Families and Frailties of the Eighteenth Dynasty

   Posted by: Keith Payne   

Categories: New Kingdom, Egypt in the News, Mummies

Was King Tut murdered?  Did Akhenaten have both a male and female physiology?  Did incest and inbreeding lead the Eighteenth Dynasty down a genetic dead end?  Last month the Family of Tutankhamun Project attempted to answer these questions—and more—with the publication of a two-year forensic study of sixteen mummies of the Eighteenth Dynasty.

This article is the first of several in which we will attempt to put the research into layperson’s terms.  First we will take a look at the what, who, where, why and how of the study itself.


The study was conducted as part of the Family of Tutankhamun Project, a mission aimed at identifying the mother and wife of Tutankhamun, along with matching names to other anonymous Eighteenth Dynasty mummies. This particular phase of the project began in September, 2007, and was concluded in October, 2009. 

The results of the two-year study were published in the Journal of the American Medical Association (JAMA) as “Ancestry and Pathology in King Tutankhamun’s Family” (Zahi Hawass, Yehia Z. Gad, Somaia Ismail, et al, JAMA. 2010;303(7):638-647), and was made available in electronic form beginning February 16, 2010, from www.jama.com.

The research was sponsored by the Discovery Channel, which in turn was allowed to premier the findings in a two-part series called King Tut Unwrapped, which aired on Sunday, February 21, and Monday, February 22, 2010.  Discovery Channel has posted clips from the program here.



Who and Where?

The project brought together seventeen researchers from Egypt, Germany, and Italy, and included some of the top names in Egyptology, anthropology, human genetics, radiology, and mummy forensics.  The tests were carried out at two labs in Cairo, primarily by Egyptian scientists at the insistence of Dr. Zahi Hawass, Secretary General of the Supreme Council of Antiquities and director of the project.

Zahi Hawass (Photo courtesy of Archeologo)

Zahi Hawass (Photo courtesy of Archeologo)

“I am not against foreigners,” Hawass explained, “I simply wanted more equality” (Source:  AFP:  “Zahi Hawass, media-savvy guardian of Egypt’s past”).  Hawass has made the promotion of native Egyptologists a part of his mission.  However, even his “all Egyptian” teams are often more international than they are presented.

The genetic analysis team was headed up by anthropologist Albert Zink, of the European Academy of Bozen/ Bolzano (EURAC), and Carsten Pusch, a human geneticist from Tübingen University. 

Dr. Zink is also the head of the Institute for Mummies and the Iceman, a EURAC program founded in 2007 to serve as a clearing house for all scientific data on Ötzi, a 5,300-year-old mummy found in the Ötztal Alps in 1991.  Dr. Pusch is the head of the Institute of Anthropology and Human Genetics at Tübingen University and is a world-renown expert in neurobiology and hereditary human diseases.

Ötzi the Iceman (Photo courtesy of Mesa Community College)

Ötzi the Iceman (Courtesy of Mesa Community College)

Dr. Paul Gostner, head of the Department of Radiology at Bolzano General Hospital at Bolzano, Italy, helped with the diagnosis of Tut’s illnesses.  Dr. Gostner has also helped with the analysis of Ötzi, and is co-author of “The Iceman: Discovery and Imaging” (Radiology, March 2003, pp. 614-629).

On the Egyptian side, Dr. Yehia Zakaria Gad, of the Department of Medical Molecular Genetics at Cairo’s National Research Center, supervised the DNA lab at the Egyptian Museum where the work was conducted.  Dr. Gad was a key member of the team credited with identifying the mummy of Queen Hatshepsut and is Egypt’s Top Doc on human genetics, both ancient and modern.



To summarize the places and people involved in the research:





The study is distinguished by the fact that, rather than making inferences about the subjects based on diagnosing artifacts, the research directed its focus on the people themselves.  For instance, rather than making assumptions about the physical attributes of Akhenaten, the study began with identifying his mummy through genetic fingerprinting then proceeded to conduct a detailed physiological study.

According to the article in JAMA, the specific objectives of the study were:

To introduce a new approach to molecular and medical Egyptology, to determine familial relationships among 11 royal mummies of the New Kingdom, and to search for pathological features attributable to possible murder, consanguinity, inherited disorders, and infectious diseases. (p 638)


Introducing a New Approach

The new approach refers to both the tools employed and the subjects made available.  Many of the tools and methods employed by Egyptologists were perfected centuries ago and still serve their purpose.  But the Computer Age has resulted in a new generation of tools and processes to help Egyptologists and archaeologists know where to look, what to look for, and how to interpret what they find.

