The authors have declared that no competing interests exist.
Conceived and designed the experiments: PC CQ OA. Performed the experiments: PA CQ OA RK RH RB CM. Analyzed the data: PC CQ OA RH AN. Contributed reagents/materials/analysis tools: PC OA CQ AN RB. Wrote the paper: OA. Conceived internet methods: PC CQ RH. Designed the software used in analysis: PC CQ.
Egyptology relies on traditional descriptive methods. Here we show that modern, Internet-based science and statistical methods can be applied to Egyptology. Two four-thousand-year-old sarcophagi in one tomb, one within the other, with skeletal remains of a woman, gave us the opportunity to diagnose a congenital nervous system disorder in the absence of a living nervous system. The sarcophagi were discovered near Thebes, Egypt. They were well preserved and meticulously restored. The skeletal remains suggested that the woman, aged between 50 and 60 years, was Black, possibly of Nubian descent and suffered from syringobulbia, a congenital cyst in the brain stem and upper spinal cord. We employed crowd sourcing, the anonymous responses of 204 Facebook users who performed a matching task of living persons' iris color with iris color of the Udjat eyes, a decoration found on Egyptian sarcophagi, to confirm the ethnicities of the sarcophagus occupants. We used modern fMRI techniques to illustrate the putative extent of her lesion in the brain stem and upper spinal cord deduced from her skeletal remains. We compared, statistically, the right/left ratios, a non-dimensional number, of the orbit height, orbit width, malar height and the infraorbital foramena with the same measures obtained from 32 ancient skulls excavated from the Fayum, North of Thebes. We found that these ratios were significantly different in this skull indicating atrophy of cranial bones on the left. In this instance, Internet science and the use of modern neurologic research tools showed that ancient sarcophagus makers shaped and decorated their wares to fit the ethnicity of the prospective occupants of the sarcophagi. We also showed that, occasionally, human nervous system disease may be recognizable in the absence of a living nervous system.
Egyptology is a descriptive discipline where, normally, the details of a new find are put into appropriate context by analysis of the decorations and inscriptions found on artifacts and remains.
We hypothesized that the size of sarcophagi (ancient coffins) was fashioned to fit the prospective occupant and their decorations were adjusted to reflect the ethnicity of the deceased, if different from the ethnicity of ancient Egyptians.
Here we show that modern methods of crowd sourcing of the opinions of hundreds of Internet users, together with statistical methods, can contribute to the reliability of the interpretations of ancient finds.
Additionally, clinical paleoneurology—the examination of human nervous system function without the presence of a living nervous system—is possible only on very rare occasions
We report an unusual paleoneurological opportunity on a woman who died approximately 4000 years ago in Ancient Egypt. To reach the diagnosis and place this into clinical and social context we enlisted the collective “brain power” of Facebook users and, for the first time in Egyptology, based our conclusions, in part, on “networked science”
Two rectangular sarcophagi (coffins) were excavated in 2004 near modern Luxor, Egypt, the site of the ancient metropolis of Thebes. They were found at their original burial site. The interment occurred ∼3750 years ago
Their extensive decorations have been meticulously restored and together with many recovered funerary artifacts allowed the detailed reconstruction of the social aspects and life histories of the occupants of the sarcophagi
The outer coffin was made for a judge of the Egyptian high court named Imeni; the smaller, inner coffin, for his wife named Geheset. The inscriptions and decorations allowed accurate dating to 1890-1740±150 (XII Dynasty, Middle Kingdom), before Christ years (BCE). Imeni's sarcophagus had more elaborate decorations and was made from different wood than Geheset's
This is a stylized, symbolic eye often found on ancient Egyptian sarcophagi. It is assumed to have been copied from a falcon's eye. This decoration is known by many names including the eye of Ra or Udjat, after the Sun God Ra, which depicts the right eye or its mirror image, the left eye, the eye of Horus, which represents the moon. These two, stylized eyes, together, encompass the entire universe. The symbol continues to be used to this day, for example the left eye as the all seeing, Masonic eye, on American banknotes.
