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Demographic, metric and palaeopathological study ofhuman remains recovered from the Lower Necropolis atSaqqara.

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Citation for published version (APA):Kozieradzka-Ogunmakin, I., Kaczmarek, M., & Myliwiec, K. (Ed.) (2013). Demographic, metric andpalaeopathological study of human remains recovered from the Lower Necropolis at Saqqara. In Old KingdomStructures between the Step Pyramid Complex and the Dry Moat, Saqqara V: Part II:Geology–Anthropology–Finds–Conservation. (Vol. 2, pp. 345-421). Warsaw: Institut des CulturesMéditerranéennes et Orientales de l'Académie Polonaise des Sciences.Published in:Old Kingdom Structures between the Step Pyramid Complex and the Dry Moat, Saqqara V

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v.2

VOLD KINGDOM STRUCTURES

BETWEEN THE STEP PYRAMID COMPLEXAND THE DRY MOAT

Fabian Welc, Jerzy Trzciński, Maria Kaczmarek, Iwona Kozieradzka-Ogunmakin, Agnieszka Kowalska, Teodozja I. Rzeuska, Zbigniew Godziejewski

with a contribution by Władysław Weker

edited by KAROL MYŚLIWIEC

PART 2: GEOLOGY  ANTHROPOLOGYFINDS CONSERVATION

9 788375 432664

SAQQARAV.2

INSTYTUT KULTUR ŚRÓDZIEMNOMORSKICH I ORIENTALNYCHPOLSKIEJ AKADEMII NAUK

iCENTRUM ARCHEOLOGII ŚRÓDZIEMNOMORSKIEJ

IM. KAZIMIERZA MICHAŁOWSKIEGOUNIWERSYTETU WARSZAWSKIEGO

POLSKO-EGIPSKA MISJA ARCHEOLOGICZNA

SAQQARAV

KONSTRUKCJE STAREGO PAŃSTWAMIĘDZY KOMPLEKSEM PIRAMIDY SCHODKOWEJ

A SUCHĄ FOSĄCZĘŚĆ 2: GEOLOGIA • ANTROPOLOGIA

ZNALEZISKA • KONSERWACJA

FABIAN WELC, JERZY TRZCIŃSKI, MARIA KACZMAREK, IWONA KOZIERADZKA-OGUNMAKIN, AGNIESZKA KOWALSKA,

TEODOZJA I. RZEUSKA, ZBIGNIEW GODZIEJEWSKIZ UDZIAŁEM WŁADYSŁAWA WEKERA

pod redakcją KAROLA MYŚLIWCA

WYDAWNICTWO NERITONWarszawa 2013

INSTITUT DES CULTURES MÉDITERRANÉENNES ET ORIENTALES DE L'ACADÉMIE POLONAISE DES SCIENCES

etCENTRE KAZIMIERZ MICHAŁOWSKI

D'ARCHÉOLOGIE MÉDITERRANÉENNEDE L'UNIVERSITÉ DE VARSOVIE

POLISH-EGYPTIAN ARCHAEOLOGICAL MISSION

SAQQARAV

OLD KINGDOM STRUCTURESBETWEEN THE STEP PYRAMID COMPLEX

AND THE DRY MOATPART 2: GEOLOGY • ANTHROPOLOGY

FINDS • CONSERVATION

FABIAN WELC, JERZY TRZCIŃSKI, MARIA KACZMAREK, IWONA KOZIERADZKA-OGUNMAKIN, AGNIESZKA KOWALSKA,

TEODOZJA I. RZEUSKA, ZBIGNIEW GODZIEJEWSKIWITH A CONTRIBUTION BY WŁADYSŁAW WEKER

edited by KAROL MYŚLIWIEC

EDITIONS NERITONVarsovie 2013

Rédacteur de la sérieKAROL MYŚLIWIEC

Rédacteur du volume:KAMIL O. KURASZKIEWICZ

Mise en pageDARIUSZ GÓRSKI

PhotographiesJarosław Dąbrowski: Pls. CLXIIe; CXCVIIc-d, f-g; CXCVIIIa-c; CXCIXa-c; CCb; CCIIb-c; CCVb, d; CCVIb-e, g; CCVIIg-l; CCVIII-CCIX; CCXb-c; CCXI. Maciej Jawornicki: Pls. CLXIIb-d, f-g; CXCVIIa-b; CXCVIIId; CCIIa; CCIIIa-b; CCIVc; CCVa, c; CCVIId-e; Fig. 132. Zbigniew Kość: Pl. CLXIIa. Kamil Kuraszkiewicz: Pls. CXCVIIe, h-i; CCa, c; CCI; CCIVa-b. Piotr Lelek: Pls. CLXVI; CLXVIIa-f; CLXVIII; CXCIIb. Wojciech Wojciechowski: Pls. CLXIXc-g; CLXXb; CLXXI; CLXXIIa, c-h; CLXIII-CLXIV; CLXXVa-d, f-g; CLXXVIa-d, f-g; CLXXVII; CLXXVIIIa-b, d-f; CLXXIX-CLXXX; CLXXXIc; CLXXXIIb-e, g-h; CLXXXIV; CXCb, d, h; CXCIb; CXCIII-CXCVI; CXCVIIIe; CCVIf; CCVIIa-c; CCXa, d, e (1). Figs. 130, 138-139, 141, 143. Agnieszka Kowalska: Pls. CXCIIa; CCVIIf; CCXe (2-3). Iwona Kozieradzka-Ogunmakin: Pls. CLXIV-CLXVI; CLXVIIg-h; CLXIXa-b, h; CLXXa, c-h; CLXXIIb; CLXXVe, h; CLXXVIe, h; CLXXVIIIc; CLXXXIa-b, d-h; CLXXXIIa, f; CLXXXIII; CLXXXV-CLXXXIX; CXCa, c, e-g; CXCIa, c-h; Figs. 126-129, 134-137, 140, 142, 144-148. Teodozja I. Rzeuska: Pls. CCXII-CCXVI. Jerzy Trzciński/Fabian Welc: Pls. CLIX-CLXI. Fabian Welc: Pls. CLV, CLVIa. Władysław Weker: Pl. CXCVIIj.

DessinsMagdalena Abramowska: Fig. 149. Mariusz Jucha: Fig. 160e. Mariusz Jucha/Agnieszka Kowalska: Figs. 153b; 154c-e, i-j; 158b. Mariusz Jucha/Kamil Kuraszkiewicz: Figs. 153e-g; 154a-b, f-g; 158e. Kalina Juszczyk: Pl. CLVIc. Kalina Juszczyk/Fabian Welc: Pl. CLII. Agnieszka Kowalska: Figs. 153a, c-d; 154h; 158a, c-d, f; 161a-c. Kamil Kuraszkiewicz: Figs. 155f, 162. Kamil Kuraszkiewicz/Fabian Welc: Pl. CLIII. Mariola Orzechowska/Kamila Orzechowska: Figs. 163-174. Joanna Rądkowska: Figs. 150-152; 155a-e; 156; 157; 159, 160a-d; 161d. Fabian Welc: Pls. CLVII; CLVIIIb. Fabian Welc/Marek Woźniak: Pl. CLIV.

Photographie de couverture: Jarosław Dąbrowski

Publié avec le soutien fi nancier du Ministère de la Recherche et de l’Enseignement Supérieur

Tytuł dotowany przez Ministerstwo Nauki i Szkolnictwa Wyższego

© Instytut Kultur Śródziemnomorskich i Orientalnych Polskiej Akademii Nauk i Wydawnictwo NERITON Warszawa 2013

ISBN 978-83-7543-266-4

Edition Wydawnictwo NERITON

Imprimé en Pologne, 1ère édition

Wydawnictwo NeritonWydanie I – Warszawa 2013Rynek Starego Miasta 29/31, 00-272 Warszawatel. 831-02-61 w. 26www.neriton.apnet.pl, neriton@ihpan.edu.plNakład: 330 egz.Objętość: 57 ark. wyd.

V

CONTENTS

PART 1: ARCHITECTURE AND DEVELOPMENTOF THE NECROPOLIS by Kamil O. Kuraszkiewicz

PREFACE by Karol Myśliwiec ...................................................................................... 1

MEMBERS OF THE MISSION .................................................................................... 4

BIBLIOGRAPHY OF THE EXCAVATED SITE .......................................................... 6

ABBREVIATIONS ......................................................................................................... 8

1. INTRODUCTION ............................................................................................... 21

2. CATALOGUE OF TOMBS ................................................................................ 27 2.1. FUNERARY COMPLEXES ......................................................................... 27 2.2. UNATTRIBUTED STRUCTURES .............................................................. 201 2.3. UNATTRIBUTED ARCHITECTURAL ELEMENTS ................................. 203 2.4. LIST OF TOMBS .......................................................................................... 209 2.5. CONCORDANCES ....................................................................................... 219 2.5.1. Attribution of shafts ............................................................................. 219 2.5.2. Attribution of chapels .......................................................................... 221 2.5.3. Localisation of burials ......................................................................... 222

3. ARCHITECTURAL STUDY ............................................................................ 224 3.1. GENERAL REMARKS ................................................................................. 224 3.2. SUPERSTRUCTURE .................................................................................... 226 3.2.1. Introductory remarks ........................................................................... 226 3.2.2. Mastaba’s core ..................................................................................... 227 3.2.3. Chapel .................................................................................................. 232 3.2.4. Building materials and methods .......................................................... 240 3.2.5. Summary .............................................................................................. 245 3.3. SUBSTRUCTURE ......................................................................................... 246 3.3.1. Introductory remarks ........................................................................... 246

VI

3.3.2. Burial apartments ................................................................................. 248 3.3.3. Ritual shaft ........................................................................................... 266 3.3.4. Blocking ............................................................................................... 267 3.3.5. Construction methods .......................................................................... 269 3.3.6. Development and dating ...................................................................... 271

4. WEST SAQQARA: A CASE STUDY ............................................................. 272 4.1. THE EVIDENCE ........................................................................................... 272 4.2. TOPOGRAPHY ............................................................................................. 273 4.3. CHRONOLOGY ............................................................................................ 274 4.4. DEVELOPMENT OF THE CEMETERY ..................................................... 275 4.4.1. Cemetery before the 6th Dynasty ....................................................... 276 4.4.2. Sixth Dynasty Cemetery ...................................................................... 276 4.5. PROSOPOGRAPHY ..................................................................................... 285

INDICES ....................................................................................................................... 296

INDEX TABLE .............................................................................................................302

LIST OF FIGURES ..................................................................................................... 305

LIST OF PLATES ....................................................................................................... 311

PLATES

PART 2: GEOLOGY • ANTHROPOLOGY • FINDS • CONSERVATION

1. GEOLOGY OF THE SITE by Fabian Welc and Jerzy Trzciński ..................... 323

1.1. GENERAL REMARKS ................................................................................. 323 1.2. INTRODUCTION ......................................................................................... 323 1.3. GEOLOGY AND GEOMORPHOLOGY OF THE WEST SAQQARA

ARCHAEOLOGICAL SITE ......................................................................... 329 1.4. GEOARCHAEOLOGICAL AND PALEOCLIMATIC RESEARCH .......... 332 1.5. MICROFACIAL ANALYSIS OF SANDY-PELITYC

AND MARL LIMESTONE FROM THE AREA OF POLISH-EGYPTIAN EXCAVATIONS IN SAQQARA ........................ 338

1.5.1. Examination under stereoscopic and polarizing microscopes .......... 338 1.5.2. Analysis of break surface and thin sections under an optical

microscope ......................................................................................... 339 1.5.3. Conclusion ........................................................................................... 341 REFERENCES ...................................................................................................... 342

2. ANTHROPOLOGY by Maria Kaczmarekand Iwona Kozieradzka-Ogunmakin .................................................................... 345

2.1. INTRODUCTION ......................................................................................... 345 2.2. MATERIALS AND METHODS ................................................................... 346

VII

2.2.1. Materials and Examination Procedure ................................................ 346 2.2.2. Post-Mortem Body Treatment ............................................................. 346 2.2.3. Skeletal Preservation and Completeness ........................................... 346 2.2.4. Sex Estimation ..................................................................................... 347 2.2.5. Age-at-Death Estimation ..................................................................... 348 2.2.6. Metric Data Collection ........................................................................ 348 2.2.7. Skeletal and Dental Pathologies .......................................................... 349 2.3. FUNERARY PRACTICES AND POST-MORTEM BODY

TREATMENT ................................................................................................ 349 2.4. DEMOGRAPHIC PROFILE ........................................................................ 354 2.5. METRICAL ANATOMICAL VARIATION .................................................. 357 2.5.1. Skull Size and Shape ........................................................................... 357 2.5.2. Body Size and Body Proportions ........................................................ 360 2.6. PATHOLOGICAL CONDITIONS IN THE OLD KINGDOM

SAQQARA POPULATION ........................................................................... 363 2.6.1. Individual Burials ................................................................................ 363 2.6.2. Skeletal pathologies ............................................................................. 380 2.6.3. Dental Pathologies ............................................................................... 396 2.7. CONCLUSIONS............................................................................................ 402 REFERENCES ..................................................................................................... 410

3. FINDS ................................................................................................................... 423

3.1. SARCOPHAGI AND COFFINS ................................................................... 423 3.1.1. Sarcophagi ........................................................................................... 423 3.1.2. Wooden coffi ns .................................................................................... 424 3.1.3. Reed coffi ns ......................................................................................... 429 3.2. SMALL FINDS ............................................................................................. 436 3.2.1. Anonymous tomb I ........................................................................... 436 3.2.2. Anonymous tomb II .......................................................................... 436 3.2.3. Anonymous tomb IV ......................................................................... 441 3.2.4. Tomb of Pehenptah (V) .................................................................... 441 3.2.5. Tomb of Iry (VII) .............................................................................. 444 3.2.6. Anonymous tomb VIII ...................................................................... 444 3.2.7. Anonymous tomb IX ........................................................................ 444 3.2.8. Tomb of Hetepu (X) .......................................................................... 445 3.2.9. Tomb of Teti-ankh (XI) ..................................................................... 445 3.2.10. Anonymous tomb XII ....................................................................... 447 3.2.11. Anonymous tomb XIII ...................................................................... 448 3.2.12. Anonymous tomb XIV ...................................................................... 449 3.2.13. Tomb of Ny-Pepy (XV) .................................................................... 449 3.2.14. Tomb of Khekeret (XVII) ................................................................. 456 3.2.15. Anonymous tomb XVIII ................................................................... 457 3.2.16. Anonymous tomb XX ....................................................................... 459 3.2.17. Anonymous tomb XXI ...................................................................... 459 3.2.18. Anonymous tomb XXIII ................................................................... 460 3.2.19. Anonymous tomb XXIV ................................................................... 461 3.2.20. Anonymous tomb XXV .................................................................... 462

VIII

3.2.21. Anonymous tomb XXVII ................................................................. 463 3.2.22. Anonymous tomb XXVIII ................................................................ 463 3.2.23. Anonymous tomb XXIX ................................................................... 464 3.2.24. Anonymous tomb XXX .................................................................... 465 3.2.25. Anonymous tomb XXXI ................................................................... 465 3.2.26. Anonymous tomb XXXII ................................................................. 469 3.2.27. Tomb of Nyankhnefertem (XXXIII) ................................................ 469 3.2.28. Tomb of Merefnebef (XXXIV) ........................................................ 469 3.2.29. Anonymous tomb XXXV ................................................................. 469 3.2.30. Unfi nished tomb XXXVI .................................................................. 469 3.2.31. Anonymous tomb XXXVII .............................................................. 471 3.2.32. Anonymous tomb XXXVIII ............................................................. 472 3.2.33. Tomb of Ptahhotep (XXXIX) ........................................................... 473 3.2.34. Anonymous tomb XLI ...................................................................... 473 3.2.35. Shaft 48 ............................................................................................. 475 REFERENCES ...................................................................................................... 475 3.3. POTTERY by Teodozja I. Rzeuska ................................................................ 477 3.3.1. Introductory remarks ........................................................................... 477 3.3.2. Pottery material ................................................................................... 479 3.3.3. Recapitulation ...................................................................................... 518 REFERENCES ...................................................................................................... 519

4. CONSERVATION by Zbigniew Godziejewskiwith a contribution by Władysław Weker ............................................................. 533

4.1. STONE ........................................................................................................... 534 4.1.1. Tomb of Pehenptah (V) ..................................................................... 534 4.1.2. Tomb of Hetepu (X) .......................................................................... 534 4.1.3. Tomb of Ny-Pepy (XV) .................................................................... 535 4.1.4. Tomb of Khekeret (XVII) ................................................................. 535 4.1.5. Tomb of Merefnebef (XXXIV) ......................................................... 535 4.1.6. Tomb of Ptahhotep (XXXIX) ........................................................... 536 4.1.7. Anonymous Tomb XLI ..................................................................... 536 4.1.8. False door of Djesti (inv. no. S/98/22.P) .......................................... 537 4.1.9. False door of Kheti (inv. no. S/99/11.P) ........................................... 537 4.1.10. Other .................................................................................................. 537 4.2. WOOD ........................................................................................................... 538 4.2.1. Anonymous tomb II .......................................................................... 538 4.2.2. Anonymous tomb VIII ...................................................................... 539 4.2.3. Anonymous tomb XII ....................................................................... 540 4.2.4. Anonymous tombs XIII and XXVIII ................................................ 540 4.2.5. Tomb of Ny-Pepy (XV) .................................................................... 540 4.2.6. Anonymous tomb XX ....................................................................... 541 4.2.7. Anonymous tomb XXIX ................................................................... 541 4.2.8. Anonymous tomb XXXI ................................................................... 541 4.2.9. Anonymous tomb XXXII .................................................................. 541 4.2.10. Tomb of Nyankhnefertem (XXXIII) ................................................. 542

4.2.11. Tomb of Merefnebef (XXXIV) ......................................................... 542 4.2.12. Anonymous tomb XXXVII ............................................................... 542 4.3. GYPSUM ....................................................................................................... 542 4.3.1. Woman’s mask ..................................................................................... 542 4.3.2. Gypsum cover of a male mummy ....................................................... 543 4.4. TEXTILE ....................................................................................................... 544 4.5. METAL by Władysław Weker ........................................................................ 545 REFERENCES ...................................................................................................... 547

INDICES ....................................................................................................................... 548

LIST OF FIGURES ..................................................................................................... 553

LIST OF PLATES ....................................................................................................... 555

PLATES

345

2.1. INTRODUCTION

The Saqqara necropolis constitutes the central part of the Memphite necropolis that also incorporates the cemeteries of Abu Roash, Giza, Zawiyet el-Aryan, and Abu Sir located to the north, as well as the Dahshur cemetery and the most remote cemetery of Meidum situated to the south.1 The cemetery site at Saqqara excavated by the Polish-Egyptian archaeological mission represents only a fraction of the entire necropolis that has produced evidence of continuous funerary activities conducted on the burial grounds from the Early Dynastic (c. 3000-2686 BC) to Byzantine Period (AD 395-641). Archaeological investigations at the present site began in 1987, and since 1996 the exca-vations have been conducted annually. Between the 1996 and 2010 archaeological campaigns, the site yielded a total of 612 burials of the Old Kingdom and Ptolemaic date. The results of the studies conducted on approximately 400 burials have been disseminated in the subsequent publications of the Saqqara monographic series, volumes I, III and IV.2 The present continuation study is based on the examination of the skeletal remains recov-ered from a total of 103 Old Kingdom burials located in the area between the enclosure of the Step Pyramid and the eastern edge of the Dry Moat. This group of burials comprises 31 inhumations that have been already presented in volumes I, III and IV,3 as well as a further 72 inhumations that are discussed in the present volume V of the Saqqara monographic series. The aim of the present study is to establish a demographic profi le and physical health condition of the Saqqara cemetery population in the Old Kingdom period. The references to detail information on the individual burials are given in Index Table.

1 SHAW, NICHOLSON, Dictionary, pp. 180-181. 2 Saqqara I-IV. 3 Saqqara I: Burial 45; Saqqara III: Burials 5, 7, 9, 15, 16, 17, 19, 21, 22, 23, 24, 27, 55, 78, 81, 199,

200, 201, 215, 344, 369, 371; Saqqara IV: Burials 373, 376, 381, 411, 424, 429, 448, 450.

2. ANTHROPOLOGYDEMOGRAPHIC, METRIC AND PALAEOPATHOLOGICAL STUDY OF HUMAN REMAINS RECOVERED FROM THE LOWER NECROPOLIS AT SAQQARA

BY MARIA KACZMAREK AND IWONA KOZIERADZKA-OGUNMAKIN

346

2. 2. MATERIALS AND METHODS

2. 2.1. MATERIALS AND EXAMINATION PROCEDURE

The study population comprised the human remains of 92 individuals (75 adults, fi ve children, and 12 individuals of undetermined age and/or sex)4 recovered from the Old Kingdom burials, representing the Lower Necropolis.5

The skeletal remains were the subject of an on-site macroscopic examination conducted in order to ascertain individual characteristics, including demographic attributes (sex and age at death) and indicators of lifestyle, such as dental and physical health status, dietary practices, and activity patterns. The examination of the inhumations was conducted in several steps, including an in-situ assessment of the body arrangement and its funerary treatment, condition and preservation of the interment, skeletal and dental completeness, followed by sex and age-at-death estimation, cranial and postcranial metric data collection and stature estimation, and fi nally recording and analysis of pathological changes in the dentition and bone.

2. 2.2. POST-MORTEM BODY TREATMENT

The analysis of the post-mortem treatment of the body received considerable attention. The fi rst factors to be recorded were the body positioning in the grave, body fl exion, as well as the arrangement of the arms and hands. The bodies in their original wrappings were subjected to autopsy following a careful removal of the enveloping materials. The exposed human remains were examined for any evidence of embalming. The skeletal inventory was conducted according to the current standards and practice for recording human remains,6 and the anthropological data gathered were entered into skeletal record-ing forms created through a modifi cation of the proposal provided by Buikstra and Ubelaker.7

2. 2.3. SKELETAL PRESERVATION AND COMPLETENESS

Once deposited in the ground, the human body is exposed to various taphonomic processes that affect its preservation through the action of environmental factors.8 In

4 In the study group of 103 Old Kingdom burials, Burials 21 and 78 comprised no human remains and the skeletal remains recovered from a further nine burials (Burials 5, 7, 15-17, 19, 22, 23, 27) were not included in the anthropological study.

5 The majority of the Old Kingdom burials presented in this study were examined on site by Prof. M. Kacz-marek during the subsequent 1999 to 2006 archaeological campaigns. The inhumations from the following campaigns (Burials 411, 453, 473, 493, 509-511, 521, 528, 532, 537-542, 551, 552, 554-558, 604, 610, 611) were examined on site by I. Kozieradzka-Ogunmakin. The results of the latter examinations have been included in the author’s PhD thesis entitled ‘A Study of Social Stratifi cation and Physical Health in an Ancient Egyptian Population of Saqqara’. The research conducted at the KNH Centre for Biomedical Egyptology, University of Manchester, has been funded by the Leverhulme Trust.

6 BRICKLEY, MCKINLEY, Guidelines.7 BUIKSTRA, UBELAKER, Standards for Data Collection, p. 328.8 NAWROCKI, Taphonomic processes; UBELAKER, Taphonomic applications.

347

addition to the depositional environment, there are also cultural factors that impact greatly on the preservation of the human remains, such as funerary practices and post-mortem disturbance. In ancient Egypt, the hot and dry desert environment most certainly facilitated exceptional preservation of the human remains, further enhanced by a set of elaborate funerary practices that were implemented and developed over time.9 These, however, were only available to the wealthy members of the society who were able to afford the expense of the complex embalming procedures, often combined with the rich adornment of the body and furnishing of the burial provided for the deceased to enjoy in the afterlife.10 It was mainly these furnished burials that were plundered in antiquity, attracting grave robbers due to the contemporary knowledge that they contained a wealth of funerary equipment. This deliberate human intervention resulted in the disarticulation, scattering, and poor preservation of the human remains encountered in the Saqqara cemetery.

Based on the degree of the articulation/disarticulation and position of the human remains and associated funerary artefacts, the burials were assessed as intact or disturbed. The preservation of the skeletal remains was evaluated as poor, satisfactory, good, or very good, and the overall completeness of the skeleton was scored as poor (<25%), partial (25-50% or 50-75%), or complete (>75% or 100%), as assessed by the count of the present against the absent skeletal elements. 11 Each category refl ects a degree of fragmentation and post-mortem damage, as well as completeness of the skeleton and dentition. In dis-turbed burials with disarticulated or commingled human remains, the minimum number of individuals (MNI) present was established by using paired bone counts (bones that could be sided), 12 a method fi rst introduced by T.E. White to study faunal remains in archaeological sites.13

2.2. 4. SEX ESTIMATION

Sex estimation based on the assessment of the size, shape, and robusticity of selected morphological characteristics of the cranium and pelvic bone was conducted only for physically mature individuals as these demonstrate sex-related skeletal changes.14 Cranial features examined included the degree of supraorbital and glabellar projection, the expres-sion of the nuchal crest, the volume of the mastoid process, the fl aring of the gonial region, and the expression of the mental eminence of the mandible. The observations of the pelvic features included the overall shape of the pelvic bone, pelvic inlet, and obturator foramen, the width of the sciatic notch and subpubic angle, the size of the acetabulum and ischial tuberosity, the presence/absence of the auricular sulcus, ventral arch and subpubic concavity, the length of the ischio-pubic ramus, the curvature of the sacrum, and the width of the sacral ala. Sex estimation criteria also included measurements of dimorphic dimen-sions, such as the maximum diameter of the femoral head or maximum facial breadth

9 TAYLOR, Death and the Afterlife.10 GRAJETZKI, Burial Customs; IKRAM, DODSON, The Mummy.11 BUIKSTRA, UBELAKER, Standards for Data Collection, p.7.12 MCKINLEY, Compiling a skeletal inventory, pp. 14-15; UBELAKER, Approaches to the study of com-

mingling; BYRD, ADAMS, J Forensic Sci 48.13 WHITE, Am Antiquity 18.14 AÇSÁDI, NEMESKÉRI, Human Life, fi g. 16; FEREMBACH et al., J Hum Evol 9; KROGMAN, ÍŞCAN, The Human

Skeleton; SCHWARTZ, Skeleton Keys.

348

(bizygomatic diameter). Sub-adult individuals were not sexed due to a lack of currently accepted methods. However, various new methods have been proposed and tested recently, and it is hoped that these will be available in the future.15

2.2. 5. AGE-AT-DEATH ESTIMATION

Different macroscopic osteological methods were employed to address age-at-death estimations in sub-adults and adults, and therefore, the initial step was to assess the individual’s skeletal maturation. This was achieved based on the observation of the state of fusion of the spheno-occipital synchondrosis, the completion of the epiphyseal union of the medial clavicle, iliac crest, ischial epiphysis, and fusion of the sacral elements, as these fuse much later than the epiphyses of other skeletal elements,16 and development of the third molars that normally erupt at approximately 19 to 20 years of age.17 Age at death in mature individuals was determined based on the evaluation of age-related changes of the pubic symphisis18 and auricular surface, 19 and closure of the cranial sutures.20 Of these methods the morphological changes of the pubic symphysis are considered the most reliable indicator of the individual’s age. The method based on the assessment of cranial suture closure is on the other hand much less reliable in age-at-death estimation due to the great variability in closure rate; hence, in incomplete specimens the method can only assist in determining the maturity of the individual rather than to provide a specifi c age estimation. The age estimations of the adult individuals in the present study population were determined with a precision of fi ve or 10 years, and fell into age categories compris-ing young adults (YA; 18˗35), middle adults (MA; 35˗50), and old adults (OA; 50+). Age at death of the immature individuals was estimated based on the physiological-age crite-ria (developmental changes in tissues correlated with chronological age), such as, in order of precision, dental development and eruption,21 epiphyseal closure timing,22 and diaphy-seal length.

2.2.6. M ETRIC DATA COLLECTION

Cranial and postcranial metric data were collected according to guidelines presented by Buikstra and Ubelaker,23 using an osteometric board, and spreading and digital calipers, as appropriate. The skull size and shape were estimated based on the cranial measurements taken following Martin and Saller24 with application of standard anthropometric

15 SAUNDERS, Subadult skeletons, pp. 138-141.16 SCHWARTZ, Skeleton Keys; SCHEUER, BLACK, Juvenile Osteology.17 SMITH, Standards of human tooth.18 BROOKS, SUCHEY, Hum Evol 5; BUIKSTRA, UBELAKER, Standards for Data Collection, pp. 23-24.19 LOVEJOY et al., Am J Phys Anthropol 68; MEINDL, LOVEJOY, Age changes; BUIKSTRA, UBELAKER, Stan-

dards for Data Collection, pp. 24-32. 20 MEINDL, LOVEJOY, Am J Phys Anthropol 68; BUIKSTRA, UBELAKER, Standards for Data Collection,

pp. 32-36. 21 MOORREES et al., J Dent Res 42; UBELAKER, Human Skeletal Remains, fi g. 71.22 SCHWARTZ, Skeleton Keys; SCHEUER, BLACK, Juvenile Osteology.23 BUIKSTRA, UBELAKER, Standards for Data Collection, pp. 74-84.24 MARTIN, SALLER, Lehrbuch der Anthropologie.

349

equipment (GPM callipers). All measurements were taken to an accuracy of the nearest 1mm. Stature estimations of the adult individuals based on the maximum lengths of the complete long bones were calculated using the regression formulae for ancient Egyptians created by Raxter et al.25

2.2.7. S KELETAL AND DENTAL PATHOLOGIES

The morbidity pattern was based on the skeletal and dental evidence of disease and nutritional status. The skeletal remains were visually examined for the occurrence of any abnormalities, evidence of trauma, or pathological changes. The observed conditions were identifi ed following Ortner, Aufderheide and Rodríguez-Martín, and Mann et al.,26 and classifi ed according to their aetiology. Skeletal and dental indicators of physiological stress associated with environmental stressors such as malnutrition, nutritional and weaning stresses were included in the health status assessment.

Dental completeness, preservation, anomalies and defects, as well as pathologies, including caries, apical abscesses, and periodontal disease were recorded following Hillson and Ortner.27 Dental attrition was recorded using a surface wear scoring system for inci-sors, canines, and premolars modifi ed by Smith, and the system for scoring surface wear in molars developed by Scott.28 Tooth loss was assessed as belonging to one of two groups: that occurring ante-mortem due to extraction or periodontal disease, and that occurring post-mortem resulting from the burial disturbance or excavation methods and lifting. Enamel hypoplasia lesions were identifi ed using dental hypoplasia standards developed by Schultz;29 the rate of enamel hypoplasia was assessed in both sexes by separate tooth type. All deciduous and permanent teeth, excluding third molars as these are considered to be too variable in developmental timing, were scored for the presence of enamel hypo-plasia. The main confounding factors in estimating prevalence of enamel hypoplasia in skeletal series include poor preservation of teeth due to ante-mortem loss, severe attrition, caries, and parodontopathy.

Analytical methods included ANOVA/MANOVA. Statistical signifi cance was judged based on the Student’s t-test, Pearson’s chi-square and Mann-Whitney U-tests, with the level of signifi cance set at p<0.05.30

2.3. FUNERAR Y PRACTICES AND POST-MORTEM BODY TREATMENT

The ancient Egyptian funerary practices varied in different periods and also among the wealthy and the poor,31 as attested by classical authors, such as Herodotus and Diodorus

25 RAXTER et al., Am J Phys Anthropol 136.26 ORTNER, Pathological Conditions; AUFDERHEIDE, RODRÍGUEZ-MARTÍN, Human Paleopathology; MANN

et al., Photographic Regional Atlas.27 HILLSON, Teeth, pp. 286-318; ORTNER, Pathological Conditions, pp. 589-608.28 SCOTT, Am J Phys Anthropol 51; SMITH, Am J Phys Anthropol 63.29 SCHULTZ, Paläopathologische Diagnostik. 30 All statistical computations were performed using STATISTICA data analysis software system, version

9.0 (2009) www.statsoft.com.31 GRAJETZKI, Burial Customs; IKRAM, DODSON, The Mummy.

350

Siculus.32 In the Saqqara cemetery, the majority of the Old Kingdom interments took place in rock-hewn shaft-tombs, with a small number of inhumations located in pit graves dug in depositional layers overlying the destroyed 6th Dynasty structures.33 The construction of the subterranean funerary structures was most certainly commissioned by the wealthy members of the society, including middle class administrators and palace offi cials, and would have been furnished with a variety of items and offerings. The latter would have attracted ancient tomb robbers who plundered the majority of the Old Kingdom inhuma-tions (69.9%) at the Lower Necropolis, causing substantial disturbance of the human remains. The skeletal remains of a total of 28 individuals (27.2%) were found in ana-tomical order possibly suggesting that the burials survived intact. The remainder of the burials demonstrated various levels of disturbance and commingling of the human remains that impeded the analysis of the original positioning of the body and its post-mortem treatment. The intact or only minimally disturbed Old Kingdom inhumations showed variations in the pattern of body arrangement, including its positioning either on the left or right side in a fl exed or extended position, or supine (face up) or prone (face down) and fully extended (Table 1).

