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CT of a Ptolemaic Period Mummy from the Ancient Egyptian City of Akhmim

Abstract

Mummies associated with the ancient city of Akhmim in Egypt provide an important portal for radiologic research concerning the ancient Egyptian population. As part of an ongoing investigation, a mummy of Akhmimic derivation owned by the Academy of Natural Sciences in Philadelphia, Pennsylvania, was scanned with a 16–detector row computed tomographic scanner. The resultant images helped confirm that the mummy was that of a female in her late teens. Although the deliberate omission of hieroglyphic texts on the painted coffin rendered the deceased individual anonymous, it is noteworthy that great care had been taken in preparing the corpse for burial. The mummy represents conscientious work by the embalmers, work that is broadly consistent with methods used during the early Ptolemaic period for well-to-do persons. Features of bodily decomposition, including the rotary dissociation of the C1 and C2 vertebral bodies and a missing right patella, point to neglect of the body prior to its recovery and mummification. The fact that the body was well prepared but thinly wrapped and interred in an uninscribed coffin further suggests that the deceased was not of the community that eventually performed the mummification. This evidence is not inconsistent with a scenario involving the body’s postmortem immersion in water. Although it cannot be determined with certainty whether the deceased was a drowning victim, it appears that the treatment of the body followed protocols developed in connection with an ancient Egyptian tradition that persons dying in, or retrieved from, the Nile River were embalmed with special care.

Introduction

Egyptian mummification developed over many millennia as a ritual process designed to overcome putrefaction and expedite resurrection. The classical historian Herodotus, writing between 450 and 430 bce (before the common era), correctly emphasized that it was a specialized activity carried out by trained personnel and that it consisted of deliberate procedures involving the entire human body over a period of 70 days. His well-known account of the three embalming methods (,1) has strongly influenced the interpretation of Egyptian evidence, particularly regarding the varying standards of care shown to deceased persons. Frequently, the lesson drawn from this evidence is that embalming was apt to be rather perfunctory for many segments of the population who could afford some treatment and that it declined in quality in later periods of Egyptian history. It is thought that, with the end of native Egyptian autonomy in the Ptolemaic period (305–30 bce), adherence to time-honored mummification protocols weakened (,2). Examination of mummies created during the earlier phase of Ptolemaic control actually shows continued interest in maintaining a relatively high standard of funerary processing. With careful radiologic analysis, we were able to see a wider range of embalming techniques than was noted in earlier studies. We could also begin to recognize the importance of a class of mummies in which the bodies were not mummified immediately after death but showed signs of substantial decomposition prior to delivery to the embalmers. The mummy discussed in this article appears to belong to this important class.

Egyptian mummies were among the earliest subjects of radiographic inquiry, with studies of individual mummies appearing in the literature soon after Röntgen’s pioneering work in 1895 (,3). In 1903, the first royal mummy (Thutmose IV) was x-rayed by Dr Khayat (,4), and such work became increasingly prominent in the 1960s in more general mummy research. Computed tomography (CT) of mummies began in the late 1970s, with the earliest published study appearing in 1979 (,5) and others in succeeding years (,6). The rapid improvement in scanning technology (such as multidetector CT) has enhanced the imaging information available for analytic and educational purposes.

In spite of their importance in the history of paleopathology (,7), Egyptian mummies of the Ptolemaic period are often lumped into the rather broadly conceived time frame known as the Greco-Roman period (305 bce–395 ce [common era]). The latter part of that time has been associated with declining standards of embalming and a rising emphasis on elaborate wrapping as opposed to tissue preservation (,2). Although this change in priorities was underway in some regions before the demise of the Ptolemaic dynasty in 30 bce, it is reasonably clear that the mummification of native Egyptians during the early Ptolemaic regime (305–200 bce) still emphasized tissue preservation and extended the carefully administered burial rituals used for the social elite to a larger range of community members (,8).

