particularly in anthropogenic Egyptian mummies, is a highly controversial topic in neuroscience and anthropological research. A recent (2015) debate between Wade and Isidro, based on the interpretation of the meningeal grooves and cast in a skull from the necropolis of Kom al-Ahmar Sharuna (Egypt), highlighted both the necessity of having clear radiological descriptions of this anatomical structure and of assessing large collections of mummified crania. Here, we present for the first time an instance of extremely well-preserved middle meningeal artery in the mummy of the ancient Egyptian dignitary Nakht-ta-Netjeret (ca. 950 BC), still inside the meninx, using paleo-radiological techniques. We finally link this find with experimental data from the neurological literature on the methodology of excerebration implemented by ancient Egyptian embalmers.

How Knowledge of Ancient Egyptian Women Can Influence Today's Gender Role: Does History Matter in Gender Psychology?

A gender role is a set of societal norms dictating what types of behaviors are considered desirable or appropriate for a person based on their sex. However, socially constructed gender roles can lead to equal rights between genders but also to severe disadvantages and discrimination with a remarkable variety between different countries. Based on social indicators and gender statistics, "women in the Arab region are on average more disadvantaged economically, politically, and socially than women in other regions." According to Banduras' social learning theory, we argue that profound knowledge of the historical contributions of Ancient Egyptian female pioneers in science, arts, and even in ruling Egypt as Pharaohs can improve today's gender role in Egypt and Middle Eastern countries. Therefore, this article provides an elaborate review of the gender role of women in Ancient Egypt, outlining their prominence, influence, and admiration in ancient societies, and discusses the possible psychological impact of this knowledge on today's gender role. We suggest that future empirical research should investigate how enhancing the knowledge of women from Ancient Egypt can improve today's gender role in Egypt and the Middle East. Bandura's social learning theory is outlined as a possible framework for future research.

From first to latest imaging technology: Revisiting the first mummy investigated with X-ray in 1896 by using dual-source computed tomography

Purpose

The aim of this study was to systematically reinvestigate the first human mummy that was ever analyzed with X-ray imaging in 1896, using dual-source computed tomography (DSCT) in order to compare the earliest and latest imaging technologies, to estimate preservation, age at death, sex, anatomical variants, paleopathological findings, mummification, embalming and wrapping of the child mummy from ancient Egypt. Radiocarbon dating was used to determine the mummy’s age and to specify the child’s living period in the Egyptian chronology.

Material and methods

The ancient Egyptian child mummy is kept in the Senckenberg Museum of Natural History in Frankfurt am Main, Germany. An accelerator mass spectrometer (MICADAS) was used for radiocarbon dating. DSCT was performed using a 2 × 64 slice dual-source CT system (Siemens Healthineers, Forchheim, Germany). A thorough visual examination of the mummy, a systematic radiological evaluation of the DICOM datasets, and established methods in physical anthropology were applied to assess the bio-anthropological data and the post mortem treatment of the body.

Results

Radiocarbon dating yielded a calibrated age between 378 and 235 cal BC (95.4% confidence interval), corresponding with the beginning of the Ptolemaic period. The mummy was a male who was four to five years old at the time of death. Remnants of the brain and inner organs were preserved by the embalmers, which is regularly observed in ancient Egyptian child mummies. Skin tissue, inner organs, tendons and/or musculature, cartilage, nerves and vasculature could be identified on the DSCT dataset. The dental health of the child was excellent. Anatomical variants and pathological defects included a congenital Pectus excavatum deformity, hepatomegaly, Harris lines, and longitudinal clefts in the ventral cortices of both femora.

Conclusion

Our results highlight the enormous progress achieved form earliest to latest imaging technology for advanced mummy research using the first human mummy investigated with X-ray. With the application of DSCT, detailed knowledge regarding age at death, sex, diseases, death, and mummification of a child from Ptolemaic Egypt are revealed while considering the temporary rites of body treatment and burial for children.

Pectus excavatum in mummies from ancient Egypt

Pectus excavatum is one of the common congenital anomalies, yet there seems to be a suspicious absence of any cases or descriptions of this deformity from antiquity. This could represent a real change in disease prevalence but is more likely just due to an inadequate reporting in medico-historical literature. The current study reviews reports of computed tomography (CT) scans of 217 ancient Egyptian mummies, revealing 3 presumed cases of this deformity. Therefore, pectus excavatum was in fact present already in ancient times, with prevalence roughly similar to the modern one.

Water supply of ancient Egyptian settlements: the role of the state. Overview of a relatively equitable scheme from the Old to New Kingdom (ca. 2543-1077 BC)

The study of the textual and archaeological evidence shows that the water supply of the settlements of ancient Egypt seems to have worked on a simple and a relatively equitable scheme, at least from the Old Kingdom until the New Kingdom (ca. 2543–1077). The water supply of the inhabitants was completely managed by the state, through the local administration which was charged to bring the water, in general from a rural area, into towns and cities and to redistribute it to the inhabitants. The method of supply is illustrated by several sources of evidence, in particular by the well known case of the “water-carriers” of the village of Deir el-Medina. Thus, drawing together text and archaeology, this paper will demonstrate that over an extended period, even when the city was far from a water source, the state did not set up complex installations such as pipe networks or wells to bring water, but preferred a simpler system using the manpower available.