Table 1. Body preservation and post-mortem treatment in the Old Kingdom inhumations from Saqqara

Burials

Burial Numbers N %

Disturbed Burials 5, 7, 15, 27, 45, 57, 59, 60, 63-70, 75, 79, 86, 95-97, 136, 199, 201, 214, 344, 373, 376, 381, 393-396, 398, 400, 403, 408, 409, 411, 424, 429, 446, 449, 450, 472, 473, 475, 476, 479, 481, 484, 489, 490, 499, 509-511, 521, 528, 532, 537, 539, 551, 552, 554, 556-558, 604, 611

72 69.9

Body in Anatomical Order 9, 16, 17, 19, 22, 23, 24, 55, 56, 100, 200, 215, 369, 397, 399, 401, 402, 407, 448, 453, 480, 493, 538, 540, 541, 542, 555, 610

28 27.2

Body Position and Limbs Arrangement

Supine and extended 56, 399, 411, 479, 542, 551 6 5.8

Supine (upper body) and legs fl exed placed on L side 63 1 1.0

Prone and extended 5, 397, 476, 541, 552 5 4.9

Prone and extended with arms fl exed 373 1 1.0

On L side:

extended 557 1 1.0

legs slightly fl exed 9, 493 2 1.9

arms and legs fl exed 7,16, 24, 27, 65, 100, 199, 393, 407, 401, 448, 480, 453, 511, 554, 555, 604, 610, 611

19 18.4

32 HERODOTUS; DIODORUS SICULUS.33 E.g. Burials 9, 15-17, 21, 22, 24, 27, 55, 200, 215 and 344 were uncovered in depositional layers

overlying destroyed 6th Dynasty structures; Saqqara III, p. 54.

351

arms along the body and legs fl exed 17, 55, 344, 401, 453, 538, 555 7 6.8

arms fl exed, R leg extended, L leg slightly fl exed 22 1 1.0

L arm fl exed, R arm along the body, legs fl exed 215, 369, 371, 480 4 3.9

R arm fl exed, L arm along the body, legs fl exed 65 1 1.0

foetal position 19, 23 2 1.9

On R side:

arms and legs fl exed 15, 402, 509, 540 4 3.9

arms along the body and legs fl exed 200, 402 2 1.9

Body Wrappings

Linen shrouding/wrapping (well or fragmentarily preserved)

5, 17, 24, 373, 400, 401, 450, 475, 480, 481, 493, 509-511, 528, 540, 552, 554-557

21 20.4

Linen wrapping (traces only) 16, 65, 75, 96, 201, 369, 371, 397, 399, 402, 409, 424, 448, 446, 449, 453, 476, 484, 537, 541, 551

21 20.4

Matting 19, 23 2 1.9

Other (funerary plaster mask) 397, 551 2 1.9

The prevailing body positioning in the Old Kingdom burials was full fl exion (both arms and legs fl exed) with the body placed on its left (18.4%) or, less frequently, on its right side (3.9%). Only in one instance, in Burial 557, the body of a male aged 30-40 years was placed on the left side but in a fully extended position. Also, the remains of a male uncov-ered in Burial 493 displayed a somewhat unusual body arrangement that would have been dictated by the insuffi ciently long burial pit to accommodate the corpse placed on the left side and in a fully extended position. Hence, the lower limbs of the deceased were slightly fl exed, and the head was facing up. The male’s arms were also slightly fl exed and crossed at the wrists, with the left forearm placed over the right forearm, and the fi sts were semi-clenched. Slightly fl exed legs were also noticed in the body of another male individual, aged 40-45 years, from Burial 9. The fl exed bodies also demonstrated variants of the upper and lower limbs arrangement. The bodies of the females from Burials 401 and 538 and the males from Burials 55, 344, 453 and 555 that rested on the left side, as well as a female from Burial 402 and a male from Burial 200 positioned on the right side showed the arms extended along the body, contrary to the prevailing fl exed arrangement of the upper limbs in the fl exed-positioned bodies.34 A further three females from Burials 65, 369 and 480, an adult male from Burial 215 and an individual from Burial 371, all resting on the left side of the body, demonstrated a mixed upper limb arrangement that comprised the right arm fl exed and the left arm extended as in Burial 65, and the reverse combination in Burials 215, 369, 371 and 480. Another combination of the limb arrangement was observed in Burial 22, where an individual rested on the left side with the arms and the left leg fl exed but the right leg extended. A total of six Old Kingdom individuals (5.8%) from

34 Saqqara III, p. 460.

Fig. 126

352

Fig. 126. A wrapped body in Burial 493

Fig. 127. Fragments of shrouding in Burial 511

353

Fig. 128. Pleated linen fabric used as shrouding in disturbed Burial 475

Fig. 129. Shrouding sheets with evidence of wear, Burial 555

Fig. 130. Burial 551. Human remains commingled with the remains of a plaster mask.

354

Burials 56, 399, 411, 479, 542 and 551 were inhumed in a supine and fully extended position, including the upper and lower limbs. The remains of a further six individuals were uncovered lying prone in a fully extended position (Burials 5, 397, 476, 541 and 552) or with the arms fl exed (Burial 373). This uncommon body positioning resulted most likely from ancient looting, when the coffi ns that would have originally contained the bodies were upturned and their contents emptied onto piles of rock rubble in the burial chambers. The inhumations would have been violated soon after the burial, as indicated by the anatomical order of the skeletal remains that would have been at the time covered with soft tissue that prevented severe disarticulation. Only two individuals from Burials 19 and 23 were inhumed in a foetal position.

The human remains recovered from the Old Kingdom burials were completely skeleton-ised35 and exhibited no evidence of embalming. The post-mortem treatment of the bodies involved wrapping (e.g. Burial 493, 510 and 528) or shrouding (e.g. Burial 509, 511, 554-556) in linen fabric. A neatly pleated linen fabric was also uncovered in Burial 475 of a young female. In total, preserved body wrappings (mostly fragments of shrouding) were uncovered in 21 inhumations (20.4%), and a further 21 interments provided only traces of the wrappings. The bodies of two individuals uncovered in Burials 19 and 23 were wrapped in, or placed on and covered by mats, with no evidence of linen shrouding or wrapping to have been applied. In a further two cases, however, the bodies of a female from Burial 397 and a male from Burial 551 were equipped with funerary plaster masks that were placed on the already wrapped corpses and remodelled to show most likely idealised facial features.36 In Burial 551 the plaster mask extended to cover the front of the body, and was also remodelled in a fashion similar to ancient Egyptian sculptures. This type of body adornment is better attested in the Giza cemetery than in other parts of the Memphite necropolis, including Saqqara.37

All Old Kingdom inhumations from the Lower Necropolis were single, although Burial 554 comprised an intrusive later-date inhumation (Burial 553) in the burial chamber. Burials 376 and 429 comprised commingled skeletal remains of adult and sub-adult individuals, most likely being a result of looting activities than intentional double inhuma-tions. In addition, the skeletal remains of the primary inhumations of a child in Burial 556 and a young male in Burial 611 were commingled with remains of other individuals from disturbed later-date burials.

2.4. DEMOGRAPHIC P ROFILE

The study population comprised a total of 92 individuals, including 45 males, 30 females, fi ve children of undetermined sex, and 12 individuals of undetermined sex and/or age. The sex and age distribution in the skeletal assemblage is presented in Table 2.

35 Sporadic soft tissue preservation was noted in the human remains from Burials 56 and 493.36 KOWALSKA et al., CECE 2009, pp. 107-109.37 Ibid., pp. 109-110 and bibliography in n. 1. Three of the funerary plaster masks from the Giza

necropolis are on permanent display at the Egyptian Museum in Cairo, and several other plaster masks from G.A. Reisner’s excavations at Giza are housed at the Boston Museum of Fine Arts (BMFA 15-11-64, 36-2-7 (37.644), 37-10-44, 39-2-7, and BMFA 39.828).

Figs. 126-127

Figs. 128-129

Fig. 130

Pl. XXV

Pls. LXX, LXXI

355

Table 2. Sex and age distribution in the Old Kingdom study population from Saqqara

Sex (N=number of individuals)

Undetermined Male Female Popu-lation

Age Groups (years) Burial No. N Burial No. N Burial No. N %

2-3 446 1 1.1

3-4 556 1 1.1

2-7 81 1 1.1

8 66 1 1.1

10 400 1 1.1

Undetermined 60, 97, 136, 371, 376, 398, 424, 429, 472, 521, 532, 537

12 13.0

Adult 20+ 57, 199, 215, 396, 481, 484

6 79 1 7.6

Young Adults 18-35 100, 344, 394, 449, 473, 490, 493, 542, 555, 610, 611

11 24, 65, 67, 69, 70, 95, 369, 397, 401, 403, 407, 409, 475, 479, 499, 552

16 29.3

Young Adult/Middle Adult 30-40 55, 175, 373, 381, 528, 604

6 68, 96, 480 3 9.8

Middle Adult 35-50 9, 45, 56, 64 (171), 86, 200, 201, 214, 393, 395, 399, 408, 411, 450, 453, 476, 541, 551, 557

19 59, 402, 448, 489 4 25.0

Old Adult 50+ 63, 510, 558 3 509, 511, 538, 539, 540, 554

6 9.8

Total 17 45 30 100.0

The demographic profi le constructed from the data for the present skeletal assemblage is bound to be biased due to the under-representation of its sub-adult component. The overall number of fi ve sub-adult specimens (5.4% of the total skeletal sample) that included no infants (aged 0-1 year) was found to be signifi cantly lower than might be expected in the stationary population, in which half of the population dies before the age of fi ve.38 Children in the period of life between birth and 5 years are particularly vulnerable to plague and childhood infectious diseases. High morbidity and mortality in this period of life is considered to be a normal process of adaptation. For this reason the signifi cantly lower than expected proportion of sub-adults did not refl ect a living population, a fi nding that could seriously bias any conclusions drawn from death rates.

38 UBELAKER, Paleodemography.

356

The proportion of sub-adults in archaeological samples varies signifi cantly.39 A very low number of children burials have been reported in Egyptian and Sudanese Nubia. In Egyptian Nubia, the proportion of sub-adult individuals ranged from 12.3% in the Predynastic Period through 16.2% in the Old and Middle Kingdoms, 11.4% in the Ptolemaic Period, and 27.4% in the Christian Period.40 In Sudanese Nubia, this proportion varied from 14.3% in the Pharaonic Period to 35.1% in the Christian times.41 In a sample from Tombos in New Kingdom Nubia, sub-adults represented only 8% of all individuals studied and there were almost no infants aged 0-3.42 Elsewhere, the proportion of dead children was found to be higher. In the skeletal sample recovered from the Saqqara necropolis dated to the Ptolemaic Period, the sub-adults constituted 21.8% of the total sample.43 In the burial ground inside and around the ruined mastaba of Ptahshepses at Abusir, re-used between the 7th century BC and 1st century AD, the ratio between sub-adult and adult skeletons was almost 1:1, with 49.7% of sub-adults versus 50.3% of adults.44 Similar fi ndings were shown by Armelagos for the skeletal sample from a Christian cemetery near Meinarti dated to AD 1050˗1150,45 where sub-adult individuals constituted 40% of the total sample.

In general, under-representation of immature individuals observed in archaeological samples could result from a combination of biological, cultural, and socio-economic factors.46 Given the high infant and childhood death rates in past populations, their smaller than expected representation in the present study sample was likely to have been due to a widespread habit of burying the dead infants and children in other locations than those designated for juvenile and adult burials. It is likely that the socio-economic factor played a signifi cant part in the decision concerning the disposal of infants and children. Equally probable, however, would be diffi culties in recovery of the human remains, or the effects of taphonomic factors that could have obstructed the preservation of sub-adult individuals (the fragile sub-adult bones are generally more susceptible to decay than the adult ones).47 At Saqqara, however, even the smallest and most delicate bones of the sub-adult and adult skeletons presented excellent preservation.

The adult component of the Saqqara sample comprised 48.9% males and 32.6% females. The male individuals outnumbered females giving the sex ratio 1.5:1, which is close to the value that refl ects the theoretically expected equal sex representation of one male to one female. A similar sex ratio, 1.3 male to one female, was found in the Saqqara sample dated to the Ptolemaic Period.48 Two combined series from Abusir further demonstrated a comparable male to female representation, consisting of 55.3% males versus 44.7% female individuals in the adult population and giving a sex ratio of 1.2 males to one female.49 This slight difference in favour of males in the skeletal sample is said to be partly due to the fragility of female skeletons, which tend not to be preserved as well as the male

39 KAMP, J Archaeol Method Th 8.40 ELLIOT SMITH, WOOD JONES, Report on the Human Remains.41 VAGN NIELSON, Human Remains.42 BUZON, Am J Phys Anthropol 130.43 Saqqara III, p. 473.44 STROUHAL, BAREŠ, Secondary Cemetery, pp. 143-147.45 ARMELAGOS, Science 163.46 CHAPESKIE, Nexus 19, p. 33.47 PFEIFFER, CROWDER, Am J Phys Anthropol 123.48 Saqqara III, p. 473.49 STROUHAL, BAREŠ, Secondary Cemetery, p. 145.

357

ones. More likely, however, the difference represents a small bias in the sex estimation criteria, resulting in an apparent excess of males in the sample. The age profi le of the adult individuals is presented in Figure 131.

Fig. 131. Male and female age distribution in the Old Kingdom inhumations from Saqqara

Most of the female deaths occurred at 18-35 years (53.3%) with median age 32.5 years (Q1 27.0 years and Q2 42.5 years), whereas most of the male deaths occurred at 35-50 years, yielding 42.2% of the total male population sample. Median age for males was 37.9 years (Q1 32.5 years and Q2 45 years) and on average, males had a signifi cantly longer survival than females (Mann-Whitney U-test p<0.05). The present fi nding is consistent with the general trend of fairly steady increase in lifespan over time.50 For example, Angel’s data for Greeks have set the average adult age at death in the Early Neolithic times at 33.6 years for males and 29.8 years for females, compared to the Classical Period when it was 44.1 years and 36.8 years, respectively.51 The male-female difference in mortality pattern is thought to be most likely caused by frequent childbirth with potentially fatal complications.

2.5 . METRICAL ANATOMICAL VARIATION

The majority (64%) of the Old Kingdom inhumations from Saqqara demonstrated poor (<25%) or partial (25%-75%) preservation resulting in varied sample sizes used in statis-tical analysis.

2.5. 1. SKULL SIZE AND SHAPE

Males are likely to have larger neurocranial and facial dimensions as compared to females. In the present skeletal assemblage, 18 male-female differences out of 27 cranial

50 AÇSÁDI, NEMESKÉRI, Human Life, pp. 138-259.51 ANGEL, Am J Phys Anthropol 30.

358

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360

measurements taken were statistically signifi cant (p<0.01) (see Table 3). The cranial modulus that expresses the size of the neurocranium is calculated as the sum of the length, breadth and height of the skull divided by three. This was calculated before the actual index values, and revealed signifi cant difference between males and females in favour of a larger mean modulus in males (154.5 mm in males versus 148.4 mm in females; p<0.01). Quantitative analysis of the skull shape, unlike its size, revealed that none of the cranial indices were statistically signifi cantly different between males and females.

Male and female groups featured a medium-length skull (mesocranial with cranial index mean values of 76.8 in males and 77.6 in females), high-skull with respect to the skull length (hypsicranial with length-height index of skull values of 74.9 in males and 74.5 in females), and medium-high skull (metriocranial) with respect to the skull breadth (with index value of 97.9 and 95.9 for males and females, respectively), with a medium-breadth forehead (metrometopic fronto-parietal index values 67.7 and 67.3 in males and females, respectively). Male individuals exhibited narrow-high face (leptoprosopic facial index value 91.7), whereas females demonstrated medium-high face (mesoprosopic with facial index 89.9). The skulls showed large-high orbits (hypsiconchic orbital index values 86.9 and 89.1 in males and females, respectively), and a broad nose (chamaerrhine with index values at 54.8 and 50.9 in males and females, respectively), with a wide jaw in males and a smaller one in females (fronto-gonial index values of 99.7 and 102.5 in males and females, respectively) also presenting a low broad ramus (ramus index values 54.5 and 55.1 in males and females, respectively). On average, the male cranium was more robust than the female one, with both gonial eversion and heavy muscle attachments being observed in the mandible.

2.5.2. BODY SIZE AND BODY PROPORTIONS

Descriptive statistics of the long bone measurements, and other dimensions of the upper and lower limbs, are summarized in Tables 4 and 5. Although the male dimensions of all postcranial skeleton measurements were larger than those of females, the statistical sig-nifi cance of the male-female differences remained inconclusive due to the small sample size.

Table 4. Descriptive statistics of metric data of the long bones of the upper and lower limbsin the Old Kingdom skeletal series from Saqqara

BoneMeasurement

Males Females

n Mean Range SD CV(%) n Mean Range SD CV

(%)

Humerus

Maximum Length 20 321.2 312-329 7.4 2.3 15 298.4 290-309 6.4 2.1

Epicondylar Breadth 20 57.3 50-61 5.1 8.9 15 55.1 51-66 5.4 9.8

Vertical Diameter of Head

20 44.8 39-52 3.9 8.7 15 39.2 35-48 3.9 9.9

Radius

Maximum Length 19 249.7 234-256 7.8 3.1 14 228.4 212-229 5.1 2.2

361

Ulna

Maximum Length 18 260.2 247-270 6.2 2.4 13 230.1 226-243 5.9 2.6

Femur

Maximum Length 24 470.1 434-514 9.7 2.1 17 438.4 410-440 7.9 1.8

Bicondylar Length 24 452.5 430-466 9.8 2.2 17 417.9 402-424 8.8 2.1

Epicondylar Breadth 24 79.6 75-83 3.5 4.4 17 69.9 62-71 3.2 7.1

Max. Head Diameter 24 49.8 44-54 2.9 5.8 17 44.7 40-47 3.1 6.9

A-P Subtroch Diam. 22 27.2 22-29 2.1 7.7 16 23.8 19-25 2.2 9.2

M-L Subtroch Diam. 22 33.3 30-38 2.8 8.4 16 29.7 26-32 2.5 8.4

A-P Midshaft Diam. 21 29.9 27-34 2.2 7.3 16 25.9 20-27 2.3 8.8

M-L Midshaft Diam. 21 28.6 25-35 2.6 9.1 16 24.9 21-31 2.8 11.2

Tibia

Maximum Length 24 397.8 360-409 8.7 2.1 16 350.7 334-369 6.6 1.8

Max. Prox. Epiphys B 24 75.3 41-85 8.1 10.7 16 68.0 62-77 6.0 8.8

Max. Dis. Epiphys B 24 49.4 40-57 5.1 10.4 16 42.5 37-48 4.3 10.1

Max. Diam. at the Nutrient Foramen

22 38.5 32-41 4.8 12.5 16 31.5 29-36 3.3 10.4

M-L Diam. at the Nutrient Foramen

22 24.3 21-29 3.0 12.3 16 22.6 20-25 3.4 15.0

Circumference at the Nutrient Foramen

22 75.1 71-88 4.1 5.4 16 68.3 60-73 4.1 6.0

Fibula

Maximum Length 19 387.4 340-390 5.4 1.4 12 353.6 307-362 6.4 1.9

Max. Diam. at Midshaft

19 22.4 18-24 2.5 11.2 12 19.3 16-21 2.5 12.9

Explanation of parameters and abbreviations used in the table: n – sample size; Mean – arithmetic mean; Range – the difference between the largest and the smallest items in the sample; SD – standard deviation; CV – percentage coeffi cient of variation; all measurements in mm; A – anterior; P – posterior; S – superior; M – medial; L – lateral; Diam – diameter; Max Prox Epiphys B – maximum proximal epiphyseal breadth; Max Dis Epiphys B – maximum distal epiphyseal breadth.

Table 5. Descriptive statistics of the long bones in the Old Kingdom series from Saqqara

ElementMales Females

n Mean Range SD CV n Mean Range SD CV

Humerus 20 321.2 312-329 7.4 2.3 15 298.4 290-309 6.4 2.0

Radius 19 249.7 234-256 7.8 3.1 14 228.4 212-229 5.1 2.2

Ulna 18 260.2 247-270 6.2 2.3 13 230.1 226-243 5.9 2.6

Femur 24 470.1 434-514 9.7 2.1 17 438.4 410-440 7.9 1.8

Tibia 24 397.8 360-409 8.7 2.2 16 350.7 334-369 6.6 1.9

Explanation of parameters and abbreviations used in the table: n – sample size; Mean – arithmetic mean; Range – the difference between the largest and the smallest items in the sample; SD – standard deviation; CV – percentage coeffi cient of variation; all measurements in mm

362

Physical stature for adult individuals was estimated based on the measurements of the maximum length and bicondylar breadth of the femur, and the maximum lengths of the tibia, humerus and radius, following the regression formulae for ancient Egyptians estab-lished by Raxter et al.52 The estimation results are presented in Table 6.

Table 6. Estimation of the living stature (cm) in males and females from the Old Kingdomsample from Saqqara

Males Females

Formula Stature Formula Stature

2.257 (femm) + 63.93 170.0 2.340 (femm) + 56.99 154.9

2.253 (femb) + 64.76 166.7 2.341 (femb) + 57.63 155.5

2.554 (tibm) + 69.21 170.8 2.699 (tibm) + 61.08 155.7

2.594 (hum) + 83.85 167.1 2.827 (hum) + 70.94 155.3

2.641 (rad) + 100.91 165.8 2.509 (rad) + 96.73 154.0

1.282 (femm + tibm ) + 59.35 170.6 1.313 (femm + tibm ) + 54.36 157.9

1.456 (hum + rad) + 83.76 166.9 1.291 (hum + rad) + 86.41 154.4

Mean Stature 168.3 Mean Stature 155.4

The estimated living stature of males ranged from 165.8cm to 170.8cm with mean 168.3cm, and the respective values for females were 154.4cm to 157.9cm with mean 155.4cm. The average difference in the stature between males and females in the sample was 12.9cm, although for selected bones it ranged from 14.9cm for estimation based on the femur to 10.2cm for other bone estimations. This is a commonly known difference in the body size between adult males and females.53 The living stature estimates in the present series were comparable with the estimates in a smaller-size Old Kingdom sample (n=11) from Saqqara54 calculated using the regression formulae established by Trotter and Gleser55 for White and Black males and females. The calculated mean living stature for males was 168.7 cm (regression formulae for Whites) and 164.4cm (regression formulae for Blacks) and the respective values for females were 156.2cm and 153.7cm. The mean values of the stature estimates calculated using the Trotter-Gleser formulae for White males and females were closely corresponding with the mean values produced from the calculations based on the formulae of Raxter et al. established for ancient Egyptians. Further comparative data of the living stature estimations were provided by a study conducted on the Old Kingdom élite and workers population from Giza.56 Here, the living stature was estimated by application of the regression formulae of Robins and Shutt57 based on the length of the tibia. The estimated mean living statures for males and females in the Giza élite sample were again closely comparable with the values produced for the Saqqara series using other regression formulae (Table 7).

52 RAXTER et al., Am J Phys Anthropol 136.53 EVELETH, TANNER, Worldwide Variation.54 Saqqara III, p. 486.55 TROTTER, GLESER, Am J Phys Anthropol 16.56 HUSSIEN et al., J Arab Soc Med Res 1.57 ROBINS, SHUTT, Hum Evol 1.

363

Table 7. Mean stature values for males and females in the Old Kingdom series from Saqqara and Giza

Saqqara* Saqqara** Giza

Élite Élite Élite Workers

Males Females Males Females Males Females Males Females

No. of Individ. 34 27 8 3 60 48 26 16

Mean Value (cm) 168.3 155.4 168.7 156.2 167.48 156.11 164.06 151.65

Stature estimated using the regression formulae of Raxter et al. (*) and Trotter and Gleser for Whites (**); Data for the Giza series given after Hussien et al., Table 2.

Adult stature could be reduced due to persistent childhood nutritional deprivation and disease that could affect the individual’s growth and result in reduced growth rate.58 Low socioeconomic status of the workers community from Old Kingdom Giza could be con-sidered as the main causative factor in the lower mean stature values in comparison to the élite groups from Giza and Saqqara. Both male and female workers demonstrated a similar difference in the mean stature, being on average 4.2cm and 4.15cm (respectively) shorter than their élite counterparts. In both élite and workers samples from Giza, the male individuals were taller than females by an average 12.41cm, compared to 12.9cm male-female stature difference in the present Saqqara series.

2.6. PATHOLOGICAL CONDITIONS IN THE OLD KINGDOM SAQQARA POPULATI ON

The human remains recovered from the Old Kingdom burials at Saqqara demonstrated a great variety of skeletal and dental conditions that impacted upon the health of the local population, indicating patterns of nutrition, methods of food preparation, living conditions, patterns of activity, and exposure to physical stress. Details of pathological changes and conditions recorded in the skeletal remains of the individuals recovered from the Old Kingdom burials at Saqqara are presented below (in numerical sequenceof the burials).

2.6.1. INDIVIDUAL BURIALS

Burial 56: the skeletal remains of a m ale individual (aged 35-45 years) displayed degen-erative changes in the spine that included vertebral osteophytosis on the tenth thoracic through fi fth lumbar vertebral bodies, accompanied by pronounced lipping and porous degeneration of the body surfaces of the thoracic vertebrae and bilateral diarthrodial joint porosity between the fi rst and second lumbar vertebrae. Additionally, the fi fth lumbar vertebra showed fusion with the sacrum (sacralisation). Dental pathological conditions observed in the individual included ante-mortem tooth loss (AMTL)59 of the upper right

58 ZAKRZEWSKI, Am J Phys Anthropol 121.59 The aetiology of AMTL is multifactorial, including a variation in dietary consistency, nutritional

defi ciency diseases, cultural or ritual ablation, and trauma, and therefore this condition provides an impor-tant measure of dental status of an individual, as well as a population; LUKACS, Int J Osteoarchaeol 17.

364

lateral incisor, severe attrition60 and alveolar abscess. Both the upper and lower incisor and canine crowns were severely worn (grade 3-4) with dentine exposure. The upper left lateral incisor exhibited a periapical abscess. The fi rst molar crowns were almost worn away (grade 9) demonstrating a marked oblique wear plane usually related to agricultural subsistence and food preparation.61 Dentine was exposed on almost the entire occlusal surface, and the lower teeth also demonstrated exposed pulp chambers. The mandibular teeth were likely to have been more affected by attrition than their maxillary counterparts. In both jaws, the fi rst molar showed much more wear than the other molars resulting in a pattern of orderly decreased wear within the tooth class in each quadrant of the jaw.

Burial 57: the mandible of an adult male, aged 20+ years, showed evidence of localised alveolar bone loss resulting in irregular thinning of the alveolar wall, destruction of its superior ridge, and slight (premolars and fi rst to second molars) to marked (incisors, canines) root exposure.62 The anterior teeth exhibited a medium stage of attrition with slight dentine exposure on the incisal edges of the incisors (grade 2) and calculus deposit on the labial surfaces. The fi rst molars demonstrated advanced tooth-crown wear with dentine exposure on the entire occlusal surface (stage 10).

Burial 59: a mature female individual (aged 40-45 years) exhibited extensive ante-mortem tooth loss that affected all the maxillary teeth, except the incisors and right third molar. The alveolar bone loss was extremely advanced due to use of gum for the process of chewing food when all teeth had been lost.

Burial 63: the skeletal remains of a male individual (aged 50-59 years) exhibited patho-logical conditions of the upper and lower alveolar processes. Recession of the alveolar region of both the maxilla and mandible resulted in root exposure of the anterior teeth (except the upper central and right lateral incisors that were lost ante-mortem) with a small apical abscess at the right canine and slight exposure of premolar and molar roots. Marked calculus deposits were present at the cementoenamel junction line of the lower central through second incisors and canines. All the teeth present demonstrated considerable attrition. Both upper and lower canine crowns were severely worn with dentine and pulp chamber exposure on the upper left canine. The lower fi rst molar crowns were worn away (grade 10) in a marked oblique wear pattern, with dentine exposure on the entire occlusal surface.

Burial 65: the tooth crowns of a young female individual (aged 20-25 years) demonstrated advanced attrition. The central and lateral incisor crowns were each worn down by at least half of their original height and had large areas of dentine exposure. The fi rst molar crowns were worn away with the crown surfaces taking on the shape of roots. All the teeth demonstrated the fl at wear plane pattern commonly attributed to hunter-gatherer dentition.63

60 Tooth wear records do not describe a particular disease but this condition can lead to bacterial infec-tion of the pulp chamber of the tooth and consequently to periodontal disease.

61 SMITH, Am J Phys Anthropol 63.62 The marked stage of root exposure was scored when loss of alveolar bone height exceeded 2mm from

the cementoenamel junction to the alveolar crest.63 SMITH, Am J Phys Anthropol 63, p. 50.

Pl. CLXIIa

365

Burial 79: the skull of an adult female (age undetermined but changes in the pubic symphyseal face and largely obliterated sutures suggested a mature adult) demonstrated an extreme bilateral thinning of the parietal bones (biparietal atrophy). The condition occurred symmetrically in the areas lying midway between the sagittal suture and the parietal prominence, and manifested itself as oblong ectocranial depressions that measured 59 mm by 54 mm. Dental pathological conditions included moderate (anterior teeth and premolars) and advanced attrition with dentine exposed on a large area of the occlusal surface of the upper and lower fi rst molars (grade 6). The mandible demonstrated bilateral alveolar resorption resulting in slight (premolars) and moderate (fi rst molars)root exposure.

Burial 86: dental pathology of a male individual (aged 45-50 years) included a severe attrition of all teeth with dentine exposure. The crowns of the anterior teeth and premolars were worn to their mid-height (grade 3-4 and 5, respectively) with calculus deposited on the labial surface of the upper and lower incisors and canines. The crowns of the lower fi rst molars were worn away (grade 7) and the teeth demonstrated bilateral root exposure due to alveolar lesions.

Burial 100: the skeletal remains of a male individual (aged 30-35 years) exhibited an advanced development of vertebral osteophytes, with almost symmetrical distribution on the bodies of the lumbar vertebrae.

Burial 171 (64): a male individual (aged 35-45 years) demonstrated pathological changes in the dento-alveolar region of the skeleton. The anterior maxillary alveolar bone was thinned and reduced resulting in formation of irregular concavities and root exposure of the right central incisor. In the mandible, the alveolar abscess was less acute than in the maxilla resulting in root exposure of the right canine. The dentition also demonstrated anterior crowding with a marked labial inclination and anteroposterior rotation of the upper lateral incisors, as well as labial inclination of the lower canines. The crowding produced a mild malocclusion (Class I) that is characterised by a normal bite with only slight overlap of the lower teeth by the upper teeth. The majority of the teeth exhibited moder-ate occlusal wear, with grades 2 and 3 in the anterior teeth. The lower fi rst molars showed advanced attrition (grade 5) manifested by exposure of two large dentine areas on the occlusal surfaces.

Burial 175: a male individual (aged 30-40 years) demonstrated a crescent-shaped opening in the left parietal bone, partially obscured by an irregularly shaped fragment of the bone. The size, shape (originally circular), and smooth edges of the perforation could possibly indicate a deliberate opening that would have resulted from a medi-cal intervention, such as trepanation. The smooth edges and partial obstruction of the opening (new bone growth) would correspond with healing processes suggesting that the individual survived the procedure, but did not live long enough after to allow the healing to complete. A similar lesion could potentially result from blunt force trauma, which considering the extent of the present opening would have been fatal. Such a blow to the skull would most certainly produce a depressed and comminuted fracture with broken portions of the bone displaced inwards causing extensive damage to the underlying brain tissue. In antiquity, trepanning would have been performed either to

Pl. CLXIIe

Fig. 132

Pl. X\CLXIIf-g

366

treat head injuries, to relieve pressure on the brain, or for magical practices, and the marks resulting from the procedure have been reported in ancient Egyptian and Nubian specimens.64

Also recorded in the individual’s skeletal remains was a mid-shaft fracture to the right ulna, which exhibited a callus bone formation at the injury site indicative of healing. The postcranial skeleton demonstrated several anomalies that included a complete sternoxi-phoidal fusion and slight vertical sclerotic bands situated in the inferior part of the corpus sterni. The male’s dentition was complete. Dental crowns displayed wear with a thick line of dentine exposure in the anterior teeth (grade 3) and two areas of dentine exposure in the lower fi rst molars (grade 4).

