History of Epidemics in Ancient Egypt-2024.pptx

This presentation illustrates some of the reported data concerning some epidemics that attacked people in Ancient Egypt .

1. Epidemics in Ancient Egypt Ekbal Mohamed Abo-Hashem(MD) Professor of Clinical Pathology Mansoura University-Egypt

2. To understand the present and predict the future, one must look at the past and realize that humanity has suffered and overcome many other catastrophes, with life eventually returning to normal or even better. Pharaonic Egypt has often been associated with epidemics and disasters ; “the great pestilence” during the reign of Pharaoh Mempses in the First Dynasty was the first recorded epidemic in human history (3180 B.C.) , and the plague of pharaoh (1495 B.C.) ,that was possibly caused by drought . INTRODUCTION

3. The “Plague of Athens,” lasting from 430 to 426 B.C. is suspected to have been originated in Ethiopia. “ This area shouldn’t be confused with the country we now know as Ethiopia but was a more general term used at that time to refer to the region south of Egypt ,” Contemporary accounts suggest that later epidemics in the Mediterranean also began in Egypt and Ethiopia, such as the Antonine Plague, the Cyprian Plague, and the Justinian Plague, which ravaged the ancient world between the 2nd and 6th centuries.

4. Egypt had a reputation in the Greco-Roman Mediterranean region as a gateway for disease—a source of pestilence that originated south of Egypt and spread north via the Nile River, an important transport axis, from the regions of inner Africa south of the first Nile cataracts or through the Red Sea . One major factor in the rapid and widespread transmission of diseases was trade. For centuries, Egypt was the “granary of Rome,” cultivating and exporting cereals abundantly.

5. PALESTINE

6. Infectious disease epidemics participated in major changes in the Ancient World history, for example, the end of the Mycenaean Palatial Empires, the end of the Hittite Empire and the end of the Near Eastern Bronze Age in c.1200 BCE ; Egypt’s withdrawal from the Levant, the fall of Athens, the end of Carthage, the fall of the Western Roman Empire, the invasion of Islamic forces into Europe during the Plague of Justinian; and even the end of the Sumerian and Indus Valley Civilizations.

7. Paleopathology has aided our understanding the overall trends in health and population over time . As a field of study, it has started from the 19th century, beginning with mummy unrollings and identification of chronic diseases of known skeletal manifestation, followed by collection of skulls to suggest biological affinity, to finally form a scientific field of research after 1945 with increased focus on standardized methods and systematic data collection .

8. This increase in scientific interest came predominantly from the large Egyptian and Nubian archaeological salvage expeditions that came with the dam projects on the Nile River, in which archaeologists were removing whole populations of skeletons from the ground, not just mummies or skulls .

9. In Egypt ,one of the eminent researchers , Eva Panagiotakopulu ,combed the workers'-village site in Amarna, where the builders of the tombs of Egyptian kings Tutankhamun and Akhenaton lived. She had been looking at fossil insect remains to learn about daily life more than 3,000 years ago. She had the belief that "People lived close to their domestic animals and to the pests that infected their household," looking at insects is a key way to reconstruct the past. “We can learn about how people lived by looking in their homes and at what was living with and on them," Pharaohs' Plague :plague in Ancient Egypt

10. There, the researcher unearthed cat and human fleas—known to be plague carriers in some cases—in and around the workers' homes. Previous excavations along the Nile Delta had turned up Nile rats Arvicanthis niloticus ., an endemic species, dating to the 16th and 17th century B.C. The plague's main carrier flea is thought to be native to the Nile Valley and is known to be a Nile rat parasite.

11. Some 5500 years ago, Egypt became cosmopolitan. Humans started living in towns, making it easier for diseases to spread. Later, international trade arrived, and black rats arrived on newly established trade routes from India and Mesopotamia. The human flea, Pulex irritans L. is one of the mobile fleas, nowadays cosmopolitan, and has been found on a wide range of host.

12. The river's annual flood would have driven Nile rats into town, where they could have shared their fleas Xenopsylla cheopis with black rats. Unlike the Nile rat, the plague bacterium kills black rats quickly, leaving lots of hungry fleas looking for a home--and surrounded by humans. And once black rats hosted the oriental fleas--and with it, Y. pestis --they spread the plague across entire continents, (Because fleas can also go for a month without feeding, they could also have spread in cloth or grain.)

