Findings in ancient Egyptian mummies from tomb KV64, Valley of the Kings, Luxor, with evidence of a rheumatic disease.

OBJECTIVE: In 2011, a spectacular find was made in the Valley of the Kings, Egypt - a well-known archaeological site, where pharaohs were buried during the New Kingdom (ca. 1500-1100 BCE). A team from the University of Basel's Kings' Valley Project discovered a tomb (KV64) containing two mummies that were buried in different time episodes (unidentified elite burial, 18th dynasty, and Nehemesbastet, 22nd dynasty). METHOD: Anthropological investigations of the mummies were performed using portable X-ray and photographic documentation. RESULTS AND CONCLUSION: The first burial was an adult individual with bilateral pathological changes at the temporomandibular joints (TMJs), most likely of inflammatory origin, possibly psoriatic arthritis. Investigations of the second burial revealed an intact body of a younger female individual.

The "Queen of the Moors". Paleopathological investigation of a natural mummy from Scicli, South-Eastern Sicily.

A natural, well-preserved mummy belonging to a 45-55 year old female was found in the Church of Santa Maria della Consolazione in Scicli, south-eastern Sicily. The body was submitted to external examination, digital radiology, and computed tomography scanning. Paleopathological investigation allowed us to detect pulmonary pathology related to tuberculosis, atherosclerosis, and phleboliths. The presence of the latter, along with good dental condition with focal caries and obesity indicates a subject belonging to a high social class in good nutritional status. Along with other examples, this case allows to infer that tuberculosis was a common disease in that area, if not in the whole island, prior to the antibiotic era. Mummies need to be properly surveyed and protected, but also adequately studied by multidisciplinary teams of experts. The presence in such a team of at least one skilled anatomic/surgical pathologist, as long as well trained in the study of ancient human remains, represents an undeniable condition.

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.

Egyptian Canopic Jars at the Crossroad of Medicine and Archaeology: Overview of 100 Years of Research and Future Scientific Expectations.

Ancient Egyptian human remains have been of interest in the fields of both medical and Egyptological research for decades. However, canopic jar holders for internal organs (liver, lungs, stomach, intestines) of Egyptian mummies appear to be but a very occasional source of data for such investigations. The few medical approaches focusing on the content of these jars are summarized and listed according to pathogens and diseases to give a structured overview of this field of study. An extensive search of the literature has been conducted from different bibliographic databases with a total of n = 26 studies found. The majority of diseases found consisted of infectious diseases and internal medicine conditions such as schistosomiasis or emphysema. These are just 2 examples of many that, instead of primarily affecting bone, muscle or skin, specifically target internal organs. Hence, a better understanding of the evolution of diseases that still affect mankind could be gained. In conclusion, this reassessment shows that canopic jars represent a highly underestimated source for histological, radiological and ancient DNA examination of Ancient Egyptian remains and should, thus, be more and more brought back into the focus of retrospective medical research.

Using micro computed tomography to investigate a fetal mummy with possible situs inversus: A case report.

OBJECTIVES: Computed tomography (CT) is commonly used to noninvasively examine mummified remains, but can have resolution limitations when analyzing smaller mummified specimens, such as fetal mummies. This short report determines if the enhanced resolution of micro CT improves the anatomical analysis of mummified fetal anatomy. METHODS: A fetal mummy from an anatomical collection was scanned by a micro CT at a resolution of 0.08 mm slice thickness. The mummy was also scanned at a resolution of 0.6 mm slice thickness to mimic the approximate minimum resolution of a conventional CT scanner. The anatomy was virtually reconstructed at both resolutions to compare anatomical detail for determining sex, gestation, and the presence of congenital/ pathological conditions. RESULTS: The anatomical reconstructions based on the micro CT were significantly more detailed than the conventional CT data. This resulted in improved identification of sex and the presence of a congenital/ pathological condition. CONCLUSION: Micro CT should be considered when examining fetal mummies, because of the enhanced resolution resulting in improve anatomical analysis.

Paleopathology of Spleens in South American Mummies.

