Archive for November, 2013

Following positive responses to an earlier blog about injuries in ancient Egypt and Nubia, and as a response to requests for more detailed information about head injuries,  I thought it would be useful to consider the range of Egyptian/Nubian sources we have for head injuries in ancient times.  
When one mentions head injuries in ancient Egypt almost always somebody raises the question: did Tutankhamun die from a head injury?  So I think it is important, straight away, to tackle this thorny question.  I am one of the few people in biological research who has actually seen the early X-rays of Tutankhamun’s skull – I can state quite categorically that there is no evidence whatsoever of his having received a head injury (either before or after death).  In a forthcoming article on the famous young king of Egypt I shall address this question again more fully and deal with other controversial issues surrounding the biological evidence emanating from the examination(s) of his body.
Throughout history cranial injury has been a universal event – people have inflicted injury upon one another sometimes in civilian or domestic disputes and more often during the course of warfare.  The people of ancient Egypt and Nubia were no exception to this fact and we have evidence of such injuries, from predynastic times right through to the Christian Medieval period (1).  Thus, the first aim of this article is to outline the range of sources informing us about the ancient Egyptian and Nubian experiences of head injuries (2).
Overall, injuries to the head are more likely to be intentionally inflicted than those to other parts of the body, although accidental falls, although perhaps rarer, cannot be disregarded.  Interestingly, regardless of the ancient culture concerned or the period in history under study, research has shown that universal patterns can be observed in head injuries  with regard to gender involvement, position of injury and types of weapons used. Thus, the second aim of this article is to demonstrate how ancient Egypt and Nubia fits into this universal model of cranial injury. For both aims of this article notes and further references are included, where relevant.
Sources: artistic and textual
We are very fortunate that ancient Egypt offers researchers a large selection of artistic and textual sources concerning aspects of their society and from these we can glean quite a lot about trauma to the skull.  Artistic sources clearly demonstrate the power of an actual cranial injury or the implied threat of inflicting one.  A familiar ancient Egyptian artistic motif is that of the king (later Pharaoh) standing legs astride, grasping enemies by the hair and holding a weapon threateningly over them.  Perhaps, the most familiar example of these ‘smiting’ images is that of the predynastic Narmer Palette – here, the king (Nar-Mer) grasps the locks of a bearded (ie. non-Egyptian) enemy with his left hand whilst holding a mace in his right hand; this iconographic stance is repeated throughout Egyptian history, probably as a symbol of power.  Whether or not the kings of ancient Egyptian actually engaged in physical combat is not the point here – clearly the possible after effects of an injury to the skull ( brain injury, disability or death) was understood by all parties involved and thus, the power of merely the threat of such an injury would have been enough to subdue most enemies of Egypt.  Further artistic evidence for head injuries is clearly demonstrated in the large number of battle scenes available for us to study (fig. 1); they also indicate the types of weapons available at particular periods of history. Thus, hand-to-hand battle scenes may show crushing, cutting or slicing injuries inflicted by maces, swords and knives whilst longer range combat scenes show bodies being pierced by arrows. 
Image figure 1
Ancient Egypt is a vast source of textual information and the medically related documents are most informative.  Perhaps the most useful text pertaining to cranial injury is that known as the Edwin Smith Papyrus (3). It is often termed the ‘Surgical’ papyrus as it describes the diagnoses and management of a variety of bodily injuries, many of which involve trauma to the head.  The papyrus was purchased by a wealthy American, Edwin Smith, after whom it is named and was translated by James Breasted in 1930 and a remarkably fine piece of work it is! The work is seemingly topographic in its design – in that it describes injuries to parts of the head and works its way down to the upper body.  The cases of injury described were possibly those witnessed, recorded and reported upon by a surgeon; each case describes an injury, suggests a prognosis and recommends treatment (or not, as the situation demands).  However, it breaks off (ie, the rest of the text is missing) in the middle of a medical case and we are left without knowing more!  The Edwin Smith Papyrus describes a range of injuries from broken noses and cuts, which are deemed treatable, to the more serious incidents involving severe gashes and exposure of the brain – which, unsurprisingly, the author deems as fatal, using the ominous phrase “An injury with which I will not contend”.
Sources: biological
The archaeological excavation of  human remains in Egypt and Nubia have brought to light quite a large number of head injuries and it is interesting to see how these compare with  the universal pattern of head injuries and with those depicted in artistic and textual sources, as alluded to above.
Researchers have noted that in most ancient cultures males sustained more head injuries than females, possibly because traditionally men were more involved in situations leading to trauma – heavy labouring jobs and, of course, war. This gender ratio is seen in Egyptian and Nubian biological remains. We see men engaged in manual work in many Egyptian tomb scenes; other scenes show men engaged in combat, often with unprotected heads.  In the universal sense, the majority of head injuries were inflicted to the left side of the head indicating a right-handed face-to-face assailant and possibly reflecting the Egyptian preference for right-handedness; some injuries affected the top part of the head suggesting an assault from above.  My personal research has found injuries to the back and right side of skulls but they seem to be in the minority.
Clearly, types of head injuries will reflect the type of weapon used. For example, the scene in figure 1 shows men engaged in hand-to-hand combat – thus any ensuing injuries will reflect this. Here we would expect slicing injuries, the severity of which would depend upon the strength of the metal from which the weapons were made. As this scene is from the Old Kingdom period the weapons were likely to be made of copper or bronze – which, although capable of inflicting serious injury, are softer metals than the iron used in later periods.
In a large group of Nubian skulls I studied, the injuries were mostly depressions – some round, some ovoid, others longitudinal.  The injuries on these skulls, which were from Kerma and dated to the Middle Kingdom period, clearly reflected the types of weapons and tools available to that society at that particular period: mallets, throwsticks and maces.  The extent of such depressed injuries can be seen in the X-ray in figure 2.
Image figure 2
By contrast, a large group of Egyptian skulls (from Giza) which I studied  were from a much later period (600 – 300 BC) and so showed far more serious injuries: gashes, blows and deep penetrating wounds; by this period of their history the ancient Egyptians had developed iron technology resulting in some heavy duty weapons – axes, swords and knives – capable of causing quite massive injuries (fig. 3). The head injury seen in figure 3 is a deep, penetrating gash probably made by an axe, however, despite its severity, the wound has healed well.
Image figure 3
Ancient Egypt and Nubia offers a large range of sources for the head injuries experienced during their history – textual, artistic and biological but clearly only a small sample can be included here.  Few ancient societies can offer such a comprehensive range of materials for us to study in order to try and comprehend human behaviour in the ancient world and compare it with that of the modern world!  It is quite clear that the ancient Egyptians and Nubians experienced head injuries in a similar manner to other ancient cultures.
Further reading:
(1) Readers may be interested in looking at  G. Elliot Smith and F. Wood Jones (1910), The Archaeological Survey of Nubia. Report for 1907-08, Volume II: Report on the Human Remains. Cairo: 1910 – although this is an ‘elderly’ work it is an excellent example of the study of burials from these periods of Egyptian history; often quite ‘dramatic’ head injuries are noted for some bodies examined during this survey.
(2) See further: Joyce M. Filer, ‘Ancient Egypt and Nubia as a source of information for violent cranial injuries’  in J. Carman (ed) Material Harm: Archaeological Studies of War and Violence, Cruithne Press: 1997, p.
(3) Edwin Smith (Surgical) Papyrus (2 vols). Published in facsimile and hieroglyphic transliteration (with translation and commentary). Chicago, Illinois: University of Chicago Press: 1930

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