13. It's possible that trade spread the disease to black rats, which then carried the bacteria to other sites of plague epidemics. Panagiotakopulu suspects that black rats, endemic to India, arrived in Egypt with sea trade. In Egypt the rats picked up plague-carrying fleas and were later born on ships that sailed across the Mediterranean to southern Europe . Fossilized remains of plague were found in large number in Tell-Amarna (Egypt) and since this site was inhabited only for few years (20-30) it was possible to date the contact among human beings and plague fleas, accurately to about 1350 B.C.

14. Rattus was already known by ancient Egyptians it was shown in both paintings on the walls of the tombs and on the sheets of papyrus . Mouse coprolites were observed in food-stuffs(grain), stored in a burial of the Ancient Kingdom, preserved in the Museum of Turin, these remains were obtained from excavations in the XIX century in the archaeological site at el- Gebelein , lying 30 km to the south of Thebes .

15. The plague in ancient Egypt could be the disease that is called within the Egyptian medical papyri as "Ta-Net", meaning the Asian disease, the papyri also mentioned some terms about epidemics, like " Renpt Iadat " that is, the “year of the epidemic,” and was related to the goddess Sekhmet, the goddess who personified divine anger .   It is worthy to mention that in the ancient times the term plague pointed out the calamities and epidemics on the whole, causing a high mortality.

16. Perhaps the first time plague is mentioned is in the Ebers Papyrus, a medical papyrus dated around 1500 BC, but probably compiled much earlier: If thou examines a man who suffers from the said (i.e. from the shivering fit described in 38.3 -10 for hours, like consuming for purulency , and he is weak like a breath that passes away, then thou shalt say that it is (due to) closing of an accumulation, which cannot be raised and does not trust in a weak remedy; it (i.e. the accumulation) has produced a bubo, and the pus has petrified, the disease has hit. Thou shalt prepare him remedies to open it by means of medicines. ( Ebers Papyrus 39, translated by Ebbell , 1937).

17. In the London Medical papyrus, dated 1350 BC, there are incantations ‘in the language of Keftiu ’ against the ‘Canaanite illness ’ . This disease was probably called the Canaanite or Asiatic (Amu) illness, because of the place in which it originated. A further possible description of the disease could be in the incomplete section of the same papyrus” When the body is coal black with charcoal (spots) in addition to the water (urine) as red liquid (i.e. bloody).... (London Medical Papyrus15, 8–10, translated by Goedicke , 1984)

18. Another tentative description of a disease that could be the plague is found in the Hearst Medical Papyrus, a text paleographically related t to the Ebers Papyrus, and dated to c.1520 BCE : one of the incantations against “the Canaanite illness”: is Who is knowledgeable like Ra? Who knows the like of this God? – When the body is blackened with black spots – to arrest the God who is above. Just as Seth had banned the Mediterranean Sea, Seth will ban you likewise. O Canaanite illness! You shall not intend to pass through the limbs of X, born of Y. (Hearst Papyrus H X1 12–15 translated by Goedicke , 1984, p.94)

19. In addition the papyrus Edwin Smith, dating back to the XV century B.C., includes, in the first paragraph, an invocation to gods against the plague.

20. The recording of bad news such as a plague by the ancient Egyptians was rare. There is little written about a plague during Amenhotep’s III reign . Following a period of trade with Western Asia, Egypt was subject to an 8-year “gap” period of no written record between the years of twelve to twenty of Amenhotep III’s reign. Bubonic plague existed in Egypt at the time of Amenhotep III and Akhenaten, if not earlier. Bubonic plague also recurred in epidemics, many years apart, when circumstances permit.

21. What could have caused the original 8-year gap in recording and subsequent episodes of a lack of recording? Amenhotep did not fight any major wars that would have killed off large numbers of young men but not women, children and artisans. Nor was Egypt invaded during his reign, which could have resulted in many men, women, children and artisans being killed. There were no major famines either. All evidence points to an epidemic or epidemics by some sort of infectious plague to account for such loss of life amongst men, women and children and the lack of skilled artisans.

