Egypt's King Tut likely died from complications of a broken leg that were exacerbated by malaria and had a club foot, an extensive study of his mummy and family suggests.
In Wednesday's issue of the Journal of the American Medical Association, Zahi Hawass, of Cairo's Supreme Council of Antiquities, and his colleagues published their findings based on DNA tests and CT scans of 16 mummies, including of Tutankhamun and his relatives.
The findings rounded out the family tree for Tut, who became a pharaoh at age 10 in 1333 BC, and ruled for nine years. After British archeologist Howard Carter discovered his tomb in 1922, Tut became known as the golden boy because of his golden tomb and the golden mask that covered his face.
Historians have suggested he was not a very powerful or important king, but the discovery of his virtually undisturbed tomb has made him famous and led to him being studied extensively by archeologists.
Historians had speculated he had been murdered in a power struggle, but a CT scan in 2005 ruled out foul play as the cause of his death.
The new study shows the pharaoh was weakened by congenital illnesses and succumbed to complications from a broken leg aggravated by severe malaria, based on the finding of DNA from a malaria parasite — the oldest genetic proof of malaria in well-dated mummies, according to an editorial that accompanies the study.
"A sudden leg fracture possibly introduced by a fall might have resulted in a life-threatening condition when a malaria infection occurred," concluded the article in the Journal of the American Medical Association. "Tutankhamun had multiple disorders. He might be envisioned as a young but frail king who needed canes to walk."
Mysteries of the past
The research also disproved speculation that Tut and his relatives suffered from rare disorders that gave them feminine attributes and misshaped bones, such as Marfan syndrome, a connective tissue disorder that can result in elongated limbs.
The artistic style and statues of the period that showed royal men with prominent breasts, elongated heads and feminine hips likely led to those theories.
"It is unlikely that either Tutankhamun or [his father] Akhenaten actually displayed a significantly bizarre or feminine physique," the study's authors said.
Representations of Akhenaten's feminine traits have long puzzled Egyptologists. But the new paper resolves the controversy, and shows they must be symbolic, said Mary-Ann Pouls Wegner, an associate professor of Egyptian archeology at the University of Toronto.
Pouls Wegner said she also learned that Tut suffered from a club foot, which had not been identified before. The latest findings also show Tut had a mild form of scoliosis, an abnormal curvature of the spine, that has been suggested before.
Tut's left foot
The study's authors also said Tut had Kohler disease, a condition in which lack of blood flow slowly destroyed the bones of his left foot.
The disease discovery now offers an explanation for 130 walking sticks and canes that were found in Tut's tomb, Pouls Wegner said. Some of the canes showed traces of wear demonstrating that they were used in the king's lifetime, the researchers said.
In his editorial, Dr. Howard Markel of the Center for the History of Medicine at the University of Michigan, Ann Arbor, said the findings also raise new questions for doctors and historians, such as whether they change current thinking about how to prevent diseases such as influenza or change understanding of the past.
There is also controversy surrounding ethical guidelines for "exhuming bodies to solve vexing pathological puzzles," and if major historical figures should enjoy the same privacy rules as private citizens after death, Markel said.
The beautiful objects from Tut's tomb continue to interest people of all ages, said Matthew Teitelbaum, director of the Art Gallery of Ontario in Toronto, which has a Tut exhibit running until April 18.
The latest medical discovery shows "how can we find out something from the past that we thought was mysterious which is in fact new knowledge for us today," he added.