King Tut Felled By Injury And Malaria, Not Murder

NEAL CONAN, host:

Since the day that Howard Carter broke into the tomb of Tutankhamun in 1922, the boy pharaoh has enjoyed an outside place in Egyptian history and in all of our imaginations. Now, the latest round of forensic study suggests that King Tut's short life may have been a painful one, and that he died not as the result of an ancient murder plot but from complications of a broken leg.

An article in the journal of the American Medical Association is based on DNA analysis and CT scans. And while it tells us a lot about both King Tut and his immediate family, it also raises some questions about the ethics of medical inquiries into history.

If you have questions about that or about the findings of this new study on King Tut, give us a call: 800-989-8255. Email us: talk@npr.org. You can also join the conversation on our Web site, that's at npr.org, click on TALK OF THE NATION.

Howard Markel is professor and the director of the Center for the History of Medicine at the University of Michigan. He wrote an editorial for JAMA that accompanied this article on the study about questions raised about ethics. He calls it a potential Pandora's box. And he joins us now from the studios of WUOM in Ann Arbor. Nice to have you with us on TALK OF THE NATION today.

Dr. HOWARD MARKEL (Center for the History of Medicine, University of Michigan): Nice to be here, Neal.

CONAN: And as you mentioned in your editorial, before this we were all able to speculate that well, yes, there was that murder plot or that maybe he died in a fall from a chariot, all kinds of things about Tutankhamun.

Dr. MARKEL: Oh, it's a great job being an armchair pathologist because no one can actually prove you're right or you're wrong.

(Soundbite of laughter)

CONAN: And I guess the latest speculation about murder was published in a book last year.

Dr. MARKEL: That's right. A very prominent mystery writer and a historian published a book about who killed King Tut, and came up with a plot that I would say was Shakespearean, but it's actually pre-Shakespearean. In that King Tut's wife who was also his sister, was unhappy with him and worked with an evil general and an evil adviser to kill King Tut and take over the kingdom.

CONAN: I think I saw that picture. Or maybe I haven't seen it yet. Anyway...

Dr. MARKEL: No.

CONAN: ...thee studies of DNA analysis and indeed the CT scans not just of King Tut's mummy, but some of those of his relatives, suggests that instead it was more prosaic, that he was born with a cleft palate and a clubfoot and had a painful time during his life.

Dr. MARKEL: Yes. He probably had an orthopedic or bone disorder called Kohler's disease that leads to a poor circulation to the bones in the foot. He probably broke his foot and walked with a limp. And in fact, in King Tut's tomb there are several walking sticks, his own walking sticks. And they have wonderful evidence of wear and tear.

CONAN: Mm-hmm.

Dr. MARKEL: He may have fallen at sometime and broken his thigh bone or the femur bone, which is the largest bone in the body, and is still a very serious injury even today with modern medicine. If you're not treated with a femur fracture, you could literally bleed to death in a matter of hours. So he had all of these problems and on top of that, he had a raging case of malaria.

CONAN: Hmm. And indeed the studies of the other people suggested they did too, that it was apparently pretty widespread in pharaonic Egypt.

Dr. MARKEL: Yeah. It's a contagious disease and it doesn't care if you're the pharaoh or you're merely a slave. If a mosquito bites you and you're infected, there you have it.

CONAN: So the other things that it tells us about his relations and not only at least according to that novel - was King Tut's sister his wife, but his father's sister was his father's wife.

Dr. MARKEL: Yes. That to me was the most exciting and intriguing part of the study of the conduct of the royal family. They married within the family, so that King Tut's parents were siblings, and King Tut indeed as you mentioned, married his sister. You know, the pharaohs not only considered themselves royal, but they considered themselves to be deities. And so no matter who you brought home to mother was not likely to be accepted...

(Soundbite of laughter)

Dr. MARKEL: ...unless she too was royal, of a deity of herself.

CONAN: And nevertheless...

Dr. MARKEL: But that...