In Middle Kingdom coffins, the Udjat eyes were painted on the outer panel of the coffin and the coffins were placed facing east. The Udjat eyes on Imeni's coffin were painted on its inside, however, whereas those on Geheset's, as usual at the time, on its outside. The Udjat eyes faced each other in the burial chamber. Her mummy was placed so that her eyes were opposite the Udjat eyes presumably allowing her “to look through the two sarcophagi” using both sets of Udjat eyes to watch the sun-rise and join the sun God Ra on its daily journey across the sky. The sets of eyes on these two sarcophagi were elaborately painted and extraordinarily well preserved (
Note the peri-pupilary regions of the irises of Imeni's Udjat eyes is shaded a lighter brown compared to that of Geheset's irises hinting at the different ethnicities of the sarcophagi's occupants as discerned by the decorators of the sarcophagi.
Two hundred and four anonymous people were asked, using the Internet, to pick living-people eyes that best matched the Udjat eyes for Imeni and for Geheset. Since both Imeni's and Geheset's iris color was dark we presented only dark irises for matching. We used this collective “brain power” gathered from network information provided by Facebook users in our statistical analysis of the responses to the matching tasks (see
We found that 70.6% (P<0.001) correctly matched Geheset's iris-color on her sarcophagus' Udjat eyes with that of dark black irises of modern individuals typical of people of Black ethnicity. The matching of the lighter (but still dark) colored eyes (see
We determined statistically that respondents did not match randomly. Using adjustments for covariates such as age, gender, ethnicity and training in medically related disciplines or experimental format such as the order of matching of the living pictures or the presentation of only one set or of both sets of Udjat eyes simultaneously, none of these covariates altered the significant models of our results. For details of our Internet-based responses and statistical analyses see:
We concluded that crowd sourcing, the collective matching power of 204 living human brains, using the Internet, was capable of correctly matching iris color painted on ancient sarcophagi with iris color of living people and, by extension, identifying the most likely ethnicity of the occupants of these ancient coffins.
Anthropological examination suggested that the deceased female died between the ages of 50–60. The skull was narrow and elongated, the maxilla and mandible were significantly protruding. She was of short stature (estimated height 1.51 m) this together with her slender build, suggested that she was likely Black, and of Nubian ethnicity
The most remarkable features of the skull included the smaller left orbit, a narrower left hard palate (
The arrows point to the hyperplastic left gonial angle. The shortened left condylar head and mushroom-like degenerate appearance of the head is shown in the lateral view.
The arrows point to lipping of the joint margins often seen in Charcot's joints.
The arrows point to the excessive wear on the left as compared to the right side. The lines on the hard palate show the narrower left hard palate also indicating the site of measurements labeled “genial tuberosities” in
Site | Right | Left | Ratio R/L |
Orbit height | 21 | 18 | 1.16 |
Orbit width | 20 | 18 | 1.11 |
Infra orb For | 1 | 2 | 0.5 |
Malar height | 22 | 21 | 1.04 |
Zygom. width | 10.5 | 10.5 | 1 |
Hard palate | 13 | 11.5 | 1.13 |
Genial tuberosities | 11 | 9.5 | 1.15 |
The R/L ratios, non-dimensional measures, clearly show that the left facial bones where smaller. A larger left infra-orbital foramen (Infra orb For) was also seen in another skull with smaller left facial bones, on the left, from ancient Egypt
The teeth showed no evidence of caries but were extensively worn more on the left, the side of the degenerated joint, than the right and had abundant dental calculus which was more extensive over the mandibular teeth (
The arrows point to the huge amount of calculus deposition suggesting difficulty in swallowing the saliva and consequent precipitation and accretion of salivary minerals.
The most remarkable skeletal features were the bilateral fixed position of the hands and the relatively well preserved soft tissues (tendons and parts of skin) and remains of bandages used in the mummification process (
Note the relatively well preserved soft tissues and remnants of bandages used in the embalming process.
The left hand was X-rayed in the field (
The images were acquired with a portable machine in the field. Several small bones show reduced density consistent with the long-standing fixed position of the deformity and disuse of the hand.
Minor sclerotic changes are indicated by the arrows.
There were no discernible abnormalities in the leg bones and no evidence of joint degenerations in any of her other joints.
Geheset's available skeletal features and the dark irises on her sarcophagus' Udjat eyes suggested she was of Black ethnicity and suffered from syringobulbia, a congenital cyst in the upper spinal cord and lower brainstem, with focal dystonia which resulted in left torticollis. Focal dystonias usually develop later in life; in this case this was likely associated with the destruction of her left temporo-mandibular joint and would have led, eventually, to the fixed position of her head-tilt towards the left shoulder evidenced by the pooling of resin in her skull after embalming.
