By Dov Michaeli
First published 4/13/11 on The Doctor Weighs In
This blog is about Health and Medicine, broadly defined. So forgive me if I start with something that looks irrelevant. It will paint the broader context in which our subject matter exists.
Since earliest times humans believed that somehow being a “savage”, meaning uncivilized, living closer to nature, equates with being purer, unspoiled by civilization’s meanness, hypocrisy, and a host of other ills. The very first written literary work that was a “best seller” in the ancient world was “The Epic of Gilgamesh”, in which Gilgamesh, a mythical Sumerian prince, goes on a voyage in search of eternal life. His friend and fellow traveler was Enkiddu, a wild but good person who lived with animals. This was 3500 years ago. The sentimental romanticism of wild and pure people has never disappeared ever since. During the 17th and 18th centuries this concept of “noble savage” enjoyed remarkable popularity in the form of novels, philosophical essays, and even political movements. Today’s back to nature, wholesome foods, anti GM crops, anti-science beliefs, all resonate with the noble savage idea.
Medicine did not escape these beliefs. Just walk into any health food store, and you will find yourself in a shrine to “natural” medicines, all promising to deliver the vitality and healing properties of nature.
One of the early proponents of the concept of “industrial diseases” was an Irish missionary doctor who lived and practiced in Africa, Dr. Dennis Burkitt. He is famous for discovering a rare form of childhood lymphoma, called Burkitt’s lymphoma. But he also propounded the theory that many of the ailments that afflict industrial society are due to its unhealthy lifestyle. He compared the prevalence of a variety of diseases in Europe and the U.S. with their prevalence in Africa, especially in the cattle herding (and war-like) Masai of Uganda and Kenya. Lo and behold, the Masai didn’t suffer from hypertension, heart disease, diabetes, diverticulosis, cancer. Conclusion: the Masai, those noble savages are healthier because they “savage”; they are closer to nature, their diet is healthier, their lifestyle is less stressful than ours.
Dr. Burkitt was not a research scientist, just a primary physician with an acute sense of observation. His observations were indeed intuitively plausible, and very quickly gained acceptance in the lay as well as medical communities. Since then we found out that the nomadic tribes in Africa are not quite the unspoiled “savages” of lore. They do have some obese people with diabetes, they do have heart disease, and they do die of cancer- albeit at a much lower rate than we do.
Surprise, surprise
Egyptian hieroglyphs from 1500BCE already described signs and symptoms of heart disease. So there was good reason to believe that at least this “disease of civilization” existed way before the industrial revolution upended our healthy way of life.
In the 18 November, 2010 issue of Journal of the American Medical Association Egyptian and American scientists reported a surprising result of a fascinating study: mummified Egyptians suffered from heart disease. The historical range of the mummies spanned over 18 centuries, starting about 3500 years ago.
Normally, internal organs, including the heart, were removed during the process of embalming. But the investigators could image the arteries (see picture above. The inset shows a mummy heart with calcium buildup in an artery). In cases where the vessels had deteriorated, they traced the tracks along which the arteries ran inside the body, looking for leftover deposits. They compared the mummy scans with those of modern heart disease patients to rule out the potential effects of embalming. The team found a buildup of calcium deposits, a common sign of heart disease, in nine out of 16 mummies, including seven of the eight who survived past the age of 45. Both sexes were affected, with four out of seven women and five out of nine men showing signs.
In the scientific session of the American Academy on Cardiology in New Orleans on April 3 the team presented expanded results of their original report in JAMA. Theyperformed CT scans on 52 of their mummies and found that 44 of the mummies still possessed identifiable cardiovascular tissue, and of these 45% exhibited definite or probable hardening of the arteries. Average age of death was 40.
Ancient Egyptian Lifestyle
Obviously, the mummified bodies did not belong to the proletariat; only royalty, their household (nursemaids, children of royalty), high officials and priests, merited embalming. Their diet consisted of salted fish (cause for hypertension?), bread, and cheese like the rest of the hoi polloi, but they also dined on rich foods such as cow, sheep, and goat meat, as well as something similar to today’s Bakhlava. In terms of physical activity, they had to walk a lot more than we do.
What did we Learn?
- First, despite what looks like a pretty healthy lifestyle, ancient Egyptians suffered from heart disease. Their diet did not contain high fat or cholesterol and were not couch potatoes. So, are we missing a risk factor? Could it be that our preoccupation with the lifestyle risk factors caused us to ignore the possibility of other risk factors?
- Second, don’t believe what “sounds right” –insist on the evidence. The ancient civilizations were not “noble savages”. The Mayas ruined their environment and killed each other as badly as we do today. The Polynesians on Easter Island wasted their resources on carving bigger and bigger statutes of their deities and cutting down all the trees on the island to transport them from the quarry –which led to their virtual extinction. And now we learn that they weren’t even
“healthy savages” –they suffered from the same diseases we do, and did not enjoy even half of our life expectancy. - Third, don’t believe your lying eyes. All those slim and fit statues of the Pharaohs are stylized images in the service of state propaganda, and bear no resemblance to the real deal. One of the most admirable Pharaohs was Queen Hatshepsut. She started her ruling career as a regent to her infant son, Tuthmosis III, but very quickly became a full-fledged Pharaoh depicted wearing the head regalia called nemes, and a false beard. Her lithe figure and strikingly beautiful visage radiating strength, captivated many a museum visitor, myself included.
So imagine the disappointment when in July 2007 a CT scan of her mummified body (see the lady’s body above) revealed that she was an obese woman between the ages of 45 and 60 who had bad teeth. She also suffered from cancer, evidence of which can be seen in the pelvic region and the spine. So much for the healthy and beautiful ancient Egyptians.
So stop kvetching already –we really don’t have it so bad.
Dov Michaeli, MD PhD is a basic researcher who writes on The Doctor Weighs In.
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