Burial 393: the skeletal remains of a male (aged 35-45 years) demonstrated osteophyte developments on the right side of the sixth and eighth thoracic vertebrae, as well as osteophytes bridging between the anterior vertebral bodies of the thoracic tenth through to twelfth and the lumbar vertebrae. The third, fourth and seventh ribs showed knobby and conical costal exostoses (10mm to 15mm in diameter) projecting towards the posterior aspect of the chest. Costal exostosis could cause chest pain and, on rare occasions, also result in haemothorax (accumulation of blood in the chest cavity) or haemopneumothorax (accumulation of air and blood in the chest cavity).65 The occurrence of exostosis in the ribs could be either sporadic, or the manifestation of a rare congenital defect known as hereditary multiple exostoses.66 Small knobby-like exostoses also projected from the metaphyseal area of the right femur and the left humerus. Hereditary multiple exos-toses is an autosomal dominant condition with a 3:1 predominance of males affected compared to females.67 Osteocartilaginous exostosis, also known as osteochondroma,

64 FILER, Disease, pp. 90-91; LISOWSKI, Report on the skulls; LISOWSKI, Trepanation; MARTIN, Int J Osteo-archaeol (2011); OAKLEY et al., Man 59; SHABAAN, Ossa 9-11.

65 E.g. BINI et al., Interact Cardiovasc Thorac Surg 2; UCHIDA et al., Eur Respir J 10.66 GŁADYKOWSKA-RZECZYCKA, URBANOWICZ, Folia Morpholog 29.67 ORTNER, PUTSCHAR, Interpretation, p. 373.

Fig. 132. Evidence of trepanning in the left parietal bone of a middle-aged male from Burial 175

367

is the most common bone tumour that accounts for 10-15% of all bone tumours and 20-50% of all benign bone tumours.68 The precise origin of osteochondroma is uncer-tain, but the condition has been identifi ed in a number of past populations,69 including one of the earliest-known cases dating to the 12th Dynasty in Egypt.70 The male’s dentition was in a poor state and exhibited ante-mortem loss of the upper left lateral incisor and lower central and lateral incisors in both quadrants of the mandible. The present teeth also demonstrated severe attrition resulting in reduced tooth crown height and exposure of a large area of dentine, as well as calculus deposits on the labial surface of the upper and lower canines and the lower right fi rst premolar. The lower fi rst to second molar roots were bilaterally exposed due to periodontal lesion of the alveolar bone.

Burial 394: the skull of a male (aged 30-35 years) demonstrated moderately expressed cribra orbitalia lesions in the orbital roofs. The vertebral bodies of the fourth through sixth cervical and lumbar vertebrae displayed ostephyte formations, as well as Schmorl’s nodes in the lumbar vertebrae. The male’s dentition exhibited moderate attrition of the upper and lower anterior teeth with moderate dentine exposure (grade 4), as well as calculus build-up deposited on the labial aspect of the lower teeth. Severe wear of the fi rst molars resulted in complete loss of the dental crowns and pulp cavities exposure. Periapical abscesses and root exposure were noted at the lower right fi rst to second molars.

Burial 395: the skeletal remains of a mature male (aged 40-50 years) demonstrated osteolytic lesions on the third through sixth ribs, a healing fracture of the proximal third of the left clavicle (medial third), and slight osteophytosis on the lumbar vertebral bodies. Long bones of the upper and lower limbs were light and subjected to post-mortem damage suggestive of osteoporotic changes. The dento-alveolar pathologic conditions included alveolar bone resorption and marked exposure of the upper central incisor, fi rst premolar and the lower fi rst to third molar roots. Ante-mortem tooth loss affected the maxillary fi rst and second molars of the right quadrant and the second premolar and fi rst molar in the left quadrant. Linear enamel hypoplasia, a retrospective indicator of physiological stress and developmental health in humans, was manifested on the crowns of the upper central and the right lateral incisors. The anterior tooth crowns were each heavily worn exposing large areas of dentine (grades 4 and 5). The lower molar tooth crowns were completely worn away demonstrating dentine exposure on the entire occlusal surface and pulp cham-ber exposure of the fi rst molars.

Burial 397: the skull of a female (aged 30-40 years) demonstrated bilateral thinning on the parietal eminences (center of ossifi cation). The condition was manifested as an oblong ectocranial depression (65mm by 56mm) on the left parietal bone, whereas the symmetri-cal defect on the right-side bone was obscured by post-mortem damage (28mm by 27mm). The damage in the affected area occurred most likely due to the extreme thinness of the bone (almost paper-thin) that was also observed in the left-side bone. The facial skeleton demonstrated a deviated nasal septum, most likely due to ante-mortem trauma. The indi-

68 ORTNER, Pathological Conditions, p. 508-509; GUIDICI et al., Radiol Clin N Am 31.69 MURPHY, MCKENZIE, J Archaeol Sci 37.70 ORTNER, Pathological Conditions, p. 517-518.

368

vidual’s dentition was complete and demonstrated advanced attrition. The anterior tooth crowns were worn with a large area of secondary dentine exposed and surrounded by a complete enamel rim (grade 5). The posterior teeth, the fi rst molars in particular, dem-onstrated an extensive loss of crowns with full dentine exposure (grade 9). In addition, the fi rst molar crowns exhibited a marked oblique wear plane. In the mandible, alveolar resorption caused slight to marked exposures of the fi rst through third molar roots. Small interproximal carious lesions on the mesial aspects of the lower right second and third molars were present. The facet area occurred at the middle of the crown of the second molar; on the third molar it extended down to the cementoenamel junction line. The exposed molar roots demonstrated calculus deposits.

Burial 398: dental health status of a male individual (aged 40-50 years) was very poor. Alveolar bone demonstrated severe resorption with root exposure of the upper right canine and premolars and the left fi rst premolar. At the upper fi rst molars, considerable periodon-tal lesions caused root exposure on both buccal and lingual surfaces. In the lower jaw, the roots of the anterior teeth and molars were markedly exposed. The lower fi rst molars also demonstrated considerable dental attrition and pulp cavity exposure. All the tooth crowns demonstrated an angular pattern of wear.

Burial 399: the skull of a male individual (aged 35-40 years) exhibited a healed depressed fracture on the right parietal bone. The postcranial skeleton displayed evidence of osteo-arthritis in the lumbar region of the spine, including osteophyte formations and the anterior erosion of the adjacent edges of the vertebral bodies. The male’s dentition dem-onstrated multiple evidence of poor dental health, including ante-mortem loss of the upper right second molar, moderate (incisal) to severe (occlusal) wear and pulp chamber expo-sure of the lower fi rst molars, periodontal lesions and root exposure at the fi rst to second lower molars, crowding localised at the lower incisors and canines with the canines labially displaced and anterioposteriorly rotated. Linear enamel hypoplasia defects were also noted on the lower central incisors.

Burial 400: the skeletal remains of a 10-year-old child demonstrated lesions of cribra orbitalia in both orbits, as well as marked defects of enamel hypoplasia on the lower incisors and canines.

Burial 401: the complete dentition of a female (aged 25-35 years) displayed crowding of the mandibular incisors and canines, with the central incisors erupted labially, the lateral incisors placed lingually, and the canines anteroposteriorly rotated. The teeth showed moderate stages of wear with hairline-shape dentine exposure on the anterior teeth (grade 2), exposure of two large dentine areas with coalescence on the occlusal surfaces of the fi rst molars (grade 5), and cusp blunting on the remaining molar teeth (grade 2). The roots of the lower incisors were exposed due to alveolar abscess formation.

Burial 402: the dento-alveolar skeleton of a female individual (aged 35-45 years) dem-onstrated periodontitis with root exposure of the upper lateral incisors, canines and premolars. Ante-mortem tooth loss affected the maxillary right molars, left second pre-molar and fi rst molar, and the mandibular right molars, left second premolar and second molar. The present teeth were heavily worn with large areas of exposed dentine.

369

Burial 449: the skull of a male individual (aged 30-35 years) demonstrated cribra orbita-lia expressed as severe porotic lesions in the orbital roofs. An advanced wear of the dental crowns affected the anterior teeth with moderate dentine exposure (grade 3-4) and the posterior teeth with advanced dentine exposure (grade 7). Ante-mortem tooth loss affected the lower right fi rst premolar and left second premolar. Abscess cavities sur-rounded the roots of the upper canines. Linear enamel hypoplasia defects were symmetrically present on the upper and lower fi rst molars.

Burial 453: the spine of a male individual (aged 40-45 years) demonstrated anterior marginal lipping on the lower lumbar vertebral bodies, a crush fracture to the fi rst lumbar vertebra, possibly associated with osteoporosis, and sacralisation of the fi fth lumbar ver-tebra. Also observed in the postcranial skeleton was periosteal new bone formation on the posterior aspect of the femora, medial aspect of the distal tibiae and fi bulae, and lateral aspect of the tibiae. The individual’s dentition demonstrated poor dental health, including ante-mortem loss of the mandibular central and left lateral incisors and left fi rst molar. In addition, the mandibular third molars were most likely congenitally absent, and the max-illary left central incisor was lost post-mortem. The present teeth exhibited moderate (incisors) to severe (canines and posterior teeth) dental wear. The latter stage was especially evident in the fi rst molars that showed angular attrition plane and crown reduction down to the cementoenamel junction line (the mandibular right fi rst molar). Moderate (anterior teeth) to severe (posterior teeth) dental calculus deposits were present on the labial/buccal and lingual surfaces of the teeth, as well as on the occlusal surface of the maxillary third molars due to congenital absence of their mandibular antimeres. Alveolar bone resorption resulted in root exposure of the present teeth. The maxillary second premolars were medi-ally rotated.

Burial 473: the skeletal remains of a male, 30-35 years of age, demonstrated lesions of porotic hyperostosis on the posterior aspects of the parietal and occipital bones. Also noted on the right parietal bone was a button osteoma. The frontal bone showed a circular pathological lesion with raised edges. Slight degenerative changes developed in the major body joints, including the glenohumeral, humeroulnar, hip and knee joints, as well as in the metacarpo- and metatarsophalangeal joints. Degenerative changes, such as lipping, porosity, and Schmorl’s nodes occurred in the spine. The lower sacral elements remained unfused and open presenting a posterior hiatus (partial spina bifi da occulta) that resulted from a developmental congenital disorder. The individual’s maxillary dentition was incomplete due to post-mortem loss of the left central incisor and right canine. In general, the teeth demonstrated moderate occlusal wear and only in one case, the right upper central incisor, the pulp chamber was exposed. Also, the anterior maxillary teeth displayed vertical enamel lesions (chipping) on the labial surfaces.

Burial 475: the skeletal remains of a young female (aged 20-25 years) demonstrated marked porosity on the inferodistal part of the humeral head and on the distal end of the tibiae, as well as porosity and eburnation on the right femoral head. Both humeri showed septal aperture, which are generally viewed as a non-metric trait, merely refl ecting incom-plete ossifi cation.71 They further tend to correlate negatively with the robusticity of the

71 FINNEGAN, J Anat 125.

Pl. CLXIII

Pls. CLXIV,CLXVa-c

Fig. 134;

Pls. CLXVd-g,CLXVI

Fig. 133;

Pl. CLXVII

370

bone,72 and are more frequently present in the gracile humeri of females.73 However, there are also explanations favouring the association of this condition with a wider range of fl exion and extension at the elbow joint.74 Porosity was present on the superior surface of the left clavicle. The right os coxa demonstrated an oval exostosis (15mm by 10mm) that developed in the central part of the retroauricular area, and a similar but much smaller lesion situated on the arcuate line posterior to the auricular surface. The fi rst right rib was bifi d at its sternal extremity and the vertebral extremity of the fourth and fi fth right ribs showed marked enthesophytes at the articular portion of the tubercle. The dentition was complete and showed slight attrition, bilateral linear enamel hypoplasia defects on the lower canines, and dental calculus on the labial aspects of the lower right incisors and all molars.

Burial 476: the skeletal remains of a male individual (aged 40-45 years) demonstrated advanced marginal lipping and eburnation of the tenth through twelfth thoracic and fourth and fi fth lumbar vertebral bodies. Slight and marked enthesophytes were observed on the lesser and greater trochanter of the femur, respectively. Marked enthesophytes were also present at the tibial tubercle. The fi rst, fi fth and sixth ribs were bifi d at their sternal extremity. The individual’s dental health status was fair. Ante-mortem tooth loss affected the upper left fi rst premolar and the lower anterior teeth were lost post-mortem. The lower right third molar was reduced in size and its left antimere was most likely genetically absent. The teeth showed moderate (anterior teeth – grade 3) to severe (premolars and fi rst molar – grade 6-7) attrition, dentine exposure, calculus build-up on the labial aspect of the upper premolars and lower molars, and root exposure of the upper right canine.

Burial 479: the skeletal remains of a young female (aged 20-25 years) demonstrated slight porotic lesions on the right parietal eminence, cribra orbitalia in both orbital roofs, and slight enamel hypoplasia on the upper right second premolar and fi rst molar, viewed as morphological responses to the environmental stress in early stages of life. The greater trochanter of the left femur had moderately expressed enthesophytes on its lateral surface. The dentition was incomplete due to post-mortem loss of the anterior upper teeth. The present teeth were slightly worn with calculus deposited on both labial and lingual aspects of the fi rst lower molars and on the labial surface of the remaining lower molar teeth.

Burial 480: the skeletal remains of a female individual (aged 30-40 years) demonstrated degenerative changes in the lumbar spine, such as Schmorls’ nodes, bilateral osteophytes on the vertebral bodies with anterior bridging osteophytes fusing the third through fi fth lumbar vertebrae. Slight enthesophytes were present on the lateral surface of the right femur. Dental status was very poor with severe attrition of all the tooth crowns with a large area of dentine exposure of the anterior teeth (grade 4-5) and complete crown loss and pulp exposure of the fi rst molars (grade 10). Dental calculus was formed on all anterior teeth on both labial and lingual surfaces of the tooth crowns and on the buccal aspect of the upper second molars. The left third molar was most likely congenitally absent and its right antimere was markedly reduced to a peg-shaped tooth.

72 BENFER, MCKERN, Am J Phys Anthropol 24.73 SINGHAI, RAO, Anat Sci Int 82.74 GLANVILLE, Am J Phys Anthropol 26.

Pl. CLXVIIIa

371

Burial 481: a male individual (aged 30-35 years) demonstrated degenerative changes, such as Schmorl’s nodes in the upper and lipping in all lumbar vertebrae. The left femur exhibited a healed mid-shaft fracture that resulted in bone shortening. Poor dental status of the individual was expressed by ante-mortem loss of the upper left premolars and lower right fi rst molar, advanced attrition with large dentine exposure (grade 4-5 in the anterior teeth and grade 7-8 in the posterior teeth), and calculus deposits on the labial surface of the upper left lateral incisor and canine.

Burial 489: the skull of a female individual (aged 40-45 years) demonstrated porotic lesions on the parietal and occipital bones (porotic hyperostosis), and on the orbital roofs (cribra orbitalia). Porotic hyperostosis is a well-recognised skeletal indicator of physio-logical stress occurring during the early years of childhood growth, and has been associated with scurvy, rickets, anaemias, treponematosis, and limited access to protein.75 Poor dental status included periodontitis of the upper and lower jaws with root exposure of the upper and lower incisors and lower canines, osteomyelitis of the left mandibular quadrant, ante-mortem loss of the upper right fi rst molar, and severe attrition of the present teeth with dentine exposure and pulp cavity exposure in the lower fi rst molars.

Burial 490: the skull of a young male individual (aged 25-30 years) displayed a circular depressed fracture (11mm in diameter) located on the left parietal bone. Poor dental health was refl ected by periodontitis and root exposure of the lower anterior teeth, moderate to severe attrition, ante-mortem loss of the lower right fi rst premolar, and post-mortem loss of the anterior maxillary teeth.

Burial 493: the skull of a young male individual (aged 25-35 years) displayed porotic lesions characteristic of cribra orbitalia (in the orbital roofs) and porotic hyperostosis (on the external surface of the occipital bone) associated with anaemia due to malnutrition. A further skeletal fi ndings, including the exaggerated posterior occipital protuberance and markedly thickened cranial vault and malar bones, elongated mandible with pronounced chin due to subperiosteal new bone deposition, elongated and broad ribs, marked perios-teal new bone formation on the femoral, tibial and fi bular shafts, arrowhead appearance of the terminal fi rst phalanges of the feet due to tufting, antero-lateral enlargement of the vertebral bodies due to extensive subperiosteal build-up, advanced osteoarthritic changes in the spine and a scoliotic curve in its thoraco-lumbar region, were all suggestive of acromegaly, a chronic metabolic disorder of the pituitary gland.76 The condition results from a pituitary adenoma (neoplasm) that causes the gland to secrete excess growth hormone after the fusion of the epiphyseal plates, stimulating endochondral bone growth and resulting in severe skeletal deformities. The postcranial skeleton of the male from Burial 493 also demonstrated lateral angulation of the humeral shafts and shortening of the left humerus with no changes to the epiphyses, suggestive of possible growth distur-bances, and osteochondritis dissecans on the left radial articular surface (for lunate) and on the patellar surface of the left femur, caused by blood deprivation in the subchondral bone. The male’s dentition was complete and included a supernumerary tooth in the left

75 ORTNER, Pathological Conditions, pp. 370-375; WALKER et al., Am J Phys Anthropol 139.76 AUFDERHEIDE, RODRÍGUEZ-MARTÍN, Human Paleopathology, pp. 327–328; ORTNER, Pathological Condi-

tions, pp. 420-422.

Pl. CLXVIIIb-g

Pls. CLXIX-CLXX

372

mandibular quadrant. The fourth molar that erupted distally to the third molar displayed normal morphology but was visibly smaller in size. In modern populations, supernumer-ary teeth are found to occur most frequently in the maxillary, rather than mandibular, anterior and molar regions, and are more often seen in males than females.77 In the pres-ent case of hyperdontia, the eruption of the supplemental fourth distomolar contributed to dental crowding resulting in mild malocclusion. In addition, the fi rst molars showed secondary dentine exposure due to advanced occlusal wear, the right maxillary fi rst molar demonstrated an occlusal caries and apical abscess that formed at its distal root, and all molars exhibited slight calculus deposits on the buccal surfaces.

Burial 499: the dentition of a young female (aged 25-30 years) was complete and dem-onstrated mild periodontitis resulting in slight to moderate tooth neck exposure of the lower teeth, enamel hypoplasia defects on the lower canines and fi rst premolars, dental calculus on the buccal surface of the lower second premolars (unilaterally on the right side) and molars (bilaterally), moderate occlusal wear with moderate to full cusp removal and moderate dentine patches on all teeth.

Burial 509: the postcranial skeleton of an elderly female (aged 50+ years) demonstrated slight degenerative changes, including lipping on the articular surfaces of the right humer-oulnar and left talocalcaneal joints, and porosity and osteophyte formations on the vertebrae. A partial fusion of the fi fth lumbar vertebra with the sacrum was most likely due to ankylosing spondylitis, an infl ammatory rheumatic disease that causes ascending destructive changes in the vertebral joints.78 The female sustained traumatic injuries to the left seventh through tenth ribs which healed during her lifetime leaving well-remodelled callus bone formation at the fracture sites. A single osteochondral lesion was noted on the vertical ridge of the right patella. The dentition demonstrated ante-mortem loss of three maxillary and one mandibular teeth, a further fi ve maxillary teeth were lost post-mortem, and the left maxillary fi rst premolar was broken at the root. The present teeth showed moderate to severe occlusal wear, especially on the maxillary anterior teeth and premolars that were worn down almost to the cementoenamel junction leading to exposure of the pulp chambers and formation of periapical abscesses at the maxillary lateral incisors and right canine, and the right mandibular central incisor. Severe cervical caries affected the interproximal surfaces of the right maxillary second and third molars and the left man-dibular fi rst molar. Poor dental health was also demonstrated by moderate to severe deposition of calculus on the upper and lower dentition. Linear enamel hypoplasia defects due to nutritional or physical stress were recorded in the mandibular canines and right fi rst premolar and second molar. Slight porosity observed on the temporomandibular joint surfaces most likely developed as a result of the joint’s dysfunction.

Burial 510: the appendicular skeleton of a male individual (aged 50+ years) demonstrated severe degenerative changes, including pitting, lipping and eburnation that affected the left radioscaphoid joint and left fi st metatarsophalangeal joint, as well as mild lipping that developed on the glenohumeral, humeroulnar, and tibiotalar joints. The right ulna showed a well-healed ‘parry’ fracture that would have been caused by a direct blow to the forearm

77 PINDBORG, Pathology; KOKTEN et al., J Contemp Dent Practice 4.78 AUFDERHEIDE, RODRÍGUEZ-MARTÍN, Human Paleopathology, pp. 102-104.

Pl. CLXXI

Pls. CLXXII-CLXXIII

373

while it was raised in a protective gesture to shield the head. Such fractures are usually indicative of an interpersonal violence.79 The individual also suffered from tuberculosis as evident from a severe kyphotic angulation of the spine produced by the anterior collapse of the eleventh thoracic through fi rst lumbar vertebral bodies. The cervical and upper thoracic vertebrae showed moderate degenerative changes, and the right sacroiliac joint was fused due to infl ammatory ankylosing spondylitis. Also noted in the sacrum was a sacral-coccygeal fusion, known to be more prevalent in males than females and among individuals of advanced age, according to modern clinical studies.80 Poor dental health was evident in the male’s dentition. In total, fi ve maxillary premolars and molars were lost ante-mortem, and only one tooth was lost port-mortem. Dental occlusal wear was moderate to severe, the latter resulting in pulp cavity exposure in the maxillary right fi rst premolar and left second molar, and formation of periapical abscesses at the roots of the maxillary fi rst premolars and right fi rst molar. Slight to moderate calculus deposits were present on the labial and buccal surfaces of the anterior dentition and premolars, and severe deposits formed on the buccal and lingual aspects of the molars. The individual anterior teeth demonstrated up to three chronological linear enamel hypoplasia defects formed during periods of stress; periodontal disease was responsible for the alveolar bone loss in the left maxillary dental arch. The right temporomandibular joint displayed advanced degenerative changes; such degeneration was less pronounced in the left joint.

Burial 511: the skeletal remains of a female individual (aged 50+ years) demonstrated mild degenerative changes on the joints of the upper limbs and lower extremities, and advanced osteophyte formations in the lower spine. The height reduction of the tenth through twelfth thoracic vertebral bodies, and a compression fracture of the eleventh vertebra that led to secondary kyphosis would have occurred due to signifi cantly dimin-ished bone mass associated with osteoporosis. Also associated with osteoporosis was bilateral parietal thinning observed in the female’s cranium. These symmetrically distrib-uted endocranial depressions are often encountered in association with post-menopausal and senile osteoporosis.81 The dentition was complete apart from the left mandibular second molar lost ante-mortem and the fi rst incisor lost post-mortem. Moderate to severe dental occlusal wear resulted in secondary dentine exposure in the majority of teeth, also causing formation of periapical abscesses at the roots of the maxillary fi rst molars and mandibular left fi rst molar. In addition, a fi stula was observed in the fl oor of the right maxillary sinus that formed due to the root protrusion of the fi rst molar. All teeth displayed slight to moderate deposition of calculus on their labial/buccal and lingual aspects. Linear enamel hypoplasia defects formed bilaterally on the lower canines. Periodontal disease was most apparent in the mandible resulting in severe molar root exposure.

Burial 521: the skeletal remains of an unsexed adult individual demonstrated very poor preservation that restricted osteological examination. The individual’s dentition was rep-resented by the upper jaw only. A total of seven maxillary teeth exhibited severe attrition with secondary dentine exposures.

79 JUDD, J Archaeol Science 35.80 TAGUE, Am J Phys Anthropol 145.81 CEDERLUNG et al., Skeletal Radiol 8; EPSTEIN, Radiology 60; LUK et al., Pan African Med J 4; STEINBACH,

OBATA, Am J Roentgenol 78.

Pls. CLXXIV,CLXXVa-d

Pl. CLXXVe-f

374

Burial 528: the spine of a male individual (aged 30-40 years) showed degenerative changes and evidence of trauma to the fi fth lumbar vertebra. The fracture to the pars interarticularis of the fi fth lumbar vertebra that resulted in separation of the vertebral body from its spinal process was most likely caused by stress. The defect known as spondy-lolysis could occur in other lumbar vertebrae, as well as in the thoracic vertebrae, and is a common occurrence in athletes in modern populations.82 The male also sustained a frac-ture to the proximal shaft of the left fi bula with no tibial involvement. This would suggest the trauma was a result of a direct impact, such as a kick, or an indirect mechanism. Such an isolated fi bular fracture could also be produced by a torsional injury to the ankle, also known as Maisonneuve fracture.83 The male’s dentition showed post-mortem loss of the anterior teeth, and ante-mortem loss of the third molars, the latter most likely associated with periodontal disease that affected the supportive alveolar bone. The premolars and fi rst molars showed advanced attrition that resulted in exposure of secondary dentine. Slight to moderate calculus deposits were present on the teeth. The male survived several episodes of nutritional or physical stress during childhood as attested by multiple linear enamel hypoplasia defects manifested on the canines and mandibular fi rst molars. The mandibular condyles showed mild porosity that would have developed in response to a temporomandibular joint disorder.

Burial 538: a traumatic injury to the distal epiphysis of the right ulna of a female indi-vidual (aged 50+ years) resulted in failure of the fractured fragments to unite causing atrophic non-union and post-traumatic bone shortening. The lower limbs demonstrated osteochondral lesions on the posterior aspects of the femoral lateral condyles, multiple exostoses on the medial aspects of the distal femora and right proximal tibia, as well as fusion of the distal tibia and fi bula. The occurrence of multiple exostoses (benign lesions) is characteristic of diaphyseal aclasia, also known as hereditary multiple exostoses or multiple osteochondromatosis, a condition that primarily affects endochondral bone dur-ing growth.84 Initially, the lesion presents itself as a rounded outgrowth, which could be modifi ed by mechanical stresses, such as muscle pull and tendon insertions in the affected area.85 Due to such stresses, the exostoses in the knee area form elongated polypoid structures with bulbous tips pointing away from the joint, as in the present case. Such slender and elongated exostoses are prone to fractures, as evident in the left femur of the female’s skeleton. The occurrence of the bony spurs in the female’s knee region could have resulted in a limited range of motion at the joint. Also observed in the postcranial skeleton were moderate degenerative changes that affected the spine. In the cranium, the occipital bone demonstrated lesions of porotic hyperostosis, a condition indicative of a nutrition-ally inadequate diet or infectious disease.86 The female’s mandible demonstrated bilateral bifi dity of the condylar head, a rather uncommon condition in modern populations.87

82 MICHELI, CURTIS, Clin Sports Med 25; MOTLEY et al., J Athletic Training 33; STANDAERT, HERRING,Br J Sports Med 34.

83 PANCHOVICH, J Bone Joint Surg 58A.84 AUFDERHEIDE, RODRÍGUEZ-MARTÍN, Human Paleopathology, p. 361; BOVÉE, Orphanet J Rare Dis 3;

HENNEKAM, J Med Genet 28; SHAPIRO et al., J Bone Joint Surg 61A.85 ORTNER, Pathological Conditions, p. 509.86 WALKER et al., Am J Phys Anthropol 139.87 BLACKWOOD, Am J Phys Anthropol 15; KANEYAMA et al., Congen Anomalies 48.

Pl. CLXXVI

Pls. CLXXVII-CLXXVIII

375

According to clinical cases,88 the anomaly causes no pain or restricted movement. However in the present case, it could have contributed to formation of degenerative changes in the individual’s left temporomandibular joint. The female showed very poor dental health. In total, seven of the maxillary teeth were lost ante-mortem, and another seven maxillary and mandibular teeth were lost post-mortem. The remaining anterior upper teeth and lower right premolars and molars showed severe occlusal wear resulting in exposure of pulp cavities followed by formation of periapical abscesses at the roots of the lower fi rst molars. Carious lesions occurred on the interproximal surfaces of the right maxillary fi rst molar, left mandibular second premolar and fi rst molar, and below the cementoenamel junction of the second molar. The latter caries occurred on the exposed root due to the loss of the supportive alveolar bone, a feature characteristic of periodontal disease.

Burial 539: the postcranial skeleton of a female individual (aged 50+ years) demonstrated multiple sites of osteophyte formations in the upper and lower limb joints, and in the thoraco-lumbar spine. Also recorded was a spondylolysis defect in the fourth lumbar vertebra and a healed trauma to the proximal left radius, the latter most likely sustained in childhood, with a consequent bone growth reduction (the left radius was 6mm shorter than the right bone). The female’s dentition showed ante-mortem loss of the right maxil-lary fi rst molar and post-mortem loss of the right maxillary and left mandibular central incisors. The remaining teeth demonstrated a severe and fairly even pattern of occlusal wear and moderate calculus deposits. Periapical abscesses formed at the roots of the maxillary right fi rst incisor and premolar and left fi rst molar. The female also showed extensive loss of the buccal alveolar bone as a result of a large abscess that affected the left mandibular second premolar through third molar. The affected teeth demonstrated calculus deposits on the occlusal surfaces indicative of the lack of involvement in masti-cation (crushing and grinding food). The loss of the occlusal function on the left-side jaws would have resulted in malfunction of the temporomandibular joints and development of degenerative changes.

Burial 540: a female individual (aged 50+ years) demonstrated porosity and pitting on the right condyle of the mandible and corresponding osteophyte development on the right-sided articular eminence that manifested an early-stage degenerative temporoman-dibular joint disease. The female most likely suffered from osteoporosis as evident from bilateral parietal thinning that resulted in formation of extensive depressions (approxi-mately 30-40mm in diameter) in the endocranial surfaces of the parietal bones. Additionally, the individual sustained a Colles’ fracture to the right distal radius that would have resulted from a fall onto an outstretched hand. The frequency of this particular type of fracture has been found to be far greater in older women (45 years of age and over with osteoporotic changes to the bone) than in men of the same age group.89 The injury is considered to be the most common fracture pattern affecting the distal radius; furthermore the radius has been shown to be the most commonly fractured long bone in modern-day studies.90 The female also sustained a spiral fracture to the right fi fth metatarsal that was well-healed, but resulted in bone shortening of approximately 5mm due to the overlap of the fragments.

88 SALES et al., Braz Dent J 18.89 PUTNAM, SEITZ, Fractures of the distal radius; JUPITER, J Bone Joint Surg 73A.90 EMMETT, BRECK, J Bone Joint Surg 40A.

Pl. CLXXIX

Pls. CLXXX-CLXXXIa-c

376

Early degenerative changes developed in the bones of the hands and right wrist, the knee joints, and in the cervical and lumbar vertebrae. Lesions of osteochondritis dissecans occurred on corresponding articular surfaces of the lateral condyles of the right femur and tibia, and on the left patella. The lower sacral elements remained unfused and open pre-senting a posterior hiatus (partial spina bifi da) that resulted from a developmental congenital disorder. The female’s dentition was incomplete due to ante-mortem loss of seven teeth (fi rst molars and lower central and second left incisors) and post-mortem loss of the upper right premolars and lower right second incisor. The present teeth demonstrated severe occlusal wear that resulted in multiple pulp cavity exposures and formation of periapical abscesses at the roots of the maxillary premolars and mandibular right fi rst and left second molars, as well as moderate to severe calculus deposits.

Burial 541: a male individual (aged 35-45 years) demonstrated evidence of multiple traumatic injuries sustained to the bones of the upper limbs, the ninth rib, and the lumbar vertebrae. The trauma that affected the left forearm resulted in posterior angulation of the distal radius with extensive bone remodelling on its posterior aspect, and damage to the distal radioulnar articulation with formation of secondary osteoarthritic changes. A similar injury affected the right distal forearm resulting in shortening and medial angulation of the distal ulna, as well as in fusion of the trapezoid to the capitate in the wrist, and approximately 6mm shortening of the second metacarpal. In addition, a proximal phalanx from the individual’s left hand demonstrated partial bifi dity on the plantar aspect of the head. Severe degenerative changes occurred on the bodies and articular facets of the third through seventh cervical vertebrae. A crush fracture sustained to the left antero-lateral aspect of the third lumbar vertebral body caused wedging and height reduction by approximately 3mm compared to the adjacent lumbar vertebrae. The fi fth lumbar vertebra showed complete separation of the neural arch as characteristic of spondylolysis deformity. The upper sacral elements remained unfused and open presenting a posterior hiatus (par-tial spina bifi da) that resulted from a developmental congenital disorder. The male’s dentition was complete apart from post-mortem loss of the lower right canine. The teeth demonstrated severe occlusal wear on the fi rst molars, a single caries on the occlusal surface of the left mandibular third molar, and multiple linear enamel hypoplasia defects on the central upper incisors and lower canine.

Burial 542: the spine of a young male (aged 30-35 years) demonstrated degenerative changes, including porosity, osteophyte formation and eburnation on the articular facets of the second, third and eighth thoracic vertebrae, as well as Schmorl’s nodes on the superior body of the second lumbar vertebra. The male’s dentition exhibited defects of dental enamel that were present on the upper canines and second molars (linear defects) and lower second molars (pits on buccal aspects of the crowns).

Burial 551: a male individual (aged 35-40 years) displayed degenerative porosity on the articular facets of the seventh through ninth thoracic vertebrae and on the bodies of the fourth and fi fth lumbar vertebrae. Additionally, one of the individual’s lower right ribs showed evidence of traumatic injury.

