Paleopathological Research Research Articles

Preliminary Anthropological and Forensic Study of an Individual from Grave No 11 of Excavation CXLIX of Bolgar Settlement

In this article the authors present preliminary data of the skeletal remains from the 11th burial of the CXLIX excavation in Bolgar fortified settlement. Unusual for medieval Bolgar burial rite attracted attention to this burial during the excavations in 2010. The authors provide the characteristics of the individual features of human remains according to the results of cranial- and osteoscopy, their description in accordance with the lifetime changes and postmotem preservation. In the course of research, it was found that the individual was male, age from 35 to 45 years old, the reconstructed body length was 158–163 cm in various methods. Paleopathological research and medical and forensic reconstruction revealed signs of ankylosing spondylitis and the fracture of the sub-language bone. Graphic and plastic reconstructions of the appearance by the M.M. Gerasimov’s method were performed, the non-metric traits of the skull of the studied individual were recorded.

Deficiency diseases in the Kyiv Rus' subadult population: The issue of the small sample effects.

This paper underlines the importance of the small sample effects consideration in paleopathological research providing an example of children from Kyiv Rus' cemeteries dated to the 10th-13th century AD. The study presents data introduction and systematization, i.e., construction of the statistically significant disease profiles combining the analyzed sites according to the distribution of anemia, scurvy, and rickets. Then we present usually provided (often 'associative') interpretations for the obtained results and question their reliability from the perspective of the small samples effects. This leads to the discussion of explanatory limits of bioarcheological research basing on the small sample analysis.

Discover the anatomy of the mummies: how imaging techniques contribute to understanding disease in the past

Mummies are the well-preserved remains of humans or animals in which non-bony tissue has been maintained naturally or artificially. Their significance lies in their contribution to paleopathological research, which involves understanding the history and evolution of diseases and providing insights into past populations’ cultural and social practices. In recent years, mummies studies used nondestructive methods, including modern imaging techniques, to assess the main pathological features of these unique human remains. This mini-review focuses on the role of paleoradiology in mummies’ studies and describes the history of mummy radiography and CT scanning over the last fifteen years. The search strategy was conducted between January and April 2023. One thousand one hundred twenty-four records (1124) were initially identified, and 52 studies were assessed for qualitative synthesis. Three main themes and four subthemes were identified, providing a general overview of the role of paleoradiology or offering methodological guidelines. Also, subthemes assessed the role that the use of radiology has in the diagnosis of specific pathologies. Therefore, imaging techniques in ancient human remains might help understand the history and evolution of past and present diseases and their risk factors.

Cattle health in the Iron Age and Roman Netherlands

ObjectiveTo investigate diachonic and regional trends in the occurrence of pathologies in cattle in the Iron Age and Roman Netherlands. A key objective is to investigate whether the intensification of cattle husbandry in the Roman period was associated with an increase in pathology. MaterialsThe data set consists of 167 sites with a combined total of 127,373 individual specimens for cattle, sheep/goat, horse, and pig. MethodsA quantitative approach was used, investigating the frequency of pathologies over time and per region. For cattle, pathology frequencies were also investigated per type. Several multi-period sites were considered in more detail. ResultsPathology frequencies increased during the Iron Age and Roman period. In cattle, joint pathology was most common, followed by dental pathology. ConclusionsThe overall frequency of pathology aligns with frequencies in other regions. Some pathological conditions in cattle can tentatively be linked to intensification, such as joint pathology at two sites in the Middle and Late Roman periods, an increase in dental pathology and trauma). SignificanceThis review revealed diachronic trends and linked them to developments in animal husbandry and highlights the importance of recording and publishing pathological lesions. LimitationsThe multi-causal origin of joint and dental pathology makes it difficult to relate them to the intensification of cattle husbandry. Suggestions for further researchIt is hoped that this review will stimulate further paleopathological research globally, especially systematic studies into foot pathologies.

