Vertebral tuberculosis in ancient Egy pt and Nubia • 193 



T 1 2 and less compressed T 11 . In spite of the expressed diag- 

 nosis of a "chronic rarefaction" leading to "gradual compres- 

 sion of the . . . vertebrae" (Abadir 1953:85), tuberculous 

 origin of the condition cannot be excluded as well. 



MUMMIES 



Notwithstanding the fact that large series of Egyptian mum- 

 mies have been subjected to radiological and other scientific 

 studies in the two recent decades, cases with vertebral tuber- 

 culosis remain rare. There is the often-quoted hunchback 

 priest of the god Amun called Nesperehan, detected among 

 44 well-preserved mummies found by Grebart in 1891 

 (Smith and Ruffer 1910: Smith and Dawson 1924:156, 

 fig. 62; Cave 1939:142). His mummy shows destruction of 

 the lower thoracic and upper lumbar vertebrae causing an 

 angular kyphosis and a large abscess cavity in the area of the 

 right psoas muscle. 



In the most probably natural mummy of a 5-year-old child 

 from an intrusive burial ( 1000-400 B.C.) found in the tomb 

 of Nebwenenef at Thebes, pulmonary and vertebral tuber- 

 culosis ending with a fatal hemorrhage was described and 

 tuberculous bacilli proved in the vertebral bones (Zimmer- 

 man 1979). 



Discussion 



Together with our two cases, 6 iconographic, 30 skeletal, and 

 2 mummy specimens attest with lesser or greater probability 

 the presence of vertebral tuberculosis in ancient Egypt and 

 Nubia. Of the skeletal cases, 19 were from Egypt and 13 

 from Nubia with no particular preference for either of the two 

 countries. Unfortunately it is not possible to guess how many 

 vertebral columns were examined by anthropologists experi- 

 enced in pathology and what was the incidence of the dis- 

 ease. The accumulated number of cases discloses, however, 

 that it was by no means negligible. 



Our case no. 1 comes from an isolated Middle Kingdom 

 tomb inserted in the ruins of an Old Kingdom temple at 

 Abusir. No data on the frequency of the disease, therefore, 

 can be given. 



Our case no. 2 was found in the Christian cemetery at 

 Sayala. The total number of identified individuals was 161 . 

 In no other individual of this group could we detect changes 

 pointing to tuberculosis. Thus a rough estimate of incidence 

 would be 0.62% . Because vertebral tuberculosis accounts for 

 1-3.5% of the incidence of tuberculosis in all its forms, this 

 would mean that 1 8-62% of people could have been infected 

 by tuberculosis at Sayala. Together with other unknown 

 causes this could explain the extremely low mean age at 

 death of its Christian population (about 18 years). 



The scarcity of findings of vertebral tuberculosis in ar- 

 tificially mummified bodies (representing members of the 

 high social stratum that could afford costs of mummification) 



could well reflect social differences in the incidence of tuber- 

 culosis. However, if we consider that some of the skeletal 

 remains could represent disintegrated mummies (as our case 

 no. 1 and possibly also the remains of the royal son Pa- 

 Ra'messu), there would be 3 cases out of the total of 32 

 belonging to the royal and priestly society. The incidence 

 (9.4%) does not seem to be significantly smaller than the 

 supposed percentage share of the high stratum in the ancient 

 Egyptian society. 



In the present state of our knowledge these reflections can 

 be no more than preliminary. Much research should be per- 

 formed in the future, aiming at establishing reliable data on 

 the incidence of vertebral tuberculosis, the excellent marker 

 for studies of tuberculous infection in different periods, re- 

 gions, and social layers. They are especially important for 

 reconstruction of the social history of ancient Egypt and 

 Nubia. 



Literature cited 



Abadir, F. 1953. Skeleton Found In Shaft No. 42 of the Uninscribed 



Mastaba "B." In A.M. Abu-Bakr. ed.. Excavations at Gi:a 



1949-1950. 85. Cairo: Government Press. 

 Allison, M.J.. D. Mcndoza, and A. Pezzia. 1973. Documentation 



of a Case of Tuberculosis in Pre-Columbian America. American 



Review of Respirator,' Diseases, 107:985-991 . 

 Brothwcll. D.R. 1963. Digging Up Bones. London; British Muse- 

 um (Natural History). 

 Baud, M. \97H. LeCaractereduDessinenEgypteAncienne. Paris: 



Librairie d'Ameriquc et d'Orient. 

 Cave, E.J.E. 1939. The Evidence for the Incidence of 1\jberculosis 



in Ancient Egypt. British Journal of Tuberculosis. 33:142. 

 Davies, N. de G. 1927. Two Ramesside Tombs at Thebes. Robb de 



PeysterTytus Memorial Series, vol. 5. New York: Metropolitan 



Museum of Art. 

 Derry, D.E. 1938. Pott's Disease in Ancient Egypt. Medical Press. 



197:1. 

 Fbrmicola, V., Q. Milanesi. and C. Scarsini. 1987. Evidence of 



Spinal Tuberculosis at the Beginning of the Riurth Millennium 



B.C. from Arcnc Candlde. American Journal of Physical An- 

 thropology. 72:1-6. 

 Ghalioungui, P.. and Z. Dawakhly. 1965. Health and Healing in 



Ancient Egypt. Cairo: Dar Al-Maarcf. 

 Grmek, M.D.I 983. Les Maladies a TAube de la Civilisation Occi- 



dentate. Paris: Payot. 

 Hanevcid, G.T. 1980. Pott"s Disease before Pott. The Netherlands 



Journal of Surgery. 32:2-7. 

 Jonckhecrc. F. 1948. Lc Bossu des Musecs Royaux d'Art et d'HIs- 



toirc de Bruxcllcs. Chronique d'Egypte. 45-46:24-35. 

 Manchester, K. 1983. The Archaeology of Disease. Bradford, 



U.K.: University of Bradford Press. 

 Mogenscn. M. 1930. Lii Glyptotheque Ny Carlsherg. La Collection 



Egyptlcnne. Copenhagen: Levin and Munksgaard. 

 Morse, D. 1967. Tuberculosis. In D. Brothwcll and AT Sandison. 



cds. . Diseases in Antiquity. 249-27 1 . Springfield, 111, : Charles C 



Thomas. 



Zagreb Paleopaiholog\ Svmp t9/l/l 