Mummy forensics, like criminal forensics, is a science which has been developing since the Victorian Age.  Like its hardboiled cousin, mummy forensics has benefitted from the technological boom, especially in the realm of genetics.  Analysis of ancient DNA is a young discipline, but this study could mark its entry into puberty. 

The Cairo Museum (Photo by Keith Payne)

The Cairo Museum (Photo by Keith Payne)

Ground Zero for the study was a laboratory set up in the basement of the Cairo Museum.  The lab, which was also funded by the Discovery Channel and equipped by Applied Biosystems, was specifically designed to analyze ancient DNA.  Staffed with scientists and doctors from the Department of Medical Molecular Genetics at Cairo’s National Research Center, the lab is the frontline of forensic Egyptian mummy studies.  Work was also carried out in a lab at Cairo University.

The new approach also refers to the subjects of the study.  According to Dr. Hawass, this is the first time royal Egyptian mummies have been sampled for DNA analyses (Source:  “Press Release – The Discovery of the Family Secrets of King Tutankhamun”). 

The scientists who conducted the study have high hopes for the application of genetic fingerprinting in identifying mummies and fleshing out the family trees of Egypt’s ancient dynasties.  “This will open to us a new era,” Hawass told National Geographic Daily News (Source:  “King Tut Mysteries Solved: Was Disabled, Malarial, and Inbred”).


Familial Relationships—The Study Group

Ten mummies were selected for the study based on their known or suspected relation to Tutankhamun, for a total of eleven in the study group.  Besides Tut, the identities of only three other mummies in the study group were known—Tut’s grandparents or great-grandparents, Yuya and Thuya, and Amenhotep III, father of Akhenaten. 

Among the suspected relatives were two miscarried fetuses that were discovered in Tutankhamun’s tomb, thought to have been his children.  Producing a genetic profile for either or both of these young princesses was a priority because if they did prove to be Tutankhamun’s offspring then Dr. Hawass hoped to use their genetic fingerprints to identify the mummy of Ankhesenamun, Tut’s sister-wife.  

Also in the study group were two unnamed noblewomen discovered in tomb KV21, known only as KV21A and KV21B, one of whom could possibly be Ankhesenamun.  Two other anonymous noblewomen included in the study, recovered from tomb KV35, are known as KV35YL, the Younger Lady, and KV35EL, the Elder Lady.  One of the goals of the study was to determine if either of the latter noblewomen could be the famous bride of Akhenaten, Nefertiti.

The final mummy in the control group came from tomb KV55 and was suspected to be the mummy of either Akhenaten or Smenkhkare.  The mummy from KV55 was an important link because, if he did prove to be Akhenaten, then he could link the two generations before him to the two generations that followed.  Five generations of Tut’s family were plotted by the study.

In all there were sixteen mummies in the study—eleven in the study group and five in the control group.  The details of all sixteen mummies will be outlined in the up-coming article, The Mummies Gallery.


Maladies Inherited and Acquired

The study also sought to determine what genetic conditions, infectious diseases, and violent traumas may have bedeviled the Eighteenth Dynasty royals.  Of the many pathologies detailed in the study, the media seem to have had a morbid fascination with the role of incest.  Although intermarriage and interbreeding were evident in the test group, the significance of this rather lurid detail may have been overstated for shock value.

For example, Times Online grabbed attention with the headline “Incest was true curse of Tutankhamun.”  According to their story, “The boy king was the product of an incestuous relationship that may have led to a weakened constitution and his early death, the first DNA study of the pharaoh’s remains has concluded.”  But did the study actually reach this conclusion?

In the appendix to the JAMA article, under the heading Pathology in the Royal Mummies, the writers state that bone diseases such as flat and club feet, cleft palate, scoliosis, hunched back, bone and joint degeneration and tumors were all observed.  The appendix further indicates that these conditions seemed to accumulate pretty rapidly in the five generations of the study group.  But what were the actual conclusions regarding the relations between the ailments and consanguinity?

Further research will show if this is suggestive of a disadvantageous genetic background resulting from interfamilial marriage in the royals. As can be seen in the genetically distant mummy control group (ie, TT320-CCG61065, TT320-CCG61066, KV60A, KV60B), there is also an obvious high frequency of disorders of the spine and feet. This makes it highly unlikely that the discussed conditions are indeed inherited.  (JAMA appendix)

In other words, the frequency of bone disorders was suspiciously high in the family of Tutankhamun, high enough to warrant further study.  But many of the same disorders were also frequent in the control group.  The control group is a control group specifically because it is not related to the family of Tutankhamun.  Observing the same conditions in both groups suggests intermarriage may not have been a significant contributor to the conditions observed in the study group.