Sex, gender, and sexuality in paleopathology: Select current developments and pathways forward

ObjectiveOverall, paleopathology trails behind related fields in exploring sex, gender, and sexuality in past societies. Here, we interrogatively synthesize scholarship on topics not included in similar reviews, focusing on sex estimation methods, and considering the social determinants of health; trauma; reproduction and family; and childhood – to highlight novel, social epidemiology- and social theory-informed frameworks and interpretive devices. ConclusionsMany paleopathological interpretations focus on sex-gender differences relative to health, with increasing use of intersectionality. Others consistently project present-day ideologies about sex, gender, and sexuality (e.g., binary sex-gender systems) into paleopathological interpretations (i.e., presentism). SignificancePaleopathologists have an ethical imperative to generate scholarship that contributes to social justice initiatives focused on dismantling structural inequalities, especially relative to sex, gender, and sexuality (e.g., homophobia), such as through denaturalizing presentist binary systems. They also have a responsibility towards greater inclusivity relative to researcher identity and diversification of method and theory. LimitationsIn addition to material limitations complicating reconstructions of sex, gender, and sexuality relative to health and disease in the past, this review wasn’t comprehensive. The review was also limited by the relative paucity of paleopathological work on these topics.Suggestions for Future Research: The outlook for paleopathological research on sex, gender, and sexuality is, however, positive; paleopathology is well situated to tackle these aspects of social identity. Future work should consider critical, self-reflective movement away from presentism; more robust contextualization; and further engagement with social theory and social epidemiology theory and approaches, including the Developmental Origins of Health and Disease (DOHaD), social determinants of health, and intersectionality.

Figurative aspects suggestive of infectious diseases in the ceramic pots of the pre-Columbian Moche culture. Analysis of the ceramics collection in the Larco Museum of Lima, Peru.

The historical-medical and anthropological studies, regarding Mesoamerica and South America, have been mainly focused on the great empires (Inca, Atzec, Maya), while other civilizations have been less investigated and only recently are gaining interest. In general, the paleopathological research provides interesting data to know the type of nutrition and the general environmental conditions as well as to point out some ritual mutilation practices, which were relatively frequent in the pre-Columbian cultures. A lot of civilizations flourished in the South America before the arrival of the Spanish Conquistadores in the new world. In the last years it is progressively increasing the interest for the study of the Moche culture as well as for a deeper knowledge of pathocenosis of infectious diseases in the Moche society. Human infectious diseases are known to have a frequent animal origin, in particular from domesticated species, although the species domesticated in the pre-Columbian era were a small number. The purpose of our paper has been to examine the archeological findings suggestive of infectious diseases in artistic ceramic pots, dating back to the Moche period. We examined the iconography of ceramic pots belonging to the collection of the Larco Museum in Lima and reproducing body signs suggestive of infectious diseases. We identified 8 handworks with very interesting features by a medical point of view. In these handworks there are signs and lesions possibly associated with infectious diseases: risus sardonicus, orbital edema, facial nerve palsy, dorsal kyphosis, face and skin lesions. These features are compatible with some infectious diseases, including: syphilis, Bartonella bacilliformis, leishmaniasis, Pott's disease and Chagas disease. A wide discussion about these handworks is provided.

A rare case of pancraniosynostosis observed in a historical skull from the 19 th century cranial collection named “Królestwo Polskie” (“Polish Kingdom”)

Rare diseases are a challenge in paleopathological research, mainly due to the ambiguity of skeletal signs, bad preservation state of the material, and lack of the reference material. The aim of our article is to present the skull characterized by the decreased values of the metrical traits and numerous pathological features of the cranial morphology and make an attempt to determine the possible cause of the observed anomalies. The subject of our study is a cranium No KP 131 belonging to Polish skeletal collection named „Polish Kingdom”. We used both standard anthropometric methods, as well as the imaging techniques to detect the probable causes of the observed pathological changes. This specimen presents a complex of pathologies. Decreased values of the metrical features, thinning of the lateral walls of the neurocranium and the presence of platybasia were probably caused by premature closure of all main cranial sutures. Pathologies observed in cranium No 131 XIX might have had a common cause in some form of syndromic disorders.