Scanning an individual who was mummified during the time at which standards are supposed to have deteriorated afforded a valuable opportunity to evaluate the accuracy of existing notions regarding the later history of Egyptian embalming. It also allowed us to collect important data on the embalming practices in an important region at a critical juncture in its history.

CT scans provide baseline data that are essential to understanding the process of ancient Egyptian mummification in all its variety. The archiving of whole-body scans of mummies, seen as problematic with respect to the preservation of trace amounts of human DNA from mummified tissues, may be our only way of retrieving data from museum-held objects for which invasive procedures are not an option. Whole-body scans provide a basis for comparison between mummies of known provenance, which allows the development of hypotheses regarding the evolution of mummification procedures in different locales and the existence of period-specific or regional variants in different parts of Egypt at historically significant junctures.

The objective of our study was to establish the social identity of the deceased on the basis of the embalming methods that were visible radiologically. We hoped to better understand the mummification protocols as they were practiced in a regional workshop during the first century of Ptolemaic rule. Our study was conducted in light of the growing body of evidence showing that Ptolemaic embalming was done carefully and that the embalmers were tellingly systematic in their approach.

Research on this question was carried forward by scanning a well-preserved Egyptian mummy that was formally incorporated into the collection of the Academy of Natural Sciences in Philadelphia (ANSP), Pennsylvania, in 1903. It is believed that the mummy was collected decades earlier by the widely traveled Dr Charles Huffnagle, U.S. Consul to Calcutta (,9), or by a member of his family. The circumstances of its excavation are unknown, but the mummy appears in ANSP records in the spring of 1885 (,10) around the time of the well-publicized discovery of the ancient Egyptian cemeteries of Akhmim (,11). Following its acceptance into the collection, the mummy ANSP 1903.1a was placed in storage with the mummy of an unrelated child. When the two mummies were rediscovered in 1977, they were briefly studied and slated for a radiographic examination (,12), of which there is no record.

ANSP 1903.1a was identified as coming from Akhmim on the basis of (a) strong stylistic evidence in the form of the painted designs on its coffin, and (b) cartonnage plaques adhering to its outer wrappings. These plaques feature a human-headed bird, which represents the human soul (Egyptian ba), and the sky goddess Nut in a checkered gown. Other depicted funerary deities include the so-called Four Sons of Horus, protectors of the embalmed viscera. The nature, pattern, coloring, and arrangement of these painted designs are completely consistent with a large body of artistic work from the early Ptolemaic era (305–200 bce), undoubtedly of Akhmimic provenance and dated with carbon 14 to the third century bce (,Figs 1–,,3). These findings allowed us to compare the present scan data with data from scans of other mummies from this site that cluster in the same time frame.

Figure 1.  Photograph shows the mask element of the mummy’s coffin. The mask is well formed and is decorated with an image of a winged disk along the chin and neck. This unusual feature has been found on only two other masks: one from Akhmim and one belonging to a young female from Saqqara. The mask and other cartonnage elements place ANSP 1903.1a in the third century bce, a time of Macedonian control established after Alexander’s conquest of Egypt (332 bce). The mask is typical of those found on more elaborately prepared mummies in the Ptolemaic period and depicts the deceased as an idealized being.
Figure 2.  Photograph shows the collar design on the coffin. The design includes a human-headed bird representing the soul of the deceased (Egyptian ba) and the sky goddess Nut (in checkered gown). The goddess protects the deceased with her wings and bestows maat, meaning “truth” or “correct action,” represented in her hands as distinctive feathers. Nearby, wed-jats (Eyes of Horus symbols) impart health and well-being to the mummified body.
Figure 3.  Photograph shows the lower cartonnage, which depicts (among other netherworld deities) the goddesses Isis and Nephthys kneeling beside the mummy and praying for its resurrection as they did for Osiris, their murdered husband and brother, respectively.

