"Grotesque" Imagery of Amarna Art Religion Not Reality

A history resource article by Mary Harrsch © 2010

Image of small statue of Akhenaten  via Wikipedia
I was researching Egypt's 18th dynasty in the course of writing a book review and came across the official journal article detailing the results of a medical analysis recently done on mummies either identified or tentatively identified as members of the 18th dynasty.  The report is fascinating, although laymen may need to keep dictionary.com handy as it is written for the medical professional members of the American Medical Association.

I had heard that the studies had definitely concluded that Pharaoh Tutankhamun was not murdered but probably died as the result of a severe infestation of malaria.  But this report goes much further and discounts most pathological speculations about his father, the "heretic" pharaoh, Akhenaten, as well.

A reproduction of the famous bust of Nefertiti photographed at the Rosicrucian Egyptian Museum by Mary Harrsch (mharrsch) via Flickr

 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 (eAppendix, Table 2). Therefore, the particular artistic presentation of persons in the Amarna period is confirmed as a royally decreed style most probably related to the religious reforms of Akhenaten.  It is unlikely that either Tutankhamun or Akhenaten actually displayed a significantly bizarre or feminine physique.

It is important to note that ancient Egyptian kings typically had themselves and their families represented in an idealized fashion. A recent radiographic examination of the Nefertiti bust in the Berlin Museum illustrates this clearly by showing that the original face of Nefertiti, present as a thin layer beneath the outer surface, is less beautiful than that represented by the artifact.33 Differences include the angles of the eyelids, creases around the corners of the mouth on the limestone surface, and a slight bump on the ridge of  the nose.34 Thus, especially in the absence of morphological justification, Akhenaten’s choice of a “grotesque” style becomes even more significant. - Ancestry and Pathology in King Tutankhamun's Family, Journal of the American Medical Association

I see the researchers also did exhaustive skull studies and apparently the elongated skulls of Akhenaten and Nefertiti's daughters portrayed in Amarna art were also exaggerated. Unlike the Mayans, the Egyptians may have admired an unusually shaped head but they did not attempt skull binding to create it.

Related articles by Zemanta

• Sculptor hid Egyptian queen Nefertiti's flawed beauty (topinews.com)
• Kristin M. Swenson, Ph.D.: Akhenaten's Art: What Some Body Can Say About Religion (huffingtonpost.com)
• Egypt's Former King Tutankhamun's Death Mystery Solved (brainz.org)

     

 

Alexander the Great's Mysterious Death: Poisoned wine or Intestinal Bug?

A history resource article by Mary Harrsch © 2015

Head of Alexander the Great photographed at
The Capitoline Museum in Rome, Italy by
Mary Harrsch  © 2005.

I noticed that a program entitled "Alexander the Great's Mysterious Death" on the Discovery Channel put forward the hypothesis that Alexander died from an accidental overdose of hellebore, a poisonous plant used to induced vomiting in ancient times.

[Alexander the Great, Photographed at the Capitoline Museum, Rome, Italy by Mary Harrsch © 2005 ]

Back in 1998, however, a group of doctors gathered for a clinical pathology conference at the University of Maryland Medical Center expressed their belief that Alexander was killed by an intestinal bug:

Alexander the Great, who ruled much of the ancient world until his death in 323 B.C., was conquered at age 32 not by an enemy, but possibly by a tiny intestinal bug. In an analysis based on available historical records, physicians at the University of Maryland Medical Center believe that Alexander was the victim of typhoid fever.

Their analysis, titled, "A Mysterious Death," is published in the June 11 issue of the New England Journal of Medicine. The most popular theories among historians previously have been that Alexander was poisoned or had died of malaria.

In the week before he died, historical accounts say Alexander the Great had chills, sweats, exhaustion and high fever, all of which are typical symptoms of certain infectious diseases, including typhoid fever.

"He was also described as having severe abdominal pain, causing him to cry out in agony," says David W. Oldach, an infectious disease expert at the University of Maryland Medical Center and lead author of the article.

"That was an important clue, because untreated typhoid fever can lead to perforation of the bowel and may have been the reason for his abdominal pain," according to Dr. Oldach, who is also an assistant professor of medicine at the University of Maryland School of Medicine.