Possible Applications of Latest Biological and Medical Trends in Anthropology

This brief note highlights the possible, remarkable role that epigenetic and proteomics on the one hand and neurogastroenterology on the other hand, may play in paleoanthropological and paleopathological research.

Towards a definition of Ancient Rare Diseases (ARD): Presenting a complex case of probable Legg-Calvé-Perthes Disease from the North Caucasian Bronze Age (2200-1650 cal BCE)

ObjectiveThis study discusses the challenges and possibilities of establishing a definition for Ancient Rare Diseases (ARD) in a probable case of Legg-Calvé-Perthes Disease (LCPD) from the Bronze Age cemetery Kudachurt 14, situated in the Northern Caucasus. MaterialsWe investigated the skeletal remains of a male aged 35–45 years at death. For comparison we examined other males buried at Kudachurt 14 (n = 24) and reviewed 22 LCPD cases from the paleopathological literature. MethodsWe use macroscopic as well as osteometric examination methods and imaging techniques. ResultsThe morphology of the left hip joint corresponds to skeletal characteristics for LCPD. Co-occurring osteochondrosis dissecans, femoral anteversion, and atrophy of the left femoral shaft suggest a complex disease course. ConclusionsModern criteria of rare diseases applied on ancient skeletal remains are either non-transferable or require completion. We conclude that rarity is dynamic, etiological uncertainty has to be accepted, and the respective socioeconomic context is crucial. Degree of disability and level of sociomedical investment are not defining criteria for ARD. SignificanceDating 2200-1650 cal BCE, this study currently presents the earliest case of probable LCPD. This is the first attempt to transform modern characteristics of rare diseases for establishing a paleopathological concept of ARD. LimitationsAs this study is limited to LCPD, our conclusions are not directly applicable to other ARD in question. Suggestions for further researchMore focused paleopathological research on skeletal populations from different cultures and time periods is needed, enabling an evolutionary perspective on the comparability of ancient, modern and future rare diseases.

Paleopathological Research in Southern Patagonia: An Approach to Understanding Stress and Disease in Hunter-Gatherer Populations

This article reviews the most relevant data regarding evidence of stress and disease in native populations from Southern Patagonia and proposes future directions for paleopathological research. It focuses on the disease patterns in hunter-gatherer societies and the changes produced by contact and colonization. Studies of oral pathologies show a high frequency of dental attrition and low frequency of caries and antemortem tooth loss. Individuals with terrestrial dietary patterns show evidence of higher mechanical stress in the spine than those who participated in marine economies, based on the prevalence of Schmorl's nodes and vertebral osteophytosis. Porotic hyperostosis is more prevalent in individuals who had a marine diet and is probably related to nutritional impairment and parasitic infections. A higher frequency of metabolic stress was identified in individuals who lived in missions, perhaps because of declining quality in diet, hygiene, and living conditions. Paleoparasitological studies identified several species of parasites associated with human skeletons and terrestrial fauna. Moreover, recent studies suggested that treponematosis and tuberculosis were present in Patagonia since at least 1000 years BP. Future paleopathological research should increase the size and quality of studied samples and apply new methods and interpretive criteria. Detailed research into infections, degenerative joint diseases, and trauma (including violence episodes) has rarely been conducted.