This study analyzed 19 naturally mummified pre-Columbian individuals excavated from desert regions of southern Peru and northern Chile. In the majority of autopsies of mummies, the spleen cannot be identified due to rapid autolysis and decomposition; therefore, our aim was to identify, in the cases in which the spleen was found, any normal and abnormal structures from mummified spleen tissues. The research consisted of gross and microscopic examinations of the spleen. Pathological features were identified, but no evidence of specific diseases was determined.

Histopathological Study of a Mummified Eye and Optic Nerve from a Strangled Peruvian Mummy.

We present the histopathological findings of a naturally mummified eye from the Peruvian Lambayeque culture (900-1,200 AD), in which rehydration, light microscopy, and scanning electron microscopy allowed a detailed analysis of several eye tissues including the eyelids, sclera, and optic nerve, the latter showing evidence of hemorrhage likely related to the documented strangulation as the cause of death. We conclude that histopathological analysis of rehydrated mummified tissues can provide valuable information from fragile eye structures including the optic nerve, and these findings can be useful from a forensic point of view.

[Tutankhamun: evidence-based paleopathology versus "curse of the pharaoh"]. / Tutanchamun: Evidenzbasierte Paleopathologie vs. "Fluch des Pharao".

AIMS: Several speculations exist regarding possible diseases of the juvenile Pharaoh Tutankhamun. In this review published paleopathological findings and artificial alterations as well as suggestions regarding underlying diseases were characterized. MATERIAL AND METHODS: A selective search of the literature was carried out in the PubMed data base in an arbitrary time interval from 1960 to 2013 (search terms: Tutankhamun, Pharaoh, paleopathology and mummy) and additional supplementary literature. RESULTS: Many artificial changes were a result of embalming and the examinations which have been performed since exhumation in 1922. Evidenced pathologies are craniofacial dysmorphia, bilateral alterations of the feet, malarial disease and an acute traumatic fracture of the knee. The cause of the knee fracture could no longer be reconstructed. Other trauma (e.g. skull fractures) or familial transmission of an eighteenth dynasty syndrome could not be confirmed. CONCLUSION: In addition to many artificial post-mortem alterations, chronic and acute diseases could be verified in Tutankhamun, although the underlying causes are partially unknown.

[The possibilities for the use of unusual personality traits in the examination of the skeletonized corpses with the long prescription of burying].

The objective of the present study was to develop the method for the detection and identification of the traces of the previous diseases on the skeletonized and mummified corpses with the purpose of discovery of the new specific traits making possible the personality identification and substantiation of the search of their localization at the burial places depending on the prescription of burying. It was shown that the identification of the corpses under conditions of their complete skeletonization should be based not only on the general (sex, age, height) but also the specific (congenital malformations, post-traumatic and pathological changes of the bones) traits. The biological structures making possible the personality identification are described, such as the mineralized (petrified) fibrous capsules of the hepatic echinoccocus vesicles, the primary lung tuberculosis complex, and postoperative scar ossificates of the abdominal white tine. Some data on the lifetime of bone remains in the ground and the duration of their possible skeletonization are presented together with the description of the method for the use of this information with a view to the personality identification of the unknown corpse.

Atherosclerosis across 4000 years of human history: the Horus study of four ancient populations.