Akhmim (located 470 km south of Cairo) was an important city located on the east side of the Nile River in the Sohag Governorate of Middle Egypt (,Fig 4). In Ptolemaic times, when Egypt was governed by a dynasty of Macedonian origin imbued with the cultural values of pan-Helle-nism, Akhmim remained firmly in the “native Egyptian” societal sphere. By 206 bce, much of Middle Egypt (probably including Akhmim) had broken away from Ptolemaic control, establishing a short-lived but independent kingdom under a native dynasty (,13). ANSP 1903.1a is believed to date from the second half of the third century bce, and findings from the scan therefore relate to a crucial period of internal political and social conflict in southern Egypt, for which there are a growing number of radiologic studies (,14).

Figure 4.  Map of Egypt shows Akhmim, which served as the capital of the ninth province of Upper Egypt from remote antiquity until well into the Ptolemaic period (300–30 bce).

CT Protocol and Technique

The radiologic team performed whole-body helical CT on ANSP 1903.1a using a 16–detector row CT scanner (Lightspeed16; GE Medical Systems, Waukesha, Wis) (,Fig 5). The mummy rested in the lower half of its coffin during the scan, which was performed from the skull vertex to the soles of the feet. Frontal and lateral scout images were obtained, and the mummy was scanned at 140 kVp and 275 mA. A total of 2552 thin-section (0.625-mm) axial images were reconstructed from the source data. There was no gantry angulation.

Figure 5.  Photograph shows ANSP 1903.1a lying in the lower half of its coffin and being scanned with a 16–detector row CT scanner (GE Medical Systems).

The wrappings of the mummy were completely intact. We suspected at the outset that we might be dealing with layers of textile material of substantial thickness and cemented with resin or other botanic adhesives. The thickness of the wrappings ranged from 14 to 64 mm, with the amount overlying the sternum measured at 46 mm. CT settings were selected to ensure adequate visualization of the underlying osseous structures and residual soft tissue through the ancient wrappings.

A Vitrea 2 workstation (Vital Images, Minnetonka, Minn) was used to reformat the data set in the coronal and sagittal planes. Volume-rendered and surface-shaded-display three-dimensional models as well as three-dimensional animated virtual “fly-throughs” were created to facilitate analysis.

Results

Radiologic examination of the coffin bottom (41.2 cm from side to side) revealed that it is constructed of three posterior planks of equal thickness (3 cm) pegged to one another along the full length of the coffin (178 cm). Interestingly, the radiating growth rings of the trees from which the planks were cut are visible on the axial views of the coffin. The sides are fairly low (7.5–9 cm). They loosely abut the bottom planks at right angles and are attached with dowels that pass diagonally through the sides and into the bottom planks. Gaps between the pegged and dowelled pieces have been filled with a gritty mortar, which has been coated with gesso and painted. The coffin is made of somewhat thinner pieces of wood than are found in other coffins associated with Ptolemaic priestly burials at Akhmim.

The study showed an extremely well-preserved body with the arms in a pendant position. The mummy’s head is tilted slightly toward the right with the mouth slightly open (,Fig 6,).

Figure 6a.  Frontal (a) and lateral (b) scout radiographs of the mummy demonstrate the generally excellent condition of the osseous structures. Opacities in the left upper thorax and left side of the abdomen represent residual cardiac tissue and visceral packets, respectively. Note the absence of the right patella.
Figure 6b.  Frontal (a) and lateral (b) scout radiographs of the mummy demonstrate the generally excellent condition of the osseous structures. Opacities in the left upper thorax and left side of the abdomen represent residual cardiac tissue and visceral packets, respectively. Note the absence of the right patella.

Multiplanar views of the head and neck showed that the ethmoid sinuses had been hollowed out and the right sphenoid sinus perforated, creating a breach 1.8 cm in diameter. These features are undoubtedly associated with removal of the brain according to the ancient Egyptian method of excerebration (,Fig 7,). A small amount of high-attenuation material representing resin layers is seen along the dependent portion of the cranium. The nasal and oral orifices are sealed with a resinous material that forms a caplike mass. Beneath the mass, the teeth are in excellent condition with no discernible enamel wear (,Fig 8). The third molar in the left maxilla is absent; the third molar in the right maxilla is partially erupted. The second and third molars of the left mandible and the second molar of the right mandible are absent.