Another misstatement of the Times Online article has to do with an affliction of King Tut’s royal tootsies, Freiberg-Kohler’s disease.  Talking about the results of the genetic fingerprinting, the article states that Tutankhamun:

…suffered from several disorders as a result of his family history.  These included a painful, degenerative bone condition known as Koehler’s disease and a club foot which meant that the pharaoh was “a young but frail king who needed canes to walk” (Source).

While his club footedness may or may not have had a genetic cause, Freiberg-Koehler’s disease almost certainly did not.  While we do not know exactly what causes Freiberg-Koehler’s disease, a degenerative bone disease of the foot, there is nothing in the literature to suggest a genetic connection, incestuous or otherwise.

There is, however, one bit of trivia I am surprised the media did not pick up on:  Freiberg-Koehler’s disease is generally an affliction of teenage girls.  This leads us to another concern of the study, whether or not the men of the Eighteenth Dynasty, Akhenaten in particular, suffered from some condition which resulted in a feminine body type. 

Do these curvy and maternal depictions of Akhenaten reflect reality or something more symbolic? (Photo by Gerbil)

Do these curvy and maternal depictions of Akhenaten reflect reality or something more symbolic? (Photo by Gerbil)

Akhenaten, and to a lesser degree, Tutankhamun, are sometimes depicted with features such as female breasts and voluptuous hips.  It has also been suggested that there is something abnormally unmanly about Akhenaten’s displays of intimacy with his family.  While this latter may have more to do with the psychology of those doing the asking, the underlying question is a fair one:  Are these accurate depictions or artistic convention?

Another surprising find was that several members of both groups had suffered exposure—sometimes multiple exposures—to malaria tropica.  The most severe form of malaria, tropica is now one of the two main contenders for the cause of Tutankhamun’s death, with the other being a severe leg injury which probably led to an overwhelming infection.

In order to do these elements of the research justice, the pathology of both groups of mummies will be covered in detail in separate articles.



Reception and Criticism



The scientists who conducted the study were amazed by how intact the ancient DNA seemed to be, which they chalked up to the mummification process itself.    A news brief from the University of Tubingen states:

The scientists were surprised by how well, comparatively speaking, the ancient DNA had been preserved, and the special embalming techniques reserved for kings may well have caused this phenomenon.  (Source:  Eberhard Karls Universität Tübingen:  “Tutankhamun’s parents identified”)

Dr. Pusch suggests this notion is supported by the superior condition of the DNA from the royal mummies as opposed to samples taken from non-royal mummies.  As he stated to National Geographic:  “The ingredients used to embalm the royals was completely different in both quantity and quality compared to the normal population in ancient times,” (Source).

This conclusion, however, was met with some qualified skepticism.  Dr. Stephen Buckley, an archaeologist from the University of York who holds a Ph.D in archaeological chemistry specializing in Eighteenth Dynasty mummification practices, does not seem convinced.  Speaking with Discovery News, Buckley muses:

It is surprising that DNA should survive in these mummies given the very harsh conditions the bodies have been subjected to over the last 3000 years. I’m referring, for example, to the methods of embalming, the relatively high temperatures and oxidising environments. Hopefully, closer independent scrutiny by ancient DNA experts might help explain these very surprising results.  (Source:  “Controversy Arises Over King Tut Findings”).



Another perennial controversy was the cause of Tutankhamun’s death.  Certainly the study was not rash in making any specific conclusions regarding the deaths of any of the subjects.  “Caution must be taken when interpreting cause of death in these mummies,” (JAMA, p. 646).  But fatal conditions in some of the mummies were decidedly less ambiguous.

The head injuries sustained by KV35YL, assuming they were not postmortem, would surely have resulted in her death.  One of the mummies from the control group, previously thought to be Thutmose I but for now known only as mummy CCG61065, took an arrow to the chest, hardly a mere flesh wound.  Another more famous member of the control group, Queen Hatshepsut, may have died as a result of a malignant tumor, blood poisoning from an abscessed tooth, or a combination of both.  (See JAMA article appendix)

Tutankhamun’s death continues to generate the most attention, if for no other reason than name recognition.  But generalizing from the critical analyses of his pathologies can provide an informative backdrop to the entire study. 

One of the conditions King Tut seems to have suffered from is osteonecrosis—bone death.  Osteonecrosis can result from genetic and environmental causes and may have played a role in his death.  “Necrosis is always bad, because it means you have dying organic matter inside your body,” Dr. Pusch said regarding Tutankhamun’s Freiberg-Koehler’s disease (Source).  Tut’s foot condition was not itself life threatening, but more generalized osteonecrosis could point to something more serious at work. 

