, it was the sacred home of Wadjet, the cobra goddess of Lower Egypt, and one of the most
in the pharaonic landscape.
Archaeologists have excavated its upper layers for decades, finding remains from the rule of the Macedonian Ptolemaic dynasty (305 to 30 B.C.) and Roman era (30 B.C. to A.D. 395). But the deeper, older layers at the site — including a mound called Kom C, sitting below groundwater level in waterlogged delta clay — had stayed stubbornly out of reach. Kom C itself rises above the surface as a visible mound, but earlier excavations had reached only the Ptolemaic and Roman layers before hitting the water table.
Now, researchers have turned to noninvasive tools, including satellite imagery, to delve into the mysterious subterranean layers.
To learn more without disturbing the site, the team ran 15 parallel lines of electrical resistivity tomography (ERT) across an area of roughly 58,100 square feet (5,400 square meters). This technique reveals the underground landscape by passing electrical currents through the earth, measuring how they travel and creating a map that archaeologists can read.
The picture that came back was layered. Between the surface and 10 feet (3 m) down, the team found scattered Ptolemaic and Roman debris, including displaced mudbricks, pottery shards and broken limestone, which point to centuries of continued occupation and rebuilding on the site. Later residents dismantled older structures for reuse and left a scatter of displaced material behind.
Deeper still, between 10 and 20 feet (3 and 6 m), the researchers found a large mudbrick structure from the 26th dynasty (688 to 525 B.C.), also known as the Saite period. They were able to date this discovery based on its layer, the unique shape of the mudbricks and other artifacts such as pottery, which the team dated by style and their archaeological layer, with carbon-14 dating applied to associated organic material. The large structure may be a tomb, a house for priests or a religious shrine, the team wrote in the study, published in March in the journal Acta Geophysica.
And below that, at 20 to 23 feet (6 to 7 m) underground, the researchers unexpectedly found a thick, clean layer of sand.
That sand is the discovery within the discovery, the team wrote in the study.
"By combining satellite radar with deep ERT profiles, we didn't just map the walls of this massive Saite-era structure — we were also able to analyze the subsurface layers," study co-author author Abdelaziz Elfadaly, an associate research professor at Egypt's National Authority for Remote Sensing and Space Sciences, told Live Science. "The detection of a significant, clean sand foundation layer beneath the mudbrick walls explains how these heavy structures survived the high water table and shifting clayey soil of Buto."
The sand layer, in effect, acts as a barrier; it stops groundwater from wicking upward into the mudbrick, which would soften and dissolve it. The sand also lets water drain sideways instead of pooling against the foundation, according to Elfadaly.
A 3-by-3 foot (10 by 10 m) excavation trench that was around 20 to 23 feet (6 to 7 m) deep confirmed the presence of thick mudbrick walls resting on that sand layer, and nearby, a spread of objects that hint at the site's sacred function. According to Elfadaly, these finds included ushabti and shawabti figurines — small servant statues typically placed in tombs to serve the deceased in the afterlife — and a limestone altar whose carved channels bore dried residues consistent with animal blood, pointing to offering rituals performed at the site. The study also noted a rarer find: a faience baboon figurine, the kind associated with Thoth, the god of wisdom.
"A monumental building of this scale underscores the Saite pharaohs' intense commitment to glorifying the Delta region," Hussein Bassir, director of the Antiquities Museum at a cultural research center known as Bibliotheca Alexandrina who wasn't involved with the study, told Live Science in a WhatsApp message. "Using pure sand as a stabilizing cushion was a brilliant, deliberate tactic — the ancient builders profoundly understood their environment."
The team is planning a return visit, this time using wider-spaced electrical resistivity surveys to reach deeper layers, along with specialists who study ancient plants and also understand how geological features changed over time, which may help reconstruct what the landscape around Buto looked like when these walls were first laid.
'> Buried for 2,600 years beneath Nile mud, a massive ancient Egyptian complex was just found — from space
The idea is not new. It's been discussed in the past, but it was difficult to get a consensus on what goes in and what should not go in. That's still going to be tricky, but at least there's a broad acknowledgement that the time is ready to start introducing biology into the DSM.
It's very likely that, at the end of it, there will be meaningful changes in a positive kind of way. It's not going to make everyone happy. There are going to be gaps, but the idea is to incrementally improve this and make it more modern as we go along.
KHC: What sort of biological markers have you seen that we can actually correlate with these disorders?
AK: What the committee is doing is taking a more nuanced approach. Outside the realm of Alzheimer's disease, which I'll get into in a minute, there are no clear-cut diagnostic biomarkers — meaning no blood tests or brain scans that you can look at and say, "This person has a diagnosis of depression," or "This person has PTSD," or "This person has schizophrenia."
The committee talked about how, in addition to biological biomarkers, there's a concept of biological factors. What I mean by that is biological pathways and mechanisms that have a role in the development of a particular disorder, but the findings have not crystallized into a laboratory test.
For example, immunology — the study of the body's response to a variety of stresses, including infections and others — has been shown to be impactful in about 30% of cases of major depression. Yet there is no single biological laboratory test that is currently available that can be used [to diagnose immune-mediated depression] in clinical practice. So these come under the category of what we call biological factors.