"My discussions with Dr. Oldach and his colleagues caused me to change my mind about what caused the death of Alexander the Great," says Eugene N. Borza. Ph.D., professor emeritus of ancient history who taught for 31 years at Penn State University. Dr. Borza, who is also an author of the New England Journal article, previously thought that malaria caused Alexander's demise.

A curious symptom described in ancient accounts is that Alexander's body did not begin to decay for at least several days after his death. Dr. Oldach says while that defies reason, those around him may have gotten that impression because of another complication of typhoid fever, called ascending paralysis. It is a neurological problem that starts with the feet and moves up the body, paralyzing muscles and slowing down breathing. It can make a person look dead, even if he is not. Alexander may have been in that state for a few days before he died.

The death of Alexander the Great.  Courtesy of History.com.

 Accounts of the death were not consistent with poisoning, although Dr. Borza says that has been a popular belief. "It was an ancient conspiracy theory. People have often suspected a conspiracy when a famous young person dies unexpectedly." Dr. Borza says ancient Greeks who didn't succumb to disease as a child or a battlefield wound often lived into their 70's, because of a healthy diet and constant physical activity.

The New England Journal of Medicine article is believed to be the first collaboration between medical scientists and an historian to answer an ancient question about what caused a famous historical figure to die. Dr. Borza says the earliest surviving accounts about Alexander's death available today were written three centuries after he died, so there was not a lot of information to go on.

"Even so, we found out that much of the scant information we do have is credible, because it makes sense to the medical community. It is important for us to be able to validate the evidence and set the record straight. As historians, that's what we try to do," says Dr. Borza.

For his analysis, Dr. Oldach also had to rely on historical medical accounts of what happens when typhoid fever goes untreated with antibiotics, which did not become available until the 1950's. U.S. physicians today rarely witness untreated patients in the late stages of typhoid fever.

Typhoid fever comes from salmonella typhi, an organism that lives only in humans and can be spread by contaminated water or because of poor hygiene.

Update: 2/18/2015:  

In January 2014 an article was published in the Journal of Clinical Toxicology.  Co-authored by the University of Otago 's Dr. Leo J. Schep, from the National Poisons Centre in New Zealand, the researchers theorized that Alexander was killed by a toxic wine created using a fermented form of Veratrum album (also known as white hellebore) sometimes used to induce vomiting.  The study's authors detailed the potential deadliness of the plant in the study abstract:

"Veratrum album flower" by Alpsdake.
Courtesy of  Wikimedia Commons.

Veratrum poisoning is heralded by the sudden onset of epigastric and substernal pain, which may also be accompanied by nausea and vomiting, followed by bradycardia and hypotension with severe muscular weakness.

"Exposure to extracts from this plant causes clinical effects similar to [Alexander's] reported signs and symptoms," Schep observes, "Of note was the duration of symptoms, which could continue for more than 12 days if intoxicated patients are not treated."

Personally, I think the analysis by the pathologists in Maryland appears more credible (to me) since they evaluated the overall reported symptoms as detailed in fragments of the ancient sources rather than focus on the relatively immediate reactions Alexander experienced at a banquet with his generals that has long been viewed historically as suspect.  If Alexander's digestive tract was  already severely compromised (by a pathogen like typhoid), his consumption of normal wine at the banquet  could have triggered an acute episode of abdominal distress. Without his remains, however, I guess we will never know!

Egyptian doctor thinks Akhenaten Suffered From hyper-pituitarism rather than Marfan's Syndrome

A history resource article by Mary Harrsch © 2015

A sculpture of Akhenaten at the Neues Museum in Berlin.
Image courtesy of Miguel Hermoso Cuesta via
Wikimedia Commons.

The so-called heretic pharaoh, Akhenaten, has fascinated both Egyptologists and the medical community for decades since the discovery of his lost city of Amarna in the late 19th century. Although a mummy was found in a tomb identified as belonging to the enigmatic pharaoh in 1907 (KV55), this identification has been called into question by a number of forensic and medical professionals. 

In his article, "A 3300-year-old medical mystery: What disease was Akhen-aton Suffering From?", Dr. Sameh M. Arab, a professor of cardiology at Alexandria University in Egypt, attempts to deduce the cause of the strangely shaped features of the 18th dynasty pharaoh as depicted in art that has been recovered from the Amarna site while taking into account the forensic evidence presented by the KV55 mummy.  What follows is an abstract of his key points:

"...[Akhenaten's] odd features could not be simply attributed to his foreign descent (Asian blood) from his maternal side. His undue tall stature and feminine-like appearance has raised suspicion that he was suffering from a certain medical syndrome."