Burial 552: a female individual (aged 25-30 years) demonstrated lesions of porotic hyperostosis on the ectocranial surface of the parietal bones, as well as slight marginal

Pls. CLXXXId-h,CLXXXII

Pl. CLXXXIIIa-b

Pl. CLXXXIIIc-h

377

lipping and porosity on the articular facets of the lumbar vertebrae. The female’s dentition was incomplete due to post-mortem loss of a total of 11 teeth. The upper right and lower left third molars were unerupted and most likely congenitally absent. There were slight calculus deposits on the present teeth, and a single carious lesion on the occlusal surface of the lower left second molar.

Burial 554: the skull of a female individual (aged 50+ years) demonstrated an extensive perforating lytic lesion (60.5mm by 53mm) surrounded by smaller perforations that developed on the right parietal bone at the junction of the sagittal and lambdoid sutures.91 Osteolytic lesions with ragged margins and no evidence of healing are characteristic of malignant neoplasm, such as metastatic carcinoma.92 The left parietal showed a large ectocranial depression (32.5mm by 22mm) that would have resulted from bone thinning, most likely associated with menopausal osteoporosis. The female also suffered from general osteoarthritis that affected the upper and lower limb joints (moderate) and the spine (severe). The lateral aspects of the tibiae and medial aspects of the fi bulae showed new periosteal bone formation in response to injury or infl ammation of the periosteum surrounding the bone. The articular surface of the lateral malleolus of the left fi bula dis-played fracture lines that occurred most likely due to impact or stress that affected the ankle joint. In the feet, the distal fi fth interphalangeal joints were completely fused. Poor dental health was noted in the female’s dentition. In total, there were 13 teeth (12 upper and one lower) lost ante-mortem, and a further fi ve teeth (four upper and one lower) lost post-mortem. The lower dentition showed severe occlusal wear that resulted in secondary dentine and pulp cavity exposure in multiple locations. In the upper dentition this led to the formation of a total of fi ve periapical abscesses. The female also suffered from peri-odontal disease as evident from severe loss of the alveolar bone and dental root exposure. The lower teeth showed moderate to severe calculus build-up and multiple linear enamel hypoplasia defects on the canines and left second premolar.

Burial 555: the cranium of an adolescent male (aged 18 years) demonstrated a bilateral parietal thinning defect that was most likely developmental or dysplastic in nature, rather than secondary to osteoporosis considering the individual’s young age. Additionally, sym-metrical cortical defects (approximately 16mm in diameter) were noted on the medial aspect of the surgical neck of the humeri. The mandible showed dental crowding that resulted in the antero-medial rotation of the left canine and slight lingual inclination of the left second premolar. The dentition demonstrated slight calculus deposits on the labial and buccal surfaces and moderate build-up on the lingual aspects of the upper teeth only. The incisal edges of the maxillary incisors and canines exhibited evidence of enamel trauma (chipping) manifested as irregular vertical lesions. In the mandibular teeth, notches were formed in the distal corners of the second left incisor and right canine. The latter type of dental modifi cation could occur as a result of pulling or holding abrasive materi-als between the teeth, and is distinguishable from the linear grooves by its greater breadth than depth. All anterior teeth and premolars demonstrated a number of linear enamel hypoplasia defects indicative of multiple episodes of nutritional or physical stress, also evident from cribrotic lesions in the orbital roofs.

91 KOZIERADZKA-OGUNMAKIN, PalArch’s J Archaeol Egypt 10.92 MARKS, HAMILTON, Int J Osteoarchaeol 17.

Pl. CLXXXIV

Pl. CLXXXV

378

Burial 556: a child, approximately 4 years of age at the time of death, showed porotic lesions in the orbital roofs associated with early stages of cribra orbitalia.

Burial 557: a male individual (aged 40-50 years) demonstrated evidence of multiple episodes of trauma sustained to the right forearm and the lower limbs. In the forearm, the thickening and roughening of the cortex of the distal radius manifested a healed traumatic injury, whereas the distal ulna showed an unhealed fracture of the styloid process, and the two bones were approximately 11mm shorter than the corresponding left-side elements. A possible unilateral misalignment of the right hip joint resulted in extensive destructive changes to the acetabular contour and osteophyte development around the acetabular rim and femoral head, sclerotic bone deposition inside the acetabulum, and formation of cystic lesions on the superior aspects of the femoral head and acetabulum. The posterior aspect of the left mid-femur showed a large (57mm by 16mm) soft tissue ossifi cation that formed most likely in response to trauma (myositis ossifi cans traumatica). The plate-like osteophyte developed from the linea aspera into the vasti muscle group or short head of biceps. Additionally, the second metacarpals showed unusually pronounced anterior angulation of the distal shaft. In the spine, Schmorl’s nodes formed on the inferior end plates of the lower thoracic vertebrae. The male’s dentition was complete apart from a total of three teeth that were lost post-mortem. The occlusal wear of the teeth was moderate to severe, especially on the upper anterior teeth and premolars. This unusual pattern of wear would suggest other uses of the dentition in addition to mastication. A periapical abscess formed in the alveolar bone that used to support the upper right central incisor. Mild periodontal disease manifested around the upper and lower molars developed most likely due to calculus build-up (observed as moderate to severe deposits on all teeth).

Burial 558: the postcranial skeleton of an old male individual (aged 50+ years) showed much evidence of entheseal ossifi cation, as well as slight degenerative changes on many of the major joint surfaces, consistent with the individual’s advanced age. Marginal lipping and osteophytes developed on the cervical through lumbar vertebrae, and the eighth and ninth thoracic vertebral bodies showed a marked reduction in height caused by compres-sion fractures often occurring in osteoporotic bones with diminished bone mass. The lower spine showed partial sacralisation of the fi fth lumbar vertebra due to the fusion of the vertebral right-sided transverse process to the superior aspect of the sacral ala. The sacrum also comprised an additional sixth segment, a rare congenital abnormality in modern populations. The male sustained a traumatic injury to a rib and a depression fracture to the lateral plateau of the left tibia. The medial aspect of the proximal left fi bula showed formation of periosteal reactive bone. The cranium demonstrated a benign tumour of button osteoma93 that developed on the right parietal bone above the squamous suture margin, benign overgrowth of the inner table of the frontal bone due to hyperostosis frontalis interna,94 and porotic lesions characteristic of cribra orbitalia on the right orbital roof. Degenerative changes, including pitting and marginal lipping developed on the articular surfaces of the right temporomandibular joint most likely as a consequence of the individual’s poor dental health. The lower dentition showed ante-mortem loss of fi ve teeth and one tooth was lost post-mortem. Severe occlusal wear resulted in secondary

93 ESHED et al., Am J Phys Anthropol 118.94 HERSHKOVITZ et al., Am J Phys Anthropol 109.

Pls. CLXXXVI-CLXXXVIIa-c

Pls. CLXXXVIId-h,CLXXXVIIIa-d

379

dentine and pulp cavity exposure that led to the formation of two large periapical abscesses around the labial aspects of the lower left premolars through second molar, and the right fi rst and second molars. Dental crowding resulted in antero-lateral rotation of the left canine. Diffused zones of enamel hypoplasia were noted on the labial aspects of the crowns of the upper canines and would have possibly occurred when the individual was two or three years old.

Burial 604: the postcranial skeleton of a male individual (aged 30-40 years) demonstrated degenerative changes on the vertebrae and articular facets of the bone of the feet, and evidence of a spiral fracture of the left fourth metatarsal with post-traumatic ossifi cation of the third dorsal interosseous muscle attachment. The male’s dentition was complete apart from three second premolars lost ante-mortem and unerupted lower third molars that allowed the corresponding upper molars to hypererupt. The teeth showed moderate occlu-sal wear and calculus deposits. Linear enamel hypoplasia defects were noted on the anterior teeth.

Burial 610: a probable male individual (aged 25-35 years) demonstrated porotic lesions on the occipital bone indicative of nutritional defi ciency. Multiple skeletal abnormalities including thoraco-lumbar scoliosis and associated deformities of the lower ribs, rhizomelic shortening of the humeri, slight varus angulation and robusticity of the humeri, severe osteoarthritic changes in the glenohumeral joints, bilateral genu varum (bow-leggedness), and shortening of the fourth metacarpal and metatarsal characteristic of brachydactyly type E1 were indicative of multiple epiphyseal dysplasia, 95 a congenital condition and one of the most commonly occurring skeletal dysplasias in modern populations. In past popu-lations, however, there is only one possible case of this condition, identifi ed in an ancient Egyptian specimen dated to the Badarian period (4400-4000 BC).96 Additional changes observed in the skeletal remains of the male from Burial 610 included mild to moderate osteophytosis, porosity, and Schmorl’s nodes on the lower thoracic and lumbar vertebrae, evidence of healed trauma on the bodies of the left seventh and eighth ribs, severe degen-erative changes on the articular surfaces of the right eleventh and twelfth ribs, mild osteoarthritic changes in the knee joints, osteochondral lesions on the lateral condyle of the left femur and on the head of the right talus, and moderate stages of degenerative changes on the articular surfaces of the metatarsals. Completeness of the male’s dentition was affected by the ante-mortem loss of a single tooth and post-mortem loss of a total of fi ve teeth. The present teeth showed moderate deposits of calculus on the labial and buccal surfaces, and a small carious lesion on the occlusal surface of the upper right second molar. In addition, the upper central and right lateral incisors and left canine, and the lower left incisors, fi rst premolar and canines demonstrated linear enamel hypoplasia defects.

Burial 611: the skeletal remains of a young male individual (aged 20-25 years) showed ossifi cation at the rectus femoris muscle attachment sites on the patellae, slight marginal osteophytic lipping on the articular facets of the left carpals and interphalangeal joints, hairline fractures on the bases of the fi rst phalanges of the left foot, and fusion at the fi fth

95 KOZIERADZKA-OGUNMAKIN, Int J Paleopathol 1.96 JONES, J Anat 66; KOZMA, Am J Med Genet 146A.

Pls. CLXXXVIIIe-h,CLXXXIXa-e

Pls. CLXXXIXf-h,CXC, CXCIa-c

Pl. CXCId-g

380

distal interphalangeal joints in the feet. The lower thoracic vertebrae showed Schmorl’s nodes, as well as slight porosity of the end plates, also noted on the lumbar vertebrae. The second cervical vertebra (axis) showed a unilateral abnormality that manifested as a concave and smooth-walled lesion on the lateral vertebral body extending to the anterior pedicle. The observed depression could be associated with a vertebral artery aneurysm that could occur as a result of blunt trauma to the neck, or together with other connective tissue disorder.97 Another skeletal abnormality was noted in the individual’s mandible, which demonstrated unusually elongated coronoid processes, a rare condition in modern populations that could greatly restrict the maximum mouth opening. Coronoid hyperplasia can occur unilaterally or bilaterally, as in the present case, and the latter form has been found to be less frequent in modern clinical cases.98 Etiopathogenesis of the bilateral condition remains unclear with possible indications to developmental and endocrine abnormalities. The individual’s dentition showed post-mortem loss of six teeth and ante-mortem loss of the upper left fi rst premolar and right second molar. There were moderate calculus deposits on the teeth, and dental roots were signifi cantly exposed indicating alveolar bone loss due to periodontal disease. The maxillary canines showed linear enamel hypoplasia defects indicative of systemic nutritional or disease stress dur-ing childhood, also evident from slight porotic lesions present on the outer table of the occipital bone.

2.6.2. SKELETAL PATHOLOGIES

The skeletal remains examined in the present assemblage demonstrated evidence of pathological conditions of various aetiologies, including congenital and developmental, metabolic and haematological, circulatory, neoplastic, infectious disease, degenerative joint disease, and trauma.

2.6.2.1 . CONGENITAL AND DEVELOPMENTAL CONDITIONS

Congenital and developmental conditions commence during foetal development and are present at birth or occur shortly thereafter. The range of this particular type of disease extends from the most minor developmental anomaly with no signs or symptoms produced in the individual, to the most severe conditions which are “incompatible with life itself”.99 Although the cause of the disease is multifactorial, there are two main recognised factors, genetic and environmental, that predispose to the development of the abnormality. It is worthy to remark that congenital malformations are likely to occur in the offspring of closely blood-related parents, and the practice of consanguineous marriages are well attested in Pharaonic Egypt, especially among the royalty and social élite,100 or in popula-tions with isolated living conditions.101 However, evidence of congenital diseases in archaeological skeletal materials is rare, for their identifi cation depends foremost on the preservation and completeness of human remains recovered from archaeological sites.

97 WALDRON, ANTOINE, Int J Osteoarchaeol 12.98 BERTACCI et al., Minerva Stomatol 54; ZHONG et al., Oral Surg Oral Med Oral Pathol Oral Radiol

Endod 107.99 ROBERTS, MANCHESTER, Archaeology of Disease, p. 30.

100 ČERNY, JEA 40; MIDDLETON, Am Soc Rev 27.101 HUSSIEN et al., Int J Osteoarchaeol 19, p. 623; PROWSE, LOVELL, Am J Phys Anthropol 101.

381

In the present skeletal sample, congenital and developmental conditions and abnor-malities observed included bilateral bifi d mandibular condyle (Burial 538), coronoid hyperplasia (Burial 611), bifurcated ribs (Burials 475 and 476), partial spina bifi da occulta (Burials 473, 540 and 541),102 hereditary multiple exostoses (Burials 393, 411103 and 538), sacralisation of the fi fth lumbar vertebra (Burials 56, 453, and 558)104 and additional sixth sacral segment (Burial 558), as well as brachydactyly type E1 (bone shortening limited to fourth metacarpals and/or metatarsals) and multiple epiphyseal dysplasia (Burial 610). Although the latter condition is one of the most commonly occurring skeletal dysplasias in modern populations,105 the specimen from Burial 610 is only the second case of the condition identifi ed so far in archaeological material.106 In the fi rst case, skeletal remains recovered from a Badarian cemetery (4400-4000 BC) in Egypt, the abnormalities observed were initially diagnosed as ‘a peculiar form of achondroplasia’ due to the lack of typical achondroplastic cranial changes,107 but recently multiple epiphyseal dysplasia has been suggested as a possible diagnosis.108 As demonstrated by the Badarian specimen, there is a high risk of misdiagnosis in incomplete skeletal remains, especially in identifi cation of complex conditions with a range of abnormalities, such as skeletal dysplasias.

Congenital abnormalities, such as a bifurcated mandibular head of condyle or bifi d ribs are rare in modern populations and occur most commonly as unilateral traits. Bifurcated ribs in which the sternal ends were cleaved in two were recorded in a female (aged 20-25 years) from Burial 475 (single rib) and a male (aged 40-45 years) from Burial 476 (mul-tiple ribs). This abnormality of the rib cage and associated muscles and nerves is usually asymptomatic; however, it could cause musculoskeletal pain and intercostal nerve entrap-

102 The prevalence of spina bifi da occulta in the Old Kingdom sample from Saqqara (3.26%) is similar to the prevalence of the condition in the élite population from Giza (3.33%); SARRY EL DIN, EL BANNA, Int J Osteoarchaeol 16.

103 Saqqara IV, pp. 104-105.104 The prevalence of transitional vertebrae in the Old Kingdom sample from Saqqara (3.26%) is slightly

higher than the prevalence of the condition in the élite population from Giza (2.22%); SARRY EL DIN, EL BANNA, Int J Osteoarchaeol 16.

105 BEIGHTON, Inherited Disorders; WYNNE-DAVIES, GORMLEY, J Bone Joint Surg Br 67B.106 KOZIERADZKA-OGUNMAKIN, Int J Paleopathol 1.107 JONES, J Anat 66.108 KOZMA, Am J Med Genet 146A.

Pls. CLXXVIIg,CXCIe

Figs. 133-134;

Pls. CLXVIc,CLXXXIb, CLXXXIIh,CLXXVIIIc-f,CLXIVg,CLXXXVIIh,CXCIc

Fig. 133

Figs. 133–134. Bifurcated rib recorded in a young female from Burial 475 (left) and posterior hiatus (partial spina bifi da occulta) in the lower sacrum of a 30-35 years old male from Burial 473 (right)

382

ment. In modern clinical cases, bifi d ribs have been associated with Gorlin (nevoid basal cell carcinoma) syndrome.109 Mild abnormalities, such as partial spina bifi da occulta would allow the affected individual to function satisfactorily and to attain advanced age, as attested by a female from Burial 540 and a male from Burial 541. The defect normally affects the posterior aspect of one or several sacral segments resulting in exposure of the spinal canal leaving the spinal cord protected only by cartilage or membrane.110

2.6.2.2. CIRCULAT ORY DISORDER

A total of fi ve individuals recovered from Burials 493, 509, 538, 540, and 610 (F=3; M=2) displayed lesions characteristic of osteochondritis dissecans, a circulatory disorder caused by blood deprivation in the subchondral bone. The aetiology of the condition remains unclear but may include repetitive physical trauma, restriction of blood fl ow (ischemia), hereditary and endocrine factors, loss of blood fl ow (avascular necrosis), rapid growth, defi ciencies and imbalances in the calcium to phosphorus ratio, as well as anomalies of bone formation.111 According to Smillie’s study,112 osteochondritis dissecans in adults is caused mainly, if not exclusively, by endogenous and/or exogenous trauma. Modern clinical cases show the condition to be associated with high-impact sports that could increase the risk of developing the disease in stressed joints, such as elbows, knees, and ankles.113 Osteochondritis dissecans occurs when a fragment of bone or cartilage separates, partially or fully, from the end of the bone and either remains in place or becomes detached causing stiffness and instability of the joint. In the present assemblage, all individuals affected by the condition displayed osteochondral lesions in the knee joints, including distal femur (Burials 538, 540, and 610), proximal tibia (Burial 540), and patella (Burials 493, 509, and 540). Individual lesions were also observed in the elbow joint of a male from Burial 493 (radius) and in the ankle joint of a probable male from Burial 610 (talus).

2.6.2.3. NEOPLASTIC CONDITIONS

A total of four individuals (4.3%) in the study series presented evidence of neoplastic conditions. A neoplasm is a new growth that is defi ned as “a mass of localised tissue growth whose cellular proliferation is no longer subject to the effects of normal growth-regulating mechanisms”.114 Persistent growth of the bone tissue can lead to formation of a tumour. A benign neoplasm does not spread beyond the tissue in which it is found and is rarely a cause of the individual’s death.115 A malignant neoplasm, on the other hand, spread beyond the tissue of its origin and is often a cause of death. The young and elderly male individuals from Burials 473 and 558, respectively, demonstrated benign tumours of button osteoma that developed on the right parietal bone.116 Also noted was a benign

109 GORLIN, GOLTZ, N Engl J Med 262.110 ROBERTS, MANCHESTER, Archaeology of Disease, pp. 36-37.111 FEDERICO et al., Arthroscopy 6; HEFTI et al., J Pediatr Orthop 8; LANGER, PERCY, Can J Surg 14.112 SMILLIE, Osteochondritis Dissecans.113 BUI-MANSFIELD et al., Am J Roentgenol 175; CLANTON, DELEE, Clin Orthop 167; FEDERICO et al.,

Arthroscopy 6; HIXON, GIBBS, Am Fam Physician 61; KADAKIA, SARKAR, J Foot Ankle Surg 46; LIVESLEY, MILLIGAN, Int Orthop 16.

114 AUFDERHEIDE, RODRÍGUEZ-MARTÍN, Human Paleopathology, p. 371.115 WALDRON, Palaeopathology, p. 168.116 ESHED et al., Am J Phys Anthropol 118.

Fig. 134

Fig. 135;

Pls. CLXXd-e,CLXXIh,

CLXXVIIIc,CLXXXIc

Fig. 136;

Pl. CLXXXVIId

383

overgrowth of the inner table of the frontal bone due to hyperostosis frontalis interna in the male from Burial 558.117 Button osteomas are common and usually small overgrowths that could be formed in the periosteum of any bone, but are most frequently encountered on the frontal bone and in the sinuses.118 This benign tumour could affect individuals of any age but is most commonly identifi ed in individuals over the age of 40, and equally in males and females.119 A male individual (aged 35-45 years) from Burial 393 also exhibited features consistent with osteochondroma. A case of a malignant neoplasm was identifi ed in an elderly female inhumed in Burial 554.120 The female’s right parietal bone demon-strated an extensive perforating lytic lesion surrounded by a number of much smaller lesions showing ragged margins and no evidence of healing. Such lesions are character-istic of metastatic carcinoma,121 a malignant neoplasm that could spread to bone through four main routes, including the blood vascular system, lymphatic system, directly from a tumour adjacent to a bone, and via the cerebrospinal fl uid in cases with tumours of the brain.122 Although almost every malignant tumour can metastasise from soft tissue to bone, modern clinical studies has established that the most likely to do so are carcinomas of the breast, lung, prostate, kidney and thyroid, the former being the most common cause of metastatic bone disease in females.123

2.6.2.4. INFECTIOUS DISEA SE

Only two possible cases (2.2%) of specifi c infection were recorded in the study series and were both identifi ed in the skeletal remains of male individuals aged 45-50 (Burial 411) and over 50 years (Burial 510). In the fi rst case of a male individual from Burial 411, a perforated lytic lesion with bony bridges that formed most likely in response to healing

117 HERSHKOVITZ et al., Am J Phys Anthropol 109.118 AUFDERHEIDE, RODRÍGUEZ-MARTÍN, Human Paleopathology, p. 375.119 WALDRON, Palaeopathology, p. 171-172.120 KOZIERADZKA-OGUNMAKIN, PalArch’s J Archaeol Egypt 10.121 MARKS, HAMILTON, Int J Osteoarchaeol 17.122 WALDRON, Palaeopathology, pp. 184-185.123 RESNICK, NIWAYAMA, Diagnosis, p. 3617.

Pl. CLXXXIVc-d

Figs. 135–137. Osteochondritis dissecans in the knee joint of a male (aged 30–35 years) from Burial 540 (left); button osteoma of the right parietal bone in an elderly female from Burial 473 (centre); metastatic carcinoma of the right parietal bone in an elderly female from Burial 554 (right)

384

was observed in the centre of the individual’s left iliac blade.124 The lesion, a possible Brodie’s abscess, could have occurred due to tuberculous osteomyelitis. In modern clini-cal studies, tuberculous osteomyelitis is not uncommon; however, isolated involvement of the bone other than spine or joints is considered a rare entity,125 and only several cases of ilium bone tuberculosis have been reported to date in the medical literature.126 An elderly male from Burial 510, on the other hand, demonstrated a severe kyphotic angula-tion of the spine produced by the anterior collapse of the eleventh thoracic through fi rst lumbar vertebral bodies. The most likely cause of this condition was deemed to be tuber-culous infection.

Tuberculosis can produce pathological changes in several areas and parts of the body depending on the type of infecting bacillus and the way the disease was contracted. For instance, pulmonary tuberculosis is the common mode of infection caused by M tubercu-losis, the human-type bacillus, whereas the stomach and intestinal tract are sites most commonly affected by M bovis, the bovine type of the bacterium.127 The resulting bone infection, however, is identical irrespective of the causative organisms. According to modern clinical studies,128 approximately 2% of individuals with tuberculosis would develop skeletal lesions, and in 90% of the cases, the spine would be involved. The disease is predominantly restricted to the vertebral bodies and most commonly affects the lumbar region of the spine. The posterior elements of the vertebrae are rarely affected. The char-acteristic feature of spinal tuberculosis is a marked angular kyphosis, also known as Pott’s disease that results from loss of bone tissue and subsequent weakening of the affected

124 Saqqara IV, p. 104 and Pl. LIVf.125 MOGHA et al., Internet J Orthop Surg 8.126 E.g. MOGHA et al., Internet J Orthop Surg 8; NELATON, Rev d’Orthop 3; RYAN, FUNSTON, J Bone Joint

Surg Am 12; TRIKHA et al., Acta Orthop Belg 71. 127 ROBERTS, MANCHESTER, Archaeology of Disease, p. 137; WALDRON, Palaeopathology, pp. 90-91.128 MKANDAWIRE, KAUNDA, Trop Doct 35; PERTUISET et al., Medicine 78.

Fig. 138

Fig. 138. Severe kyphotic angulation of the thoraco-lumbar spine associated with tuber-culosis in an elderly male from Burial 510; also note marginal osteophyte formations

385

vertebral bodies, and their eventual collapse and ankylosis, all paralleled with progression of the disease. The evidence of tuberculous infection in ancient Egypt has been well attested in human remains from various sites and periods,129 and also by artistic represen-tations of the individuals showing characteristic skeletal deformation caused by the disease.130 Tuberculosis is widely considered to be a disease of poverty, overcrowding and malnutrition. Two possible cases recorded in the Saqqara study series would therefore indicate very limited exposure of the individuals to the afore-mentioned causative factors.

2.6.2.5. METABOLIC BONE DISOR DER

Several cases of osteoporosis, a metabolic bone disorder, were identifi ed in the study population. In the individuals with osteoporosis, total bone mass per unit volume is reduced; however, a normal ratio of bone mineral to bone matrix is retained.131 The disease is also characterised by microarchitectural deterioration in bone tissue that consequently leads to weakening of the skeleton and increasing its susceptibility to fractures.132 The majority of fractures associated with osteoporosis are sustained by elderly individuals during accidental falls, and most commonly affect the wrist, spine and hip. In the present study sample, fi ve individuals (6.7% of the adult study population) manifested traumatic injuries that affected weakened bones at the wrist joint and in the spine.133

An elderly female (50+ years of age) from Burial 540 sustained a Colles’ fracture to the right distal radius that would have resulted from a fall onto an outstretched hand. The frequency of this particular type of fracture has been found to be far greater in older women (45 years of age and over) with osteoporotic changes to the bone than in men of the same age group.134 This is due to a gradual loss of bone in the distal radius. In post-menopausal women, this varies from 0.7% to 1.5% per annum.135 A further four individuals (5.3% of the adult study population), including males aged 40-45 and 35-45 years from Burials 453 and 541, as well as an elderly female and male from Burials 511 and 558, respectively, sustained a crush fracture to the lumbar vertebra (Burials 453 and 541) and a compression fracture to the lower thoracic vertebra (Burials 511 and 558), most likely due to osteoporotic changes to the bone. Compression fractures of the vertebral bodies were also noted in 19.08% of the Giza population of high offi cials.136 The high prevalence of the vertebral fractures due to osteoporosis among the Giza élite could be explained by sedentary life style and reduced physical activity; studies have shown that the risk of developing osteoporosis is lower in people who are physically active.137 Also

129 DERRY, Med Press 197; ELLIOT SMITH, RUFFER, Pott’sche Krankheit; MORSE et al., Am Rev Respir Dis 90; NERLICH et al., Lancet 350; ZIMMERMAN, Bull N Y Acad Med 55; ZINK et al., J Clin Microbiol 50; ZISKIND, HALIOUA, Rev Mal Respir 24.

130 For example, a marked angular kyphosis could be seen in predynastic clay fi gures, in the statue of a man with a humped spine (Old Kingdom, Cairo Museum), in the fi gure of a gardener shown in the tomb of Ipwy (19th Dynasty).

131 KRANE, HOLICK, Metabolic bone diseases, p. 1921.132 AUFDERHEIDE, RODRÍGUEZ-MARTÍN, Human Paleopathology, p. 314-316.133 Pathological hip fractures due to underlying osteoporosis have been recorded in the Ptolemaic series

from Saqqara (KOZIERADZKA-OGUNMAKIN, Patterns and management of fractures), as well as in other skel-etal remains from ancient Egypt (e.g. DEQUEKER et al., J Bone Miner Res 12; GRAY, Radiological aspects).

134 PUTNAM, SEITZ, Fractures of the distal radius; JUPITER, J Bone Joint Surg 73A.135 MCEWAN et al., Calcif Tissue Int 74.136 EL BANNA, Osteoporosis Assessment; HUSSIEN et al., Int J Osteoarchaeol 19, p. 622.137 MENSFORTH, LATIMER, Am J Phys Anthropol 80.

Fig. 139

Pls. CLXIVf,CLXXVa-b,CLXXXIIg

Figs. 140-141

386

associated with post-menopausal and senile osteoporosity is bilateral parietal thinning, characterised by symmetrical ectocranial depressions in the parietal bones. The condition was recorded in the crania of the female individuals from Burials 79 (adult), 397 (indi-vidual aged 30-40 years), 511 and 540 (individuals aged over 50 years), and a male individual aged 28-35 from Burial 373. Another case was also recorded in an 18-year-old male individual from Burial 555. The presence of symmetrical parietal depressions in a sub-adult individual excludes their development secondary to osteoporosis and may indicate a developmental or dysplastic pathogenesis.138 Furthermore, a unilateral depres-sion in the left parietal bone was also noted in an elderly female from Burial 554.

Parietal thinning has been found in virtually all periods of ancient Egyptian history at an overall frequency rate of 4.9%, with sample-specifi c frequency rates ranging from 3.4% to 11.1%.139 In the present sample, the condition was noted in 8% of the adult population. A frequent occurrence of thinned parietal bones among the élite classes of the 4th to 20th Dynasties led some researchers to believe that the defects resulted from constant pressure applied by large and heavy wigs worn by the wealthy representatives of the society.140 For the past 150 years, some other explanations have been suggested,141 for example that the condition was the result of a hereditary pathological condition,142 post-menopausal osteo-porosis or senile atrophy,143 muscle movement, growth defect,144 or epigenetic variation.145

138 LODGE, Thinning of the parietal bones, p. 407.139 PHILLIPS, Cranial Anomaly.140 ELLIOT SMITH, J Anat Physiol 41, p. 233.141 PHILLIPS, Cranial Anomaly.142 STROUHAL et al., Int J Osteoarcheol 13.143 ORTNER, PUTSCHAR, Identifi cation, pp. 292-293.144 DURVARD, J Anat 63.145 PHILLIPS, Cranial Anomaly.

Fig. 142

Pl. CLXXXa, d

Pl. CLXXXVe

Pl. CLXXXIVa, d

Figs. 139–141. Colles’ fracture to the right distal radius in an elderly female from Burial 540 (left); crush fracture to a lower thoracic vertebra in a male (aged 35–45 years) from Burial 541 (centre); compres-sion fracture to a lower thoracic vertebra in an elderly male from Burial 558 (right); note marginal lipping on the vertebral bodies (right)

387

The question, however, remains open as there is no scientifi c consensus on the aetiology of this condition. Overall, osteoporotic changes were observed in 14.7% of the adult population (n=11/75), including an adult female from Burial 79, a female aged 30-40 years from Burial 397, elderly females from Burials 511, 540, and 554, a young male indivi-dual from Burial 373, middle-aged males from Burials 395, 453, 541, an elderly male from Burial 558, and an unsexed adult from Burial 398. A study conducted on a similar size Old Kingdom population (n=74) from Giza that included skeletal remains of high offi cials and workers revealed a higher frequency of the condition in male workers (10.5%) than in male high offi cials (8.3%), and in female high offi cials (20%) than in female workers (12.5).146 The latter difference could be related to a sedentary lifestyle among the upper class females, whereas the former elevated prevalence could be related to the effects of nutritional stress and excessive workload among male workers. In the Saqqara study sample, the prevalence of osteoporosis among male and female individuals was found to be 11.1% and 16.7%, respectively. The prevalence rate for the male representatives of the Saqqara study population was higher than the prevalence of the condition among the high offi cials and workers from the Giza sample, but the calculated rate for the female indi-viduals was slightly lower than in the female high offi cials from Giza.

2.6.2.6. ENDOCRINE DISORDER

A single case of an endocrine disorder was also recorded in the present study series from Saqqara. The skeletal remains of a male aged 20-30 years from Burial 493 manifested multiple skeletal changes characteristic of acromegaly. The condition results from a pituitary adenoma (neoplasm) that causes the gland to secret excess growth hormone. It usually affects adults whose epiphyseal plates have fully fused resulting in endochondral bone growth causing severe skeletal deformities.147 A possible case of acromegaly was

146 ZAKI et al., Int J Osteoarchaeol 19.147 AUFDERHEIDE, RODRÍGUEZ-MARTÍN, Human Paleopathology, pp. 327-328; ORTNER, Pathological Condi-

tions, pp. 420-422.