However, Dr. Gino Fornaciari, director of palaeopathology at the University of Pisa, questions whether or not the published images of Tut really warrant a diagnosis of osteonecrosis.  Even if Tut did suffer from osteonecrosis, Dr. Fornaciari suggests that it may have been a result of a malarial infection rather than bad genes (Source).

Indeed, King Tut was one of the mummies who showed the genetic markers for malaria tropica.  However, Dr. Robert Connolly, a physical anthropologist from the University of Liverpool who has himself worked with Tut, points out that the presences of the parasite in Tut’s blood does not necessarily mean he ever developed full-blown malaria (Source:  Pattaya Daily News:  “New Speculations Over King Tut’s Death”).

Dr. Frank Ruhli, head of Applied Anatomy at the University of Zurich and front man of the Swiss Mummy Project, questions whether we will ever be able to answer the question of what killed King Tut.  The condition of his mummy and the lack of internal organs will always leave room for uncertainty.  Dr. Ruhli observes:

This is a major work in Egyptian mummy studies.  It proves the value of modern methods such as CT and molecular testing. Yet, one needs to be cautious in stating any definite medical diagnosis.   (Source)

Overall, reception has been positive.  At the risk of committing an appeal to authority fallacy, the study’s acceptance into the Journal of the American Medical Association is itself a ringing endorsement.  But as stated near the beginning of this article, genetic and radiographic analysis of ancient mummies is a young science.  Continuing critical analysis, along with independent verification and replication, are vital for its growth.



The Future of the Project

The Family of Tutankhamun Project is an ongoing endeavor which will undoubtedly grow in both depth and scope as the field continues to mature.  Some specific short-term goals have already been enumerated.  Writing in Asharq Alawsat, Dr. Hawass points to the continuing work with the two fetuses and the search for Ankhesenamun, as well as the search for Nefertiti (Source:  “Tutankhamen’s Dynasty in the Valley of Kings”).

Drs. Zink and Pusch are also enthusiastic knights in the Egyptological Grail Quest.  “And we shall continue our research: Nefertiti will be our next project. We have moved our research onto a new and so far unexplored level!”

In terms of a timeframe, Dr. Hawass suggested in an article with News Trends Today that additional results could be released within six months (Source:  “Tutankhamun: one part of the mystery cleared up, but many riddles”).   Such projections have historically been dubious, but most of us are willing to exchange timeliness for accuracy and transparency.  So long as King Tut continues to enchant the popular imagination, the work—and show—must go on.


See Also



Copyright by Keith Payne, 2010.  All rights reserved.

Photo “Zahi_Hawass” by Archeologo is used in accordance with the GNU Free Documentation License.   Photo “Akhenaten and child” is adapted from this photo by Gerbil from de.wikipedia.org and is used in accordance with the GNU Free Documentation License.  Graphic “family tree scroll” adapted from “Tutankhamun’sAncestry-MostProbableGeneticLineage.svg” by Captmondo is used in accordance with the Creative Commons Attribution-Share Alike 2.5 Generic license, and is altered in accordance with the same.  Photo  “OetzitheIceman” courtesy of Mesa Community College is used in accordance with the Fair Use Doctrine.  Mr. Mackey appears courtesy of South Park Studios, m’kay?

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This entry was posted on Tuesday, March 16th, 2010 at 9:29 pm and is filed under New Kingdom, Egypt in the News, Mummies. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

8 comments so far


Well done Keith!!
At long last, a comprehensive review, full of facts and figures. Yours is without the ignorance presented on all of the amateur blogs. Looking forward to your next.

March 17th, 2010 at 5:24 am
Jean-Pierre Houdin

Hi Keith,

Once again an excellent article. The characters of the drama are well described, the stage set, the scenario written…This King Tut saga is worth the reading.

March 17th, 2010 at 5:31 am

Thanks so much for your very readable breakdown, Keith. Do you have any idea when (and if) the Control Group’s DNA results will be published, as they might throw light on earlier Thutmose genes & relationships eg was Hatshepsut related to her nurse Sitra-In ? Thutmose II shows both Scoliosis & Dolichcephaly (making him `part of the Amarnan family’ ?), and control-group member Ahmose-Nefertari was excluded from the JAMA report.

March 17th, 2010 at 7:42 am

Thanks to everyone for the kind encouragement! I am particularly grateful to those who provide instruction and criticism behind the scenes. Em Hotep is much more of a team effort than it appears.