BACKGROUND: Atherosclerosis is thought to be a disease of modern human beings and related to contemporary lifestyles. However, its prevalence before the modern era is unknown. We aimed to evaluate preindustrial populations for atherosclerosis. METHODS: We obtained whole body CT scans of 137 mummies from four different geographical regions or populations spanning more than 4000 years. Individuals from ancient Egypt, ancient Peru, the Ancestral Puebloans of southwest America, and the Unangan of the Aleutian Islands were imaged. Atherosclerosis was regarded as definite if a calcified plaque was seen in the wall of an artery and probable if calcifications were seen along the expected course of an artery. FINDINGS: Probable or definite atherosclerosis was noted in 47 (34%) of 137 mummies and in all four geographical populations: 29 (38%) of 76 ancient Egyptians, 13 (25%) of 51 ancient Peruvians, two (40%) of five Ancestral Puebloans, and three (60%) of five Unangan hunter gatherers (p=NS). Atherosclerosis was present in the aorta in 28 (20%) mummies, iliac or femoral arteries in 25 (18%), popliteal or tibial arteries in 25 (18%), carotid arteries in 17 (12%), and coronary arteries in six (4%). Of the five vascular beds examined, atherosclerosis was present in one to two beds in 34 (25%) mummies, in three to four beds in 11 (8%), and in all five vascular beds in two (1%). Age at time of death was positively correlated with atherosclerosis (mean age at death was 43 [SD 10] years for mummies with atherosclerosis vs 32 [15] years for those without; p<0·0001) and with the number of arterial beds involved (mean age was 32 [SD 15] years for mummies with no atherosclerosis, 42 [10] years for those with atherosclerosis in one or two beds, and 44 [8] years for those with atherosclerosis in three to five beds; p<0·0001). INTERPRETATION: Atherosclerosis was common in four preindustrial populations including preagricultural hunter-gatherers. Although commonly assumed to be a modern disease, the presence of atherosclerosis in premodern human beings raises the possibility of a more basic predisposition to the disease. FUNDING: National Endowment for the Humanities, Paleocardiology Foundation, The National Bank of Egypt, Siemens, and St Luke's Hospital Foundation of Kansas City.

Skeletal metastatic carcinomas from the Roman period (1st to 5th Century AD) in Hungary.

OBJECTIVES: According to paleopathological records, tumors have a great antiquity. The prevalence of cancer in ancient populations might have differed from that in modern humans because of substantial differences in environmental factors, life expectancy and the availability of treatment. This study presents 3 cases of probable skeletal metastatic carcinoma from the Roman period (1st-5th century AD) in Hungary, showing the development of bone metastases of cancer without chemo- and radiotherapy. METHODS: All skeletons were subjected to a careful macroscopic investigation, which was extended by radiological, stereo- and scanning electron microscopic analyses. RESULTS: In 1 case, the mixed nature and localization of the lesions, as well as the sex and age of the individual, suggested breast cancer as the primary focus. In the other 2 cases, based on the mostly osteoblastic nature and the localization of the lesions as well as on the sex and age of the individuals, the most probable diagnostic option is prostate carcinoma with skeletal metastases. CONCLUSIONS: In view of the scarcity of cancer metastases that have been diagnosed in archeological specimens in general, identification of all examples of cancer in antiquity represents an important contribution both to paleopathology and to modern medicine.

Atherosclerosis in mummified human remains from Vilnius, Lithuania (18th-19th centuries AD): a computed tomographic investigation.

OBJECTIVE: Through the study of preserved human remains, it is now known that atherosclerosis, commonly thought to be a modern disease, also existed in historic and prehistoric periods. To date, however, little evidence of atherosclerosis has been reported in samples of tissues from spontaneously mummified bodies that are often found in European crypts and churches. METHODS: Within the framework of the Lithuanian Mummy Project, whole-body computed tomographic scans of seven spontaneous mummies from a crypt in Vilnius were obtained and assessed for indications of atherosclerosis. RESULTS: Three of the mummies investigated showed clear evidence of atherosclerosis, which was at times quite severe. Atherosclerosis is believed to have been prevalent among affluent members of Lithuanian society, which is corroborated by historical sources. CONCLUSIONS: In accordance with recent, significant data, this study further demonstrates the antiquity of this disease. Documentary and ethnographic data suggest that lifestyle may have played a role in the onset of atherosclerosis in these individuals.

Maori heads (mokomokai): the usefulness of a complete forensic analysis procedure.