"Mariette, the famous French Egyptologist argued that Akhen-Aton was castrated, but
such claim was rejected. He was known to have 6 daughters (and possibly at least one son, his successor, Smenkh-Ka-Ra, from a secondary wife Kiya)."

"The striking features found from the study of his statues, pictures as well as his
mummy (if it were truly his) were those of tall stature, unduly long limbs, elongated skull, long slender neck and long face with a huge mandible (lower jaw)." 

A colossal statue of
Pharaoh Akhenaten
from Karnak.  Image
courtesy of Wikimedia.

"In addition, his feminine features included gynaecomastia (female-like breasts) and a
wide pelvis with fat hips (the breadth of the pelvis exceeds that of the shoulders – a characteristic feature of females). A nude statue during his early reign showed him without genitalia at all. Moreover, he showed a redundant belly in all his pictures."

"Studies of the assumed mummy and specifically the ossification of bony epiphyses (union between the bone shaft and its both ends) have concluded a “bony age” of 26 years (according to Prof. Eliot Smith) or 23 years (Prof. Derry). This age does not match his [Akhenaten's] chronological age as estimated by Egyptologists and historians, which was 37 – 40 years at his death or disappearance." 

Such discrepancy obviously [could be explained] by delayed bony ossification, a condition known in medicine to be due to retarded sexual gland activity." 

But, Arab admits that relying on the physical attributes of a questionable mummy is problematic.

[DNA analysis in 2010 points to discrepancies as analyzed by Kate Phizackerley in her article "DNA Shows that KV55 Mummy Probably Not Akhenaten"]

In 1907, Prof. Eliot Smith also claimed the KV55 mummy indicated a slight hydrocephalus (fluid accumulating inside the brain cavity) and epilepsy. 

"Careful study of the skull has negated the presence of any hydrocephaly. In addition, epilepsy is known to leave no pathological marks on the skull. It is diagnosed in the living by measuring the electrical impulses from the brain. Such claims would certainly be untrue, observes Arab.

Skull from mummy found in KV55.  Image courtesy of
Wikimedia Commons.

Study of depictions of the pharaoh throughout different stages of his life have proved helpful, though. 

"His early reliefs do not show any deformity, while the later ones do. This denotes a disease presenting later in life, at least not during childhood or adolescence," Arab observes.

Several diagnoses were suggested.  The earliest proposed was Florisch's syndrome. 

Florisch's syndrome, a disease caused by diminished secretion of the pituitary gland occurring before puberty or a tumor of the pituitary gland after puberty. The syndrome is characterized by retarded puberty, hypogonadism (diminished sexual activity) and feminine-like fat distribution (thighs, hips and breasts) as depicted in some representations of Akhenaten.  However, it is also associate with dwarfism (if occurs before puberty) and obesity but normal stature if it occurs after puberty.  Akhenaten was described as tall (not dwarfed) and not depicted as obese.

Other suggestions included Marfan's and Kleinfilter's syndromes as well as pituitary gland dysfunction. 

"Klienfilter's syndrome could be ruled out as well," Arab states, "Despite the abnormal skeletal features of the disease that resemble Akhen-Aton's condition, as well as gynaecomastia and small testes, two characteristic features of the disease are inconsistent. Akhen-Aton was neither obese nor infertile. Egyptologists give hard evidence that he had had children."

Fragmentary relief depicting
either a pathogenic condition
or simply stylized portrait of
the pharaoh Akhenaten.

"Marfan's syndrome, [however], could not be [immediately] ruled out. [However,]though the skeletal anomalies are suggestive, there is no evidence of any cardiovascular or eye manifestations [characteristic of this condition] to support this likelihood, even if the mummy found was his. It was a tradition to remove the eye during the process of embalming [so examination of the eyes would not be possible]. Moreover, the feminine-like manifestation would still remain unexplained."

"The most likely diagnosis of Akhen-Aton's disease is hyper-pituitarism. All bony abnormalities seem to favor such diagnosis, together with the sexual ones. A late onset of acromegaly or delayed hypo-gonadism sound to be most descriptive for his illness."

