King Tutankhamun, the boy pharaoh, was frail, crippled and suffered “multiple disorders” when he died at age 19 in about 1324 BC, but scientists have now determined the most likely agents of death: a severe bout of malaria combined with a degenerative bone condition.
The researchers said that to their knowledge “this is the oldest genetic proof of malaria in precisely dated mummies.” Several other mummies in the study also showed DNA evidence for the presence of the malaria parasite Plasmodium falciparum, perhaps not surprising in a place like the Nile Valley.
The application of advanced radiological and genetic techniques to royal Egyptian mummies marks a new step in the ever deepening reach of historical inquiry through science.
The study, reported on Tuesday, turned up no evidence of foul play, as had been suspected by some historians and popular writers familiar with palace intrigues in ancient Egypt. Previous examinations of the Tut mummy had revealed a recent leg fracture that happened sometime before his death, possibly from a fall. This might have contributed to a life-threatening condition in an immune system already weakened by malaria and other disorders, the researchers said.
In addition, genetic “fingerprinting” of the 11 mummies in the study established family connections over five generations of Tut’s lineage. The identities were previously certain for only three of the mummies. Now, scientists said the tests identified the ones of Tut’s father and mother, who appear to be siblings, as well as the mummies of his grandmother and other probable relatives.
The two-year investigation, completed in October, is described in the current issue of the Journal of the American Medical Association. The research was directed by Zahi Hawass, an Egyptologist who heads the Supreme Council of Antiquities in Cairo, and included medical scientists and anthropologists from Egypt, Germany and Italy. Carsten Pusch of the Institute of Human Genetics at the University of Tuebingen, in Germany, was the report’s corresponding author.
In an accompanying editorial in the journal, Howard Markel of the Center for the History of Medicine at the University of Michigan, who was not involved in the study, praised the thoroughness of the new research “based on unfettered access to the actual mummies.”
Recalling the myriad postmortem claims that have surrounded the young king, Markel suggested that now “the legion of Tutankhamun admirers might be well advised to reconsider several existing theories.”
Though not one of the great rulers of ancient Egypt, King Tut is easily the best known in public lore. He was the son and successor of Akhenaten, the controversial reform pharaoh who ruled from about 1351 to 1334. One of the other achievements of the study was the first positive identification of Akhenaten’s mummy, a historical puzzle in its own right.
The British archaeologist Howard Carter’s discovery in 1922 of Tut’s opulent tomb in the Valley of the Kings was a sensation. The young king’s visage and premature death in the ninth year of his reign inspired fanciful speculation, and the golden and bejeweled artifacts from his tomb still dazzle crowds at touring museum exhibitions.
One overall impression from the new research is that the royal family’s power and wealth did not spare them from ill health and physical impairment. Several mummies revealed instances of cleft palate, clubfeet, flat feet and bone degeneration. Four of the 11 mummies, including Tut’s, contained genetic traces of malaria tropica, the most severe form of the infection.
The researchers said that several other pathologies were diagnosed in the Tut mummy, including a bone disorder known as Kohler’s disease II, which alone would not have caused death. But he was also afflicted with avascular bone necrosis, a condition in which diminished blood supply to the bone leads to serious weakening or destruction of tissue. The finding led to the team’s conclusion that it and malaria were the most probable causes of death.
The effects of this bone disease, notably the “definitely altered structure” of the left foot, probably explained the presence of walking canes in the Tut tomb, the researchers said.
Speculation had also centered on the fact that Tutankhamun left no heirs and the stylized reliefs and other sculptures of him and family members showed them having a somewhat feminized or androgynous appearance. This suggested certain inherited syndromes, including gynecomastia, which is the excessive development of breasts in men, usually the result of a hormonal imbalance.
The breasts of Akhenaten and Tutankhamun were not preserved. But Tut’s penis, no longer attached to the body, “is well developed,” the researchers reported.
“Most of the disease diagnoses,” the scientists concluded, “are hypotheses derived by observing and interpreting artifacts and not by evaluating the mummified remains of royal individuals apart from these artifacts.”
Markel, the medical historian, commented that use of 21st century radiological and genetic techniques in studies of human history raised ethical questions that need to be addressed.
Writing in the journal, he asked: “What will the rules be for exhuming bodies to solve vexing pathological puzzles? Are major historical figures entitled to the same privacy rules that private citizens enjoy even after death? Most pragmatically, what is actually gained from such studies? Will they change current thinking about and prevent threatening diseases such as influenza? Will they change the understanding of the past, such as the Jefferson study’s powerful elucidation of intimacy during the era of slavery and the Tutankhamun study’s window on the conduct of the royal family of Egypt?”
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