Based on an analysis of 19 mummified Maori heads (mokomokai) referred to our forensic laboratory for anthropological analysis prior to their official repatriation from France to New Zealand, and data from the anthropological and medical literature, we propose a complete forensic procedure for the analysis of such pieces. A list of 12 original morphological criteria was developed. Items included the sex, age at death, destruction of the skull base, the presence of argil deposits in the inner part of the skull, nostrils closed with exogenous material, sewing of eyelids and lips, pierced earlobes, ante-mortem and/or post-mortem tattoos, the presence of vegetal fibers within nasal cavities, and other pathological or anthropological anomalies. These criteria were tested for all 19 mokomokai repatriated to New Zealand by the French authorities. Further complementary analyses were limited to fiberscopic examination of the intracranial cavities because of the taboo on any sampling requested by the Maori authorities. In the context of global repatriation of human artifacts to native communities, this type of anthropological expertise is increasingly frequently requested of forensic anthropologists and other practitioners. We discuss the reasons for and against repatriating non-authentic artifacts to such communities and the role played by forensic anthropologists during the authentication process.

Paleoimaging: a review of applications and challenges.

This paper reviews the contributions and current practices of paleoimaging modalities as applied to the bioarchaeological research setting. The paper provides a brief historical perspective regarding imaging approaches in this unique context and a description of various modalities including photography, 3D surface scanning, aerial imaging, LiDAR, GPR, portable radiography, endoscopy, X-ray fluorescence, and advanced medical imaging. The paper presents a review of issues and applications of paleoimaging with an emphasis on specific research questions. A description of the limitations and challenges for paleoimaging within the bioarchaeological construct follows and offers support for the multimodal approach to paleoimaging. Interpretation of imaging data by consensus including paleoimagers, medical scientists and bioarchaeologists is addressed. The paper concludes with a look to the future of paleoimaging from an applications and standards development perspective.

"Modeling ancient Egyptian embalming": radiological assessment of experimentally mummified human tissue by CT and MRI.

OBJECTIVE: To assess changes in different tissues during the process of artificial mummification by natron using computed tomography (CT) and magnetic resonance imaging (MRI), and to translate the results to image interpretation in paleoradiological studies of ancient mummies. MATERIALS AND METHODS: A human lower limb (LL) was amputated from a female donor 24 h post-mortem and mummified by artificial natron (54 % NaCl, 16 % Na2SO4, 18 % Na2CO3 12 % NaHCO3) in ancient Egyptian style. The LL was kept in a fume hood at 16-25 °C and 30-75 % relative humidity. CT and MRI were performed at specific intervals with quantitative evaluation of Hounsfield units (HU) and signal intensities (SI). RESULTS: Evaluated tissues showed different HU and SI changes during the experimental mummification. All tissues revealed an overall but varying increase of HU in CT examinations. All tissues except for the compact bone revealed an overall but varying decrease of SI in the IR and T2-weighted sequences of the MRI. Typical findings included a distinct increase of HU in the cutis at the end of the study and a temporary increase of SI in the IR and T2-weighted sequences in all muscle groups. CONCLUSIONS: Radiological findings showed a regular, controlled and effective dehydration by the applied natron without detectable putrefaction. Evaluated tissues revealed different radiological changes during the experiment, which altogether led to preservation of the tissues without radiologically identifiable destruction. The cutis revealed radiological signs of direct interaction with the natron in the form of covering and possibly permeation.

[Decomposition of corpses--a microbial degradation process with special reference to mummification, formation of adipocere and incomplete putrified corpes]. / Leichenzersetzung--ein mikrobieller Abbauprozess (unter besonderer Berücksichtigung der Entstehung von Mumien, Fettwachs und Faulleichen).

Decomposition of the human body is a microbial process. It is influenced by the environmental situation and it depends to a high degree on the exchange of substances between the corpse and the environment. Mummification occurs at low humidity or frost. Adipocere arises from lack of oxygen, incomplete putrified corpses develop when there is no exchange of air or water between the corpse and the environment.

Palaeopathology: the study of disease in the past.

Palaeopathology studies ancient human or animal remains from a pathological point of view, for which techniques and tools such as inspection and light and electron microscopy after adequate rehydration, immunohistochemistry and molecular biology are used. Despite the degradation of tissues, partial preservation of their structure and content after a natural or artificial mummification process often allows the extraction of valuable biological data, which sometimes provides interesting historical information.