Health in Ancient Egypt

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Circumcision
Commoners, who lived in Ain Ladkha, 130 mile southwest of Luxor, between 100 B.C. to A.D. 200, died on average at the age of 38. In the cemeteries of the pyramid builders, most men died between 40 and 45 most women died between 30 and 35. Few people lived beyond 50. More women below 30 died than men of a similar age. This and the figure above is probably explained by complications due to childbirth. Upper class women lived five to ten years longer than lower class ones. Still few people lived beyond 40.

According to Minnesota State University, Mankato: The prescription for a healthy life, (which was almost always given by a member of the priestly caste) meant that an individual undertook the stringent and regular purification rituals (which included much bathing, and often times shaving one's head and body hair), and maintained their dietary restrictions against raw fish and other animals considered unclean to eat. Also, and in addition to a purified lifestyle, it was not uncommon for the Egyptians to undergo dream analysis to find a cure or cause for illness, as well as to ask for a priest to aid them with magic. This obviously portrays that religious magical rites and purificatory rites were intertwined in the healing process as well as in creating a proper lifestyle. [Source: Minnesota State University, Mankato, ethanholman.com]

Excavations in graveyards dated to 3500 B.C. have revealed the bodies of individual who generally seemed healthy and well nourished but died around 15 to 35 years of age. Graveyards are often filled with children and young mothers, which implies that infant mortality and the death rate among young mothers was very high.

Vanessa Thorpe wrote in The Observer, “Mummies disinterred down the ages are usually found to belong to those who were between 25 or 30 years old when they died, and these would have been the bodies of the elite, people who lived in comparative wealth. A few ancient Egyptians survived until they reached 70 or 80 and they were then revered because the gods had so favoured them.” "110 was seen as the ideal target age, but I can't imagine anyone ever made it," [Source: Vanessa Thorpe, The Observer, October 24, 2010]

Websites on Ancient Egypt: UCLA Encyclopedia of Egyptology, escholarship.org ; Internet Ancient History Sourcebook: Egypt sourcebooks.fordham.edu ; Discovering Egypt discoveringegypt.com; BBC History: Egyptians bbc.co.uk/history/ancient/egyptians ; Ancient History Encyclopedia on Egypt ancient.eu/egypt; Digital Egypt for Universities. Scholarly treatment with broad coverage and cross references (internal and external). Artifacts used extensively to illustrate topics. ucl.ac.uk/museums-static/digitalegypt ; British Museum: Ancient Egypt ancientegypt.co.uk; Egypt’s Golden Empire pbs.org/empires/egypt; Metropolitan Museum of Art www.metmuseum.org ; Oriental Institute Ancient Egypt (Egypt and Sudan) Projects ; Egyptian Antiquities at the Louvre in Paris louvre.fr/en/departments/egyptian-antiquities; KMT: A Modern Journal of Ancient Egypt kmtjournal.com; Ancient Egypt Magazine ancientegyptmagazine.co.uk; Egypt Exploration Society ees.ac.uk ; Amarna Project amarnaproject.com; Egyptian Study Society, Denver egyptianstudysociety.com; The Ancient Egypt Site ancient-egypt.org; Abzu: Guide to Resources for the Study of the Ancient Near East etana.org; Egyptology Resources fitzmuseum.cam.ac.uk

Dr. Arthur Aufderheide of the University of Minnesota is regarded as one of the world’s leading experts on the dissection of mummies and a founder of modern paleopathology — the study of ancient diseases.

Tough Life for Ancient Egyptians

Ramses III mummy
A study by team of researchers lead by Gerome Rose and Barry Kemp of the University of Arkansas of people buried in the cemetery of Tell el-Amarna — a city that was the capital of ancient Egypt for 15 years in the 14th century B.C. under the Pharaoh Akhenaten — found that life was short, brutish and tough for the ancient Egyptians. Many suffered from anemia, fractured bones, stunted growth and high juvenile mortality rates. The study found that anemia ran at 74 percent among children and teenagers buried there and 44 percent among adults. Several teenagers had severe spinal injures, thought to have been caused by construction accidents that occurred during the building of the city. The average height was 159 centimeters among men and 153 centimeters among women. Rose said, “Short stature reflect a diet deficient in protein...People are not growing to their full potential.” [Source: Alaa Shahine Reuters, March 29, 2008]

Rose, a professor of anthropology at the University of Arkansas, told Reuters adults buried in the cemetery were probably brought there from other parts of Egypt."This means that we have a period of deprivation in Egypt prior to the Amarna phase," he said. "So maybe things were not so good for the average Egyptian and maybe Akhenaten said we have to change to make things better," he said.

"A very large number of ordinary cemeteries have been excavated but just for the objects and very little attention has been paid for the human remain," Kemp told Reuters. “The idea of treating the human remains ... to study the overall health of the population is relatively new." Paintings in the tombs of the nobles show an abundance of offerings, but the remains of ordinary people tell a different story.

Rose displayed pictures showing spinal injuries among teenagers, probably because of accidents during construction work to build the city. The study showed that anemia ran at 74 percent among children and teenagers, and at 44 percent among adults, Rose said. The average height of men was 159 cm (5 feet 2 inches) and 153 cm among women. "Adult heights are used as a proxy for overall standard of living," he said. "Short statures reflect a diet deficient in protein. ... People were not growing to their full potential."

Concepts of Body and Self in Ancient Egypt

Christina Riggs of the University of East Anglia wrote: “The human body is both the physical form inhabited by an individual “self” and the medium through which an individual engages with society. Hence the body both shapes and is shaped by an individual’s social roles. [Source:Christina Riggs, University of East Anglia, UK, UCLA Encyclopedia of Egyptology 2010, escholarship.org ] “The culture of ancient Egypt offers rich resources for analyzing the Egyptians’ conceptualization of the body and the embodied self, in terms of texts and language, pictorial representation, religious beliefs and eschatology, rituals, bodily practices (including grooming and medicine), and social differentiation (such as class, age, and gender). The practice of mummification informs us, not only of the Egyptians’ knowledge of human physiology, but of their conceptualization of the body, which is culturally constructed in every society, while extant physical remains give a much greater insight into the physical anthropology of the populace than is possible for other ancient societies.

