An x-ray image of Kohler's disease in the navicular of the left foot.Can examining pedal skeletal remains provide any information about an individual’s health or quality of life? Actually, a vast amount of information regarding lifestyle and systemic health can be ascertained from these osseous remains.

The Dayr Al-Barsha project in Egypt studies mummies and artifacts that span the entire era of the pharaohs into early Christian history.1 There were two bodies recovered from this excavation site showing signs of amputation through the metatarsal area (distal foot).2 These amputations were non-traumatic in nature, suggesting that a systemic illness brought about the auto-amputation.3 Diabetes is likely the underlying culprit that contributed to the loss of their toes, since medical papyrus from that era documented how common this conditions was in Egypt at the time.4 The diet of the ancient Egyptians contributed to the prevalence of diabetes largely due to over consumption of honey.5

Another mummy recovered from Sheik Abd el-Qurna on the west bank of the Nile, shows evidence of a big toe amputation fitted with a wooden prosthetic device.6 It should be noted that as of 2014 in the United States, 29.1 million people have diabetes.7 Diabetes is still the leading cause of non-traumatic lower extremity amputation today.8 Auto-amputation of toes is a result of uncontrolled diabetes leading to ischemic vascular disease.9 The lack of blood flow gives way to dry gangrene and putrefaction.10

Pediatric skeletal deformities are also noted in ancient Egypt. King Tut, the young pharaoh, was plagued with painful ailments throughout his short life.11 Most notably amongst his maladies were a clubfoot and bone necrosis, appearing on Computerized Tomography (CT) scans of his extremities.12 Clubfoot, also known as talipes equinovarus (TEV), is a congenital birth defect leaving the patient’s foot severely contracted.13 This deformity still occurs in one out of every 1,000 births and without treatment can be debilitating.14 The bone necrosis identified on the CT scan is that of Kohler’s disease.15 Kohler’s disease is necrosis of the navicular bone, due to disruption of the blood supply with usual onset around 4 years of age.16 This condition usually resolves with skeletal maturity and rarely persists into adulthood.17

Evaluation of pedal bones provides a glimpse into the medical conditions of past civilizations. In the modern era, pediatric deformities like clubfoot can be managed by casting and surgical intervention, if needed. Despite all the advances in science and technology, humanity is still battling diseases like diabetes and its complications today.


  1. DAYR AL-BARSHA PROJECT. N.p., n.d. Web. 8 Dec. 2015.
  2. Malnasi, Cindy. PALEOPATHOLOGY IN ANCIENT EGYPT: EVIDENCE FROM THE SITES OF DAYR AL-BARSH AND SHEIKH SAID. Thesis. University of Central Florida, 2010: Web. 07 Dec. 2015.
  3. Malnasi, pg 150
  4. Ibid.
  5. Owen, James. "Egyptian Princess Mummy Had Oldest Known Heart Disease." National Geographic News Apr.-May 2011: 1-2. Web. 8 Dec. 2015.
  6. Malnasi pg 151
  7. 2014 National Diabetes Statistics Report. Rep. N.p.: n.p., n.d. Centers for Disease Control and Prevention. Web. 9 Dec. 2015.
  8. Driver, V. R., J. Madsen, and R. A. Goodman. "Reducing Amputation Rates in Patients With Diabetes at a Military Medical Center: The Limb Preservation Service Model." Diabetes Care 28.2 (2005): 248-53. Web. 9 Dec. 2015.
  9. Fikri, R., C. D. Bicknell, L. M. Bloomfield, S. P. R. Lyons, D. G. Samarasinghe, R. G. J. Gibbs, and J. Valabhji. "Awaiting Autoamputation: A Primary Management Strategy for Toe Gangrene in Diabetic Foot Disease." Diabetes Care 34.8 (2011): n. pag. Web
  10.  Ibid
  11. Buyting, Sonya. "King Tut Felled by His Feet, No His Foes." Globe and Mail 17 Feb. 2010: 1-2. Web.
  12.  Ibid.
  13. Kennedy, Seamus, CPed. "" Treating Pediatric Clubfoot and    Pes Planus. N.p., May 2009. Web. 08 Dec. 2015. .
  14. Ibid.
  15. Ibid. “King Tut Felled by His Feet”
  16. Wheeless, Charles, MD. "Kohler's Disease I." Wheeless' Textbook of Orthopaedics. N.p., Apr.-May 2012. Web. 08 Dec. 2015. .
  17. Ibid.