CONAN: ...if you got some genetic problems in your family, this is only going to increase them.

Dr. MARKEL: Exactly. That's what I was about to say. It really sets yourself up if you're carrying genetic disorders, particularly recessive disorders, it really sets it up to be transmitted generation to generation.

CONAN: And the more prosaic description of the end of King Tut's life suggests that, well, a boy who only ruled for 10 years, and may not have been in total political control for the first part of that at least, may not be deserving of all the attention we've been giving him all this time since Howard Carter in 1922.

Dr. MARKEL: May not but, you know, the discovery of that tomb was so remarkable in 1922, and, of course, the relics and the riches that were found therein. And it had just captured our imagination. And, of course, he has that great nickname, King Tut. And there's even been songs about him as I recall, the Steve Martin hit in 1978.

CONAN: Well, you may have anticipated us. In any case, the other part of this that I found interesting is there has been, as you note in your editorial, an explosion of the use of modern technology in historical research, going back to find the relationship of Thomas Jefferson and Sally Hemings' children. That, of course, forced us to reconsider the Hemingses of Monticello and, indeed, our third president.

We've also had to go back and change other ideas about, for example, there were samples left of people who died from the 1918 pandemic flu. So when we were looking again at the question of flu, we had examples of history to go back and look at those.

Dr. MARKEL: Yes. It's a remarkable tool, isn't it, that we can use modern science to better understand the past? And I think that really adds to two really critical questions of these types of studies. Does it really change our view of history, as the King Tut study most definitely does? Or does it help issues of understanding of health and disease today, as the influenza study does? And I think we need to be very careful about answering one or the other or both questions affirmatively before we embark on such studies. But those are very important. For example, the Jefferson study really opens up a whole window of issues of love and intimacy during the era of slavery.

CONAN: And, indeed, we did find out a lot about influenza. Of course, it was tremendously important - nevertheless, still important to remember the dignity of the dead even the very distantly dead.

Dr. MARKEL: Absolutely. And, you know, this is something that goes across cultures and nationalities and eras, but we tend not to exhume the dead. We tend not to disturb the dead for all sorts of ethical issues.

But particularly when you're talking about the pharaohs, I mean, the reason why King Tut was buried in a tomb that was impossible to get to until several thousand years later was not only did they not want to be disturbed - and there was supposedly a curse laid on those who would disturb King Tut - but these people also felt that it would affect their chances in the afterlife if they were disturbed. So these are things that we have to be very careful about to temper our curiosity.

CONAN: Well, there are all kinds of questions asked for - about all kinds of historical personages. You think of William Clark, of the Lewis and Clark expeditions - excuse me, Meriwether Lewis, about whether he committed suicide or not, questions like that. Is that kind of curiosity worth going back to satisfy?

Dr. MARKEL: Well, again, if you look at those two major questions, does it really change our understanding of the Lewis and Clark expedition or does it really help our issues of health and disease? I'm not so sure on that. Similarly, you know, would it really matter if we exhumed Abraham Lincoln to find out if he had an upset stomach the day before he was murdered? I don't think so. But there are other examples where we may have thought about foul play or problems that may have existed that would be very interesting to find out. Now, the real...

CONAN: For example.

Dr. MARKEL: Well, for example, Woodrow Wilson's final stroke. How incapacitated was he? But I doubt that you would be able to find that information out on a body that was buried in the 1920s and exhumed in the 2010 era. That's what's so remarkable about the mummies is that they were embalmed in a very specific way that allows us to examine these bodies to this very day.

CONAN: We're talking with Howard Markel about a study that appears in the Journal of the American Medical Association today that goes into the results of DNA and CT scans of King Tutankhamun, the fabled boy pharaoh of Egypt, whose body was discovered in 1922 by Howard Carter. Of course, the fabulous treasures of his tomb uncovered as well.

Let's see if we can get Sarah(ph) on the line. Sarah is calling us from Kerrville in Texas.