“The human being as a complete entity was composed of numerous elements in addition to, or residing in, the physical body. These included fate, the extent of one’s lifetime (aHaw), the name (rn), the shadow (Swt), one’s personal magic (HkAw), the life force (kA), and in some interpretations, the soul (bA). The heart (jb or HAtj) was a metonym for emotion and cognition, and the pumping of the heart was recognized as an indicator of health and life. The jb- heart connoted emotions and cognition, while the HAtj-heart was the physical organ, although the two words could be used interchangeably. An individual was also linked to his parents and ancestors through both the life force (kA) and the physical body, as the expression “heart (jb) of my mother” may suggest (Book of the Dead 30 a - b). Bringing together these elements of the person is a goal expressed in funerary literature and in art, for instance through the symbolism of coffin iconography, including the Four Sons of Horus associated with the integrity of the corpse. A scene from the Ramesside tomb of Amenemhat depicts each of the Four Sons presenting one of these elements to the deceased: Amset bears the heart (jb), Hapi the bA, Duamutef the kA, and Qebehsenuef the XAt-corpse, presaged as a mummy (saH) by being shown in the wrapped form.”

Ancient Egyptian View of the Physical Body

Christina Riggs of the University of East Anglia wrote: “In the Egyptian language, the physical form of the person is the Dt or Haw, the latter of which may refer more broadly to the concept of self. The Dt-body outlasts the physical body, but at the same time is distinct from the corpse or the mummy. Assmann interprets the Dt-body as a physical form, whereas Walker argues for the Dt as an eternal, transcendent form—not the human body itself. The dead body, or XAt, forms a binary opposition with the bA (ba) in funerary texts: “Your ba will live in the sky in the presence of Re. . . . Your corpse will endure in the underworld in the presence of Osiris”. Loprieno treats the kA (ka), ba, and the transfigured spirit, Ax (akh), as distinct conceptions of personhood, with the ka based on relations among the living, the akh associated with the dead and the gods, and the ba mediating between these worldly and otherworldly states of being. Smith goes further in proposing that the ba is not a component of the individual person, but the whole person as manifested after death. [Source: Christina Riggs, University of East Anglia, UK, UCLA Encyclopedia of Egyptology 2010, escholarship.org ]

Ancient Egyptian pathology

“The vessels, sinews, and muscles of the physical body were known as mtw, and the Egyptians had some conception of bodily fluids, especially blood, flowing through the body and making it whole and intact. Parts of the body that could be removed or excreted— especially hair, semen, saliva, and menstrual blood—were potent symbolic loci. Locks of hair were incorporated into amulets, and the shaving of children’s heads might have signaled a rite of passage or invoked healing. Bodily fluids, which transcend the boundaries of the body and are created within it, were both powerful and dangerous. Saliva was used in magical practice, through spitting, licking, or swallowing actions, and spittle was thought of as having generative powers. Semen and menstrual blood were pollutants, though their power could be corralled through magic. The word mtwt could mean both semen and poison; magical spells express fear of being inappropriately violated by semen, for instance by a demon ejaculating in one’s ear during sleep. There is some evidence that women undertook purification after menstruation, and for the isolation of women during their menstrual periods. The tyet-amulet, which may represent a blood-soaked menstrual cloth, was a protective symbol linked especially to the goddess Isis. Women’s procreative ability meant that breast milk and the urine of pregnant women were used in predictive magic and medical diagnoses.

“The fragmentation of the self into several components—ka, heart, shadow, etc.— mirrored the fragmentation of the body in Egyptian thought. The Egyptians readily conceived of the body as a multitude of discrete parts—hair, head, skin, sensory organs, internal organs, arms, legs, blood, and so on—which must be bound together in both life and death for completeness. Egyptian texts for the rejuvenation of the dead list parts of the body from head to foot to energize them, comparing each body part with a god, and the parts of the body are described as if deified in numerous funerary, magical, and religious texts. Funerary texts and other sources express a deep fear of the body not being intact or being destroyed.

“Physical fracture is also at the core of the hieroglyphic writing system, where human body parts are even more numerous than animal body parts; the former are chiefly limbs and facial features, while the latter are internal organs. Human body parts are core alphabetic signs, common bi- and tri-literals, and determinatives (Gardiner sign-list: D9, a weeping eye; D54, a pair of legs to show movement). The whole human body is essential for the range of hieroglyphic determinatives , which include sitting, standing, and dancing postures, as well as depictions of injured or dead bodies.

“The centrality of the human body in the Egyptian world-view is exemplified by the fact that almost all Egyptian gods take human forms, in whole or in part. A wrapped (“mummiform”) body typifies many depictions of gods and otherworldly beings; indeed the chthonic, creative, or regenerative gods—Ptah, Min, and Osiris—take this form throughout Egyptian history. However, animal and animal-headed human forms prevail for other gods, offering various images that the gods can inhabit; the true essence or appearance of the gods remains hidden, or unknowable. Like mortals, the gods in their embodied forms are also susceptible to fragmentation, and Egyptian myth is replete with fractured bodies, in particular the dismembered corpse of Osiris. In magical and mythological formations the wounding and healing of Horus’s eye is compared to the waning and waxing of the moon, and in the Litany of Ra, the sun god takes on numerous physical forms as aspects of his complete being.

“Such “appearances” (xprw) or transformations suggest a physical shape- shifting, by which one body or state of being can be changed for another. The ability to have multiple forms and move between them is a characteristic of the gods, and human beings aspired to this ability after death, exemplified by the transformation spells of the Book of the Dead). Spell 76 calls, in particular, for “assuming any form one wishes”. Attaining a transfigured state (Ax) depended on correct performance of the rituals relating to mummification and burial.”