Pls. CLXIX-CLXX

Fig. 142. Biparietal thinning in the cranial vault of an elderly female from Burial 511

388

also identifi ed in an ancient Egyptian female skull, currently housed at the British Museum in London, which demonstrated considerable facial lengthening due to additional growth in the mandibular and palatal regions, which is characteristic of the condition.148

2 .6.2.7. DEGENERATIVE JOINT DISEASE

Osteoarthroses were a common problem in the study series in both males and females of age over 25 years. Degenerative changes were manifested in the main synovial joints, such as the hip and knee, and on the vertebral bodies of various parts of the spine, but predominantly in the thoracic and lumbar regions. Vertebral pathology was most often identifi ed as age-related structures such as Schmorl’s depressions, osteophytic expansions of the vertebral bodies, or eburnation (bone sclerosis at the area of cartilage loss). Schmorl’s nodes (protrusions of the cartilage of the intervertebral disc through the vertebral body endplate and into the adjacent vertebra) are a fairly common occurrence in the ageing spine, but could also be found in younger individuals due to various strains on the verte-brae and intervertebral discs during spinal, especially torsional, movements.149 The depressions are predominantly observed in the thoraco-lumbar spine where the load is much increased compared to the upper spinal column. Osteophytes (abnormal bony projec-tions) are strongly associated with degenerative changes in the spine, but could form along any joint, including the hip, knee, or distal interphalangeal joints.150 According to modern clinical studies, spinal osteophytes affect approximately 20-30% of the elderly popula-tion.151 In the present study series, minor to severe degenerative changes of the spine were noted in a total of 34 individuals (Burials 9, 56, 100, 393, 394, 399, 411, 429, 448, 450, 453, 473, 475, 476, 480, 481, 493, 509-511, 528, 538, 539-542, 551, 552, 554, 557, 558, 604, 610, and 611), constituting 45.3% of the adult population. Degenerative disease of the spine affected slightly over a half (51.1%) of the male study population (n=23/45), whereas among females degenerative changes were observed in 33.3% (n=10/30) of the individuals (not signifi cant male-female difference; χ2 test, p=0.128). A comparative study of degenerative disease of the spine between the high offi cials and workers’ populations from Old Kingdom Giza revealed that all regions of the spinal column demonstrated degenerative changes, but the lumbar region was predominantly affected.152 In the élite males and females from Giza, 31.11% and 22.16% of the lumbar vertebrae, respectively, displayed severe osteoarthritic changes.

In the Saqqara series, degenerative changes in the peripheral joints were commonly manifested as porosity and lipping on articular facets, osteophyte formation and eburna-tion, and varied from slight to severe. A total of 16 individuals (21.3% of the adult population) from Burials 411, 473, 475, 476, 479, 509-511, 539, 540, 541, 554, 558, 604, 610, 611 manifested degenerative changes at the elbow, wrist, hip, knee, and/or ankle joints. Here, the prevalence rates of the condition between the male and female populations were comparable, being 20% (n=9/45) among males and 23.3% (n=7/30) among females (male-female difference was not signifi cant; χ2 test, p=0.729). The élite population from Giza also demonstrated degenerative changes in the four large joints, the knee joint being the most commonly affected. The male individuals showed a higher percentage of the

148 BROTHWELL, Digging up Bones, pp. 156-157, fi g. 60, plate 4c.149 DAR et al., Eur Spine J 19.150 KLAASSEN et al., Anat Sci Int 86.151 NEUMANN, Osteoarthritis.152 HUSSIEN et al., Anthropological differences, pp. 327-329.

Pls. CLXXXVIh,CXCIg

Pl. CLXXIIIa

Pls. CLXVIg,CLXXIIg-h,

CLXXIIIb, e-f,CLXXVd,

CLXXXIc,CLXXXIVg,

CLXXXVIIb,CLXXXVIIIb

CXCf-h

389

condition compared to females. In the Saqqara series, the majority of the cases of degen-erative joint disease were primary osteoarthroses. However, in several instances the changes occurred secondary to trauma, as in the distal radii and ulnae of a male aged 35-45 year from Burial 541, or other conditions, such as multiple epiphyseal dysplasia with an early-onset osteoarthritis in a young male from Burial 610. Additionally, a pos-sible case of ankylosing spondylitis, an infl ammatory rheumatic disease that causes ascending destructive changes in the vertebral joints, was recorded in an elderly female from Burial 509 whose fi fth lumbar vertebra was partially fused with the sacrum.

2.6.2.8. TRAUM A

Numerous instances of trauma were manifested in the skeletal remains of a total of 20 mature individuals that constituted 26.7% of the adult study population. No evidence of trauma was observed in the sub-adults. The affected skeletal elements included the skull (Burials 399 and 490), clavicle (Burial 395), ribs (Burials 411, 509, 511, 541, 551, 558, and 610), upper limbs (Burials 411, 510, 538-541, and 557), lower limbs (Burials 175, 481, 528, 554, 557, and 558), vertebrae (Burials 511, 528, 539, 541), hip (Burial 557), and the feet (Burials 540, 604, and 611).

The majority of the trauma recorded in the study sample occurred as a complete break in the bone (fracture). In general, the main causative factors of fractures in bone are trauma (direct or indirect violence), stress (fatigue fractures that develop slowly over a period of increased physical stress) and underlying pathology (pathological fractures due to progres-sive weakness of the bone).153 All these types of fractures were identifi ed in the study sample. Traumatic injuries were by far the most common causes of fracture, the majority of which would have resulted from indirect trauma. In three cases, however (Burials 399, 490, and 510), the sustained injuries most likely resulted from direct trauma. An elderly male from Burial 510 demonstrated a fracture to the right ulna that would have been caused by a direct blow to the forearm raised in a protective gesture to shield the head during an act of interpersonal violence (‘parry’ fracture).154 A further two male individuals (aged 35-40 and 25-30 years) from Burials 399 and 490 sustained a depressed fracture to the right and left parietal bone, respectively. The lesions, which appeared as oval depres-sions sunk below the horizontal plane of the skull, would have resulted from a blunt force trauma that caused no penetration into the cranial cavity. Considering that the violence-related evidence of trauma affected only the male individuals, it is possible that the injuries were sustained in combat or otherwise deliberate violence. In addition, the location of the lesions on the parietal bones would indicate a most likely face-to-face assault. A study of head injuries conducted on a sample of 1726 skulls from the 26th to 30th Dynasty burials from Giza revealed a low frequency rate of 1.2%.155 In the present sample from Saqqara, cranial trauma affected 2.7% of the adult population.

Stress fractures were recorded in two males from Burials 528 and 541 and a female from Burial 539 (4% of the adult population), and involved the lower lumbar vertebrae. The fracture, known as spondylolysis, is typically presented as a complete separation through the isthmus between the superior and inferior articular processes (pars interarticularis) on both sides of the vertebral arch. The separation of the neural arch as a result of a bilateral

153 ROSENBERG, Bones, p. 1288.154 JUDD, J Archaeol Science 35.155 FILER, JEA 78.

Fig. 139

Pl. CLXXIIIg

Fig. 143;

Pl. CLXXIXh

390

fracture in a stressed erect posture could potentially lead to anterior slippage (spondylolis-thesis) above the point of defect.156 In ancient Egyptian skeletal collections, Gaballah and Batrawy reported a single fi nding of bilateral spondylolysis in 90 skeletons investigated,157 but no cases were found in the Old Kingdom population from Giza.158 In the modern world, spondylolysis occurs in 3-6% of the population and most commonly in adolescents who overtrain in particular sporting activities.159 It has also been noted that the defect is more prevalent in some populations, suggesting a hereditary (genetic) component.160

Fractures due to underlying pathology were recorded in a total of four individuals from Burials 511, 540, 541, and 558, and were all associated with osteoporosis. All fractures to the long bones were sustained ante-mortem and demonstrated early stages of healing (a fractured clavicle in an individual from Burial 395) or well-remodelled callus formation at the fracture site indicating that the injury occurred a long time before the individuals’ death (the fracture repair and remodeling could continue for years after the bone’s stabil-ity is restored161). In three cases, however, the fractures to the forearm elements failed to unite resulting in atrophic non-union of the transolecranon anterior fracture dislocation in the left elbow joint in a male from Burial 411,162 the styloid base fracture of the ulna in a male from Burial 557, and in a female from Burial 538 the fracture to the distal ulnar epiphysis resulted in post-traumatic bone shortening. A fracture-separation of the ulnar distal epiphysis in young individuals may result from hyperpronation and, as in any injury sustained to the epiphyseal plate, it may result in premature growth arrest.163 A study conducted on the Old Kingdom sample from Saqqara revealed that the most frequently injured long bones were those of the forearm (in both males and females), and males were

156 MERBS, Yrbook Phys Anthropol 39; MERBS, Am J Phys Anthropol 119.157 GABALLAH, BADAWY, Egypt J Anat 3.158 SARRY EL DIN, EL BANNA, Int J Osteoarchaeol 16.159 MERBS, Am J Phys Anthropol 119; STANDAERT, HERRING, Br J Sports Med 34.160 TURKEL, Congenital abnormalities, p. 120.161 BUCKWALTER et al., Bone and joint healing, p. 253.162 Saqqara IV, p. 104 and Pl. LIVg.163 ENGBER et al., J Bone Joint Surg 67, p. 1131.

Figs. 139-141

Pls. CLXXXVIIa,CLXXVIIIb

Fig. 143. Stress fracture in the fi fth lumbar vertebra (spondylolysis) in a male (aged 30–40 years) from Burial 528

391

affl icted by trauma more frequently than females, a fi nding that could be activity- and occupation-related.164 In the majority, the observed fractures were nonviolence-related and most likely resulted from accidental falls, or were in other ways infl uenced by occupation or the environment. Good alignment and general state of healing of the fractures indicated medical intervention in bone setting and external stabilisation. Long bone fractures were also investigated in the Old Kingdom population from Giza that comprised individuals of the social élite and workers.165 Similarly to the Saqqara sample, the Giza population was also characterised by forearm fractures, and the majority of the fractures were well healed, aligned, and without substantial deformities. The high frequency of fractures in the work-ers’ population is thought to be related to work and interpersonal violence.

2.6.2.9. PHYSIOLOGICAL RESPON SES TO ENVIRONMENTAL STRESSORS IN THE OLD KINGDOM SAQQARA SERIES

Non-specifi c indicators of stress, such as cranial porosities (porotic hyperostosis and cribra orbitalia), micro-structural enamel defects (enamel hypoplasia), and reduced growth rates resulting from diseases and nutritional defi ciencies were observed throughout the developmental years in many past populations.166 In regards to the ancient Egyptian population studies based on the investigation of stress indicators, such as cribra orbitalia, porotic hyperostosis, dental enamel hypoplasia, infectious disease, or stature and long bone lengths, present contradicting fi ndings on the general population health status, espe-cially from the Early Dynastic to Middle Kingdom periods.167 According to Duhig’s study conducted on approximately 800 crania from various ancient Egyptian sites, the health status of the population remained constant from the Early Dynastic to First Intermediate Period. Her fi ndings were contradicted by Zakrzewski’s study based on long bone lengths and stature, which demonstrated a decrease in health from the Early Dynastic to Middle Kingdom. This was suggested to have occurred due to the increase of social complexity that led to a greater differentiation in access to resources.

In the present study series cranial porosities and enamel hypoplasia defects were considered in evaluation of the population’s health status.

2.6.2.9.1. Cribra orbitalia and po rotic hyperostosis

Osseous signs of anaemic stress, such as cribra orbitalia and porotic hyperostosis were observed in a total of 14 individuals (15.2%) of the study sample. The individuals affected demonstrated isolated or congregated small or medium pores that formed pitting lesions of cribra orbitalia in the superior aspect of the orbit, and/or lesions of porotic hyperostosis localised on the ectocranial surfaces of the cranial vault. The latter were characterised by multiple, discrete pinhead-sized perforations or porosity with coalescing foramina that were distributed symmetrically and predominantly on the squamous portions of the occipital and parietal bosses. The lesions would develop as a response to anaemia, a decrease in number of red blood cells or less than normal quantity of hemoglobin in the blood, usually suffered in childhood. Anaemia acquired after the growth period seems

164 KOZIERADZKA-OGUNMAKIN, Patterns and management of fractures.165 ZAKI et al., Fracture patterns.166 GOODMAN, ROSE, Yrbook Am J Phys Anthropol 33; GOODMAN, Adv Dent Res 3; LEWIS, ROBERTS, Int

J Osteoarchaeol 7; SAUNDERS, HOPPA, Yrbook Phys Anthropol 36; STARLING, STOCK, Am J Phys Anthropol 134.167 DUHIG, Skeletal Indicators; ZAKRZEWSKI, Am J Phys Anthropol 121.

Fig. 144

392

not to affect the bone tissue, hence the lesions observed in adult individuals are inactive (remodelled). Healing and remodelled lesions of cribra orbitalia and porotic hyperostosis were found in a total of nine mature individuals, whereas active lesions were observed in the orbital roofs of the four-year-old and 10-year-old children from Burials 556 and 400, respectively. Interestingly, only the skull of a young male from Burial 493 and a young female from Burial 479 exhibited both type of lesions, whereas the remaining individuals demonstrated lesions of either cribra orbitalia (Burials 369, 373, 394, 400, 449, 556, and 558) or porotic hyperostosis (Burials 473, 489, 538, 552, and 610). Mutually exclusive presence of both conditions among the affected individuals was observed in several skeletal samples from archaic to protohistoric sites from North America and Asia,168 and a similar segregation of the lesions was also reported by Stuart-Macadam169 in the skeletal material from a Romano-British site. These fi ndings challenge the concept of the orbital and vault lesions as being related and resulting from the same underlying disorder.170 Some studies, however, report both cribra orbitalia and porotic hyperostosis as co-occurring lesions,171 supporting the theory that they develop in response to the same systemic prob-lem, and stress their “virtually identical morphological as well as demographic features and associations”.172 Since mid-20th century, it has been widely accepted that chronic iron-defi ciency anaemia is the probable cause of both conditions.173 Hence, the prevalence of these conditions suggests that the living conditions of the past populations led to dietary iron defi ciency, iron malabsorption, and iron loss from diarrheal disease and intestinal parasites. According to Walker et al.,174 however, recent haematological research demon-strates that “iron defi ciency per se cannot sustain the massive red blood cell production that causes the marrow expansion responsible for these lesions”. Therefore, the most likely proximate cause of porotic hyperostosis seems to be the accelerated loss and compensatory overproduction of red blood cells as observed in haemolytic and megaloblastic anaemias. It has been concluded that porotic hyperostosis and cribra orbitalia reported in various

168 ROTHSCHILD et al., Paleobios 13.169 STUART-MACADAM, Am J Phys Anthropol 80.170 AUFDERHEIDE, RODRÍGUEZ-MARTÍN, Human Paleopathology, pp. 348-351.171 E.g. AUFDERHEIDE, Field Report; Present Saqqara series.172 AUFDERHEIDE, RODRÍGUEZ-MARTÍN, Human Paleopathology, p. 349.173 AGARWAL et al., Am J Roentgenol Radium Ther Nucl Med 110; ENG, Acta Haematol 19; MOSELEY,

Semin Roentgenol 9.174 WALKER et al., Am J Phys Anthropol 139, p. 109.

Fig. 144. Lesions of cribra orbitalia in the orbital roofs of a four–year–old child from Burial 556

393

skeletal collections175 could result from nutritionally inadequate diets, poor sanitation, infectious disease, as well as cultural practices related to pregnancy and breastfeeding.176

Life expectancy of the affected individuals could be dramatically reduced, as shown by Mittler and van Gerven’s study of the medieval Christian populations of Kulubnarti.177 Their comparative studies of life expectancy between the individuals manifesting cribra orbitalia lesions and those unaffected by the condition have demonstrated a dramatic reduction in mean life expectancy for the individuals with cribra orbitalia across the childhood years (0-16). The most striking life expectancy reduction has been found at age fi ve where 78% of the children exhibited lesions. In this group, the mean life expectancy was reduced by 15.5 years compared to the group without the lesions. In Predynastic and Pharaonic Egypt, the prevalence of cribra orbitalia lesions has been found to vary among the populations from different sites and time periods. In the study of a total of six Early Predynastic (el-Badari), Mid-Predynastic and Protodynastic (Hierakonpolis, Nagada B, Nagada T), and Proto-Early Dynastic (Tarkhan and Abydos) cemetery populations, the average prevalence of cribra orbitalia (severity scores 2 and above) demonstrated a gradual decrease from 30% and 24.39% to 22.03%, respectively.178 In a total of 121 skulls of Khufu’s courtiers recovered from the mastaba tombs at Giza (Old Kingdom), 18.2% of the specimens manifested the orbital lesions.179 At Tell Amarna (New Kingdom, 18th Dynasty) a total of 23% of the adult population demonstrated anaemic stress lesions in the orbits.180 The latter result is comparable with the prevalence of the condition in the Late Period series from Abusir totaling 26.8% of the population, but rising to 41.9% when only children aged 0-14 years were considered.181 Also in the Ptolemaic population from Saqqara, the cribra orbitalia rate was higher among the immature individuals (27.3%), but fell to 21.9% when the total population was taken into account.182 The highest rates of the condition were found in the skeletal samples from pre-Roman and Roman cemeteries in Dakhleh Oasis, totaling 78.4% and 54.6% of the population, respectively.183 Such a dra-matic difference in the prevalence of cribra orbitalia between the Nile Valley populations and the oasis population could have occurred due to a higher rate of infectious disease (e.g. gastroenteritis possibly exacerbated by malaria), cultural differences in weaning practices (e.g. development of megaloblastic anaemia in infants weaned on goat’s milk), and a change in dietary components and proportions of constituents of diet (e.g. cases of botulism in infants caused by introduction of honey as a dietary supplement). In the present Old Kingdom sample (n=92), porotic hyperostosis of the cranial vault and orbital lesions were observed in 15.2% (n=14) of the total population. When only cribra orbitalia was considered, the frequency rate among the sub-adult group (children aged <12 years, n=5) was found to be 40%, but fell dramatically to 12% when only the adult individuals (n=9/75) were considered. The prevalence of the condition is very low in comparison to

175 E.g. BLOM et al., Am J Phys Anthropol 127; FAIRGRIEVE, MOLTO, Am J Phys Anthropol 111; HENGEN, Homo 22; SALVADEI et al., Am J Hum Biol 13; WALKER, Am J Phys Anthropol 69.

176 WALKER et al., Am J Phys Anthropol 139, p. 113, fi g. 4.177 MITTLER, VAN GERVEN, Am J Phys Anthropol 93.178 MUSSELWHITE, Skeletal Health, p. 38, fi g. 13.179 LEEK, Cheops’ courtiers, p. 191.180 ROSE, Mem Inst Oswaldo Cruz 101.181 STROUHAL, BAREŠ, Secondary Cemetery, p. 173.182 Saqqara III, p. 499.183 FAIRGRIEVE, MOLTO, Am J Phys Anthropol 111.

394

the population samples from other ancient Egyptian sites, as well as to the Ptolemaic series from the same cemetery at Saqqara. The fi ndings would therefore suggest that the under-lying causative factors of anaemia, such as synergistic effects of disease and nutrition, were far less pervasive in the Old Kingdom population of the Saqqara cemetery, which at the time comprised the inhumations of the wealthy offi cials and courtiers. A compara-tive series of the skulls from the courtiers’ cemetery at Giza also demonstrated a much lower frequency of cribra orbitalia compared to the other skeletal series, but nevertheless, it was almost three times higher than in the Saqqara sample. Bearing in mind the social representation of the cemetery population at Saqqara and Giza, it could be concluded that the wealthier members of the society were less susceptible to anaemia due to better living conditions and richer diet. However, this image of the potentially healthier social groups could be severely distorted by a considerable under-representation of children, as in the case of the present population sample and the skull assemblage from Giza. The low prevalence of anaemic stress in the Old Kingdom series from Saqqara should therefore be considered cautiously.

2.6.2.9.2. Enamel hypoplasia defects

Another non- specifi c stress indicator recorded in the skeletal series from Saqqara was enamel hypoplasia. Linear or circular enamel defects are caused by nutritional or disease factors operating during the process of tooth bud formation extending from the foetal period up to the age of approximately seven years.184 The main confounding factors of estimating prevalence of this quantitative enamel defect in the skeletal series included poor preservation of the teeth due to ante-mortem loss, severe attrition, caries, and paro-dontopathy. In the present series, all permanent teeth, except for the third molar, which is considered to be too variable in developmental timing, were scored for the presence of enamel hypoplasia. However, the teeth that demonstrated severe attrition of the dental crowns were not included in the study. The total number of permanent teeth studied was 844 (M=550; F=294). Enamel hypoplasia defects were recorded in adult individuals of both sexes (M=13/45; F=6/30), as well as in the sub-adult specimen (n=1/5). Dental enamel hypoplasia manifested predominantly as linear defects, but pits were also observed in the dentition of a male individual from Burial 541. The frequency rates of enamel defects were assessed by separate tooth type in both sexes and the results are presented in Table 10. The male individuals demonstrated no enamel defects in the maxillary second molars only. In the female dentition, there were no enamel hypoplasia defects observed in the maxillary incisors through fi rst premolars and second molars, and in the mandibu-lar incisors and second molars. The frequencies of the defects between the male and female groups were signifi cantly different in the maxillary central incisors (p=0.005), lateral incisors (p=0.05), canines (p=0.006), as well as in the mandibular central incisors (p=0.041). In the male individuals, predominantly affected teeth were the maxillary inci-sors and canines and the mandibular central incisors and canines, whereas in the female dentition only the mandibular canines were distinctly more affected than the remainder of the teeth. The frequencies of the observed dental enamel defects were also compared with the results of the study conducted on the élite and workers’ population from Giza185 (see Table 8).

184 GOODMAN, ROSE, Yrbook Am J Phys Anthropol 33.185 HUSSIEN et al., J Arab Soc Med Res 1, pp. 3-4, Tables 4 and 5.

Figs. 147-148

395

Tabl

e 8.

Fre

quen

cy ra

tes

of d

enta

l ena

mel

def

ects

in th

e O

ld K

ingd

om s

erie

s fr

om S

aqqa

ra a

nd G

iza

Saqq

ara

Giz

a

Élit

eÉ

lite

Wor

kers

Mal

esFe

mal

eM

ales

Fem

ales

Mal

esFe

mal

es

Max

illa

Nn

%N

n%

Nn

%N

n%

Nn

%N

n%

I140

1127

.524

00.

0▲25

1040

172

11.7

1711

64.7

1814

77.7

**

I239

615

.422

00.

0▲23

939

.13

213

14.2

1911

57.8

1511

73.3

**

C44

1329

.520

00.

0▲52

3363

.437

1027

4338

88.3

*38

3078

.9**

P141

37.

316

00.

045

1124

.435

38.

528

1553

.5*

2716

39.2

**

P232

26.

315

16.

753

23.

734

12.

931

1032

.2**

229

40.4

**

M1

282

7.1

151

6.7

473

6.38

383

7.8

279

33.3

*26

1246

.1*

M2

320

0.0

150

0.0

454

8.8

300

035

1851

.4**

2516

64**

Man

dibl

eN

n%

Nn

%N

n%

Nn

%N

n%

Nn

%

I138

615

.823

00.

0▲16

318

.716

00

216

28.5

1912

63.1

**

I243

49.

327

00.

024

625

251

418

844

.414

321

.4

C45

920

.031

1032

.341

2868

.231

825

.829

2586

.228

2589

.2**

P149

48.

224

28.

355

610

.948

510

.421

1047

.6**

248

33.3

*

P249

36.

122

14.

566

23.

0359

23.

329

825

.2**

2716

59.2

**

M1

342

5.9

191

5.3

702

2.85

692

2.8

339

27.2

**29

827

.5**

M2

362

6.3

210

0.0

826

7.3

752

2.6

3618

41.6

**36

1336

.1**

N: n

umbe

r of t

eeth

exa

min

ed; n

: num

ber o

f tee

th a

ffect

ed; I

1: c

entra

l inc

isor

s; I2

: lat

eral

inci

sors

; C: c

anin

es; P

1: fi

rst p

rem

olar

s; P

2: s

econ

d pr

emol

ars;

M1:

fi rs

t mol

ars;

M

2: se

cond

mol

ars;

▲: s

tatis

tical

ly si

gnifi

cant

Saq

qara

mal

e-fe

mal

e di

ffere

nce

in fr

eque

ncy

rate

s, p<

0.05

; *st

atis

tical

ly si

gnifi

cant

diff

eren

ce in

Giz

a él

ite v

ersu

s wor

kers

, p<

0.00

5 an

d **

p<0

.000

5

396

The Giza study revealed that the dentition of the workers, both males and females, was signifi cantly more affected by dental enamel hypoplasia than the élites.186 This fi nding could be linked to the workers’ low socioeconomic status and exposure to malnutrition, health hazards, and workloads during childhood. When the two élite populations were compared, the Saqqara males showed lower frequencies of the defects in all teeth than the Giza males, but both groups demonstrated higher frequencies of enamel hypoplasia in the anterior dentition, and in the maxillary teeth in particular. Similarly to the male élite groups, the Giza females exhibited more evidence of stress in their dentition than the Saqqara group, with the maxillary anterior teeth and the mandibular canines and fi rst premolars being predominantly affected. Furthermore, the two élite populations and the Giza workers’ population demonstrated differences in the incidence of dental enamel hypoplasia between the sexes. Among the élites, the male individuals exhibited higher frequencies of the dental stress indicator, whereas in the workers group the male indi-viduals were less affected than females. The fi ndings would therefore suggest that the upper class males and the worker females were more affected by non-specifi c stress during childhood. Possible explanations of the fi ndings could be cultural favouritism of one sex over the other, as well as privileged access to basic resources, such as food, and sex-related labour division.

The comparatively low prevalence of non-specifi c skeletal and dental stress indica-tors in the Saqqara series could be attributed to the individuals’ high socioeconomic status also associated with access to nutritional foods, comfortable living conditions, medical care, and limited exposure to physical stress. However, it should be borne in mind that the study was based almost exclusively on the adult individuals due to the under-representation of children in the study series, and it is children who represent the most sensitive indicator in assessing a population’s ability to adapt to stress. Insults, especially severe, suffered during childhood could result in reduced fertility and capac-ity for work, and poor health in adulthood.187 The low prevalence of non-specifi c stress indicators in the Old Kingdom series from Saqqara should therefore be considered cautiously.

2.6.3. DENTAL PATHOLOGIES

Dental diseases were very common in the present population sample. Their aetiology commonly refl ects variations in human genetic, dietary, and physiological aspects. Dental attrition, known as tooth-to-tooth wear, is one of several regressive changes in dental hard tissues that are generally associated with a coarse diet and the ageing process. Pulp expo-sure as a result of enamel and dentine erosion could cause the living tissue inside the tooth to die, leaving empty root canals that easily become a source of chronic infection and abscesses. Attrition appeared to have played a major initiating role in formation of peri-apical and periodontal abscesses, root caries, ante-mortem tooth loss, and temporo mandibular joint disease. Table 9 summarises the rate of occlusal surface wear of permanent teeth within the maxilla and mandible in the present study series.

186 HUSSIEN et al., J Arab Soc Med Res 1.187 KAMP, J Archaeol Method Th 8, p. 10.

Figs. 145-146

397

Table 9. Attrition rate of permanent teeth in males and females from the Old Kingdomdental sample from Saqqara

Tooth I1 I2 C P1 P2 M1 M2 M3

Males Maxilla

n 21 20 20 22 22 27 25 21

Mean 3.3 3.5 3.2 4.2 4.4 8.2 7.5 6.5

Range 2-5 2-5 2-5 1-6 3-6 5-10 5-10 4-9

SD 1.1 1.2 1.3 1.6 1.1 2.1 2.1 2.0

Males Mandible

n 25 23 25 23 23 29 24 22

Mean 3.6 3.5 3.4 4.2 4.2 8.5 7.5 6.2

Range 2-5 2-5 2-5 3-5 3-5 6-10 5-10 4-9

SD 1.1 1.2 1.2 1.0 1.1 2.2 2.4 2.1

Females Maxilla

n 18 18 19 23 23 24 21 18

Mean 3.3 3.0 3.0 3.9 3.8 6.8 6.5 4.4

Range 2-5 1-5 1-5 1-7 1-7 3-10 3-9 1-7

SD 1.02 1.2 1.14 1.4 1.3 2.6 2.5 2.2

Females Mandible

n 18 19 18 22 21 23 21 16

Mean 3.0 3.0 3.0 3.5 3.7 8.0 7.7 4.5

Range 2-5 2-5 1-5 1-6 1-7 3-10 3-10 1-7

SD 1.05 1.17 1.14 1.3 1.3 2.1 2.2 2.7

Explanation of parameters and abbreviations used in the table: n – number of observations; Mean – arith-metic mean; Range – the difference between the largest and the smallest items in the sample; SD – standard deviation

Severe attrition (grade 8-10) of the maxillary fi rst molars was found in almost half of the teeth studied (49.9%). The overall attrition level in males was likely to have been signifi cantly higher as compared to females. The study of dental conditions, summarised in Table 10, revealed that in general, women were more likely to have been affected by these conditions than men. Periodontitis, a condition that results in the loss of the bony support of the teeth and is often associated with plaque forming dental calculus on the teeth, was also frequently found in the sample. The ultimate effect of periodontitis is extensive periodontal disease and tooth loss. A detailed description of these conditions is presented in Table 10.

Dental caries or cavities were frequent in the study sample and were observed exclu-sively in the premolars and molars. Another problem in dental condition found in the sample under study was ante-mortem tooth loss, which primarily results from caries and/or periodontal infection. As Brinch and Møler-Christensen have pointed out,188 there appears to be a tendency for a proportion of infected teeth to be less fi rmly held in their

188 BRINCH, MØLLER-CHRISTENSEN, Odont tidskr 4.

Figs. 144-146;

Pls. CLXXIVe,CLXXVIIg,CLXXXIIb,CLXXXIIIh

398

sockets and thus more likely to fall out than the healthy ones. This observation made in modern dental practice to consider much of the tooth loss in as primarily resulting from caries or periodontal abscess is applied to the studies of past populations. Another major problem encountered in studying dentition of past populations is staining and erosion, which may affect a tooth during the post-mortem period, as well as post-mortem tooth loss, especially of the anterior dentition. Owing to post-mortem tooth loss, it remains inconclusive to what extent careless handling during excavation or pathological changes are responsible for the observed dental pathology. With this in mind, estimates of the dental health picture were attempted cautiously.

The dental health profi le of the studied sample displayed a rather poor picture. The overall wear level observed on permanent teeth was moderate to severe. The severe level was described using codes for molar wear, in which a score of 5 represented two dentinal patches that had coalesced and score of 6 represented three or four dentinal patches coalesced with an island of enamel. In the present series, the dentition of both young and adult individuals was worn most likely due to a consumption of coarse and grit-laden diet. Studies on food preparation by ancient Egyptians have found that the fl our used for making bread was ground with coarse-grained grinding stones such as quarts, mica, ferromagnesium, minerals and other foreign bodies.189 Although the process of enamel attrition is believed to be multifactorial, this explanation could be taken into considera-

189 STROUHAL, Ancient Egyptians, pp. 125-135; BROTHWELL, BROTHWELL, Food in Antiquity; SAMUEL, Brewing and baking; ALCOCK, Food.

Table 10. Number of expressions of dental pathological conditions (n) over the number of observable teeth (N) in the Old Kingdom dental sample from Saqqara

M F M F

Periodontitis n/N n/N Ante-mortem Tooth Loss (ATML) n/N n/N

Maxillary incisors 0/77 1/52 Maxillary incisors 3/77 5/52

Maxillary canine 2/42 1/28 Maxillary canine 0/42 6/28

Maxillary premolars 6/84 11/60 Maxillary premolars 14/84 17/60

Maxilary molars M1-3 19/135 12/86 Maxilary molars M1-3 19/135 27/86

Mandibular incisors 8/82 1/51 Mandibular incisors 2/82 6/51

Mandibular canines 5/46 1/31 Mandibular canines 0/46 0/31

Mandibular premolars 11/91 22/63 Mandibular premolars 6/91 7/63

Mandibular molars M1-3 33/128 24/96 Mandibular molars M1-3 21/128 17/96

Dental caries Calculus

Maxillary incisors and canines 0/119 0/80 Maxillary incisors and canines 56/119 26/80

Maxillary premolars 3/84 2/60 Maxillary premolars 34/84 17/60

Maxilary molars M1-2 13/96 14/59 Maxilary molars M1-2 58/96 22/59

Mandibular incisors and canines 0/127 0/82 Mandibular incisors and canines 55/127 31/82

Mandibular premolars 2/91 5/68 Mandibular premolars 42/91 28/68

Mandibular molars M1-2 4/98 14/67 Mandibular molars M1-2 56/98 32/67

399

tion among many others as bread was the staple food in the ancient Egyptian diet for people from various demographic (children and adults) and social strata (nobles and commoners).

According to Larsen et al. “(…) dental caries is a disease process characterized by the focal demineralization of dental hard tissues by organic acid produced by bacterial fer-mentation of dietary carbohydrates, especially sugars (…)”, and ultimately lead to the formation of cavities in the crown or root surface.190 The aetiology of dental caries is multifactorial, but diet is an essential factor in its cause. There is a characteristic pattern in dental caries seen in living human populations with a westernised diet. For all types of carious lesions, molars are most commonly affected, followed by premolars and then the anterior teeth. Pits and fi ssures of premolars and molars are the most frequently affected sites of the tooth. Fewer caries are found on the proximal crown surfaces of posterior and anterior teeth. Coronal caries is largely a disease of children, and more common in girls than in boys.191 This may be due to more advanced dental maturation and earlier eruption of permanent teeth in girls. Diachronic analyses of dental caries or cavities in ancient Egyptians or Nubians revealed that these conditions occurred apparently less frequent than in modern populations.192 It has been speculated that the absence of sugar in the diet of ancient Egyptians, and the extreme attrition, which provides a more diffi cult environment for decay to begin, may be responsible for the low frequency of caries in this population. In fact, severe attrition, which is considered to be the greatest single problem in dental health of the earlier Egyptian population, was also found in the studied sample. It is believed, however, that part of the difference in prevalence of dental caries results from its problematic statistical evaluation, poor preservation state of skeletal remains, as well as small sample sizes.