22. The infectious disease introduced into the Hittite Empire by the Egyptian prisoners of war in 1322 BCE was possibly a recurrence of bubonic plague, because there is evidence of it in Amarna only a few years earlier from c.1348–1334 BCE and from c.1378 BCE (after year twelve Amenhotep’s reign). German archaeologists refer to the Hittite Epidemic of 1322 BCE as an outbreak of bubonic plague. The end of the Hittite Empire occurred over 120 years later in c.1200 when it was part of the bigger catastrophe known as the end of the Bronze Age. Two of the Hittite kings’ deaths were attributed to this epidemic .

23. There is an Amarna letter (EAII) written during the time of Amenhotep’s son Akhenaten’s reign that mentions the plague during Amenhotep’s reign. Akhenaten wrote to Burnaburiyas , king of Babylon stating that one of his father’s wives (but not his first wife Tiye ) had died of plague. If a pharaoh’s wife can die of the plague, so can the rest of Egypt. Now :what are the possible proofs for occurrence of plague during Amenhotep III and Akhenaten reigns ?

24. Plague in the time of Akhenaten

25. PROOF 1: Plagues Usually Occurred in Times of Increased International Activity Amenhotep’s reign showed Egypt engagement in trade and commerce with Mediterranean states ,the Levant, the Middle East and the Indian subcontinent from where the bubonic plague may have originated. PROOF 2: Devastation of Dense Populations Data indicate a decreasing population from the Middle of the XVIII Dynasty and finally Nubia seems to be more or less depopulated . Tombs from the reign of Amenhotep III onwards were impoverished due to the lack of skilled artisans and gold workers . These workers were housed together in fortified settlements along the Nile. Such close population concentrations were perfect conditions in which a plague could spread.

26. PROOF 3: Flight to Plague-free Areas Amenhotep relocated his palace from Karnak to Malkata , this may be provoked by a desire to find a plague-free area in which to live. Malkata was a mud-brick complex located on the West Bank of the Nile near Thebes .Construction started around year eleven of his reign which is the same time the 8-year “gap”, possibly due to the plague, commenced – so it may have been built to flee the plague. In addition , Akhenaten’s move to Akhetaten (Amarna) was an attempt to find an area free of plague . It was established by Akhenaten in a previously uninhabited area , and remained the capital for only 17 years (c.1349-1332) BCE.

27. PROOF 4: Mass Burials, Non-traditional Burial Methods and Poverty of Grave Goods An un-decorated Theban tomb chamber was discovered in the mid-nineteenth century. It was sealed with Amenhotep’s name and dated year twenty-seven of his reign. The chamber contained no bodies but had artefacts for the king’s sister Tiaa , his grand-daughter Nebetta , many other princesses, butlers, guards, accountants and an embalmer. One explanation for the tomb being empty is that the bodies had “been disposed of in a more expedient manner” earlier because they had died of plague. At Amarna, Akhenaten’s second daughter, Meketaten died around age 12, and was commemorated by various depictions of the royal family mourning in her royal tomb .

28. PROOF 5: New Cults and Changes in Religious Affiliation The worship of gods associated with health, disease and healing increased during Amenhotep’s reign. The most important of these was the increase in the number of statues of Sekhmet the goddess of war and pestilence. Another religious evidence favoring a plague is that Amenhotep’s son Akhenaten started a religious revolution when he started monotheism with the God Aten. He may have done this because the traditional gods had failed him and he was trying desperately to save his kingdom from the plague.

29. PROOF 6: Changes in Artistic Subject, Style and Quality Art during Amenhotep’s reign became more spiritual and ritualistic instead of the usual happy scenes. Early in his reign tomb painting flourished but in the middle of his reign tomb painting nearly ceased , may be due to a lack of artists. The tomb painters lived at Deir el Medina, which was destroyed by fire during the time of Amenhotep or Akhenaten. Deir el Medina was probably infested with plague, which was killing the tomb painters, then the best way to cleanse the site would be to destroy it with fire.

30. PROOF 7: Increase in Marriage Amenhotep III married several members of the royal family toreplenish the numbers of the royal family with pure stock,because its members had been killed off by the plague. Amenhotep made himself a God and married his two daughters just before his year thirty celebrations. Amenhotep also set a marriage incentive to help repopulate the empire.

31. The Italian Archaeological Mission to Luxor (MAIL) found the remains of victims struck down by the ancient plague that St. Cyprian believed to signal the end of the world. Cyprian is named for Saint Cyprian, a bishop of Carthage and an early Christian writer who first described the epidemic as a signal of the end of days.