Egyptian Environment and Health

Giving birth

Joyce M Filer, an Egyptologist and expert on mummies and ancient Egyptian health issues, wrote for the BBC: “Many accounts of ancient Egypt begin by stressing the influence of the environment, and particularly the great River Nile, on the everyday life of its people. It is a good place to start in considering the health of the Egyptians, as the Nile was the life-and health-giving source of water for drinking, cooking and washing. It also, however, harboured parasites and other creatures that were less beneficial. [Source :Joyce M Filer, BBC, February, 17, 2011 |::|]

“As people waded through standing water, particularly in the agricultural irrigation channels, parasites such as the Schistosoma worm could enter the human host, via the feet or legs, to lay eggs in the bloodstream. These worms caused a lot of damage as they travelled through various internal organs, making sufferers weak and susceptible to other diseases. Sometimes ancient Egyptians took in guinea worms in their drinking water. The female guinea worm would travel to its preferred site-the host's legs-in order to lay her eggs, again causing ill health. |::|

“Despite the fairly wide range of foodstuffs, cereals, fruits, vegetables, milk and meat produced by the ancient Egyptians, not everybody would have had adequate nutrition. There is evidence from the bodies of ancient Egyptians, retrieved from their graves, that some people suffered nutritional deficiencies. |::|

“As in other societies, ancient Egyptians also suffered from more everyday types of sickness. Records reveal that some tomb builders complained of headaches, others were too drunk to go to work, and some had emotional worries. Although it is difficult to gain information from mummies and skeletons about eye complaints, some artwork suggests that such problems were not uncommon. Flies, dirt and sand particles would have caused infections in the eyes and lungs. Many Egyptians wore eye paint, which may have been an attempt to ward off eye infections-it is now known that the green eye paint containing malachite had medicinal properties.” |::|

Short Lifespans and Early Deaths in Ancient Egypt

Joyce M Filer wrote for the BBC: “Life expectancy in ancient Egypt and Nubia was lower than in many modern populations. Whilst some ancient Egyptians undoubtedly enjoyed longevity, most were unlikely to live beyond about 40 years of age. This may seem young by today's standards, but it is important to view age within the context of a particular society. Thus, today people are shocked at the death of King Tutankhamun at the age of about 18 years, yet in his own society he was already 'mature' in terms of family and kingly responsibility. [Source: Joyce M Filer, BBC, February, 17, 2011 |::|]

“Many women died as young adults, and childbirth and associated complications may well have been the cause. Although Egyptians 'experimented' with contraception-using a diverse range of substances such as crocodile dung, honey and oil-ideally they wanted large families. Children were needed to help with family affairs and to look after their parents in their old age. This would have led to women having numerous children, and for some women these successive pregnancies would have been fatal. Even after giving birth successfully, women could still die from complications such as puerperal fever. It was not until the 20th century that improved standards of hygiene during childbirth started to prevent such deaths. |::|

“People are open to the greatest health risks during infancy and early childhood, and in Egypt and Nubia there was a high infant mortality rate. During the breastfeeding period the baby is protected from infections by ingesting mother's milk, but once weaned onto solid foods the chances of infection are high. Consequently many infants would have died of diarrhoea and similar disorders caused by food contaminated by bacteria or even intestinal parasites. In some ancient Egyptian and Nubian cemeteries at least a third of all burials are those of children, but such illnesses rarely leave telltale markers on the skeleton, so it is hard to know the exact numbers affected.” |::|

Health of Ancient Egyptians as Seen Through Their Bones

arms and legs

A CT scan of the skull of a 2,200-year-old Egyptian mummy displayed at the Israel Museum in Jerusalem showed signs of osteoporosis and tooth decay. Other remains from ancient Egypt include a child's skull with anaemic lesions in the eye sockets and an adult with an abscess drainage hole in his worn teeth. [Source: BBC]

Joyce M Filer wrote for the BBC: “Some conditions do leave evidence of their existence on bones. Anaemia, often a consequence of iron deficiency during childhood, leaves markers on the roofs of the eye sockets or on the top of skulls in the form of small holes, and these are frequently seen on Egyptian skulls. [Source: Joyce M Filer, BBC, February, 17, 2011 |::|]

“In ancient Egypt, iron deficiency could have been caused by infestation of bloodsucking parasites, such as hookworms, or by people living on a largely cereal diet, with relatively little iron content. Even the wealthier classes, who had access to meat, may not have consumed it on a regular basis. An examination of the great king Ramesses II, however, revealed he suffered from hardening of the arteries-and this was possibly as a consequence of rich living. Whilst anaemia was not a direct cause of death, it would have made sufferers weak and vulnerable to other diseases. |::| Arthritis and dental problems are features of many ancient societies, and ancient Egypt was no exception. Although arthritis can set in after an accident or infection, generally it is a consequence of the ageing process. As joints wear down through usage the cartilage wears away, leaving the bones rubbing together and causing the ends of the bones to develop lipping at the edges-leaving proof of the sufferer's condition for posterity. |::|

Worn teeth and cavities testify to the poor dental health of some Egyptians. The quantity of sand particles in their bread has been suggested as the cause of the often serious amount of wear on ancient Egyptian teeth. Many Egyptian dentitions present a round drainage hole, suggesting the presence of an abscess, where infection has forced an exit through the bone. This may have solved the problem, but there may also have been many deaths caused by un-drained dental abscesses in ancient times. |::|

“Evidence for serious conditions such as tuberculosis, leprosy, tumours, polio, cleft palate has also been noted in exhumed Egyptian and Nubian bodies.” |::|

