DIET, DISEASE AND DEATH AT DAKHLEH: A HISTOLOGICAL EXAMINATION OF TEN MUMMIES FROM THE KELLIS 1 CEMETERY IN THE DAKHLEH OASIS, EGYPT. A thesis submitted to the University of Manchester for the degree of Doctor of Philosophy in the Faculty of Life Sciences. 2011 CONSTANCE ISABEL LORD LIST OF CONTENTS LIST OF FIGURES 11 LIST OF TABLES 26 ABSTRACT 28 ACKNOWLEDGEMENTS 29 AUTHOR INFORMATION 30 DECLARATION 31 COPYRIGHT STATEMENT 32 CHAPTER ONE AIMS AND INTRODUCTION 33 1.1 AIMS AND PROJECT OUTLINE 33 1.2 INTRODUCTION 36 1.2.1 Chronology 36 1.2.2 The Dakhleh Oasis 39 1.2.2.1 Water Supply 40 1.2.2.2 Climate 41 1.2.2.3 Subsistence 41 1.2.2.4 Egyptian Occupation of the Dakhleh Oasis 42 1.2.2.5 The Dakhleh Oasis Project 42 1.2.3 Kellis – Ismant el-Kharab (Ismant the Ruined) 46 1.2.3.1 Food in Kellis 48 1.2.3.2 The Ruin of Ismant 52 1.2.4 The Cemeteries 54 1.2.5 The Mummies 58 1.2.5.1 Cultural Objects 65 1.2.6 Data Sources 66 1.2.6.1 Excavation Reports 66 1.2.6.2 Human Remains 67 1.2.6.3 Nile Valley Sources 68 1.3 THE USE OF HISTOLOGY IN MUMMY STUDIES 69 2 1.3.1 Mummy Studies before Marc Armand Ruffer 70 1.3.2 Mummy Studies and Histology 73 1.3.3 The Ethics of Mummy Studies 79 CHAPTER TWO MATERIALS AND METHODS 82 2.1 MATERIALS – SAMPLES 82 2.1.1 Mummification patterns in the Kellis 1 Cemetery 83 2.1.2 The Case Studies 83 2.1.3 Comparative Samples 84 2.1.4 Case Study One – Mummy A1 85 2.1.5 Case Study Two – Mummy A4 87 2.1.6 Case Study Three – Mummy A5 89 2.1.7 Case Study Four – Mummy A8 91 2.1.8 Case Study Five – Mummy A13 93 2.1.9 Case Study Six – Mummy A101 95 2.1.10 Case Study Seven – Mummy A102 97 2.1.11 Case Study Eight – Mummy A108 99 2.1.12 Case Study Nine – Mummy A126 101 2.1.13 Case Study Ten – Mummy A129 103 2.1.14 Comparative Sample – Mummy A9 105 2.1.15 Comparative Sample – Mummy A15 106 2.1.16 Comparative Sample – Mummy A105 107 2.1.17 Comparative Sample – Mummy A106 108 2.1.18 Comparative Sample – Mummy A107 109 2.1.19 Comparative Sample – Mummy A110 110 2.1.20 Comparative Sample – Mummy A111 111 2.1.21 Comparative Sample – Mummy A112 112 2.1.22 Comparative Samples – Mummy A132 113 2.1.23 Comparative Sample - Asru 115 2.1.24 Comparative Sample – Peruvian Mummy (Coprolite 116 Sample) 2.1.25 Comparative Sample – York Conglomerate 117 2.1.26 Comparative Sample – Kulab Narti 117 2.1.27 Summary of Samples 118 2.1.28 Summary of Blocks and Slides produced 119 3 2.2 METHODS – PARAFFIN WAX 122 2.2.1 Rehydration 124 2.2.2 Fixation 124 2.2.3 Processing 126 2.2.4 Embedding and Sectioning 126 2.2.5 Mounting Wax Sections 127 2.2.6 Pre-Stain Slide Preparation 127 2.2.7 Staining 127 2.2.8 Dehydration, Clear and Mount 128 2.2.9 Microscopy 128 2.2.9.1 Focus Stacking Microscopy 129 2.2.9.2 Differential Interference Contrast Microscopy 132 2.3 METHODS – ACRYLIC RESIN 133 2.3.1 Bone 134 2.3.2 Decalcification (Bone only) 136 2.3.3 Decalcification Endpoint (Bone only) 138 2.3.4 Processing and Embedding 138 2.3.5 Blocking Out the Resin 140 2.3.6 Mounting the Resin Blocks onto Chucks 140 2.3.7 Sectioning the Resin Blocks 141 2.3.7.1 Adhesive Tape Methods 141 2.3.8 Staining with Toluidine Blue 142 2.3.9 Mounting the Stained Resin Sections 142 2.3.10 Microscopy 143 