2.6.3.1. NON-ALIMENTARY USE OF D ENTITION

In the present Old Kingdom assemblage from Saqqara, teeth were also investigated for evidence of non-alimentary uses. Such non-masticatory functions of the dentition are often

190 LARSEN et al., Dental caries, p. 179.191 HILLSON, Dental Anthropology.192 HARRIS et al., Dental health.

Figs. 145–146. Poor dental health in elderly (aged 50+ years) females from Burial 509 (left) and Burial 511 (right)

400

referred to as ‘a third hand’ or ‘teeth use as tools’ in cases when the dentition was involved in performing habitual or occupational activities. A number of such activities have been identifi ed through ethnographic studies of traditional societies, providing a valuable source of information for identifying dental modifi cation patterns in relation to particular activi-ties in past populations.193 Frequent examples of non-intentional dental alterations in archaeological materials have demonstrated that the phenomenon is a global fi nding that can be dated back to as early as the appearance of the genus Homo.194 Non-intentional dental modifi cations were also recorded in the anterior dentition of the specimens from the Old Kingdom and Ptolemaic inhumation series from Saqqara.195 The alterations were presented as linear grooves, notches, enamel trauma, and severe occlusal and lingual attrition (LSAMAT) caused by teeth-tool use that in modern times has been replaced by tools such as vices, pliers, or scissors.

In the present Old Kingdom sample, only fi ve individuals displayed non-intentional dental modifi cations, such as enamel trauma (Burials 473, 509, and 555), notches (Burial 555), and more advanced occlusal dental attrition of the anterior teeth compared to the posterior dentition (Burials 373196, 509 and 557). Ante-mortem enamel trauma (chipping) most commonly affected the maxillary incisors forming irregular lesions on the incisal edges that in some cases extended further to the labial surfaces taking a linear and verti-cally orientated form.197

The individuals that demonstrated enamel chipping were adolescent and young adult males (Burials 555 and 473, respectively), and an old female (Burial 509). When the Old Kingdom and Ptolemaic series were pooled, this type of dental trauma was predominantly observed in males (n=7) with only one female case recorded (Burial 509). A similar pattern of distribution between the sexes was noted in the Moroccan specimens from Taforalt where males demonstrated a signifi cantly higher frequency of chipping than females.198 The variations in frequencies of chipping between males and females, and between the anterior and posterior dentition in geographically different populations seem to be related to masticatory as well as extra-masticatory use of the teeth,199 such as dietary behaviour that involves crushing and chewing bone, occupational activities like hunting, fi shing, or lithic tool-making, as well as manipulating tools held between clenched teeth. Overall, the main causative factor of dental chipping would be excessive pressure applied to the tooth that would produce accidental lesions.200 In two instances in the present Old Kingdom sample this type of dental trauma occurred alongside severe incisal attrition (Burial 509) and mandibular notching (Burial 555). The latter could occur as a depression in the incisal or occlusal aspect of the tooth, and run perpendicular or transversely to the

193 E.g. BROWN, MOLNAR, Am J Phys Anthrop 81; ERDAL, Int J Osteoarchaeol 18; MERBS, Archaeol Survey Canada 119; PEDERSEN, Proc R Soc Med 40; TURNER, ANDERSON, Int J Osteoarchaeol 13.

194 E.g. BERMUDEZ DE CASTRO et al., Am J Phys Anthropol 102; ESTALRRICH et al., Am J Phys Anthropol 144; LORKIEWICZ, Am J Phys Anthropol 144; LUKACS, PASTOR, Am J Phys Anthropol 76.

195 KOZIERADZKA-OGUNMAKIN, Proc World Congress (in press).196 Saqqara IV, p. 100.197 The observed evidence of chipping was representative of grades 1 and 2 following the classifi cation

by BONFIGLIOLI et al., Int J Osteoarchaeol 14, p. 449.198 BONFIGLIOLI et al., Int J Osteoarchaeol 14, p. 449.199 BELCASTRO et al., Dental alterations; GOULD, Nat Hist 77; MILNER, LARSEN, Teeth as artifacts; LARSEN,

Bioarchaeology; TURNER, CADIEN, Am J Phys Anthropol 31.200 LUCAS, Dental Functional Morphology, p. 257; SCOTT, WINN, Int J Osteoarcheol 21; TURNER, CADIEN,

Am J Phys Anthropol 31.

Figs. 147-148

Fig. 147;

Pl. CLXVe

401

mesio-distal axis of the tooth.201 The observed dental notches in an adolescent male from Burial 555 showed smooth appearance and were symmetrically distributed in the man-dibular left second incisor and right canine. The smooth appearance of the notches would result from a contact with a round object or other highly abrasive material held between the teeth.202 Such dental modifi cations are often associated with personal habits and are more often observed as unilateral lesions. Similar lesions were also observed in an ado-lescent female from Burial 553. Severe occlusal dental attrition of the anterior teeth compared with the posterior teeth was recorded in the dentition of a female from Burial 509 and male individuals from Burials 373 and 557. In the previously studied larger-size population from the same cemetery site at Saqqara, six individuals also exhibited the highest dental wear scores in the anterior (upper and lower) dentition.203 The group com-prised three males and three females from young adult (n=1) and middle adult (n=5) age cohorts. Furthermore, dental attrition attributed to non-alimentary use of the teeth has been also observed in specimens recovered from a New Kingdom (1550-1069 BC) tomb of a high offi cial at Saqqara.204 Given sharply angled occlusal surfaces of the fi rst molars, it has been concluded that the teeth were used in task-activities involving stripping fi bers, or otherwise as a vice or a third hand.

The prevalence of the individual dental alterations recorded in the combined Saqqara population (Old Kingdom and Ptolemaic series) varied between the sexes; however, it was not signifi cantly different in any of the cases.205 Interestingly, linear grooving and notching have been recorded exclusively in adolescent and/or young adult individuals. The cases of severe occlusal attrition were observed exclusively in the middle and old adult age cohorts. The number of the observed cases of enamel trauma increased with age; therefore, it seems plausible, that the occurrence of certain non-intentional dental modifi cations in the Saqqara population could be age-related. In addition, taking into account the rapid progression of occlusal wear in the ancient Egyptian population, some dental modifi cations

201 BONFIGLIOLI et al., Int J Osteoarchaeol 14, p. 449; MOLNAR, Am J Phys Anthropol 34.202 ALT, PICHLER, Artifi cial modifi cations; BONFIGLIOLI et al., Int J Osteoarchaeol 14, p. 452; CRUWYS

et al., J Paleopathol 4; TURNER, ANDERSON, Int J Osteoarchaeol 13.203 Saqqara III, p. 511.204 WALKER, Skeletal remains, p. 66.205 KOZIERADZKA-OGUNMAKIN, Proc World Congress (in press).

Fig. 148

Pls. CLXXId,CLXXXVIf

Figs. 147–148. Enamel chipping on the incisal edges of the upper anterior teeth (left) and a notch lesion on the lower lateral incisor (right) of a male (aged 18 years) from Burial 555; also note multiple linear enamel hypoplasia defects on the upper and lower teeth

402

could be obliterated by subsequent tooth wear, which may explain the scant evidence of non-alimentary tooth use in the old adult individuals. None of the dental modifi cations observed in the Saqqara population has clearly demonstrated labour-division in relation to sex; however, some differences in modifi cation patterns could tentatively indicate the presence of sex-specifi c tasks.

2.7. CONCLUSIONS

The present study sample from the Old Kingdom Lower Necropolis at Saqqara com-prised a total of 92 individuals, of whom fi ve were sub-adults aged 10 years or under, constituting only 5.4% of the total population. In a stationary population such as this one, approximately half of the population would be expected to die before the age of fi ve due to plague and childhood infectious diseases. Therefore, the signifi cantly lower than expected representation of the immature individuals in the study series did not refl ect a living population, consequently resulting in biased conclusions drawn from death rates. Dramatic under-representation of infants and children in the present assemblage could have resulted from a combination of biological, cultural, and socioeconomic factors, including differ-ent body treatment and body disposing locations for sub-adults and adults, taphonomic processes affecting the preservation of human remains, as well as ancient plundering. With regard to the adult individuals of the present sample, 48.9% were males and 32.6% were females, presenting a sex ratio of 1.5:1 that was close to the theoretically expected equal sex representation of one male to one female. The highest mortality among the male individuals was recorded in the 35-50 years age group, yielding 42.2% of the total male population sample. The majority of the female deaths occurred in the 18-35 years age group and constituted 53.3% of the total female population. Median age among the male individuals was 37.9 years (Q1 32.5 years and Q2 45.0 years), whereas among the females it was 32.5 years (Q1 27.0 years and Q2 42.5 years). The highest mortality rate among young females could be related to frequent childbirth with potentially fatal complications.

The skeletal remains of the adult individuals in the present Old Kingdom study sample demonstrated evidence of pathological conditions of various aetiologies, including con-genital and developmental (e.g. multiple epiphyseal dysplasia, partial spina bifi da, hereditary multiple exostoses), metabolic and hematological (e.g. anaemia, osteoporosis), circulatory (osteochondritis dissecans), and neoplastic conditions (benign tumours of but-ton osteoma and malignant metastatic carcinoma), infectious disease (spinal and osseous tuberculosis), degenerative joint disease, and trauma. However, the predominant two skeletal pathological conditions were osteoarthritic changes (of the spine in particular) and trauma. In the present study series, the male individuals were more frequently affected by degenerative disease of the spine (51.1%; n=23/45) than females (33.3%; n=10/30). Evidence of direct trauma, including a ‘parry’ fracture and depressed fractures to the parietal bones was observed exclusively in the male individuals, whereas evidence for indirect trauma, such as stress and pathological fractures were manifested in the skeletal remains of both males and females. Considering that the violence-related evidence of trauma affected only the male individuals, it is possible that the injuries were sustained in combat or other types of deliberate violence.

Physical markers of nutritional and health-related stress during childhood were observed in the teeth and bone, and included porotic hyperostosis, cribra orbitalia, dental enamel

403

hypoplasia, and stature. The frequency of non-specifi c stress indicators in the present study proved to be much lower in comparison to the other Old Kingdom and later samples. However, when compared to the Old Kingdom high offi cials and workers populations from Giza, the Saqqara series demonstrated close similarities to the élite group of indi-viduals. Similar results were also observed in the living stature estimations for the Saqqara individuals and the Giza élites. The fi ndings would therefore suggest that the synergistic effects of disease and nutrition were far less pervasive in the Old Kingdom population of the Saqqara cemetery, and would also confi rm the high social status of the individuals representing the cemetery population at the given time. The lower prevalence of non-specifi c skeletal and dental stress indicators, as well as taller living stature in the Saqqara series could be attributed to the individuals’ privileged socioeconomic status with better access to nutritional foods, comfortable living conditions, medical care, and limited exposure to physical stress. The study, however, was based almost exclusively on the adult individuals due to the under-representation of children in the study series, and it is children who represent the most sensitive indicator in assessing a population’s ability to adapt to stress. Therefore, the low prevalence of non-specifi c stress indicators in the Old Kingdom series from Saqqara should rather be considered cautiously.

The common fi ndings in the study series were dental pathological conditions, such as ante-mortem tooth loss, calculus, carious lesions, periodontal disease, as well as severe dental attrition. The latter condition, which results from tooth-to-tooth wear, is generally associated with a coarse diet and the ageing process. In the ancient Egyptian population, attrition appeared to have played a major initiating role in formation of periapical and periodontal abscesses, root caries, ante-mortem tooth loss, and temporomandibular joint disease, all of which were observed in the Saqqara study series. In the study sample, it was revealed that in general women were more likely to have been affected by these conditions than men. Although dental carious lesions were frequent in the study sample, they were observed exclusively in the premolars and molars. No evidence of dental caries in the anterior dentition was observed; however, this could have been due to severe attri-tion, and ante-mortem, as well as post-mortem tooth loss, effectively making the statistical evaluation of the condition diffi cult in the Saqqara sample. Overall, dental health profi le in the studied sample displayed a rather poor picture. The permanent dentition of both young individuals and adults tended to be moderately to severely worn, which was most likely due to consumption of coarse and grit-laden diet. Evidence for non-masticatory use of the teeth was also observed in the Saqqara sample, which in the long term could have contributed to poor dental health in the affected individuals.

Index Table (SQ I, III, IV, V – Saqqara series volumes I, III, IV, V)

404

Burial no.

Burial context Body treatment

Biological data (inc. sex and

age)

Pathological conditions Figures and plates

5 SQ III.1, p. 52

SQ III.1, p. 52; SQ V.2, Table 1, p. 351

– – SQ III.1, Fig. 15

7 SQ III.1, pp. 52, 54

SQ III.1, p. 52; SQ V.2, Table 1

– – SQ III.1, Figs. 16-17

9 SQ III.1, p. 58

SQ III.1, p. 58, SQ III.2, pp. 459-460; SQ V.2, Table 1, p. 351

SQ III.1, p. 58; SQ V.2, Table 2

SQ III.1, p. 58; SQ V.2, p. 388

SQ III.1, Fig. 20, Pls. XVb-XVI

15 SQ III.1, p. 62

SQ III.1, p. 62; SQ V.2, Table 1

– – SQ III.1, Fig. 25, Pl. XIVb

16 SQ III.1, pp. 62, 64

SQ III.1, p. 62; SQ V.2, Table 1

– – SQ III.1, Figs. 26-27, Pl. XXIIa

17 SQ III.1, p. 64

SQ III.1, p. 64; SQ V.2, Table 1

– – SQ III.1, Fig. 31, Pl. XXIIIa

19 SQ III.1, p. 66

SQ III.1, p. 66; SQ V.2, Table 1; pp. 351, 354

– – SQ III.1, Figs. 32-33, Pl. XXIIIb-d

21 SQ III.1, p. 68

SQ III.2, p. 459; SQ V.2, Table 1

– – SQ III.1, Fig. 34, Pl. XXIVb

22 SQ III.1, p. 68

SQ III.1, p. 68; SQ V.2, Table 1, p. 351

– – SQ III.1, Figs. 35-36, Pl. XXV

23 SQ III.1, pp. 68, 70

SQ III.1, pp. 68, 70; SQ V.2, Table 1; pp. 351, 354

– – SQ III.1, Fig. 37, Pl. XXIVc

24 SQ III.1, pp. 70, 72-78

SQ III.1, pp. 70, 78; SQ V.2, Table 1

SQ III.1, p. 78; SQ V.2, Table 2

SQ III.2, p. 497

SQ III.1, Figs. 38-39, Pls. XXVI-XXVII

27 SQ III.1, pp. 79, 81

SQ III.1, pp. 79, 81; SQ V.2, Table 1

– – SQ III.1, Fig. 43, Pl. XXXa

45 SQ I, pp. 53-63

SQ V.2, Table 1 SQ I, pp.185-189; SQ V.2, Table 2

– SQ I; Pls. Xc, LXXXd-e

55 SQ III.1, p. 113

SQ III.1, p. 113; SQ V.2, Table 1, p. 351

SQ III.1, p. 113; SQ V.2, Table 2

SQ III.2, p. 505

SQ III.1, Fig. 74, Pl. XLVa

56 SQ V.1, p. 74

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 363-364, 381, 388

SQ V.1, Pl. LVIIc

57 SQ V.1, p. 141

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, p. 364 –

59 SQ V.1, pp. 90-92

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, p. 364 SQ V.1, Pl. LXIVb

405

60 SQ V.1, p. 137

SQ V.2, Table 1 SQ V.2, Table 2 – –

63 SQ V.1, p. 90

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, p. 364 SQ V.1, Fig. 36d, Pl. LXIIIa, c-d

64(171) SQ V.1, p. 85

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, p. 365 SQ V.1, Pl. LXIb-c

65 SQ V.1, p. 169

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, p. 364 SQ V.1, Fig. 86, Pl. CXXVIb-c; SQ V.2, Pl. CLXIIa

66 SQ V.1, p. 137

SQ V.2, Table 1 SQ V.2, Table 2 – –

67 SQ V.1, p. 143

SQ V.2, Table 1 SQ V.2, Table 2 – SQ V.2, Pl. CLXIIb-d

68 SQ V.1, p. 147

SQ V.2, Table 1 SQ V.2, Table 2 – –

69 SQ V.1, p. 143

SQ V.2, Table 1 SQ V.2, Table 2 – SQ V.1, Pl. CIIIb

70 SQ V.1, p. 87

SQ V.2, Table 1 SQ V.2, Table 2 – –

78 SQ III.1, p. 127

SQ V.2, Table 1 – – SQ III.1, Fig. 88

79 SQ V.1, p. 76

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 365, 386-387

SQ V.1, Pl. LVIIIc

81 SQ III.1, p. 127

SQ III.1, p. 127; SQ V.2, Table 1

SQ III.1, p. 127; SQ V.2, Table 2

– SQ III.1, Pl. LIVa

86 SQ V.1, p. 165

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, p. 365 –

95 SQ V.1, p. 197

SQ V.2, Table 1 SQ V.2, Table 2 – –

96 SQ V.1, p. 132

SQ V.2, Table 1 SQ V.2, Table 2 – –

97 SQ V.1, p. 51

SQ V.2, Table 1 SQ V.2, Table 2 – –

100 SQ V.1, p. 45

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 365, 388

SQ V.1, Pl. XXXC; SQ V.2, Pl. CLXIIe

136 SQ V.1, p. 54

SQ V.2, Table 1 SQ V.2, Table 2 – –

175 SQ V.1, p. 201

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 365-366, 389

SQ V.1, Fig. 104d-e, Pl. CXLIVa; SQ V.2, Fig. 132, Pl. CLXIIf-g

199 SQ III.1, pp. 172, 174

SQ III.1, pp. 172, 174; SQ III.2, pp. 459-460; SQ V.2, Table 1

SQ III.1, p. 172; SQ V.2, Table 2

– SQ III.1, Fig. 173, Pl. LXXXIIb

200 SQ III.1, p. 174

SQ III.1, p. 174; SQ III.2, p. 460; SQ V.2, Table 1, p. 351

SQ III.1, p. 174; SQ V.2, Table 2

SQ III.2, p. 505

SQ III.1, Fig. 174, Pl. LXXXIIc

406

Burial no.

Burial context Body treatment

Biological data (inc. sex and

age)

Pathological conditions Figures and plates

201 SQ III.1, p. 174

SQ III.1, p. 174; SQ V.2, Table 1

SQ V.2, Table 2 SQ III.2, p. 497

SQ III.1, Fig. 175, Pl. LXXXIId

214 SQ V.1, p. 31

SQ V.2, Table 1 SQ V.2, Table 2 – –

215 SQ III.1, p. 182

SQ III.1, p. 182; SQ III.2, pp. 459-460; SQ V.2, Table 1, p. 351

SQ III.1, p. 182; SQ V.2, Table 2

– SQ III.1, Figs. 188-189, Pl. LXXXVIIIc-d

344 SQ III.1, pp. 245, 247

SQ III.1, pp. 245, 247; SQ III.2, p. 460; SQ V.2, Table 1, p. 351

SQ III.1, p. 247; SQ V.2, Table 2

– SQ III.1, Figs. 298-299, Pl. CXXf

369 SQ III.1, pp. 263, 265

SQ III.1, p. 263; SQ V.2, Table 1, p. 351

SQ III.1, p. 265; SQ V.2, Table 2

SQ III.2, pp. 497, 505; SQ V.2, p. 392

SQ III.1, Fig. 321, Pl. CXXXVc

371 SQ III.1, p. 265

SQ III.1, p. 265; SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ III.2, pp. 497, 505

SQ III.1, Fig. 323, Pl. CXXXVIa

373 SQ IV, pp. 98, 100

SQ IV, p. 98; SQ V.2, Table 1, p. 351

SQ IV, pp. 98, 100; SQ V.2, Table 2

SQ V.2, pp. 386-387, 392, 400-401

SQ IV, Figs. 36-37, Pl. LXVIII

376 SQ IV, p. 100

SQ V.2, Table 1; p. 354

SQ IV, pp. 100-101; SQ V.2, Table 2

– –

381 SQ IV, p. 101

SQ V.2, Table 1 SQ IV, pp. 101-102; SQ V.2, Table 2

– –

393 SQ V.1, p. 147

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 366-367, 381, 383, 388

SQ V.1, Fig. 70c-e, Pl. CVI

394 SQ V.1, p. 56

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 367, 388, 392

SQ V.1, Pl. XXXVIa

395 SQ V.1, p. 59

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 367, 387, 389-390

SQ V.1, Fig. 19d, Pl. XXXVIc

396 SQ V.1, p. 107

SQ V.2, Table 1 SQ V.2, Table 2 – SQ V.1, Fig. 46d, Pl. LXXVIIa

397 SQ V.1, p. 40

SQ V.2, Table 1; pp. 351, 354

SQ V.2, Table 2 SQ V.2, pp. 387-388, 388-389

SQ V.1, Fig. 9f, Pls. XXIVc, XXV

398 SQ V.1, p. 135

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 368, 387

–

399 SQ V.1, p. 60

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 386, 388-389

SQ V.1, Fig. 20d-e, Pl. XXXVIIIb-c

407

400 SQ V.1, p. 100

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 368, 392

SQ V.1, Fig. 43, Pl. LXVI

401 SQ V.1, p. 100

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, p. 368 SQ V.1, Fig. 44, Pl. LXVIII

402 SQ V.1, p. 109

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, p. 368 SQ V.1, Fig. 47d-f, Pl. LXXIIIb-c

403 SQ V.1, p. 111

SQ V.2, Table 1 SQ V.2, Table 2 – SQ V.1, Fig. 48d, Pl. LXXXa

407 SQ V.1, p. 60

SQ V.2, Table 1 SQ V.2, Table 2 – SQ V.1, Fig. 21d, Pl. XXXIXb

408 SQ V.1, p. 92

SQ V.2, Table 1 SQ V.2, Table 2 – SQ V.1, Fig. 39d, Pl. LXVb

409 SQ V.1, p. 69

SQ V.2, Table 1 SQ V.2, Table 2 – SQ V.1, Fig. 26d

411 SQ IV, p. 102

SQ V.2, Table 1, p. 351

SQ IV, pp. 102-105; SQ V.2, Table 2

SQ IV, pp. 103-105; SQ V.2, pp. 381, 383, 388-390

SQ IV, Fig. 35c, Pls. LIIIb, LIV

424 SQ IV, p. 105

SQ IV, p. 102; SQ V.2, Table 1

SQ V.2, Table 2 – SQ IV, Pl. LV

429 SQ IV, p. 105

SQ IV, p. 105; SQ V.2, Table 1; p. 354

SQ IV, p. 105; SQ V.2, Table 2

SQ IV, p. 105; SQ V.2, p. 388

–

446 SQ V.1, p. 123

SQ V.2, Table 1 SQ V.2, Table 2 – SQ V.1, Pl. XCVb

448 SQ IV, p. 105

SQ V.2, Table 1 SQ IV, pp. 106-107; SQ V.2, Table 2

SQ IV, p. 107; SQ V.2, p. 388

SQ IV, Pls. XLV-XLVI

449 SQ V.1, p. 171

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 369, 392

SQ V.1, Fig. 89d, Pl. CXXVIb; SQ V.2, Pl. CLXIII

450 SQ IV, p. 108

SQ IV, p. 108; SQ V.2, Table 1

SQ IV, pp. 108-109; SQ V.2, Table 2

SQ IV, p. 109; SQ V.2, p. 388

SQ IV, Fig. 32d; Pl. XLI

453 SQ V.1, p. 119

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 369, 381, 385, 387-388

SQ V.1, Fig. 53e, Pls. LXXXIX, XCb-c; SQ V.2, Pls. CLIX, CLXVa-c

472 SQ V.1, p. 165

SQ V.2, Table 1 SQ V.2, Table 2 – –

473 SQ V.1, p. 171

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 369, 381-382, 388, 392, 400

SQ V.2, Figs. 134, 136; Pls. CLXVd-g, CLXVI

475 SQ V.1, p. 149

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 369-370, 381, 388

SQ V.1, Fig. 73d-e, Pl. CXII; SQ V.2, Figs. 128, 133; Pl. CLXVII

408

Burial no.

Burial context Body treatment

Biological data (inc. sex and

age)

Pathological conditions Figures and plates

476 SQ V.1, p. 42

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 370, 381, 388

SQ V.1, Fig. 10d, Pl. XXVIIIc; SQ V.2, Pl. CLXVIIIa

479 SQ V.1, p. 31

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 370, 388, 392

SQ V.1, Fig. 4b, Pl. XVII

480 SQ V.1, p. 117

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 370, 388

SQ V.1, Fig. 51, Pls. LXXXVb-c, LXXXVI

481 SQ V.1, p. 141

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 371, 388-389

SQ V.1, Fig. 74d-e, Pl. CXIIb-c

484 SQ V.1, p. 69

SQ V.2, Table 1 SQ V.2, Table 2 – SQ V.1, Fig. 25d, Pl. XLVIIId

489 SQ V.1, p. 149

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 371, 392

SQ V.2, Pl. CLXVIIIb-g

490 SQ V.1, p. 149

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 371, 389

–

493 SQ V.1, p. 113

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 371-372, 382, 387-388, 392

SQ V.1, Fig. 49e, Pl. LXXXIVc; SQ V.2, Fig. 126, Pls. CLXIX-CLXX

499 SQ V.1, p. 163

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, p. 372 –

509 SQ V.1, p. 117

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 372, 382, 388-389, 400-401

SQ V.1, Fig. 52d-e, Pl. LXXXVIb-d; SQ V.2, Fig. 145, Pl. CLXXI

510 SQ V.1, p. 123

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 372-373, 383-384, 388-389

SQ V.1, Fig. 57, Pls. XCIII-XCIV; SQ V.2, Fig. 138, Pls. CLXXII-CLXXIII

511 SQ V.1, p. 163

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 373, 385-390

SQ V.1, Fig. 81d-e, Pl. CXXIIIb-d; SQ V.2, Figs. 127, 142, 146; Pls. CLXXIV, CLXXVa-d

521 SQ V.1, p. 64

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, p. 373 SQ V.2, Pl. CLXXVe-f

528 SQ V.1, p. 123

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 374, 388-389

SQ V.2, Fig. 143; Pl. CLXXVI

532 SQ V.1, p. 67

SQ V.2, Table 1 SQ V.2, Table 2 – –

537 SQ V.1, p. 119

SQ V.2, Table 1 SQ V.2, Table 2 – SQ V.1, Fig. 54d, Pl. XCIIa

409

538 SQ V.1, p. 45

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 374-375, 381-382, 388-390, 392

SQ V.1, Pl. XXXa; SQ V.2, Pls. CLXXVII, CLXXVIII

539 SQ V.1, pp. 149-153

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 375, 388-389

SQ V.1, Fig. 74d-e, Pl. CXIIb-c; SQ V.2, Pl. CLXXIX

540 SQ V.1, p. 153

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 375-376, 381-382, 385-390

SQ V.1, Fig. 75c-d, Pl. CXV; SQ V.2, Figs. 135, 139; Pls. CLXXX, CLXXXIa-c

541 SQ V.1, p. 36

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 376, 381-382, 385, 387-388, 394

SQ V.1, Fig. 7f, Pl. XXIIa; SQ V.2, Fig. 140; Pls. CLXXXId-h, CLXXXII

542 SQ V.1, p. 183

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 376, 388

SQ V.1, Fig. 94c, Pl. CXXXIIIc; SQ V.2, Pl. CLXXXIIIa-b

551 SQ V.1, p. 95

SQ V.2, Table 1, pp. 351, 354

SQ V.2, Table 2 SQ V.2, pp. 376, 388-389

SQ V.1, Pl. LXIXb-c; SQ V.2, Fig. 130

552 SQ V.1, p. 179

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 376-377, 388, 392

SQ V.1, Fig. 93e, Pl. CXXXIIb-c; SQ V.2, Pl. CLXXXIIIc-h

554 SQ V.1, p. 159

SQ V.2, Table 1; pp. 351, 354

SQ V.2, Table 2 SQ V.2, pp. 377, 383, 386- 389

SQ V.1, Fig. 78d, Pl. CXIX; SQ V.2, Fig. 137; Pl. CLXXXIV

555 SQ V.1, p. 159

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 377, 386, 400-401

SQ V.1, Fig. 79d-e, Pls. CXX, CXXIa-b, CXXII; SQ V.2, Figs. 129, 147-148; Pl. CLXXXV

556 SQ V.1, p. 155

SQ V.2, Table 1; pp. 351, 354

SQ V.2, Table 2 SQ V.2, pp. 378, 392

SQ V.2, Fig. 144

557 SQ V.1, p. 155

SQ V.2, Table 1, p. 351

SQ V.2, Table 2 SQ V.2, pp. 378, 388-390, 400-401

SQ V.1, Fig. 77d, Pl. CXVIIIa; SQ V.2, Pls. CLXXXVI, CLXXXVIIa-c

558 SQ V.1, p. 179

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 378-379, 381-383, 3853, 387-388, 392

SQ V.1, Fig. 92e, Pl. CXXXc; SQ V.2, Fig. 141; Pls. CLXXXVIId-h, CLXXXVIIIa-d

604 SQ V.1, p. 201

SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 379, 388-389

SQ V.1, Fig. 102d, Pl. CXLIIIc-d; SQ V.2, Pls. CLXXXVIIIe-h, CLXXXIXa-e

610 SQ V.2, Table 1 SQ V.2, Table 2 SQ V.2, pp. 379, 381-382, 388-389, 392

SQ V.2, Pls. CLXXXIXf-h, CXC, CXCIa-c

611 SQ V.1, p. 191

SQ V.2, Table 1; p. 354

SQ V.2, Table 2 SQ V.2, pp. 379-381, 388-389

SQ V.1, Fig. 100, Pl. CXXXIXc; SQ V.2, Pl. CXId-g

410

REFERENCES Complementing the Bibliography from pp. 6-25

AÇSÁDI, NEMESKÉRI, Human Life G. Açsádi, I. Nemeskéri, History of Human Life Span and Mortal-ity, Budapest: Akadémiai Kiadó 1970.

AGARWAL et al., Am J Roentgenol K.N. Agarwal, N. Dhar, M.M. Shah, O.P. Bhardwaj, Roentgeno-Radium Ther Nucl Med 110 logic changes in iron defi ciency anemia, American Journal of

Roentgenology, Radium Therapy, and Nuclear Medicine 110 (1970), pp. 635-637.

ALCOCK, Food J.P. Alcock, Food in the Ancient World, Greenwood Press 2006.ALT, PICHLER, Artifi cial modifi cations K.W. Alt, S. Pichler, Artifi cial modifi cations of human teeth, Den-

tal Anthropology. Fundamentals, Limits and Prospects, K.W. Alt, F.W. Rosing, M. Teschler-Nicola (eds.), Wien: Springer-Verlag 1998, pp. 387-415.

ANGEL, Am J Phys Anthropol 30 J.L. Angel, The bases of paleodemography, American Journal of Physical Anthropology 30 (1969), pp. 427-438.

ARMELAGOS, Science 163 G.J. Armelagos, Disease in ancient Nubia, Science 163 (1969), pp. 255-259.

AUFDERHEIDE, Field Report A.C. Aufderheide, Field Report of Results from Examination of 140 Chiribaya Mummies Excavated from Chiribaya Alta Site in Lower Osmore Valley near Ilo, Peru. Manuscript on fi le at the De-partment of Physical Anthropology, University of Chicago 1990.

AUFDERHEIDE, RODRÍGUEZ-MARTÍN, A.C. Aufderheide, C. Rodríguez-Martín, The Cambridge Ency-Human Paleopathology clopedia of Human Paleopathology, Cambridge: Cambridge Uni-

versity Press, 1998.BEIGHTON, Inherited Disorders P. Beighton, Inherited Disorders of the Skeleton, 2nd ed., Edin-

burgh: Longman Group, Ltd., Churchill Livingstone 1988.BELCASTRO et al., Dental alterations M.G. Belcastro, B. Bonfi glioli, C. Consiglio, F. Facchini, The

Roman Imperial Age to Early Middle Ages regional transition: the analysis of dental alterations of the skeletal samples of Qua-drella (I-IV sec.) and Vicenne-Campochiaro (Early Middle Ages) in central Italy (Molise), XIVe Congrès de l’Union Internationale des Sciences Préhistoriques et Protohistoriques, Liège, 2-8 sep-tembre 2001.

BENFER, MCKERN, Am J Phys R. Benfer, T. McKern, The correlation of bone robusticity withAnthropol 24 the perforation of the coronoid-olecranon septum of the humerus

of man, American Journal of Physical Antropology 24 (1966), pp. 247-252.