I am currently pulling together The Mummies Gallery, which will up toward the end of this week. There are separate articles on the pathologies—malaria, Akhenaten’s androgyny, the role Freiberg-Koehler’s disease may have played in Tut’s death—and as I wrap these up others may suggest themselves.

These will roll out pretty rapidly. In the past I have made the mistake of starting a series of articles and then getting side-tracked. I have learned some valuable lessons from those decisions and am settling into my rhythm now. The most valuable lesson is to strike while the iron is hot. While the research is fresh in my mind, write! Don’t allow other things to pull me away and put distance between the research and the writing.

So I am doing a little archaeological work of my own, digging from the top down. I am not going to commit myself to anything else until the Family of Tutankhamun material is wrapped up. The next layer is the Pyramid City material, dealing with Mark Lehner’s project uncovering the city which evolved around the Old Kingdom Giza building projects. Then a quick side trip to wrap up the Great Temple at Edfu, and then down to the Good Stuff—Jean Pierre Houdin’s Project Khufu (and beyond).

That doesn’t mean I won’t cover relevant material as it comes up, but so far as any feature-length stories go I have made the painful decision to sit them out until I am caught up! And just because I have an order of operations that doesn’t mean everything else is on a back burner. The Tell Edfu Project has helped with understanding on a smaller scale how Lehner’s Pyramid City would have functioned, and it all increases my understanding of how Jean-Pierre’s work… works.

To Gill’s questions:

I am not sure when the Control Group’s DNA will be published, but that is a very good question. As I reference in the article, Dr. Hawass says that there will be additional results released within six months, but then again, I was personally present when he promised at Indianapolis that the material in the JAMA article would be released in September or October. We now know that the work wasn’t even complete at the time of that promise, so we will have to wait and see.

I would be cautious about inferring from Thutmose II’s scoliosis and Dolichcephaly that he might be genetically connected to the Amarna family. The appendix cites the fact that the hereditary disorders (which may also have environmental causes, something that should be kept in mind) manifested in both groups, despite both groups being genetically separate. This is one of the observations which cast some doubt on incest being a major factor in the disorders of the study group, although it almost surely played some role.

I can’t comment on the possibility of Sitra-In being of royal blood, I am still working on my write up of the mummies of both groups. Maybe one of our more informed readers can answer that? But thank you for bringing it up, I will be sure to address it in The Mummies Gallery. I will also use the next article as an opportunity to explore why no tomography scan was performed on Ahmose-Nefertari (as per footnote a in Table 2). Great questions! I will work on getting some answers!

March 17th, 2010 at 1:12 pm

A Spanish laboratory, DNA Solutions Europe, has done its own analysis of the DNA results
Clearly sets out answers to JAMA tests. Please read here:


April 12th, 2010 at 6:07 pm

Although I am enjoying the series with Zahi Hawass, I think that most of it is “made for tv”. It’s been known for years who Tut’s g’grandparents were – the only doubt lay in his direct parentage. I also find it disappointing that more is not being done to discover the kinship of Smenkhkare! He was obviously of some importance in that he reigned for a short time prior to Tutankhamun. These two mummies together with others of the period have been found to have the common factor of a hereditary deformity in their humorous bone! So who was this guy – Tut’s brother? Almost certainly!

May 31st, 2010 at 1:29 pm

Hi Nikki!

Thanks for joining the discussion, I hope you decide to become a regular contributor!

Smenkhkare is a name that seems to haunt the perimeter of this discussion like a restless spirit. There is considerable disagreement regarding the identification of Mummy KV55 as Ankhenaten. A few have suggested that it may actually be the mummy of Smenkhkare, which would make Smenkhkare Tut’s father, which in the convoluted family tree of the Eighteenth Dynasty, is not mutually exclusive to him being Tut’s brother!

It will be interesting to see how all of this shakes out. In fact, just watching to process of it shaking out has proven to be a spectator sport unto itself.

Stay tuned!

May 31st, 2010 at 6:13 pm

I have long had the idea that Akhenaten had himself portrayed with some female characteristics to show he was the earthly manifestation of the one god- Aten. I think it is reasonable that he would have conceived of the Aten, or wanted the people to accept that Aten would encompass all the properties that they might otherwise attribute to a pantheon of male and female deities. Even if we suppose he was subject to Marfan Syndrome, which is far from proven, the statues don’t look like an attempt to illustrate this, and, in fact, appear to have a tendency to idealize the subjects if anything.

July 11th, 2016 at 10:06 pm

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