Sensationalism and speaking to the public: Scientific rigour and interdisciplinary collaborations in palaeopathology

ObjectivesIn this brief communication we discuss issues concerning scientific rigour in palaeopathological publications, particularly studies published in clinical or general science journals, that employ skeletal analysis to elucidate the lives and deaths of historical figures or interpret “mysterious” assemblages or burials. We highlight the relationship between poor methodological rigour and lack of interdisciplinary communication, and discuss how this can result in scientifically weak, sensational narratives being presented to the public. ConclusionsAlthough most high profile publications involving analysis of archaeological human remains are methodologically sound and well interpreted, others have suffered from poor scientific rigour stemming from an apparent lack of awareness of anthropological methods and ethics. When these publications are highlighted by the press, sensationalistic narratives are perpetuated which may reflect poorly on our discipline and give the public unrealistic expectations about our work. Suggestions for future researchWe suggest that best practice in high-profile paleopathological research include recruitment of a range of authors and reviewers from clinical sciences, anthropology, and the humanities, consideration of the ethical issues surrounding retrospective diagnosis, and transparency with the press in regards to the limitations inherent in this kind of work.

Advances in the molecular detection of tuberculosis in pre-contact Andean South America

Andean paleopathological research has significantly enhanced knowledge about the geographical distribution and evolution of tuberculosis (TB) in pre-Columbian South America. In this paper, we review the history and progress of research on ancient tuberculosis (TB) in the Andean region, focusing on the strengths and limitations of current approaches for the molecular detection of ancient pathogens, with special attention to TB. As a case study, we describe a molecular screening approach for the detection of ancient Mycobacterium tuberculosis in individuals from Late Intermediate Period (1000–1400 CE) contexts at the site of Huari, Peru. We evaluate 34 commingled human vertebrae and combine morphological assessments of pathology with high throughput sequencing and a non-selective approach to ancient pathogen DNA screening. Our method enabled the simultaneous detection of ancient M. tuberculosis DNA and an evaluation of the environmental microbial composition of each sample. Our results show that despite the dominance of environmental DNA, molecular signatures of M. tuberculosis were identified in eight vertebrae, six of which had no observable skeletal pathology classically associated tuberculosis infection. This screening approach will assist in the identification of candidate samples for downstream genomic analyses. The method permits higher resolution disease identification in cases where pathology may be absent, or where the archaeological context may necessitate a broad differential diagnosis based on morphology alone.

Hidden, Unwanted or Simply Forgotten? A Bioarchaeological Profile of the Subačius Street 41 Population

In 2014–2015, an unknown 16th–17th-century cemetery was discovered at the Subačius Street 41 plot in Vilnius. The uncovered human remains are considered to be one of the most abundant and best-preserved anthropological material in the territory of present-day Vilnius. Paradoxically, historical sources do not mention this burial site, although the abundance of the interred individuals does not imply an accidental burial, but perhaps a functioning cemetery for some time. In such exceptional cases, the only source of information is the synthesis of archaeological and anthropological research data.This article presents preliminary results and a brief overview of bioarchaeological (demographic, paleopathological, and dental research, height reconstruction) investigation. A total of 151 individuals were studied, with almost half (45%) of them consisting of children. Almost 60% of the individuals had one or more pathological lesions. The average height of male individuals was estimated 168.2 cm, the average height of females was 157.8 cm. The aim of this study can be defined as twofold: an attempt to identify the people buried outside the city walls and systematize for the first time the bioarchaeological data of one-out-of-many Vilnius populations. Currently, the Subačius Street 41 population does not resemble a typical urban community, so the study itself is the first attempt to reveal the osteobiography of these 16th–17th century Vilnius residents.

Contribution of paleopathology to the knowledge of the origin and spread of tuberculosis: evidence from Portugal

Paleopathology contributes to the knowledge of health and disease in past populations. In the case of tuberculosis, paleopathological research contributes to a better understanding of the antiquity and spread of the disease around the globe, as well as in Portugal. These aspects are the objectives of this work. Genomic research on the Koch bacillus indicates a co-evolution with African Homo sapiens. However, macroscopic, microscopic, imaging and biomolecular analyzes of human skeletal remains suggest that tuberculosis (TB) began to affect humans during the Neolithic period. For several decades the paleopathological diagnosis of tuberculosis was essentially based on the identification of Pott’s disease. More recently, the study of identified skeletal collections has revealed a statistically significant association between both new bone formation on the visceral surface of the ribs and hypertrophic osteoarthropathy and cause of death by pulmonary tuberculosis. Therefore, these skeletal signs have been used to assist in the differential diagnosis of pulmonary TB. Portugal, as in many other countries, notably European countries, was greatly affected by tuberculosis. However, the paleopathological record in the national territory can be considered quite scarce. Amongst the 8000 individuals studied from archaeological excavations, only 81 have bone changes compatible with the disease. Continued research on human and animal osteological remains will certainly bring new developments concerning the antiquity, evolution and spread of tuberculosis across populations and continents.