Figure 7a.  CT scan of the skull (a) and cut-away volume-rendered image of the skull base (b) reveal that the ethmoid and sphenoid sinuses have been hollowed out, almost certainly to allow excerebration.
Figure 7b.  CT scan of the skull (a) and cut-away volume-rendered image of the skull base (b) reveal that the ethmoid and sphenoid sinuses have been hollowed out, almost certainly to allow excerebration.
Figure 8.  CT scan of the skull obtained at the level of the posterior fossa demonstrates the excellent condition of the maxillary teeth with no discernible enamel wear. The right third molar is partially erupted. These findings indicate that the individual was young at the time of death.

There is complete craniocervical dislocation with rotary dissociation of C1 and C2 (,Fig 9). C1 has detached from C2, and the odontoid process of C2 has rotated 90° to the right. The two vertebrae remain in approximate alignment with the foramen magnum but have shifted forward and lie in the oropharynx. There is no evidence of vertebral fracture, and the hyoid bone is intact.

Figure 9.  Oblique sagittal reformatted CT image of the cervical spine shows rotary dissociation of C2 with settling of the skull, so that the spine protrudes into the oropharynx. Note that the ring of C2 is intact and that no fractures involving the remaining bones are present. This vertebral dissociation likely has a postmortem cause, namely, decomposition prior to the start of the mummification process.

Examination of the upper torso showed that the sternal clavicular epiphyses of ANSP 1903.1a are incompletely fused. The embalmers have carefully positioned the mummy’s arms in a pendant arrangement, with the forearms lying uncrossed on the pelvis but converging between the thighs. The left hand is turned inward. There is no evidence of traumatic injury or degenerative changes to the wrists or hands. The arms have not been separately wrapped, although some high-attenuation material (possibly resin) adheres to the surface of the arms.

The internal organs, with the exception of the heart, have been removed, separately embalmed, and wrapped in cylindric visceral packets. Residual cardiac tissue is seen along the left aspect of the thoracic spine. The visceral packets were reintroduced into the body cavity through an incision made above the left iliac crest. The mummy contains four such packets, all of which were positioned in the left side of the thoracic cavity and abdomen (,Fig 10). The right sides of the thorax and abdominal cavity contain a small amount of pooled resin but are otherwise empty. The vertebrae of the thoracic and lumbar spine are in excellent condition, with little evidence of degenerative changes. The pelvis has a gynecoid morphologic appearance (,Fig 11).

Figure 10.  Image from an animated virtual fly-through created on a Vitrea 2 workstation (Vital Images) shows the thoracic cavity with four visceral packets on the left side.
Figure 11.  Volume-rendered image with a semitransparent foreground and background shows that the pelvis has a gynecoid morphologic appearance (long pubis and wide subpubic angle), findings that are consistent with a female pelvis.

The legs of the mummy are enclosed within the general body wrap and show none of the thick bandaging of individual limbs seen in the preparation of the mummies of elite women. The right and left femora are 39.0 and 39.5 cm in length, respectively, and exhibit normal bone architecture and mineralization. Both tibiae measure 33 cm, and the right and left fibulae measure 33 and 34 cm, respectively. The right patella is missing; otherwise, the right knee joint articulation is normal, with no evidence of developmental or acquired deformities (,Fig 12). The left knee is normal. No evidence of degenerative osseous changes is present.

Figure 12.  Coronal volume-rendered image of the knees with a semitransparent background reveals absence of the right patella. The right knee has an otherwise normal morphologic appearance, indicating that the patella was likely not absent until after death.

The living stature of the individual is estimated to have been 150.4–151.7 cm (59.2–59.7 inches) based on the femoral linear regression formula for Caucasian females developed by Trotter in 1970 (,15). If the femora and tibiae are considered together, a maximum living stature of 153.3–154.0 cm (60.4–60.6 inches) is indicated.

