International Journal of Osteoarchaeology
Int. J. Osteoarchaeol. 19: 443–446 (2009)
Book Reviews
AN APPRAISAL OF THE SKULLS AND DENTITION OF ANCIENT EGYPTIANS, HIGHLIGHTING
THE PATHOLOGY AND SPECULATING ON THE
INFLUENCE OF DIET AND ENVIRONMENT
J. Miller. BAR International Series 1794 Archaeopress, Oxford, UK 2008; 143 pp ISBN 13: 978 1
407302829. £29.00
This publication developed from a doctoral thesis
by Judith Miller, a dental surgeon, who examined
the crania and dentition of ancient Egyptians for
diet related effects over a 5000-year period. The
sample of Egyptian skulls was selected from two
robust collections: the Duckworth Osteological
Collection, housed in the School of Biological
Anthropology in Cambridge, and the British
Museum (Natural History). Specimens were
grouped by dynastic period to identify significant
differences in pathology over time: Predynastic
(5000–3100 BC), Archaic (3100–2686 BC), Old
Kingdom (2686–2613 BC), Middle Kingdom
(1991–1786 BC), New Kingdom (1567–1085
BC), Late (664–332 BC) and Ptolemaic GrecoRoman (332 BC-AD 400). The sample provided a
good representation of geographic variation as it
included specimens from at least 13 sites along
the Nile, with more than one site for each time
period (except for the Late Period). Dietary changes
known to occur were related to the subsistence
transition from Neolithic hunting and gathering to
increased reliance on agriculture and pastoralism.
In addition to these dietary shifts, Miller considered the effects from intermittent drought and
flooding on ancient Egyptian diet and health.
The author expands on her dissertation with an
interesting review of Egyptian medical papyri
(pg. 15) that describe and prescribe treatments for
various ailments. She traces the evolution that
Copyright # 2009 John Wiley & Sons, Ltd.
occurred from ‘‘magician to physician’’ (pg. 15), as
Egyptian medical practice developed from the use
of incantations directed at malevolent spirits to
therapeutic praxis. Chapter one includes a list of
common dental terms (pg. 16) with their meanings translated in English. The medicinal qualities
of various remedies are explained (pg. 19), such as
the addition of honey to ancient oral treatments
and the antibacterial properties of honey recognized today. The chapter also presents several
cases from the papyri (pgs. 17–18) that describe
the examination, diagnosis and treatment of a
patient. I was particularly interested in the
treatment for toothache in pregnant women
(pg. 17), which Miller explains may have
included ground willow (the precursor of aspirin).
The geography, climate and diet of ancient
Egypt, and associated medical conditions are summarized concisely in chapter two. This section is
central to understanding the dietary changes over
the millennia, as well as the cultural changes that
contributed to the severity of disease occurrence
in the dynastic populations. Miller discusses the
diets of populations from sites throughout the
Nile Valley, which were reconstructed through
the excavation of tomb contents. She explains the
primacy of the six hundred mile long Nile River
and its effect on ancient Egyptian life. The
Paleolithic predynastic inhabitants consumed a
protein-rich diet of wild game and grains that
grew abundantly in the region. Miller explains
that during dynastic times, populations increased
and there was a shift to agriculture and
pastoralism. This transition has been associated
with the region’s fertile soil, which allowed
greater reliance on cereal grains (i.e., barley,
emmer wheat), vegetables (i.e., lentils, beans,
cucumbers, leeks, garlic), fruits (i.e., dates, figs,
grapes, pomegranates), and the domestication of
444
herd animals (cattle, sheep, goats and pigs).
Although ancient Egyptians consumed a varied
and nutritious diet, the sporadic ebb and flow of
the Nile brought episodes of malnutrition and
famine (pg. 27). Moreover, meat was reserved for
the wealthy during dynastic times, so protein
intake was reduced and bread became a dietary
staple (pg. 23). Thus a majority of the region’s
inhabitants consumed a diet of sticky fruits and
highly glutinous breads, that were interspersed
with coarse grains of sand. The effects of this diet
along with periodic food shortages left signs of
malnutrition, scurvy, dental wear, and a range of
dental pathologies. The results of her assessment
lead Miller to propose that the severity of dental
disease was greater than would be expected, given
what is known of the living conditions in ancient
Egypt.
In chapter three, Miller examines the evidence
for the role of dentists and dental treatment in
ancient Egypt. It is interesting that the medical
papyri identify only six ‘dentists’, whom Miller
lists with brief biographies. Due to the extensive
dental pathology recorded, Miller speculates
whether these individuals were, in fact, dental
health practitioners or, if the role of dentist in
ancient Egypt was limited to casting spells to drive
out ‘‘tooth worms’’, since caries were thought to be
caused by demons in the form of worms (pgs. 28–
29). In this chapter, Miller reviews the limited
evidence for dental treatment, such as bridgework
or tooth extraction for which no instruments
have ever been identified (pgs. 29–30). Miller’s
experience as a dental surgeon lends support to
her assertion that the evident lack of treatment
and the limited number of dentists named in
medical papyri indicates that no specified medical
intervention took place until the Greco-Roman
period. Miller discusses one therapeutic treatment found in the papyri, that for a dislocated
mandible (pg. 31). She explains that the
procedure described is the only one possible
and is still in use today. She also suggests that this
might have occurred frequently, as a result of agerelated wear and osteoarthritis of the temporomandibular condyle (pg. 69).
Chapter four contains a summary of previous
examinations of dentition in ancient Egyptian
skeletal and mummified remains, as well as a brief
description of the mummification process (pg.
Copyright # 2009 John Wiley & Sons, Ltd.