BERMUDEZ DE CASTRO et al., Am J Phys J.M. Bermudez de Castro, J.L. Arsuaga, P.-J. Perez, InterproximalAnthropol 102 grooving in the Atapuerca-SH Hominid dentition, American

Journal of Physical Anthropology 102 (1997), pp. 369-376.BERTACCI et al., Minerva Stomatol 54 A. Bertacci, N. Landi, D. Manfredini, G. Ferronato, M. Bosco,

Coronoid hyperplasia. A case report, Minerva Stomatologica 54 (7-8) (2005), pp. 461-470.

BINI et al., Interact Cardiovasc A. Bini, M. Grazia, F. Stella, F. Petrella, Acute massive haemo-Thorac Surg 2 pneumothorax due to solitary costal exostosis, Interactive Car-

diovascular and Thoracic Surgery 2 (2003), pp. 614-615.BLACKWOOD, Am J Phys Anthropol 15 H.J.J. Blackwood, The double-headed mandibular condyle, Amer-

ican Journal of Physical Anthropology 15 (1) (1957), pp. 1-8.BLOM et al., Am J Phys Anthropol 127 D.E. Blom, J.E. Buikstra, L. Keng, P. Tomczak, E. Shoreman,

D. Stevens-Tuttle, Anemia and childhood mortality: latitudinal patterning along the coast of pre-Columbian Peru, American Journal of Physical Anthropology 127 (2005), pp. 152-169.

BONFIGLIOLI et al., Int J B. Bonfi glioli, V. Mariotti, F. Facchini, M.G. Belcastro, S. Condemi, Osteoarchaeol 14 Masticatory and non-masticatory dental modifi cations in the Epi-

palaeolithic necropolis of Taforalt (Morocco), International Jour-nal of Osteoarchaeology 14 (2004), pp. 448-456.

411

BOVÉE, Orphanet J Rare Dis 3 J.V.M.G. Bovée, Multiple osteochondromas, Orphanet Journal of Rare Disease 3 (3) (2008) (http://www.ojrd.com/content/3/1/3).

BRICKLEY, MCKINLEY, Guidelines M. Brickley, J.I. McKinley (eds.), Guidelines to the Standards for Recording Human Remains, Institute of Field Archaeologist Paper No. 7, BABAO and IFA 2004.

BRINCH, MØLLER-CHRISTENSEN, O. Brinch, V. Møller-Christensen, On comparative investigations Odont tidskr 57 into the occurrence of dental caries in archaeological studies,

Odontologisk tidskrift 4 (1949), pp. 357-380.BROOKS, SUCHEY, Hum Evol 5 S. Brooks, J.M. Suchey, Skeletal age determination based on the

os pubis: a comparison of the Açsádi-Nemeskéri and Suchey-Brooks Methods, Human Evolution 5(3) (1990), pp. 227-238.

BROTHWELL, Digging up Bones D.R. Brothwell, Digging up Bones. The Excavation, Treatment and Study of Human Skeletal Remains, 2nd ed., London: British Museum (Natural History) 1972.

BROTHWELL, BROTHWELL, Food P. Brothwell, D.R. Brothwell, Food in Antiquity: A Survey of thein Antiquity Diet of Early Peoples, Baltimore: Johns Hopkins University Press

1998.BROWN, MOLNAR, Am J Phys Anthropol T. Brown, S. Molnar, Interproximal grooving and task activity in81 Australia, American Journal of Physical Anthropology 81 (1990),

pp. 545-553.BUCKWALTER et al., Bone and joint J.A. Buckwalter, T.A. Einhorn, J.L. Marsh, Bone and joint healing, healing Rockwood and Green’s Fractures in Adults, 5th ed., Vol. 1,

R.W. Bucholz, J.D. Heckman (eds.), Philadelphia: Lippincott Williams and Wilkins 2001, pp. 245-271.

BUIKSTRA, UBELAKER, Standards J.E. Buikstra, D.H. Ubelaker, Standards for Data Collection from for Data Collection Human Skeletal Remains, Proceedings of a Seminar at The Field

Museum of Natural History Organized by Jonathan Haas (Arkan-sas Archaeological Survey Research Series No. 44), Fayetteville, Arkansas 1994.

BUI-MANSFIELD et al., Am J Roentgenol L.T. Bui-Mansfi eld, M. Kline, F.S. Chew, L.F. Rogers, L. Lenchik,175 Osteochondritis dissecans of the tibial plafond: imaging charac-

teristics and a review of the literature, American Journal of Roent-genology 175 (5) (2000), pp. 1305-1308.

BUZON, Am J Phys Anthropol 130 M.R. Buzon, Health of the non-elites at Tombos: nutritional and disease stress in New Kingdom Nubia, American Journal of Physical Anthropology 130 (2006), pp. 26-37.

BYRD, ADAMS, J Forensic Sci 48 J.E. Byrd, B.J. Adams, Osteometric sorting of commingled human remains, Journal of Forensic Sciences 48(4) (2003), pp. 717-724.

CEDERLUND et al., Skeletal Radiol 8 C.-G. Cederlund, L. Andrén, H. Olivecrona, Progressive bilat-eral thinning of the parietal bones, Skeletal Radiology 8 (1982), pp. 29-33.

ČERNÝ, JEA 40 J. Černý, Consanguineous marriages in Pharaonic Egypt, Journal of Egyptian Archaeology 40 (1954), pp. 23-29.

CHAPESKIE, Nexus 19 A. Chapeskie, Sub-adults in the bioarchaeological record, Nexus 19 (2006), pp. 32-51.

CLANTON, DELEE, Clin Orthop 167 T.O. Clanton, J.C. DeLee, Osteochondritis dissecans. History, pathophysiology and current treatment concepts, Clinical Ortho-paedics and Related Research 167 (1982), pp. 50-64.

CRUWYS et al., J Paleopathol 4 E. Cruwys, N.D. Robb, B.G.N. Smith, Anterior tooth notches: an Anglo-Saxon case study, Journal of Paleopathology 4 (3) (1992), pp. 211-220.

DALE, Cribra orbitalia J.M. Dale, Is cribra orbitalia synonymous with anemia? Analysis and interpretation of cranial pathology in Sudan, Master’s The-sis, Simon Fraser University 1994.

DAR et al., Eur Spine J 19 G. Dar, Y. Masharawi, S. Peleg, N. Steinberg, H. May, B. Medley, N. Peled, I. Hershkovitz, Schmorl’s nodes distribution in the hu-man spine and its possible etiology, European Spine Journal 19 (2010), pp. 670-675.

412

DEQUEKER et al., J Bone Miner Res 12 J. Dequeker, D.J. Ortner, A.I. Stix, X.-G. Cheng, P. Brys, S. Boonen, Hip fracture and osteoporosis in a XIIth dynasty fe-male skeleton from Lisht, Upper Egypt, Journal of Bone and Min-eral Research 12 (6) (1997), pp. 881-888.

DERRY, Med Press 197 D.E. Derry, Pott’s disease in ancient Egypt, Medical Press and Circular 197 (1938), pp.196-199.

DIODORUS SICULUS Diodorus Siculus, Diodorus of Sicily in Twelve Volumes, Vol. 1-Books: 1-2.34, Translated by C.H. Oldfather, F.R. Walton (ed.), London 1933.

DUHIG, Skeletal Indicators C. Duhig, “They Are Eating People Here!” Skeletal Indicators of Stress in the Egyptian First Intermediate Period, Unpublished Ph.D. dissertation, University of Cambridge 2000.

DURVARD, J Anat 63 A. Durvard, A note on symmetrical thinning of the parietal bones, Journal of Anatomy 63 (Pt 3), (1929), pp. 356-362.

EL BANNA, Osteoporosis Assessment A.R. El Banna, Osteoporosis Assessment in Ancient Egyptian Skel-etal Remains, Unpublished PhD thesis, Cairo University 2005.

ELLIOT SMITH, J Anat Physiol 41 G. Elliot Smith, The causation of the symmetrical thinning of the parietal bones in ancient Egyptians, Journal of Anatomy and Physiology 41 (1907), pp. 232-233.

ELLIOT SMITH, WOOD JONES, Report G. Elliot Smith, F. Wood Jones, Report on the Human Remains.on the Human Remains The Archaeological Survey of Nubia, Report for 1907-1908,

Vol. 2, Cairo: National Printing Department 1910.ELLIOT SMITH, RUFFER, Pott’sche G. Elliot Smith, M.A. Ruffer, Pott’sche Krankheit in einer Krankheit ägyptischen Mumie, aus der Zeit der 21. Dynastie (um 1000

vor Chr.), Heft 3 of Sudhoff and Sticker’s Historische Biologie der Krankheitserreger, Giessen 1910.

EMMETT, BRECK, J Bone Joint Surg 40A J.E. Emmett, L.W. Breck, A review and analysis of 11,000 frac-tures seen in a private practice of orthopaedic surgery, Journal of Bone and Joint Surgery 40A (1958), pp. 1169-1175.

ENG, Acta Haematol 19 L. Eng, Chronic iron defi ciency anemia with changes resembling Cooley’s anemia, Acta Haematologica 19 (1958), pp. 263-268.

ENGBER et al., J Bone Joint Surg 67 W.D. Engber, J.S. Keene, M.D. Madison, Irreducible fracture-separation of the distal ulnar epiphysis. Report of a case, Journal of Bone and Joint Surgery 67 (1985), pp. 1130-1132.

EPSTEIN, Radiology 60 B.S. Epstein, The concurrence of parietal thinness with postmeno-pausal, senile, or idiopathic osteoporosis, Radiology 60 (1953), pp. 29-35.

ERDAL, Int J Osteoarchaeol 18 Y.S. Erdal, Occlusal grooves in anterior dentition among Kovuk-lukaya inhabitants (Sinop, Northern Anatolia, 10th Century AD), International Journal of Osteoarchaeology 18 (2008), pp. 152-166.

ESHED et al., Am J Phys Anthropol 118 V. Eshed, B. Latimer, C.M. Greenwald, L.M. Jellema, B.M. Rots-child, S. Wish-Baratz, I. Hershkovitz, Button osteoma: its etiol-ogy and pathophysiology, American Journal of Physical Anthro-pology 118 (2002), pp. 217-230.

ESTALRRICH et al., Am J Phys Anthropol A. Estalrrich, A. Rosas, S. García-Vargas, A. García-Tabernero,144 D. Santamaría, M. de la Rasilla, Brief communication: subver-

tical grooves on interproximal wear facets from the El-Sidrón (Asturias, Spain) Neandertal dental sample, American Journal of Physical Anthropology 144 (2011), pp. 154-161.

EVELETH, TANNER, Worldwide Variation P.B. Eveleth, J.M. Tanner, Worldwide Variation in Human Growth, 2nd ed., Cambridge: Cambridge University Press 1990.

FAIRGRIEVE, MOLTO, Am J Phys S.I. Fairgrieve, J.E. Molto, Cribra orbitalia in two temporally Anthropol 111 disjunct population samples from the Dakhleh Oasis, Egypt, Amer-

ican Journal of Physical Anthropology 111 (1999), pp. 319-331.FEDERICO et al., Arthroscopy 6 D.J. Federico, J.K. Lynch, P. Jokl, Osteochondritis dissecans of

the knee: a historical review of etiology and treatment, Arthros-copy 6 (3) (1990), pp. 190-197.

413

FEREMBACH et al., J Hum Evol 9 D. Ferembach, I. Schwidetzky, M. Stloukal, Recommendations for age and sex diagnoses of skeleton, Journal of Human Evolu-tion 9 (1980), pp. 517-549.

FILER, JEA 78 J.M. Filer, Head injuries in Egypt and Nubia: a comparison of skulls from Giza and Nubia, Journal of Egyptian Archaeology 78 (1992), pp. 281-285.

FILER, Disease J.M. Filer, Disease, London: British Museum Press 1995.FINNEGAN, J Anat 125 M. Finnegan, Non-metric variation of the infracranial skeleton,

Journal of Anatomy 125 (1) (1978), pp. 23-37. GABALLAH, BADAWY, Egypt J Anat 3 M.F. Gaballah, Z.H. Badawy, A further anatomical study of spon-

dylolysis in human lumbar vertebrae, Egyptian Journal of Anato-my 3 (1980), pp. 9-18.

GIUDICI et al., Radiol Clin N Am 31 M.A. Giudici, R.P. Moser Jr., M.J. Kransdorf, Cartilaginous bone tumors, Radiologic Clinics of North America 31 (2) (1993), pp. 237-259.

GLANVILLE, Am J Phys Anthropol 26 E.V. Glanville, Perforation of the coronoid-olecranon septum humero-ulnar relationships in Netherlands and African popula-tions, American Journal of Physical Anthropology 26 (1) (1967), pp. 85-92.

GŁADYKOWSKA-RZECZYCKA, J. Gładykowska-Rzeczycka, M. Urbanowicz, Multiple osseous URBANOWICZ, Folia Morphol 29 exostoses of the skeleton from a prehistoric cemetery of a former

population of Pruszcz Gdański, Folia Morphologica 29 (1970), pp. 284-296.

GOODMAN, Adv Dent Res 3 A.H. Goodman, Dental enamel hypoplasia in prehistoric popula-tions, Advances in Dental Research 3 (2) (1989), pp. 265-271.

GOODMAN, ROSE, Yrbook Am J Phys A.H. Goodman, J.C. Rose, Assessment of systemic physiologicalAnthropol 33 perturbations from dental enamel hypoplasias and associated his-

tological structures, Yearbook of American Journal of Physical Anthropology 33 (S11) (1990), pp. 59-110.

GORLIN, GOLTZ, N Engl J Med 262 R.J. Gorlin, R.W. Goltz, Multiple nevoid basal-cell epithelioma, jaw cysts and bifi d rib: a syndrome, New England Journal of Medicine 262 (1960), pp. 908-912.

GOULD, Nat Hist 77 R.A. Gould, Chipping stones in the outback, Natural History 77 (1968), pp. 42-49.

GRAJETZKI, Burial Customs W. Grajetzki, Burial Customs in Ancient Egypt: Life in Death for Rich and Poor, London 2003.

GRAY, Radiological aspects P.H.K. Gray, Radiological aspects of the mummies of ancient Egyptians in the Rijksmuseum van Oudheden, Oudheidkundige Mededelingen uit het Rijksmuseum van Oudheden te Leiden 47 (1966), pp. 1-30.

HARRIS et al., Dental health J.E. Harris, P.V. Ponitz, B.K. Ingalls, Dental health in ancient Egypt, Mummies, Disease & Ancient Cultures, 2nd ed., A. Cock-burn, E. Cockburn, T.A. Reyman (eds.), Cambridge: Cambridge University Press 1998, pp. 59-68.

HAWASS, Plaster mask Z. Hawass, A burial with an unusual plaster mask in the Western Cemetery of Khufu’s Pyramid, The Followers of Horus. Stud-ies dedicated to Michael Allen Hoffman, R. Friedman, B. Adams (eds.), Egyptian Studies Associated Publication No. 2, Oxbow Monograph 20, Oxford 1992, pp. 327-336.

HEFTI et al., J Pediatr Orthop 8 F. Hefti, J. Beguiristain, R. Krauspe, B. Möller-Madsen, V. Ric-cio, C. Tschauner, R. Wetzel, R. Zeller, Osteochondritis dissecans: a multicenter study of the European Pediatric Orthopedic Society, Journal of Pediatric Orthopaedics B 8 (4) (1999), pp. 231-245.

HENGEN, Homo 22 O.P. Hengen, Cribra orbitalia pathogenesis and probable etiology, Homo 22 (1971), pp. 57-76.

HENNEKAM, J Med Genet 28 R.C.M. Hennekam, Hereditary multiple exostoses, Journal of Medical Genetics 28 (1991), pp. 262-266.

414

HERODOTUS Herodotus, The Histories: Book II, Translated by R. Waterfi eld, Oxford: Oxford University Press 1998.

HERSHKOVITZ et al., Am J Phys I. Hershkovitz, C. Greenwald, B.M. Rothschild, B. Latimer, Anthropol 109 O. Dutour, L.M. Jellema, S. Wish-Baratz, Hyperostosis fronta-

lis interna: an anthropological perspective, American Journal of Physical Anthropology 109 (1999), pp. 303-325.

HILLSON, Dental Anthropology S. Hillson, Dental Anthropology, Cambridge: Cambridge Univer-sity Press 1996.

HILLSON, Teeth S. Hillson, Teeth, Cambridge: Cambridge University Press 2005.HIXON, GIBBS, Am Fam Physician 61 A.L. Hixon, L.M. Gibbs, Osteochondritis dissecans: a diagnosis

not to miss, American Family Physician 61 (1) (2000), pp. 151-158.HUSSIEN et al., Anthropological F.H. Hussien, S. Shabaan, Z. Hawass, A.M. Sarry El Din, Anthropo -differences logical differences between workers and high offi cials from the

Old Kingdom at Giza, Egyptology at the Dawn of the Twenty-First Century, Vol. 2: History, Religion, Proceedings of the Eighth International Congress of Egyptologists, Cairo 2000, Z. Hawass, L. Pinch Brock (eds.), Cairo: The American University in Cairo Press 2003, pp. 324-331.

HUSSIEN et al., J Arab Soc Med Res 1 F.H. Hussien, R.A. El Banna, A.M. Sarry El Din, Non-specifi c stress indicators in ancient Egyptians from Giza and Bahriyah Oasis, Journal of the Arab Society for Medical Research 1 (1) (2006), pp. 1-13.

HUSSIEN et al., Int J Osteoarchaeol 19 F.H. Hussien, A.M. Sarry El-Din, W.A. El Samie Kandeel, R.A.E.-S. El Banna, Spinal pathological fi ndings in ancient Egyptians of the Greco-Roman period living in Bahriyah Oasis, International Journal of Osteoarchaeology 19 (2009), pp. 613-627.

IKRAM, DODSON, The Mummy S. Ikram, A. Dodson, The Mummy in Ancient Egypt: Equipping the Dead for Eternity, London: Thames and Hudson 1998.

JONES, J Anat 66 E.W.A.H. Jones, Studies in achondroplasia, Journal of Anatomy 66 (1932), pp. 569-573.

JUDD, J Archaeol Science 35 M.A. Judd, The parry problem, Journal of Archaeological Sci-ence 35(6) (2008), pp. 1658-1666.

JUPITER, J Bone Joint Surg 73A J. Jupiter, Current concept review fractures of the distal end of the radius, Journal of Bone and Joint Surgery 73A (1991), pp. 461-469.

KADAKIA, SARKAR, J Foot Ankle Surg 46 A.P. Kadakia, J. Sarkar, Osteochondritis dissecans of the talus involving the subtalar joint: a case report, Journal of Foot and Ankle Surgery 46 (6) (2007), pp. 488-92.

KAMP, J Archaeol Method Th 8 K.A. Kamp, Where have all the children gone?: the archaeology of childhood, Journal of Archaeological Method and Theory 8 (2001), pp. 1-34.

KANEYAMA et al., Congen Anomalies 48 K. Kaneyama, N.Segami, T. Hatta, Congenital deformities and devo-lopmental abnormalities of the mandibular condyle in the temporo-mandibular joint, Congenital Anomalies 48 (2008), pp. 118-125.

KLAASSEN et al., Anat Sci Int 86 Z. Klaassen, R.S. Tubs, N. Apaydin, R. Hage, R. Jordan, M. Lou-kas, Vertebral spinal osteophytes, Anatomical Science Interna-tional 86 (2011), pp. 1-9.

KOKTEN et al., J Contemp Dent G. Kokten, H. Balcioglu, M. Buyukertan, Supernumerary fourth Practice 4 and fi fth molars: a report of two cases, Journal of Contemporary

Dental Practice 4(4) (2003), pp. 67-76.KOZIERADZKA-OGUNMAKIN, PalArch’s I. Kozieradzka-Ogunmakin, A case of a metastatic carcinoma inJ Archaeol Egypt 10 an Old Kingdom skeleton from Saqqara. 2nd Conference on the

Bioarchaeology of Ancient Egypt (Cairo, 31st January – 2nd Febru-ary 2013). PalArch’s Journal of Archaeology of Egypt/Egyptology 10 (1) (2013), pp. 21.

KOZIERADZKA-OGUNMAKIN, I. Kozieradzka-Ogunmakin, Multiple epiphyseal dysplasia in anInt J Paleopathol 1 Old Kingdom Egyptian skeleton, International Journal of Paleo-

pathology 1, pp. 200-206.

415

KOZIERADZKA-OGUNMAKIN, Patterns I. Kozieradzka-Ogunmakin, Patterns and management of fractures and management of fractures of long bones: a study of the ancient population of Saqqara,

Egypt, Ancient Medical and Healing Systems and Their Legacy, A.R. David (ed.), Manchester: John Rylands University of Man-chester Bulletin 89 Supplement (in press).

KOZIERADZKA-OGUNMAKIN, Proc I. Kozieradzka-Ogunmakin, Teeth used as a tool: evidence ofWorld Congress (in press) task-related dental modifi cations from an ancient cemetery at

Saqqara, Egypt, Proceeding of the 7th World Congress on Mummy Studies (San Diego, 12th-16th June 2011) (in press).

KOZMA, Am J Med Genet 146A C. Kozma, Historical review II: skeletal dysplasia in ancient Egypt, American Journal of Medical Genetics 146A (2008), pp. 3104-3112.

KRANE, HOLICK, Metabolic bone disease S.M. Krane, M.F. Holick, Metabolic bone diseases, Harrison’s Principles of Internal Medicine, J.D. Wilson, E.B. Braunwald, K.J. Isselbacher, R.G. Petersdorf, J.B. Martin, A.S. Fauci, R.K. Root (eds.), New York: McGraw-Hill 1991, pp. 1921-1933.

KROGMAN, ÍŞCAN, The Human Skeleton W.M. Krogman, M.Y. Íşcan, The Human Skeleton in Forensic Medicine, 2nd edition, Springfi eld, IL: Charles C. Thomas Pub-lisher 1986.

LANGER, PERCY, Can J Surg 14 F. Langer, E.C. Percy, Osteochondritis dissecans and anomalous centres of ossifi cation: a review of 80 lesions in 61 patients, Ca-nadian Journal of Surgery 14 (3) (1971), pp. 208-215.

LARSEN, Bioarchaeology C.S. Larsen, Bioarchaeology. Interpreting Behaviour from the Human Skeleton, Cambridge: Cambridge University Press 1997.

LARSEN et al., Dental caries C.S. Larsen, R. Shavit, M.C. Griffi n, Dental caries evidence for dietary change: an archaeological context, Advances in Dental Anthropology, M.A. Kelley, C.S. Larsen (eds.), New York: Wiley-Liss, Inc. 1991, pp. 179-202.

LEEK, Cheops’ courtiers F.F. Leek, Cheops’ courtiers: their skeletal remains, Science in Egyptology, A.R. David (ed.), Manchester: Manchester Univer-sity Press 1986.

LEWIS, ROBERTS, Int J Osteoarchaeol 7 M. Lewis, C. Roberts, Growing pains: the interpretation of stress indicators, International Journal of Osteoarchaeology 7 (1997), pp. 581-586.

LISOWSKI, Report on the skulls F.P. Lisowski, Report on the skulls from excavations at Sesebi (Anglo-Egyptian Sudan), Actes du 4e Congrès International des Sciences, Vienne 1952, Tome 1. Wein: Verlag Adolf Holzhausens NFG 1954, pp. 228-240.

LISOWSKI, Trepanation F.P. Lisowski, Prehistoric and early historic trepanation, Diseases in Antiquity: A Survey of the Diseases, Injuries, and Surgery of Early Populations, D. Brothwell, A. Sandison (eds.), Springfi eld, IL: Charles C. Thomas Publisher 1967, pp. 320-345.

LIVESLEY, MILLIGAN, Int Orthop 16 P.J. Livesley, G.F. Milligan, Osteochondritis dissecans patellae, International Orthopaedics 16 (2) (2004), pp. 126-129.

LODGE, Thinning of parietal bones T. Lodge, Thinning of parietal bones in early Egyptian populations, Disease in Antiquity: A Survey of the Disease, Injuries and Sur-gery of Early Populations, D.R. Brothwell, A.T. Sandison (eds.), Springfi eld: Charles C. Thomas Publisher 1967, pp. 405-412.

LORKIEWICZ, Am J Phys Anthropol 144 W. Lorkiewicz, Nonalimentary tooth use in the Neolithic population of the Lengyel culture in Central Poland (4600-4000 BC), Ameri-can Journal of Physical Anthropology 144 (2011), pp. 538-551.

LOVEJOY et al., Am J Phys Anthropol 68 C.O. Lovejoy, R.S. Meindl, T.R. Pryzbeck, R.P. Mensforth, Chrono logical metamorphosis of the auricular surface of the il-ium: a new method for the determination of adult skeletal age at death, American Journal of Physical Anthropology 68 (1985), pp. 15-28.

LUCAS, Dental Functional Morphology P.W. Lucas, Dental Functional Morphology: How Teeth Work, Cambridge: Cambridge University Press 2004.

416

LUK et al., Pan African Med J 4 S.Y. Luk, J.S.F. Shum, J.K.W. Chan, J.L.S. Khoo, Bilateral thin-ning of the parietal bones: a case report and review of radiological features, Pan African Medical Journal 4 (2010).

LUKACS, Int J Osteoarchaeol 17 J.R. Lukacs, Dental trauma and antemortem tooth loss in prehis-toric Canary Islanders: prevalence and contributing factors, Inter-national Journal of Osteoarchaeology 17 (2) (2007), pp. 157-173.

LUKACS, PASTOR, Am J Phys Anthropol 76 J.R. Lukacs, R.F. Pastor, Activity-induced patterns of dental abra-sion in prehistoric Pakistan: evidence from Mehrgarh and Ha-rappa, American Journal of Physical Anthropology 76 (1988), pp. 377-398.

MANN et al., Photographic R.W. Mann, R. David, P.D. Hunt, Photographic Regional Atlas ofRegional Atlas Bone Disease: A Guide to Pathologic and Normal Variation in the

Human Skeleton, 2nd edition, Springfi eld, IL: Charles. C. Thomas Publisher 2005.

MARKS, HAMILTON, Int J Osteoarchaeol M.K. Marks, M.D. Hamilton, Metastatic carcinoma: palaeopa-17 thology and differential diagnosis, International Journal of Os-

teoarchaeology 17 (2007), pp. 217-234.MARTIN, Int J Osteoarchaeol (2011) D.C. Martin, Like you need a hole in the head: tool innovation

a possible cause of trephination. A case from Kerma, Nubia, In-ternational Journal of Osteoarchaeology (2011) (http://onlineli-brary.wiley.com/doi/10.1002/oa.1281/pdf).

MARTIN, SALLER, Lehrbuch der R. Martin, K. Saller, Lehrbuch der Anthropologie, Vol. 1, Stuttgart: Anthropologie Gustav Fischer 1957.MCEWAN et al., Calcif Tissue Int 74 J.M. McEwan, S. Mays, G.M. Blake, Measurements of bone min-

eral density of the radius in a medieval population, Calcifi ed Tis-sue International 74 (2004), pp. 157-161.

MCKINLEY, Compiling a skeletal J.I. McKinley, Compiling a skeletal inventory: disarticulated andinventory co-mingled remains, Guidelines to the Standards for Recording

Human Remains, M. Brickley and J.I. McKinley (eds.), Insti-tute of Field Archaeologist Paper No. 7, BABAO and IFA 2004, pp. 14-17.

MEINDL, LOVEJOY, Am J Phys R.S. Meindl, C.O. Lovejoy, Ectocranial suture closure: a revisedAnthropol 68 method for the determination of skeletal age at death based on the

lateral-anterior suture, American Journal of Physical Anthropol-ogy 68 (1985), pp. 57-66.

MEINDL, LOVEJOY, Age changes R.S. Meindl, C.O. Lovejoy, Age changes in the pelvis: implica-tions for paleodemography, Age Markers in the Human Skeleton, M.Y. Ísçan (ed.), Springfi eld, IL: Charles C. Thomas Publisher 1989, pp. 137-150.

MENSFORTH, LATIMER, Am J Phys R.P. Mensforth, B.M. Latimer, Hamann-Todd collection agingAnthropol 80 studies: osteoporosis fracture syndrome, American Journal of

Physical Anthropology 80 (1989), pp. 461-479.MERBS, Archaeol Survey Canada 119 C.F. Merbs, Patterns of activity-induced pathology in a Canadian

Inuit population, Archaeological Survey of Canada Paper 119 (1983).

MERBS, Yrbook Phys Anthropol 39 C.F. Merbs, Spondylolysis and spondylolisthesis: a cost of being an erect biped or a clever adaptation?, Yearbook of Physical An-thropology 39 (1996), pp. 201-228.

MERBS, Am J Phys Anthropol 119 C.F. Merbs, Asymmetrical spondylolysis, American Journal of Physical Anthropology 119 (2002), pp. 156-174.

MICHELI, CURTIS, Clin Sports Med 25 L.J. Micheli, C. Curtis, Stress fractures in the spine and sacrum, Clinics in Sports Medicine 25 (1) (2006), pp. 75-88.

MIDDLETON, Am Soc Rev 27 R. Middleton, Brother-sister and father-daughter marriages in ancient Egypt, American Sociological Review 27 (5) (1962), pp. 603-611.

MILNER, LARSEN, Teeth as artifacts G.R. Milner, C.S. Larsen, Teeth as artifacts of human behaviour: intentional mutilation and accidental modifi cations, Advances in

417

Dental Anthropology, M.A. Kelley, C.S. Larsen (eds.), New York: Wiley-Liss Inc. 1991, pp. 357-378.

MITTLER, VAN GERVEN, Am J Phys D.M. Mittler, D.P. van Gerven, Developmental, diachronic, and Anthropol 93 demographic analysis of cribra orbitalia in the medieval Christian

populations of Kulubnarti, American Journal of Physical Anthro-pology 93 (1994), pp. 287-297.

MKANDAWIRE, KAUNDA, Trop Doct 35 N.C. Mkandawire, E. Kaunda, Bone and joint TB at Queen Eliza-beth Hospital Centre 1986 to 2002, Tropical Doctor 35 (2005), pp. 14-16.

MOGHA et al., Internet J Orthop Surg 8 A. Mogha, S.K. Verma, M. Dhingra, N.S. Kushwaha, O. Gupta, Isolated left ileum bone tuberculosis: a case report, The Internet Journal of Orthopedic Surgery 8 (1) (2008).

MOLNAR, Am J Phys Anthropol 34 S. Molnar, Human tooth wear, tooth function and cultural vari-ability, American Journal of Physical Anthropology 34 (1971), pp. 175-190.

MOORREES et al., J Dent Res 42 C.F.A. Moorrees, E.A. Fanning, E.E. Hunt, Age variation of for-mation stages for ten permanent teeth, Journal of Dental Research 42 (1963), pp. 1490-1501.

MORSE et al., Am Rev Respir Dis 90 D. Morse, D.R. Brothwell, P.J. Ucko, Tuberculosis in ancient Egypt, American Review of Respiratory Disease 90 (1964), pp. 524-541.

MOSELEY, Semin Roentgenol 9 J.E. Moseley, Skeletal changes in the anemias, Seminars in Roent-genology 9 (1974), pp. 169-184.

MOTLEY et al., J Athletic Training 33 G. Motley, J. Nyland, J. Jacobs, D. Caborn, The pars interarticu-laris stress reaction, spondylolysis, and spondylolisthesis progres-sion, Journal of Athletic Training 33 (4) (1998), pp. 351-358.

MURPHY, MCKENZIE, J Archaeol Sci 37 E.M. Murphy, C.J. McKenzie, Multiple osteochondromas in the archaeological record: a global review, Journal of Archaeological Science 37 (2010), pp. 2255-2264.

MUSSELWHITE, Skeletal Health S. Musselwhite, Skeletal Health in Early Egypt: The Effects of Cultural Change and Social Status, Master of Philosophy thesis, University of Cambridge 2011.

NAWROCKI, Taphonomic processes S.P. Nawrocki, Taphonomic processes in historic cemeteries, Bodies of Evidence: Reconstructing History Through Skeletal Analysis, A. Grauer (ed.), New York: Wiley-Liss, 1995, pp. 49-66.

NELATON, Rev d’Orthop 3 C. Nelaton, Tuberculose de l’os iliaque gauche, Revue d’Orthopédie 3 (1892), p. 338.

NERLICH et al., Lancet 350 A.G. Nerlich, C.J. Hass, A. Zink, U. Szeimies, H.G. Hagedorn, Molecular evidence for tuberculosis in an ancient Egyptian mum-my, The Lancet 350 (1997), p. 1404.

NEUMANN, Osteoarthritis R.D. Neumann, Osteoarthritis, Orthopedic Secrets, 3rd ed., D.E. Brown, R.D. Neumann (eds.), Philadelphia: Hanley and Bel-fus 2004, pp. 1-8.