How Age and Sex are Estimated from Skeletal Remains

Sonia Zakrzewski of Southampton University wrote: “In order to undertake demographic analyses, reliable and precise estimates of age and sex are required. Biological ages (as opposed to chronological or social ages) are estimated from markers of maturation and growth or markers of degeneration of the bones and teeth. Similarly, while it may seem odd to refer to the “estimation” of sex, the sex of skeletons (as opposed to mummies) can be treated as “known” only under certain circumstances, such as if sexing through genetic methods or the visual inspection of preserved external genitalia. [Source: Sonia Zakrzewski, Southampton University, UK, UCLA Encyclopedia of Egyptology 2015, escholarship.org ]

“ Assigning sex and age categories to skeletal material involves errors and probabilities, and so this process should be considered as estimation or assessment rather than the determination of age and sex. Although sex is of less importance than aging when considering the ancient Egyptian life span, it does have an impact on demographic studies. In an ideal situation, some individuals would form a reference sample of persons of “known” sex against which other individuals might be sexed. Ideally this would be done through genetic studies, but more commonly and practically involves using the Phenice pubic bone characteristics.

arthritis bone deformities

“Research is currently ongoing to develop metric methods for estimating sex for ancient Egyptians based on modern forensic methods. Biological age can more accurately be assessed for juveniles than for mature aged individuals. Long bone length, dental development, and timing of formation of ossification centers (zones in which bones form in juveniles as part of the growth process) and epiphyseal union (joining together of such separate bones as part of the growth and development process) can all be used to estimate age-at-death for subadult remains. Dental development is considered the most accurate means of estimating age-at-death in subadults because it is thought to be under the greatest genetic control. By adulthood, no further dental or bone growth occurs, and hence age estimation of adults relies on degenerative methods.

“The most common methods include assessment of the pubic symphysis (anterior area of the pelvis), auricular surface (where each of the two pelvic bones joins the sacrum at the base of the spine), rib ends, cranial sutures, and dental wear. Some of these, such as dental wear, are problematic for Egyptian samples as many ancient Egyptian teeth exhibit high grades of dental wear as a result of the foods consumed and the storage and processing methods used for those foods. Transition analysis and multifactorial methods, based upon Bayesian analysis, appear hopeful in improving the accuracy and precision of Egyptian age estimates. These latter methods use “known” reference samples and survivorship models to estimate at what age those known aged individuals transition from one skeletal phase to another. In the absence of Bayesian methods, most bioarchae-ologists working in Egypt rely on multiple indicators to obtain the best estimates of age. Skeletal and Mummified Assemblages As noted earlier, there are issues with the overall representatives of assemblages of Egyptian skeletal and mummified material. Within western museum collections, skeletons have usually been obtained and curated as a result of historical personal connections between excavators, patrons, and/or museum curators.”

Health Data on Ancient Egyptians from Skeleton Collections

skeletol remains in basketwork coffin, 3000 BC

Some interesting findings have come from individual skeletons and mummies but it is hard make generalizations from these about the general ancient Egyptian population. Sonia Zakrzewski of Southampton University wrote: “Many large Egyptian skeletal collections exist, such as the Phoebe Hearst Museum of Anthropology (UC Berkeley), the Duckworth Collection (Cambridge University), the Smithsonian National Museum of Natural History (Washington DC), the Natural History Museum (London), the Peabody Museum (Harvard University), the Naturhistorisches Museum (Vienna), and the Kasr el Aini medical school (Cairo) collections, but none can be said to be truly representative of either a site, a period, or even a complete cemetery. Large collections of mummies are rarer, but do exist in locations such as the Egyptian Museum. More commonly, individual mummies or a few mummies are found in a variety of different museums, often brought to the west as a result of family travels or business transactions in the eighteenth and nineteenth centuries. [Source: Sonia Zakrzewski, Southampton University, UK, UCLA Encyclopedia of Egyptology 2015, escholarship.org ]

“Such collections are therefore not random and are rarely suitable for demographic studies. Following the pioneering work of the Manchester Mummy Project, and its development of the International Ancient Egyptian Mummy Tissue Databank, “virtual” collections are being developed, so that biological data may be available to multiple researchers. The osteological paradox influences our understanding of ancient Egyptian demography and longevity. Wood et al. showed that the absence of skeletal evidence of disease does not mean that there was an absence of disease; individuals may have died at either an early or acute phase of the disease, which would mean that those people died before their body developed lesions as a result of the disease. Furthermore, the implication of the osteological paradox is that individuals who exhibit skeletal markers of chronic disease may actually reflect long-term survival with such chronic conditions, and therefore may be the healthier individuals within the overall population. Furthermore many diseases affect only the soft tissues and so do not leave osseous signatures. This means that aspects of health are very hard to ascertain from the skeletal and palaeopathological record.

“Individuals who survived repeated episodes of stress and infection may have many skeletal markers of such episodes of ill-health or stress upon their bodies. This is likely to impact unevenly on the sample, as individuals who lived longer have had more time to become exposed to, and develop markers of, such stresses and diseases. This does not mean that older-aged individuals within a group were less healthy than younger individuals, but rather may imply that the frailer individuals died when they were young, but before they developed skeletal lesions.“

What Mummies Tell Us About Ancient Egyptian Health

Ramses IV mummy
Mummy expert Dr. Arthur Aufderheide estimates that only 10 percent to 15 percent of mummies show the cause of death. They are more revealing about chronic ailments, the presence of parasites and determining what people ate (if their intestines are still there).

In 1910, Marc Armand Ruffer, a French microbiologist, found dried eggs of the schistosomiasis worm in kidneys of two 3000-year-old mummies. Schistosomiasis remains a disease that is prevalent in Egypt today. In other mummies he found gallstones, inflamed intestines, and a spleen that had apparently been enlarged by malaria. Ruffer looked inside ancient blood vessels and found calcified spots — evidence of hardening of the arteries, surprising considering the ancient Egyptians ate a low-fat high-fiber diet with a lot of grains. Ruffer invented a solution of salts for rehydrating ancient tissues (some researchers today use fabric softener) and popularized the term “paleopathology.”