Skeletal stigmata as keys to access to the composite and ancient Gorlin-Goltz syndrome history: The Egypt, Pompeii and Herculaneum lessons

There are several genetic diseases with a wide spectrum of congenital bone stigmata in association to cutaneous and visceral benign and malignant neoplasms. Gorlin-Goltz syndrome, also named nevoid basal cell carcinoma syndrome, is an autosomal dominant systemic disease with almost complete penetrance and high intra-familial phenotypic variability, caused by germline mutations of the gene PTCH1. The syndrome is characterized by unusual skeletal changes and high predisposition to the development of multiple basal cell carcinomas, odontogenic keratocysts tumors and other visceral tumors. The Gorlin syndrome, clinically defined as distinct syndrome in 1963, existed during Dynastic Egyptian times, as revealed by a costellation of skeletal findings compatible with the syndrome in mummies dating back to 3000years ago and, most likely, in the ancient population of Pompeii. These paleogenetic and historical evidences, together with the clinical and biomolecular modern evidences, confirm the quite benign behavior of the syndrome and the critical value of the multiple and synchronous skeletal anomalies in the recognition of these rare and complex genetic disease.

No rheumatoid arthritis in ancient Egypt: a reappraisal

Antiquity of rheumatoid arthritis (RA) remains controversial, and its origins in Americas or in the Old World are disputed. Proponents of the latter frequently refer to RA in ancient Egypt, but validity of those claims has never been examined. Review of all reported RA cases from ancient Egypt revealed that none of them represent real RA, instead being either examples of changing naming conventions or of imprecise diagnostic criteria. Most cases represented osteoarthritis or spondyloarthropathies. Also review of preserved ancient Egyptian medical writings revealed many descriptions of musculoskeletal disorders, but none of them resembled RA. This suggests that RA was absent in ancient Egypt and supports the hypothesis of the New World origin of RA and its subsequent global spread in the last several centuries.

Cribra orbitalia in the ancient Nile Valley and its connection to malaria

Cribra orbitalia is a common skeletal lesion found on ancient human remains excavated from the Nile Valley. Recent etiological research implicates hemolytic anemia as a main factor leading to the formation of cribra orbitalia. Further, an association between the hemolytic anemia caused by malaria and cribra orbitalia has been demonstrated. The presence of malaria in the ancient Nile Valley has been verified directly through genetic and immunologic studies of Egyptian mummies, but its prevalence and spread remain unknown. As some models have pointed to the Nile Valley as the pathway of malarial dispersion during the Egyptian Dynastic period, variability in cribra orbitalia rates should provide a way to track the disease spread. This study surveyed cribra orbitalia frequencies at 29 ancient Nile Valley sites, representing 4760 individuals ranging from prehistoric to Christian periods and situated between the 3rd Cataract and Nile Delta. Results showed high cribra orbitalia rates, with an overall mean of 42.8% of the total population affected. Over time and space, the data showed no significant correlation, suggesting high levels of anemia affected individuals in the Nile Valley equally from late pre-dynastic to Christian periods. These findings suggest widespread endemic malaria in the Nile Valley before Dynastic Egypt.

Pectus excavatum in relief from Ancient Egypt (dating back to circa 2400 BC)

Pectus excavatum is one of the most common congenital deformities of the chest wall. The aim of the study was to analyse 621 artefacts (reliefs, sculptures, paintings) from Ancient Egypt in terms of anatomical defects of the chest. The team which analysed artefacts consisted of historians of medicine and thoracic surgeons. The researchers found a relief, depicting a man with an abnormal shape of the chest. The relief was from Niankhkhnum and Khnumhotep mastaba and dates back to circa 2400 BC. The authors think it is possible that the relief may represent a pectus excavatum deformity and believe the image will open up debate on the occurrence of this deformity in ancient times.

Cranial trepanation in The Egyptian

INTRODUCTION

Medicine and literature have been linked from ancient times; proof of this shown by the many doctors who have made contributions to literature and the many writers who have described medical activities and illnesses in their works. An example is The Egyptian, the book by Mika Waltari that provides a masterly narration of the protagonist's medical activity and describes the trepanation technique.

DEVELOPMENT

The present work begins with the analysis of trepanations since prehistory and illustrates the practice of the trepanation in The Egyptian. The book mentions trepanation frequently and illustrates how to practice it and which instruments are required to perform it. Trepanation is one of the oldest surgical interventions carried out as treatment for cranial trauma and neurological diseases, but it also had the magical and religious purpose of expelling the evil spirits which caused the mental illness, epilepsy, or migraine symptoms.

CONCLUSIONS

Trepanation is a surgical practice that has been carried out since prehistory to treat post-traumatic epilepsy, migraine, and psychiatric illness. The Egyptian is a book that illustrates the trepan, the trepanation technique, and the required set of instruments in full detail.