SARAH (Caller): Yes. I was curious if - I heard your - I heard it mentioned that Tut's mother or father were brother and sister. I'm curious, has it been definitively determined that Akhenaten was Tut's father and, therefore, Nefertiti, his mother?

Dr. MARKEL: It was definitively discerned that Akhenaten was his father.

SARAH: Oh. Okay.

Dr. MARKEL: The scholars who did the study have identified the mother as a mummy called KV35YL, which was probably not...

CONAN: What a romantic name.

(Soundbite of laughter)

Dr. MARKEL: Yeah - but probably not Nefertiti as thought. But this group of scholars is actually doing more studies as we speak to determine that more closely.

SARAH: Wonderful. Thank you very much.

CONAN: Thanks very much for the question, Sarah. And that suggests that, indeed, there are so many people curious about this one personage and his place in history. Of course, his father was the one who brought monotheism to Egyptian - to prominence in Egypt.

Dr. MARKEL: Yes. He was a far more prominent pharaoh. He brought about many changes and reforms in ancient Egypt. Yet it's his son who we talk about today.

CONAN: And, indeed, the studies of the Necropolises, the burial grounds around the pyramids, suggest studies of all those findings have proven, or at least the current theory is that they were not built by slaves but rather erected as civic enterprises.

Dr. MARKEL: Yes, that's absolutely true.

CONAN: And this email question from Patricia Fletcher(ph). If King Tut was not murdered, then how did that begin to be told? If he died of complications from a broken leg, what sort of complications were they? Well, we answered that part. It was the malarial infection that contributed. But how did the story of the murder start to be brooded about, do you think?

Dr. MARKEL: Well, it started in the late 1960s. And in 1968, a team of physicians and historians and anthropologists looked at King Tut's mummy and did an old fashion X-ray of his skull and of his skeleton, what used to be called a flap plate X-ray. And they found a fracture to the back of the skull, and they found this fractured leg. And then as doctors are want to do, we all love to make diagnoses whether we're looking at a patient or not. People began to read that paper, and people wrote articles and medical journals and such.

And one good story led to another. And he - it was suggested that he either fell off his horse or he fell off his chariot. Another story suggested that he was kicked to the head by a horse or a beast of burden. And then finally, the best story of all is that there was this nefarious plot to kill him and take over the kingdom.

CONAN: And those were later disproven when further studies indicated that hole in his head was used to extract his brain as part of the mummification process?

Dr. MARKEL: Yes. Yes, it was. The fracture of the leg though was probably incurred in real life.

CONAN: And whether that incurred from a dramatic fall from a chariot or a trip down the stairs, who knows?

Dr. MARKEL: Yeah. Well, you know - and I - this was, you know, making fun of armchair pathologists but I'll take a stab at it too. Think about it, when you hurt your own foot you walk sort of funny, and you always injure something else once you injure one part of your body. So he could've been walking in a very difficult way, using canes, and then he could've fallen from, you know, a great height or some steps and broken that thigh bone.

CONAN: Finally, Howard Markel, as you suggest that we answer these questions, these ethical questions about the historical value and degree of disturbance before we go in to answer some of these forensic questions about history, who would decide that?

Dr. MARKEL: That's a good question because this is such a new field when you think about it, you know? Historians have long enjoyed reading other people's mail but we have not looked at people's bodies all that frequently. But I think there are ways of mirroring institutional review boards that are at every hospital and medical center today as well as museums or museums of antiquities...

CONAN: Okay.

Dr. MARKEL: ...to develop a team of historians, ethicists and so on, experts to decide this issue.

CONAN: Howard Markel, thanks very much for your time.

Dr. MARKEL: Thank you.

CONAN: Howard Markel, professor and director of the Center for the Study of Medicine at the University of Michigan. And as we mentioned, he wrote an editorial on the study that questions the ethical implications of the search of dead bodies for evidence of historical interest. He joined us from WUOM in Ann Arbor, Michigan.

And this is TALK OF THE NATION from NPR News.

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