Over the decades scientists have learned to glean information from ancient bones. Leprosy, anemia, stunted growth, syphilis and tuberculosis leave behind characteristic marks in the eye sockets, spine and other bones. Bones also leave behind clues about arthritis and vitamin deficiencies and can indicate whether a person who died violently such as being struck by an ax or knife or a blunt instrument. Even so 80 percent of ailments — plague, aneurisms, measles and others — leave behind no clues or marks.

A 2,200 year old mummy displayed at the Israel Museum in Jerusalem in 2016 showed how unhealthy some ancient Egyptians were. Scott Simon of NPR wrote: “His name was Iret-hor-irou, the protective Eye of Horus. He was an Egyptian priest, 5 foot 6, who was probably between 30 and 40 years of age when he died, according to tests run on the linen in which he's been wrapped since the second century B.C. The priest seems to have suffered from a series of ailments, which we think of as afflicting people who may have a little too much idle time on their hands-osteoporosis, cardiovascular disease and lack of vitamins from the sun. [Source: Scott Simon, NPR.org, July 30, 2016]

“Osteoporosis is a disease that's characteristic of the 20th century when people don't work so hard. Galit Bennett, who curated the mummy exhibit, told the Associated Press, we are glued to screens. We were very surprised that there were people who didn't do physical work and that it affected their bodies like this man here. The mummy also reportedly has tooth decay.”

King Tutankhamun's Health Determined from CT Scans and DNA Tests

X-ray of Tutankhamun's head

King Tutankhamun was five feet six inched tall and slightly built and 18 to 20 when he died. In the June 2005 issue of National Geographic, artists and scientists produced striking images of what they believed King Tutankhamun looked like using a CT (computerized tomography) scans and facial reconstruction. The images that were produced showed a fair-skinned young man with a ski-sloped nose, a small cleft planate, an elongated skull, good teeth, and a slight overbite possessed by other members of his family. He had no cavities in his teeth. [Source: A.R. Williams, National Geographic, June 2005]

Tutankhamun age was determined by the maturity of his skeleton (his skull had not closed) and his wisdom teeth (which hadn’t grown in yet). Careful examinations of his head revealed he had a distinctive egg-shaped head, and he lacked the feminine appearance he seems to have in his death mask and other artifacts. He may have fractured his thighbone.

CT images, which were part of a study published in the February 2010 of the Journal of the American Medical Association, revealed that Tutankhamun had a club foot and other deformities, meaning he probably had to walk with a cane. DNA analysis of Tutankhamun and his relatives seem to indicate that he had several disorders, some of which ran in his family such as a bone disease and club foot. The authors of the study wrote Tutankhamun was “a young but frail king who needed canes to walk because of the bone-necrotic and sometimes painful Koehler disease II, plus oligodactyly (hypophalangism) in the right foot and clubfoot on the left.”

Zahi Hawass wrote in National Geographic,” When we began the new study, Ashraf Selim and his colleagues discovered something previously unnoticed in the CT images of the mummy: Tutankhamun's left foot was clubbed, one toe was missing a bone, and the bones in part of the foot were destroyed by necrosis — literally, "tissue death." Both the clubbed foot and the bone disease would have impeded his ability to walk. Scholars had already noted that 130 partial or whole walking sticks had been found in Tutankhamun's tomb, some of which show clear signs of use.” [Source: Zahi Hawass, National Geographic, September 2010]

“Some have argued that such staffs were common symbols of power and that the damage to Tutankhamun's foot may have occurred during the mummification process. But our analysis showed that new bone growth had occurred in response to the necrosis, proving the condition was present during his lifetime. And of all the pharaohs, only Tutankhamun is shown seated while performing activities such as shooting an arrow from a bow or using a throw stick. This was not a king who held a staff just as a symbol of power. This was a young man who needed a cane to walk.” [Ibid]

Famine in Ancient Egypt

Laurent Coulon of the University of Lyon wrote: “In ancient Egypt, food crises were most often occasioned by bad harvests following low or destructive inundations. Food crises developed into famines when administrative officials— state or local—were unable to organize storage and redistribution systems. Food deprivation, aggravated by hunger-related diseases, led to increased mortality, migrations, and social collapse. In texts and representations, the famine motif is used as an expression of chaos, emphasizing the political and theological role of the king (or nomarch or god) as “dispenser of food.” [Source: Laurent Coulon, University of Lyon, France,UCLA Encyclopedia of Egyptology 2008, escholarship.org ]

relief showing starving Bedouins in the 4th century BC

“In pre-modern times, food production in Egypt was heavily dependent on cultivation of the Nile Valley lands, watered and fertilized by the annual flood. Because the inundation level was irregular, food crises recurred fairly frequently, ranging from food shortages to famine, a term which, strictly speaking, should be reserved for “critical shortage of essential foodstuffs, leading through hunger to a substantially increased mortality rate in a community or region, and involving a collapse of the social, political and moral order”. The correspondence between Hekanakht, a landowner who lived during the early 12th Dynasty, and his dependents gives an account of the serious difficulties encountered by various strata of society at a time when the Nile only partially flooded the cultivated lands. Epigraphic and literary sources give numerous mentions of successive years of low flood, exemplified by the biblical episode in which Joseph interprets Pharaoh’s dream of seven lean cows and seven dried stalks of wheat. At the beginning of the First Intermediate Period, Ankhtify’s autobiography recounts a dark period when, except in his nome, “all of Upper Egypt was dying of hunger and people were eating their children.” Paleopathologic studies also provide cases of nutritional stress and high mortality at various times, but it is only for the Greco-Roman Period that we possess the papyrological documentation for a historical overview of famines in ancient Egypt; the study of such documentation shows—not surprisingly—the coincidence of famines with plague epidemics.

“Famines were also capable of prompting migrations of population. Ankhtifi’s autobiography mentions that “the whole country has become like locusts going upstream and downstream.” Migrations probably played a significant role in the birth of Egyptian civilization during the Holocene Period, when drastic climatic changes and increasing aridity may have forced inhabitants of the Western and Eastern Deserts to settle on the banks of the Nile.