"Further studies of the mummies and pictures of Akhen-Aton's family might be an additive. The mummy of his grandfather Yoya (maternal side) shows a tall man with thick lips and large nose. The mummies of his two successors Smenkh-Ka-Ra and Tut-Ankh-Aton (Tut-Ankh-Amon) also show large skulls. Both are thought by some Egyptologists to be his sons from a secondary wife, Kiya. The early death of a younger brother at young age should also be kept in consideration."

"All reliefs of Akhen-Aton's family show that this large elongated skull was a common feature among his daughters, and his wife Nefertiti as well. This has led some scholars to believe that this skull feature has become a model of Egyptian art during this time. Nefertiti, the six princesses and all the court as well were so depicted as [possibly] a compliment to Akhen-Aton" [who may have indeed exhibited the actual physical characteristics depicted]. 

House altar relief of Nefertiti with her
daughters, Meketaten and Ankhesenpaaten.
Courtesy of Wikimedia Commons.

If this suggestion is untrue, then the possibility of a hereditary disease - rather than an acquired one - is very likely. - More, Sameh M. Arab. MD.

Shakespeare's Portraits Point to Mikulicz Syndrome and Systemic Sarcoidosis

A history resource article by Mary Harrsch © 2015

Several years ago I posted an abstract from an article about the controversy surrounding a death mask identified as William Shakespeare. I received an email from University of Mainz academic Hildegard Hammerschmidt-Hummel, who is a champion of the mask, pointing out that she has written a book about the mask entitled "The True Face of William Shakespeare. The Poet's Death Mask and Likenesses from Three Periods of His Life". In it, she explains the scientific methods she used to analyze the mask and compare it to four Shakespearean portraits.

She also includes information about how the portraits and mask point to the cause of Shakespeare's early death at 52 years old.

"By combining exhaustive academic research with the latest technology and collaborating over
many years with specialists from the most varied disciplines - including forensic experts from the German Federal Bureau of Criminal Investigation (BKA=CID), Professors of Medicine, 3D imaging engineers, archivists and an expert on old masters - Hildegard Hammerschmidt-Hummel has proved the authenticity of the Chandos portrait, the Darmstadt death mask and the Flower portrait (recently incorrectly dismissed as a ‘fake’ by the National Portrait Gallery, as shown by the author's latest evidence). Her revolutionary research has also authenticated another true face of Shakespeare - the Davenant bust. This haunting sculpture has resided in the Garrick Club since 1855 and was thought to be the work of an eighteenth century sculptor. According to the author’s new documentary sources, it derives from the collection of Sir William Davenant (1606-1668), Shakespeare’s godson, who also owned the Chandos portrait.

William Shakespeare at Madame Tussaud's
Wax Museum in London.  Photo by Mary Harrsch
© 2006

By tracing the development of certain signs of illness in each of the images, first noticed by
Hildegard Hammerschmidt-Hummel, the author’s medical experts have identified and verified the most probable cause of Shakespeare’s death. The conspicuous growth on the upper left eyelid, they interpreted as Mikulicz Syndrome (a probably cancerous abnormality of the tear glands), the swelling in the nasal corner of the left eye as a fine caruncular tumour, and the considerable swelling on the forehead (in conjunction with the other pathological symptoms) as systemic sarcoidosis, an inner disease that affects the organs and takes a very protracted course, but proves to be fatal."

Beethoven: A Symphony of Illness

A history resource article by Mary Harrsch © 2015

Portrait of Ludwig Van Beethoven by Joseph Karl Stieler, 1820.
Image courtesy of Wikimedia Commons.

"A 56-year-old Beethoven sought medical care after suffering chills, fever, respiratory distress, and spitting up blood. He complained of chest pain on the right side. He said he had been in good health until two weeks before when he noted a loss of appetite, diarrhea, weight loss, increased thirst, and a swelling of his feet and abdomen. He admits he had been working in the cold at his brother's country home dressed in only flimsy clothing and returned in an open-air cart."

Thus begins a study to determine what may have caused Beethoven's death as a clinical exercise at a 1999 clinical pathologists' conference at the University of Maryland School of Medicine. Each year, a team of practicing pathologists select a famous individual from the past whose manner of death remains speculative and attempt to derive a definitive cause of death.