Book Reviews
37). The section includes a chart that identifies
male-female cranial differences (pg. 33). However, a problem that Miller addresses is the use of
unempirical terms, such as ‘‘large’’ and ‘‘small’’ as
too subjective. There is a detailed synopsis of agerelated changes to dentition and the author is
careful to distinguish between dental attrition and
abrasion, the former resulting from occlusal
contact and the latter considered pathological
due to friction from a foreign body (pg. 39–40).
The next three chapters cover materials and
methods (chapter five), results (chapter six) and
discussion (chapter seven). Miller reviews the
source of sample material in chapter five, with a
total of 524 specimens examined and each time
period represented by 60þ skulls (pgs. 44–45).
Age at death for the sample ranged from infant to
over 40 years, with 60% between 20 and 40 years.
Miller reassessed all adult skulls previously assigned
sex through condylar measurement (based on
sexual dimorphism), and identified 265 male and
211 female skulls (pg. 60). The ‘‘gender identification’’ table that she provides (pg. 71) is an
improvement on the previous studies’, although I
would have preferred the use of the term ‘‘sex’’ for
biological determination, reserving ‘‘gender’’ for
cultural domains. Analyses included statistical
and lab tests, as well as checks for inter- and intraobserver reliability. Due to study constraints, no
radiography was performed on the sample. In the
beginning of chapter seven, Miller outlines a brief
history and provenance for each period (pgs. 55–
56). Her comprehensive discussion of caries,
antemortem tooth loss and periodontal breakdown was particularly informative (pgs. 63–64). I
was surprised to learn that no known oral hygiene
was practiced among ancient Egyptians, given
their many other achievements.
Miller concludes in chapter eight by restating
the study’s objective as a diachronic appraisal of
the diet and dental health of ancient Egyptians.
The spatial and temporal breadth of the sample
was extensive, and included sites that span Egypt’s
Nile Valley and date from predynastic times,
through the end of Pharaonic reign, and the rise
of Roman rule. Miller provides a generous number
of tables and the addition of many sharp
photographs offer excellent illustrative aids
(although there are a few that are out of focus).
All together, the volume is well organized and
Int. J. Osteoarchaeol. 19: 443–446 (2009)
DOI: 10.1002/oa
Book Reviews
informative, providing a practical reference guide
and interesting discussion of material. Miller
gives meaningful insights into the changes in
ancient Egyptian diet and dental health throughout the text. She methodically constructs a
compelling argument that illuminates a time of
renowned human achievement, with some surprising revelations about the afflictions endured
by individual ancient Egyptians.
FARMERS, MONKS AND ARISTOCRATS: THE
ENVIRONMENTAL ARCHAEOLOGY OF ANGLOSAXON FLIXBOROUGH (EXCAVATIONS AT
FLIXBOROUGH VOLUME 3)
K. Dobney, D. Jaques, J. Barrett & C. Johnstone.
Oxbow Books, Oxford, UK 2007; 313 pp ISBN
13: 978 1 842172902. USD $60.00
Excavations between 1989 and 1991 at Flixborough, in North Lincolnshire, England recovered
the remains of an Anglo-Saxon rural settlement
(7th–11th Century AD) situated on a belt of windblown sand 8 km south of the Humber estuary.
The excavations produced an enormous number
of finds including one of the largest faunal
assemblages as yet discovered from this period in
England. The volume is the third of four devoted
to the analysis of this site. Although other forms
of environmental evidence are analysed in this
monograph, the bulk of the finds are animal bones
(over 200,000 fragments including over 40,000
identified mammal and bird bones from hand
recovery of phased features and over 10,000 fish
bones from sieved samples). It is therefore one of
the largest assemblages investigated from an
Anglo-Saxon site.
The archaeological background to the site (by
C. Loveluck) is provided in Chapter 2 following a
short introduction outlining the research objectives of the project. This provides a summary of
the six main phases with supporting plans. Whilst
this provides a good general overview of the
sequence, there are a number of places that refer
the reader to other volumes in the series for
Copyright # 2009 John Wiley & Sons, Ltd.
445
Misty Fields
Department of Anthropology
University of Nevada, Las Vegas, USA
Published online in Wiley InterScience
(www.interscience.wiley.com)
DOI: 10.1002/oa.1092
further information and the description otherwise
does assume that the reader has a fair knowledge
of the period and other information about the
site. It is made clear, however, that the settlement
is of some importance, enjoying periods of
prosperous trade links and acting as a high-status
centre, possibly with ecclesiastical inhabitants in
some periods. A summary table at the end of this
section outlining the phasing and chronology
would be helpful. Further detail of the nature of
the deposits, their chronology and the preservation of the assemblages is provided in Chapter
3. There is an honest consideration of whether
residuality of animal bones was a serious problem
(it wasn’t). Variations in the state of preservation
of the bones are also discussed. This discussion is
very detailed with regard to the fish from the
sieved samples but much more cursory in relation
to the mammal and bird bones.
Chapter 4 provides the species counts by period
and demonstrates that the identified mammal and
bird assemblages are dominated by elements of
domestic species (cattle, sheep/goat, pig, chicken
and goose). There are interesting variations in
species abundance between phases, which are
further explored in later chapters. Amongst the
wild species, there are an unusually high number
of cetacean bones, which may relate to the high
status of the site. These are mainly from bottlenose
dolphins, which DNA analysis suggests were from
a distinct local, now extinct, population that once
may have inhabited the Humber Estuary. There
are also unusually large numbers of fish bones
retrieved from the sieving with migratory species,
particularly eel and smelt providing the bulk of
Int. J. Osteoarchaeol. 19: 443–446 (2009)
DOI: 10.1002/oa