“The consequences of low or destructive inundations depended to a large degree on the ability of administrative officials—state or local—to anticipate subsistence crises: sufficient storage of surpluses from one year to the next and an efficient redistribution system could counter bad harvests. Conversely, famine clearly correlates with mismanagement of the state administration—for example, during the 20thDynasty, when the workmen of Deir el- Medina were compelled to go on strike to obtain their salaries. The prosperity of the Egyptian state was nevertheless famous throughout the Near East, and New Kingdom pharaohs used grain supplies as diplomatic gifts when their allies, especially the Hittites, were facing starvation; on the other hand, the Egyptian army commonly induced famine artificially, through destruction of harvests and cattle, to subdue foreign enemies.

“The Egyptians viewed food deprivation as a liminal experience, approaching chaos. Because the experience of chaos was included as a kind of “rite of passage” in the funerary ritual, the deceased were therefore required to suffer hunger and thirst before being regenerated by funerary offerings. The evocation of the elite suffering famine is also an essential feature of the social anarchy described in texts such as The Prophecy of Neferty and The Admonitions of Ipuwer. Conversely, representations occasionally emphasize the opulence of the Egyptians from the Nile Valley by contrasting them with the starving nomadic tribes, as we see, for example, in 5th-Dynasty reliefs depicting emaciated Bedouin and in the 12th-Dynasty relief of a cowherd in a tomb of Meir. “Nourishing the land” and “giving bread to the hungry” are the basic definitions of the role of the king and high officials; the evocation of famine in hieroglyphic texts is embedded in this ideological discourse. Recent studies suggest that the repeated evocation of famines in First Intermediate Period texts reflects the employment of a new rhetoric of the nomarch as “dispenser of food,” featuring realistic descriptions rather than the standard clichés . To use these texts as evidence of climatic changes is therefore misleading, the more so as this self-presentation of the nomarch is still attested during the Middle Kingdom. Divine intervention against famine is also a frequent motif of Late Period texts, among the most famous of which is the so-called “Famine Stela” at Sehel, a Ptolemaic inscription celebrating the prosperity granted to the region by the god Khnum after a seven-year famine during the reign of Djoser.”

Dwarfs in Ancient Egypt

Dwarfs were regarded as auspicious figures rather than freaks. The dwarf Seneb was a famous artist. Another dwarf was an “overseer of dwarfs in charge of dressing” the king. Dwarfs also served as tutors of the king and his son, high prestige positions. In the grave of a dwarf named Pemiankhu, a lovely basalt figure was found with a hieroglyphic text that read: “The one who delights his lord everyday, the King’s dwarf Periankhu of the Great Palace.”

The divine “god dance” performed by dwarves was greatly loved. If dwarves weren’t available chondrodystrophic cripples were used. Grotesque dwarf-figure toys and figures have been discovered. The dwarf gods Aha and Bes figure as musicians and singers in reliefs of royalist rituals. There is also some evidence that foreign “exotic” dancers — namely Libyans and Nubians — were in demand,. There are images of scantily-clad, black-skinned dancers at celebrations marking the arrival of the divine barks at Karnak. Libyan dancers are pictured doing a boomerang hunting dance with phallic shapes and ostrich feathers in their hair.

Trying to Determine Life Expectancy of Ancient Egyptians

dancing dwarf

The study of the human remains at the South Tombs of Amarna showed an inverse mortality curve, ages at death highest between 7 and 35 years, with the peak between 15 and 24 years. Although average life span was lower in ancient Egypt than it is today, Michael R. Zimmerman of Villanova University in Pennsylvania, told the New York Times that many individuals, especially the wealthy, lived a relatively long time. [Source: George Johnson, New York Times, December 27, 2010 ==]

Sonia Zakrzewski of Southampton University wrote: “How long did the average ancient Egyptian live? What was the life expectancy at birth? How did life expectancy change as a person aged? Did this vary across time periods or between areas in Egypt? While some individuals lived to reach a very old age, the average age-at-death was probably not nearly so great.” [Source:Sonia Zakrzewski, Southampton University, UK, UCLA Encyclopedia of Egyptology 2015, escholarship.org ]

“It is impossible to obtain an estimate of how old the average ancient Egyptian when he or she died. “Arguments should focus instead on variations in patterns of age profiles across Egypt, both in terms of time and place, and in the actual importance of chronological, biological, and social age. Skeletal and mummy studies permit biological age estimates to be made for individuals. These are not chronological ages, as they mark and evaluate the biological changes occurring to that particular person. Chronological ages, in terms of years, may be obtained from documentary sources. It is, however, hard to compare and link these two types of age. In addition, of potentially greater importance is social age. At what age was an individual considered to be a “person,” a “child,” an “adult,” or eligible for marriage or suitable to be a worker? How do these social ages correlate with either biological or chronological ages? Were there social or corporeal markers to delineate such social age categories? Certainly some Egyptian texts contain clear descriptions of what it meant both to be a child and to become old .

“Life expectancy at birth can be estimated in certain situations, as undertaken by Bagnall and Frier for the Roman Period. The key is to remember that life expectancy rises after the child’s survival of the early years, and that life expectancy at birth is not the average age at which adults died within the Egyptian population. Some individuals certainly lived to an old age, and there are plentiful artistic representations indicating respect for elderly men, such as in the tomb of Sennefer. Despite the clear evidence for an idealized life span of 110 years, one should not expect many ancient Egyptians to have ever reached the age of 100 or 110 years.

“When a cemetery is well excavated, using current bioarchaeological and bioanthropological methods, and the skeletal preservation is good, it is possible to obtain good estimates for age-at-death for most individuals. This is easier for subadults, but, apart from the Kellis 2 cemetery at Dakhla oasis, these are not always as well represented in the Egyptian archaeological record. In these cemetery situations, life tables or Bayesian hazard analysis might be employed, and estimates of life expectancy and the age-at-death structure of the sample obtained. In certain situations, mortality profiles developed may then be linked with other archaeological evidence, such as the seasonal peaks in mortality at Kellis 2 in the Dakhla oasis.”