2.3.11 Summary of Methods used in this Project 143 CHAPTER HISTOLOGY 144 THREE 3.1 STAINS AND STAINING METHODS 145 3.1.1 Staining Results 148 3.1.2 Staining Discussion 154 3.2 PRESERVATION ASSESSMENT 155 4 3.2.1 Post-Mortem Hypostasis (Lividity) 156 3.2.2 Rigor Mortis 156 3.2.3 Algor Mortis (Cooling) 157 3.2.4 Microorganisms 157 3.2.4.1 Bacteria in the Kellis Mummies 157 3.2.4.2 Fungi in the Kellis Mummies 157 3.2.5 Insects and Egyptian Mummies 162 3.3 PRESERVATION ASSESSMENT OF THE KELLIS 1 164 SAMPLES 3.3.1 Breast Tissue 164 3.3.2 Gastro-intestinal Tract and Contents 166 3.3.3 Heart 170 3.3.4 Liver 174 3.3.5 Lungs 176 3.3.6 Skeletal Muscle 179 3.3.7 Skin 181 3.3.8 Bone 185 3.3.9 Summary of the Preservation Assessment of The 190 Kellis 1 Samples 3.4 CAVEATS FOR THE USE OF HISTOLOGY ON ANCIENT 194 MATERIAL 3.4.1 Tissue Identification 194 3.4.2 Histological Technique Problems 199 3.4.2.1 Rehydration and Fixation 199 3.4.2.2 Decalcification 200 3.4.2.3 Embedding 201 3.4.2.4 Blocking Out 202 3.4.2.5 Sectioning 202 3.4.2.6 Staining 203 3.4.2.7 Mounting 205 3.5 CONCLUSION 206 3.5.1 Case Study – Bone Sample from Mummy A15 206 5 CHAPTER FOUR CASE STUDIES 212 4.1 INTRODUCTION 212 4.1.1 Mummification 213 4.1.2 Brain Removal 216 4.1.3 Pathologies of the Ten Case Studies 217 4.1.3.1 Dental Pathologies 219 4.2 RESULTS – MUMMY A1 224 4.2.1 Skin (Ear) 224 4.2.2 Liver 226 4.2.3 Muscle 227 4.2.4 Bone (Femur) 229 4.2.5 Bone (Rib) 230 4.3 TO BE OR NOT TO BE – CIRCUMCISION IN ANCIENT 232 EGYPT – DISCUSSION OF MUMMY A1 4.3.1 Circumcision in Ancient Egypt 232 4.4 RESULTS – MUMMY A4 241 4.4.1 Skin (Ear) 241 4.4.2 Scalp 247 4.4.3 Breast (Chest Wall) 248 4.4.4 Liver 249 4.4.5 Lung 251 4.4.6 Muscle 254 4.4.7 Bone (Rib) (Intercostal Ligament) 256 4.5 THE NOT-SO-BEAUTIFUL BURIAL IN ROMAN EGYPT – 257 DISCUSSION OF MUMMY A4 4.5.1 Mummification and Burial 259 4.6 RESULTS – MUMMY A5 267 4.6.1 Skin (Ear) 267 4.6.2 Heart 270 4.6.3 Liver 271 6 4.6.4 Muscle 273 4.6.5 Bone (Rib) 274 4.7 NOT FROM HERE – DISCUSSION OF MUMMY A5 275 4.7.1 Parasites and Human Health 276 4.7.1.1 Nematodes 277 4.7.1.2 Trematodes 278 4.7.1.3 Archaeoparasitology of Ancient Egypt 278 4.7.2 Schistosomes 280 4.7.2.1 Transmission and Life Cycle of Schistosoma sp. 281 4.7.2.2 Symptoms of Schistosoma sp. in Humans 282 4.7.2.3 Ancient Schistosomiasis and Modern Findings 282 4.7.2.4 Ancient Egyptian Artistic and Textual Sources for 288 Schistosomiasis 4.7.2.5 The Medical Papyri and Schistosomiasis 291 4.7.2.6 Implications of Schistosomiasis in Mummy A5 295 4.7.3 Possible Trichinella spiralis in Mummy A5 295 4.7.3.1 Transmission and Life Cycle of Trichinella spiralis 295 4.7.3.2 Symptoms of Trichinosis 296 4.7.3.3 Pigs and Trichinosis in Ancient Egypt 297 4.8 RESULTS – MUMMY A8 301 4.8.1 Skin (Ear) 301 4.8.2 Scalp 302 4.8.3 Liver (Bowel) 304 4.8.4 Bone (Femur) 306 4.8.5 Bone (Rib and intercostal ligament) 307 4.9 NOT GROWING OLD IN ANCIENT EGYPT – 308 DISCUSSION OF MUMMY A8 4.9.1 Children in Ancient Egypt 308 4.10 RESULTS – MUMMY A13 315 4.10.1 Skin (Ear) 315 4.10.2 Colon 316 7 4.10.3 Liver 317 4.10.4 Lung 318 4.10.5 Muscle 319 4.10.6 Bone (Rib) 320 4.11 GETTING OLD IN ANCIENT EGYPT – DISCUSSION OF 323 MUMMY A13 