This somewhat irreverent exhumation of a legendary Viking takes place at the end of
Egil's Saga, one of the most widely read and popular of the medieval Icelandic sagas.
Egil Skallagrimsson whose bones these were believed to be is one of the saga's most
colourful characters: a vicious killer (from the age of 6), a violent drunkard, a gifted and
sensitive poet, a farmer, and a lawyer. He died in his 80s-an extraordinary age for a man
of his times and lifestyle-and was buried in a pagan grave mound. About a decade later
his son in law was converted to Christianity and built a church at his farm. Egil's bones
were then disinterred and moved to the church. About 150 years later a new church was built,
and again Egil's bones were exhumed to move them to the new churchyard. The description
above of these much travelled bones refers to that time.
Right: Egil Skallagrimsson in a seventeenth century manuscript of the saga
Long into this century the sagas
were believed by many to be gospel truth, and the characters and lives of their players were
discussed heatedly among Icelanders as if they were old neighbours or family members, which
naturally the most illustrious of them were claimed to be. It is therefore interesting that
this description seems never to have awoken the slightest medical curiosity. Given Egil's
reputation as a ruthless fighting man and killer of phenomenal ugliness, it may have been
thought only slightly fanciful, rightly emphasising his mighty physique.
Although the
sagas have now lost their status of historical fact, there is no dispute that they are the
flesh on historical bones. The second exhumation of Egil took place only a century before
his saga was written, whereas the story of his life is set 250-300 years earlier, in the
tenth century. No physician seems to have made the obvious connection between this
description of his bones and a well known and well documented disease.
Paget's
disease
Sir James Paget was an English physician at St Bartholomew's Hospital in London.
Late in life he became surgeon extraordinary to Queen Victoria. His name became a household
word in medicine because of his description of several diseases, the most
famous still carrying his name: Paget's disease (osteitis deformans). In this condition the
bone mass initially softens, causing diseased bones to bow or bend out of shape.
The
body's attempts at repair increase bone mass and result in extremely hard bones with an
irregular surface. The disease commonly affects the skull, causing damage to the cranial
nerves and therefore deafness and blindness. Often the facial bones are unaffected, but if
they are the patient develops a vaguely leonine appearance, with bilateral and symmetrical
hypertrophy of the bones, called leontiasis ossea.
Right: Current church at Egil's family's farm
The cause of Paget's disease is
unknown, but studies estimate that 1-3% of North American adult men have some form of the
disease, which is thought to be hereditary. The disease is often painless, although patients
sometimes complain of vague aches in their bones. Compression fractures of the spine can
occur in the bone resorption stage, causing considerable pain. Patients are at greater risk
of arteriosclerosis than the general population and often have heart failure. Osteogenic
tumours-sarcomas-often affect the diseased bone. Symptoms rarely develop before the age of
40, and they progress slowly and insidiously. For example, one Icelandic patient, a
policeman, began to suspect that something was wrong only when he kept needing larger and
larger uniform caps.
Egil's illness
In old age his movements became
heavy and his sight and hearing began to fail him badly.... One day Egil was walking outside
beyond the wall when he stumbled and fell. Some of the women saw this and laughed at him.
'You're really finished now, Egil,' they said, 'when you fall without being
pushed'....Then Egil made this verse:
My bald pate bobs and blunders
I hang it
when I fall;
My cock's gone soft and clammy
And I can't hear when they
call.(1)
Egil is here describing impotence, deafness, a stooped posture, and
a lowered head. Another time Egil complains of cold feet:
...I walk on two widows,
Once true women,
Now frosted and feeble,
Needing the old flame.(1)
He tries to warm his feet at a fire but is told to be careful not to stick them
right into the flames. "I'll do as you say," answered Egil, "but I find it hard to
control my feet now that I can't see. It's a bore to be blind."(1)
Egil's symptoms
are catalogued nicely: he is blind, deaf, feeble, and prone to stumble and fall; he has cold
extremities, he trembles, and his head hangs forward. His bones were much larger than
average and his skull massive and extraordinary.
All these symptoms match those of
Paget's disease-even the cold feet are possibly due to arteriosclerosis. But it is the
description of the skull that removes most doubts. It is "ridged all over like a scallop
shell." This simile is unique in all the sagas, as revealed in a computer search of their
entire text. This is the only sentence in which it appears. A corrugated and irregular bone
surface hardly seems to add to the lustre of a great warrior and poet. It is, however, a
common description in medical textbooks. A curious and observant twelfth century Icelander
noticed the same irregular corrugated features that twentieth century medical students are
taught to look for as signs of Paget's disease.
Even the description of the whitening of
the skull as the priest Skapti struck it is an indication of Paget's disease. A textbook
states that when Paget's disease is advanced the bones become hard, difficult to cut
through, and heavier than usual.(2) And in the Hunterian collection of the Royal
College of Surgeons there is a bone 3 cm thick which, though not Egil's, had received severe
blows like Egil's skull and shows even today the characteristic whitening at the point of
impact as described in Egil's Saga.
Egil's ugliness
Egil's ugliness is
legend. According to the saga: "He had a wide forehead, bushy eyebrows and a nose, not
long, but impressively large. A great broad beard grew on a chin as massive as his jaws; his
neck was stout and his shoulders heavy, far heavier than those of other men."(1)
At the table of King Athelstan of York he sat "with one eyebrow sunk down right to the
cheek and the other lifting up to the roots of the hair. His eyes were black and his
eyebrows joined in the middle.... [He] did nothing but pull his eyebrows up and down, now
this one, now the other."(1)
The saga's author allows himself a massive
understatement in saying that "Egil was a man who caught the eye." And Egil describes
himself in his poetry as having a "louring cliff-face," a "rock-helm of a head," even
starting one poem with: "Ugly as I, Egil, am."
But were they Egil's bones?
Now
we come to the question of whether it really was Egil's bones that were exhumed. Obviously
there can be no absolute certainty about that, but there is considerable evidence to suggest
that they are.
Egil's original pagan burial mound was visible from the family farmhouse.
The time between the first exhumation by his adoptive daughter and son in law to the second
exhumation was only 130-150 years and coincided with a period of unusual stability in the
Icelandic farming community. During all of this time Egil's descendants would have known
where his burial place was; one of them was the priest Skapti, who tested the famed
thickness of Egil's skull.
The story of Egil's illness and disinterred bones may be one
of the oldest recorded descriptions of the various symptoms of osteitis deformans.
Interestingly for British readers, a British king preserved Egil's skull: King Eirik
Bloodaxe of Northumbria saved Egil's head in return for Egil composing a eulogy in his
honour.
Department of Medicine,
Landspitalinn,
University Hospital,
101 Reykjavik,
Iceland
Thordur Hardarson,
professor of medicine
Elisabet
Snorradottir
Correspondence to:Professor Hardarson.
This paper is based on an article in Skirnir, Timarit hins
islenska bokmenntafelags (an Icelandic literary magazine) in 1984 by Professor
Hardarson.
References:
1
Palsson H, Edwards P. Egil's saga. London: Penguin Classics,
1976.
2 Hamperl H. Lehrbuch der Allgemeinen Pathologie und der Pathologischen
Anatomie, 24./25. Auflage. Berlin: Springer, 1960:688-9.