Discussion

On the basis of the eruption of the third molar, which generally occurs between the ages of 17 and 25 years, this individual was at least 17 years old at the time of death. Egyptians were prone to severe dental disease, due in large part to food impurities, primarily sand. Furthermore, it has been speculated that the Egyptians added a small amount of sand to their grain to facilitate its being ground into flour. The excellent condition of the teeth and lack of discernible enamel wear also attest to the young age of the individual at the time of death. Adolescence is similarly indicated by incomplete fusion of the sternal (medial) clavicular epiphyses. This is the third of five recognized stages of clavicular ossification, not reached before 16 years of age (,16).

The issue of the gross dissociation of the cervical vertebrae initially raises an intriguing question as to whether this finding represents a potential cause of death. Minor displacement of cervical vertebrae and fragmentation of the skull base in mummies has sometimes been seen as a side effect of excerebration (,17), but severe cervical disruptions of the kind seen in ANSP 1903.1a (a full 90° rotary dissociation of C1 and C2 without any perforation of the surrounding soft tissue or any fractures) are extremely uncommon. The diameter of the cribriform breach in ANSP 1903.1a (1.8 cm) is more than adequate to have permitted normal nasal route excerebration without drastic craniocervical manipulation. At first blush, the condition of the neck of ANSP 1903.1a is difficult to explain as anything other than the result of postdepositional disruption or display-related damage. However, when damage of this type occurs, the wrappings themselves are usually loosened or undermined, and the vertebral separation occurs at a lower level (frequently at the C6–C7 junction), with the skull remaining articulated with the uninterrupted C1 through C6 vertebral bodies (,18).

Close inspection of the exterior of the bundling of ANSP 1903.1a reveals that the bandages at the cervical region are intact and tightly bonded. The dermis of the neck itself is also well preserved. In the absence of vertebral body fractures or other evidence of trauma, we feel justified in suggesting that the peculiar C1–C2 rotational displacement seen in ANSP 1903.1a was nontraumatic and had a postmortem cause, as if the body were already undergoing slow decomposition prior to delivery to the embalmers.

Immersion of a corpse in water impedes the processes of putrefaction seen in bodies on land and exposed to the open air, particularly insect feeding and propagation with an accompanying rapid loss of soft tissue and massive bloating. Nevertheless, after initially sinking, a body will become buoyant and come to the surface when putrescent gases build up. In warmer water temperatures, this may occur within a few days.

Most important in the case of ANSP 1903.1a is the observation discussed by Pounder in 1992 (,19) that cadavers in water float face downward with the head lower than the body. As the head hangs down, the attached soft tissues of the head, neck, and upper chest will eventually display substantial bruising and discoloration known as lividity. These areas of bruised tissue will be the first to undergo putrefaction (,19). If the body is floating in a stream or river with a substantial current, the chances of unusual flexion being sustained by decomposing ligaments are increased. A pattern of weakening of the neck muscles or ligaments followed by lividity and softening could account for the rotary dissociation of the C1–C2 vertebrae seen in ANSP 1903.1a. Rough or careless embalming need not be assumed as a cause.

Considerable care is shown in the mummification procedure. Egyptian religious practice dictated that embalmers avoid removing the heart during evisceration of the other organs. Retention of the heart allowed it to undergo the proper rituals of judgment in the presence of Osiris, god of the underworld. The outcome of these rituals (which involved weighing the heart on a scale) determined whether the individual could enter the afterlife. The residual cardiac tissue within the thoracic cavity of ANSP 1903.1a is well preserved, indicating that ritual imprecations were recognized and that considerable care was exercised in preparing the mummy for burial.