Beethoven's case is examined by Drs. Michael S. Donnenberg, Michael T. Collins, R. Michael Benitez and Philip K. Mackowiak with their results entitled "The Sound That Failed" ultimately published in The American Journal of Medicine in 2000 (Volume 108, p. 475-480).

The pathology team continues:

"In addition to suffering from progressive deafness that began in his early twenties, the patient suffered recurrent bouts of depression, social isolation and personal neglect. He also began suffering from abdominal pain that he relieved with alcohol. The patient had survived smallpox as a child as well as typhus or typhoid fever. He subsequently claimed to have intermittent winter attacks of "asthma" since the age of 17. In his late forties he noted the onset of chronic headaches and recurrent joint pains which were thought to be rheumatism or gout. At age 51 he suffered an episode of jaundice that lasted six weeks. He also developed a painful eye affliction that was resolved after nine months of patching and noted that he experienced increasing swelling of the lower extremities accompanied by intermitten bouts of nosebleeds, vomiting blood, and coughing or spitting of blood."

"Physical examination revealed a stocky, powerfully built but somewhat emaciated man of swarthy complexion. His face was flushed and prominently pockmarked. His lips were thin and parched, his tongue dry and coated. The skin was hot, flushed , and dry and showed evidence of hair loss."

What was the instrument of the famous composer's death?  (PDF of original article reprinted with permission)

Did the Roman Emperor Claudius accidentally die of poison mushrooms or marital treachery?

A history resource article by Mary Harrsch © 2015

Bust of the Roman Emperor Claudius
Photographed at the Museo Archaeologico
Nazionale di Napoli in Naples, Italy
by Mary Harrsch © 2007

"He ate and drank in excess regularly, rarely leaving his dining room until he was "stuffed and soaked". This caused him to gain considerable weight in later years and produced heartburn so severe that it is reported that he contemplated suicide as his only means of relief."

Thus begins a study to determine what may have caused the Roman Emperor Claudius' death as a clinical exercise at a 2001 clinical pathologists' conference at the University of Maryland School of Medicine. Each year, a team of practicing pathologists and historical consultants select a famous individual from the past whose manner of death remains speculative and attempts to derive a definitive cause of death.

Claudius' case is examined by Drs. William A. Balente, MD, Richard J. A. Talbert, PhD, Judith P. Hallett, PhD and Philip K. Mackowiak, MD.

The researchers continue:

"Born prematurely after only 7 months of gestation, he suffered from a succession of disorders including milk allergy, malaria, measles, deafness, and colitis. He suffered from weakness in both legs to the extent that he noticeably limped and could not walk more than a short distance without assistance. He had longstanding tics and jerks of his head and hands, as well as a stammer and drooling, which were most pronounced when he was excited. He was also prone to fits of inappropriate laughter."

Claudius cowers behind a curtain after the murder of his younger brother,  the
Roman emperor Gaius (Caligula) Caesar.  He is astonished when the Praetorian
Guard declare him Emperor instead of murdering him as well.  "A Roman
Emperor AD 41" by Sir Lawrence Alma-Tadema courtesy of Wikimedia.

"A physical examination revealed that his temperature was normal butt his abdomen was mildly tender throughout."

"An attending physician induced additional vomiting by placing a feather in the back of the patient's throat. Shortly thereafter, the emperor became confused and exhibited signs of unremitting abdominal pain and fecal incontinence. He died 12 hours later."

Was it a case of the "cure" being worse than the disease? (PDF of original article reprinted with permission)

Although the team ends up suspecting that a particular variant of mushroom was a contributor to Claudius' death, surprisingly, the researchers point to Claudius' existing physical disabilities as the reason the episode is ultimately fatal.  In fact, the researchers suspect if Claudius had not be otherwise impaired, the assassination attempt probably would have failed.

I found Dr. Valente's  discussion of possible causes of Claudius' long list of physical defects to be most interesting.  He eventually arrives at a conclusion that Claudius suffered from congenital dystonia caused by abnormal basal ganglia - brain cells interconnected with the cerebral cortex, thalamus, and brainstem - the result of an extremely premature birth. Typical of this disorder, Claudius suffered from a twisting of the foot, involuntary cranial and cervical muscle contractions, an inability to control salivation at times and hypertrophy of the neck muscles as seen in some of his portrait sculptures.  Claudius' excellent cognitive function, however, enabled the researchers to eliminate a number of other conditions.