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An Appraisal of the Skulls and Dentition of Ancient Egyptians

International Journal of Osteoarchaeology, Vol. 19 Issue 3: 443-445 Miller gives meaningful insights into changes to ancient Egyptian diet and dental health. She constructs a compelling argument that illuminates a time of renowned human achievement, with some surprising revelations about afflictions endured by individuals in ancient Egypt. Misty Fields Department of Anthropology University of Nevada, Las Vegas, USA Published online in Wiley InterScience http://www3.interscience.wiley.com/journal/122357377/abstract

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