Advances in paleopathology in context: A focus on soft tissue paleopathology

Skeletal and mummified remains from South America have had a significant impact on the progress of paleopathological research. In 1997, John Verano synthesized the state of paleopathological research, identifying trends and highlighting future potentials. The goal of this contribution is to consider Verano’s observations on advances in soft tissue paleopathology within the context of the development of the field of mummy studies. As his article was published near the midpoint between the present and the early 1970s, when the modern form of mummy studies began to form, considering his observations in this context allows researchers the opportunity to consider how the field has progressed since the late 1990s.

Developmental anomalies and South American paleopathology: A comparison of block vertebrae and co-occurring axial anomalies among three skeletal samples from the El Brujo archaeological complex of northern coastal Peru

Though developmental anomalies have been noted for over a century in South American paleopathology, they have received less attention than other pathological conditions. When anomalies are reported, they tend to be unusual case studies or incidental findings. Paleopathological research should also consider anomalies from a population perspective, to broaden our understanding about the frequency of specific anomalies, and potentially offer insight into genetic relationships, cultural behavior, or environmental factors. This investigation compared block vertebrae and co-occurring postcranial axial anomalies among three skeletal samples reflecting an occupational sequence at the El Brujo Archaeological Complex of Peru. Block vertebrae demonstrate both considerable antiquity and persistence through time, though frequencies, vertebral level, and co-occurring anomalies varied by sex and cultural period. Among the Late Preceramic sample, the frequency of C2-C3 block vertebrae was highest and only seen among females, which may suggest familial influence, genetic isolation, and potentially matrilocality. The Moche sample demonstrated a moderate frequency of blocks, which in combination with the frequencies of other developmental anomalies, may suggest population continuity paired with an influx of new genes, demographic expansion, and possible cultural change with regard to postmarital residence. The Lambayeque sample demonstrated the lowest frequency of blocks and the highest frequency and greatest diversity of anomalies, which may suggest genetic continuity from the Moche, an expanded gene pool, broader opportunities for mate choice, and cultural change. It is hoped that this investigation will provide data for future comparisons and call attention to the need for the broader study of developmental anomalies in South America.

Brief communication: Test of a method to identify double-zonal osteon in polarized light microscopy.

Double-zonal osteons (DZ) have been of interest in paleopathological research because they might be linked to physiological pathology. DZ are thought to be evidence of arrested osteon formation with a brief but abrupt increase in mineralization of lamellae occurring during bone remodeling. Originally identified from microradiographs as hypermineralized rings, recent studies have identified DZ from linear polarized light microscopy (PLM). However, PLM does not guarantee the adequate detection of DZ since PLM captures bone birefringence and not hyper-mineralization. Scanning electron microscopy with backscatter electrons (BSE-SEM) allows observation of DZ by detecting differences in mineralization. The purpose of this study is to investigate whether DZ, as identified by BSE-SEM, can indeed be identified with PLM. The sample consists of an archaeological collection of adult midshaft femurs (n = 30) from St. Matthew cemetery, Quebec City (1771-1860). DZ were identified and counted independently with PLM and BSE-SEM for the same sections. Results from both methods were compared. Chi-square test shows that there was no significant difference between the two methods (p = 0.404). No significant bias was found on Bland-Altman analysis and Cohen's kappa shows a substantial agreement between the two methods (Κ = 0.66). PLM shows a good accuracy (sensitivity 79%, specificity 99.4%) and reliability (Positive Predictive Value: 86.71%; Negative Predictive Value: 99.45%). These findings indicate that the two methods are interchangeable. PLM, using our proposed protocol, is reliable to accurately identify DZ. We discuss how PLM and BSE-SEM that measure different features of the bone tissue can converge on the identification of DZ.