32. The human remains found at the site were covered with a thick layer of lime, used historically as a disinfectant. The MAIL researchers also found three kilns where the lime was produced, and more human remains scattered over an area that appears to have been a giant bonfire, in which many of the plague victims appear to have been incinerated. Pottery found inside the kilns allowed the scientists to date the site to the third century A.D., when the so-called “Plague of Cyprian” was ravaging Egypt and the rest of the Roman Empire. (A.D. 250-271) .

33. The MAIL team found no evidence that the corpses at the Theban funerary complex had received any religious rites, indicating that those who buried them did so quickly in the hopes of curbing the plague’s spread. After its use during the plague, the burial monument appears to have been abandoned, and was never used again. The site has been particularly important in aiding in understanding of an innovative period in Egyptian art known as the Pharaonic Renaissance, which lasted from the early seventh to mid-sixth century B.C.

34. The end of the Late Bronze Age in the Near East (1300 – 1200 BCE) saw the widespread collapse of several large cultural centers, this cultural collapse suggest epidemic disease may have factored into the eventual downfall of these early civilizations. Malaria in ancient Egypt : Introduction

35. Recent DNA analysis from Egyptian mummies who lived during the period leading up to the Late Bronze Age collapse identified malaria in several elite individuals, suggesting the widespread prevalence of this infectious disease in Egypt. However, the exact prevalence, antiquity, and dynamics of malaria in the Near East, including what role it may have played in the shifting cultural and political landscape of the Late Bronze Age, remain unknown .

36. Malaria has been identified in the mummified tissue of ancient Egyptians of various time periods, dating back to as early as 3200 BCE using ancient DNA ( aDNA ) sequencing and antigen evidence .This direct genetic and immunological evidence verifies the presence of malaria in antiquity, but leaves the prevalence and spread of the disease unknown. Although malaria failed to leave any visible effect on the mummies, its DNA analysis confirmed the presence of three genes for a parasite that causes malaria in 4 mummies. Evidence of Malaria infection in Ancient Egypt :

37. “A punishment from the gods infects man and not other living creatures .. a punishment that inflicts a mosquito to eliminate that evil that dominated our country”.. Thus the Egyptian crossed over 3500 years ago, when the land of Egypt was struck by a plague of malaria, and a pestilence that eliminated many Villages and cities, and reached his power that eliminated King Tutankhamun, in keeping with the results of DNA analysis and a CT scan of the king's mummy.

38. Many ancient Egyptian papyri, on top of which are papyri, Chester Beatty , Ramesseum , Kahon , Edwin Smith, Harris, Ypres, London, Berlin, Carlsberg, Brooklyn and Bruges, confirm the Egyptians practice of medicine to protect against infectious diseases. The Ypres Papyrus, which is the oldest treatment document in history dating back over 3500 years , describes the success of the doctor, the priest Sekhmet, in developing a treatment for malaria and smallpox, after the death of an oversized number of residents of the town of Tel el-Amarna with malaria .

39. Ancient DNA ( aDNA ) evidence showed positive genetic markers for two different strains of tropical malaria (Plasmodium falciparum) in Tutankhamun’s mummified tissue, suggesting he had a double infection of malaria at his time of death (1325 B.C). Two other mummies of the royal family were also tested and shown to be positive for malaria infection ,including Tutankhamun mother .

40. Porous lesions of the eye orbits,( cribra orbitalia ) along with the similar porous cranial vault lesions ( porotic hyperostosis), are the most common skeletal lesions noted in ancient human skeletal remains excavated from the Nile Valley .They represent an expansion of the marrow space in the cranial vault . It was suggested to be caused by iron-deficiency anemia ,developing as a result of the expansion of the hemopoietic diploe of the cranium (seen as the characteristic “hair on end” appearance radiographically), to allow greater red blood cell generation to compensate for the severe anemia .

41. A link was discovered between direct evidence for malaria ( positive malarial aDNA detection) and skeletal lesions of anemia. Testing ancient Egyptian mummies for immunological evidence of malarial antigens, and of those testing positive for falciparum malaria, showed that 92% had porotic hyperostosis and cribra orbitalia .