In keeping with later Egyptian practices, representative portions of important organs were returned to the interior of the body following evisceration, wrapped within linen packets (which tradition held to be under the protection of the Four Sons of Horus). As mentioned earlier, four visceral packets were inserted into the left side of ANSP 1903.1a and are clustered in the lower thoracic and upper abdominal cavities. They are all loosely rolled irregular packets cemented with unguent. Their arrangement and uniformly small size are somewhat different from what is seen in other Ptolemaic mummies, many of which show bilateral placement of tightly rolled packets and contain one or two packets that are twice as large as the others. The body cavities contain very little of the translucent resin found in other Akhmimic mummies of the Ptolemaic period. Instead, some granular material, rosin (resinated solids), or mud has settled against the posterior of the body cavities and forms a substrate below the visceral packets.

Of particular interest in ANSP 1903.1a is the missing right patella. Although congenital disorders resulting in absent patellae are described in the medical literature, including Meier-Gorlin syndrome and Nail-Patella syndrome, an array of other developmental anomalies would also be evident if a congenital condition had actually precluded patellar formation. However, no such anomalies are observed in ANSP 1903.1a. Additionally, it is unlikely that unilateral absence of the right patella was a congenital defect given the otherwise normal appearance of the remainder of the right lower extremity. The absence of the patella, like the cervical dissociation, is believed to have occurred in the postmortem setting.

The decomposition of Egyptian corpses prior to mummification has been noted in the literature (,20). Herodotus suggested that deceased persons (particularly young women) were deliberately held back for several days to protect against necrophilia on the part of embalmers. Although such tales are likely apocryphal, the tendency for decomposition to have advanced prior to embalming has been noted in mummies of the Ptolemaic period, leading some investigators to suggest that standards of mummification declined during that era. Instead, we suggest that the decomposition noted in some bodies from the Ptolemaic period was a product of population displacement during times of internal unrest within the Ptolemaic polity. The Akhmim region likely endured significant upheaval as part of a full-scale defection of the native population of southern Egypt during the late third century bce (,13). The nearby city of Abydos (,Fig 4) is known to have been under rebel control by 202 bce. Unrest was undoubtedly mounting at the time that ANSP 1903.1a was prepared. It is possible that this teenage girl had died under circumstances that not only delayed the retrieval of her body, but rendered her anonymous to the embalmers.

Conclusions

The radiologic data from our study support a tentative reconstruction of certain aspects of the deceased girl’s social identity. Despite the fact that the girl was anonymous, the quality of her mummification indicates that considerable time and expense were invested to provide her with a ritually correct burial. Although the cause of her death cannot be established with certainty, the absence of skeletal trauma suggests that her demise involved no blunt force injuries or impacts. A missing right patella and the pattern of disarticulation of C1 and C2 are indicative of the onset of bodily decomposition prior to mummification. These factors are not inconsistent with ANSP 1903.1a being a “found person” whose circumstances of death induced the embalmers to treat her according to ritual protocols beyond her years or station. Herodotus’ description of the special dignities in burial accorded to persons who died in the Nile is interesting to consider in this case. The law apparently held that such persons, regardless of their social position (Egyptian or foreigner), be properly retrieved “by the inhabitants of the city near which the body is cast up,” then embalmed and buried “with all possible magnificence” (,1). Although we are not yet able to exclude the possibility that death resulted from an acute illness, death or discovery of the body in the Nile is not impossible in this case. It would account for the physical decomposition and the unexpectedly high level of care taken to mummify a complete unknown.

CT has become an indispensible tool for the noninvasive study of ancient Egyptian mummies. Using a modern 16–detector row CT scanner and advanced image processing software, we were able to create highly detailed three-dimensional reconstructed images of the mummy with a virtual fly-through of the thoracic cavity from submillimeter source data. These images not only allowed us to ascertain the approximate age, sex, and physical condition of the mummy, but furnished evidence of decomposition in a watery environment prior to mummification. In the context of a conspicuous lack of identifying markings on the coffin, these data provide the first physical evidence of funerary care given to anonymous victims of the Nile, an ancient Egyptian tradition described by Herodotus nearly 25 centuries ago.

We thank Edward B. Daeschler, PhD, of the Academy of Natural Sciences for his generous support in making the mummy available for our research effort.

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