This diagnosis was based on the following localizing features: 1. The “coat hanger” like deformities of the upper limbs. 2. The absence of skeletal abnormalities in the lower limbs. 3. The gross deformity of her left temporo-mandibular joint. 4. The asymmetry of the skull bones (see
The analysis was based on right/left ratios (a dimensionless measure) of her skull, obtained from photographs, to obviate the influence of possible photographic distortions, and compared to the same ratios gleaned from caliper measurements of 8 female skulls excavated from the Fayum. Geheset's ratios (red dots) are outliers with highly significant differences (z-scores) from the measures obtained from the Fayum skulls. 1 = Orbit width; 2 = Orbit height; 3 = Malar height; 4 = Infraorbital foramen. Note: the left infraorbital foramen was larger on the affected side; negative R/L ratio.
Because of the location of the lesion (see
The arrows point to the tasks used to activate various nuclei. The red ovals show the putative site of the syrinx in Geheset's brain. (
The arrows point to activated regions produced by tapping the fingers against the thumb in the nucleus cuneatus (N Cu) the ventral posterior lateral nucleus (VPL) and somatosensory cortex (S Cx). The red circles show the putative site of the syrinx in Geheset's brain. (
Activation is shown in the hypoglossal nucleus (XII) and upper segments of the spinal cord when the tongue is pushed against the hard palate. The red oval shows the putative site of the syrinx in Geheset's brain. (
We next compared the caliper measurements of the orbit's width and height from 32 skulls dating to about the same period, excavated from the Fayum, North of Thebes, nearer the Nile Delta
The gross deformity of her left temporo-mandibular joint (
To live to the age of 50–60, as Geheset did
A congenital abnormality likely caused her disabilities because of her relatively long and successful survival, for that time-period, and the fixed position of her hands including the asymmetry of her facial bones. These could only have resulted from some lesion of the brain or upper spinal cord and the most likely site is a congenital cyst in the upper spinal cord extending into the brain stem - a syringobulbia. (
Her head was pointing to the left shoulder when she died and was fixed in this position at the time of embalming shown by the pooling of resin in the left occipital region of her skull (
The arrows point to the resin which dried after it was poured into the empty calvarium during the embalming process.
While dental calculus is often more marked over the mandibular teeth, the amount of calculus deposition was extraordinarily large consistent with difficulty swallowing during life, prolonged pooling of saliva and perhaps drooling due to involvement of the nucleus ambiguous (
Affected brainstem nuclei | yes/no | symptoms & signs |
Trigeminal sensory (V) | yes | denervated TMJ, degenerated joint |
Nucleus Cuneatus (N Cu) | yes | Finger weakness spasticity |
Nucleus Ambiguus (N Am) | yes | Swallowing pooling of saliva |
Nucleus Tractus Solitairus (NTS) | yes | Taste |
Putative signs and symptoms caused by the life-long malfunction of these structures are indicated.
The extensive restorations of the elaborate decorations of this unusual find
The two coffins of this unique find were entered into a small burial chamber stacked one within the other, and the putative ages of the coffins were deduced from the style of their decorations
The coffin makers fashioned their products according to the size of the occupants. Females are generally smaller than males. In this case it was evidenced by Geheset's smaller sarcophagus fitting into the larger coffin made for her husband. Close inspection of the color of the irises of the Udjat eyes on the two sarcophagi (
The elaborate decorations on these sarcophagi suggested that they were especially fashioned for the prospective occupants and expensive items for the anticipated funerary rites.
To support our hypothesis we used network science
The sarcophagi, which date from the Third Intermediate Period and Middle Kingdom, illustrate the variations in iris coloring applied by the decorators; none were blue or green. These were presumably ordinary sarcophagi, not made especially for well paying customers, their decorations were not as elaborate as those found on Imeni's or Geheset's sarcophagi. This supports our contention that the iris colors of Imeni's and Geheset's Udjat eyes on their sarcophagi, was not standard decorators practice but they reflected, nevertheless, the prevailing iris color of Egyptians of the time. From the Egyptian Museum, Turin, Italy, with permission. 1 = First Intermediate Period (Dynasties VII–XIa from 2195 to 2066 BC). Name of the deceased:
Further analysis of the respondents' matching also revealed a subset of 64 (31.4%) of the total that chose the correct lighter colored living iris from our set of nine for Imeni's Udjat eyes and the darker living iris for Geheset's Udjat eyes and the difference in choices in this subset of respondents was also significant (P = 0.03).
