Introduction

Paleopathology, the study of disease in ancient remains, is aimed at improving our understanding of the evolution of diseases and their interaction with human biologic and social history (Aufderheide & Rodriguez-Martin, 1998; Brothwell & Sandison, 1967; Ortner & Aufderheide, 1991). Pathogenic organisms, environmental factors, and patterns of disease evolve just as do larger organisms, including hosts and vectors of disease. There is evidence, however, for considerable stability in some host-parasite relationships. Similar parasitic worms have been found in Egyptian mummies and modern Egyptians. Such historical perspectives are necessary to prepare us for changes in disease incidence and for new diseases, such as Legionnaire's disease and AIDS (Zimmerman, 2001).

Evidence of ancient disease is obtained from historic records, works of art such as paintings, pottery effigies, and figurines, religious statuary, figures and faces on coins, skeletons, and mummies. Many diseases leave little or no direct mark on the bones and pseudopathologic changes can be produced by erosive forces or animals chewing on bones. Although lesions in archeological specimens represent only a small proportion of the total morbidity, the incidence of disease of a population, there are valid reasons for such studies. Certain characteristics or anomalies are useful as genetic markers. Evidence of traumatic injuries can give information on the occupational or military orientation of the group under study. Infectious diseases provide inferences on the general health status of the population.

A major consideration in dealing with ancient material is that modern patients with skeletal pathology present one with symptoms and signs, whereas archeological material presents one with a bone that has either a hole or a bump. The diagnosis of skeletal lesions is properly based on history, radiological findings, and pathology, but we rarely have adequate history in dealing with ancient skeletal material, and pathology is generally confined to the gross appearance, as microscopy is highly technical (Schultz, 2001). One other caution is the paradox that skeletons showing pathology are usually those of relatively healthy individuals. Unhealthy individuals die very quickly, before they have time to develop skeletal lesions.

Mummies are bodies preserved either artificially or naturally. The Egyptian practice of artificial mummification developed from the natural preservation of bodies buried in the desert in pre-Dynastic times, which may have had a role in the development of the belief in life after death. When it became customary to provide the deceased with food and funerary furniture, larger graves and above-ground tombs allowed decomposition, necessitating the development of artificial techniques of mummification. All deceased Egyptians were mummified until the Christian era, ca. 200-400 AD, with a gradual refinement of technique over the millennia, although in all periods the poor were less carefully mummified (Zimmerman & Angel, 1986). Artificially preserved mummies are found in many other areas of the world as well.

Natural mummies, due to freezing or drying, have been found in bogs and in arctic and arid areas.

These bodies, both human and animal, often show excellent preservation (Spindler, Wilfing, Rastbichler, et al., 1996).

The rehydrated tissues of mummies subjected to autopsy examination result in the diagnosis of many conditions with a considerable degree of confidence and accuracy (Cockburn & Cockburn, 1998). Mummified tissues and bones are studied by light and electron microscopy, chemical analyses, and paleoserology. Microbiological studies have not been useful, as viable pathogens have not been cultured from paleopathologic material, although organisms can be identified histologi-cally, including viruses, using electron microscopy.

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