Determining Life Expectancy of Ancient People

Sonia Zakrzewski of Southampton University wrote: “The mortality or death rate (denoted by q) is defined for a specific time interval as the proportion of the population that is alive at the start of that interval but dies before the end of the time interval. The probability of dying, however, is not constant with age. The following section provides a series of definitions of terms required for demographic study. For all these technical terms, an age category is referred to as x, so age-specific mortality (qx) is the mortality rate of individuals in age category x. Age-specific mortality (qx) is high in juveniles, falls to a low during adolescence and early adulthood, and then rises steadily with increasing age. Mortality rates are also affected by factors such as sex and social status. Most groups normally exhibit an attritional mortality profile, where the mortality pattern follows that described above. However, there are also situations where high mortality (or crisis/catastrophic mortality) conditions exist, such as during natural disasters, e.g., flooding or famine, epidemic disease, or period of conflict, and this affects the profile. Life tables are a way of representing the mortality of populations, and model life tables summarize this for typical populations and are useful when reconstructing the life table of a population for which reliable data is only available for some of the age categories (as in most archaeological assemblages). The model life table most commonly used when modeling historical or prehistoric populations, with their high levels of mortality, is the Coale and Demeny “West” model, such as for Roman Egypt. [Source: Sonia Zakrzewski, Southampton University, UK, UCLA Encyclopedia of Egyptology 2015, escholarship.org ]

artial lessions from Egyptian mummies

“Life expectancy can be calculated from a life table. The most commonly quoted life expectancy is the average life expectancy at birth (e0). It is important to distinguish between life expectancy at birth and life expectancy at later ages because they impact upon understanding how long each ancient Egyptian person actually lived. In addition, ideally an understanding of the risks that may affect the quality of life, death and birth rates, and the causes of death need to be known. The archaeological populations or samples that are available for study are also problematic because skeletons of juveniles are rarely as well preserved as those of adults. This means that this massive number of deaths in the early years of life is rarely recognizable archaeologically, although the Kellis 2 cemetery at Dakhla oasis is an exception.

“Paleodemography is the term used for such studies of ancient or past populations, Methods for demographic analyses of mummies and skeletal samples has recently changed as it has been understood that the methods used to assign ages and sexes to skeletons are conditional upon the samples from which the methods are derived. As a result, aging and sexing are now undertaken in association with demographic studies. Indeed Konigsberg and Frankenberg argue that “individual age or sex estimates cannot be produced until after the demographic analyses have been performed.” Life table study, although still common, has started to be superseded by analysis of hazard models of mortality and estimations of the age-at-death structure of a population. Hazard models are a type of statistical model that specifies the time until an event (death) occurs, and so hazard functions express the risk of death as a function of time . This means that these models can represent a continuous age-at-death distribution using a relatively small string of parameters, such as frequencies of juvenile mortality, and old-age mortality, but enable the maximum amount of information to be used in the analysis of deaths in a population. Hazard models develop probability density functions (f(x)) which are the rate of change of the probability that an individual survives to at least age x (S(x)). These values are thus similar to the life table values of dx and lx respectively. Use of such methods requires both mathematical and computational analysis and so are, at this stage, only starting to be implemented within bioarchaeology.”

Life Expectancy Based on Roman-Era Censuses

Sonia Zakrzewski of Southampton University wrote: “In Roman Egypt there are a variety of different documentary sources of demographic data, including tax and census returns. From this period, over 840 census declarations still exist, with the earliest dating from 12 CE and the latest to about 259 CE. From these census returns, nearly 1100 registered persons can be made out, with sex known for more than 1000 people, and age for more than 700. Census data have their own issues, such as the unit of filing (i.e., at the household or person level) or who was required to file a declaration, but Bagnall and Frier (1994) believe that the entire population of Egypt, whatever the social status, was registered. About three quarters of the Roman Egyptian census returns are from the Arsinoite and Oxyryhnchite nomes, and so are neither fully representative nor random. It is also impossible to quantify how thorough Egyptian administrators were in collating such census returns, or how diligent and accurate residents were in completing their returns. [Source: Sonia Zakrzewski, Southampton University, UK, UCLA Encyclopedia of Egyptology 2015, escholarship.org ]

“ Bagnall and Frier recorded ages for 337 women from Egyptian census returns. Using the Coale-Demeny “West” model, the life expectancy at birth (e0) for Egyptian women was 22.5 years, but on their 20th birthday (e20) it was another 29.9 years (i.e., 49.9 years of age). Overall, they reconstruct Roman Egyptian female life expectancy at birth as 20 to 25 years, and life expectancy at age 10 of 34.5 to 37.5 additional years. Furthermore, from the census returns, they calculated an annual female birth rate of 42-54 per thousand and an annual female death rate of 42-49 per thousand. They also recorded ages for 350 males from census returns, and obtained an overall sex ratio of 1.104 (males to females, i.e., more than 110 males for every 100 females). Separating the villages from the metropoleis provided a different pattern, with the sex ratio in villages being just 0.861, whereas it was 1.447 in metropolitan areas. This demonstrates the problems with calculating sex ratios from raw data in census returns. Bagnall and Frier also argue for a male life expectancy at birth of at least 25 years, of between 35 and 40 further years at age 10, and of slightly more than 30 additional years at age 20. In addition, they suggest an annual birth rate of about 45 per thousand and an annual death rate of just over 40 per thousand across the whole population.

“Bagnall and Frier noted 211 instances where the census returns preserve both the age of the mother and of her child. From these they calculated that the median age of Egyptian maternity was about 26 years. They also noted 155 cases in which both the age of the father and his child were known, with paternity recorded as rare before age 20 and peaking in the early thirties. The median age of paternity was approximately 37 to 38 years. Slaves also presented census problems, as documentarily, at least, they did not have legal fathers and rarely had a named mother unless the mother was also a slave resident within the household. Less well studied for demographic purposes, but common in earlier periods in Egypt, are commemorative inscriptions.”