Finally, additional analyses, using covariates of respondents' characteristics such as age, gender, training in medically related disciplines or in the presentation of only one or both Udjat eyes, simultaneously, for matching and order of living eyes presented for matching, showed no effect on the statistically significant results.
Thus our initial hypothesis that the color of the irises of Udjat eyes, if well preserved, might reflect, as in this case, the ethnicity of the occupants of the sarcophagi was confirmed using the modern tool of “networked science”
A neurologic diagnosis in the absence of a living nervous system, paleoneurology, is only rarely attempted
Her skull asymmetry, fixed deformities of the upper limbs with normal lower limbs and survival into middle age suggested that she may have had a non-life threatening congenital abnormality that affected the brain stem, which extended into the upper spinal cord. This conclusion was reached using the usual steps in clinical neurology such as localization of the lesion followed by attempts at guessing the functional implications and pathogenesis of the lesion(s).
The extensive left temporo mandibular joint arthropathy implied a life-long painless but still functioning joint. This is also supported by the marked wear of the teeth on both sides. Such massive joint destruction with continued function, evidenced by the even more pronounced wear of the teeth on the affected side and the hyperplastic left gonial angle, may have been promoted by the collapse of the joint, shortened condylar head and disappearance of the cartilage.
Osteoarthritis of the temporo-mandibular joint in ancient remains has been assessed
The remarkably extensive deposition of calculus
The dental health of 93 Egyptians excavated at Amarna from the same historic period was reviewed
The fixed positions of her hands are reminiscent of the position assumed by tapping fingers against the thumb and consistent with lesions affecting the nucleus cuneatus bilaterally (see
Taken together, these skeletal features point to a long-standing disorder affecting the nuclear structures in the brain stem and the upper spinal cord, most likely a congenital cyst—a syrinx.
To reach this diagnosis we show that the traditional techniques used in clinical neurology, that is, localization of the lesion based on clinical deficits and guessing at pathogenesis continued to serve well but they may have been overshadowed, in our study, by modern techniques such as fMRI and crowd sourcing.
The study was approved by the Human Research Protections Office of the University of New Mexico Albuquerque NM, USA, Protocol #11-613 dated 26-January-2012.
Participants accessed the online experiment through any browser on any computer or device connected to the Internet, at the following address:
For details of the Internet-conducted interrogation of respondents (Facebook users) see
For details of the analyses see
Briefly, there were three binary factors that could be determined for the nine pictures of living eyes and that differed for Imeni and Geheset: there were seven males and two females; four pictures had somewhat lighter colored dark irises consistent with Caucasian ethnicity (Egyptian) and five had dark irises more like a person of Black ethnicity (Geheset).
We tested whether respondents correctly matched more than expected by random choice by a one sample, two-tailed binomial test, comparing the observed percentage to the random choice percentage.
Additionally, we tested whether the matches were random and found, using a Chi-squared goodness-of-fit for the 9×9 = 81 combined choices of the living eyes that they were not random. Lastly, we used Fisher's exact test for the 9×9 frequency table and the paired responses were not independent of each other.
We compared the right/left ratios, a non-dimensional measure, obtained from photographs of Geheset's skull with similar measures using calipers on thirty two skulls excavated from the Fayum, now kept at the Natural History museum, London, UK. We used the measures obtained from the height and width of the orbits, the malar height and the width of the infraorbital foramena for comparison purposes.
Standard neurological diagnostic techniques were applied. Because of the absence of a living nervous system we used the available clues from the skeletal abnormalities of Geheset's remains to deduce the site of the lesion. We then, diagrammatically, delineated the extent of the lesion on the fMRI images obtained from living normal humans from reference
Standard
This widely used, non-invasive research method, employs neuronal activity induced by appropriate tasks, given to living subjects, to alter the hemodynamic pattern in the neural structures normally involved in these tasks. This in turn produces alterations in functional magnetic resonance imaging (fMRI) signals which can be recorded. The activated structures are detected by the changes in
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We thank the German Archeological Institute, Cairo, Egypt for allowing use of copyrighted material and Peter Windszus for the photographs of the Udjat eyes
We wish to acknowledge the generous contributions to this work by Dr. Daniel Polz, of the German Archeological Institute, Cairo, Egypt.
We are grateful to Drs. Eleni Vassilika, Director of the Fondazione Museo delle Antichità Egizie di Torino, Turin, Italy and to her assistant Sara Caramello for granting access to the sarcophagi collection.