OAKLEY et al., Man 59 K. Oakley, M. Brooke, A. Akester, D. Brothwell, Contributions on trepanning or trepanation in ancient and modern times, Man 59 (1959), pp. 92-96.

ORTNER, Pathological Conditions D.J. Ortner, Identifi cation of Pathological Conditions in Human Skeletal Remains, 2nd edition, London: Academic Press 2003.

ORTNER, PUTSCHAR, Identifi cation D.J. Ortner, W.G. Putschar, Identifi cation of Pathological Condi-tions in Human Skeletal Remains, Washington: Smithsonian Insti-tution Press 1985.

PANCHOVICH, J Bone Joint Surg 58A A. Panchovich, Maisonneuve fracture of the fi bula, Journal of Bone and Joint Surgery 58A (1976), pp. 337-342.

PEDERSEN, Proc R Soc Med 40 P.O., Pedersen, Dental investigations of Greenland Eskimos, Pro-ceedings of the Royal Society of Medicine 40 (1947), pp. 726-732.

PERTUISET et al., Medicine 78 E. Pertuiset, J. Beaudreuil, F. Liote, A. Horusitzky, F. Kemi-che, P. Richette, D. Clerc-Wyel, I. Cerf-Payraste, H. Dorfmann,

418

J. Glowinski, J. Crouzet. T. Bardin, O. Meyer, A. Dryll, J.M. Ziza, M.F. Kahn, D. Kuntz, Spinal tuberculosis in adults. A study of 103 cases in a developed country, 1980-1994, Medicine (Baltimore) 78 (1999), pp. 309-320.

PFEIFFER, CROWDER, Am J Phys S. Pfeiffer, C. Crowder, An ill child among Mid-Holocene foragersAnthropol 123 of Southern Africa, American Journal of Physical Anthropology

123 (2004), pp. 23-29.PHILLIPS, Cranial Anomaly S. R. Phillips, Cranial Anomaly, Pathology, or Normal Variant?

Thin Parietal Bones in Ancient Egyptian Human Remains, PhD Dissertation, University of Pennsylvania 2007.

PINDBORG, Pathology J.J. Pindborg, Pathology of the Dental Hard Tissues, Munksgaard, Copenhagen 1970.

PROWSE, LOVELL, Am J Phys T.L. Prowse, N.C. Lovell, Concordance of cranial and dental Anthropol 101 morphological traits and evidence for endogamy in ancient Egypt,

American Journal of Physical Anthropology 101 (1996), pp. 237-246.

PUTNAM, SEITZ, Fractures of the M.D. Putnam, W.H. Seitz, Jr., Fractures of the distal radius, distal radius Rockwood and Green’s Fractures in Adults, 5th edition, Vol. 1,

R.W. Bucholz, J.D. Heckman (eds.), Philadelphia: Lippincott Williams and Wilkins 2001, pp. 815-867.

RAXTER et al., Am J Phys Anthropol 136 M.H. Raxter, C.B. Ruff, A. Azab, M. Erfan, M. Soliman, A. El-Sawaf, Stature estimation in ancient Egyptians: a new technique based on the anatomical reconstruction of stature, American Jour-nal of Physical Anthropology 136 (2008), pp. 147-155.

RESNICK, NIWAYAMA, Diagnosis D. Resnick, G. Niwayama (eds.), Diagnosis of Bone and Joint Disorders, 2nd ed., Philadelphia: W.B. Saunders 1988.

ROBERTS, MANCHESTER, Archaeology C. Roberts, K. Manchester, The Archaeology of Disease, 2nd ed.,of Disease Sutton Publishing Ltd. 1995.ROBINS, Shutt, Hum Evol 1 G. Robins, C.C.D. Shutt, Predynastic Egyptian stature and physi-

cal proportions, Human Evolution 1 (4) (1986), pp. 313-324.ROSE, Mem Inst Oswaldo Cruz 101 J.C. Rose, Paleopathology of the commoners at Tell Amarna,

Egypt, Akhenaten’s capital city, Memórias do Instituto Oswaldo Cruz (Rio de Janeiro), Vol. 101(Suppl. II) (2006), pp. 73-76.

ROSENBERG, Bones A.E. Rosenberg, Bones, joints, and soft tissue tumors, Rob-bins and Cotran Pathologic Basis of Disease, 7th ed., V. Kumar, A.K. Abbas, N. Fausto (eds.), Elsevier Saunders 2005, pp. 1273-1324.

ROTHSCHILD et al., Paleobios 13 B.M. Rothschild, F.J. Rühli, J. Sebes, V. Naples, M. Billard, Re-lationship between porotic hyperostosis and cribra orbitalia?, Pa-leobios 13 (2004).

RYAN, FUNSTON, J Bone Joint Surg C.A. Ryan, R.V. Funston, Osteomyelitis of ilium (probably Am 12 tuberculous): case report, Journal of Bone and Joint Surgery

(American Volume) 12 (1930), pp. 165-167.SALES et al., Braz Dent J 18 M.A. Sales, J.X. Oliveira, M.G. Cavalcanti, Computed tomogra-

phy imaging fi ndings of simultaneous bifi d mandibular condyle and temporomandibular joint ankylosis: case report, Brazilian Dental Journal 18 (2007), pp. 74-77.

SALVADEI et al., Am J Hum Biol 13 L.Salvadei, F.Ricci, G. Manzi, Porotic hyperostosis as a marker of health and nutritional conditions during childhood: studies at the transition between Imperial Rome and the Early Middle Ages, American Journal of Human Biology 13 (2001), pp. 709-717.

SAMUEL, Brewing and baking D. Samuel, Brewing and baking, Ancient Egyptian Materials and Technology, P.T. Nicholson, I. Shaw (eds.), Cambridge: Cam-bridge University Press 2000, pp. 537-574.

SARRY EL DIN, EL BANNA, Int J M.A. Sarry El Din, A.R. El Banna, Congenital anomalies of theOsteoarchaeol 16 vertebral column: a case study on ancient and modern Egypt,

International Journal of Osteoarchaeology 16 (2006), pp. 200-207.

419

SAUNDERS, Subadult skeletons S.R. Saunders, Subadult skeletons and growth related studies, Bi-ological Anthropology of the Human Skeleton, M.A Katzenberg, S.R. Saunders (eds.), New York: Wiley 2000, pp. 135-162.

SAUNDERS, HOPPA, Yrbook Phys S.R. Saunders, R.D. Hoppa, Growth defi cit in survivors and Anthropol 36 non-survivors: biological mortality bias in subadult skeletal sam-

ples, Yearbook of Physical Anthropology 36 (1993), pp. 127-151.SCHEUER, BLACK, Juvenile Osteology L. Scheuer, S. Black, Developmental Juvenile Osteology, Lon-

don: Academic Press 2000.SCHULTZ, Paläopathologische Diagnostik M. Schultz, Paläopathologische Diagnostik, Anthropologie Hand-

buch der vergleichenden Biologie des Menschen, R. Knußmann (ed.), Stuttgart: Gustav Fischer Verlag 1988, pp. 480-496.

SCHWARTZ, Skeleton Keys J.H. Schwartz, Skeleton Keys: An Introduction to Human Skeletal Morphology, Development and Analysis, Oxford: Oxford Univer-sity Press 1995.

SCOTT, Am J Phys Anthropol 51 E.C. Scott, Dental wear scoring technique, American Journal of Physical Anthropology 51 (1979), pp. 213-218.

SCOTT, WINN, Int J Osteoarcheol 21 G.R. Scott, J.R. Winn, Dental chipping: contrasting patterns of microtrauma in Inuit and European populations, International Journal of Osteoarchaeology 21 (6) (2010), pp. 723-731.

SHAABAN, Ossa 9-11 M.M. Shaaban, Trephination in ancient Egypt and the report of a new case from Dakleh Oasis, Ossa 9-11 (1984), pp. 135-142.

SHAPIRO et al., J Bone Joint Surg 61A F. Shapiro, S. Sheldon, M.J. Glimcher, Hereditary multiple ex-ostoses: anthropometric, roentgenographic, and clinical aspects, Journal of Bone and Joint Surgery 61A (6) (1979), pp. 815-824.

SHAW, NICHOLSON, Dictionary I. Shaw, P. Nicholson, The Dictionary of Ancient Egypt, New York: Harry N. Abrams Inc. 2003.

SINGHAL, RAO, Anat Sci Int 82 S. Singhal, V. Rao, Supratrochlear foramen of the humerus, Ana-tomical Science International 82 (2007), pp. 105-107.

SMILLIE, Osteochondritis Dissecans I.S. Smillie, Osteochondritis Dissecans. Loose Bodies in Joints; Etiology, Pathology, Treatment, Edinburgh and London: Living-stone Ltd. 1960.

SMITH, Am J Phys Anthropol 63 B.H. Smith, Patterns of molar wear in hunter-gatherers and agri-culturalists, American Journal of Physical Anthropology 63 (1) (1984), 39-56.

SMITH, Standards of human tooth B.H. Smith, Standards of human tooth formation and dental age assessment, Advances in Dental Anthropology, M.A. Kelly, C.S. Larsen (eds.), New York: Wiley-Liss, 1991, pp. 143-168.

STANDAERT, HERRING, Br J Sports C. Standaert, S. Herring, Spondylolysis: a critical review, BritishMed 34 Journal of Sports Medicine 34 (2000), pp. 415-422.STARLING, STOCK, Am J Phys A. Starling, J.T. Stock, Dental indicators of heath and stress inAnthropol 134 early Egyptian agriculturalists: Diffi cult transition and gradual

recovery, American Journal of Physical Anthropology 134 (4) (2007), pp. 520-528.

STEINBACH, OBATA, Am J Roentgenol 78 H.L. Steinbach, W.G. Obata, The signifi cance of thinning of the parietal bones, American Journal of Roentgenology 78 (1957), pp. 39-45.

STROUHAL, Ancient Egyptians E. Strouhal, Life of the Ancient Egyptians, Cairo: American Uni-versity in Cairo Press, 1992.

STROUHAL, BAREŠ, Secondary Cemetery E. Strouhal, L. Bareš, Secondary Cemetery in the Mastaba of Ptahshepses at Abusir, Prague 1993.

STROUHAL et al., Int J Osteoarcheol 13 E. Strouhal, A. Němečková, A. Kouba, Paleopathology of Iufaa and other persons found beside his shaft tomb at Abusir (Egypt), International Journal of Osteoarcheology 13 (2003), pp. 331-338.

STUART-MACADAM, Am J Phys P. Stuart-Macadam, Porotic hyperostosis: relationship betweenAnthropol 80 orbital and vault lesions, American Journal of Physical Anthro-

pology 80 (1989), pp. 187-193.TAGUE, Am J Phys Anthropol 145 R.G. Tague, Fusion of coccyx to sacrum in humans: preva-

lence, correlates, and effect on pelvic size, with obstetrical and

420

evolutionary implications, American Journal of Physical Anthro-pology 145 (2011), pp. 426-437.

TAYLOR, Death and the Afterlife J.H. Taylor, Death and the Afterlife in Ancient Egypt, London: The British Museum Press 2001.

TRIKHA et al., Acta Orthop Belg 71 V. Trikha, M.K. Varshney, S. Rastogi, Tuberculosis of the ilium: is it really so rare, Acta Orthopaedica Belgica 71(3) (2005), pp. 366-8.

TROTTER, GLESER, Am J Phys M. Trotter, G.C. Gleser, A re-evaluation of estimation of statureAnthropol 16 based on measurements of stature taken during life and of long

bones after death, American Journal of Physical Anthropology 16 (1958), pp. 79-123.

TURKEL, Congenital abnormalities S.J. Turkel, Congenital abnormalities in skeletal populations, Re-construction of Life from the Skeleton, M.Y. İşkan, K.A.R. Ken-nedy (eds.), New York: Wiley-Liss 1989, 109-127.

TURNER, ANDERSON, Int J G. Turner, T. Anderson, Marked occupational dental abrasion Osteoarchaeol 13 from medieval Kent, International Journal of Osteoarchaeology

13 (2003), pp. 168-172.TURNER, CADIEN, Am J Phys C.G. Turner II, J.D. Cadien, Dental chipping in Aleuts, Eskimos Anthropol 31 and Indians, American Journal of Physical Anthropology 31

(1969), pp. 303-310.UBELAKER, Human Skeletal Remains D.H. Ubelaker, Human Skeletal Remains: Excavation, Analysis,

Interpretation, 2nd edition, Washington: Taraxacum 1989. UBELAKER, Taphonomic applications D.H. Ubelaker, Taphonomic applications in forensic anthropol-

ogy, Forensic Taphonomy: The Postmortem Fate of Human Re-mains, W.D. Haglund, M.H. Sorg (eds.), Boca Raton: CRC Press 1997, pp. 77-90.

UBELAKER, Approaches to the study D.H. Ubelaker, Approaches to the study of commingling in of commingling human skeletal biology, Advances in Forensic Taphonomy:

Method, Theory, and Archaeological Perspective, W.D. Haglund, M.H. Sorg (eds.), CRC Press 2002, pp. 332-353.

UBELAKER, Paleodemography D.H. Ubelaker, Paleodemography, Encyclopedia of Archaeology, D.M. Pearsall (ed.), New York: Academic Press 2008, pp. 1767-1777.

UCHIDA et al., Eur Respir J 10 K. Uchida, Y. Kurihara, S. Sekiguchi, Y. Doi, K. Matsuda, M. Mi-yanaga, Y. Ikeda, Spontaneous haemothorax caused by costal ex-ostosis, European Respiratory Journal 10 (1997), pp. 735-736.

VAGN NIELSEN, Human Remains O. Vagn Nielsen, Human Remains: Metrical and Non-metrical Anatomical Variation, Copenhagen: Scandinavian University Book, 1970, pp. 26-34.

WALDRON, Palaeopathology T. Waldron, Palaeopathology, Cambridge: Cambridge University Press 2009.

WALDRON, ANTOINE, Int J T. Waldron, D. Antoine, Tortuosity or aneurysm? The palaeo-Osteoarchaeol 12 pathology of some abnormalities of the vertebral artery, Interna-

tional Journal of Osteoarchaeology 12 (2002), pp. 79-88.WALKER, Am J Phys Anthropol 69 P.L. Walker, Porotic hyperostosis in a marine-dependent Califor-

nia Indian population, American Journal of Physical Anthropol-ogy 69 (1986), pp. 345-354.

WALKER et al., Am J Phys Anthropol 139 P.L. Walker, R.R. Bathurst, R. Richman, T. Gjerdrum, V.A. An-drushko, The causes of porotic hyperostosis and cribra orbitalia: a reappraisal of the iron-defi ciency-anemia hypothesis, American Journal of Physical Anthropology 139 (2009), pp. 109-125.

WALKER, Skeletal remains R. Walker, Skeletal remains, The Tomb of Iurudef: A Memphite Offi cial in the Reign of Ramesses II, M.J. Raven (ed.), Leiden: National Museum of Antiquities & London: Egypt Exploration Society 1991, pp. 55-76.

WHITE, Am Antiquity 18 T.E. White, A method for calculating the dietary percentages of various food animals utilized by aboriginal peoples, American Antiquity 18 (1953), pp. 396-398.

421

WYNNE-DAVIES, GORMLEY, J Bone R. Wynne-Davies, J. Gormley, The prevalence of skeletal Joint Surg Br 67B dysplasias. An estimate of their minimum frequency and the num-

ber of patients requiring orthopaedic care, Journal of Bone and Joint Surgery British 67B (1) (1985), pp. 133-137.

ZAKI et al., Int J Osteoarchaeol 19 M.E. Zaki, F.H. Hussien, R.A. El-Shafy El Banna, Osteoporosis among ancient Egyptians, International Journal of Osteoarchae-ology 19 (2009), pp. 78-89.

ZAKI et al., Fracture patterns M. Zaki, A. Sarry El-Din, W. Basha, M. Soliman, Fracture pat-terns in ancient Egyptian populations from Old Kingdom and Greco-Roman periods, Conference on Materiality, Memory and Cultural Heritage, Istanbul 2011 (abstract).

ZAKRZEWSKI, Am J Phys Anthropol 121 S.R. Zakrzewski, Variation in ancient Egyptian stature and body proportions, American Journal of Physical Anthropology 121 (2003), pp. 219-229.

ZHONG et al., Oral Surg Oral Med S.C. Zhong, Z.J. Xu, Z.G. Zhang, Y.H. Zheng, T.X. Li, K. Su,Oral Pathol Oral Radiol Endod 107 Bilateral coronoid hyperplasia (Jacob disease on right and elonga-

tion on left): report of a case and literature review, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontol-ogy 107 (3) (2009), pp. 64-67.

ZIMMERMAN, Bull N Y Acad Med 55 M.R. Zimmerman, Pulmonary and osseous tuberculosis in an Egyptian mummy, Bulletin of the New York Academy of Medicine 55 (6) (1979), pp. 604-608.

ZINK et al., J Clin Microbiol 50 A. Zink, C. J. Hass, U. Reischl, U. Sheimies, A.G. Nerlich, Molec-ular analysis of skeletal tuberculosis in an ancient Egyptian popu-lation, Journal of Clinical Microbiology 50 (2001), pp. 355-366.

ZISKIND, HALIOUA, Rev Mal Respir 24 B. Ziskind, B. Halioua, La tuberculose en ancienne Égypte, Revue des Maladies Respiratoires 24 (10) (2007), pp. 1277-1283.

553

Fig. 126-148: Anthropology126. A wrapped body in Burial 493.127. Fragments of shrouding in Burial 511.128. Pleated linen fabric used as shrouding in disturbed Burial 475.129. Shrouding sheets with evidence of wear, Burial 555.130. Burial 551. Human remains commingled with the remains of a plaster mask.131. Male and female age distribution in the Old Kingdom inhumations from Saqqara.132. Evidence of trepanning in the left parietal bone of a middle-aged male from Burial

175.133-4. Bifurcated rib recorded in a young female from Burial 475 (left) and posterior

hiatus (partial spina bifi da occulta) in the lower sacrum of a 30-35 years old male from Burial 473 (right).

135-7. Osteochondritis dissecans in the knee joint of a male (aged 30–35 years) from Burial 540 (left); button osteoma of the right parietal bone in an elderly female from Burial 473 (centre); metastatic carcinoma of the right parietal bone in an elderly female from Burial 554 (right).

138. Severe kyphotic angulation of the thoraco-lumbar spine associated with tuberculosis in an elderly male from Burial 510; also note marginal osteophyte formations.

139-141. Colles’ fracture to the right distal radius in an elderly female from Burial 540 (left); crush fracture to a lower thoracic vertebra in a male (aged 35–45 years) from Burial 541 (centre); compression fracture to a lower thoracic vertebra in an elderly male from Burial 558 (right); note marginal lipping on the vertebral bodies (right).

142. Biparietal thinning in the cranial vault of an elderly female from Burial 511.143. Stress fracture in the fi fth lumbar vertebra (spondylolysis) in a male (aged 30–40

years) from Burial 528.144. Lesions of cribra orbitalia in the orbital roofs of a four–year–old child from Burial

556.145-6. Poor dental health in elderly (aged 50+ years) females from Burial 509 (left) and

Burial 511 (right).147-8. Enamel chipping on the incisal edges of the upper anterior teeth (left) and a notch

lesion on the lower lateral incisor (right) of a male (aged 18 years) from Burial 555; also note multiple linear enamel hypoplasia defects on the upper and lower teeth.

LIST OF FIGURES

PL. CLXII

a. Burial 65 in situ. Female aged 20-25 years;

Plates 162-191: Anthropology

d. Skull – superior view; e. Burial 100 in situ. Male aged 30-35 years;

f-g. Burial 175. Male aged 30-40 years; f. Skull – frontal view;

g. Skull – left lateral view; note a possible trepanation le-sion in the parietal eminence.

b-d. Burial 67. Female aged30-35 years; b. Skull – frontal view;

c. Skull – right lateral view;

PL. CLXIII

a. Skull – left lateral view;

a-g. Burial 449. Male aged 30-35 years

b. Skull – frontal view; c. Skull – right lateral view;

d. Skull – superior view; e. Skull – posterior view;

f. Skull – inferior view; g. Mandible – superior view.

PL. CLXIV

a. Skull – right lateral view;

a-g. Burial 453. Male aged 40-45 years

b. Skull – posterior view;

c. Maxillary dentition – inferior view; d. Mandible – superior view; e. Lumbar vertebrae;

f. 1st lumbar vertebra; note crush fracture; g. Sacralisation of 5th lumbar resulting in anterior height reduction vertebra.

PL. CLXV

a-c. Burial 453. Male aged 40-45 years; a. Right humerus; note stress markers on the antero-medial surface of the bone;

b. Left tibia; note new bone ap-position on the medial aspect of the distal bone;

c. Left tibia; note hairline fracture on the inferior surface of the distal bone;

d-g. Burial 473. Male aged 25-35 years; d. Commingled skeletal remains in-situ;

e. Skull – frontal view;

f. Skull – right lateral view; g. Skull – left lateral view.

PL. CLXVI

a. Skull – superior view;

a-g. Burial 473. Male aged 30-35 years

b. Skull – posterior view; c. Skull – inferior view;

d. Button osteoma on the right parietal bone;

e. Partial spina bifi da in the sacrum;

f. Cervical vertebrae – inferior view; note degenerative changes; g. Slight lipping on the right dis-tal femur; antero-medial view.

PL. CLXVII

a. Skull – frontal view;

a-h. Burial 475. Female aged 20-25 years

b. Skull – left lateral view; c. Skull – left lateral view;

d. Skull – posterior view; e. Skull – inferior view; f. Mandible – superior view;

g. Septal aperture in distal humeri – anterior view; h. Oval exostoses in the right pelvic bone (posterior to the auricular surface.

PL. CLXVIII

a. Burial 476. Male aged 40-45 years; note soft tissue preserved in the lower legs; b-g. Burial 489. Female aged 40-45 years; b. Skull – frontal view;

c. Skull – left lateral view; d. Skull – posterior view; e. Skull – inferior view;

f. Left mandibular quadrant; note root exposure and periosteal new bone for-mation (osteomyelitis);

g. Mandible – superior view.

PL. CLXIX

a. Skull – right lateral view;

a-h. Burial 493. Male, aged 25-35 years, with acromegaly;

b. Skull – left lateral view;

c. Occipital bone; note lesions of porotic hy-perostosis;

d. Occipital bone; note thickening of diploe; e. Right maxilla; note periapical ab-scesses at the roots of the 1st molar;

f. Maxillary dentition; inferior view; g. Elongated mandible with pro-nounced chin; anterior view;

h. Mandibular dentition; note left supernu-merary distomolar.

PL. CLXX

a. Angulation deformity of the hu-meri – anterior view; note shortness of the left humerus;

a-h. Burial 493. Male, aged 25-35 years, with acromegaly

b. Excessive periosteal bone forma-tion on the tibiae – posterior view;

c. Thoraco-lumbar scoliosis;

d. Left distal radius; note lesion of osteochon-dritis dissecans;

e. Left distal femur; note lesion of os-teochondritis dissecans;

f. Terminal digit tufting in the fi rst foot pha-langes;

g. Cervical vertebrae – superior view; note degenerative changes; h. Thoracic vertebrae – superior view; note exten-sive subperiosteal build-up.

PL. CLXXI

a. Skull – frontal view;

a-h. Burial 509. Female aged 50+ years

b. Skull – left lateral view; c. Skull – superior view;

d. Skull – inferior view; e. Partial fusion of the 5th lumbar vertebra with the sacrum due to ankylosing spon-dylitis;

f. Cervical vertebrae – inferior view; note de-generative changes;

g. Mandibular dentition – superior view; h. Lesion of osteochondritis dissecans on the right pa-tella.

PL. CLXXII

a. Skull – left lateral view;

a-h. Burial 510. Male aged 50+ years

b. Skull – frontal view; c. Skull – right lateral view;

d. Skull – posterior view; e. Skull –inferior view; f. Mandibular dentition;

g. Lipping and eburnation on the articular surfaces of the left radioscaphoid joint;

h. Lipping and eburnation on the articular surfaces of the 1st metatarsophalangeal joint.

PL. CLXXIII

a. Severe kyphotic angulation of the thora-co-lumbar spine due to tuberculosis; right lateral view;

a-h. Burial 510. Male, aged 50+ years, with spinal tuberculosis

b. Pelvic bones – postero-lateral view; note degenerative changes;

c. Right sacroiliac fusion due to ankylosing spondylitis;

d. Sacral-coccygeal fusion; e. Left talus – superior view; note degenera-tive changes;

f. Right humerus – anterior view; note degenerative changes;

g. Right ulna – anterior view; note well healed ‘parry’ fracture.

PL. CLXXIV

a. Skull – left lateral view;

a-h. Burial 511. Female aged 50+ years

b. Skull – frontal view; c. Skull – right lateral view;

d. Skull – superior view; note bilateral parietal thinning;

e. Skull – inferior view; f. Fistula in the fl oor of the right maxil-lary sinus;

g. Mandibular dentition; h. Lower rib; note two healed fractures.

PL. CLXXV

a-d. Burial 511. Female aged 50+ years; a. T11 vertebrae – inferior view; note crush fracture;

b. Vertebral column (T10-L5); note height reduction in T10-12;

c. Glenoid fossae of the scapulae; note degenerative changes;

d. Degenerative changes on the lumbar vertebrae – inferior view;

e-f. Burial 521. Unsexed adult individual; e-f. Right maxillary dentition – inferior and anterior views.

PL. CLXXVI

a. Skull – left lateral view;

a-h. Burial 528. Male aged 30-40 years

b. Skull – frontal view; c. Skull – right lateral view;

d. Skull – superior view; e. Skull – posterior view; f. Skull – inferior view;

g. Mandibular dentition; h. Left proximal fi bula; note healed fracture.

PL. CLXXVII

a. Skull – left lateral view;

a-h. Burial 538. Female aged 50+ years

b. Skull – frontal view; c. Skull – right lateral view;

d. Skull – superior view; e. Skull – posterior view; f. Skull – inferior view;

g. Mandibular dentition; note bilateral bifi dity of the con-dylar head;

h. Mandible – right lateral view.

PL. CLXXVIII

a. Left mandibular fossa; note de-generative changes;

a-h. Burial 538. Female, aged 50+ years, with hereditary multiple exostosis (osteochondromatosis)

b. Right ulna; note atrophic none-union;

c. Distal femora – posterior view; note lesions of osteochondritis disse-cans on the lateral condyles;

d. Femora – anterior view; note exostoses on the medial aspects of the distal bones;

e-f. Right tibia and fi bula; note exostosis on the medial aspect of the proximal tibia and fusion of the distal tibia and fi bula.

PL. CLXXIX

a. Skull – left lateral view;

a-h. Burial 539. Female aged 50+ years

b. Skull – frontal view; c. Skull – right lateral view;

d. Skull – superior view; e. Skull – posterior view; f. Skull – inferior view;

g. Mandibular dentition; h. Spondylolysis defect in the four lumbar vertebra (inferior view); note degenerative changes.

PL. CLXXX

a. Skull – left lateral view;

a-h. Burial 540. Female aged 50+ years

b. Skull – frontal view; c. Skull – right lateral view;

d. Skull – superior view; e. Skull – posterior view; f. Skull – inferior view;

g. Mandibular dentition; h. Right 5th metatarsal; note spiral fracture with overlapped fragments.

PL. CLXXXI

a-c. Burial 540. Female aged 50+ years; a. Lumbar vertebrae; note degen-erative changes;

b. Partial spina bifi da of the lower sacrum – posterior view;

c. Patellae; note lipping and lesion of osteochondri-tis dissecans in the left bone;

d-h. Burial 541. Male aged 35-45 years; d. Skull – left lateral view;

e. Skull – frontal view; f. Skull – right lateral view;

g. Skull – superior view; h. Skull – posterior view.

PL. CLXXXII

a. Skull – inferior view;

a-h. Burial 541. Male aged 35-45 years

b. Mandibular dentition; note carious lesion in the occlusal surface of the left 3rd molar;

c. Left distal ulna and radius; note pos-terior angulation of the radius due to traumatic injury;

d. Right 2nd metacarpal; note spiral fracture and lipping of the articular facets;

e. Proximal left hand phalanx with head bifi d-ity;

f. Cervical vertebrae; note degenera-tive changes;

g. Crush fracture to the 3rd lumbar verte-bra;

h. Partial spina bifi da in the upper sacrum – pos-terior view.

PL. CLXXXIII

a-b. Burial 542. Male aged 30-35 years; a. Left side of the mandible;

b. Degenerative changes on the articular facets of the 3rd (superior view) and 2nd (inferior view) thoracic vertebrae;

c-h. Burial 552. Female aged 25-30 years; c. Skull – frontal view;

e. Skull – superior view;

f. Skull – posterior view; note lesions of porotic hy-perostosis;

g. Skull – inferior view; h. Mandibular dentition; note a carious lesion in the occlusal surface of the left 2nd molar.

d. Skull – right lateral view;

PL. CLXXXIV

a. Skull – left lateral view; note parietal thinning;

a-h. Burial 554. Female aged 50+ years

b. Skull – frontal view; c. Skull – right lateral view; note osteolytic le-sions of metastatic carcinoma;

d. Skull – superior view; note unilateral pa-rietal thinning and lesions of metastatic car-cinoma;

e. Skull – inferior view; f. Mandibular dentition;

g. Proximal tibiae; note degenerative changes of the condyles; h. Left talus; note lesion of ostechon-dritis dissecans.

PL. CLXXXV

a. Skull – left lateral view;

a-h. Burial 555. Male aged approx. 18 years

b. Skull – frontal view; c. Skull – right lateral view;

d. Skull – superior view; e. Skull – posterior view; f. Skull – inferior view;

g. Mandible; note linear enamel hypoplasia de-fects on lateral incisors and canines;

h. Humeri; note symmetrical cortical defects on the me-dial aspect of the surgical neck.

PL. CLXXXVI

a. Skull – left lateral view;

a-h. Burial 557. Male aged 40-50 years

b. Skull – frontal view; c. Skull – right lateral view;

d. Skull – superior view; note persistent metopic suture;

e. Skull – posterior view; f. Skull – inferior view;

g. Mandibular dentition; h. Lower thoracic vertebrae – inferior view; note Schmorl’s nodes.

PL. CLXXXVII

a-c. Burial 557. Male aged 40-50 years; a. Evidence of traumatic injuries to the right distal radius and ulna;

b. Possible misalignment of the right hip joint; note destructive chang-es to the acetabular contour and degenerative changes;

c. Left distal femur; note plate-like soft tis-sue ossifi cation;

d-h. Burial 558. Male aged 50+ years; d. Endocranial surface of the right frontal bone; note hyperostosis frontalis interna and cribra orbitalia of the orbital roof;

e. Left maxillary dentition; f. Mandibular dentition;

g. Cervical vertebrae (3rd-7th) – superior view; note degenerative changes; h. Sacrum with six segments.

PL. CLXXXVIII

a-d. Burial 558. Male aged 50+ years; a. Callus bone formation at the fracture sites on fragmented ribs;

b. Distal femora – posterior view; note degenerative changes;

c. Left proximal tibia; note depressed fracture of the lateral plateau;

d. Right navicular; note marginal lipping; e-h. Burial 604. Male aged 30-40 years; e. Left 4th metatarsal; note spiral fracture;

f. Skull – left lateral view; g. Skull – frontal view; h. Skull – right lateral view.

PL. CLXXXIX

a-e. Burial 604. Male aged 30-40 years; a. Skull – superior view;

b. Skull – posterior view; c. Skull – inferior view;

d. Enamel chipping on the upper anterior teeth; e. Mandibular dentition;

f-h. Burial 610. A probable male aged 25-35 years; f. Left side facial bones; g. Occipital bone; note lesions of porotic

hyperostosis;

h. Left maxillary dentition.

PL. CXC

a. Mandibular dentition;

a-h. Burial 610. A probable male, aged 25-35 years, with multiple epiphyseal dysplasia

b. Scoliosis of the thoraco-lumbar spine;

c. Left-side ribs; note slightly deformed angle due to scoliosis;

d. Severe degeneration of the rib heads; e. Healed fractures to the ribs; f. Glenoid fossae of the scapulae; note degenerative changes;

g. Humeri showing abnormal shape and size;

h. Abnormal left humerus and normal-size radius and ulna.

PL. CXCI

a-c. Burial 610. A probable male, aged 25-35 years, with multiple epiphyseal dysplasia;

a. Left femur; note an abnormal posteromedial angulation of the distal di-aphysis – medial view;

b. Proximal tibiae – posterior view; note distal location of the medial con-dyles characteristic of bilateral genu varum condition;

c. Left metatarsal bones; note slim 2nd-5th diaphy-ses and fl ared proximal epiphyses, angulation and shortening of the 4th MT;

d-g. Burial 611. Male aged 20-25 years; d. Maxillary dentition;

e. Mandible; note (bilateral) coronoid hy-perplasia;

f. 2nd cervical vertebra –inferior view; note concave smooth-walled lesion, most likely vertebral artery an-eurysm;

g. Lower thoracic vertebrae – inferior view; note Schmorl’s nodes.