More than metabolic: Considering the broader paleoepidemiological impact of vitamin D deficiency in bioarchaeology.

Vitamin D deficiency has traditionally been viewed as a metabolic bone disease by bioarchaeologists and considered primarily in terms of the development of specific musculoskeletal changes used for diagnosis in paleopathological research. These skeletal manifestations are usually interpreted as representing general ill-health. Clinical research shows that vitamin D is also integral to a number of extra-skeletal physiological processes including immunoregulation, blood pressure homeostasis, cell division, and programmed cell death. Vitamin D deficiency and sub-clinical insufficiency are thought to be risk factors for infectious and autoimmune diseases, as well as certain cancers and cardiovascular diseases. Epidemiological work indicates that the skeletal manifestations of vitamin D deficiency represent the extreme end of a spectrum of morbidity associated with negative health outcomes, including increased risk for secondary tuberculosis. This article provides a review of clinical research on the extra-skeletal roles of vitamin D and the pathological consequences of poor vitamin D status. Additionally, it presents an interpretive model for bioarchaeological analyses of rickets and osteomalacia for consideration of the whole-body impact of poor vitamin D nutriture and possible comorbidities that may have affected the wider population. Am J Phys Anthropol 160:183-196, 2016. © 2016 Wiley Periodicals, Inc.

Cranial vault trauma and selective mortality in medieval to early modern Denmark

To date, no estimates of the long-term effect of cranial vault fractures on the risk of dying have been generated from historical or prehistoric skeletons. Excess mortality provides a perspective on the efficacy of modern treatment, as well as the human cost of cranial injuries largely related to interpersonal violence in past populations. Three medieval to early modern Danish skeletal samples are used to estimate the effect of selective mortality on males with cranial vault injuries who survived long enough for bones to heal. The risk of dying for these men was 6.2 times higher than it was for their uninjured counterparts, estimated through a simulation study based on skeletal observations. That is about twice the increased risk of dying experienced by modern people with traumatic brain injuries. The mortality data indicate the initial trauma was probably often accompanied by brain injury. Although the latter cannot be directly observed in skeletal remains, it can be inferred through the relative risks of dying. The ability to identify the effects of selective mortality in this skeletal sample indicates it must be taken into account in paleopathological research. The problem is analogous to extrapolating from death register data to modern communities, so epidemiological studies based on mortality data have the same inherent possibility of biases as analyses of ancient skeletons.

Dental Caries in 104 Skulls about 2,200 Years Ago from the Site of the Emperor Qinshihuang`s Mausoleum in China

Background: Dental caries appears long time ago and attracts great attention in the paleopathological research all over the world. However, few reports presented the status of dental caries in Chinese ancient people. Aim: To describe the prevalence of dental caries in 104 skulls about 2,200 years ago. Materials and Methods: This cross-sectional study was performed using 104 skulls which were excavated from the ar- chaeological sites of Emperor QinShihuang's Mausoleum and Terra-Cotta Warriors and Horses. The degree of caries le- sions was identified and the distribution of tooth cavity was recorded and all the data were statistically analyzed using SPSS15.0 for Windows. Results: Dental caries was common before 2,200 years and the prevalence of dental caries increased with age. The posi- tion of dental caries in the skeletal remains was significantly different and the sequence of prevalence of dental caries was M2 > M3 > M1 > P2 > P1 > I1 > I2 > C. The interproximal lesions were identified as the most common type and the se- verity of every caries lesions was not the same in every skull. Conclusion: This investigation drew a picture of the dental caries of Chinese males living around 2,200 years ago, which will be beneficial to understanding the people's working and living conditions at that time.