In the Alzheimer's disease field there are clear-cut biomarkers. There are now blood tests for proteins called tau and amyloid that have been approved by the FDA [Food and Drug Administration] as biomarkers for Alzheimer's disease. Meaning, if you have a clinical picture and a mental-status exam consistent with intellectual decline, you must have a positive biomarker test to be categorized as having definitive Alzheimer's disease.
And that's new. Ten or 15 years back, there were brain scans, and if you did a lumbar puncture, you could find these proteins in the spinal fluid. But those are invasive. Now you actually have a blood test.
A neuron, in blue, is surrounded by a plaque of amyloid-beta protein, in yellow, which causes the symptoms of Alzheimer's disease. Tests can be used to detect biomarkers for Alzheimer's disease. (Image credit: JUAN GAERTNER/SCIENCE PHOTO LIBRARY via Getty Images)But that degree of precision, for lack of a better term, is not available in the other branches of psychiatry. Nonetheless, there are clues that other pathways and mechanisms are involved.
I mentioned immunology as one. Another big elephant in the room is genetics.
Most people think of genetics as an abnormal gene or a mutation — meaning a gene switches or changes and confers increased risk — as one mutation causing one disease. That's how most people in the general public think about mutations: They cause disease.
But when you get into complex diseases like heart disease and diabetes, there are multiple genes involved. And diseases may or may not be caused by a gene. Abnormal genes may or may not cause the disease, but they increase risk.
With mental disorders, the situation becomes immensely more complicated. It's not just a few genes here and there. There are hundreds of genes, each increasing the risk for depression, schizophrenia and anxiety disorders by a small amount.
So while there is no single genetic test that can now be used, large numbers of genes have consistently been shown — and many of the recent studies are strong — to be associated with certain disorders. But because there's no single gene or small group of genes, we cannot walk away from the science. Complexity doesn't mean we throw our hands up and say, "Well, it's all too much."
It may seem overwhelming, but genetic profiles are better understood today than they were 20 years ago. So that's something else this committee is thinking about and I think should take into account going forward: to somehow incorporate that into the diagnostic categories.
KHC: Do you think there's any sort of risk with adding those biological factors into the DSM?
AK: I don't think so, because if you think about genetics, it's not going to be introduced as a biological test.
Most folks know that mental disorders, like other medical disorders, run in families. And genetics is the most plausible explanation for that. What this does, I hope, is introduce a degree of more comprehensive description of these disorders. So when a busy clinician looks at it, it confirms what they already suspected: There's a family history here, and family history means genetics.
It's complex, many genes are involved, and it produces a better characterization of this. The diagnosis is still going to remain clinical, but this provides a biological context, very much like, say, diabetes or heart disease.
Genes and environment cause a variety of medical disorders. With heart disease, there's no one gene. When cardiologists develop a risk profile for heart disease, it includes genes, other physiological factors such as BMI, which is the weight-height ratio, diet and a variety of environmental factors.
That degree of classification is missing today in mental health and psychiatry. We hope this is a first step in correcting, if you will, those conceptions about what causes these disorders.
KHC: How would you end up using this in a psychiatrist's office to guide treatment?
AK: I can give you one possible example. I'm reaching a bit.
There's a term commonly used in clinical psychiatry and psychology called comorbidity. What it means is that people who are diagnosed with depression also have anxiety, or people who are diagnosed with an anxiety disorder also have substance abuse or alcoholism in general.
That is not coincidental. It's not something that we just somehow find. A lot of these disorders share genes.
For example, about 45%, roughly, of patients diagnosed with a major mood disorder also have an anxiety disorder. And you flip that around: About 45%, roughly, of patients diagnosed with an anxiety disorder — it could be generalized anxiety disorder, what we call PTSD, or a phobia — also have a mood disorder.
Patients with anxiety may also be diagnosed with a mood disorder. (Image credit: MementoJpeg via Getty Images)I think when clinicians classify them together, not as the same disorder but as sharing a lot of psychological as well as genetic risk, clinicians should be on the lookout for both. A patient with a mood disorder, for example, could either now or at some later point develop an anxiety disorder. Or someone with an anxiety disorder is at risk for substance abuse.
So treatments need to be tailored a little more broadly. I'm hoping that'll be something clinicians think about when they talk to patients and their families.
KHC: What do you think is the most unique aspect, from your perspective, of this upcoming DSM-6?
AK: My bias is the biology. I say this because a lot of the other things, the cultural factors, etc., are largely appreciated, and they'll be better characterized. Some things like cognitive changes, such as working memory and attention [tests], are not unique to any given disorder.
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Biology will be qualitatively new when introduced into the DSM, and I hope it's done well. I hope that they do it appropriately, and I think they will [do it] correctly.
It's not going to be perfect, but it's going to be a first step. I think introducing the idea that genetics, immunology and other factors are very important in the causation of mental disorders, and explain some of the phenomena that we previously could not find an explanation for, is — I hate to use the word "leapfrog" — but that's kind of what it is.
It moves the field conceptually forward, and not as a slow, steady, gradual increase. For the DSM, it would be an important step forward.
This interview has been condensed and edited lightly for clarity.
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'> 'Now you actually have a blood test': Psychiatry's bible, the DSM, is getting upgraded to include biological markers. A psychiatrist explains what...