Life Expectancy Based on Funerary Stelae and Tombs Information

mummified heart and lung

Sonia Zakrzewski of Southampton University wrote:“From the Middle Kingdom onwards,funerary stelae and tombs contain biographical information, but almost always lack ages at death or dates of birth or death. Autobiographical elements, albeit primarily related to the tomb-owner’s work and position in society, are most common in tomb decoration during the New Kingdom. An example of a private citizen detailing their life with ages occurs in the 21st Dynasty. Examples from the 18th Dynasty include an autobiographical stela from Memphis in which the name of Thutmose may be invoked as an omen for protection. Other artifacts, however, do provide some evidence. [Source: Sonia Zakrzewski, Southampton University, UK, UCLA Encyclopedia of Egyptology 2015, escholarship.org ]

“From the reign of Ramesses II, the high priest of Amun at Karnak, Bakenkhons, provides career information on one of his limestone block statues. Altogether, summing together his years of education and periods as various forms of priest, a time span of 85 years is recorded, suggesting that he must have been at least 90 when he died. Such commemorative inscriptions, while useful, are often biased in terms of ages or gender, and usually vastly underrepresent children and infants.

“Scheidel has demonstrated that, during the Roman Period at least, where dates are given on tombstones and mummy labels, these refer to the completion of mummification rather than the actual date of death. In addition to the taxation records noted earlier, longevity and other demographic data may also be obtained from other written sources, such as ostraca, papyri, etc. These may be in the form of letters, receipts, lists of workers, or other similar documents.”

Problems with Health and Life Expectancy Data from Cemeteries

Sonia Zakrzewski of Southampton University wrote: “Aspects of demography can be developed from data obtained by analyzing skeletal or mummified remains. There are, however, a number of issues that arise with this data. No cemetery sample fully and accurately reflects the population structure. The remains buried and excavated from a cemetery are a sample of those who lived at a particular time. Four major extrinsic factors affect the dead assemblage, and all tend to reduce the size of the sample so that it is much smaller than the original population. They are: i) the proportion of all those who died that were buried at the site, ii) the proportion of those who were buried whose remains survived to discovery, iii) the proportion discovered, and iv) the total excavated, recovered, and curated. The final skeletal assemblage studied is therefore only a sample of those who lived, were buried, whose burial survived, and whose body could be discovered, excavated, and studied. It is a sample very much removed from the living population . [Source: Sonia Zakrzewski, Southampton University, UK, UCLA Encyclopedia of Egyptology 2015, escholarship.org ]

map of the Giza necropolis

“The proportion of the dead that are buried at the site is itself complex. The dead individuals are not necessarily representative of the living population, as they are, by definition, dead. The buried population studied thus is related to the living population from which it originally derived, but it is not a straight and simple reflection of the composition of that living population. This is especially important when considering the interaction with disease and the aging process. Superficially, one might assume that a skeleton displaying greater number of pathological lesions was more “ill” than a skeleton not displaying any such lesions. Similarly, rationally, one might assume that if a population shows a higher proportion of skeletal lesions, or a lower age-at-death profile, the more “unhealthy” that population was relative to comparator groups. Paradoxically, this is not the case.

“Many diseases do not affect the skeleton. In addition, many people suffering from a disease that does leave pathological lesions on the bone may die before any pathological lesions form on the skeleton. As a result, those disease processes seen on the body do not fully represent the health or illness of the individual. This is the osteological paradox, whereby individuals expressing skeletal lesions of disease may be the healthier portion of the living population as they were the people who lived long enough with the disease to produce the skeletal markers of that disease. This means that they survived long enough to display the pathology. Furthermore, within any living population variation in susceptibility to disease exists (so-called “frailty”).

“Those individuals who are actually the most “sickly” or “ill” in a population may leave a skeleton bearing no evidence of disease, whereas those whose health was more robust in life may leave a skeleton exhibiting severe skeletal pathology due to their long survival with one or more infections. Furthermore, infection can reduce immunity to other infections, thereby also affecting mortality patterning, with the most “frail” being most susceptible to other disease processes. Following this osteological paradox, the people recovered from a funerary context may have been more or less susceptible to disease or other biological stressors than the surrounding wider population.

“In addition, social customs for a particular period or place may restrict those who get a burial in such a way that the cemetery would never reflect the true distribution of deaths in the population. It is well-known that Egyptian graves and cemeteries were prone to disturbance as a result of grave robbing or agricultural or urban encroachment. Taphonomic factors affect the relative preservation of burials in differing conditions, with small bones, such as those of juveniles, more rarely being preserved.”

Image Sources: Wikimedia Commons, The Louvre, The British Museum, The Egyptian Museum in Cairo

Text Sources: UCLA Encyclopedia of Egyptology, escholarship.org ; Internet Ancient History Sourcebook: Egypt sourcebooks.fordham.edu ; Tour Egypt, Minnesota State University, Mankato, ethanholman.com; Mark Millmore, discoveringegypt.com discoveringegypt.com; Metropolitan Museum of Art, National Geographic, Smithsonian magazine, New York Times, Washington Post, Los Angeles Times, Discover magazine, Times of London, Natural History magazine, Archaeology magazine, The New Yorker, BBC, Encyclopædia Britannica, Time, Newsweek, Wikipedia, Reuters, Associated Press, The Guardian, AFP, Lonely Planet Guides, “World Religions” edited by Geoffrey Parrinder (Facts on File Publications, New York); “History of Warfare” by John Keegan (Vintage Books); “History of Art” by H.W. Janson Prentice Hall, Englewood Cliffs, N.J.), Compton’s Encyclopedia and various books and other publications.

Last updated September 2018