4.11.1 Growing Old in Ancient Egypt 324 4.12 RESULTS – MUMMY A101 330 4.12.1 Skin (Ear) 330 4.12.2 Coprolite 332 4.12.3 Liver (Bowel) 341 4.12.4 Muscle 344 4.12.5 Bone (Rib) 346 4.13 PRODUCE AND PARASITES – DISCUSSION OF 348 MUMMY A101 4.13.1 Ascaris 349 4.13.1.1 Ascaris sp. 349 4.13.1.2 Transmission and Life Cycle of Ascaris sp. 350 4.13.1.3 Symptoms of Ascaris lumbricoides in Humans 352 4.13.1.4 Ancient Ascaris sp. and Modern Findings 352 4.13.1.5 Ascaris sp. and the Medical Papyri 354 4.13.2 Diet 355 4.13.2.1 Overview of the Egyptian Diet 356 4.13.2.2 Plant Remains in the Gastro-intestinal Tract of 358 Mummy A101 4.14 RESULTS – MUMMY A102 368 4.14.1 Skin (thigh) 368 4.14.2 Colon 371 4.14.3 Liver 372 4.14.4 Lung 374 4.14.5 Bone (Rib) 379 8 4.15 RESPIRE AND EXPIRE; LUNG DISEASE IN ANCIENT 381 EGYPT – DISCUSSION OF MUMMY A102 4.15.1 Lung Disease in Ancient Egypt 382 4.15.1.1 Tuberculosis 383 4.15.1.2 Emphysema 385 4.15.1.3 Pneumonia 386 4.16 RESULTS – MUMMY A108 389 4.16.1 Bowel 389 4.16.2 Heart 390 4.16.3 Liver 395 4.16.4 Lung 398 4.16.5 Muscle 400 4.16.6 Bone (Rib) 403 4.17 HEARTACHE IN ANCIENT EGYPT – DISCUSSION OF 404 MUMMY A108 4.17.1 The Heart in Ancient Egypt 404 4.17.2 Cardiovascular Disease in Ancient Egypt (The Texts) 406 4.17.3 Cardiovascular Disease in Ancient Egypt (Human 407 Remains) 4.18 RESULTS – MUMMY A126 412 4.18.1 Skin (Bone) 412 4.18.2 Lung 414 4.18.3 Muscle 418 4.18.4 Bone (Rib) 419 4.19 SHORT OF BREATH – DISCUSSION OF MUMMY A126 421 4.19.1 Anthracosis and Silicosis 421 4.20 RESULTS – MUMMY A129 427 4.20.1 Skin (Ear and Leg) 427 4.20.2 Bowel 430 4.20.3 Liver 432 4.20.4 Muscle 433 9 4.20.5 Bone (Rib) 434 4.21 ALL WRAPPED UP – DISCUSSION OF MUMMY 129 438 CHAPTER FIVE CONCLUSION 444 3.1 FURTHER WORK 448 3.1.1 The Medical Papyri 448 3.1.2 Mummification and Burial Practices 449 3.1.3 Children in Ancient Egypt 450 3.1.4 Histology other than Soft Tissue 450 REFERENCES 452 APPENDIX ONE HISTOLOGICAL TECHNIQUES 482 APPENDIX TWO AUTOPSY REPORT – KELLIS 1 CEMETERY 496 Final Word Count – 76 150 10 LIST OF FIGURES FIGURE PAGE 1.1 Location of Dakhleh Oasis 39 1.2 Looking across the Dakhleh Oasis 39 1.3 Date Palms (Dakhleh Oasis) 42 1.4 Map of Dakhleh Oasis 44 1.5 Mud-brick Remains of Kellis 46 1.6 Temple of Tutu (Kellis) 47 1.7 The Kellis Agricultural Account Book 48 1.8 Decorated Walls (Kellis) 53 1.9 Pottery (Kellis) 53 1.10 Map of Kellis 54 1.11 Tomb Entrance (Kellis 1 Cemetery) 55 1.12 Type One Mummification 61 1.13 Type Two Mummification – Wrapped 62 1.14 Type Two Mummification - Unwrapped 62 1.15 Type Three Mummification 62 1.16 Type Four Mummification – Before Autopsy 63 1.17 Type Four Mummification – After Autopsy 63 1.18 Type Five Mummification 63 1.19 Type Five Mummification – Cranial Cavity 63 1.20 Type Six Mummification 64 1.21 Type Seven Mummification 65 1.22 Chart Summary of Mummification Types 65 1.23 Grain Production – Tomb of Menna 68 1.24 Radiograph of a Cat Mummy 71 1.25 Desiccated and Rehydrated Head 72 1.26 Marc Armand Ruffer 74 1.27 Mummy 1770 Autopsy (1975) 76 1.28 Two Brothers‟ Autopsy (1908) 77 11 2.1 Mummy A1 85 2.2 Mummy A4 87 2.3 Mummy A5 89 2.4 Mummy A8 91 2.5 Mummy A13 93 2.6 Mummy A101 95 2.7 Mummy A102 97