sábado, setembro 22, 2012

The Medical History of King Tut

Writing about king Tutankhamun, as over the years different theories have arise, can we scientifically prove what really might have killed him, who were his parents and other health conditions affecting him at the time of his death?

The latest: did he die of epilepsy?

His tomb was discovered by Carter in 1922. Since the 1930’s some attempts have been made by Flaherty (1984) to prove kinship between mummies, such as the tests done on Tutankhamen and Smenkhkare by Connolly in 1976 and already by Harrison in 1969; estimating the blood groups of each one and comparing them was essential to this assessment. Both mummies proved to have the same blood type (group A, and both are MN systems) and so, it was thought they can be related. If these were the only blood groups in Egypt at that time remains to be proved but it is a very probable certainty.
Tutankhamun was due to have been tested for his DNA in 2000 by a Japanese team but The Egyptian Government backed on his decision shortly after, and Tutankhamun was not tested for any genealogy or paleopathology identification.
Even in the case of the foetuses found in his tomb, a DNA test would solve the doubts arisen from the difference between the two bodies, if they are really sisters and twins as it was suggested by Connolly, who says that they are a rare case of twins where one consumes more nutrients from the mother than the other, and therefore one is born much bigger and stronger than the other. I learned this from Dr. Connolly himself when at Manchester’s KNH Centre for Biomedical Egyptology in 2008. Premature and deficient newborns were prevented as possibilities of life were reduced at birth. Probable examples of these were the daughters of Tutankhamen dead at five and six months of gestation.

In 2005, Madeeha Khattab’s team, the Dean from the School of Medicine of University Cairo, with specialists from Italy and Switzerland analyzed Tutankhamun with CAT scans, National Geographic Society and Siemens Medical Solutions donated the equipment. In 2007 Dr. Benson Harer already suggested that his cause of death might have been linked to an accident affecting his leg.
Another interesting detail is that if he really had a deficitary immune system, ancient Egyptians had already found that, as black cumin oil was known in Egypt as a stimulant and reinforcing agent for the immunitary system. At the moment of the opening of the tomb of Tutankhamun, archaeologists found a bottle of black cumin oil, no doubt to ensure lack of pain in the afterlife.

Not related but nevertheless funny is to mention that Tutankhamun’s lost phallus was, after all, buried since the sixties in the sandbox, and this generated much controversy. He was found (again) in 2006 by Hawass, as it never left the sand box where it was in the first place.
The speculation about his death (and his missing penis) started in 1968, when a team from Liverpool University, led by Professor Ronald Harrison, X-rayed Tutankhamun's body in his tomb. These images revealed a possible blunt force injury to the back of his head and the presence of what looked like bone fragments inside the skull.

I learned from Dr. Connolly (and I saw the original X-rays) that the bone fragments inside Tutankhamun’s skull, commonly called ‘the vault’, were small fragments from the smallest bones we have in the skull next to the eyes and nose (nasal, lachrymal, palatine), that break easily, and thus could have been damaged while mummification procedures were in progress. The photos of Tut and his daughters can be seen published in Leek F. The Human Remains from the Tomb of Tutankhamun. Oxford, UK: Tutankhamun Tomb Series V; 1972. More bibliography on the serological tests, previous tests done on Tut and his daughters can be browsed in the JAMA article references’ list.

The pathological condition in the leg is a bone inflammation that, according to the recent released article was enhanced by his weakened immunitary system.
Sir Marc Armand Ruffer studied several Egyptian bodies and published in 1921, regarding leg pathologies in the bone that: “In contrast to the spine, the femurs showed, as a rule, but slight lesions, and even these did not occur often. Altogether only nine femurs showed any lesions, the most pronounced of which, at the upper end.”
Osteomyelitis is the inflammation of the marrow cavity; thirty-one cases were noted on twenty-six individuals from the Predynastic cemetery at Naga ed-Der. The tibia and maxilla are the most frequent affected bones, with ten examples known for the tibia. Elliot Smith and Wood Jones nevertheless concluded that inflammatorydisease s of bone were rarely seen in ancient Egyptian skeletons. New data are also published as they found that “the left second metatarsal head was strongly deformed and displayed a distinctly altered structure, with areas of increased and decreased bone density indicating bone necrosis.”
About Tut’s deformities diagnosed in his foot, they indicate that the disease was ongoing at the time of his death. Since Howard Carter discovered 130 whole and partial examples of sticks and staves in the king’s tomb, we might say that ancient Egyptians prepared him well for the afterlife and this supports the hypothesis of a walking impairment being necessary for the king’s travel after death. And some of those show traces of wear which consolidates the idea that he must have needed some kind of cane to walk.

According to Dr. Corthals, genotype defines phenotype, so, the application of DNA testing can also help to determinate if the strange physiognomy observed in Akhenaten and his children (also Tutankhamun?) may derive from a genetic ‘corridor’ set up in his descendants was indeed a genetic inherited feature. The environment at new kingdom’s times did not have changed substantially enough to disrupt a genetic trace, so it would be possible to confirm Akhenaten’s genetic characteristic and its passage to his offspring. The just published article in JAMA says “a Marfan diagnosis cannot be supported in these mummies.”
So all the theories suggesting feminine traits in this dynasty fall as science once again proved them wrong. And more; “Macroscopic and radiological inspection of the mummies did not show specific signs of gynecomastia, craniosynostoses, Antley-Bixler syndrome or deficiency in cytochrome P450 oxidoreductase, Marfan syndrome, or related disorders.”
Of interest to these findings is also that, in many cases, DNA analysis may provide information about detecting an otherwise invisible infection.
According to the scientific data published in the JAMA (Ancestry and Pathology in KingTutankhamun's Family), “Syngeneic Y-chromosomal DNA in the Amenhotep III, KV55, and Tutankhamun mummies indicates that they share the same paternal lineage.” KV55 is thought to have housed Akhenaten’s body and the article clearly states that “...the KV55 mummy, who is most probably Akhenaten, father of Tutankhamun. The latter kinship is supported in that several unique anthropological features are shared by the 2 mummies and that the blood group of both individuals is identical.” but we still have not got the identification of the mummy in KV55 confirmed. And last but not least, after PCR amplification of DNA samples they found indicative proof of at least a double infection with the P falciparum parasite (malaria) in Tutankhamun, Thuya and Yuya. The stripe was of malaria tropica, the most severe form of this disease. But although his relatives also suffered from malaria, they lived longer than him maybe because although they all lived in a malaria endemic area, the ‘ladies’ did not suffer from the same other pathologies Tutankhamun did.

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