42. The pathophysiology of the resorptive effect of malaria on the skeleton, especially regarding the chemical release and hormone activation of the blood formation, was studied on mice and suggested that the influx of free heme in the bloodstream leads to impaired bone formation and an imbalance favoring bone resorption . This imbalance may also be affected by the increase of acid phosphatase, a known osteoclast stimulator, in the bloodstream during malaria infection. The hemolysis of red blood cells has also been shown to quickly affect bone marrow and bones in the malarial mice as compared with bled mice .

43. A virulent epidemic, similar to bubonic plague or typhus, hit Ancient Egypt in the middle of the Bronze Age .. Documented in medical papyri as well as archaeological findings, and re-echoed in biblical texts, a plague entered Egypt's main harbor, Avaris ,through one of the neighbouring ethnic groups around 1715 BC. As a result, the country was severely weakened at a time when it was already facing serious sociopolitical issues. The Epidemic of Tularemia in Ancient Egypt affected the Course of World History. Tularemia in Ancient Egypt :

44. Hebrews appeared immune against the etiological agent of the epidemic: Francisella tularensis , the Gram-negative bacterium passed by ticks, and that causes tularemia. Urban dwellers of Avaris , who had a limited contact to animals, were defenseless against the virulent strains, unlike the Hebrews, who lived off sheep and other animals. Attempting to consolidate Egypt's central government in the aftermath of the tularemia epidemic, led to the exodus of the Hebrew community from Egypt at a later time .

45. Egyptian history usually begins with the Early Dynastic Period (dynasties one and two) beginning c.3100BCE (±150 years) with the reign of Menes, Prior to this time were the Pre-Dynastic Kings, of which little is known. The Old Kingdom (dynasties three to seven) from c.2700 BCE , The First Intermediate Period (dynasties eight to ten), The Middle Kingdom (dynasties eleven and twelve) from c.2134 BCE The Second Intermediate Period (dynasties thirteen to seventeen). The New Kingdom (dynasties eighteen to twenty) began c.1575 BCE The final period—the Late Dynastic Period (dynasties twenty one to thirty one) from c.1087 BCE until the end of the Egyptian Empire in 332 BCE when it was conquered by Alexander the Great. During this time it consolidated the Kingdoms of the Upper and Lower Nile and also expanded into the Levant (Palestine and Syria) Egypt history timeline

46. The Paleoepidemiology of Malaria in the Ancient Near East A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Anthropology by : Nicole Elizabeth Smith May 2015 University of Arkansas A critical assessment on proposed outbreaks of plague and other epidemic diseases in Ancient Egypt Habicht , Michael E ; Eppenberger , Patrick E ; Rühli , Frank Main Library Strickhofstrasse 39 University of Zurich CH-8057 Zurich Zurich Open Repository and Archive www.zora.uzh.ch Year: 2021 History of Disease in Ancient Times, P. Norrie, DOI 10.1007/978-3-319-28937-3_1( 2016 ) Sources:

47. 20https://english.ahram.org.eg/ NewsContent /50/1209/3703513 Feb 2004 1/ AlAhram -Weekly/Focus/Plague,-cholera,--and--Spanish-04) John Whitfield Did Plague Start Between the Pyramids? From malaria to corona: a history of epidemics in Egypt Mohamed Abdel Salam, Randa Borhan 17 Dec ,2020 Pharaonic Egypt and the origins of plague Eva Panagiotakopulu Journal of Biogeography( J.Biogeogr .) (2004) 31, 269–275 http://egyptiangeographic.com/en/news/user/

48. Panagiotakopulu , E. (2001)Journal of Archaeological Science, 28, 1235-1246. Panagiotakopulu , E. , Buckland, P. C. & Kemp, B. (2010) Journal of Archaeological Science 37, 474-481. Fleas from pharaonic Amarna E. PANAGIOTAKOPU ANTIQUITY 75 (2001): 499-50 New records for ancient pests: Archaeoentomology in Egypt. Underneath Ra- Nefer's house floors: Archaeoentomological investigations of an elite household in the Main City at Amarna, Egypt. https://direct.mit.edu/jinh/article/54/2/163/118031/Egypt-as-a-Gateway-for-the-Passage-of-Pathogens https://www.rockandart.org/ancient-egypt-facilitating-spread-of-plagues/

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